Cataract phacofragmentation in horses

Cataract surgeries were carried out in fifty-one eyes of 36 horses over a 15-year period. Cataracts were removed using phacofragmentation and aspiration. Useful vision was restored after surgery in 30 horses. One year after surgery 16 of the 19 horses for which follow up information was available were still visual with several still being used as working horses. At 5-6 years after surgery three horses were still visual. The most frequent intraoperative complication was tearing of the posterior lens capsule. The most frequent postoperative problem was superficial corneal ulceration. Four eyes in three horses developed postoperative infectious endophthalmitis resulting in blindness.     

Management and outcome of cats with ureteral calculi: 153 cases (1984-2002)

OBJECTIVE: To determine outcome of medical and surgical treatment in cats with ureteral calculi. DESIGN: Retrospective study. ANIMALS: 153 cats. PROCEDURE: Medical records were reviewed. Owners and referring veterinarians were contacted for follow-up information. RESULTS: All cats were initially treated medically before a decision was made to perform surgery. Medical treatment included parenteral administration of fluids and diuretics to promote urine production and passage of the ureteral calculus and supportive treatment for renal failure. Ureteral calculi in the proximal portion of the ureter were typically removed by ureterotomy, whereas ureteral calculi in the distal portion of the ureter were more likely to be removed by partial ureterectomy and ureteroneocystostomy. Ureterotomy could be performed without placement of a nephrostomy tube for postoperative urine diversion. Postoperative complication rate and perioperative mortality rate were 31% and 18%, respectively. The most common postoperative complications were urine leakage and persistent ureteral obstruction after surgery. Chronic renal failure was common at the time of diagnosis and continued after treatment, with serum creatinine concentration remaining greater than the upper reference limit in approximately half the cats. Twelve-month survival rates after medical and surgical treatment were 66% and 91%, respectively, with a number of cats dying of causes related to urinary tract disorders, including ureteral calculus recurrence and worsening of chronic renal failure. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that medical and surgical management of ureteral calculi in cats are associated with high morbidity and mortality rates. Treatment can stabilize renal function, although many surviving cats will continue to have impaired renal function.     

A survey of antimicrobial use during bovine abdominal surgery by western Canadian veterinarians

Members of the Western Canadian Association of Bovine Practitioners were surveyed regarding their use of antimicrobials in bovine abdominal surgery. Perioperative antimicrobials were used in 100% of abdominal surgeries by 96 of 98 respondents. Although postoperative administration was the most common perioperative period for antimicrobial use, intraoperative intraperitoneal use was reported by more than half of the veterinarians surveyed. Procaine penicillin G and oxytetracycline were the most commonly administered perioperative antimicrobials.     

Retrospective evaluation of maropitant and perioperative factors affecting postoperative appetite in cats

The primary goal of this retrospective study was to evaluate the effect of postoperative appetite return in cats premedicated with maropitant citrate. Medical records of 75 cats admitted for gastrointestinal (GI) and urogenital (UG) surgeries were reviewed and analyzed. Buprenorphine analgesia was used with 36 cats (48%) premedicated with maropitant and 39 cats (52%) that were used as a control group. No significant differences in postoperative appetite return were reported with maropitant premedication compared to controls. Age, breed, preoperative weight, surgery type, surgery and anesthesia times, and total hospitalization time were also evaluated and were not reported to be significantly associated with postoperative appetite return. Presenting complaints of hyporexia or anorexia were significantly associated with earlier postoperative appetite return. Results of this study suggest that cats treated with buprenorphine for GI or UG surgeries do not have postoperative appetites return sooner when premedicated with maropitant.     

Bilateral ureterocystostomy to correct left ureteral atresia and right ureteral ectopia in an 8-month-old standardbred filly

OBJECTIVES: To report the diagnosis and outcome after surgical correction of bilateral distal ureteral anomalies in a Standardbred filly. STUDY DESIGN: Clinical case report. ANIMAL: An 8-month-old, 310 kg Standardbred filly with left ureteral atresia and right ureteral ectopia. METHODS: The filly was admitted for evaluation of incontinence since birth and severe urine scalding of the hindquarters. Diagnosis was made by both direct (cystoscopy and vaginoscopy) and indirect (intravenous pyelography, ultrasonography, and scintigraphy) evaluation of the ureters and bladder. The filly had left ureteral atresia, hydronephrosis, and decreased left-sided renal function and right ureteral ectopia before surgery. Surgical correction was performed on the left by an end-to-side stapled anastomosis technique and on the right by a side-to-side hand-sewn anastomosis technique. RESULTS: Surgical correction was successful. The filly had no postoperative complications and remained continent 18 months after surgery. Left renal function improved. CONCLUSION: Ureteral anomalies can be successfully repaired in larger (>300 kg) foals and some renal function may be restored after surgical correction. CLINICAL RELEVANCE: Scintigraphy should be considered in diagnosis of ureteral anomalies, assessing renal function, and determining prognosis for horses with hydronephrosis caused by ureteral ectopia and atresia.     

