Evaluation of two novel self-anchoring barbed sutures in a prophylactic laparoscopic gastropexy compared with intracorporeal tied knots.

OBJECTIVE: To compare laparoscopic gastropexy using 2 self-anchoring barbed sutures to gastropexy using laparoscopically tied intracorporeal knots. STUDY DESIGN: Prospective, randomized controlled, clinical trial. ANIMALS: Dogs (n = 30) weighing >16 kg. METHODS: Dogs were randomly assigned to 1 of 3 laparoscopic gastropexy groups: group 1 (controls), intracorporeal 2-0 polydioxanone sutures (PDSII, Ethicon); group 2, barbed suture (0 Quill™ PDO; Angiotech); and group 3, barbed suture (2-0 V-Loc™ 180; Covidien). Gastropexy suturing time (GST) and total surgery time (TST) were recorded for each dog. Complications were recorded. Each dog was examined by ultrasound (1, 3, and 6 months postoperatively) to ensure persistence of the gastropexy. One dog each in group 2 and group 3 had 2nd look laparoscopy to evaluate the gastropexy. RESULTS: All gastropexies were intact at 6 months. Mean GST was significantly longer for group 1 (36 minutes; range, 25-46 minutes) than for groups 2 (20 minutes; range, 16-37 minutes) and 3 (19 minutes; range, 15-30 minutes; P < .05), which were not significantly different from each other. Likewise TSTs for groups 2 and 3 were significantly shorter than for group 1 (P < .05). CONCLUSION: Barbed sutures (Quill™ and V-Loc™) allowed for effective intracorporeal laparoscopic suturing of an incisional gastropexy without tying intracorporeal knots.

Complications associated with 696 tibial plateau leveling osteotomies (2001-2003).

A total of 696 tibial plateau leveling osteotomy (TPLO) procedures were performed over a 30-month period following TPLO training. The overall complication rate was 18.8%. Complications were classified as perioperative (1%), short-term (9.3%), and long-term (8.5%). Examples of complications encountered during the study were hemorrhage, swelling at the incision site, premature staple removal by the dog, tibial tuberosity fracture, patella tendon swelling, and implant complications. Based on the rate of complications observed, clinical outcomes of TPLO procedures within 30 months of TPLO training were considered good.

Effects of hyperbaric oxygen therapy on hydroxyapatite orbital implant vascularization in rabbits.

PURPOSE: To deterrmine if hyperbaric oxygen therapy affects the rate of hydroxyapatite orbital implant vascularization in normal rabbit orbits. METHODS: We performed a randomized comparative experimental pilot study involving 6 rabbits. All rabbits were enucleated and implanted with hydroxyapatite orbital spheres. The animals were randomized for enucleation of the right or left eye and for treatment or nontreatment (control) with hyperbaric oxygen. The implants were removed after 3 weeks of treatment and histologically examined for fibrovascular ingrowth, inflammation, and multinucleated giant cells. Each parameter was graded on a numeric scale and analyzed. RESULTS: Hyperbaric oxygen therapy did not increase implant vascularization compared with nontreatment implants. Although treated implants had less central fibrovascular maturity compared with control implants, the difference was not statistically significant (p < 0.055). There was no significant difference in inflammation or the number of multinucleated giant cells between treated and control implants. CONCLUSIONS: In this pilot study, hyperbaric oxygen therapy did not increase hydroxyapatite vascular ingrowth and possibly delayed fibrovascular maturation in normal sockets. Further studies with more subject numbers are needed to confirm these conclusions. The effect of hyperbaric oxygen therapy in vascularly compromised sockets also needs to be determined.

Effect of hyperbaric oxygen treatment on incorporation of an autogenous cancellous bone graft in a nonunion diaphyseal ulnar defect in cats.

