Unstable endobronchial intubation in a cat undergoing tracheal laceration repair

A peri-carinal tracheal laceration was produced in a 11-year-old cat during tracheal intubation. Before reconstructive surgery began, the leak was bypassed with an endobronchial tube positioned using endoscopy and direct vision. However, single-lung ventilation could not be sustained because the tube became dislodged and could not be repositioned. Consequently, surgery was completed with periods of intermittent apnoea interspersed with manually controlled hyperventilation. Cardiovascular variables were stable during anaesthesia and no signs of hypoxia were detected. The difficulties in maintaining endobronchial tube position resulted from the animal's small size relative to the dimensions of the endotracheal tube.     

Gastric Torsion from an Intestinal Hernia Through a Rent in the Gastrosplenic Ligament in a Horse

The present report describes an 8-year-old gelding presenting with signs of severe abdominal pain. After performing a thorough physical examination, including rectal palpation and additional diagnostic tests, an exploratory laparotomy was recommended. The jejunum was found herniated through the gastrosplenic ligament, and the stomach was severely distended with gas. Given a poor prognosis, the horse was euthanized on the table. At necropsy, the stomach appeared dilated, with an 180° horizontal gastric torsion, from left (lateral) to right (medial), dividing the organ into dorsal and ventral compartments. We believe that the chronic traction exerted by an incarcerated and distended loop of jejunum, in the dorsal aspect of the gastrosplenic ligament, associated with trauma during episodes of intense rolling, enlarged the rent until it ruptured. Because of this rupture, the lateral dorsal aspect of the stomach became unattached, predisposing it to the torsion.     

In vitro evaluation of the 18 and 36 kg Securos Cranial Cruciate Ligament Repair System

OBJECTIVE: To evaluate the mechanical properties of the 18 and 36 kg Securos Cranial Cruciate Ligament Repair System. STUDY DESIGN: In vitro mechanical evaluation. SAMPLE POPULATION: Loop constructs of 18, 27, and 36 kilogram test (kgt) nylon leader line (NLL) secured with Securos crimp-clamps (SCC, n=40 per NLL test weight) or by a clamped square knot (CSK; n=40/NLL test weight). METHODS: The 36 kg SCC were used for the 27 and 36 kgt NLL, and 18 kg SCC were used for the 18 kgt NLL. Loop constructs were mounted on a material testing machine, and distracted at 500 mm/min for static tests, and for cyclic tests at 500 mm/min to a distraction limit of 6 mm (18 kgt) or 7.5 mm (27 and 36 kgt) for 49 cycles, until failure. Constructs were tested at 20 degrees C except for 1 group of 27 kgt CSK loops tested at 40 degrees C. Load at failure, elongation, and stiffness was recorded and compared between groups under static or cyclic testing conditions. RESULTS: All 27 and 36 kgt loops failed by disruption of NLL contained within the knot or crimp-clamp, whereas 18 kgt SCC loops failed by the NLL pulling through the crimp-clamp. The 18 kg SCC loops had considerable variability in ultimate load and elongation (coefficient of variation 29.6% and 18.3%, respectively). There was no significant difference in elongation between 27.3 kgt CSK loops tested at 20 degrees C and 40 degrees C. Generally, in both static and cyclic testing, SCC constructs formed with 27.3 or 36.4 kgt NLL performed as well or better than CSK constructs, resulting in loops that were strong, underwent minimal elongation, and had high stiffness. CONCLUSION: The results support use of the 36 kg Securos system but not the 18 kg Securos system (with the clamp and crimping device used). The significantly lower load required for failure, slippage through the clamp, and substantial variability suggested that the crimp tube diameter or the crimping device tested may be inappropriate for use with 18 kgt NLL. CLINICAL RELEVANCE: Surgeons should be aware that crimp-clamp design is important in controlling suture slippage or breakage within the clamp, and that novel systems should undergo mechanical testing with the size suture material they are intended to secure before clinical use.     

Computed tomography of nuchal ligament and semispinalis capitis tendon avulsions in a foal

Head trauma is a common injury in young horses. This case report describes a 10‐week‐old Thoroughbred foal with an open wound following trauma to the poll region, showing abnormal head carriage and depression. A computed tomography (CT) study was performed under general anaesthetic (GA). This identified a complete avulsion of the nuchal ligament (NL) and partial avulsions of the left and right semispinalis capitis (SS) tendons. Following diagnosis and conservative treatment the foal made a good recovery and 18 months later the filly had no detectable neurological or physical abnormalities. Computed tomography enabled an accurate and rapid diagnosis of a novel injury.     

