Scapular Osteotomy for Lateral Access to a T1-2 Foraminal Disc Extrusion, Treated by Mini-Hemilaminectomy in a Dog.

A 4-year-old female spayed French bulldog was presented with a 2-day history of neck pain and left thoracic limb lameness with no neurological deficits. A computed tomography (CT) examination showed a left foraminal T1-2 disc extrusion. Surgical management was performed using a left lateral approach to the vertebral column with a scapular osteotomy. A T1-2 mini-hemilaminectomy was performed. The scapular osteotomy was stabilized with two 2.4-mm locking compression plates. The postoperative CT and radiographic examinations showed adequate decompression of the T1-2 foramen and good reduction in the scapular osteotomy. The dog was able to walk the following day. At the 1-month follow-up, the dog had no neck pain but persistent slight left thoracic limb lameness. Ten months postoperatively, a CT scan showed no abnormalities at the surgical site, and the dog had no neurological deficits nor lameness. The aim of this case report was to describe a new lateral approach to T1-2 intervertebral space.

Malakoplakia of the Bladder in a 4-Month-Old Puppy.

A 4 mo old female Staffordshire bull terrier puppy was presented with chronic Escherichia coli cystitis. Ultrasound and cystoscopic examination revealed innumerable, intraluminal, finger-like proliferations arising from the dorsal urinary bladder (UB) wall. Histological examination of mucosal biopsies obtained by cystoscopy was suggestive of granulomatous cystitis. The proliferative lesions were removed surgically and submitted for histological examination. The UB submucosa was heavily infiltrated by macrophages with periodic acid-Schiff-positive cytoplasm exhibiting rare Michaelis-Gutmann bodies, leading to the diagnosis of malakoplakia. The puppy was prescribed with sulfamethoxazole-trimethoprim. The urinary signs disappeared despite the persistent UB wall thickening revealed by abdominal ultrasound. Urine culture performed during the ninth week of treatment showed a persistent infection by E coli resistant to sulfamethoxazole-trimethoprim. The dog was switched to doxycycline but was then lost to follow-up. Malakoplakia is a chronic granulomatous inflammation well documented in humans. Its pathophysiology is not fully understood, but bacterial infection, immunodepression, and a defective lysosomal function may lead to the intracytoplasmic accumulation of partially degraded bacteria that can subsequently mineralize to form the Michaelis-Gutmann bodies. Malakoplakia should be suspected when UB mass lesions are identified in a young dog with bacterial cystitis.

Effects of urinary bladder retroflexion and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia: 41 cases (2002-2009).

OBJECTIVE: To evaluate the effects of urinary bladder retroflexion (UBR) and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia. DESIGN: Retrospective case series. ANIMALS: 41 client-owned dogs with perineal hernia that underwent surgery between November 2002 and November 2009. PROCEDURES: Medical records were reviewed for information on dog signalment, history, physical examination findings, ultrasonographic findings, surgical techniques, intraoperative complications, duration of hospital stay, postoperative complications, and long-term outcome. RESULTS: 31 dogs had no UBR, and 10 dogs had UBR. Internal obturator muscle transposition (IOMT) was performed in 20 dogs, and a cystopexy or colopexy was performed before the IOMT (LapIOMT) in 21. Postoperative complications included tenesmus (n = 8) and urinary incontinence (1). Rates of postoperative complications were not significantly different between the no-UBR and UBR groups or between the IOMT and LapIOMT groups. Thirty-two dogs were free of clinical signs at the time of the study. The median disease-free interval did not differ significantly between dogs in the no-UBR and UBR groups, but it was significantly lower in the LapIOMT group than in the IOMT group. None of the 7 dogs with UBR that were treated without cystopexy developed recurrence of UBR. CONCLUSIONS AND CLINICAL RELEVANCE: UBR was not associated with an increased rate of postoperative complications relative to no UBR and had no effect on the long-term outcome in dogs with perineal hernia. The use of IOMT alone may be recommended for clinical use because LapIOMT offered no clear advantage.

