Use of vascular access ports with intrathoracic drains for treatment of pleural effusion in three dogs

CASE DESCRIPTION: 3 dogs (9 to 12 years old) were evaluated because of recurrent pleural effusion that was refractory to treatment of the underlying cause. CLINICAL FINDINGS: Dogs were evaluated because of cough, dyspnea, tachypnea, or lethargy or a combination of these clinical signs. Radiography, ultrasonography, or thoracocentesis were used to confirm the presence of pleural fluid in each dog. A neoplastic cause of pleural effusion was confirmed in 2 dogs. In 1 dog, fasciitis of the mediastinum and the left parietal pleura was diagnosed, with no evidence of neoplasia. TREATMENT AND OUTCOME: Each dog was anesthestized, and thoracotomy was performed with manual perforation of the mediastinum. Permanent, subcutaneously placed vascular access ports were attached to intrathoracic, Jackson-Pratt drain tubing for repeated drainage of pleural fluid. Drains were used successfully in the 3 dogs for periods of 6 weeks, 11 weeks, and > 3 years. CLINICAL RELEVANCE: Findings suggest that subcutaneous vascular access ports attached to intrathoracic drain tubing may be an effective way to remove recurrent pleural effusion in dogs.     

Complications associated with the use of vascular access ports in dogs receiving external beam radiation therapy

OBJECTIVE: To assess the perioperative and postoperative complications associated with use of vascular access ports (VAPs) in the jugular and lateral saphenous veins of dogs requiring frequent anesthetic episodes for radiation therapy. DESIGN: Cohort study. ANIMALS: 40 dogs referred to a veterinary teaching hospital. PROCEDURES: VAPs were used in 23 dogs, and intravenous catheters inserted in a peripheral vein were used in 17 dogs. The frequency of perioperative and postoperative complications associated with VAP use and the frequency of infection associated with intravenous catheter use were recorded. Results of bacterial culture of VAP tips and amount of time required for VAP placement and removal and for anesthetic induction were also recorded. RESULTS: VAP-associated perioperative complications included malposition of the catheter tip in 4 of 23 (17.4%) dogs. The VAP-associated postoperative complications included seroma formation in 7 (30.4%) dogs, breakage of port-anchoring sutures in 3 (13.0%) dogs, suspected fatal catheter-related septicemia in 1 (4.3%) dog, and temporary partial withdrawal occlusion in 18 of 255 (7.1%) anesthetic episodes. CONCLUSIONS AND CLINICAL RELEVANCE: Placement of VAPs provided ready access in dogs receiving radiation therapy. Most complications were minor and self-limiting; however, a low risk of serious complications existed. Use of fluoroscopy to assess position of the catheter tip is recommended to decrease the risk of malposition. Immediate removal of a VAP is recommended when clinical signs of infection develop. Removal of a VAP at the completion of radiation therapy should be performed unless the benefit of continued vascular access outweighs the risks.     

Comparison of hematologic and biochemical values for blood samples obtained via jugular venipuncture and via vascular access ports in cats

OBJECTIVE: To determine whether hematologic and serum biochemical values for blood samples obtained from cats via vascular access ports (VAP) are comparable to those for samples obtained by direct venipuncture. DESIGN: Prospective study. ANIMALS: 14 healthy cats. PROCEDURE: A VAP was surgically implanted in a jugular vein in each cat. Blood samples were obtained from the VAP and by direct venipuncture of the contralateral jugular vein 10 weeks after VAP placement. Results of hematologic and serum biochemical analyses were compared by use of a paired t-test. The Pvalue to reject the null hypothesis was adjusted to account for multiple comparisons by using the Bonferroni procedure in which the nominal P-to-reject value is divided by the number of comparisons (0.05/24 = 0.002). RESULTS: Paired samples (VAP and venipuncture) obtained 10 weeks after VAP placement were evaluated for each cat. Of the 24 measured analytes, only potassium, total protein, and albumin concentrations differed significantly (P< 0.001 for all 3) between VAP and venipuncture samples. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that samples obtained from VAP are suitable for routine hematologic monitoring of feline cancer patients. Sample hemolysis may account for a slight increase in potassium, total protein, and albumin concentrations obtained from VAP samples. However, the values of variables most critical for monitoring of patients receiving chemotherapy (ie, mature neutrophil and platelet counts) are comparable. If proper techniques are used, VAP may be used for administration of chemotherapy as well as for blood collection in cats undergoing cancer treatment.     

