Long-term outcome and risk factors associated with death or the need for revision surgery in dogs with permanent tracheostomies.

OBJECTIVE: To evaluate long-term outcomes and identify factors associated with death or the need for revision surgery in dogs with permanent tracheostomies (PTs). DESIGN: Retrospective cohort study. ANIMALS: 69 client-owned dogs that received a PT between January 2002 and June 2016 at 1 of 4 veterinary teaching hospitals. PROCEDURES: Medical records were reviewed, and data extracted included signalment, history, clinical signs, radiographic and laryngeal examination findings, presence of esophageal abnormalities, date and reason for receiving a PT, postoperative complications, cause of death, and survival time. Dogs surviving < 2 weeks after receiving a PT were excluded. RESULTS: Major complications occurred in 42 of 69 (61%) dogs, with aspiration pneumonia (13 [19%]), skinfold occlusion (13 [19%]), and stoma stenosis (12 [17%]) being most common. Revision surgery was performed in 24 of 69 (35%) dogs, most commonly because of stoma stenosis or skinfold occlusion (9/24 [38%] each). Brachycephalic dogs were more likely (OR, 3.5; 95% confidence interval, 1.2 to 10.2) to require revision surgery than were nonbrachycephalic dogs. The overall median survival time was 1,825 days, and dogs that received corticosteroids before receiving a PT, had tracheal collapse, or were older had shorter survival times. CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study indicated that creation of a PT was a viable treatment option for obstructive upper airway diseases in dogs and that long-term survival after receiving a PT was possible; however, a PT may not reduce the risk of aspiration pneumonia in dogs.

Chronic Renal Changes After a Single Ischemic Event in an Experimental Model of Feline Chronic Kidney Disease.

Previous work demonstrated renal fibrosis 70 days after a single unilateral in vivo renal ischemic event, but changes associated with a single episode of renal ischemia past this time are unknown. In this study, we evaluated renal function and structural changes 6 months after a 90-minute in vivo unilateral renal ischemic event. Six adult female cats underwent unilateral renal ischemia and renal function was followed for 6 months, at which time the kidneys were evaluated by histology and histomorphometry. Over time, there was a significant reduction in the glomerular filtration rate and an elevation of serum creatinine of 31% and 42%, respectively. All cats had tubulointerstitial lesions characterized by segmental interstitial inflammation, tubular atrophy, and interstitial fibrosis. Unlike short-term studies, ischemic kidneys had variable numbers of obsolescent glomeruli, consistent with the development of atubular glomeruli and subsequent ischemic glomerulosclerosis. Chronic changes associated with acute renal ischemia may include loss of function and glomerulosclerosis.

Incidence of and risk factors for postoperative regurgitation and vomiting in dogs: 244 cases (2000-2012).

OBJECTIVE: To determine the incidence of and risk factors for postoperative regurgitation and vomiting (PORV) in dogs. DESIGN: Retrospective cohort study. ANIMALS: 244 client-owned dogs. PROCEDURES: Dogs referred for nonelective surgery in the first 3 months of 2000 and 2012 were included. Breed; sex; age; weight; body condition score; emergency status; food withholding status; history of vomiting or regurgitation; American Society of Anesthesiologists score; presence of diabetes or hypothyroidism; preoperative PCV and total solids concentration; anesthesia protocol; corticosteroid, opioid, neuromuscular blocking agent, and nitrous oxide usage; anesthesia time; surgery time; type of surgery; and occurrence of vomiting or regurgitation within 24 hours after recovery from anesthesia were recorded. Data were analyzed by means of the Fisher exact test, Wilcoxon rank sum test, and logistic regression. RESULTS: 30 of 244 (12.3%) dogs meeting study inclusion criteria developed PORV. There was no significant difference in the incidence of PORV between the 2000 (12/111 [10.8%]) and 2012 (18/133 [13.5%]) cohorts, although the incidence of regurgitation was higher in 2012. Univariate logistic regression identified the most significant risk factors as gastrointestinal surgery (OR, 11.15; 95% confidence interval [CI], 3.11 to 40.03), premedication without strong sedatives including either an α2-adrenoceptor agonist or acepromazine (OR, 5.36; 95% CI, 1.89 to 15.17), American Society of Anesthesiologists score of 4 (OR, 5.25; 95% CI, 1.05 to 26.15), history of vomiting or regurgitation (OR, 5.12; 95% CI, 1.83 to 14.31), emergency surgery (OR, 4.08; 95% CI, 1.29 to 12.90), neurologic surgery (OR, 3.18; 95% CI, 1.02 to 9.92), sevoflurane inhalation anesthesia (OR, 2.78; 95% CI, 1.25 to 6.13), and being sexually intact (OR, 2.37; 95% CI, 1.07 to 5.27). Multivariate analysis was not clinically useful owing to the low sensitivity and specificity of the model. CONCLUSIONS AND CLINICAL RELEVANCE: Between 2000 and 2012, there was no change in the incidence of PORV for dogs undergoing neurologic, orthopedic, and soft tissue surgical procedures; however, the proportion of dogs that regurgitated increased significantly in 2012. Preoperative antiemetic prophylaxis should be considered in dogs undergoing gastrointestinal surgery and in those in which other risk factors are present.