Surgical cytoreduction for the treatment of non-lymphoid vertebral and spinal cord neoplasms in cats: retrospective evaluation of 26 cases (1990–2005)

Medical records of 26 cats with non‐lymphoid vertebral and spinal cord neoplasms treated surgically were reviewed to determine outcome and prognostic factors for survival. Of the factors examined, only tumour phenotype was significantly associated with survival. Osteosarcoma (3/26 cats) and meningioma (16/26 cats) were the most common malignant and benign tumours, respectively. The median survival time for cats with malignant neoplasms was 110.5 days, compared with 518 days for cats with benign tumours. Cytoreductive surgery resulted in clinical improvement in 25/26 cats, but local treatment failure occurred in 10/26 cats. Overall, 19/26 cats died of confirmed (12/19) or suspected (7/19) tumour‐related causes, including all eight cats with malignant neoplasms. Results suggest that contemporary neurosurgical techniques commonly result in incomplete excision of feline non‐lymphoid vertebral and spinal cord tumours but are efficacious at palliation of clinical signs of spinal cord dysfunction.     

Palmar or plantar process fractures of the distal phalanx in riding horses: 22 cases (1994–2003)

No case series exists in the literature describing palmar/plantar process fractures (PPFs) of the distal phalanx in a nonracehorse population. We aim to describe the distribution of these injuries, together with their clinical, radiographic and scintigraphic features. In a retrospective case study, horses were selected based on radiographic evidence of a PPF. Data were collected relating to clinical and lameness examination, radiography, scintigraphy, management and follow‐up information. Oblique and flexed oblique radiographic views of the distal phalanx are the most sensitive in detecting PPFs of the distal phalanx and this study concluded that fractures of palmar or plantar process are likely to be missed in horses showing mild lameness if oblique radiographic views of the palmar process are not included.     

Left atrial rupture in dogs: 14 cases (1990–2005)

Objective: To describe the clinical parameters, treatment, and prognosis of dogs with left atrial rupture secondary to chronic mitral valve insufficiency. Design: Retrospective study. Setting: University referral hospital. Animals: 14 dogs with left atrial rupture. Interventions: None. Measurements and main results: Mixed breed dogs (n=6, 43%) and Shetland Sheepdogs (n=3, 21%) were most commonly affected. The median age was 12 years (range 5.8–18 y). The median weight was 11 kg (range 4–30 kg). Eight dogs had been previously diagnosed with chronic valvular disease. The most common presenting complaints included collapse (13/14), cough (9/14), and dyspnea (8/14). Four dogs were presented in either respiratory or cardiac arrest. Pericardial effusion was present in 13 dogs. The median left atrium:aortic outflow ratio was 2.66 (range 1.66:1–5.52:1). Pericardiocentesis was performed to alleviate tamponade in 3 dogs. Five dogs were discharged from the hospital, 3 of which were euthanized within 35 days of initial diagnosis for recurrence of clinical signs (n=2) and for hematochezia and lethargy (n=1). Five dogs were euthanized while in the hospital for a variety of reasons including DIC, progressive azotemia, collapse and recurrence of pericardial effusion, or possible seizure episode. Conclusions: Although rare, left atrial rupture resulting in pericardial effusion should be considered in older small‐ to medium‐sized dogs presenting with collapse, cough, and dyspnea. The overall prognosis appears poor.     

Survival and factors affecting survival in small ruminants and camelids attacked by dogs: 62 cases (1994–2004)

Objective: To determine the survival rates and factors affecting survival in small ruminants and camelids attacked by dogs. Design: Retrospective study. Setting: Two university teaching hospitals. Animals: Thirty goats, 28 sheep, 3 alpacas, and 1 llama. Measurements and main results: Medical records were reviewed to obtain signalment, time between injury and admission, hospitalization length, lesion site, treatment, complications, survival rate, and cost. Follow‐up information was obtained by telephone conversation with the owner. Sixty‐two patients met the inclusion criteria. Six animals were euthanized at admission and thus excluded. Of the 56 animals that were treated, 43 (77%) were discharged, 5 (9%) died, and 8 (14%) were euthanized. Animals that had thoracic or abdominal injuries, required surgery, or received more potent analgesic therapy were less likely to survive to discharge from hospital compared with animals that did not. Complications developed in 50 (82%) animals. Animals with respiratory complications were also less likely to survive to discharge from hospital than animals that did not. Long‐term follow up was available on 38/43 (88%) animals that were discharged. Thirty‐five of 38 (92%) animals were discharged and recovered from their injuries and 5 animals had long‐term complications. Conclusions: Small ruminants and camelids that are attacked by dogs have a good prognosis for short‐term survival. Short‐term survival is affected by lesion location and complications.     