Correction of bilateral ureteral defects in a foal

Bilateral ureteral defects were diagnosed as the cause of depression and azotemia in an 8-day-old Thoroughbred filly. The azotemia resulted from accumulation of urine in the retroperitoneal area. A ventral midline laparotomy was performed, and defects found in both the left and right ureter were repaired. Uroperitoneum and abdominal distention, presumably from urine leakage at the left ureteral surgery site, were detected on the fourth postoperative day and necessitated abdominal drainage. Thirty-six hours later, the leakage stopped spontaneously, and the foal recovered normally. This report should help to differentiate ureteral defects in foals from the more common syndrome of ruptured bladder.     

Bilateral rostral maxillectomy and nasal planectomy for large rostral maxillofacial neoplasms in six dogs and one cat

This paper describes in detail an aggressive rostral maxillectomy procedure in one cat and six dogs, and the postoperative complications and outcomes are reported. The surgeries were performed to attempt complete excision of large and extensive rostral maxillary fibrosarcomas (n=4), squamous cell carcinomas (n=2), or poorly differentiated mesenchymal neoplasia (n=1). The surgeries involved transection of the maxilla at the level of premolar (PM)1 and PM2 in a cat and two dogs, and between PM2 and PM3 in four dogs. There were no intraoperative complications. Complete margins of resection were obtained in all cases. The postoperative appearance was acceptable to owners. Local recurrence was only observed in one dog (10 months after surgery) during a follow-up period of 11 to 66 months (median, 21.5 months).     

Comparison of two surgical techniques for management of intramural ureteral ectopia in dogs: 36 cases (1994-2004)

OBJECTIVE: To determine outcome associated with intramural ureteral ectopia treated with 1 of 2 surgical techniques (neoureterostomy with ligation of the distal ureteral segment vs neoureterostomy with resection of the distal ureteral segment) and compare results of these 2 techniques in dogs. DESIGN: Multicenter retrospective case series. ANIMALS: 36 dogs (15 treated with the ligation technique and 21 treated with the resection technique). PROCEDURES: Information was obtained from medical records. Long-term follow-up information was obtained by owner questionnaire. RESULTS: 15 of 21 (71%) dogs in the resection group and 7 of 14 (50%) dogs in the ligation group still had urinary incontinence after surgery. Three of 20 (15%) dogs in the resection group and 4 of 14 (29%) dogs in the ligation group reportedly had multiple episodes of urinary tract infection following surgery. The outcome of surgery was judged to be excellent by the owners of 10 of 18 (56%) dogs in the resection group and 9 of 14 (64%) dogs in the ligation group. No significant differences were found between surgery treatment groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study suggest that although most owners of dogs that undergo surgery for treatment of intramural ureteral ectopia consider the outcome of surgery to be excellent, substantial proportions of dogs will continue to have urinary incontinence and recurrent urinary tract infections after surgery. Findings do not provide any support to the hypothesis that the resection technique is superior to the ligation technique for management of dogs with intramural ureteral ectopia.     

Colic surgery in the horse: a retrospective study of 272 patients

In the period from January 1995 until December 2000, 272 horses underwent a laparotomy for gastrointestinal disorders. The results of these surgeries were evaluated. From these 272 patients 176 (= 65%) were discharged in good health from the hospital. When the patients that were euthanized immediately after the start of the surgery, because of a fatal deterioration, were not taken into account, the short time survival rate was 77%. Strangulated small and large intestinal obstructions (48%) had a lower short time survival rate than non-strangulated obstructions (87%). Fatal postoperative complications occurred in 18% of the patients in which the surgery was completed. Postoperative shock was the most common cause. Non-fatal complications were found in 16% of the patients which survived surgery. The major non-fatal complications were incisional hernia and thrombophlebitis of the jugular vein. From the patients that survived the surgery 81% returned to their former level of performance. Early referral may decrease the percentage of fatal complications and improve the prognoses of surgery.     

Diagnosis and surgical management of ectopic ureters

Ureteral ectopia is a congenital abnormality of the terminal segment of one or both ureters in which the ureteral orifice is located distal to the trigone of the bladder. Continuous or intermittent urinary incontinence is the most frequently reported clinical symptom associated with ureteral ectopia. A variety of anatomic morphologies of ectopic ureters have been reported. Historically, surgical therapy focused on reestablishing drainage of the ureters into the bladder lumen. However, continued urinary incontinence after surgery is the most frequently reported complication. Specific classification and successful management of the various types of ectopic ureters remain diagnostic and therapeutic challenges to the veterinary clinician. Cystoscopic evaluation of the lower urinary tract and urodynamic evaluation of bladder and urethral function has improved the presurgical assessment of the patient. Surgical procedures, which are aimed at repositioning the ureteral orifice(s) within the bladder lumen and treating primary sphincter incompetence, are necessary to successfully manage small animal patients with ectopic ureters.     

