Experimental Large Colon Resection at the Cecocolic Ligament in the Horse

Ten normal horses had approximately 95% of the length of the large colon resected with a side-to-side anastomosis between right ventral and right dorsal colon performed with surgical stapling equipment. Four horses died shortly after surgery of colitis (1 horse) or failure of the TA 90 transection staple line (3 horses). Another horse died 4 months after surgery from disseminated streptococcal infection but had recovered well from the colon resection. Five horses survived long term (18 months) with no clinical evidence of adverse effects of the resection. Surviving horses had weight loss and soft fecal consistency for 3 to 12 weeks after surgery but returned to preoperative values within 12 months. At a second surgery 1 year later (5 horses) or at necropsy 4 months later (1 horse), fibrous omental adhesions were present over the transection staple line in four horses and over the anastomotic staple line in two horses. Omental adhesions to the everted staple line were moderate but not associated with any clinical sequellae. An incisional hernia was present in one horse. The anastomotic stomata measured between 8 and 9 cm, which was 60% of the size of the original surgically created stomata. Failure of the transection staple line occurred in the first three of five horses in which the procedure was attempted due to improper configuration of the staples or crushing of the tissue between the staples. Experience corrected this complication.     

Effect of Dimethylsulfoxide on Articular Cartilage Proteoglycan Synthesis and Degradation, Chondrocyte Viability, and Matrix Water Content

Objective—To determine the effects of dimethylsulfoxide (DMSO) exposure on cartilage proteoglycan (PG) synthesis, PG degradation, chondrocyte viability, and matrix water content. Study Design—Using a cartilage explant culture system, PG synthesis, PG degradation, matrix water content, and chondrocyte viablity were determined for cartilage exposed to DMSO daily for selected periods of time. Animals or Sample Population—Juvenile bovine (calf) carpometacarpal joint cartilage ex-plants. Methods—PG synthesis: Explants (n = 30/group) were separated into 10 groups based on the time of daily exposure to 10% DMSO. Exposure time was repeated daily for 3 days. The control group was incubated in basal medium alone for 3 days, with daily medium changes. Once all DMSO exposure times were complete for the third day, PG synthesis was determined by analysis of incorporation of radiolabelled sulfate. Cell viability: Explants (n = 3/group) were subjected to an identical DMSO exposure protocol, and examined histologically. The percentage of viable cells/high power field (hpf) was calculated for each group. PG degradation: Explants (n = 21/group) were preincubated with radiolabelled sulfate, then subjected to a similar DMSO exposure protocol. The medium was collected from all explants daily and assayed for PG content. After 3 days, the explants were digested and total labelled PG content determined. Percent of total explant labelled PG content released into the medium daily was determined for each group. Water content: Explants (n = 21/group) were separated into three treatment groups, one of which had no treatments performed, whereas the other two groups were incubated in basal medium for 72 hours, one with, and one without, 10% DMSO. Wet and dry weights were determined, and percent water calculated, for all three groups. Separate 1-way ANOVA were performed, with appropriate post hoc tests (p < .05). Results—PG synthesis was significantly lower than control for all time periods of DMSO exposure except for 1 and 3 hours, and decreased in a time-dependent manner after the 1-hour exposure time. The mean percentage of viable cells/hpf was significantly lower than control for the 1-, 3-, 9-, 12-, and 24-hour treatment groups. There was no significant difference in PG degradation for any group compared with control for the first 2 days of incubation. All groups except the 24-hour group had a significantly higher degradation compared with control for the third day of incubation. Cartilage exposed to DMSO for 72 hours had a significantly lower water content, and cartilage incubated in basal medium alone for 72 hours had a significantly higher water content than cartilage that received no DMSO and no incubation. Conclusions—DMSO, in relatively low concentration, is detrimental to articular cartilage PG     

Laparoscopic Cholecystectomy for Management of Uncomplicated Gall Bladder Mucocele in Six Dogs

Objectives— To describe a technique for, and outcome after, laparoscopic cholecystectomy (LC) for management of uncomplicated gall bladder mucocele (GBM) in dogs. Study Design— Case series. Animals— Dogs (n=6) with uncomplicated GBM. Methods— Dogs with ultrasonographic evidence of GBM but without imaging or laboratory signs of gall bladder rupture, peritonitis, or extra‐hepatic biliary tract rupture that had LC were included. A 4 portal technique was used. A fan retractor was used to retract the gall bladder to allow dissection around the cystic duct with 5 or 10 mm right‐angle dissecting forceps. The cystic duct was ligated using extracorporeally tied ligatures supplemented sometimes with hemostatic clips. A harmonic scalpel was used to dissect the gall bladder from its fossa. The gall bladder was placed into a specimen retrieval bag and after bile aspiration the bag was withdrawn through the 11 mm portal incision. Results— Five dogs had mild intermittent clinical signs including vomiting, inappetence, and lethargy. All dogs had successful LC without conversion to an open approach. All dogs with clinical signs had improvement or resolution of signs postoperatively. No important perioperative complications occurred and all dogs were alive at a median of 8 months postoperatively (range, 3–14 months). Conclusions— LC can be accomplished safely and effectively in dogs with uncomplicated GBM. Clinical Relevance— A minimally invasive approach for cholecystectomy can be used for the treatment of GBM in dogs.     

