Pulmonary artery compression in a Thoroughbred colt due to a mediastinal abscess

In the case presented, a young horse was referred for further evaluation based on a presumptive diagnosis of pulmonic valve endocarditis, bronchopneumonia and a cranial mediastinal abscess based on thoracic ultrasound, echocardiography and clinical signs. However, further echocardiographic evaluation revealed that the abscess was compressing the right ventricular outflow track causing outflow obstruction, a murmur associated with right ventricular outflow tract obstruction (acquired pulmonic stenosis) and right ventricular hypertrophy. Vegetative endocarditis was not present. Medical management was unsuccessful, but surgical drainage and long‐term antimicrobial therapy were effective and the horse returned to a successful racing career.     

Esophageal duplication cyst as a cause of choke in the horse

A mare was examined for episodic choking and an abscess in the perilaryngeal region. One month before referral, the mass progressively enlarged, causing esophageal choking. An extraluminal compression of the esophagus 90 cm from the external nares was found on endoscopy and contrast radiography. Serosanguinous fluid aspirated from the mass contained keratinized squamous cells and neutrophils, compatible with an esophageal cyst. Surgical exploration was performed, with incomplete surgical excision. The remaining portion of the cyst was marsupialized and treated locally with a 2% inorganic iodine solution. Further episodes of esophageal choke in this horse have not been reported.     

Nasal obstruction caused by cystic nasal conchae in cattle

Four Holstein heifers were found to have partial nasal obstruction caused by bilateral cystic conchae. Three of the heifers (age range, 4 to 6 months) had a history of progressive nasal obstruction since near birth, were affected severely, and required surgical management. Each of 2 surgical procedures, a bilateral dorsolateral nasal flap approach and a dorsal nasal flap approach, was used successfully. The fourth heifer, which was 15 months old, had signs of nasal obstruction since shortly after birth, but was affected only mildly and was not treated. Follow-up information obtained 10 to 37 months later revealed that all cattle were considered normal and had no signs of nasal obstruction. In each case, a developmental problem or malformation of the ventral nasal concha resulting in cystic enlargement was suspected. The onset of clinical signs early in life and the bilateral nature suggested that the defect was of congenital origin.     

Free jejunal segment for treatment of cervical esophageal stricture in a dog

A 2-year-old female Chinese Shar Pei was admitted with a 20-cm cervical esophageal stricture that was untreatable by conventional medical and surgical methods. A free jejunal segment was used to replace the strictured portion of the esophagus. Twenty-one months after surgery, the dog was able to eat liquefied canned dog food with minimal regurgitation and was maintaining normal body weight. Free jejunal transfer offers a treatment method for otherwise fatal esophageal lesions that are not responsive to conventional methods of medical and surgical treatment.     

Esophageal obstruction in horses: a retrospective study of 34 cases

The major purpose of this investigation was to describe the causes, possible complications, and prognoses of horses with esophageal obstruction. Of 34 cases presenting with esophageal obstruction, 28 cases were due to impaction of ingesta. Obstruction due to pre-existing esophageal disease occurred in 4 horses with megaesophagus, in 1 horse with stricture in the upper third of the esophagus, and in 1 horse with esophageal diverticulum. There was no significant difference in the contamination of the trachea between horses that subsequently developed aspiration pneumonia and those that did not. The duration of esophageal obstruction prior to admission was significantly longer in horses that developed aspiration pneumonia (median 18, range 2-48 h) than in those horses that did not (median 4, range 0.5-48 h). Although the obstruction was relieved in all 34 horses, 4 were euthanized because of recurring obstruction due to megaesophagus (n = 2), esophageal diverticulum (n = 1), and esophageal stricture (n = 1).     