Surgery of the scrotum.

Scrotal surgery is common in routine veterinary practice. Many techniques are available for commonly performed surgeries, and most can be accomplished easily in private practice and in the field. Procedures are described for surgical and nonsurgical castration, unilateral castration, inguinal herniorrhaphy, cryptorchidectomy, caudal epididymectomy, and vasectomy. Changes in current thinking about the timing of castration and about pain control in cattle surgery likely will alter the way veterinarians perform scrotal surgery in the years to come.     

Preparation and equipment useful for surgery in small exotic pets.

Because many exotic pets are so small, the instrumentation and equipment used for surgery are different from in larger animals. Magnification greatly improves the surgeon's ability to accomplish surgeries in small patients and helps to provide hemostasis because small amounts of blood are significant in these tiny patients. Microsurgical instrumentation is important to allow for proper tissue handling and suture placement. Various other considerations, instrumentation, and equipment are useful when performing surgery on small exotic pets.     

Miscellaneous surgeries in ferrets.

This article describes the most common extra-abdominal surgeries performed in ferrets, including anal sacculectomy for descenting, mammary and prepucial adenoma or adenocarcinoma removal, chordomas, and perineal urethrostomy. Thoracotomy and special considerations for performing surgery on ferrets also are discussed.     

Urinary Incontinence after Surgical Repair of Ureteral Ectopia in Dogs

Eleven of 20 dogs (55%) were incontinent after surgical treatment of ureteral ectopia. Ureterocystostomy was performed in 15 dogs, ureteral transection and bladder reimplantation in four dogs, and ureteronephrectomy in one dog. Siberian huskies had a significantly higher rate of persistent postoperative incontinence than other breeds. There was no difference in postoperative incontinence between dogs with unilateral and bilateral ectopia. Concurrent bacterial cystitis was not associated with persistent postoperative incontinence. Age at the time of surgical correction had no effect on the rate of postoperative incontinence. Eight incontinent dogs were treated medically; three are continent with medication, three are improved but still incontinent, and two did not improve.     

Attitudes of owners regarding tendonectomy and onychectomy in cats

OBJECTIVE: To compare the incidence of behavior problems following tendonectomy or onychectomy in cats, as well as attitudes of owners following these procedures. DESIGN: Nonrandomized clinical trial. ANIMALS: 18 cats that underwent tendonectomy and 39 cats that underwent onychectomy. PROCEDURE: Owners of cats that underwent tendonectomy or onychectomy between February 1993 and May 1998 were contacted by telephone and asked several questions regarding reasons for surgery as well as complications and behavioral changes in cats following surgery. RESULTS: The most common reason for considering tendonectomy or onychectomy was to avoid damage caused by the cat scratching household materials. Avoidance of injury to humans or animals was chosen more often by owners whose cats underwent onychectomy than those that underwent tendonectomy. Tendonectomy was more likely to have been recommended by veterinarians than onychectomy. Significantly more cats that underwent tendonectomy (67%) than onychectomy (44%) returned to normal activity within 3 days after surgery. Significant differences were not detected regarding behavior problems after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Although tendonectomy and onychectomy involved some medical complications and behavior changes following surgery, owners had positive attitudes regarding both surgeries after the immediate postoperative period. Tendonectomy may be a humane alternative to onychectomy, although owners need to be advised that nail trimming is still necessary in cats after surgery.     

Treatment of experimental ureteral strictures by endourological ureterotomy and implantation of stents in the porcine animal model

The objective of this study is to evaluate the dilation of the ureter using endoureterotomy and an expanding-sheath double pigtail ureteral stent in the treatment of experimentally induced ureteral strictures in the porcine animal model. This is a new treatment in the ureteral strictures resolution in Veterinary Urology, although it is not a common affection, it usually appears as a consequence of ureteritis and in the iatrogenic female genital surgery. The experimental study is design in three phases: induction of experimental stricture, diagnosis and treatment of the stricture and follow-up. We have used 10 healthy Large White female pigs. The internal ureteral diameter was measured prior to laparoscopic ligature stricture induction using retrograde ureteropyelography (RUPG). Experimental stricture was diagnosed 4 weeks after intervention, using RUPG and ultrasound, and treated by endoureterotomy and subsequent placement of a double pigtail ureteral stent, which was removed 6 weeks later. The study finished 4 weeks later with measurement of ureteral diameters using RPUG and ultrasound evaluation. Except in one case, all ureters displayed permanent dilation of the strictured area for 10 weeks after treatment (6 weeks with ureteral stent and 4 more weeks without stent). Finally, this technique proved to be effective in cases of short-length and short-living ureteral strictures, and represents a viable alternative to conventional surgery in animals.     

