PARACLOACAL GLAND CARCINOMA IN A SUGAR GLIDER (PETAURUS BREVICEPS)

A male sugar glider (Petaurus breviceps) was presented to the National Taiwan University Veterinary hospital for repeated self-mutilation of the cloacal region. After correction of husbandry deficiencies and medical management of the lesion, the condition improved but a pericloacal mass was found. Surgical removal of the mass resolved the self-mutilation, and a dorsal paracloacal gland carcinoma was diagnosed on histopathological examination. Straining to defecate and a pericloacal mass could indicate neoplasia in sugar gliders. A tumor should be differentiated from chronic inflammation, infection, paracloacal gland impaction, and hyperplasia. Surgical removal is recommended as a treatment for paracloacal gland carcinoma in sugar gliders. Further monitoring is suggested after surgical removal of the tumor.     

Principles of wound management of small mammals: hedgehogs, prairie dogs, and sugar gliders.

The management of wounds is a common scenario for the exotic animal practitioner. When presented with such cases, the practitioner must first adhere to the firmly established principles of wound healing, and then modify available treatment modalities to fit the needs of the species at hand. Practicing wound management on exotic patients can be challenging due to their small size, unusual anatomy, difficult behaviors, and tendency for developing secondary stress-related health problems. A review of the stages of wound healing as well as traditional wound management techniques is provided here. This review is followed by a summary of typical wounds encountered in hedgehogs, prairie dogs, and sugar gliders, as well anatomic, physiologic, and behavioral characteristics that should be taken into consideration when managing wounds on such species.     

Comparison of two topical treatments on wound healing 7 days after disbudding of calves using thermocautery

ABSTRACT

Aims To compare wound healing 7 days after cautery disbudding of dairy calves treated immediately after disbudding with a traditional antimicrobial spray (OXY) or with a topical anaesthetic gel containing cetrimide, adrenaline and two local anaesthetics, lignocaine and bupivacaine (TA).

Method Eighty-one female dairy calves between 6–8 weeks of age were disbudded using a standard cautery disbudding protocol (sedation, cornual block, and analgesia), with complete removal of the horn bud. After disbudding, the wound on the right and left horn buds within each animal were randomly allocated to receive either OXY or TA. One week after disbudding, wounds were visually assessed for the presence of exudate, necrotic tissue, crust, or granulation tissue which were each assigned a grade from 1–3, where 1?=?no evidence, 2?=?moderate presence; and 3?=?marked presence.

Results At 7 days after disbudding, the prevalence of wounds with exudate or necrotic tissue was very low, and independent of treatment. The odds of a disbudding wound treated with TA being scored as having granulation tissue and was 5.2 (95% CI?=?1.72–15.7) times that of a wound treated with OXY. Conversely, the odds of wounds treated with TA being scored as having crusts was 0.18 (95% CI?=?0.06–0.57) that of a wound treated with OXY. No sign of infection was seen in any calves.

Conclusion and clinical relevance The greater prevalence of granulation tissue and reduction in crusting in disbudding wounds treated with topical anaesthetic gel compared to those treated with the antimicrobial spray suggests that use of the topical anaesthetic gel may speed wound healing compared to using antimicrobial spray. This should be further tested in a larger study undertaken over a longer period.     

High pressure pulsatile lavage and high pressure syringe lavage in the treatment of contaminated wounds in dogs

The effectiveness of high pressure pulsatile lavage and syringe lavage in cleansing experimentally contaminated and infected wounds was studied. Such treatment significantly (P < 0.05) lowered the bacterial counts in contaminated wounds, but high pressure pulsatile lavage caused extensive damage to tissue and was considered to be unsuitable for treatment of wounds in the loose skin areas of the dog. Both pulsatile and syringe lavage caused significant (P < 0.05), but transient, reduction in the bacterial counts in infected wounds but both methods failed to lower the wound bacterial counts to 10⁵ or less. Successive wound biopsies for quantitative bacterial analysis showed that syringe lavage with povidone-iodine caused greater reduction in bacterial numbers than did pulsatile lavage with povidone-iodine. Combination of high pressure syringe lavage with povidone-iodine and systemic penicillin-streptomycin given at the time of lavage sufficiently reduced the bacterial numbers to allow for safe closure of the wounds.     

