In Vitro and In Vivo Evaluation of Ferric-Hyaluronate Implants for Delivery of Amikacin Sulfate to the Tarsocrural Joint of Horses

Objective— To assess the antimicrobial elution characteristics, toxicity, and antimicrobial activity of amikacin‐impregnated ferric‐hyaluronate implants (AI‐FeHAI) for amikacin delivery to the tarsocrural joint of horses. Study Design— Experimental study. Sample Population— AI‐FeHAI implants, equine cartilage, and synovium, and horses (n=6). Methods— In vitro study: Five AI‐FeHAI were placed in saline solution with daily replacement until implant degradation. Eluent was tested for amikacin concentration and bioactivity. Synovial and cartilage explants were incubated in the presence or absence of AI‐FeHAI for 72 hours and subsequently assessed for morphology, viability, and composition. Synovial explants were incubated with Staphylococcus aureus in the presence or absence of AI‐FeHAI. Spent medium was cultured daily and explants were assessed for morphology and viability after 96 hours. In vivo study: AI‐FeHAI were placed in 6 tarsocrural joints. Standard cytologic analysis and amikacin concentration (SFAC) were determined in synovia obtained regularly for 28 days thereafter. Similar analyses were conducted after a single intra‐articular injection of amikacin 6 months later. Results— In vitro study: Amikacin concentrations exceeded 16 μg/mL and inhibited S. aureus growth for 8 days. AI‐FeHAI had no effect on cartilage explants. AI‐FeHAI eliminated bacteria from synovial explants. In vitro study: After AI‐FeHAI placement, SFAC was highest (140.78+63.81 μg/mL) at first sampling time. By 24 hours SFAC was <16 μg/mL. After intra‐articular injection, SFAC was the highest (377.91 ± 40.15 μg/mL) at first sampling time. By 48 hours SFAC was <16 μg/mL. Conclusions— A single intra‐articular amikacin injection demonstrated superior pharmacokinetics than AI‐FeHAI prepared as described. Clinical Relevance— AI‐FeHAI cannot be recommended for clinical use.     

Use of Computed Tomography in Standing Position to Identify Guidelines for Screw Insertion in the Distal Phalanx of Horses: An Ex Vivo Study

Objectives— To compare the precision of radiography and computed tomography (CT) preoperatively in the standing position for identification of guidelines for screw insertion in the distal phalanx, and to identify whether standing CT might improve operative time compared with preoperative radiographic planning.
Study Design— Experimental ex vivo study.
Animals— Cadaveric equine thoracic limb pairs (n=10).
Methods— Insertion of a 4.5 mm cortex screw in lag fashion into an intact distal phalanx was evaluated in 2 groups (n=10) of cadaveric equine thoracic limbs. In 1 group, the site, direction, and length of the implant were determined by radiography, and in the other group, by CT. Accuracy of screw placement was verified by specimen dissection. Outcomes were (1) absence of penetration of the articular surface, the solar surface, or the semilunar canal (2) appropriate length and direction of the screw. Surgical time was also measured.
Results— No screw penetrated the articular surface, the solar surface, or the semilunar canal in either group. CT was more accurate to identify guidelines for screw insertion (U=23.50, P =.049). With CT, surgical time (mean, 7.7 minutes) was significantly shorter (U=0.000, P =.000) than with radiography (mean, 12.7 minutes).
Conclusion— Standing CT can be used to accurately determine anatomic landmarks for screw insertion in lag fashion in sagittal fractures of the distal phalanx.
Clinical Relevance— This study has a clear clinical relevance for improved internal fixation of sagittal fractures of the distal phalanx.     

USE OF ULTRASOUND TO DIAGNOSE DIAPHRAGMATIC RUPTURE IN DOGS AND CATS

Twenty-one cats and six dogs that presented to a first-opinion clinic with signs of dyspnea and muffled cardiac auscultation received ultrasonography to look for signs of diaphragmatic rupture. The presence or absence of diaphragmatic rupture was subsequently determined on the basis of unequivocal radiographic signs, surgical findings, or necropsy. Consistent findings in animals with diaphragmatic rupture were irregular or asymmetric cranial aspect of the liver and abdominal viscera in the thorax. Accuracy of ultrasonography was 25/27 (93%). One false-negative result occurred in a cat with a chronic diaphragmatic rupture in which adhesions between the liver and lung simulated the appearance of an intact diaphragm. One false-positive result occurred in a dog with an abscess involving the left lung and pleural cavity, which was misinterpreted as the stomach. The results of this study support use of ultrasonography in animals with suspected diaphragmatic rupture.     

REVIEW OF DIAGNOSTIC IMAGING OF EAR DISEASES IN THE DOG AND CAT

Diagnostic imaging techniques (conventional radiography, computed tomography and magnetic resonance imaging) are an essential tool in the diagnostic work-up of ear diseases. Conventional radiography is commonly used, but often lacks sensitivity. Computed tomography (CT) and magnetic resonance (MR) are complementary imaging studies of the middle ear, labyrinth, internal auditory canal and their contents. CT provides excellent images of bony structures and is indicated where osseous changes are of greatest diagnostic importance. MR is superior in imaging soft tissue components including intralabyrinthine fluid. Therefore, more than one of these imaging techniques may be required in order to make a diagnosis.     

ULTRASONGRAPHIC FINDINGS IN HEPATIC AND SPLENIC LYMPHOSARCOMA IN DOGS AND CATS

In a survey of patients with histologically-confirmed hepatic lymphosarcoma at Tufts University, abnormal ultrasound findings were detected in 3 of 14; two had diffuse hepatic hypoechogenicity, one had a focal hypoechoic lesion. In contrast, 5 of 6 patients with spleic lymphosarcoma had an abnormality on ultrasongraphy; two had diffuse hypoechogenicity, one had multiple hypoechoic foci, one had a large, cavitated-appearing mass, and one had an irregular border. In our experience, ultrasonography is an insensitive means of detecting hepatic lymphosarcoma but appears more sensitive for detection of splenic lymphosarcoma.     

