Risk factors for complicated perioperative recovery in dogs undergoing staphylectomy or folded flap palatoplasty: Seventy-six cases (2018-2022).

OBJECTIVE: To analyze risk factors for complicated perioperative recovery of dogs undergoing either staphylectomy or folded flap palatoplasty. STUDY DESIGN: Retrospective study. ANIMALS: Seventy-six client-owned dogs. METHODS: Medical records of dogs that underwent either staphylectomy or folded flap palatoplasty were reviewed for signalment, brachycephalic risk (BRisk) score, history of gastrointestinal signs, laryngeal collapse grade, presence of preoperative aspiration pneumonia, intraoperative respiratory and cardiovascular complications, length of general anesthesia, number of corrected brachycephalic obstructive airway syndrome (BOAS) components, and gastrointestinal and respiratory postoperative complications. Complicated recovery was defined as requirement for prolonged oxygen treatment and/or tracheostomy or perioperative death. Penalized logistic regression was used to identify risk factors. RESULTS: Seventy-six dogs were enrolled in the study. Multivariate penalized logistic regression identified four risk factors for complicated recovery. These include surgery type (p = .0002), age (p = .0113), laryngeal collapse grade >2 (p < .0001) and length of general anesthesia (p = .0051). CONCLUSIONS: In this population, dogs that had staphylectomy, increasing age, laryngeal collapse grade >2 and increasing length of general anesthesia were at increased risk for perioperative complicated recovery. CLINICAL SIGNIFICANCE: The results of this study identified risk factors for perioperative complicated recovery in dogs undergoing elongated soft palate correction and may assist in surgical planning and early prediction of complications.

Bilateral neoureterocystostomy with distal ureteral tapering in a dog with severe bilateral hydroureteronephrosis.

A 3.5-year-old intact male Labrador retriever was seen for hematuria. The results of clinical pathology tests were unremarkable. However, urinalysis revealed dark, cloudy, alkalotic, and isosthenuric urine containing red and white blood cells, epithelial cells, and struvite crystals. Severe bilateral enlargement of ureters and markedly enlarged kidneys were identified on abdominal radiographs. Computerized tomography revealed extensive bilateral hydroureteronephrosis with no definitive cause of obstruction. The dog underwent bilateral ureteral tapering with bilateral neoureterocystostomy and placement of temporary bilateral ureteral stents and a cystostomy tube. The dog was monitored in the intensive care unit for 7 d after surgery and was discharged 9 d after surgery and after the stent and cystostomy tube were removed. The dog remained clinically normal and was reported to have been euthanized at 11 y of age (2021) due to unspecified causes. Key clinical message: There are several potential causes of severe bilateral hydroureteronephrosis in animals. Based on this case report, dogs with severe bilateral hydroureteronephrosis that are clinically asymptomatic may have favorable outcomes following bilateral ureteral reconstruction and neoureterocystostomy, even if a definitive cause is not identified.

Néourétérocystostomie bilatérale avec effilement urétéral chez un chien avec hydrourétéronéphrose bilatérale sévère. Un labrador mâle non-castré âgé de 3,5 ans a été vu pour hématurie. Les résultats des tests de pathologie clinique ne présentaient pas d'anomalie. Toutefois, l'analyse d'urine a mis en évidence une urine foncée, trouble, alcaline et isosthénurique, contenant des globules rouges et blancs, des cellules épithéliales et des cristaux de struvite. Une augmentation bilatérale sévère de la taille des urètres ainsi qu'une augmentation de la taille des reins ont été notées lors des radiographies abdominales. Un examen par tomodensitométrie a révélé une hydrourétéronéphrose bilatérale marquée sans cause identifiable d'obstruction. On procéda à un effilement urétéral bilatéral avec néourétérocystostomie bilatérale et mise en place de stents urétéraux bilatéraux temporaires et un tube à cystotomie. Le chien a été sous surveillance à l'unité des soins intensifs pendant 7 j après la chirurgie et a obtenu son congé 9 j après la chirurgie, après que les stents et le tube à cystotomie aient été retirés. Le chien est demeuré cliniquement normal jusqu'à son euthanasie à l'âge de 11 ans (2021) pour des raisons non-spécifiées.Message clinique clé :Il y a plusieurs causes potentielles d'hydrourétéronéphrose bilatérale chez les animaux. Sur la base de ce rapport de cas, les chiens avec hydrourétéronéphrose bilatérale sévère qui sont cliniquement asymptomatique un résultat favorable peut être obtenu à la suite d'une reconstruction urétérale bilatérale et une néourétérocystostomie même si une cause définitive n'est pas identifiée.(Traduit par Dr Serge Messier).

Receiver operating characteristics of computed tomography (CT) compared to cystoscopy in diagnosis of canine ectopic ureters: Thirty-five cases.

