End-to-End Colonic Anastomosis A Comparison of Techniques in Normal Dogs

Colonic resections were repaired in normal dogs by crushing suture, inverting suture, or staple anastomosis techniques. Dogs were sacrificed 2, 4, 7, 10, 14, 21, and 28 days following surgery. Bacterial cultures, breaking strength measurement, adhesion formation, and gross and histopathologic examinations were made. Anastomoses closed by staples showed the least tissue reaction, least neutrophilic infiltration, most mature fibrous connective tissue, most normal arrangement of muscle layers, and fewest numbers of mucoceles and necrotic areas. The staple and crushing anastomosis techniques caused significantly less reduction in luminal radius than did the inverting anastomosis technique. Bacteria were isolated least frequently and adhesions were least severe following staple anastomosis, though these results were not statistically significant. Stapled anastomosis appeared to result in a higher tensile strength of the wounds at the anastomotic sites compared with the other techniques studied.     

Intrapelvic Urethral Anastomosis A Comparison of Three Techniques

Three intrapelvic urethral anastomosis techniques were performed on 12 mature male dogs to compare the degree of stricture. The intrapelvic urethra was transected 1 cm caudal to the prostate, and anastomosis was performed using either suturing of the urethra over an indwelling catheter, suturing of the urethra without an indwelling catheter, or apposition of the urethra without sutures over an indwelling catheter. Postoperatively, the dogs were evaluated using clinical urination patterns, biochemical tests, radiography, and pathology. Three of four suture-catheter dogs and one of four catheter-only dogs had normal urinary patterns. Stricture (25-84%) with urethral dilation or fistulas tracts was visible on retrograde, positive contrast urethrograms of 3 of 12 intact dogs 20 weeks after surgery, and on all 12 excised lower urinary tracts. Suture-catheter dogs subjectively had the least amount of stricture. All eight dogs (1 suture-catheter dog, 4 suture-only dogs, and 3 catheter-only dogs) with severe stricture (greater than 60% lumen diameter reduction) had histopathologic signs of chronic, inflammatory urinary tract disease, including four with chronic, ascending lymphocytic pyelonephritis. Hydroureter and hydronephrosis developed in two catheter-only dogs. Complete urethral transection resulted in some degree of stricture, regardless of technique used for anastomosis. Urethral anastomosis over an indwelling catheter appeared to result in a lesser degree of stricture and clinical and histopathologic derangement.     

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.     

Delayed Wound Closure A Review and Report of Use of the Technique on Three Equine Limb Wounds

Limb wounds of three horses were managed by delayed wound closure. In each, the wound was such that it was unlikely that healing would occur following primary closure and that second intention healing would have been unsatisfactory. Wounds were cleaned and debrided at the time of admission and maintained under sterile pressure bandages until free of infection and devitalized tissue. Suture closure of the wound at that time resulted in satisfactory healing in each case.     

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.     

Comparison of Three Drilling Techniques for Carpometacarpal Joint Arthrodesis in Horses

Objective: To evaluate 3 drilling techniques for arthrodesis of the equine carpometacarpal (CMC) joint. Study Design: Experimental study. Sample Population: Cadaveric equine forelimbs (n=15). Methods: Limbs were divided into 3 groups (5 limbs each) to evaluate 3 drilling techniques: (1) use of a 4.5 mm drill bit inserted into the joint through 4 entry points and moved in a fanning motion; (2) a 5.5 mm drill bit inserted through 2 entry points to create 3 nonfanned drill tracts (3 drill technique); and (3) a 4.5 mm drill bit used in a 3 drill technique. The CMC joint was disarticulated after drilling, and cartilage and subchondral bone damage evaluated visually and by gross and microradiographic examination using planimetry. Results: Technique 1 produced significantly more damage of the proximal surface, but significantly less to the subchondral bone of the distal surface. Technique 1 produced the most damage to both the articular cartilage and subchondral bone of the total CMC joint than either of the 3 drill tract techniques; however, the difference between techniques 1 and 2 was not significant. Damage from technique 3 was significantly less than that with techniques 1 or 2. Conclusions: Techniques 1 and 2 produced the most cartilage and subchondral bone damage with technique 2 changes more equally distributed between proximal and distal joint surfaces. Clinical Relevance: Technique 1 (fanning) and 2 (5.5 mm 3 drill tracts) may be preferable to achieve arthrodesis of the CMC joint. Morbidity and efficacy of these arthrodesis techniques need to be evaluated in vivo.     