Characteristics and outcomes in surgical management of severe acute pancreatitis: 37 dogs (2001–2007)

Objective – Describe clinical characteristics and outcomes associated with canine patients undergoing surgical intervention for treatment of acute pancreatitis.
Design – Retrospective outcome study from 2001 to 2007.
Animals – Thirty-seven dogs.
Interventions – None.
Measurements and Main Results – The following data were collected for dogs who underwent surgical intervention in the course of treatment for severe acute pancreatitis: preoperative clinicopathologic and physical data, ultrasonographic findings, surgical procedure detail, histopathologic findings, and transfusion requirements. The survival rate was 80.8% in dogs with extrahepatic biliary obstruction, 64.3% in dogs undergoing necrosectomy, and 40.6% with pancreatic abscess. Overall survival was 63.6%. Surgical complications included intraoperative and postoperative hemorrhage in 12 dogs, postoperative development of diabetes mellitus in 3 dogs, exocrine pancreatic insufficiency in 1 dog, and bacterial peritonitis in 2 dogs.
Conclusion – Surgical intervention and aggressive postoperative care may be pursued in select dogs with severe acute pancreatitis. In dogs with extrahepatic biliary obstruction secondary to acute pancreatitis, surgical intervention may be associated with a good prognosis whereas dogs with pancreatic abscess formation may have a more guarded prognosis.     

Surgical Repair of an Intrathoracic Esophageal Pulsion Diverticulum in a Horse

An intrathoracic esophageal pulsion diverticulum causing repeated episodes of esophageal obstruction in a Morgan weanling colt was diagnosed by endoscopy, positive contrast radiography, and pleuroscopy. Surgical excision of the diverticulum alleviated clinical signs, and the horse was able to resume a normal diet by day 6. After 9 months the colt remains asymptomatic.     

Esophageal obstruction by antibiotic boluses in a thoroughbred filly: A case report

A case of equine midcervical esophageal obstruction by medicinal boluses is described. A discussion of the physical and endoscopic examination is included. Attempts at medical and manipulative therapy including massage, intraesophageal probing and endoscopically assisted efforts to snare the obstruction were nonrewarding. A standing midcervical esophagotomy was performed to facilitate the removal of the entrapped boluses. A positive contrast esophagram obtained five days after surgery indicated an absence of leakage of contrast media from the lumen of the esophagus. The filly was returned to athletic competition at seven days following surgery. No evidence of dysphagia or esophageal obstruction was reported six months following surgery. In this particular case, a standing midcervical esophagotomy afforded a successful alternative when manipulative and medical therapy proved inadequate.     

Omentalization of a nonresectable uterine stump abscess in a dog

One month after ovariohysterectomy, a 2-year-old spayed female Golden Retriever was evaluated because of an extensive uterine stump abscess. Clinical signs included intermittent vomiting, signs of depression, lethargy, and pollakiuria. The dog underwent abdominal surgery; the greatly enlarged uterine stump was tightly adhered to the dorsal surface of the bladder, encompassing the distal portions of the ureters and the bladder's neurovascular supply. En bloc resection of the uterine stump was not considered an acceptable treatment option because of the risk of surgical damage to and subsequent devitalization of the bladder or ureters, urinary incontinence, or urinary tract obstruction. Therefore, the diseased uterine tissue that extended cranial to the bladder was resected, and the remaining abscess cavity was lavaged and packed with omentum. The dog recovered fully from the procedure. The omentum is an effective physiologic drain; its extensive vascular and lymphatic networks absorb fluid and actively promote elimination of infection. Omentalization appears to be an option for surgical management of nonresectable uterine stump abscesses in dogs.     

牛食道阻塞防治

牛食道阻塞又被称为食道梗塞,是因为食道中被大块食物堵塞,难以下咽所引发的一种急性食道疾病。按照阻塞程度的不同划分为完全阻塞和不完全阻塞2种。按照阻塞部位的不同可以划分为颈部食道阻塞、胸部食道阻塞和腹部食道阻塞3种。因阻塞性质和阻塞程度不同,会继发不同程度的瘤胃臌气。牛食道阻塞具有发病急、发病突然、发病过程快、致死率高的特点,发生后如果不能立即采取措施抢救,患病牛在短时间内会死亡。为提高食道阻塞救治成功率,该文主要探讨牛食道阻塞的诊断和防治过程。     