OBJECTIVE: The aim of the study was to determine receiver operating characteristics (ROC) of computed tomographic excretory urography (CTEU) in predicting cystoscopic findings of ureteral anatomy. STUDY DESIGN: Retrospective cohort study. ANIMALS: Thirty-five client-owned dogs. METHODS: The medical records of dogs referred for suspected ectopic ureters were reviewed. Inclusion criteria included CTEU findings reported by board-certified radiologists, followed by rigid cystoscopy with or without ureteral cystoscopic laser ablation (CLA). Data included signalment, urinary incontinence degree, body condition score, weight, degree of colon distension, CTEU and cystoscopy findings. ROC analysis was used to compare CT-predicted ureteral orthotopia/ectopia to cystoscopy findings. Additionally, ROC of CT predicted ureteral orifice locations was analyzed. Regression covariate analysis was performed to identify factors that may have influenced accuracy of diagnosis. RESULTS: The ability of CT to identify a normal and intra-or extramural ectopic ureters conclusively and correctly was 13/26 (50%) and 32/41(78%), respectively. Sensitivity and specificity of identifying extramural versus intramural ureters was 2/7 versus 30/46 (29 vs. 65%) and 61/63 versus 17/24 (97 vs. 71%), respectively. Ectopic orifice determination sensitivity and specificity varied widely depending on location from 0% to 76% and 67% to 97%, respectively. Covariate analysis failed to identify interfering factors. CONCLUSIONS: CT did not accurately predict anatomy of ureters; CT findings may need confirmation by cystoscopy and possibly intraoperative fluoroscopy prior to determining if CLA is indicated or not. CLINICAL SIGNIFICANCE: Our results may be of importance for surgeons interpreting the CTEU findings. CTEU prediction of the location of the ureteral orifice shows low sensitivity especially in or close to the urethral sphincter area.

3D-printed, patient-specific cutting guides improve femoral and tibial cut alignment in canine total knee replacement.

OBJECTIVES: The purpose of this cadaveric study was to determine whether patient-specific guides (PSGs) improve the accuracy of tibial and femoral cut alignment in canine total knee replacement (TKR), as compared with generic cutting guides. STUDY DESIGN: Original research. ANIMALS: Sixteen pelvic limbs from skeletally mature medium- to large-breed canine cadavers. METHODS: Specimens were randomly allocated to one of two groups (PSG or Generic; N = 8/group). In the Generic group, femoral and tibial ostectomies were made using the standard canine TKR femoral cutting blocks and tibial alignment guide. In the PSG group, the cuts were made using a series of custom 3D-printed cutting guides. "Planned" and "actual" tibial and femoral cut alignments were compared in the frontal and sagittal planes, and errors were calculated by subtracting actual from planned values. RESULTS: Use of 3D-printed PSGs improved tibial cut alignment in the frontal plane but not the sagittal plane. PSGs also improved the alignment of the cranial and distal femoral ostectomies but did not impact varus-valgus alignment. CONCLUSIONS: These findings support the use of PSGs for TKR in dogs. Clinical trials are now needed to determine whether the benefits of PSGs translate into measurable improvements in joint function and implant longevity. CLINICAL SIGNIFICANCE: PSGs have the potential to improve femoral and tibial component alignment in canine TKR.

Three-Dimensional Morphometry of the Canine Pelvis: Implications for Total Hip Replacement Surgery.

OBJECTIVES: Two-dimensional measurements of acetabular geometry are widely used for the assessment of acetabular component orientation following total hip replacement (THR). With the increasing availability of computed tomography scans, there is an opportunity to develop three-dimensional (3D) planning to improve surgical accuracy. The aim of this study was to validate a 3D workflow for measuring angles of lateral opening (ALO) and version, and to establish reference values for dogs. METHODS: Pelvic computed tomography scans were obtained from 27 skeletally mature dogs with no radiographic evidence of hip joint pathology. Patient-specific 3D models were built, and ALO and version angles were measured for both acetabula. The validity of the technique was determined by calculating intra-observer coefficient of variation (CV, %). Reference ranges were calculated and data from left and right hemipelves were compared using a paired t-test and symmetry index. RESULTS: Measurements of acetabular geometry were highly repeatable (intra-observer CV 3.5-5.2%, inter-observer CV 3.3-5.2%). Mean (± standard deviation) values for ALO and version angle were 42.9 degrees (± 4.0 degrees) and 27.2 degrees (± 5.3 degrees) respectively. Left-right measurements from the same dog were symmetrical (symmetry index 6.8 to 11.1%) and not significantly different. CONCLUSIONS: Mean values of acetabular alignment were broadly similar to clinical THR guidelines (ALO of 45 degrees, version angle of 15-25 degrees), but the wide variation in angle measurements highlights the potential need for patient-specific planning to reduce the risk of complications such as luxation.