Prepubic urethrostomy and placement of a caudal superficial epigastric flap for treatment of a self-mutilation injury in a serval

A 10-year-old male serval was examined for treatment of a self-inflicted perineal wound that obliterated the ventral anocutaneous junction, penis, scrotum, testicles, and proximal portions of the caudomedial thigh muscles. Repair required placement of a caudal superficial epigastric flap and prepubic urethrostomy. Although it is generally preferable to delay repair of contaminated wounds until a healthy wound bed is established, circumstances related to wound location, affected tissues, and patient compliance led to a decision for immediate wound closure. In this serval, a history of food intolerance, recent diet change, eosinophilia, and eosinophilic granuloma-like skin lesions suggested that the self-mutilation injury was a result of food hypersensitivity, although foreign body or a spider bite could not be ruled out.     

Evaluation of LHP? (1% hydrogen peroxide) cream versus petrolatum and untreated controls in open wounds in healthy horses: a randomized,blinded control study

Background

Treatment and protection of wounds in horses can be challenging; protecting bandages may be difficult to apply on the proximal extremities and the body. Unprotected wounds carry an increased risk of bacterial contamination and subsequent infection which can lead to delayed wound healing. Topical treatment with antimicrobials is one possibility to prevent bacterial colonization or infection, but the frequent use of antimicrobials ultimately leads to development of bacterial resistance which is an increasing concern in both human and veterinary medicine.

Methods

Standardized wounds were created in 10 Standardbred mares. Three wounds were made in each horse. Two wounds were randomly treated with LHP^® or petrolatum and the third wound served as untreated control. All wounds were assessed daily until complete epithelization. Protocol data were recorded on day 2, 6, 11, 16, 21 and 28. Data included clinical scores for inflammation and healing, photoplanimetry for calculating wound areas and swab cytology to assess bacterial colonization and inflammation. Bacterial cultures were obtained on day 2, 6 and 16.

Results

Mean time to complete healing for LHP^® treated wounds was 32 days (95%CI = 26.9-37.7). Mean time to complete healing for petrolatum and untreated control wounds were 41.6 days (95%CI = 36.2-47.0) and 44.0 days (95%CI = 38.6-49.4) respectively. Wound healing occurred significantly faster in LHP^® wounds compared to both petrolatum (p = 0.0004) and untreated controls (p < 0.0001). There was no significant difference in time for healing between petrolatum and untreated controls. Total scores for bacteria and neutrophils were significantly (p < 0.0001) lower for LHP^® treated wounds compared to petrolatum from day 16 and onwards. Staphylococcus aureus and Streptococcus zooepidemicus were only found in cultures from petrolatum treated wounds and untreated controls.

Conclusions

Treatment with LHP^® reduced bacterial colonization and was associated with earlier complete wound healing. LHP^® cream appears to be safe and effective for topical wound treatment or wound protection.     

Treatment of pigs with enrofloxacin via different oral dosage forms – environmental contaminations and resistance development of Escherichia coli

BackgroundAntibacterial agents play important roles in the treatment of bacterial infections. However, the development of antimicrobial resistance (AMR) and carry-over of substances into the environment are several problems arising during oral treatment of bacterial infections. We assessed AMR development in commensal Escherichia coli (E. coli) in enrofloxacin treated and untreated animals. In addition, we examined fluoroquinolone in the plasma and urine of treated and untreated animals, and in sedimentation dust and aerosol.MethodsIn each trial, six pigs were treated with enrofloxacin via powder, granulate or pellet forms in two time periods (days 1–5 and 22–26). Four pigs served as untreated controls. The minimum inhibitory concentration (MIC) was determined to evaluate AMR development. Analysis of enro- and ciprofloxacin was performed with high performance liquid chromatography.ResultsNon-wildtype E. coli (MIC > 0.125 µg/mL) was detected in the pellet treated group after the first treatment period, whereas in the other groups, non-wildtype isolates were found after the second treatment period. E. coli with MIC > 4 µg/mL was found in only the pellet trial. Untreated animals showed similar susceptibility shifts several days later. Bioavailability differed among the treatment forms (granulate > pellet > powder). Enro- and ciprofloxacin were detected in aerosols and sedimentation dust (granulate, powder > pellet).ConclusionsThis study indicates that the kind of the oral dosage form of antibiotics affects environmental contamination and AMR development in commensal E. coli in treated and untreated pigs.     