OBJECTIVE: To determine whether hyperbaric oxygen treatment (HBOT) would affect incorporation of an autogenous cancellous bone graft in diaphyseal ulnar defects in cats. ANIMALS: 12 mature cats. PROCEDURE: Bilateral nonunion diaphyseal ulnar defects were created in each cat. An autogenous cancellous bone graft was implanted in 1 ulnar defect in each cat, with the contralateral ulnar defect serving as a nongrafted specimen. Six cats were treated by use of hyperbaric oxygen at 2 atmospheres absolute for 90 minutes once daily for 14 days, and 6 cats were not treated (control group). Bone labeling was performed, using fluorochrome markers. Cats were euthanatized 5 weeks after implanting, and barium sulfate was infused to evaluate vascularization of grafts. Ulnas were evaluated by use of radiography, microangiography, histologic examination, and histomorphometric examination. RESULTS: Radiographic scores did not differ between treatment groups. Microangiographic appearance of grafted defects was similar between groups, with all having adequate vascularization. Differences were not observed between treated and nontreated groups in the overall histologic appearance of decalcified samples of tissue in grafted defects. Mean distance between fluorescent labels was significantly greater in cats given HBOT than in nontreated cats. Median percentage of bone formation in grafted defects was significantly greater in cats given HBOT. CONCLUSIONS: Hyperbaric oxygen treatment increased the distance between fluorescent labels and percentage of bone formation when incorporating autogenous cancellous bone grafts in induced nonunion diaphyseal ulnar defects in cats, but HBOT did not affect revascularization, radiographic appearance, or qualitative histologic appearance of the grafts.

Physical and pharmacologic restraints in long-term care facilities.

This study examined the effects of education on the attitudes and practices of long-term care staff toward use of restraints. The intervention, a 1-day educational seminar, used a collaborative team of speakers from the Utah Survey Agency and medical professions. Seminar goals were threefold: first, to provide information about best practices for managing behaviors of individuals with dementia in long-term care settings; second, to provide an explanation of the Omnibus Budget Reconciliation Act regulations pertaining to restraint use; and third, to present alternative strategies to link best practice guidelines to the provision of care. Results showed significant changes in participants' attitudes toward use of restraints. Participants reported replicating the seminar for nursing home staff, revisiting facility policies on restraints, and modifying resident care plans.

Evaluation of shelf arthroplasty as a treatment for hip dysplasia in dogs.

OBJECTIVE: To evaluate effects of shelf arthroplasty on coxofemoral joint laxity and progression of degenerative joint disease in young dogs with hip dysplasia. DESIGN: Prospective, controlled study. ANIMALS: 10 dogs between 10 and 24 months old and weighing between 20 and 27 kg. All dogs had bilateral coxofemoral joint laxity (i.e., an Ortolani's sign). PROCEDURE: In all dogs, shelf arthroplasty was performed on the right coxofemoral joints, and a sham procedure was performed on the left. Dogs were evaluated before and after surgery by means of lameness assessment, coxofemoral joint palpation and goniometry, thigh circumference measurement, and radiography. RESULTS: There were no significant changes in coxofemoral joint mobility, range of motion, joint laxity, degree of degenerative joint disease, or thigh circumference during the study. A greater amount of periacetabular bone formed on the right side than on the left side; however, dogs did not develop large bony shelves, and the amount of periarticular bone decreased over time. The polymer implants remained in their original position and were encapsulated by fibrous tissue. There was no histologic evidence of osteoconduction by the implants. CLINICAL IMPLICATIONS: The polymer implants used in this procedure do not appear to be osteoconductive. Shelf arthroplasty was associated with minimal morbidity and was not associated with serious adverse sequelae in this study, but the procedure did not alter the progression of hip dysplasia in these dogs. We cannot advocate shelf arthroplasty using this polymer as a treatment for dogs with hip dysplasia.

Deep-frozen allogeneic cancellous bone grafts in 10 dogs: a case series.