Secondary approaches to the abdominal cavity for horses with signs of colic may be key to successful resolution of an either very proximal or very distal small colon obstruction

Equine emergency colic surgery is one of the most common surgeries performed. Small colon obstructions (as the cause of the exploratory celiotomy) are relatively infrequently diagnosed (2–5%). The most frequently seen small colon problems are small colon impactions, a small colon faecalith, small colon enterolith(s), small colon lipomas and small colon foreign bodies. Less frequently, a diagnosis of rents in the small colon mesentery, damage to the small colon vascular supply after a foaling accident or intramural masses are made.     

Ultrasonographic determination of resistive index and graft size for evaluating clinical feline renal allografts.

Ultrasonographic examination is a commonly employed technique for postoperative renal allograft evaluation after transplantation. Allograft size and resistive index (RI) are two objective ultrasonographic measures that may help establish a diagnosis and direct postoperative management for grafts with suboptimal function but their diagnostic efficacy has not been evaluated in clinical veterinary patients. Results of 69 feline renal transplant ultrasonographic examinations and RI determinations were studied. Based on clinical parameters at the time of the ultrasonographic examination, patients were grouped into six clinical/functional categories including evaluations of clinically normal grafts, delayed graft function, ureteral obstruction, uroabdomen, graft thrombosis, and rejection. RI, graft size (length, cross-sectional area, and volume), cyclosporine A whole blood trough concentration, Doppler blood pressure, creatinine concentration, and days from transplantation were compared between these categories and associations with each other were examined. RI was of little value in differentiating among the clinical categories with the exception of graft thrombosis. Graft volume and time from transplantation were significantly greater in grafts with signs of rejection and ureteral obstruction compared to clinically normal ultrasound examinations. Graft volume, cross-sectional area and length were generally associated. Cyclosporine A blood concentrations was associated with RI in both the pooled data and in the delayed graft function category. These results indicate RI should be used only as part of a larger clinical picture and in light of other factors including cyclosporine A concentration and the timing of the study relative to the implantation surgery for the diagnosis of postoperative transplantation complications. Graft volume may provide a more sensitive, albeit, nonspecific, indicator of allograft dysfunction.     

Ureteral obstructions in dogs and cats: a review of traditional and new interventional diagnostic and therapeutic options

Objective – To describe and review both traditional and newer diagnostic and therapeutic options for canine and feline ureteral obstructions currently being performed clinically in veterinary medicine. Data Sources – A Medline search with no date restrictions was used for this review. Human Data Synthesis – The human literature would support the use of minimally invasive endourological techniques for the treatment of nearly all causes of ureteral obstructions, whenever possible. This typically includes extracorporeal shockwave lithotripsy, intracorporeal lithotripsy via retrograde ureteroscopy or antegrade percutaneous nephroureterolithotomy, ureteral stenting, percutaneous nephrostomy tube placement, and laparoscopic endopyelotomy. Typically open surgery is only suggested in cases of ureteral or gynecological malignancy when en bloc resection is considered a good option, or when various methods of endourological techniques have failed. Veterinary Data Synthesis – The veterinary literature is scarce on the use of interventional endourological techniques for the treatment of ureteral obstructions and has been growing over the last 5 years. The current literature reports the use of extracorporeal shockwave lithotripsy for ureteral stones, as well as the use of ureteral stents for the treatment of trigonal obstructive transitional cell carcinoma, ureterolithiasis, and ureteral strictures. Traditional surgical interventions, like ureterotomy, ureteronephrectomy, and ureteral reimplantation is more vastly reported and accepted. This review will focus on new clinical data using interventional endourological techniques for ureteral obstructions. Conclusions – Various treatment options for ureteral obstructions are now available for veterinary patients, and the trend away from traditional surgical techniques will hopefully be followed now that they are technically and clinically available for dogs and cats.     

Complications observed during and after ovariohysterectomy of 142 bitches at a veterinary teaching hospital

The clinical, anaesthetic and surgical records of 142 bitches admitted into the primary care clinic at the Small Animal Hospital, University of Liverpool, between January 2002 and August 2004 for routine ovariohysterectomy by final-year students were analysed for complications during and after the surgery. The time taken to perform the surgical procedure was recorded, to allow assessment of the time involved in one-to-one surgical teaching during live-recovery surgeries of client-owned pets. The types of complications were similar to those reported in earlier studies: nine bitches suffered haemorrhage of the ovarian arteries during surgery, and there were four cases of haemorrhage after surgery, 12 cases of wound inflammation and four other types of complication. The rates of intraoperative, postoperative and total complications were 6.3, 14.1 and 20.6 per cent, respectively.