A Comparison of Three Local Anaesthetic Techniques for Skin Biopsy in Dogs

Abstract— Three local anaesthetic preparations (one per cent lignocaine, one per cent lignocaine with 1 in 100 000 adrenaline, both administered by subcutaneous infiltration, and a novel topically-active eutectic mixture of lignocaine and prilocaine called EMLA cream) were assessed for their effectiveness as analgesic agents for skin biopsy in each of 25 dogs with skin disease. One dog would not accept application of the EMLA cream but otherwise all three agents were well tolerated. While the lignocaine and lignocaine/ adrenaline combination gave comparable and effective results in all dogs, analgesia using EMLA was assessed as good, moderate or poor in 37.5, 37.5, and 25 per cent of cases respectively. Blanching of the skin was seen in six dogs with EMLA and surface keratin was lost from EMLA-treated sites in two dogs. The inclusion of adrenaline with lignocaine caused vasoconstriction of otherwise dilated blood vessels, obscuring the presence of circulating eosinophils, in two dogs. Swelling of dermal collagen fibres as reported in man with lignocaine/adrenaline combinations was not seen. Subcutaneous infiltration of one per cent lignocaine appears to be the local analgesic agent of choice for skin biopsy in dogs. Résumé— Trois préparations anesthésiques locales (lignocaïne à 1%, lignocaïne à 1% avec adrénaline au 100 000 ème, les duex administrés par infiltration sous-cutanée, et un nouveau mélange eutectique topique de lignocaïne et de prilocaïne appelé EMLA crème) ont étéévaluées pour leur effet d'agents analgésiques lors de biopsie cutanée chéez 25 chiens atteints de maladies de peau. Un chien n'accepta pas l'application de la crème EMLA mais par ailleurs les 3 agents furent bien tolérés. Alors que la lignocaïne et le mélange lignocaïne/adrénaline donnèrent des résultats comparables et efficaces chez tous les chiens, l'analgésie par l'EMLA fut evaluée comme étant bonne, modérée, ou mauvaise dans 37,5, 37,5, et 25 pour cent des cas respectivement. Le blanchissement de la peau fut observé chez 6 chiens avec l'EMLA et la kératine de surface disparut des zones triatées à l'EMLA chez 2 chiens. L'adjonction d'adrénaline à la lignocaïne provoqua une vasoconstriction des vaisseaux sanguins par ailleurs dilatés, masquant la présence d'éosinophiles circulants, chez 2 chiens. L'oedème des fibres de collagènes dermiques qui a été décrit chez l'homme avec l'association lignocaïne/adrénaline n'a pas été observé. L'infiltration sous-cutanée de lignocaïne à un pour cent semble être l'agent analgésique local de choix pour la biopsie cutanée chez le chien. Zusammenfassung— Drei Lokalanästhetika (1 %ige Lignocainlösung und die Kombination mit Adrenalin 1:100 000, die beide subcutan infiltriert wurden, und EMLA-Creme, eine neue, örtlich aktive eutektische Mischung aus Lignocain und Prilocain) wurden auf ihre Wirksamkeit als Analgetika bei der Entnahme von Hautbiopsien bei 25 Hunden mit Hauterkrankungen untersucht. Ein Hund ließ die Applikation der EMLA-Creme nicht zu. Ansonsten wurden alle drei Substanzen gut vertragen. Lignocain alleine sowie die Kombination Lignocain/Adrenalin brachten vergleichbare und effektive Resultate bei alien Tieren. Die Analgesie durch EMLA wurde in jeweils 37.5% als gut bzw. befriedigend und in 25% als schlecht beurteilt. Eine Bleichung der Haut wurde in 6 Fällen und eine Lösung des Oberflächenkeratins in 2 Fällen an den mit EMLA behandelten Hautbezirken gesehen. Der Zusatz von Adrenalin zu Lignocain verursachte eine Vasokonstriktion von den ansonsten dilatierten Blutgefäßen, was das Vorkommen zirkulierender Eosinophilen bei zwei Hunden überdeckte, Die beim Menschen beschriebene Schwellung der dermalen Kollagenfasern bei der Anwendung von Lignocoin/Adrenalin-Kombination wurde nicht beobachtet. Die subcutane Infilatration mit l%iger Lignocainlösung scheint das Mittel der Wahl zur Lokalanästhesie bei der Entnahme von Hautbiopsien beim Hund zu sein. Resumen Se estudian las propiedades analgésicas y su aplicación en la toma de biopsias cutáneas de tres preparados anestésicos locales (lignocaina al 1%, lignocaina al 1% con adrenalina al 1/100.000, estos dos productos administrados via subcutánea y una mezcla de lignocaina y prilocaina denominada ELMA, de aplicación tópica). Estos tres agentes se aplicaron en 25 perros que presentaban diferentes enfermedades cutáneas. Un perro no toleró la aplicación de la crema EMLA pero en tódos los demás casos los tres agentes se toleraron sin problemas. Mientras que la lignocaina y la combinación lignocaina/adrenalina daban unos resultados, efectivos y muy parecidos en todos los perros, la analgesia que producía la EMLA se calificó de buena, moderada o mala en el 37,5%, 37,5% y 25% de los casos respectivamente. En 6 perros tratados con EMLA se observó una palidez de cutánea en la zona de aplicación, en dos animales también tratados con la crema EMLA se apreció una pérdida de la queratina superficial. La aplicación de adrenalina con la lignocaina producía una vasoconstricción en los vasos cutáneos que antes del tratamiento estaban dilatados, ocultando la presencia de polinucleares eosinófilos circulantes, en dos de los animales. La tumefacción de la fibras de colágeno dérmicas que se ha descrito en medicina humana después de la aplicación de combinaciones de lignocaina/adrenalina no se observó en estos perros. La infiltración subcutánea de lignocaina al 1% parece ser la forma de analgesia local de elección para la toma de biopsias en el perro.     