Deep-frozen, aseptically collected and processed allogeneic cancellous bone was implanted in eight dogs during the surgical repair of diaphyseal long bone fractures and in two dogs during arthrodeses. A combined allogeneic and autogeneic cancellous bone graft was used in two fractures with a segmental bone loss of more than 5 cm. Bone union occurred in five fractures and in both arthrodeses. Failure of fixation occurred in two dogs with nonunion fractures and in a third dog with an open, infected fracture. Biopsies from the fracture sites were obtained from these dogs following failure of their fracture fixation. The cancellous bone graft appeared to be in the process of normal incorporation in each case. Failure of fixation was attributed to technical or case management errors or both, in each of the three fractures that failed to achieve bony union. Frozen allogeneic cancellous bone grafts were effectively incorporated when used in the primary repair of fractures and arthrodeses. Combined autogenous and allogeneic cancellous bone grafts may be particularly useful in the repair of fractures with large segmental diaphyseal bone defects. The use of allogeneic cancellous bone grafts in nonunion fractures requires further investigation before it can be recommended.

Germfree technique for the rearing of kittens--a research tool.

Techniques to derive and rear germfree kittens (Felis catus) for biomedical research were explored and refined. The isolator units, equipment, sterilization procedures, husbandry techniques, and safety issues are discussed. This method proved to be successful for the surgical derivation and hand-rearing of germfree kittens.

Surgery of the external ear canal.

Otitis externa may account for up to 20% of presenting complaints in small animal practice. Many of these cases are non-responsive to medical therapy and require surgical intervention. The modified Zepp procedure or lateral wall resection should be considered early in the course of the disease. Performing this procedure in advanced cases of otitis externa, which involve both the medial and lateral walls of the ear canal, is responsible for 34-47% of these cases showing no improvement. Vertical ear canal ablation is the procedure of choice when the entire vertical canal is involved but the horizontal canal is free of disease. If the disease involves both the vertical and horizontal canals, a total ear canal ablation, along with removal of the lateral aspect of the bony bulla should be performed. By removing this portion of the bulla, improved drainage is achieved, and the complication rate following total ear canal ablations is decreased.

The effects of plaster of Paris and autogenous cancellous bone on the healing of cortical defects in the femurs of dogs.

Four one quarter inch evenly spaced circular defects were created bilaterally in the lateral femoral diaphysis of 12 clinically normal adult dogs. The defects were left unfilled (control), or were filled with one of the following: (1) plaster of Paris, (2) an equal-volume mixture of plaster of Paris and autogenous cancellous bone, and (3) autogenous cancellous bone. The degree of bone healing was evaluated radiographically and histologically at 2, 4, 6, 8, 10, and 12 weeks. Radiographically, no objective conclusions could be drawn due to the small size of the defects and limited amount of plaster of Paris implanted. Histologically, there was no inflammatory reaction to the plaster of Paris. No differences were determined in the degree of bone healing between autogenous cancellous bone, plaster of Paris, and a mixture of plaster of Paris and autogenous cancellous bone. All implants were superior to the control defect in degree of bone healing.

Canine distemper viral inclusions in blood cells of four vaccinated dogs.

Four cases of canine distemper were detected by the presence of numerous cytoplasmic inclusions in various circulating blood cells. Fluorescent antibody techniques and electron microscopy confirmed the identity of the viral inclusions. The cases occurred in the same geographic area and within a short time span. All four dogs had been vaccinated against canine distemper, but stress or other factors may have compromised their immune status. The possibility of an unusually virulent virus strain was also considered.

Tracheal surgery in dogs: a review.

Though tracheal injuries often appear only superficial, exploration may reveal severe lacerations or fractures of the cartilaginous rings. A thorough physical examination and thoracic radiographs should precede tracheal surgery. Severe tracheal trauma is best repaired by partial resection and primary end-to-end anastomosis. Tension-relieving sutures aid healing of the anastomotic area, which is closed with synthetic absorbable sutures with extraluminal knots. Tracheal collapse, which primarily occurs in small or toy breeds, causes inspiratory dyspnea and can be corrected with polypropylene prostheses. Permanent tracheostomy may be required with laryngeal paralysis or irreparable tracheal injuries.