Use of laparoscopic-assisted cryptorchidectomy in dogs and cats

A laparoscopic-assisted technique for localization and removal of retained testes was performed on 13 client-owned dogs and cats. Operative time and intraoperative complications were recorded. One month after surgery, follow-up examinations were performed on all animals and owners were asked to complete questionnaires concerning signs of illness and complications observed after surgery and their overall satisfaction with the procedure. The laparoscopic-assisted technique was effective in identifying and removing retained testes. Owners were satisfied with the procedure. Laparoscopic-assisted crytorchidectomy can be used to minimize the invasiveness of the procedure while maintaining the safety associated with good visibility of abdominal structures.     

Use of anti-inflammatory and analgesic drugs in dogs and cats

SUMMARY: Responses (486) were collated from a survey of 5054 Australian veterinarians on their use of anti-inflammatory and analgesic drugs in dogs and cats. Almost all respondents used glucocorticoids (usually prednisolone) to treat allergic, pruritic dermatoses in dogs, while two-thirds also gave fatty acid supplements and one-half used antihistamines. Almost 60% of respondents initially injected a glucocorticoid (frequently a long-acting preparation) when treating inflammatory skin diseases in dogs. More than 90% of respondents used glucocorticoids to treat immunemediated haemolytic anaemia or thrombocytopenia, and about one-third also gave cytotoxic drugs. Administration of prednisolone on alternate days was generally favoured for long-term enteral steroid therapy. Phenylbutazone was the most preferred treatment for painful or inflammatory musculoskeletal disorders of dogs, but aspirin and pentosan polysulphate were also used widely. Regarding the use of analgesics drugs generally, both narcotic analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) were used more widely in dogs than in cats, but alpha-2 agonists were used similarly in both species. The most commonly used narcotic analgesics were pethidine and buprenorphine in both species, while the NSAIDs used most often were flunixin and dipyrone in dogs and ketoprofen in cats. More than 80% of respondents generally used analgesic drugs with potentially painful surgical procedures, with doses given usually before anaesthetic recovery. Analgesic use rates varied with the condition, ranging from 94% for patients with acute severe trauma, through 60% for cruciate ligament repair and 29% for perineal herniorrhaphy, to about 5% for ovariohysterectomy and dog castration. The three clinical signs most frequently nominated as indicators of pain in dogs and cats were (in descending order) vocalisation, response to handling or palpating the affected area, and mental depression. Other items mentioned frequently were behavioural changes and immobility (in both species), inappetence/anorexia in cats, and altered respiration in dogs.     

The use of vascular access ports for blood collection in feline blood donors

We investigated vascular access ports for feline blood donation. Eight cats were anesthetized for conventional blood collection by jugular venipuncture at the beginning and end of the study. In-between conventional collections, vascular access ports were used for collection with or without sedation every 6 to 8 wk for 6 mo. Ports remained functional except for one catheter breakage, but intermittent occlusions occurred. Systolic blood pressure was lower during conventional collection. Behavioral abnormalities occurred during 3 port collections. Packed red cells prepared from collected blood were stored at 4°C for 25 d and assessed for quality pre- and post-storage. With both collection methods, pH and glucose level declined, and potassium level, lactate dehydrogenase activity and osmotic fragility increased. There were no differences between methods in pre-storage albumin and HCO(3)(-) levels, and pre and post-storage hematocrit, lactate dehydrogenase activity, and glucose and potassium levels. Pre-storage pH and pCO(2) were higher with conventional collection, and pre- and post-storage osmotic fragility were greater with port collection. One port became infected, but all cultures of packed red cells were negative. Tissue inflammation was evident at port removal. In a second study of conventional collection in 6 cats, use of acepromazine in premedication did not exacerbate hypotension. The use of vascular access ports for feline blood donation is feasible, is associated with less hypotension, and may simplify donation, but red cell quality may decrease, and effects on donors must be considered.     

