Determination of Safe Depth of Pin Penetration for Repair of Distal Femoral Physeal Fractures in Immature Dogs: A Comparison of Normograde and Retrograde Pin Placement

Objective —The purpose of this study was to determine the depth that implants may be safely placed into the distal femoral epiphysis (DFE) for the repair of distal femoral physeal fractures.
Study Design —The depth of the DFE was related to the radiographic thickness of the patella in this experimental study.
Animals or Sample Population —Twenty immature canine cadavers.
Methods —Patella thicknesses were measured from lateral radiographs. Actual DFE depths were determined for pins driven in normograde fashion and for pins driven retrograde from the central depression between the metaphyseal pegs and from the cranial pegs. The association of DFE depth and patella thickness was evaluated using linear regression analysis. Using 95% confidence intervals, rules for estimating the safe depth of implant placement into the DFE were determined.
Results —DFE depth had significant correlation with patella thickness for pins placed in retrograde fashion from the central depression between the metaphyseal pegs (r²= .83) and from the cranial pegs (r²= .82) and for pins placed in normograde fashion (r²= .65).
Conclusions —Based on 95% confidence intervals, pins placed in retrograde fashion from the central depression between the metaphyseal pegs may be safely driven into the DFE a distance equal to 140% of patella thickness. Pins placed from the cranial metaphyseal pegs may be driven to a depth equal to 80% of patella thickness, and pins placed in normograde fashion may be driven to a depth equal to 30% of patella thickness.
Clinical Relevance —Measurement of patella thickness assists the surgeon in determining the approximate depth that pins may be driven into the DFE without penetrating the articular surface of the stifle joint.     

Diaphragmatic Hernia Repair in Three Young Horses

Objective- This clinical report describes surgical correction of diaphragmatic hernia in three young horses.
Study Design- Retrospective investigation of medical records and subsequent racing performance.
Animals- Three young horses with diaphragmatic hernia.
Results- Three young horses with signs of abdominal pain had diaphragmatic hernia causing small intestinal strangulation. The strangulated small intestine was resected and an end-to-end jejuno-jejunal (two horses) or a side-to-side jejuno-cecal anastomosis (one horse) was performed. Diaphragmatic hernias were closed with a continuous suture pattern. All horses recovered and raced. No difference in race records was found between the subject horses and their siblings. One subject horse died of colic at 5 years of age, but the cause of the colic was undetermined. The remaining two horses are in use as broodmares and have produced multiple foals without recurrence of signs of diaphragmatic hernia
Conclusions- Diaphragmatic hernias can be repaired in horses. These horses can achieve race records similar to their siblings and can produce foals without recurrence of signs of diaphragmatic hernia.     

Epoxy Putty for Free-Form External Skeletal Fixators

Objective —To evaluate the suitability of epoxy putty for use as a connecting beam material in a free-form external skeletal fixator.
Design —Mechanical evaluation of beams and the pin-material interface of commonly used methacrylates and the proposed epoxy putty.
Procedure —The apparent modulus, bending strength, and toughness of 10 beams of three methacrylates (Technovit, APEF System, Bone Cement) and three epoxy putties (Oatey Epoxy Putty, All-Metals PowerPoxy, and Plumber's PowerPoxy) were determined in three-point bending. The shear strength of smooth and roughened-shaft pins embedded in the three methacrylates and the Oatey Epoxy Putty was determined by pull-out testing.
Results —The epoxy putties had similar strength, greater apparent modulus, and reduced toughness when compared with the methacrylates. The shear strength of the smooth pin interface with the Oatey Epoxy putty was greater than that with the methacrylates. The interface with roughened pins was much stronger than that with smooth pins for all materials tested.
Clinical Relevance —Epoxy putty is a suitable material for free-form external fixators. It is easy to handle, inexpensive, and has suitable setting times and mechanical properties.     

