Approach to the canine coxofemoral joint using an osteotomy of the deep gluteal muscle insertion for total hip replacements.

Canine total hip replacements (THR) are commonly performed using a craniolateral approach to the craniodorsal aspect of the hip which traditionally involves a partial deep gluteal tendon tenotomy (DGT). Performing an osteotomy of the insertion of the deep gluteal tendon has been utilized by some surgeons. Utilizing bone healing over tendon healing aims to improve post operative hip stability. To the authors' knowledge, this is the first published description of the novel deep gluteal osteotomy (DGO) approach. It differs from a greater trochanteric osteotomy as the latter involves an osteotomy of both the deep and middle gluteal insertions. DGT and the novel DGO approach were performed in ten medium to large breed cadavers on contralateral limbs. The surface area of acetabular exposure was measured in contralateral limbs following the approaches and the iatrogenic damage to the deep gluteal, middle gluteal and vastus lateralis muscles following femoral reaming was visually graded (none, mild, moderate or severe) based on muscle proportion damaged. There was no statistically significant difference (p = 0.8223) between the surface area of acetabular cartilage exposed by each approach with the mean surface area for the DGO approach being 2.99 cm2, whilst the mean surface area for the DGT was 2.97 cm2. In 80% of cadavers, the DGO approach achieved lower muscle damage following retraction and femoral reaming compared to the DGT approach for the middle gluteal and deep gluteal muscles (p = 0.0073). In all cadavers, overall muscle damage was lower for the DGO approach compared to the DGT approach (p = <0.001). There was no difference in vastus lateralis damage between procedures. The DGO approach may be a reasonable alternative to the DGT for approaching the hip joint and femur for Zurich THR as it provides similar exposure to the acetabulum with less muscle damage. It relies on more reliable osseous healing compared to tendon healing. Reduced muscle damage may be important for postoperative hip stability following THR. Further studies are required to biomechanically assess the strength of DGO repair compared to DGT repair as well as a case series documenting clinical outcomes.

Partial resolution of chronic unilateral sinonasal obstructive disease in a cat using a temporary polyvinylchloride stent.

CASE SUMMARY: A 3-year-old male neutered domestic shorthair cat presented for further investigation of a swollen left eyelid and a hard, non-painful bony swelling over the left frontal sinus. Physical examination revealed no nasal discharge or airflow through the left nostril. A CT of the head revealed a left frontal sinus obstruction with expansile remodelling and osteolucency. Drainage of the frontal sinus obstruction was alleviated via placement of a temporary polyvinylchloride (PVC) stent that was left in place for 6 weeks. Purulent material removed from the frontal sinus returned a positive culture for Pseudomonas aeruginosa susceptible to marbofloxacin that was continued for 4 weeks, and for an additional 2 weeks after stent removal. A left-sided mucoid nasal discharge returned 3 months after removal of the stent. Repeat CT performed 20 months after surgery found the presence of a gas-filled frontal sinus and partial resolution in the amount of fluid within the mid and rostral nasal cavity. A repeat positive culture for P aeruginosa was also obtained. The exact cause of the chronic unilateral sinonasal obstruction remains unclear, but an underlying chronic rhinitis with secondary obstructive frontal sinusitis or sinus mucocoele with secondary nasal extension was suspected. RELEVANCE AND NOVEL INFORMATION: Chronic rhinosinusitis in cats can be a challenging condition to treat and cure. This case illustrates the partial resolution of chronic unilateral sinonasal obstructive disease in a cat using a temporary PVC stent.

Outcomes of cellophane banding for congenital portosystemic shunts in 106 dogs and 5 cats.

OBJECTIVE: To report outcomes after cellophane banding of single congenital portosystemic shunts in dogs and cats. STUDY DESIGN: Retrospective study of sequential cases. ANIMALS: One hundred and six dogs and five cats. METHODS: Medical records were reviewed for breed, sex, age at surgery, shunt anatomy, results of pre- and postoperative biochemical analysis, development of postligation neurologic dysfunction, portal hypertension or other serious complications, and the owners' perception of their animal's response to surgery. RESULTS: Ninety-five dogs and all 5 cats had extrahepatic shunts. Eleven dogs had intrahepatic shunts. Six dogs (5.5%) died as a result of surgery from portal hypertension (2 dogs), postligation neurologic dysfunction (2), splenic hemorrhage (1) and suspected narcotic overdose (1). Serious complications were more common in dogs with intrahepatic shunts than those with extrahepatic shunts (P=.002). Postligation neurologic dysfunction necessitated treatment in 10 dogs and 1 cat; 8 dogs and the cat survived. Clinical signs attributed to portosystemic shunting resolved or were substantially attenuated in all survivors. Postoperative serum bile acid concentrations or results of ammonia tolerance testing were available for 88 animals; 74 (84%) were normal and 14 (16%) were abnormal. Multiple acquired shunts were documented in two animals. CONCLUSIONS: Cellophane banding is a safe and effective alternative to other methods of attenuation. CLINICAL RELEVANCE: Slow occlusion of portosystemic shunts using a variety of methods is being evaluated world wide. Cellophane banding is a relatively simple procedure with comparable safety and efficacy to previously reported techniques.