Effectiveness of a bipolar vessel sealant device for sealing uterine horns and bodies from dogs

OBJECTIVE: To compare the bursting strength of a vessel sealant device (VSD) with that of an encircling suture on uterine horns and bodies from dogs. SAMPLE: Uteri from 24 shelter dogs with unknown reproductive histories. PROCEDURES-Uterine horns and bodies were allocated to groups to be sealed with suture or a VSD. Uteri were then infused with saline (0.9% NaCl) solution until the seals burst or the uteri reached a maximal pressure of 300 mm Hg. Variables recorded included dog age, uterine body and horn diameter, and maximal pressure. RESULTS-The median (range) bursting pressure reached in sealed uterine horns was 300 (0 to 300) mm Hg for the VSD group and 300 (200 to 300) mm Hg for the suture group. Within the VSD group, seals of 2 of 3 uterine horns with a diameter ≥ 9 mm burst before intraluminal pressure reached 100 mm Hg, compared with 1 of 21 uterine horns with a diameter < 9 mm. The median bursting pressure for uterine bodies was 237 (0 to 300) mm Hg for the VSD group versus 300 (175 to 300) mm Hg for the suture group. Within the VSD group, seals in uterine bodies with a diameter ≥ 9 mm failed at a significantly lower pressure (125 [0 to 125]) mm Hg than those with a diameter < 9 mm (275 [125 to 300]) mm Hg. CONCLUSIONS AND CLINICAL RELEVANCE-The failure pressure for both sealing techniques was high, which indicated that the VSD may be a safe instrument for sealing the uterine horn in dogs. Given the low mean bursting pressure for seals in uterine bodies with large diameters, the VSD cannot be recommended for sealing uterine bodies ≥ 9 mm in diameter.     

Partial pancreatectomy and splenectomy using a bipolar vessel sealing device in a cat with an anaplastic pancreatic carcinoma

A 14-year old domestic shorthair cat was presented because of vomiting, anorexia and an abdominal mass. A diagnosis could not be made preoperative and during surgery the mass was assigned to the gastric part of the pancreas. A partial pancreatectomy and splenectomy was performed using a Ligasure? vessel sealing device. No surgery related complications occurred. Histological examination revealed an anaplastic carcinoma of the pancreas. The cat was in a good clinical condition 14 days after surgery. After 2 months the cat was euthanized with the suspicion of a bone tumor. Findings of this case demonstrate that pancreatic carcinoma in cats has a poor prognosis but pancreatectomy can be performed using a bipolar vessel sealing device as a safe and fast alternative to standard surgical techniques.     

Use of a vessel sealant device for splenectomy in dogs

Objective: To (1) describe a technique for splenic vessel hemostasis and (2) report complications and outcome after use of bipolar sealant device during splenectomy in dogs. Study Design: Case series. Animals: Dogs (n=27) with naturally occurring splenic disease. Methods: Between January 2006 and March 2008, splenectomy was performed using a vessel sealant device in 27 dogs with naturally occurring splenic disease. Number of sutures needed for splenectomy and complications were recorded. Splenic artery diameter was measured using a caliper. Intraoperative hemostasis, device ease of use, postoperative hemorrhage, and short‐term survival were evaluated. Results: Splenectomy was performed successfully in 27 dogs with the vessel sealant device; none of the dogs required vessel ligation with suture. The splenic artery was dissected and adequately sealed in each dog. One dog was readmitted 4 days after surgery with hemoabdomen. Abdominal exploration revealed splenic pedicle hemorrhage and pancreatitis, the vessel sealant device was used to coagulate splenic pedicle bleeding. The dog was alive at suture removal. Conclusion: In dogs, a vessel sealant device may be used to achieve efficient and safe hemostasis of the splenic vascular pedicle without sutures.     

Evaluation of a vessel‐sealing device to assist eye enucleation and exenteration in the horse

This study describes and evaluates the LigaSure for eye enucleation or exenteration in horses. According to the medical records of the Clinique Desbrosse, 17 horses underwent eye removal using the LigaSure between April 2005 and March 2009. It was applied at 7 different steps of the procedure and accounted for the different possible sources of bleeding. The Ligasure was also used to transect the optic pedicle in the 5 most recent cases. Very few complications were encountered with the technique described. Reliable vessel sealing and haemostasis was achieved in all horses.     

Advanced multimodality imaging of an anomalous vessel between the ascending aorta and main pulmonary artery in a dog

A 1-year-old male German shorthaired pointer was referred for evaluation of tachypnea and hemoptysis. A grade VI/VI left basilar continuous murmur was ausculted. Multimodality imaging consisting of thoracic radiographs, transthoracic and transesophageal echocardiography, fluoroscopy-guided selective angiography, computed tomography angiogram (CTA) and magnetic resonance angiogram (MRA), was performed on this patient. The defect included a left-to-right shunting anomalous vessel between the ascending aorta and main pulmonary artery, along with a dissecting aneurysm of the main and right pulmonary artery. An MRA post-processing technique (PC VIPR) was used to allow for high resolution angiographic images and further assessment of the patient's hemodynamics prior to surgical correction. This case report describes the clinical course of a canine patient with a rare form of congenital cardiac disease, and the multiple imaging modalities that were used to aid in diagnosis and treatment.     