A Comparison of Liver Sampling Techniques in Dogs

Background

The liver sampling technique in dogs that consistently provides samples adequate for accurate histopathologic interpretation is not known.

Hypothesis/Objectives

To compare histopathologic results of liver samples obtained by punch, cup, and 14 gauge needle to large wedge samples collected at necropsy.

Animals

Seventy dogs undergoing necropsy.

Methods

Prospective study. Liver specimens were obtained from the left lateral liver lobe with an 8 mm punch, a 5 mm cup, and a 14 gauge needle. After sample acquisition, two larger tissue samples were collected near the center of the left lateral lobe to be used as a histologic standard for comparison. Histopathologic features and numbers of portal triads in each sample were recorded.

Results

The mean number of portal triads obtained by each sampling method were 2.9 in needle samples, 3.4 in cup samples, 12 in punch samples, and 30.7 in the necropsy samples. The diagnoses in 66% of needle samples, 60% of cup samples, and 69% of punch samples were in agreement with the necropsy samples, and these proportions were not significantly different from each other. The corresponding kappa coefficients were 0.59 for needle biopsies, 0.52 for cup biopsies, and 0.62 for punch biopsies.

Conclusion and Clinical Importance

The histopathologic interpretation of a liver sample in the dog is unlikely to vary if the liver biopsy specimen contains at least 3–12 portal triads. However, in comparison large necropsy samples, the accuracy of all tested methods was relatively low.     

Quality of Life Measurement in Prospective Studies of Cancer Treatments in Dogs and Cats

Background

Quality of life (QOL) is an important consideration in healthcare decision‐making for pets with cancer. To determine the effect of disease and treatment on pet QOL, this important variable should be objectively measured as an outcome in veterinary cancer studies.

Objectives

To determine the prevalence and methodology of QOL measurement in a sample of recently published reports of prospective studies evaluating cancer treatments in client‐owned dogs and cats; to characterize reporting of QOL outcomes and to identify article characteristics associated with QOL measurement.

Methods

English‐language reports of prospective studies of cancer treatments in dogs and cats published from 2008 to 2013 were identified using medical research databases combined with a hand‐searching strategy. Data pertaining to general article characteristics and QOL measurement were abstracted and summarized.

Results

Reports of 144 eligible studies were identified. QOL was measured in 16 (11.1%) studies, with 8 (5.6%) reporting the results. All studies that measured QOL reported using unvalidated instruments, or did not report how QOL was assessed. Only 1 study provided sufficient information for QOL measurements to be replicated. Recently published articles (2011–2013) were significantly more likely to report measuring QOL, compared with earlier articles.