Partial Maxillectomy in the Dog Comparison of Suture Materials and Closure Techniques

This study compares the healing of oronasal defects created by partial maxillectomy when closed using two different suture materials and two different suture patterns. In experiment 1, 24 dogs were divided into four equal groups. Partial maxillectomy was performed on each dog and was closed using either a two-layer simple interrupted suture pattern (12 dogs) or a modified Mayo mattress pattern (12 dogs) with either polyglactin 910 (12 dogs) or polypropylene (12 dogs) sutures. On the seventh postoperative day, the dogs were euthanized, suture line bursting pressures were measured, and wound healing was evaluated grossly and histopathologically. Suture line dehiscence occurred in one dog from each of the four groups. These were the only dogs in which electrocoagulation had been used. The healing of suture lines closed with the two-layer simple interrupted pattern was superior to that of those closed with the modified Mayo mattress pattern based on the degree of gross oral ulceration, suppurative inflammation, fibrosis and oral epithelial covering at the suture line, and the number of necrotic sites in the adjacent tissue. The healing of suture lines closed with polypropylene was superior to that of those closed with polyglactin 910 based on suture line bursting pressures and the degree of suppurative inflammation and tissue necrosis at the suture sites. In Experiment 2, partial maxillectomies were performed on four dogs, and closure was achieved using a two-layer simple interrupted suture pattern with either polyglactin 910 (two dogs) or polypropylene (two dogs). On the 30th postoperative day, the dogs were euthanized, and wound healing was evaluated grossly and histopathologically. All suture lines were well healed. All polyglactin 910 oral sutures were absent, while all polypropylene oral sutures were still present.     

Esophagotomy Closure in the Dog A Comparison of a Double-Layer Appositional and Two Single-Layer Appositional Techniques

Esophagotomies were performed on 36 dogs and closed with 3-0 polydioxanone in double-layer simple interrupted, single-layer simple interrupted, or single-layer simple continuous patterns. The operative time was shortest for single-layer simple continuous closure, followed by single-layer simple interrupted and double-layer simple interrupted, respectively. Three dogs with each suture pattern were euthanatized at hours 0 and 1, and days 4 and 28 after surgery. The esophagotomy incisions were subjected to bursting strength testing and examined microscopically. The bursting wall tension was higher for all three suture pattern groups at 28 days than at 0 and 1 hour. The double-layer closure had higher bursting wall tension than the single-layer closures at 0 hour and 4 days. Single-layer simple continuous closure had the lowest bursting wall tension for each time period. Single-layer simple interrupted closure had the highest bursting wall tension at 28 days. Microscopic examination revealed close approximation of tissue planes for the double-layer closure and mucosal ever-sion for the simple interrupted and simple continuous single-layer closures. Healing was superior histologically with the double-layer closure.     

Primary Closure of Equine Laryngotomy Incisions: A Review of 42 Cases

Laryngotomy incisions for either staphylectomy, ventriculectomy, cordectomy, resection of the palatopharyngeal arch, or subepiglottal cyst removal, were closed primarily in 42 horses. Incisional complications were subcutaneous emphysema (11 horses, 26%), incisional discharge (4 horses, 10%), postoperative fever (4 horses, 10%), incisional abscessation (3 horses, 7%), incisional seroma (2 horses, 5%), and subcutaneous edema (2 horses, 5%). Incisional complications were identified in 22 horses, but only 8 horses (19%) required intervention for incisional healing to occur. Factors such as preoperative and postoperative administration of antibiotics or nonsteroid anti-inflammatory drugs, use of antibiotic lavage or drains, type of suture material and suture pattern, were not significantly associated with incisional complications. Horses with incisional complications had significantly shorter mean surgical time ( P =.011) than horses without incisional complications. Surgical experience was associated with fewer complications ( P =.018), but had no significant effect on the frequency of complications requiring intervention. Results of this study indicate that equine laryngotomy incisions can be closed primarily and that most will heal without need for further surgical intervention.     

Comparison of Three Methods for Evaluation of Equine Insulin Regulation in Horses of Varied Body Condition Score

Multiple dynamic field tests are used for assessment of equine insulin resistance or altered insulin regulation. However, the relationship between markers of glucose homeostasis and insulin disposal obtained by different testing protocols is unknown. We hypothesized that two recently developed field tests for evaluation of equine insulin dysregulation, the insulin response to dexamethasone test (IRDT) and oral sugar test (OST), would yield comparable results to the hyperinsulinemic euglycemic clamp (HEC). Fifteen light breed horses with body condition scores (BCS) 3 of 9 to 8 of 9 were used in this study. Eight horses (BCS, 5 of 9 to 7 of 9) underwent an OST under two different housing conditions, pasture, and stall (experiment 1). These eight horses also underwent an HEC and IRDT over a 4-week period (experiment 2), and results were compared with the OST stall. Finally, eight horses (BCS, 3 of 9 to 8 of 9), including one horse from experiments 1 and 2, underwent an OST on pasture three times over a 14–16-week period during the summer and the fall (experiment 3). The HEC did not correlate with either the OST or IRDT. The OST was not different when performed in the pasture compared within a stall but did change significantly over time on pasture. These results suggest that in insulin-sensitive horses, the OST and IRDT results are not primarily determined by tissue insulin sensitivity in horses of varying BCS. Furthermore, OST results may vary depending on pasture composition or season.     