Thrombocytopenia in Horses: 35 Cases (1989–1994)

The records of 3,952 equine patients presenting to the Veterinary Teaching Hospital at North Carolina State University College of Veterinary Medicine were evaluated to determine risk factors associated with thrombocytopenia. Of 2,346 horses from which a CBC was obtained, 35 (1.49%) were thrombocytopenic (platelet count < 75,000/μL). A reference population of 189 horses with normal platelet counts (75,000 to 300,000/μL) was also studied. Standardbred horses were at increased risk for thrombocytopenia. but age and gender were not identified as significant risk factors. Horses with infectious or inflammatory diseases were at increased risk for thrombocytopenia. The potential association of clinical and clinicopathologic factors with thrombocytopenia were assessed by reviewing a series of multiple logistic regression models. Clinical and clinicopathologic variables significantly associated with thrombocytopenia in the final model included increased PCV, increased band neutrophil count, increased total WBC, and decreased plasma protein concentration. Increased mature neutrophil count was associated with normal platelet counts. Thrombocytopenic horses were significantly more likely to die or be euthanized than were horses with normal platelet counts. J Vet Intern Med 1996;10:127–132. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

Thrombocytosis in 24 Horses (1989–1994)

The records of horses presented to the Veterinary Teaching Hospital of North Carolina State University College of Veterinary Medicine between January 1, 1989 and April 30, 1994 were evaluated to determine risk factors associated with thrombocytosis. Of the 2,346 horses for which a CBC was performed, 24 (1.0%) had a platelet count > 400,000/μL. Demographic, diagnostic, physical examination, and clinicopathologic variables from these cases were compared with a reference population consisting of 189 horses with a normal platelet count presenting during the same period. Infectious/inflammatory disorders were observed more commonly in horses with high platelet counts than in horses with normal platelet counts. Initial independent evaluation of demographic variables revealed that horses more than 3 years of age, females, and geldings were less likely to have thrombocytosis than were younger horses or stallions. Independent analysis of clinicopathologic variables revealed that horses with thrombocytosis were more likely to have hyper-fibrinogenemia, leukocytosis, hypoproteinemia, and anemia than were horses with normal platelet counts. Physical examination parameters associated with thrombocytosis included tachycardia and pyrexia. In the final multivariable model, the variables with the strongest association with thrombocytosis included leukocytosis, anemia, and hyper-fibrinogenemia. Thrombocytosis rarely causes clinical problems in horses and is not likely to require specific antiplatelet therapy. The strong association of thrombocytosis with infectious/inflammatory disorders, however, should lead clinicians to suspect these types of conditions in horses with high platelet counts.     

Femoral capital physeal fractures in dogs: 34 cases (1979-1989)

Complications associated with femoral capital physeal (CP) fractures in 34 dogs were evaluated. Fractures were surgically repaired, using divergent K-wires or lag screws; radiographic follow-up was available for 21 CP fractures. In all cases, radiographic abnormalities such as degenerative joint disease and resorption of the femoral neck and/or head were seen. Changes were more severe when fracture occurred at an early age. For 4 of 21 dogs (20%), femoral head and neck excision was performed because of complications associated with CP fracture repair. Prognosis for femoral CP fractures is guarded, although affected dogs should be able to function as pets.     

Scapula stress fractures in Thoroughbred racehorses: Eight cases (1997–2006)

No case series exists in the literature describing scapula stress fractures. The purpose of this study was to review the clinical findings, diagnostic images and outcome of 8 horses diagnosed with scapula stress fractures. Scapula stress fractures were seen in Thoroughbred racehorses displaying acute moderate forelimb lameness. Nuclear scintigraphy identified the mid‐distal scapula spine and/or scapula supraspinous fossa as predilection sites. Conservative management resulted in a good prognosis for return to racing, but stress fracture recurrence may be seen.     

Tooth root abscesses in llamas and alpacas: 123 cases (1994-2005)

OBJECTIVE: To determine features, outcome, and complications of surgical treatment of camelid tooth root abscesses. DESIGN: Retrospective case series. ANIMALS: 123 camelids with tooth root abscesses. PROCEDURES: Signalment, history, teeth involved, surgery performed, ancillary diagnostic tests, and short-term complications were recorded from each medical record. An owner questionnaire was used to obtain long-term (> 1 year) follow-up information. RESULTS: The most common surgical treatments included tooth extraction (n = 106) and apicoectomy (13). Owners provided follow-up information on 84 animals. Postoperative complications were reported in 42 of 84 animals. The most common complications included reinfection (n = 15), chronic draining tract (14), and osteomyelitis (14). Significantly more camelids that were in good or obese body condition at the time of surgery were alive at the time of follow-up, compared with those with thin body condition at the time of surgery. Camelids with 2 teeth extracted had significantly more complications than those with 1 tooth extracted. Thirty-four of 47 owners reported that they were completely satisfied with the outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Owners of camelids in poor body condition should be forewarned that such animals are at greater risk for complications following dental surgery. Clinicians should recognize that the number of teeth affected was not associated with a poorer outcome.     