Hemodynamic Changes During Laparoscopic Radiofrequency Ablation of Normal Adrenal Tissue in Dogs

Objective— To determine the hemodynamic response to radiofrequency ablation (RFA) of normal adrenal tissue in dogs.
Study Design— Experimental study.
Animals— Healthy adult mixed-breed dogs (n=6).
Methods— During general anesthesia a Swan–Ganz thermodilution catheter was flow directed into the pulmonary artery and used to quantify cardiac output. An arterial catheter was used for direct blood pressure measurements. An RFA device was introduced into the left adrenal gland under observation through laparoscopic instrumentation. Blood samples were collected and hemodynamic variables studied after a stable surgical anesthetic depth was achieved (time 1), during CO₂ insufflation of the abdomen (time 2), during adrenal RFA (time 3), and after completed RFA (time 4). Catecholamine determinations were performed with a human enzyme immunoassay. Histopathology was performed to verify medullary necrosis.
Results— Arterial, pulmonary arterial and central venous pressure, and plasma norepinephrine increased more during RFA than during abdominal insufflation. Heart rate and cardiac index did not differ between time points. High baseline epinephrine was present and significant differences between time points were not detected. Systemic vascular resistance had very high individual variation and differences were not detected.
Conclusions— RFA of normal adrenal tissues is associated with severe hemodynamic alterations. Further studies of the optimal blockage of catecholamine-induced hypertension in dogs are warranted.
Clinical Relevance— Clinicians should prepare for potential hypertensive crisis during RFA of adrenal masses, especially if treating a margin of normal tissue.     

Partial Right Ventriculectomy Using the Incised Patch Technique to Treat Double Chambered Right Ventricle and Chylothorax in a Cat

Objective— To report successful surgical treatment of double chambered right ventricle (DCRV) in a cat.
Study Design— Clinical report.
Animals— Cat with DCRV.
Methods— DCRV was diagnosed in a 5-month-old male Maine Coon cat using echocardiography and angiocardiography. At 2 years, despite medical therapy, chylothorax developed. A section of the right ventricular free wall that spanned the fibromuscular obstruction was excised under total venous inflow occlusion (TVIO) using the incised pericardial patch technique.
Results— Short-term recovery was complicated by return of chylothorax but this resolved after thoracocentesis and diuretic therapy. Three years after surgery, the cat is free of clinical signs and no longer on any medical therapy.
Conclusions— Partial right ventriculectomy can be performed under TVIO through an incised pericardial patch.
Clinical Relevance— DCRV in cat can be successfully treated by partial right ventriculectomy performed under TVIO through an incised pericardial patch.     

Biomechanical Analysis of the Three-Dimensional Motion Pattern of the Canine Cervical Spine Segment C4–C5

Objective— To study the kinematics of cervical spine segment C₄–C₅ and its association with disc dimensions and the coupled motion (CM) in relation to primary motion (PM).
Study Design— Cadaveric biomechanical study.
Animals— Cadavers of large breed dogs (>20 kg; n=11).
Methods— Spines were freed from muscles. Radiographs were taken orthogonal to the C₄–C₅ disc space and disc thickness, endplate width, and height were measured. Spines were mounted on a simulator for 3-dimensional motion analysis. Data were recorded with an optoelectronic motion analysis system. Range of motion (ROM) and neutral zone (NZ) were determined in the direction of flexion/extension, left/right lateral bending, and left/right axial rotation, as well as the ROM of CM.
Results— ROM in flexion and extension was similar; there was no CM in flexion/extension. Left/right axial rotation and left/right lateral bending were coupled to the same side. CM was 1.72 and 3.56 times the ROM of the PM in lateral bending and axial rotation, respectively. Disc dimensions were positively correlated with body weight. Flexion/extension magnitude was significantly reduced for larger endplates, but axial rotation was not influenced. Lateral bending had no correlation with weight or disc dimensions.
Conclusion— Left/right lateral bending and left/right axial rotation are coupled differently in the C₄–C₅ segment in dogs compared with humans.
Clinical Relevance— The canine C₄–C₅ spinal segment has unique motion coupling patterns that should be considered for dynamic implant designs.     