Mupirocin, fusidic acid and bacitracin: activity, action and clinical uses of three topical antibiotics

Antibiotics applied to the skin must be formulated in a base that is nonirritant and nontoxic. They may have a narrow or fairly wide spectrum of activity but should produce no local reaction or sensitization; the commensal flora should not be affected unduly. Three antibiotics that have been used topically in humans and animals are fusidic acid, mupirocin and bacitracin, all of which have a narrow antibacterial spectrum. When applied to intact skin, fusidic acid penetrates more rapidly than other antibiotics. Clinically, the frequency of staphylococcal resistance to it and to mupirocin has remained low. Fusidic acid and mupirocin have been recommended for the treatment of acute staphylococcal skin lesions. However, the use of topical antibiotics for the treatment of chronic or recurring dermatitis and surgical or infected wounds may be inappropriate because of possible development of resistance and sensitization. Topical use of bacitracin may produce treatment failure and sensitization.     

Fatal anemia and dermatitis in captive agoutis (Dasyprocta mexicana) infested with Echidnophaga fleas

Two captive agoutis (Dasyprocta mexicana) died of anemia with centrilobular hepatocellular necrosis (2/2), severe flea ectoparasitism (2/2), and cardiomegaly attributed to anemia (1/2). Other agoutis were similarly parasitized and one had anemia. Fleas were manually removed and all agoutis treated topically with propoxur and selamectin and moved to another enclosure. No additional cases of fatal anemia were seen. Cutaneous lesions suggestive of hypersensitivity were observed in three additional agoutis with dorsal alopecia (3/3), a penetrating wound associated with pruritus and self-mutilation in the flank (2/3), flea ectoparasitism at the time of morphologic diagnosis (1/3), and hyperplastic perivascular dermatitis (3/3). One of these died of bacterial infection of the wound. Similar but milder skin disease was seen in 3 out of over 30 maras (Dolichotis patagonum) housed in the same exhibit. Fleas collected from all the fatal agouti cases and maras were classified in the genus Echidnophaga based on the angular front margin of head, contracted thorax, absence of genal and pronotal combs, and the fact that fleas did not jump. These findings suggest that flea ectoparasitism may be an important cause of morbidity and mortality in captive rodents.     

Effect of a single acupuncture treatment on surgical wound healing in dogs: a randomized,single blinded,controlled pilot study

Background

The aim of the study was to investigate the effect of acupuncture on wound healing after soft tissue or orthopaedic surgery in dogs.

Methods

29 dogs were submitted to soft tissue and/or orthopaedic surgeries. Five dogs had two surgical wounds each, so there were totally 34 wounds in the study. All owners received instructions for post operative care as well as antibiotic and pain treatment. The dogs were randomly assigned to treatment or control groups. Treated dogs received one dry needle acupuncture treatment right after surgery and the control group received no such treatment. A veterinary surgeon that was blinded to the treatment, evaluated the wounds at three and seven days after surgery in regard to oedema (scale 0-3), scabs (yes/no), exudate (yes/no), hematoma (yes/no), dermatitis (yes/no), and aspect of the wound (dry/humid).

Results

There was no significant difference between the treatment and control groups in the variables evaluated three and seven days after surgery. However, oedema reduced significantly in the group treated with acupuncture at seven days compared to three days after surgery, possibly due the fact that there was more oedema in the treatment group at day three (although this difference was nor significant between groups).

Conclusions

The use of a single acupuncture treatment right after surgery in dogs did not appear to have any beneficial effects in surgical wound healing.     

