Suspected bilateral phrenic nerve damage following a mediastinal mass removal in a 17-week-old pug.

The anesthetic management of a pediatric pug for removal of a mediastinal mass is described. During recovery from anesthesia, the dog's respiratory pattern was compatible with bilateral diaphragmatic paralysis. Incidence, complications, possible treatments of phrenic nerve injury, problems of long-term mechanical ventilation, and alternative case management are discussed.

Lésion bilatérale suspectée du nerf phrénique après l'ablation d'une masse médiastinale chez un Pug âgé de 17 semaines. Nous décrivons la gestion anesthésique d'un Pug pédiatrique présenté pour l'ablation d'une masse médiastinale. Durant le réveil après l'anesthésie, le profil respiratoire du chien était compatible avec la paralysie diaphragmatique bilatérale. L'incidence, les complications et les traitements possibles d'une blessure du nerf phrénique, les problèmes de la ventilation mécanique à long terme et les solutions pour la gestion du cas sont discutés.(Traduit par Isabelle Vallières).

Liver size, bodyweight, and tolerance to acute complete occlusion of congenital extrahepatic portosystemic shunts in dogs.

OBJECTIVE: To investigate the relationship between preoperative liver size, bodyweight, and tolerance to shunt occlusion in dogs with congenital extrahepatic portosystemic shunt(s) (CPSS). STUDY DESIGN: Longitudinal cohort study. ANIMALS: Dogs with CPSS (n=35). METHODS: Ultrasonography was used to measure preoperative maximum transverse dimension of the liver (TS) of each dog. Intraoperative portal pressures were measured, before and after CPSS occlusion, via a jejunal vein catheter. Tolerance to shunt occlusion was judged on gross visceral observations, and on changes in portal pressure, central venous and mean arterial pressures. RESULTS: TS was significantly related to bodyweight (P<.05). Mean ratios for TS/bodyweight were calculated for dogs tolerant and intolerant of acute complete shunt occlusion. Dogs tolerant to occlusion had significantly higher TS/bodyweight ratios than dogs intolerant to occlusion (P=.025). Dogs with a TS/bodyweight ratio of >7 were more likely to tolerate CPSS occlusion than dogs with a TS/bodyweight ratio of <5 (P=.036). A model was generated to predict portal pressure rise after shunt occlusion, based on liver dimensions and bodyweight (R=0.668). Intestinal oxygenation did not correlate significantly with tolerance to CPSS occlusion (P=.29). CONCLUSION: In dogs with CPSS, liver size (relative to bodyweight) is significantly greater (P=.025) in dogs that are tolerant of full ligation than intolerant of occlusion. CLINICAL RELEVANCE: Preoperative measurement of bodyweight and liver size help indicate the likelihood of tolerance to acute complete occlusion of CPSS in dogs.

Acute oropharyngeal and esophageal stick injury in forty-one dogs.

OBJECTIVE: To report clinical findings, treatment, and outcome in dogs with acute (<7 days) oropharyngeal or esophageal stick injury. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=41) with acute oropharyngeal or esophageal injury. METHODS: Dogs had clinical and radiographic examination, and frequently, cervical surgical exploration. The decision to operate was based on radiographic findings of cervical emphysema. Outcome was determined by owner or veterinarian interview. RESULTS: Of 41 dogs, 27 had oropharyngeal injury and 14 had esophageal injury. Five dogs with esophageal injury died. All dogs with radiographic evidence of cervical emphysema (n=34) had ventral median cervical exploration or necropsy; 11 had wood fragment(s) retrieved. In 7 dogs without radiographic signs of cervical emphysema, wounds involving the pharynx or soft palate were treated by local debridement and lavage using an oral approach. Mean follow-up time was 36.4 months. All wounds healed without complication; however, 1 dog that was not surgically explored had a piece of wood surgically retrieved 3 months later. CONCLUSIONS: Radiographic evidence of cervical emphysema is a frequent finding in dogs with acute penetrating oropharyngeal or esophageal injury and indicates trauma to the deeper cervical tissues. Acute penetrating injury of the oropharyngeal region, when treated appropriately, has a better prognosis than acute esophageal penetration. CLINICAL RELEVANCE: Ventral median cervical surgical exploration is recommended in dogs with acute penetrating injury of the oropharynx or esophagus if there is radiographic evidence of tissue emphysema.