COMBINED USE OF ULTRASONOGRAPHY AND CONTRAST ENHANCED COMPUTED TOMOGRAPHY TO EVALUATE ACUTE NECROTIZING PANCREATITIS IN TWO DOGS

The imaging findings in two miniature schnauzers with acute necrotizing pancreatitis are described. Both dogs were treated previously for diabetes mellitus and hyperlipidemia. Vomiting, anorexia, and lethargy were observed in both dogs at presentation. Laboratory evaluations supportive of pancreatitis included left shift, abnormally high serum amylase and lipase activities, hypocalcemia, and abnormally high serum activities of liver enzymes. Sonographically, both dogs had diffusely enlarged hypoechoic pancreatic tissue with anechoic foci compatible with necrosis, abscessation, phlegmon, and pseudocysts formation. Contrast-enhanced computed tomography (CT) findings in both dogs were compatible with pancreatic necrosis. Dog 1 was managed medically for 11 days. Follow-up CT scan in this dog disclosed decreased pancreatic size and increased contrast enhancement compatible with partial resolution of pancreatitis.     

Detection of Bacteria in Equine Synovial Fluid by Use of the Polymerase Chain Reaction

Equine synovial fluid aliquots were inoculated with Salmonella enteritidis, Escherichia coli, Actinobacillus equuli, Staphylococcus aureus , and Streptococcus zooepidemicus to obtain approximate concentrations of 1000, 100, 10, and 1 colony forming U/mL. Synovial fluid aliquots were also inoculated with an unquantitated inoculum of Bacteroides fragilis and Clostridium perfringens. Inoculated synovial fluid was incubated in trypticase-soy broth or Columbia broth for approximately 12 hours. Then aliquots were removed for DNA extraction and polymerase chain reaction (PCR) analysis for detection of a 531 base-pair segment of bacterial DNA corresponding to a region of the 16S ribosomal gene. Duplicate samples of inoculated synovial fluid were prepared for microbial culture. Bacteria were detected in all samples inoculated with bacteria but not in control synovial fluid samples. Under experimental conditions there was no difference between microbial culture and PCR analyses for detection of bacteria. Experimentally, PCR was able to detect bacteria in synovial fluid within 24 hours of inoculation.     

Suture Materials and Suture Selection for Use in Exotic Pet Surgical Procedures

Exotic animals are becoming increasingly popular and more exotic pet owners are seeking veterinary care. This has led to a demand for properly trained veterinarians who are capable of providing quality, up-to-date medical and surgical treatments. Many surgeries are now performed on exotic pets, and selection of the appropriate suture material is an important part of the treatment protocol. An understanding of different available suture materials, healing times of different tissues, and knowledge of different anatomic and physiologic characteristics in different species is important in the selection of the most appropriate suture material. This review will summarize important aspects of suture selection in exotic animals.     

Minimally Invasive Surgery Techniques in Exotic Animals

The term minimally invasive surgery refers to procedures performed using endoscopic guidance to enter a part of the body (e.g., laparoscopy, thoracoscopy, arthroscopy, rhinoscopy, gastroscopy). Endoscope-assisted procedures generally use a rigid endoscope to improve visualization and/or access or permit completion of the procedure extracorporeally to access internal body structures through small openings compared with traditional “open” incision techniques. Endoscope-assisted procedures currently performed in exotics include, but are not limited to, exploratory laparoscopy/coelioscopy/thoracoscopy, procurement of thoracic and abdominal organ biopsies, intestinal foreign body removal, cystotomy, and reproductive sterilization.     