Comparison of Three Clinical Techniques for the Diagnosis of Laryngeal Paralysis in Dogs

Objectives— To evaluate laryngeal function using 3 diagnostic techniques: echolaryngography (EL), transnasal laryngoscopy (TNL), and laryngoscopy per os (LPO).
Study Design— Prospective clinical study.
Animals— Dogs with laryngeal paralysis (n=5) and control dogs (n=10); 5 age- and breed-matched dogs and 5 young, breed-matched dogs.
Methods— Laryngeal function was evaluated in conscious dogs using EL. All examinations were recorded and evaluated by separate, blinded observers upon completion of the study. The methods were compared with a standard evaluation incorporating all clinical knowledge of the case (STD) using sensitivity, specificity, positive, and negative predictive values.
Results— Three dogs with bilateral laryngeal paralysis requiring surgery were diagnosed as unilaterally affected or normal on EL. Three dogs had paradoxic motion on TNL and LPO, 2 of those were considered normal on EL, and 1 had no motion on EL. Paralysis was diagnosed in 1 age-matched and 3 young control dogs on EL. LPO and TNL falsely diagnosed lack of arytenoid movement in 2 age-matched controls and 1 young control. Two age-matched and 1 young control dog were misdiagnosed as paralyzed with TNL and LPO.
Discussion— Direct observation of the larynx allowed better evaluation of laryngeal function compared with EL. TNL did not require induction of anesthesia, but did not improve the ability to assess laryngeal function compared with LPO.
Conclusions— EL was not as effective as direct observation of the larynx. TNL did not improve the evaluation of laryngeal function compared with LPO.
Clinical Relevance— We use LPO combined with knowledge of the clinical history and physical examination to diagnose laryngeal paralysis in preference to EL and TNL.     

A Comparison of Repair Methods for Gap Healing in Equine Flexor Tendon

In nine horses (18 forelimbs), a 3 cm section of superficial digital flexor tendon was removed and the tendons were repaired with immobilization for 6 weeks and (1) no suture (n = 6); (2) a double locking loop tenorrhaphy with carbon fiber (n = 6); or (3) a double locking loop tenorrhaphy with size 2 nylon suture (n = 6). Clinical assessment, gross evaluation, morphometry, histology, and mechanical testing were performed on two limbs from each treatment group at weeks 6, 12, and 24. At weeks 6 and 12, the unsutured tissue was less mature than the tissue sutured with nylon. By week 24, the carbon fiber repair had breaking stress (mean, 12.5 M Pa) similar to the unsutured repair (mean, 10.6 M Pa). There was necrosis and a granulomatous foreign body reaction around the carbon fiber. The nylon suture repair had significantly greater strength per unit area (mean breaking stress, 20.4 M Pa) because of a smaller area of repair tissue in the gap (mean, 3.6 cm2). At week 24, the nylon suture repair tissue was the most mature with the least inflammation of the three repair methods. A nylon double locking loop suture was the preferred method for equine flexor tenorrhaphy of a tendon gap because of greater breaking stress, histologic maturity, biocompatibility, and the adequate functional and cosmetic outcome.     

Characteristics of Normal Equine Tarsal Synovial Fluid

Physical, biochemical, and cytologic properties of synovial fluid from normal equine tarsal joints were investigated. Tarsal synovial fluid was pale yellow, clear, free of flocculent material, and did not clot. Volume varied in direct proportion to individual tarsal joint size. Relative viscosity was related to volume, polymerization and quantity of hyaluronic acid, and protein concentration. Mucinous precipitate quality (hyaluronic acid polymerization) was uniformly high.

Results of certain analyses of serum were compared with those of tarsal synovial fluid. Tarsal synovial fluid protein concentration was low in conjunction with a high A:G ratio. Serum: synovial fluid sugar ratio was 1.24:1. Serum ALP, ACP, LDH, GOT, and GPT activity levels were higher than their corresponding levels of activity in tarsal synovial fluid. Serum ALD activity level was slightly lower than its tarsal synovial fluid counterpart. Total erythrocyte counts ranged markedly, while total leukocyte counts were uniform and low. Lymphocytes were the predominant synovial fluid cell type.

     

Feline Thyroidectomy A Comparison of Postoperative Hypocalcemia Associated with Three Different Surgical Techniques

Three bilateral thyroidectomy techniques used in 41 hyperthyroid cats over a 7 year period were compared for rates of postoperative hypocalcemia. Extracapsular dissection of the thyroid glands resulted in an 82% rate of postoperative hypocalcemia. An intracapsular dissection technique produced a 36% rate of postoperative hypocalcemia. The incidence of postoperative hypocalcemia was reduced to 11% when bilateral thyroidectomies were done asynchronously (staged), 3 to 4 weeks apart. Immediate postoperative treatment with dihydrotachysterol did not reduce the incidence of postoperative hypocalcemia. Because the incidence of hypocalcemia did not differ significantly between intracapsular and staged intracapsular dissection, the authors concluded that staged bilateral thyroidectomy in hyperthyroid cats had limited benefit over simultaneous bilateral thyroidectomy.