DIETARY VITAMIN D3 INFLUENCE ON SERUM 25-HYDROXY VITAMIN D CONCENTRATIONS IN CAPTIVE SUGAR GLIDERS (PETAURUS BREVICEPS)

A pilot study was performed to investigate the impact of dietary vitamin D on circulating 25-hydroxyvitamin D (25[OH]D) metabolite concentrations in sugar gliders (Petaurus breviceps). The study with diets containing 0, 0.2 (low), or 0.4 (moderate) International Units vitamin D₃ per gram of dry matter and fed to adults at 2 locations. Serum 25[OH]D concentrations did not differ between animals fed produce only (no added vitamin D–either D₂ or D₃) for 3 weeks (8.83 ± 0.98 nmol/L), n?=?6, or low dietary levels (7.86 ± 3.80 nmol/L), n?=?7, continuously for multiple years. Conversely, animals consuming diets containing moderate vitamin D₃ levels displayed increased circulating concentrations (15.00 ± 3.59), n?=?8, after 3 weeks. Despite the response to diets supplemented with vitamin D, overall metabolite levels were low and may indicate minimal metabolic dependence on this nutrient in sugar gliders, similar to processes documented in other hindgut fermenters.     

Multi-drug-resistant Enterococcus spp. as a cause of non-responsive septic synovitis in three horses

Abstract

CASE HISTORY: Three Thoroughbred horses, a 6-week-old filly (Case 1), a 15-year-old broodmare (Case 2) and a yearling filly (Case 3), sustained synovial sepsis secondary to trauma.

CLINICAL FINDINGS: Case 1 presented with a heel bulb laceration communicating with the distal interphalangeal joint. Arthroscopic lavage was performed and treatment commenced using systemic and local broad spectrum antimicrobial drugs. A pure growth of multi-drug-resistant (MDR) Enterococcus gallinarum was cultured from samples of synovium and joint fluid. Antimicrobial treatment was changed according to the susceptibility results. Response to treatment was poor and despite repeat arthroscopic lavage and intra-osseous regional perfusion of antimicrobials the filly was subject to euthanasia 24 days after the initial injury. Post-mortem examination confirmed septic synovitis, cartilage degeneration and osteomyelitis.

Case 2 sustained a full thickness wound to the carpus which was sharply debrided and closed. The wound dehisced with effusion within the tendon sheath. Drainage was established and treatment included systemic broad spectrum antimicrobials, topical lavage with povodine-iodine and manuka honey infusion. A mixed infection including MDR Enterococcus faecalis was cultured from the synovial fluid. Antebrachiocarpal joint effusion developed 21 days after initial injury and joint sepsis was confirmed. Arthroscopic lavage and tendon sheath debridement were performed, followed by treatment with systemic and local antimicrobials. The mare improved and was discharged. Three months later lameness recurred and corticosteroids were administered intra-articularly. The mare became non-weight bearing lame and was subject to euthanasia. Post-mortem examination confirmed joint sepsis of the antebrachiocarpal and intercarpal joint.

Case 3 presented with a complete articular open fracture of the tibial crest. Under general anaesthesia the fracture was stabilised and the wounds debrided and closed. Systemic broad-spectrum antimicrobials were administered. Six days later the wound dehisced and a bone fragment was removed. Three weeks post-surgery the wound deteriorated with a purulent discharge. Culture of the discharge revealed a mixed bacterial infection, including a MDR Enterococcus faecalis. Femoropatellar joint involvement was confirmed, and treatment included joint lavage, local and systemic antibiosis, and manuka honey instilled into the wound. The filly initially improved, and then deteriorated such that euthanasia was performed.

DIAGNOSIS: All three cases had synovial sepsis with MDR Enterococcus spp.

CLINICAL RELEVANCE: Increased awareness of MDR pathogens in equine wound infections is essential. Prompt diagnostic testing, appropriate therapy, infection control strategies and on-going monitoring and management are vital to limit the clinical impact of these organisms.     