Evaluation of the use of subcutaneous implantable vascular access ports in feline blood donors

OBJECTIVE:To compare the ease and effects of collecting blood from cats by use of subcutaneous totally implantable vascular access ports (VAPs) with collection via conventional jugular phlebotomy. DESIGN: Prospective randomized experimental study. ANIMALS: 8 healthy cats. PROCEDURES: Cats in the port group (n = 4) underwent monthly blood donation by use of VAPs and manual restraint, and cats in the nonport group (4) underwent monthly blood donation by use of conventional jugular phlebotomy and sedation, for 6 months. RESULTS: Postsurgical VAP-related complications developed in 3 cats and included port erosion (n = 1), disconnection of the port from the catheter (1), and seroma formation (1). Blood was successfully collected 24 of 24 and 20 of 20 times in the nonport and port groups, respectively. Results of bacterial culture of blood were negative in 22 of 24 and 15 of 20 nonport and port collections, respectively. No differences in RBC morphology were observed between groups. Mean blood collection and total donation times were significantly longer for the nonport group. Collection time was more variable in the nonport group, and cats were less tolerant of handling during venipuncture, compared with cats in the port group. Blood collection required a mean of 2.4 persons for the nonport group and 2.1 persons for the port group. CONCLUSIONS AND CLINICAL RELEVANCE: Positive results for blood collections via VAPs were increased donor acceptance, decreased number of personnel required, and decreased collection time. Drawbacks included contamination of blood products and port-related complications.     

The use of complementary and alternative therapies in dogs and cats with cancer

The use of complementary and alternative medical therapies is becoming widespread. The objective of this study was to examine the use of complementary and alternative therapies in dogs and cats with cancer. The types of modalities used, the intended purpose for each modality, sources of information pet owners used, and the level of interest in these modalities were all evaluated. Information was obtained by written survey, and 254 owners agreed to participate. Complementary and alternative therapy use was commonplace, with 76% of surveyed owners reporting some use. When prayer for health reasons was excluded, the number of owners reporting use dropped to 65%. Nutritional supplements were the most commonly used therapy.     

Management of humeral and femoral fractures in dogs and cats with linear- circular hybrid external skeletal fixators

Linear-circular hybrid fixators were used to stabilize humeral and femoral fractures in 21 dogs and five cats. Twenty-two of 24 fractures with sufficient follow-up radiographic evaluation obtained union. Time to radiographic union ranged from 25 to 280 days (mean +/- standard deviation [SD] 110+/-69 days; median 98 days). Eleven animals developed minor and two dogs developed major pin and/or wire tract inflammation. Functional outcome was rated as excellent (n=16), good (n=5), and fair (n=3) at the time of final long-term assessment (range 4.5 to 60.0 months; mean +/- SD 28.4+/-15.4 months; median 28.5 months). Follow-up information was unavailable for two animals. Hybrid fixators were useful constructs for stabilization of humeral and femoral fractures, particularly fractures with short, juxta-articular fracture segments.     

Development of a questionnaire assessing health-related quality-of-life in dogs and cats with cancer

Health-related quality-of-life (HRQoL) has been studied extensively in human medicine. There is currently no standard HRQoL evaluation for veterinary oncology patients. The aim of this study was to assess the practicality, usefulness and robustness, from a pet owner and clinician perspective, of a questionnaire for the assessment of HRQoL in canine and feline cancer patients. A HRQoL assessment entitled 'Cancer Treatment Form' and two questionnaires entitled 'Owner Minitest' and 'Clinician Minitest' were designed. The first and second were completed by owners of patients presenting to a veterinary oncology referral service and the third by attending clinicians. The 'Cancer Treatment Form' was well received by owners and clinicians and provided a valuable assessment of HRQoL with 98% (82/84) of owners reporting an accurate reflection of their pet's quality-of-life. Following this, minor improvements to the form could be suggested prior to regular use in evaluation of clinical oncology patients.     