Comparison of cardiac output determined by arterial pulse pressure waveform analysis method (FloTrac/Vigileo) versus lithium dilution method in anesthetized dogs

Objective – To compare the determination of cardiac output (CO) via arterial pulse pressure waveform analysis (FloTrac/Vigileo) versus lithium dilution method. Design – Prospective study. Setting – University teaching hospital. Animals – Six adult dogs. Interventions – Dogs were instrumented for CO determinations using lithium dilution (LiDCO) and FloTrac/Vigileo methods. Direct blood pressure, heart rate, arterial blood gases, and end‐tidal isoflurane (ETIso) and CO₂ concentrations were measured throughout the study while CO was manipulated with different depth of anesthesia and rapid administration of isotonic crystalloids at 60 mL/kg/h. Measurements and Main Results – Baseline CO measurements were obtained at 1.3% ETIso and were lowered by 3% ETIso. Measurements were obtained in duplicate or triplicate with LiDCO and averaged for comparison with corresponding values measured continuously with the FloTrac/Vigileo method. For 30 comparisons between methods, a mean bias of ?100 mL/kg/min and 95% limits of agreement between ?311 and +112 mL/kg/min (212 mL/kg/min) was determined. The mean (mL/kg/min) of the differences of LiDCO?Vigileo=62.0402+?0.8383 × Vigileo, and the correlation coefficient (r) between the 2 methods 0.70 for all CO determinations. The repeatability coefficients for the individual LiDCO and FloTrac/Vigileo methods were 187 and 400 mL/kg/min, respectively. Mean LiDCO and FloTrac/Vigileo values from all measurements were 145 ± 68 mL/kg/min (range, 64–354) and 244 ± 144 mL/kg/min (range, 89–624), respectively. The overall mean relative error was 48 ± 14%. Conclusion – The FloTrac/Vigileo overestimated CO values compared with LiDCO and the relative error was high, which makes this method unreliable for use in dogs.     

Treatment of Perianal Fistulas With ND: YAG Laser—Results in Twenty Cases

Excision of perianal fistulas using a 1.064 micron wavelength neodymium:yttrium aluminum garnet (ND:YAG) contact tipped laser with primary wound closure was used to treat 20 dogs with perianal fistulas. Overall, 19 of 20 (95%) dogs had resolution of fistulas after one or more ND:YAG treatments. The period of resolution ranged from 10 to 42 months with a mean of 22.9 months. Sixteen of 20 (80%) dogs had resolved fistulas after one laser excision. Three of the four recurrences underwent additional laser treatments with successful results. The total number of laser procedures ranged from one to three with a mean of 1.2 procedures. Postoperatively, anal tone as judged by digital rectal examination was reduced in about 60% of the cases, but clinical evidence of fecal incontinence only occurred in four of 20 cases. This was managed effectively with diet modification. The tendency toward loss of anal tone or fecal incontinence depended on the severity of preexisting anal stenosis. On a client survey, 19 of 20 owners believed that their animals experienced less pain during defecation after surgery and rated the results as excellent or good. The overall success rate using ND:YAG laser excision compared very favorably with previously reported studies of other methods of treatment for perianal fistulas in dogs.     

Complications of Celiotomy Incisions in Horses

Complications of celiotomy incisions were evaluated retrospectively in 274 horses that survived at least 1 month after surgery, or died or were euthanatized within 1 month of surgery, as a direct result of these complications. Horses were divided into four groups; group A, a ventral median celiotomy for intestinal disease; group B, ventral median celiotomy for nonintestinal disease; group C, repair of an umbilical hernia; and group D, celiotomy in a region other than the midline. Specific incisional complications were peri-incisional edema, drainage, incisional abscess, suture sinus, and dehiscence. Incision-related complications occurred in 30% of the horses (group A, 40%; group B 18%; group C, 7%; and group D, 88%). Complications occurred more frequently in group D than group A ( P =.009), which were higher than in groups B and C ( P <.00001). Incisional hernia occurred in 28 of 256 (11%) horses that survived at least 4 months and were available for follow-up. Hernia formation was more common ( P <.00001) in horses that had other incisional complications (23 horses) than those without (5 horses). Serous or purulent incisional drainage, were more likely to be associated with hernia formation than was serosanguineous drainage or other incisional complications.