Trichophytobezoar duodenal obstruction in New World camelids

OBJECTIVE: To describe clinical findings, surgical treatment, and outcome associated with trichophytobezoar duodenal obstruction in New World camelids. STUDY DESIGN: Retrospective study. ANIMALS: Alpacas (7) and 1 llama. METHODS: Historical and clinical data were obtained from the medical records of New World camelids with a diagnosis of trichophytobezoar duodenal obstruction confirmed by surgical exploration or necropsy. RESULTS: Seven camelids were <1 year old. Abnormal clinical findings included anorexia, reduced fecal output, recumbency, colic, abdominal distension, regurgitation, decreased serum chloride concentration, increased serum bicarbonate concentration, and/or elevated first gastric compartment chloride concentration. Survey abdominal radiographs obtained (4 animals) revealed gastric distension (4) and/or visualization of the obstruction (2). Diagnosis was confirmed at necropsy (1) or surgery (7). Right paracostal celiotomy was performed on all animals and duodenotomy (3) or retropulsion of the trichophytobezoar combined with third compartment gastrotomy (4) was used to remove the obstruction. Six animals survived to discharge and 5 were healthy at follow-up, 8-20 months later. The remaining discharged alpaca was healthy at 12 months but subsequently died of unrelated causes. CONCLUSIONS: Diagnosis of trichophytobezoar duodenal obstruction should be considered in juvenile New World camelids with abdominal distension and hypochloremic metabolic alkalosis. Right paracostal celiotomy can be used for access to the descending duodenum and third gastric compartment for surgical relief of obstruction. CLINICAL RELEVANCE: Duodenal obstruction from bezoars should be considered in New World camelids <1year of age with abdominal distension and hypochloremic metabolic alkalosis. Surgical relief of the obstruction by right paracostal celiotomy has a good prognosis.     

Surgical Repair of an Esophageal Stricture in a Horse

An esophageal stricture was diagnosed in a 9-month-old quarterhorse by esophagoscopy and positive pressure contrast esophagography. Medical management and two attempts at surgical intervention were unsuccessful. The initial surgical technique used was a linear esophagotomy, mucosal resection and anastomosis, and closure of the muscular tunic, which resulted in a more severe stricture. The second surgical procedure was interruption of the stricture cicatrix by a single linear esophagotomy and primary closure of only the esophageal muscular tunic. This technique resulted in an increased lumen diameter, but failed to adequately resolve the stricture. Successful resolution of the stricture with return to a normal diet was achieved by a two stage repair using formation of an esophagostomy to stabilize the esophagus, followed by fenestration of the mucosal-submucosal cicatrix. Six months postoperatively, the horse was asymptomatic on a normal diet.     

Retrospective Study: Surgical intervention in the management of severe acute pancreatitis in cats: 8 cases (2003–2007)

Objective – To evaluate clinical characteristics and outcomes of cats undergoing surgical intervention in the course of treatment for severe acute pancreatitis. Design – Retrospective observational study from 2003 to 2007 with a median follow‐up period of 2.2 years (range 11 d–5.4 y) postoperatively. Setting – Private referral veterinary center. Animals – Eight cats. Interventions – None. Measurements and Main Results – Quantitative data included preoperative physical and clinicopathologic values. Qualitative parameters included preoperative ultrasonographic interpretation, perioperative and intraoperative feeding tube placement, presence of free abdominal fluid, intraoperative closed suction abdominal drain placement, postoperative complications, microbiological culture, and histopathology. Common presenting clinical signs included lethargy, anorexia, and vomiting. Leukocytosis and hyponatremia were present in 5 of 8 cats. Hypokalemia, increased total bilirubin, and hyperglycemia were present in 6 of 8 cats. Elevated alanine aminotransferase and aspartate transferase were present in all cats. Surgery for extrahepatic biliary obstruction was performed in 6 cats, pancreatic abscess in 3 cats, and pancreatic necrosis in 1 cat. Six of the 8 cats survived. Five of the 6 cats that underwent surgery for extrahepatic biliary obstruction and 1 cat that underwent pancreatic necrosectomy survived. All 5 of the cats with extrahepatic biliary obstruction secondary to pancreatitis survived. The 2 nonsurvivors included a cat with a pancreatic abscess and a cat with severe pancreatitis and extrahepatic biliary obstruction secondary to a mass at the gastroduodenal junction. Postoperative complications included progression of diabetes mellitus, septic peritonitis, local gastrostomy tube stoma inflammation, local gastrostomy tube stoma infection, and mild dermal suture reaction. Conclusion – Cats with severe acute pancreatitis and concomitant extrahepatic biliary obstruction, pancreatic necrosis, or pancreatic abscesses may benefit from surgical intervention. Cats with extrahepatic biliary obstruction secondary to severe acute pancreatitis may have a good prognosis.     