MAGNETIC RESONANCE IMAGING OF SUBARTICULAR BONE MARROW LESIONS IN DOGS WITH STIFLE LAMENESS

A bone bruise is a magnetic resonance (MR) imaging sign thought to signify acute traumatic microfracture of trabecular bone with hemorrhage and edema in the marrow that may occur without grossly visible disruption of the adjacent cortices or overlying cartilage. In approximately 75% of people with acute anterior-cruciate ligament tears, bone bruises are detected in characteristic locations within the femur and tibia and are best seen as high-signal lesions using fat-suppression sequences. We questioned whether this is a component of naturally acquired stifle lameness in dogs and obtained short-tau inversion recovery (STIR) images of six dogs with stifle lameness. High-signal STIR lesions were detected in five of six (83%) dogs and eight of 12 (67%) limbs. We observed these lesions deep to the intercondylar fossa of the femur and intercondylar eminence of the tibia, which are atypical locations in people. High-signal STIR lesions were detected in dogs with only synovitis, partial tear of the cranial cruciate ligament (CCL) and complete tear of the CCL. One of these lesions was seen in the lateral tibial condyle, a typical location in humans with acute anterior cruciate ligament tear. As the MR imaging appearance of stress fractures and bone bruises are similar, and the high-signal STIR lesions are at attachment sites of the CCL, this finding may be due to stress disease or other unknown causes, rather than bone bruising. High-signal STIR lesions may be a common sign in naturally acquired canine stifle disease, but the pathogenesis, prognostic and diagnostic values need further investigation.     

Candida peritonitis in dogs: report of 5 cases

Candida peritonitis is reported in people and is associated with significant morbidity and mortality compared with sterile or bacterial peritonitis. Recognized predisposing risk factors include peritoneal dialysis, hollow viscous organ perforation, abdominal surgery, inflamed intestinal mucosa, antimicrobial administration, and immunosuppression. In this report, we describe 5 cases of dogs with peritonitis complicated by Candida spp; 3 dogs with C albicans, one dog with C albicans and C glabrata, and one dog with C glabrata only. The 3 dogs with C albicans peritonitis presented with duodenal perforation due to NSAID therapy, intestinal resection and anastomosis following postspay‐surgery dehiscence, and intestinal foreign body removal. The 2 dogs with C glabrata peritonitis had undergone cholecystectomy due to gall bladder rupture and dehiscence of intestinal biopsy removal sites following exploratory laparatomy. In all cases, initial diagnosis of fungal peritonitis was made via cytologic examination of peritoneal effusions, which revealed marked pyogranulomatous inflammation with numerous 3–8 μm oval, deeply basophilic yeast organisms with thin clear capsules noted within phagocytes and extracellularly. In addition, germ tube formation, hyphae, and pseudohyphae were rarely seen in some of the cases with pure C albicans. Identity of the organisms was determined by culture in all cases and confirmed by PCR in 3 cases. Candida spp. are commensals normally inhabiting the alimentary, the upper respiratory, and the lower urogenital tracts of mammals. They are opportunistic pathogens that can invade and colonize tissue when a patient is immune‐compromised or there is disruption of the mucosal barrier. Candida peritonitis should be considered in patients with peritoneal contamination with gastrointestinal or biliary contents.     

前十字韧带断裂犬胫骨平台角的X线和CT测量

为探究胫骨平台角（tibial plateau angle,TPA）在犬前十字韧带断裂（cranial cruciate ligament rupture,CCLR）中的临床意义及为犬CCLR的整体发病规律与风险、诊断和治疗方案提供参考,本研究选用2018年6月至2019年1月在中国农业大学动物医院确诊为CCLR的共15只患犬的30个膝关节,使用X线和CT测量TPA （R-TPA和CT-TPA）并比较X线和CT测量TPA的一致性及优缺点。结果显示,R-TPA大小与年龄、体重、胖瘦、性别及绝育/去势与否均无关（P>0.05）,前十字韧带是否断裂亦与TPA大小无关（P>0.05）。经CT测量所得30个CT-TPA的平均值为26.93°（范围：19.03°~32.67°）;左侧膝关节的CT-TPA的平均值为26.82°,右侧为27.04°。R-TPA与CT-TPA值具高度相关性（r>0.75,P>0.05）;21个膝关节（70%）可在CT图像中观察到骨赘生成,其CT图像比X线图像能更清楚地辨识出骨赘与骨皮质的分界。结果表明,TPA与CCLR患犬的临床病理因素无关,X线与CT在测量犬TPA方面具有一致性,CT测量在测量图像的采集上较X线拍摄更方便、快捷与全面,并在骨关节炎病例中的测量精度更高。     