Use of a von Frey device for evaluation of pharmacokinetics and pharmacodynamics of morphine after intravenous administration as an infusion or multiple doses in dogs

OBJECTIVE: To evaluate the pharmacokinetics and pharmacodynamics of morphine after IV administration as an infusion or multiple doses in dogs by use of a von Frey (vF) device. ANIMALS: 6 dogs. PROCEDURE: In the first 2 crossover experiments of a 3-way crossover study, morphine or saline (0.9%) solution was administered via IV infusion. Loading doses and infusion rates were administered to attain targeted plasma concentrations of 10, 20, 30, and 40 ng/mL. In the third experiment, morphine (0.5 mg/kg) was administered IV every 2 hours for 3 doses. The vF thresholds were measured hourly for 8 hours. Plasma concentrations of morphine were measured by high-pressure liquid chromatography. RESULTS: No significant changes in vF thresholds were observed during infusion of saline solution. The vF thresholds were significantly increased from 5 to 8 hours during the infusion phase, corresponding to targeted morphine plasma concentrations > 30 ng/mL and infusion rates > or = 0.15 +/- 0.02 mg/kg/h.The maximal effect (EMAX) was 78 +/- 11% (percentage change from baseline), and the effective concentration to attain a 50% maximal response (EC50) was 29.5 +/- 5.4 ng/mL. The vF thresholds were significantly increased from 1 to 7 hours during the multiple-dose phase; the EC50 and EMAX were 23.9 +/- 4.7 ng/mL and 173 +/- 58%, respectively. No significant differences in half-life, volume of distribution, or clearance between the first and last dose of morphine were detected. CONCLUSIONS AND CLINICAL RELEVANCE: Morphine administered via IV infusion (0.15 +/- 0.02 mg/kg/h) and multiple doses (0.5 mg/kg, IV, every 2 hours for 3 doses) maintained significant antinociception in dogs.     

Development of a pressure nociceptive threshold testing device for evaluation of analgesics in cats

A pressure analgesiometric device was developed for unrestrained cats. Eleven cats were studied. Stimulation was via three rounded pins within a bracelet on the forearm. The pins were advanced by manual bladder inflation. Bladder pressure was measured using a strain gauge pressure transducer. The threshold was recorded at the behavioural end point. Thresholds were measured at 5 and 15min intervals for 2-4h, after removal/replacement of the cuff, for 120min after SC butorphanol (0.4mg/kg), and with mild skin inflammation at the testing site. Data were analysed using ANOVA. Pressure thresholds in untreated cats were around 150mmHg. The minimum interval for testing was established as 15min. Data were reproducible over 4h and beyond 24h. Thresholds in 5 cats increased (P<0.05) above baseline for 45min after butorphanol with a maximum increase of 270+/-182mmHg at 10min. Thresholds decreased with inflammation. The method appears suitable for feline analgesia investigations.     

Effects of extrathoracic airway obstruction on intrathoracic pressure and pulmonary artery pressure in exercising horses

OBJECTIVE: To determine whether dorsal displacement of the soft palate (DDSP) results in pulmonary artery hypertension and leads to increases in transmural pulmonary artery pressure (TPAP); to determine whether pulmonary hypertension can be prevented by prior administration of furosemide; and to determine whether tracheostomy reduces pulmonary hypertension. ANIMALS: 7 healthy horses. PROCEDURE: Horses were subjected to 3 conditions (control conditions, conditions after induction of DDSP, and conditions after tracheostomy). Horses were evaluated during exercise after being given saline (0.9% NaCl) solution or furosemide. RESULTS: Controlling for drug, horse, and speed of treadmill, DDSP-induced increase in intrathoracic pressure was associated with a significant increase in minimum (36 mm Hg), mean (82 mm Hg), and maximum (141 mm Hg) pulmonary artery pressure, compared with values for control horses (30, 75, and 132 mm Hg, respectively). Increases in pulmonary artery pressure did not induce concomitant increases in TPAP. Tracheostomy led to a significant reduction of minimum (53 mm Hg), and mean (79 mm Hg) TPAP pressure, compared with values for control horses (56 and 83 mm Hg, respectively). When adjusted for horse, speed of treadmill, and type of obstruction, all aspects of the pulmonary artery and TPAP curves were significantly decreased after administration of furosemide, compared with those for horses given saline (0.9% NaCl) solution. CONCLUSIONS: DDSP was associated with increases in pulmonary artery pressure but not with increases in TPAP. CLINICAL RELEVANCE: Expiratory obstructions such as DDSP are likely to result in pulmonary hypertension during strenuous exercise, but may not have a role in the pathogenesis of exercise-induced pulmonary hemorrhage.     

Use of ultrasonic Doppler waveforms to estimate changes in uterine artery blood flow and vessel compliance

Previous data from our laboratory have demonstrated that uterine blood flow (UBF) and uterine arterial smooth muscle tone vary regularly during the estrous cycle of the cow. Uterine blood flow is highest and uterine arterial tone is lowest at estrus, whereas UBF is lowest and uterine arterial tone is highest during the luteal phase of the cycle. Blood flow through arteries is highly pulsatile; changes in arterial wall properties affect shape of the velocity waveform. This study was conducted to evaluate changes in uterine arterial velocity waveforms throughout the estrous cycle of the cow and to relate these changes to fluctuations in UBF and concentrations of estrogen and(or) progesterone in systemic blood. Pulsatile velocity waveforms were obtained daily from pulsed-wave ultrasonic probes placed surgically on the middle uterine artery of five beef cows exhibiting estrous cycles of normal duration (d 0 = day of estrus). Velocity waveforms varied regularly during the estrous cycle of each cow in association with changes in UBF and steroid concentrations. Further, two distinct velocity waveform shapes were observed during the estrous cycle. The first waveform shape, which was observed during periods of high UBF (d -4 to +4 of the estrous cycle), was characteristic of a highly compliant vessel and was associated with a high estrogen:progesterone ratio. The second waveform shape, which was observed from d 7 to 14 of the estrous cycle, was characteristic of a less compliant vessel and was associated with a depressed estrogen:progesterone ratio. These data suggest that compliance of the uterine artery changes during the estrous cycle in association with the changing estrogen:progesterone ratio in blood.