Arthroscopic treatment of fractures of the lateral malleolus of the tibia: 26 cases

Reasons for performing the study: A minimally invasive arthroscopic technique for removal of fractures of the lateral malleolus of the tibia is considered to be beneficial but data to this effect are required. Hypothesis: Arthroscopic removal of fractures of the lateral malleolus of the tibia is technically feasible, provides a comprehensive evaluation of the tarsocrural joint and enables removal of remote comminuted fragments and disrupted short collateral ligaments. The technique is associated with low patient morbidity, requires only short periods of hospitalisation and affords a good prognosis to affected horses. Methods: The case records of all horses that underwent arthroscopic removal of a fractured lateral malleolus of the tibia, admitted to a referral hospital, were evaluated retrospectively. Follow‐up information was obtained from race records and by telephone questionnaire. Results: Fractures were successfully removed arthroscopically in all cases following dissection from the short lateral collateral ligaments. Significant post operative complications occurred in only one horse. All other horses recovered well from surgery and of 22 horses with long‐term follow‐up, 18 returned to their previous use. Conclusion: Arthroscopic removal of fractures of the lateral malleolus of the tibia is technically demanding, but can be performed with minimal complications and with low patient morbidity and short periods of hospitalisation. The majority of horses are able to successfully return to work following the procedure. Potential relevance: The advantages of arthroscopic removal compared to removal via arthrotomy make this the technique of choice for treatment of fractures of the lateral malleolus of the tibia.     

Short‐ and long‐term results following standing fracture repair in 34 horses

Reasons for performing study: Standing fracture repair in the horse is a recently described surgical procedure and currently there are few follow‐up data. This case series contains 2 novel aspects in the standing horse: repair of incomplete sagittal fractures of the proximal phalanx and medial condylar repair from a lateral aspect. Objectives: To describe outcome in a case series of horses that had lower limb fractures repaired under standing sedation at Rossdales Equine Hospital. Method: Case records for all horses that had a fracture surgically repaired, by one surgeon at Rossdales Equine Hospital, under standing sedation and local anaesthesia up until June 2011, were retrieved. Hospital records, owner/trainer telephone questionnaire and the Racing Post website were used to evaluate follow‐up. Results: Thirty‐four horses satisfied the inclusion criteria. Fracture sites included the proximal phalanx (incomplete sagittal fracture, n = 14); the third metacarpal bone (lateral condyle, n = 12, and medial condyle, n = 7); and the third metatarsal bone (lateral condyle, n = 1). One horse required euthanasia due to caecal rupture 10 days post operatively. Twenty horses (66.7% of those with available follow‐up) have returned to racing. Where available, mean time from operation to return to racing was 226 days (range 143–433 days). Conclusions: Standing fracture repair produced similar results to fracture repair under general anaesthesia in terms of both the number of horses that returned to racing and the time between surgery and race. Potential relevance: Repair of lower limb fracture in the horse under standing sedation is a procedure that has the potential for tangible benefits, including avoidance of the inherent risks of general anaesthesia. The preliminary findings in this series of horses are encouraging and informative when discussing options available prior to fracture repair.     

Histiocytic sarcomas in flat-coated retrievers: a summary of 37 cases (November 1998–March 2005)

Thirty‐seven cases of histiocytic‐like sarcomas (HLSs) in flat‐coated retriever dogs were evaluated retrospectively. This tumour accounted for 36% of the malignant tumours seen in this breed during the study period. The median age at presentation was 8.2 years. Thirty‐four dogs presented with a swelling or mass in a muscle group or surrounding a joint. The remaining three presented for rib (1), cutaneous (1) or primary splenic origin (1). A high rate of metastasis to local lymph nodes (45%), thorax (20%) and abdominal organs (20% confirmed) was seen. Overall metastastic rate by the time of death was 70%. The median survival for all dogs was 123 days. The most significant prognostic indicator was presence of distant metastasis at the time of diagnosis with median survival of 68 or 200 days, with or without metastasis, respectively. Chemotherapy and radiation therapy significantly improved survival. Dogs given chemotherapy survived a median of 185 versus 34 days for dogs that were not (P = 0.0008). Dogs treated with radiation survived a median of 182 versus 60 days for those that were not (P = 0.0282). Dogs receiving only palliative therapy survived a median of 17 versus 167 days in dogs receiving any kind of radiation, chemotherapy, surgery or combinations. A set protocol of radiation and CCNU (RTCCNU) induced minimal toxicity and provided a median survival of 208 versus 68 days for all other dogs. While this tumour carries a poor long‐term prognosis in flat‐coated retrievers, it is reasonable to treat these dogs for palliation of signs and extension of life.     