Ex Vivo Evaluation of the Effect of Tibial Plateau Osteotomy on the Proximal Tibial Soft Tissue Envelope With and Without the Use of Protective Gauze Sponges

Objective— To investigate the effect of tibial plateau leveling osteotomy (TPLO) on the proximal tibial soft tissue envelope with and without use of protective gauze sponges, and to determine whether the action of an oscillating saw blade on the gauze sponges would result in retention of particulate cotton debris. Study Design— Cadaveric study. Animals— Medium to large breed dog cadavers (n=10; 20 pelvic limbs). Methods— TPLO was performed using the currently recommended technique involving dissection of the proximal tibial soft tissue envelope and its protection using cotton gauze sponges. In paired limbs, the procedure was repeated but no attempt was made to retract and protect the proximal tibial soft tissue envelope. Damage to the soft tissue envelope and presence of gross particulate cotton debris were investigated by direct observation and photographic analysis. Presence of microscopic cotton debris was investigated using light microscopic analysis of wound lavage fluid. Results— No soft‐tissue trauma was found in gauze sponge‐protected specimens. When protective gauze sponges were not used, full‐thickness (sagittal plane) lacerations to the caudoproximal tibial muscle group occurred in all specimens with a mean craniocaudal width of 9.5 mm (range 2–12 mm). The cranial tibial muscle was traumatized in only 1 specimen without protective gauze sponges. Trauma to the popliteal vessels was not identified in any specimen. No gross cotton debris was identified, but microscopic cotton fibers (diameter, 7–35 μm) were identified in lavage fluid from all gauze sponge‐protected specimens. Conclusions— Use of protective gauze sponges is effective in protecting the proximal tibial soft tissue envelope from an oscillating TPLO saw blade, but results in retention of microscopic cotton particulate debris within the operative site. Significant soft tissue trauma is seen only in the caudoproximal tibial muscle group if protective gauze sponges are not used. Clinical Relevance— Retraction and protection of the caudoproximal tibial soft tissue envelope is recommended during TPLO; however, to prevent retention of microscopic particulate cotton debris, alternatives to cotton gauze sponges should be considered as protective devices.     

Clinical Evaluation of Pancarpal Arthrodesis Using a CastLess Plate in 11 Dogs

Objective— To describe the use of a 3.5/2.7 mm CastLess Plate (CLP) for pancarpal arthrodesis (PCA) in dogs.
Study Design— Case series.
Animals— Dogs with traumatic/degenerative carpal disease (n=11).
Methods— Records (September 2006–July 2007) of dogs that had PCA using a 3.5/2.7 mm CLP were reviewed to determine intra- and postoperative complications and use of external coaptation. Follow-up (≥12 months) was obtained by telephone interview of owners.
Results— Thirteen PCA procedures were performed; 5 intraoperative complications occurred in 4 procedures and included iatrogenic metacarpal fissure fracture (2), inability to remove an alignment pin (1), and poor distal plate position (2). External coaptation was used in 4 dogs: concomitant or iatrogenic injuries (3), bilateral PCA (1), for 3–6 weeks. Clinical evaluation 6–24 weeks postoperatively revealed iatrogenic metacarpal fractures to have healed and that 1 postoperative complication (infection) developed. Telephone follow up for 10 dogs (mean, 14 months; range, 12–20 months) revealed no further problems.
Conclusion— PCA using a 3.5/2.7 mm CLP reduces the need for external coaptation and seemingly reduces postoperative morbidity associated with other internal fixation techniques.
Clinical Relevance— PCA can be performed safely and successfully using a 3.5/2.7 mm CLP, with low postoperative morbidity compared with other PCA techniques. Particular attention should be taken when applying the distal component of the plate.     

Colonic Luminal Pressure in Horses With Strangulating and Nonstrangulating Obstruction of the Large Colon

Colonic luminal pressure (median, range) measured during ventral midline celiotomy in 69 horses with strangulating obstruction (SO) of the large colon (SO; ≥ 270° large colon volvulus; 27 cm H₂O: 2 to 80 cm H₂O) was greater ( P =.0023) than that measured in 37 horses with nonstrangulating obstruction (NSO) of the large colon (NSO; ≤ 180° volvulus or a nonstrangulating displacement; 18 cm H₂O; 6 to 46 cm H₂O). Sixty-five percent (45 of 69) of horses with SO and all horses with NSO survived. Survival analysis was restricted to 59 horses with large-colon SO that survived to hospital discharge or met the criteria specified for classification as nonsurvivors. Colonic luminal pressure in nonsurvivors (48.5 cm H₂O; 34 to 80 cm H₂O) was higher ( P =.0001) than that measured in survivors (18 cm H₂O; 2 to 50 cm H₂O) of SO. From response operating characteristic curves, a luminal pressure of 38 cm H₂O optimized the distribution of horses with SO into survivor and nonsurvivor groups. Sensitivity, specificity, and positive and negative predictive values for a colonic luminal pressure greater than 38 cm H₂O in predicting nonsurvival were 0.89, 0.91, 0.72 and 0.97, respectively. Measurement of colonic luminal pressure may be useful for predicting survival in horses with colonic volvulus.