Video-assisted thoracoscopic surgery for pneumothorax induced by migration of a K-wire to the chest.

A 2 yr old female English setter dog was admitted for acute dyspnea. The dog underwent treatment of a T9T10 thoracic vertebral fracture subluxation at the authors' institution 15 mo earlier. Upon admission, a chest X-ray revealed a pneumothorax and a metallic foreign body in the left hemithorax. An emergency video-assisted thoracoscopic surgery was successfully performed to remove a 4.6-mm long Kirschner wire that migrated from the thoracic vertebral column to the thoracic cavity. The operating time was 27 min. The dog made an uneventful recovery and was discharged on the third day after surgery. Pneumothorax should be considered in patients that develop acute dyspnea and have a history of wire fixation in the thoracic vertebral column. Video-assisted thoracoscopic surgery is a safe and effective treatment of this condition.

Effects of bilateral arytenoid cartilage stenting on canine laryngeal resistance ex vivo.

OBJECTIVE: To evaluate the effect of Nitinol stents for bilateral arytenoid lateralization on canine laryngeal resistance. STUDY DESIGN: Ex vivo experimental study. ANIMALS: Canine cadaver larynges (n=7). METHODS: Laryngeal resistance was calculated in all specimens with the epiglottis in open and closed positions. Bilateral arytenoid stenting was performed, rima glottidis width measured, and laryngeal resistance calculated. The effects of stenting on laryngeal resistance were evaluated by repeated measures ANOVA. RESULTS: Calculated laryngeal resistance in the 3 stented groups, 2 cm (0.034±0.059 cmH(2) O/L/s), 3 cm (0.034±0.059 cmH(2) O/L/s), and 4 cm (0.034±0.059 cm H(2) O/L/s), was significantly decreased versus the control (unstented) group (0.947±0.624 cmH(2) O/L/s; P=.0098) with an epiglottis in the normal position. Calculated laryngeal resistance in the 3 stented groups, 2 cm (43.407±17.348 cm H(2) O/L/s), 3 cm (70.659±34.705 cmH(2) O/L/s), and 4 cm (92.637±44.509 cm H(2) O/L/s), was significantly increased versus the control (unstented) group (29.561±14.499 cm H(2) O/L/s) (P=.0185) with an epiglottis in the closed position. The width of the rima glottidis correlated with the size of the stent (r=0.95, P<.001). CONCLUSIONS: Bilateral arytenoid stenting significantly reduced calculated laryngeal resistance with an open epiglottis. Stenting resulted in a significant increase in laryngeal resistance versus the control with a closed epiglottis. Use of bilateral arytenoid stenting in clinical cases of laryngeal paralysis may provide an adequate decrease in open-epiglottis airway resistance to alleviate clinical signs, while increasing closed-epiglottis airway resistance. This could potentially lead to a decrease in the risk of postoperative aspiration pneumonia.

Effects of suture tension during unilateral cricoarytenoid lateralization on canine laryngeal resistance in vitro.

OBJECTIVE: To evaluate the effect of abduction suture tension for unilateral arytenoid lateralization on laryngeal resistance. STUDY DESIGN: Experimental study. ANIMALS: Canine cadaver larynges (n=16). METHODS: Laryngeal resistance was calculated in all specimens with the epiglottis in open and closed positions. Left cricoarytenoid lateralization was performed under low or high suture tension, and laryngeal resistance was re-calculated. The effects of suture tension on laryngeal resistance were evaluated by repeated measures ANOVA. RESULTS: Cricoarytenoid lateralization under low or high suture tension significantly reduced laryngeal resistance with the epiglottis in an open or closed position. There was no difference in laryngeal resistance with an open epiglottis between the low-tension (1.00+/-0.0001 cm H(2)O/L/s) and high-tension (1.10+/-0.35 cm H(2)O/L/s) groups (P=.33). The low-tension group (22.80+/-14.20 cm H(2)O/L/s) had significantly greater laryngeal resistance than the high-tension group (8.45+/-4.00 cm H(2)O/L/s) with a closed epiglottis (P=.016). There was no difference in laryngeal resistance with a closed epiglottis for the low-tension group before (34.30+/-36.50 cm H(2)O/L/s) and after (22.80+/-14.20 cm H(2)O/L/s; P=.42) arytenoid lateralization. CONCLUSIONS: Cricoarytenoid lateralization under low suture tension significantly reduced laryngeal resistance with an open epiglottis, but resulted in a significantly greater resistance with a closed epiglottis than cricoarytenoid lateralization under high suture tension. CLINICAL RELEVANCE: Clinically, use of a low-tension suture for cricoarytenoid lateralization may provide an adequate decrease in open-epiglottis laryngeal resistance to alleviate clinical signs, while maintaining enough closed-epiglottis laryngeal resistance to reduce the risk of postoperative aspiration pneumonia.