The use of vacuum-assisted closure therapy for the treatment of distal extremity wounds in 15 dogs

Objective— To evaluate clinical outcome after vacuum-assisted closure (VAC) therapy in dogs with traumatic wounds located in the distal extremities and report our early experience with VAC.
Study Design— Retrospective study.
Animals— Dogs (n=15) with traumatic distal extremity wounds.
Methods— Medical records (1999–2003) of dogs with traumatic injuries to the distal extremities managed by VAC were evaluated. Data included signalment, location of wound, time until surgical intervention, wound reconstruction methods, orthopedic procedures, outcome, complications associated with VAC, and length of hospitalization.
Results— The mean number of days until reconstruction was 4.6 days (range, 2–7 days). Reconstructive surgery was successful in all cases. Mean hospitalization was 9.7 days (range, 6–16 days). Complications included dermatitis at the wound margin and loss of vacuum causing wound desiccation.
Conclusion— VAC therapy can be used to achieve adequate management of traumatic distal extremity wounds. VAC provides an effective method of securing skin grafts over the wound bed.
Clinical Relevance— VAC therapy can be used as an ancillary treatment for distal extremity wounds in dogs before surgical repair as well as a method for securing skin grafts to the wound bed.     

Superficial Osteitis and Sequestrum Formation as a Result of Skin Avulsion in the Horse

Metatarsal injuries with exposed bone are described in seven horses. Superficial osteitis and sequestrum formation occurred in six of the seven horses. The basic pathophysiology includes local vascular stasis leading to ischemic necrosis of osteocytes and establishment of bacterial infection within dead bone. Radiographic features of superficial osteitis and sequestrum formation include reactive periosteal new bone formation, an area of radiodense necrotic bone (sequestrum) surrounded by a radiolucent zone of granulation tissue, which in turn, is surrounded by an area of increased radiodensity (involucrum). The presence of a sequestrum may usually be confirmed radiographically by 12–14 days after injury. Surgical management included wound debridement, wound irrigation, bandaging or casting, sequestrectomy and skin grafting. Five of the seven patients required sequestrectomy, in one the sequestrum disappeared without removal. Mixed bacterial populations were commonly found in the wounds. No specific etiologic agent was associated with sequestrum formation.     

Effect of Porcine Small Intestinal Submucosa on Acute Full-Thickness Wounds in Dogs

Objective— To evaluate the effects of porcine small intestinal submucosa (PSIS) on the healing of full-thickness wounds in dogs, specifically the appearance of granulation tissue, percent epithelialization and contraction, histologic variables of inflammation and repair, and aerobic culture results.
Study Design— Prospective, controlled, experimental study.
Animals— Purpose-bred, female dogs (n=10).
Methods— Wounds were created bilaterally on the trunk; 1 side as a control and 1 treated with PSIS. First appearance of granulation tissue was recorded. Total wound area, open wound area, and epithelialized area were measured at 21 time points—wound contraction and percent epithelialization were calculated. Aerobic cultures were taken at 4 time points and wound biopsies at 8. Histologic features were graded into an Acute Inflammation Score and Repair Score.
Results— There was no difference in first appearance of granulation tissue between PSIS-treated and control wounds. Wound contraction was significantly faster in control wounds as was percent epithelialization after day 21. Histologic Acute Inflammation Scores were significantly higher in PSIS-treated wounds compared with control wounds on days 2 and 6. There were no differences in Histologic Repair Scores between PSIS-treated and control wounds or in aerobic culture results.
Conclusion— Wounds treated with PSIS contract more slowly, epithelialize less, and have more pronounced acute inflammation after implantation than control wounds.
Clinical Relevance— Acute, full-thickness wounds in dogs do not benefit from treatment with PSIS.     

Penetrating thoracic injury with associated abdominal visceral involvement in a mare

A mare was presented for evaluation of a penetrating thoracic injury. Surgical exploration of the thoracic wound was performed, revealing diaphragmatic perforation and the presence of a foreign body lodged in the right dorsal colon. The foreign body was removed through the thoracic deficit, the colon repaired and the thoracic wound closed utilising a latissimus dorsi muscle flap. It can be concluded that successful management of thoracic wounds with concurrent abdominal viscera involvement is achievable if minimal contamination is evident. In addition reconstruction of large thoracic defects with primary muscle flaps is a viable option in the horse.     