Complications of Methylprednisolone Sodium Succinate Therapy in Dachshunds with Surgically Treated Intervertebral Disc Disease

Objective: To compare the incidence of clinically evident post-operative complications, financial cost and length of hospital stay for Dachshunds with acute intervertebral disc disease treated with decompressive surgery with and without the use of methylprednisolone sodium succinate (MPSS).
Design: Retrospective clinical study
Setting: Veterinary Teaching Hospital
Animals: Dachshunds that presented to the Veterinary Hospital of the University of Pennsylvania between January 1994 and December 1999 with acute intervertebral disc disease that were treated with decompressive surgery.
Intervention: None
Measurements and Main Results: Dogs were divided into 2 groups dependent upon whether they had received MPSS. Medical records were examined for evidence of post-operative complications. Other parameters recorded included details of drugs administered (principally corticosteroids and gastrointestinal protectant drugs), length and cost of hospital stay and neurological status at 24 hours post-operatively and at suture removal. Compared to other corticosteroids, dogs receiving MPSS had a significantly higher incidence of clinically evident post-operative gastrointestinal complications, an increased use of gastrointestinal protectant drugs, and an increased cost for hospital stay (p<0.01).
Conclusions: The use of MPSS inDachshunds with acute intervertebral disc disease is associated with an increased post-operative complication rate and an increased financial cost to the client. The use of MPSS should be carefully evaluated for each patient.     

Pulse Oximetry in Horses

The clinical usefulness of two pulse oximeters was evaluated at two probe sites in nine anesthetized horses. The hemoglobin saturation determined by the pulse oximeters (SaOx) was compared with the hemoglobin saturation calculated from the measured arterial oxygen tension (SaO2). The mean and standard deviation (SD) were calculated from the differences in saturation measurements, over the saturation range of 80% to 100%, for each oximeter used at the tongue probe site and for one oximeter used at the ear. The oximeter results tended to underestimate the SaO2 with mean differences of -3.7% on the tongue and -6.0% on the ear. The limits of agreement were defined as the mean difference +/- 2 SD. Each oximeter used at the tongue produced limits of agreement of +1% to -8%, which meant that 95% of the SaOx values were 1 percentage point above or 8 percentage points below the SaO2. The variability of the differences and limits of agreement were larger when the ear was used as the probe site and at saturations less than 80%. Although both oximeters tended to underestimate the SaO2, they appeared to be clinically useful in detecting changes in arterial hemoglobin saturation.     

ULTRASONOGRAPHIC FEATURES OF CANINE HEPATIC NODULAR HYPERPLASIA

Hepatic nodular hyperplasia is a benign, usually clinically inapparent, proliferative lesion commonly found at necropsy in older dogs. Three examples of hepatic nodular hyperplasia are described in dogs with clinical signs compatible with hepatic disease in which ultrasonography revealed a variety of echotextural changes in the liver similar to those reported in primary or secondary hepatic neoplasia. In subsequent in vitro ultrasonographic studies of hepatic nodular hyperplasia lesions detected at necropsy in dogs without clinical signs of hepatic disease, only subtle echotextural changes were seen. Hence, hepatic nodular hyperplasia may be inapparent in vivo in many dogs. Hepatic nodular hyperplasia is a potentially confusing sporadic finding which must be considered by ultrasonographers examining dogs with clinical signs of hepatic disease. The diagnosis of hepatic neoplasia should not be made on the basis of ultrasonographic findings alone.     

The clinical use of the neuromuscular blocking agent rocuronium in dogs

Objective The aim of this study was to characterize the onset and duration of action of the aminosteroid muscle relaxant rocuronium in dogs under clinical conditions. Study design Prospective single dose trial. Animals Twenty‐three dogs aged between 6 months and 12 years, weighing between 5.5 and 61.5 kg admitted to the University of Liverpool Small Animal Hospital between January and March 2000, and undergoing elective surgical procedures under general anaesthesia. Materials and methods Following induction of general anaesthesia, neuromuscular function was evaluated using train‐of‐four (TOF) stimulation. An initial dose of 0.4 mg kg^?1 rocuronium was administered intravenously (IV) and neuromuscular blockade was monitored by visually assessing the number of responses (twitches) to TOF stimulation (train‐of‐four count: TOFC). Incremental doses of 0.16 mg kg^?1 rocuronium were administered as indicated, when at least two twitches of the TOFC had returned. Results Rocuronium (0.4 mg kg^?1) abolished all responses to TOF stimulation in all dogs. The mean time to onset of neuromuscular blockade (complete abolition of all twitches) was 98 ± 52 seconds. Neuromuscular blockade (absence of all twitches to return of all four) lasted 32.3 ± 8.2 minutes. Incremental doses of 0.16 mg kg^?1 had a mean duration of action of 20.8 ± 4.9 minutes and up to seven increments were shown to be noncumulative. The effects of rocuronium were readily antagonized with neostigmine and atropine. Small transient increases in arterial blood pressure, which occurred in three dogs after the administration of rocuronium, were the only cardiovascular side‐effects observed. Conclusions Rocuronium is an effective nondepolarizing neuromuscular blocking agent in the dog, with a rapid onset of neuromuscular block after intravenous administration and an intermediate duration of action. Clinical relevance Rocuronium produced a neuromuscular block with similar characteristics to those obtained with vecuronium, thus apparently offering little advantage over vecuronium. However, its availability in aqueous solution and a longer shelf‐life increases convenience.