Conclusions

Quality of life of pets undergoing cancer treatment is largely unreported and cannot be meaningfully compared across treatments or disease states using the existing literature. Reliable, validated instruments are needed to facilitate the measurement and comparison of pet QOL in veterinary cancer research. Consistent reporting practices could improve transparency and interpretation of QOL results.     

A Retrospective Study of Cavernous Sinus Syndrome in 4 Dogs and 8 Cats

Cavernous sinus syndrome (CSS) is characterized by deficits in more than one of the cranial nerves (CN) that traverse the cavernous sinus at the base of the cranial vault: CN III (oculomotor), IV (trochlear), VI (abducens), and the first two branches of CN V (trigeminal). Records from 4 dogs and 8 cats with CSS diagnosed over a 14-year period were reviewed. The most common clinical signs were ophthalmoparesis or ophthalmoplegia, mydriasis with no direct or consensual pupillary light reflexes, ptosis, decreased corneal sensation, and decreased retractor oculi reflex. All cats had initial signs referable to a left CSS lesion (one had bilateral CSS), whereas in all dogs the lesions were localized to the right cavernous sinus. Median ages at diagnosis were 9 and 10 years of age for dogs and cats, respectively. Cerebel lomedullary cisternae cerebrospinal fluid analysis in 6 animals was useful as a sensitivebut nonspecific diagnostic test of an intracranial inflammatory or neoplastic lesion. Magnetic resonance imaging scans provided a more definitive diagnostic test in all dogs, revealing a contrast-enhancing mass on T1 weighted scans in the region of the cavernous sinus. A definitive pathological diagnosis was obtained in 2 dogs: a primary intracranial neoplasm and a metastatic intracranial neoplasm. A definitive diagnosis was obtained in 6 cats: metastatic neoplasm (n =1), primary intracranial neoplasm (n = I), primary intracranial infectious disease (n = 2). and associated systemic infectious disease (n = 2). The prognosis associated with CSS in dogs and cats was considered guarded to poor. J Vet Intern Med 1996_;10:65–71. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

Gonadectomy in Cats and Dogs: A Review of Risks and Benefits

The necessity, and in particular the timing, of gonadectomy in dogs and cats is still controversial. This is mainly because gonadectomy confers a mixture of benefits and adverse effects that depend upon the age at neutering, sex, species and breed. In this paper, the long-term risks and benefits of gonadectomy, at various ages, in dogs and cats are reviewed using data describing the effects of desexing on the urogenital tract and on other medical conditions, such as orthopaedic diseases, immune-mediated diseases, tumour development and behaviour.     

Comparison of Histopathologic Findings in Biopsies from the Duodenum and Ileum of Dogs with Enteropathy

Background: In the investigations of dogs with chronic small intestinal diarrhea collection of ileal biopsies lengthens procedural time and has been of uncertain value.
Objectives: To evaluate whether there was agreement between histologic changes present in samples of duodenal and ileal mucosa, and hence to provide initial information in the process of determining whether collection of ileal biopsies is clinically justified.
Animals: 40 dogs with chronic small and large intestinal diarrhea from which endoscopic (in 30 cases) or surgical (in 10 cases) duodenal and ileal biopsies had been collected.
Methods: Samples were reviewed concurrently by two observers (MJD and MDW) using the scoring system developed by the World Small Animal Veterinary Association (WSAVA) Gastrointestinal Standardization Group. Comparisons were made by kappa analysis.
Results: Microscopic pathology was observed in 30 cases. Only eight out of this 30 (27%) had the same histopathologic diagnosis in both the duodenum and the ileum. This dropped to 3 out of 30 (10%) if different disease severity was also considered as disagreement. Microscopic pathology would have been found in 60% and 80% of the 30 cases, if only duodenal or ileal biopsies respectively, had been available.
Conclusions and clinical importance: There was poor agreement between histopathological findings from duodenal versus ileal biopsies with abnormalities sometimes being more readily detected in the ileum. Routine collection of ileal plus duodenal samples appears warranted when concurrent small and large intestinal diarrhea is present.     

