Malunion of an in utero open tibial fracture in an aborted equine fetus

An in utero tibial fracture was examined at necropsy in a seven-month-old male aborted Thoroughbred fetus. Grossly the healed fracture had a smooth cortical surface. Histologically there was no callus formation or excessive osteoclastic or osteoblastic activity.     

Presumed immune‐mediated hemolytic anemia in two foals with Rhodococcus equi infection

Objective – To describe the clinical presentation, case management, and outcome in 2 foals with Rhodococcus equi infection associated with presumptive severe immune‐mediated hemolytic anemia. Series Summary – Two foals diagnosed with R. equi pneumonia on the basis of tracheal wash cultures, thoracic radiographs, and thoracic ultrasonography were concurrently diagnosed with hemolytic anemia. Both foals required whole blood transfusions, and were treated with the antimicrobial combination of rifampin and a macrolide (eg, clarithromycin, erythromycin, or azithromycin). Dexamethasone was used to prevent further hemolysis in both foals, and to treat acute lung injury/acute respiratory distress syndrome in 1 of the foals. Both foals survived, and required prolonged antimicrobial therapy. New or Unique Information Provided – Although extra‐pulmonary disorders are commonly diagnosed in foals infected with R. equi, hemolytic anemia is rarely described. Dexamethasone is considered the treatment of choice for immune‐mediated hemolytic anemia, but may be contra‐indicated in foals with severe bacterial infections. In these foals, a relatively low dose and short duration of dexamethasone was utilized in an attempt to minimize immune suppression, although early discontinuation in 1 foal precipitated a second hemolytic crisis.     

Clinical evaluation of serum alcohol dehydrogenase activity in horses with acute intestinal obstruction

Objectives – To measure serum alcohol dehydrogenase (ADH) activity in horses with acute intestinal obstruction and to determine the diagnostic and prognostic utility of this analyte. Design – Prospective observational study. Setting – University Veterinary Hospital. Animals – Thirty healthy horses (control group) and 77 horses with acute intestinal obstruction, including 36 horses with nonstrangulating obstruction (23 with left ventral colon impaction and 13 with left dorsal displacement [G1], 22 with small intestinal strangulation [G2], and 19 with colon torsion [G3]). Interventions – Serum ADH activity was assayed spectrophotometerically in all horses. Serum lactate concentration and hepatic enzyme (aspartate aminotransferase, gamma‐glutamyl transferase, glutamate dehydrogenase) activities were measured using an automatic analyzer. Measurements and Main Results – The median [interquartile range] serum ADH activity in healthy horses was 10.5 [8.7 – 11 U/L]. ADH activity was significantly increased (P<0.05) in G1=16.5 [13.8 – 18 U/L], G2=40 [20 – 74.9 U/L], and G3=63.2 [40 – 78 U/L] compared with healthy controls. Aspartate aminotransferase and glutamate dehydrogenase activities were also significantly increased in G3 in comparison with controls. ADH activity was correlated with serum lactate concentration in G1 and G3, respectively (P<0.01, r=0.55 and 0.8). Other liver enzymes did not show any significant correlation with lactate. ADH activity was directly related to the probability of strangulation; odds ratio=1.11. ADH activity >20 U/L had 80.6% specificity and 80.5% sensitivity for discriminating horses with strangulating obstruction. Twelve horses euthanized before surgery were excluded from the outcome analysis. Increasing ADH activity was associated with nonsurvival; odds ratio=1.03. ADH activity <80 U/L had 94.44% specificity and 66.67% sensitivity for survival. Conclusion – Serum ADH activity may be a useful clinical parameter in detecting intestinal strangulation in horses and may provide some prognostic value in horses with acute intestinal obstruction.     

CAUDAL VENOUS RETURN THROUGH A LEFT AZYGOS VEIN IN A DOG

The Clinical, radiologic and echocardiographic findings in a one-year old dog with mild subvalvular aortic stenosis and aberrant caudal vena circulation are described. Aberrant systemic venous return to the right side of the heart usually has little clinical significance, but the unusual features in survey radiographs, contrast angiograms and contrast echocardiograms constitute the reasons for this report.     

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.     

EFFECT OF REGION OF INTEREST SELECTION AND UPTAKE MEASUREMENT ON GLOMERULAR FILTRATION RATE MEASURED BY 99mTc-DTPA SCINTIGRAPHY IN DOGS

Determinations of different methods of measurement of uptake of 99mTc-DTPA using scintigraphy of glomerular filtration rate (GFR) were made from 29 studies on 10 healthy beagle dogs. GFR was measured by calculating the percentage dose uptake (integral method) and rate of uptake (slope method) of 99mTc-DTPA using manual kidney regions of interest (ROI) and automatic kidney and background ROIs at different time periods of the uptake phase. These results were compared using linear regression analysis to the GFR obtained from 99mTc-DTPA plasma clearance using multiple blood samples. The best correlation coefficient between percentage DTPA uptake and GFR by DTPA clearance (r = 0.84, P < 0.001) was derived from time intervals between 30s-120s with a perirenal background ROI at 1 or 2 pixels out from the kidney ROI using automatic kidney ROI at 20% threshold. With the slope method, the best correlation coefficient (r = 0.85, P < 0.001) was obtained from time intervals between 30s-peak with the background ROI at 2 pixels out from the kidney ROI using automatic ROI at 35% threshold. The offset was higher, and the correlation varied more with different ROIs and the method was unreliable at time intervals extending beyond the peak radioactivity. Manual kidney ROIs with automatic background ROIs had slightly lower correlations. With DTPA renography both integral and slope uptake method with automatic kidney and background ROIs are accurate methods to estimate the GFR, but that the integral method is much more stable to variations in ROI size and the duration of the uptake phase of the renogram.     