Ultrasound-guided retrieval of plant awns

In dogs, surgical removal of plant awns causing a foreign body granuloma or abscess may be challenging. The inability to localize the foreign body during surgical removal often leads to abscess recurrence. In this report, we describe ultrasound-guided retrieval as an alternative to standard surgical retrieval in animals where the plant awn can be identified sonographically. This procedure was used in six dogs with a superficial abscess due to a plant awn, and in all dogs the foreign body was successfully retrieved with Hartmann forceps. No complication was observed and no abscess recurred. Minimally invasive ultrasound-guided plant awn retrieval appears to be a safe effective method of retrieving superficially located plant awns in the dog.     

Partial esophagectomy with single layer closure for treatment of esophageal sarcomas in 6 dogs

OBJECTIVE: To report partial esophagectomy (PE) as a treatment for esophageal sarcoma in dogs. STUDY DESIGN: Retrospective study (2000-2002). ANIMALS: Six dogs with caudal thoracic esophageal tumors. METHODS: Medical records of 6 dogs that had surgical removal of esophageal tumors were reviewed. Signalment, medical history, physical examination results, complete blood count, surgical procedure, tumor classification, postoperative treatment, and complications were retrieved. RESULTS: Esophageal masses were approached by thoracotomy and esophagotomy on the side opposite the mass, removed with 1 cm margins by full thickness excision, and the defects closed with a single layer of interrupted sutures. All dogs recovered rapidly without major complications. Tumors were fibrosarcoma (3 dogs), undifferentiated sarcoma (1), and osteosarcoma (2). Five dogs were administered doxorubicin chemotherapy after surgery. Good quality of life was observed postoperatively in 5 dogs until deterioration necessitated euthanasia; survival ranged from 2-16 months. The remaining dog was alive, 20 months after surgery. CONCLUSIONS: Partial esophagectomy and closure using 1 suture layer, was an effective, simple, and safe technique for removal of sarcomas of the distal thoracic esophagus. CLINICAL RELEVANCE: Removal of esophageal masses by partial esophagectomy can be used reliably as a method of esophageal surgery.     

Paraesophageal hiatal hernia and pyloric obstruction in a dog

Paraesophageal hiatal herniation and pyloric obstruction were diagnosed in a pup with a history of vomiting. Findings of contrast radiography included esophageal reflux, delayed gastric emptying time, and paraesophageal herniation. Exploratory celiotomy revealed increased firmness of the pylorus and a primary defect in the esophageal hiatus, which allowed gastric herniation. Nissen fundoplication was performed following reconstruction of the esophageal hiatus, and pyloroplasty was performed to relieve the gastric outlet obstruction. Pyloric biopsy findings were consistent with a diagnosis of chronic gastritis. Recovery from surgery was initially unremarkable; however, the dog died suddenly 3 weeks after surgery. Necropsy revealed a large diaphragmatic hernia adjacent to the esophageal hiatus; the hernia had resulted in incarceration of the abdominal organs. The hiatal hernia reconstruction remained intact and was not the cause of the diaphragmatic disruption.     