Colopexy as a Treatment for Rectal Prolapse in Dogs and Cats: A Retrospective Study of 14 Cases

Colopexy was evaluated as a treatment for recurrent rectal prolapse in eight dogs and six cats. Cases included in the study were from two institutions; the University of Pennsylvania School of Veterinary Medicine and the University of Tennessee College of Veterinary Medicine. Two different colopexy techniques were used: A simple suture technique was used in two cats and four dogs (University of Pennsylvania), and an incisional technique was used in four cats and four dogs (University of Tennessee). Rectal prolapse had not recurred in any of the 14 animals at the time of follow-up. Incisional dehiscence occurred in two animals and in one instance may have been related to the colopexy procedure. Infection at the colopexy site, secondary to suture penetration of the colonic lumen, is a potential complication of this procedure. Colopexy, using either surgical technique described here, was effective in preventing recurrent rectal prolapse.     

A Retrospective Comparison of Three Techniques for Femoral Head and Neck Excision in Dogs

Femoral head and neck excision was performed in 169 dogs over a 7 year period. A written questionnaire completed by 56 owners, evaluating a total of 72 joints, was the basis for retrospective evaluation of the efficacy of the procedures used. There were four surgical groups: femoral head and neck excision (FHNE) in dogs with body weights over 14 kg, the same procedure in dogs with body weights less than 14 kg (SMALL), femoral head and neck excision with muscle interposition (MI), and the wedge resection technique (WRT). Although differences in results were noted, there were no statistically significant differences between any of the groups for the percentage of leg use during normal activity (p greater than 0.05), mean postoperative time until leg use, use of the leg or hopping while running, or lameness with exercise (p greater than 0.10). The results of this study suggest that there is little advantage in performing the more time-consuming and traumatic muscle interposition and wedge resection procedures.     

Fractures of the Humerus in Dogs and Cats A Retrospective Study of 130 Cases

Case histories of 130 dogs and cats with humeral fractures were reviewed. The different types of fractures were classified. Most animals with proximal, shaft, and supracondylar fractures had excellent results. The poor prognosis associated with distal articular fractures was due most often to failure of the fixation device in the supracondylar area; best results were achieved with a plate on the caudal and medial surface of the distal humerus.     

A Retrospective Study of the Use of Total Parenteral Nutrition in Dogs and Cats

The records of all dogs and cats receiving total parenteral nutrition (TPN) over a 43-month period were examined retrospectively. Dextrose, amino acids, lipids, electrolytes, and vitamins were administered by central venous catheter according to published nutrient recommendations; 72 dogs and 12 cats were studied, accounting for 380 patient days of TPN. Duration of TPN administration was 1–14 days with a mean of 4.5 days. Most animals required TPN because of gastrointestinal dysfunction, and more than half of them gained weight during TPN administration. Mechanical complications were frequent. Metabolic complications, especially lipid and glucose intolerance, were also commonly seen. Septic complications were the least frequently encountered, but resulted in patient morbidity and may have contributed to mortality. Most animals receiving TPN were returned to enteral nutrition and discharged. For critically ill animals unable to tolerate enteral alimentation, TPN can be supportive therapy in the treatment of the primary disease.     

Total and Partial Orbitectomy for the Treatment of Periorbital Tumors in 24 Dogs and 6 Cats: A Retrospective Study

Total or partial orbitectomy were used to treat 24 dogs and six cats with invasive periorbital tumors. The surgical procedure and clinical results were evaluated in this retrospective study. The most common types of tumors treated in this series of patients were multilobular osteochondrosarcoma and squamous cell carcinoma. Two patients died of cardiopulmonary arrest within 24 hours after surgery. One patient developed neurological signs after total orbitectomy that resolved with conservative therapy. Minor complications, which included infection, strabismus, and conjunctivitis, occurred in seven patients. Regrowth of tumor in the periorbital region occurred in 11 patients (36.7%). Tumor resection by orbitectomy provided local disease-free interval of more than 1 year in more than 50% of patients. Survival rate for the first year was 70.4% in this series of patients as determined by life table analysis. Orbitectomy requires detailed knowledge of regional anatomy and experience with performing a combination of surgical procedures. Preoperative diagnostic tests should include imaging techniques to define the extent of the disease. When performed properly, orbitectomy is a valuable procedure that can be used to effectively treat invasive tumors of the orbit.     