Micromorphology and topography of tarsal joint capsule's vascular elements in cats and dogs

Both cats and dogs belong to animals with the same type of limb support but have different nature of movement. Despite belonging to digitigrade animals, cats and dogs have a different nature of motion. While moving, the medial joint surface in cats and lateral surface in dogs carry the larger pressure. The aim of the study was to compare the similar surfaces of the cat's and dog's tarsal joint capsule and to detect differences in its histostructure and vascularisation. For the study, we used the capsule of the tarsal joint of five cats and five dogs dissected with accordance to anatomical surfaces. Sections of the capsule joint were stained with haematoxylin–eosin. The sections were examined with a microscope at magnification ×250 and ×400. The statistical analysis of the results was done using Student's t test. During the research, a difference in histostructure and vascularisation of tarsal joint capsule in cats and dogs on respective surfaces were found. The medial surface of the tarsal joint capsule was the most saturated with hemomicrocirculatory bed structures in cats, whereas this was the lateral surface in dogs. The most active metabolic processes also take place in these areas of the joint capsule, which is important to know when prescribing therapeutic procedures and determining an optimal surgical access.     

Anesthesia in dogs and cats with althesin

Tests of the effect of the new steroid anaesthetic alfadion in the drug Althesin are described. Experiments were carried out in three experimental groups. Intramuscular administration of Althesin to dogs at doses 5 to 15 mg. kg-1 does not induce required anaesthesia. After intravenous administration of Althesin to dogs at a dose of 2 mg. kg-1 after diazepam pre-medication at a dose of 0.25 mg.kg-1 i. m., anaesthesia started without excitations immediately after completed application. Anaesthesia lasted on the average 10 minutes and at the time of recovery excitations and side effects occurred. After intravenous administration of Althesin at a dose of 6 mg. kg-1 with diazepam pre-medication 0.25 mg. kg-1 i.m., the course of narcosis in cats was similar to that in dogs, only its duration was on the average 29 minutes.     

Use of inhaled medications to treat respiratory diseases in dogs and cats

Noninfectious disorders of the respiratory tract, including laryngitis, tracheitis, bronchitis, and asthma are common problems in dogs and cats. Traditional therapies have often included corticosteroids and bronchodilators given by mouth or injection. Side effects of this form of treatment can be severe and can result in cessation of therapy. Inhaled corticosteroid drugs are not as absorbed into the systemic circulation, do not result in significant side effects, and are now the standard of care for dogs and cats with respiratory diseases that would otherwise be treated with systemic medications.     

Use of external skeletal fixators in the repair of femoral fractures in cats

This paper reports the results of fixation of 35 femoral fractures in cats using an external skeletal fixator alone or in combination with supplementary devices. All the fractures healed. The average time to fixator removal was eight weeks and two days. The external skeletal fixator offers a method of repairing many types of femoral fractures in cats allowing sound orthopaedic principles to be maintained and producing a successful outcome.     

Use of an external skin-stretching device for wound closure in dogs and cats

Use of an externally applied, noninvasive skin-stretching device in 24 dogs and cats is described. The device uses adhesive-coated pads that are applied to the skin of an animal; pads are positioned on opposite sides of a surgical site and are connected by means of adjustable elastic cables. The cables maintain continuous tension, and cable tension is adjusted and progressively increased at intervals of 6 to 8 hours to promote skin recruitment (stretching), using the cutaneous viscoelastic properties of mechanical creep and stress relaxation. Consequently, skin adjacent and distant to the surgical site can be recruited to facilitate wound closure, typically within 72 to 96 hours after application of the device. The skin-stretching device has been used effectively in dogs and cats to stretch skin prior to elective surgical procedures, stretch skin during management of open wounds prior to suturing, and alleviate incisional tension after surgery.