Concurrent proximal suspensory desmopathy and injury of the proximal aspect of the accessory ligament of the deep digital flexor tendon in forelimbs or hindlimbs in 19 horses

Clinical features of proximal suspensory desmopathy (PSD) and concurrent injury of the proximal aspect of the accessory ligament of the deep digital flexor tendon (ALDDFT) have not been documented. The objectives were to describe clinical signs and diagnosis. This was a retrospective study. Patient details, lame limb(s), response to diagnostic analgesia, and radiographic and ultrasonographic findings were recorded. PSD and injury of the proximal aspect of the ALDDFT were identified in 19 horses, 14 with forelimb lameness (unilateral 5, bilateral 9) and 5 with hindlimb lameness (unilateral 2, bilateral 3). Localising clinical signs were seen in 7/31 lame limbs (subtle thickening in the region of the ALDDFT [n = 3], pain on palpation of the body of the suspensory ligament (SL) [n = 6], heat in the proximal metacarpal or metatarsal region [n = 2]). Forelimb lameness was abolished by perineural analgesia of the palmar metacarpal (subcarpal) nerves in 17/23 limbs. In the remaining limbs intra‐articular analgesia of the middle carpal joint (n = 2) or an ulnar nerve block (n = 4) were required to eliminate the lameness. Hindlimb lameness was abolished by perineural analgesia of the deep branch of the lateral plantar nerve (n = 2) or local infiltration of the proximal plantar aspect of the metatarsus (n = 3); a tibial nerve block resolved lameness in the remaining 3 limbs. Lesions of the SL and of the ALDDFT were characterised ultrasonographically by enlargement, heterogeneous echogenicity and loss of long linear echoes in longitudinal images. In 3 horses adhesions between the ALDDFT and the SL were identified post mortem. Close apposition of these structures seen ultrasonographically may indicate adhesion formation. It was concluded that the clinical features of PSD and concurrent injury of the ALDDFT are similar to those for PSD alone, highlighting the need for comprehensive and systematic ultrasonographic assessment.     

DILATED CORONARY SINUS IN A DOG WITH PERSISTENT LEFT CRANIAL VENA CAVA

This paper describes the electrocardiographic, echocardiographic (two-dimensional, M-mode, contrast and Doppler) and non-selective angiocardiographic features in a 3 year old female Beagle with dilated coronary sinus due to persistent left cranial vena cava. Negative P waves in leads III and aVR and a positive P wave in lead aVL were seen. Echocardiographically, a hipoechoic circular structure was seen between the left atrium and the pericardium in the area where the coronary sinus is located. A velocity pattern with two peaks was obtained, one systolic with velocity = 0.44 ± 0.05 m/sec and the other diastolic with velocity = 0.27 ± 0.01 m/sec. By M-mode echocardiography, at level of the aorta and the left atrium, a linear structure was identified between the left atrium and the pericardium; this structure was characterized by phasic movements of the anterior wall during the cardiac cycle. Following a left cephalic vein injection of saline, bubbles were seen within the coronary sinus; when saline was injected into the right cephalic vein, bubbles were also seen within the coronary sinus and right atrium and ventricle. Non-selective angiocardiography confirmed a dilated coronary sinus with persistent left cranial vena cava. The right cranial vena cava was absent. The dog was clinically normal and the unusual vessel was an incidental finding.     

DIAGNOSIS OF URINARY BLADDER RUPTURE USING ULTRASOUND CONTRAST CYSTOGRAPHY: IN VITRO MODEL AND TWO CASE-HISTORY REPORTS

Because urinary bladder rupture can be life threatening, a simple, safe technique for evaluating patients is desirable. Current diagnostic protocols involve radiographic imaging, but ultrasound-based contrast techniques have not been methodically evaluated in veterinary patients with urologic trauma. Ultrasound contrast cystography (contrast cystosonography) involves infusion of microbubbled saline solution through a urinary catheter. It was performed in an in vitro model and in 2 dogs with naturally occurring urinary bladder rupture. A positive result consisted of visualizing microbubbles sonographically in fluid surrounding the bladder immediately after infusion of contrast into the urinary catheter. A positive result was obtained both in the in vitro model and in the 2 dogs, with radiographic and surgical confirmation of naturally occurring intraperitoneal urinary bladder rupture in the dogs. Based on the results of this study, ultrasound contrast cystography appears to be more sensitive than two-dimensional (2D) abdominal sonography for detecting naturally occurring urinary bladder rupture in dogs.