THE SCINTIGRAPHIC EVALUATION OF SOLID PHASE GASTRIC EMPTYING IN NORMAL CATS

The gastric emptying half-time of solid food in normal cats was determined using a scintigraphic technique. ^99mTc-sulfur colloid was applied to dry food. Sequential images were acquired post prandial, and the gastric emptying half-time was determined for several different acquisition and processing parameters. Good correlation was found between different acquisition and processing methods, some of which made use of edge detection applications, while others used different views, or number of views from which the gastric emptying half-time was calculated. The mean ± standard deviation, (range) and median of the gastric emptying half-time determined using the geometric mean of total counts in hand-drawn regions of interest from the lateral and ventral images were 2.47 × 0.71, (1.42–3.61) and 2.37 hours respectably.     

Comparative Evaluation of Two Surgical Scrub Preparations in Cattle

One hundred seventeen cattle that had undergone surgery were assigned randomly to two preoperative skin preparation protocols. Group 1 (60 animals) skin preparation was with povidone-iodine soap and isopropyl alcohol, whereas group 2 (57 animals) had skin preparation with chlorhexidine gluconate and isopropyl alcohol. Quantitative microbial culture plates were used to estimate the number of colony forming units (CFUs) before skin preparation (prescrub), after skin preparation (postscrub), after surgery (postoperative), and in room air (environment). A significant decrease in CFU occurred postscrub for both skin preparations ( P <.05). Chlorhexidine and alcohol preparation resulted in significantly fewer CFUs (LSMean ± SE = 2.79 CFU ± 1.74) and a greater percentage reduction in CFUs (98.64%± 2.01) postscrub than povidone and alcohol (LSMean ± SE = 10.27 CFUs ± 1.51, 93.29%± 1.85); ( P <.005). Group 2 had a significantly higher frequency of negative cultures postscrub (49.1%) compared with group 1 (18.3%) ( P <.001). The number of postoperative CFUs were not significantly different between the two treatment groups. Wound infection frequency for clean surgical procedures was not significantly different between the two skin preparation protocols (group 1 = 9.8%, group 2 = 10.7%), however, infection frequency was significantly higher for surgical procedures with a ventral abdominal approach (5 of 14, 35.7%), compared with a flank approach (1 of 41, 2.4%) or other approaches (orthopedic procedures) (1 of 16, 6.3%) ( P <.05). Both skin preparation protocols were effective and safe in decreasing the skin microflora population of cattle before surgery and although preparation with chlorhexidine gluconate and alcohol resulted in less CFUs immediafly postscrub, the frequency of surgical wound infection was similar for both protocols.     

Radical Lateral Body-Wall Resection for Fibrosarcoma With Reconstruction Using Polypropylene Mesh and a Caudal Superficial Epigastric Axial Pattern Flap: A Prospective Clinical Study of the Technique and Results in 6 Cats

OBJECTIVE: To describe and evaluate a technique for radical resection of the lateral body wall for treatment of fibrosarcoma with reconstruction using polypropylene mesh and a caudal superficial epigastric axial pattern flap in cats. STUDY DESIGN: Prospective, clinical study. ANIMALS OR SAMPLE POPULATION: Six client-owned cats with fibrosarcoma. METHODS: Six cats with histologically confirmed fibrosarcoma of the lateral body wall were staged using radiography and/or computer tomography scanning. Preoperative radiotherapy was used in 3 cats. All cats had the lateral abdominal wall resected and reconstructed with polypropylene mesh. A caudal superficial epigastric flap was mobilized and rotated to close the skin deficit. The animals were evaluated after surgery for wound complications, tumor recurrence, and metastasis. Outcome was assessed by patient examination and client consultation. RESULTS: Minor dehiscence of the skin flaps occurred in 2 cats, and 1 other cat was successfully resuscitated from respiratory and cardiac arrest after surgery. All tissue specimens were tumor-free at the surgical margins. Follow-up times ranged from 12 to 21 months, with a mean time of 17.2 months. None of the cats had evidence of local tumor recurrence or metastasis; outcome was judged good to excellent in all cats. CONCLUSIONS AND CLINICAL RELEVANCE: Radical lateral body-wall resection and reconstruction is an effective technique for achieving local tumor control with acceptable patient morbidity. Further studies are needed to assess whether the technique will result in improved tumor-free intervals and survival times.