Metacarpal and metatarsal fractures in dairy cattle: 33 cases (1979-1985)

Metacarpal (22) and metatarsal (11) fractures in 33 dairy cattle were treated by application of short or full limb casts. Twelve fractures involved the distal physis (6 closed, 6 open) and 21 fractures were nonphyseal (17 closed, 4 open). All physeal fractures were noncomminuted and 11/12 were classified as Salter-Harris type II. Eleven (52%) of nonphyseal fractures were comminuted. Closed fractures were reduced and a cast was applied after manual restraint, sedation with xylazine (along with use of ropes), or general anesthesia. Open fractures were best treated with the cow under general anesthesia. These fractures were carefully debrided, lavaged, and reduced, and a cast was applied. Antibiotics and analgesics were given parenterally. All cattle were restricted to a box stall during fracture healing. Fracture healing generally was rapid and uncomplicated. No closed fracture perforated the skin. Fracture healing was characterized radiographically by extensive circumferential periosteal new bone growth, closure of the distal physis, and preservation of articulations adjacent to the fracture site. Follow-up ranged from 6 to 78 months (mean, 32 months). Thirty of 33 (91%) cattle survived for a long period. All cows with closed (23) and 7 of 10 (70%) with open fractures survived. Three cows were euthanatized; 2 developed severe osteomyelitis and one fractured her metatarsus above a short cast. All 30 surviving cattle were considered by their owners not lame on the previously injured limb, with no noticeable angulation, bowing, or shortening. No deleterious effects on milk production were detected.     

Tilt table recovery of horses after orthopedic surgery: fifty-four cases (1994-2005)

OBJECTIVE: To describe an assisted anesthetic recovery technique using a tilt table for horses after high-risk orthopedic-related procedures and to evaluate outcome. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Anesthetic recoveries (n=54) for 36 horses. METHODS: Medical records (April 1994-October 2005) for horses that had high-risk orthopedic surgery and recovery from general anesthesia on a tilt table were reviewed. Information about the surgical procedure, anesthetic and recovery period was analyzed. RESULTS: Of 54 anesthetic recoveries, 1 horse (1.9%) had complete failure of internal fixation during recovery and was euthanatized. Six (11% recoveries) horses failed to adapt to the tilt table system, which necessitated transfer to a conventional recovery room. Complications without important consequences for clinical outcome (skin abrasions, myositis, cast breakage, partial implant failure) occurred during 8 (15%) recoveries. CONCLUSIONS: A tilt table recovery system was associated with minimal incidence of serious complications. Potential disadvantages of the system are the number of personnel required, longer recovery time, and the need for a specialized table. CLINICAL RELEVANCE: A tilt table is a useful system for recovering horses believed to be at increased risk of injury during anesthetic recovery after high-risk orthopedic-related procedures.     

Spontaneous femoral capital physeal fractures in adult cats: 26 cases (1996-2001)

OBJECTIVE: To determine clinical, radiographic, and histologic abnormalities in adult cats > 1 year old with spontaneous (ie, nontraumatic) femoral capital physeal fractures. DESIGN: Retrospective study. ANIMALS: 26 cats. PROCEDURE: Medical records of cats > 1 year old with femoral capital physeal fractures and no history of trauma were examined. RESULTS: Mean +/- SD age of the cats was 22.5 +/- 6.5 months. Twenty-five cats were neutered males. Mean weight of the cats was significantly greater than mean weight of a group of age- and sex-matched control cats. Of 16 cats for which age at the time of neutering was known, 14 had been neutered before 6 months of age. Nine cats had bilateral fractures. Severity of femoral neck osteolysis and sclerosis increased with increased duration of clinical signs. The contralateral femoral capital physis, distal femoral physes, and proximal tibial physes were radiographically open in 13 of 18,19 of 24, and 24 of 24 cats, respectively. Histologically, the epiphysis contained normal articular cartilage and bone, but attached growth plate cartilage lacked the normal columnar arrangement of chondrocytes. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that adult cats with spontaneous femoral capital physeal fractures were most likely to be heavier, neutered males with delayed physeal closure.