Evaluation of the clinical presentation and histologic lesions of hepatic copper accumulation in sugar gliders (Petaurus breviceps)

Hepatic toxicosis caused by copper accumulation has been reported in most domestic species, as well as multiple small exotic mammals, including ferrets, fruit bats, and sugar gliders. The purpose of this study was to determine the signalments, clinical presentations, and histologic findings associated with hepatic copper accumulation in sugar gliders based on post-mortem histologic findings and retrospective analysis of reported antemortem clinical signs. Sugar gliders with histologic evidence of various hepatopathies were identified within the Northwest ZooPath archive. Sections of formalin-fixed, paraffin-embedded hepatic samples were stained for copper, and copper deposition was graded semiquantitatively. The prevalence of copper accumulation in the evaluated hepatopathies was 28%. Copper deposition was seen in all individuals with icterus and non-ataxia neurologic signs. Grossly, individuals with hepatic masses and nodules were 5.50 times more likely to have hepatic copper accumulation. Sugar gliders with biliary hyperplasia were 16.20 times more likely to have copper accumulation while all individuals with cholestasis had hepatic copper accumulation. The results of this study indicate that hepatic copper accumulation is frequently identified in post-mortem evaluation of sugar gliders with hepatopathy. Copper accumulation is frequently noted in individuals with icterus, neurologic abnormalities, hepatic masses, biliary hyperplasia, and cholestasis. This study details the prevalence of hepatic copper accumulation in sugar gliders and illustrates associations between copper hepatotoxicosis and other hepatic diseases.     

Wounds of the pastern and foot region managed with phalangeal casts: 50 cases in 49 horses (1995–2006)

Objective   Describe the use of a phalangeal cast as treatment for wounds in the pastern and foot region of horses. Secondly, to evaluate the healing and soundness of horses treated with phalangeal casts.
Design   Retrospective study of 49 horses.
Procedures   Medical records of 49 horses that were treated with a phalangeal cast for 50 cases of wounds in the pastern and foot region at equine referral hospitals from 1995 to 2006 were reviewed and follow-up information was obtained.
Results   Treatment consisted of wound debridement, lavage, wound closure (28 wounds), cast application and antibiotics (84%). At follow-up, the majority of horses were sound (42 of 47 wounds, 89.4%), three horses were still lame and one horse was euthanased because of persistent lameness. Three horses were lost to follow-up. There was no statistical difference between the outcomes of horses treated acutely (<24 h) or after a 24-h delay. Similarly, the involvement of synovial structures in the wound did not significantly influence outcome.
Conclusions   In this study, wounds involving the pastern and foot that were treated with a phalangeal cast carried a good prognosis for soundness (89.4%) and cosmetic healing (89.5%). The phalangeal casts were well-tolerated and effective.     

Assessment of a caudal external thoracic artery axial pattern flap for treatment of sternal cutaneous wounds in birds

OBJECTIVE: To assess the use of a caudal external thoracic artery axial pattern flap to treat sternal cutaneous wounds in birds. ANIMALS: 16 adult Japanese quail. PROCEDURE: A cutaneous defect in the region of the mid-sternum was surgically created in all quail. In 6 quail (group I), an axial pattern flap was created from the skin of the lateral aspect of the thorax and advanced over the sternal defect. In 8 quail (group II), a flap was similarly created and advanced but the flap vasculature was ligated. All quail were euthanatized at 14 days after surgery and had necropsies performed. Sections of the flap and the surrounding tissue were examined histologically to assess flap viability. RESULTS: All axial pattern flaps in group-I quail had 100% survival. In group II, mean percentage area of flap survival was 62.5%; mean area of necrosis and dermal fibrosis of flaps were significantly greater than that detected in group I. In flaps of group-II quail, neovascularization in the deep dermis and profound necrosis of the vascular plexus in the superficial dermis were observed. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that the caudal external thoracic artery axial pattern flap could be used successfully in the treatment of surgically created sternal cutaneous defects in quail with no signs of tissue necrosis or adverse effects overall. Use of this technique to treat self-mutilation syndromes or application after surgical debulking of tumors or other masses might be beneficial in many avian species.