Miniplate Fixation for Repair of Mandibular and Maxillary Fractures in 15 Dogs and 3 Cats

Maxillofacial miniplates and screws were used for skeletal fixation in 15 dogs and 3 cats that sustained a variety of mandibular and maxillary fractures. These implants were used as neutralization or buttress fixation in 11 caudal (junction of the ramus with the mandibular body) and 2 rostral mandibular fractures, 4 maxillary fractures, and 2 zygomatic arch fractures. All but one of the fractures healed with appropriate occlusion and excellent function. In one case of a rostral mandibular fracture, soft tissue dehiscence occurred accompanied by a loss of the fixation and subsequent distraction of the bone fragments; reasonable function was obtained by performing a rostral mandibulectomy. Plate contouring and application of the miniplates along the appropriate biomechanical lines of stress was easily performed and permitted the biomechanical principles of tension band fixation to be applied in most cases. Miniplate fixation, either used alone or in combination with other fracture fixation techniques, achieved sufficiently rigid skeletal fixation to provide uncomplicated healing and good to excellent functional and cosmetic results in 14 dogs and 3 cats.     

A Practical Technique for Electron Microscopy of Buffy Coats in Dogs and Cats

Plastic hematocrit tubes (PHTs) are convenient tools for electron microscopy (EM) of peripheral blood buffy coats, and the PHT‐EM technique is expected to be a practical method for veterinary clinical medicine. In this study, fixatives composed of various concentrations of sucrose, glutaraldehyde, and phosphate buffer (PB) were tested for preparing canine and feline buffy coats. The highest quality images were obtained using a fixative consisting of 2.5% glutaraldehyde in 0.1 m PB, and it was concluded that this method allows clinicians who are inexperienced in histological techniques can conveniently transport buffy coat samples to diagnostic laboratories for analysis by EM.     

A Comparison of the Plasma Fructose Concentrations in Dogs and Cats and Changes in the Fructose Concentrations in Dogs Following Intravenous Administration of Fructose

The plasma concentrations of fructose, glucose, free fatty acids (FFA) and triglycerides (TG) were measured in dogs and cats. Changes in these concentrations were investigated in dogs by an intravenous fructose tolerance test (IVFTT) at a dose of 0.1 g/kg body weight. Fructose concentrations in the plasma of dogs were significantly higher than those of cats. There was no significant difference in plasma glucose concentrations between dogs and cats. Plasma FFA concentrations decreased and TG concentrations increased after feeding in both dogs and cats. During the IVFTT, the plasma fructose concentrations in the dogs increased rapidly to a peak by 2 min and then decreased to half of the peak by 5 min after the administration of fructose. Administration of fructose resulted in an increase in the plasma TG concentrations and reduced plasma FFA concentrations in the dogs. Only 4% of the administered fructose was detected in the urine of dogs following IVFTT. Plasma fructose was considered to be rapidly absorbed and metabolized in both dogs and cats. However, as with glucose metabolism, there appear to be some differences in fructose metabolism between dogs and cats.     

Corynebacterium spp. in Dogs and Cats with Otitis Externa and/or Media: A Retrospective Study

The role of Corynebacterium spp. in the pathogenesis of canine and feline otitis externa/media and their appropriate antimicrobial therapy are unclear. The objectives of this study were to (1) better establish the pathogenicity of Corynebacterium spp. in otitis utilizing reported criteria and by assessing clinical response to antibiotic therapy and (2) to determine the antimicrobial susceptibility patterns of Corynebacterium spp. associated with otitis. The study was retrospective, targeting cultures positive for Corynebacterium spp. Corynebacterium spp. were part of mixed microbial populations in 79/81 cultures. Corynebacterium spp. pathogenicity was highly questionable because of their almost invariable presence with other microbes and the observation that Corynebacterium spp. usually disappear from the ear with resolution of other infections, even when the Corynebacterium spp. are resistant to the prescribed antibiotic(s). However, 2/81 cultures came from two canine ears wherein Corynebacterium spp. may have been pathogenic. Antimicrobial sensitivities for Corynebacterium spp. were available for 54 isolates. Most isolates were susceptible to chloramphenicol (53/54), amikacin (50/54), tetracycline (50/54), gentamicin (46/54), and enrofloxacin (32/54). Among those antibiotics available in otic products, gentamicin and enrofloxacin would be rational choices for the empirical, topical therapy of Corynebacterium spp.