Omentalization of Prostatic Abscesses and Large Cysts in Ferrets (Mustela putorius furo)

Neutered male ferrets are occasionally presented with cystic prostatic disease or prostatic abscesses, most often secondary to elevated, circulating sex steroid hormones caused by adrenocortical disease. Useful features of the omentum, such as tissue adhesion, angiogenesis, and stimulation of the immune system, can be used for surgical treatment of large prostatic cysts and abscesses. Two cases of prostatic abscess omentalization are described. In one case, the underlying cause was a sustentacular (Sertoli cell) tumor associated with a retained testicle. In the other case, adrenocortical disease was determined to be the underlying disease. The first ferret had a residual prostatic abscess 5 months after omentalization. A small, residual prostatic cyst was detected by ultrasound in the second ferret 9 weeks after surgery. Although omentalization may be an effective technique to surgically manage large prostatic cysts and abscesses in ferrets, clinical studies comparing omentalization with other surgical and nonsurgical methods are needed in this species.     

Esophageal phytobezoar in a horse

A 23-year-old Thoroughbred stallion was admitted to the hospital for treatment of acute esophageal obstruction. Clinical examination and contrast radiography confirmed the presence of an esophageal obstruction. The horse was euthanatized, and examination revealed a bolus of feed material occluding the esophageal lumen 6 cm caudal to the thoracic inlet, with underlying necrosis of the esophageal mucosa. A large pulsion diverticulum was identified in the caudocervical portion of the esophagus. Apparently, the phytobezoar was formed within the esophageal diverticulum and subsequently became dislodged, occluding the esophagus.     

Acute Oropharyngeal and Esophageal Stick Injury in Forty‐One Dogs

Objective— To report clinical findings, treatment, and outcome in dogs with acute (<7 days) oropharyngeal or esophageal stick injury. Study Design— Retrospective study. Animals— Dogs (n=41) with acute oropharyngeal or esophageal injury. Methods— Dogs had clinical and radiographic examination, and frequently, cervical surgical exploration. The decision to operate was based on radiographic findings of cervical emphysema. Outcome was determined by owner or veterinarian interview. Results— Of 41 dogs, 27 had oropharyngeal injury and 14 had esophageal injury. Five dogs with esophageal injury died. All dogs with radiographic evidence of cervical emphysema (n=34) had ventral median cervical exploration or necropsy; 11 had wood fragment(s) retrieved. In 7 dogs without radiographic signs of cervical emphysema, wounds involving the pharynx or soft palate were treated by local debridement and lavage using an oral approach. Mean follow‐up time was 36.4 months. All wounds healed without complication; however, 1 dog that was not surgically explored had a piece of wood surgically retrieved 3 months later. Conclusions— Radiographic evidence of cervical emphysema is a frequent finding in dogs with acute penetrating oropharyngeal or esophageal injury and indicates trauma to the deeper cervical tissues. Acute penetrating injury of the oropharyngeal region, when treated appropriately, has a better prognosis than acute esophageal penetration. Clinical Relevance— Ventral median cervical surgical exploration is recommended in dogs with acute penetrating injury of the oropharynx or esophagus if there is radiographic evidence of tissue emphysema.     

Surgical Correction of a Persistent Right Aortic Arch in a Foal

A persistent right fourth aortic arch causing esophageal stenosis was diagnosed in a foal. Presenting signs included cervical swelling that developed following introduction to solid feed at weaning, and symptoms of chronic aspiration pneumonia. The esophagus was distended at the thoracic inlet; neither an endoscope nor a small nasogastric tube could be passed through the strictured esophagus at the heart base. The esophagus was seen to be dilated to the level of the heart base on plain and contrast radiographs. A left lateral thoracotomy through the fifth intercostal space was used to gain access for surgical correction of the defect. Radiographic and clinical evaluation of the foal 2 and 6 months following surgery showed a gradual decrease in size of the esophageal dilatation and an enlargement in the functional diameter of the esophagus at the previously strictured area at the heart base. Ten months following surgery the colt was eating normally and was of normal height and weight.