Evaluation of survival rate and prognostic indicators for surgical treatment of left-to-right patent ductus arteriosus in dogs: 52 cases (1995-2003).

OBJECTIVE: To determine factors associated with long-term survival in dogs treated surgically for patent ductus arteriosus (PDA). DESIGN: Retrospective case series. Animals-52 dogs treated surgically for left-to-right shunting PDA. PROCEDURE: Data pertaining to age, breed, sex, body weight, clinical examination findings, type and duration of medical treatment, results of thoracic radiography and echocardiography, and surgical and postoperative complications were collected from records. Follow-up information was obtained from medical records or telephone interviews with owners or referring veterinarians. RESULTS: 22 dogs had mitral valve regurgitation. Mean weight and age were not significantly different between dogs with or without mitral valve regurgitation. Twenty-four (46.2%) dogs had clinical signs related to cardiac insufficiency. Left atrial dilatation was observed in 56.3% of dogs that were radiographed. Sonographic imaging was used to diagnose left atrial dilatation in 23 dogs and left ventricular dilatation in 25 dogs. The 1- and 2-year survival rates were 92% and 87%, respectively. Diagnosis of mitral valve regurgitation before surgery was not associated with the probability of survival. Age, weight, lethargy, preoperative treatment with angiotensin-converting enzyme inhibitors, and right atrial dilatation on radiographs at the time of surgery were negatively associated with probability of survival. CONCLUSIONS AND CLINICAL RELEVANCE: Surgical treatment of PDA was curative in young dogs without clinical signs of heart failure. Surgical correction of PDA should be recommended as early as possible after diagnosis, and mitral valve regurgitation is not a contraindication for surgery.

Effects of suture tension and surgical approach during unilateral arytenoid lateralization on the rima glottidis in the canine larynx.

OBJECTIVES: To evaluate the effect of abduction suture tension and cricothyroid (CT) joint disarticulation on the area, height, and width of the rima glottidis (RG) during unilateral arytenoid lateralization. STUDY DESIGN: Experimental study. ANIMALS: Nine canine cadaver larynges. METHODS: Left arytenoid lateralization was performed with high or low abduction suture tension. RG area, height, and width were measured by computerized planimetric analysis with the epiglottis in an open and closed position. The experiment was performed with the CT joint intact and disarticulated. The effects of suture tension, CT disarticulation, and their interaction on RG area with the epiglottis closed or open were evaluated by repeated measures analysis of variance (ANOVA). RESULTS: RG area increased by 82% and 129% (P <.0001) with low and high suture tension, respectively. The aperture not covered by the epiglottis in a closed position was 467% larger with high suture tension than with low tension (P <.0001). CT disarticulation had no significant effect on RG geometry with either low or high suture tension (P =.4970). CONCLUSIONS: Low suture tension increased RG area when the epiglottis was in an open position without increasing RG aperture when the epiglottis was closed. Suture tension had a significant effect on RG opening when the epiglottis was closed. CT disarticulation did not modify the geometry of the RG. CLINICAL RELEVANCE: Use of a low-suture tension should be considered during arytenoid lateralization because it has the potential to reduce the risk of aspiration pneumonia.