Anastomosis of the caudal thoracic duct and intercostal vein using a microvascular anastomotic coupler device: Experimental study in six dogs.

OBJECTIVE: To describe the technique for anastomosis of the caudal thoracic duct (TD) to the 10th or 11th intercostal vein (ICV) using a microvascular anastomotic coupler (MAC) device in dogs and assess patency of the anastomosis on days 0 and 30. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Six adult Beagle dogs. METHODS: Under general anesthesia, fluoroscopic popliteal lymphangiography was performed and the TD identified. A right ninth or 10th intercostal thoracotomy was performed. Using an operating microscope, the TD and the 10th or 11th ICV were isolated, ligated, and anastomosed using a 1.5 or 2.0 mm MAC. Fluoroscopic popliteal lymphangiography was repeated immediately after surgery and on day 30. RESULTS: The anastomosis was successful and lymphangiography documented flow into the azygos vein in all six dogs immediately after surgery. At day 30, the anastomosis was patent in four of six dogs. In two dogs, flow through the anastomosis was obstructed due to kinking of the ICV just cranial to the MAC. CONCLUSION: Anastomosis of the TD and ICV using a MAC was feasible and was shown to maintain patency up to 30 days. When performing the anastomosis, care should be taken to ensure the ICV is not kinked by the MAC. CLINICAL SIGNIFICANCE: Direct anastomosis of the TD and ICV may have application for treatment of idiopathic chylothorax in dogs by maintaining flow from the abdominal lymphatics to the central venous circulation and thereby preventing the stimulus for collateral circulation and persistent chylous effusion. Further investigation is warranted to assess the efficacy of this technique in dogs affected with idiopathic chylothorax.

Computed tomographic findings in a canine ovarian teratoma.

A 2-year-old, intact female, Labrador Retriever was referred for progressive abdominal distension, assessed by emergency clinicians as being extrauterine in origin on AFAST. Abdominal radiographs and ultrasound identified a large, lobulated, partially mineralized, soft tissue, mid-abdominal mass and gravid uterus. Contrast-enhanced CT identified a mixed fat to soft tissue attenuating mass with a complex internal mineralized matrix, heterogeneous contrast enhancement, receiving blood from the left ovarian artery. Histology confirmed a left ovarian teratoma, diffuse endometrial hyperplasia, and fetal implantation. The patient had a good post-operative outcome for 2 years, but was later diagnosed with primary cranial mediastinal neuroendocrine carcinoma.

Evaluation of two nephrocystostomy techniques for ureteral bypass in cats.

OBJECTIVE: To describe two techniques for nephrocystostomy (NCT) in cats. STUDY DESIGN: Experimental study. ANIMALS: Twelve, adult, purpose-bred, cats. METHODS: A simple NCT (n = 3) or bladder cuff NCT (n = 9) was performed in the right or left kidneys. For simple NCT, an 8F catheter was placed through the caudal pole into the renal pelvis and the bladder was sutured around the catheter. For bladder cuff NCT, a 6 mm defect was removed from the caudal pole and a cuff of bladder mucosa was advanced and sutured into the renal pelvis. A 10F catheter was placed through the defect into the renal pelvis and the bladder wall was sutured around the catheter. Catheters were removed 41-118 days post-surgery. Computed tomography (CT) was performed 25 days after catheter removal for the simple NCT and 30 (n = 6) and 90 (n = 3) days after catheter removal for bladder cuff NCT. Histological evaluation of the nephrocystostomy site was performed. RESULTS: All simple NCTs became obstructed after catheter removal. All bladder cuff NCTs were patent, and CT revealed contrast flow into the bladder. Hematuria, clot-associated urethral obstruction, catheter dislodgement, and bladder infection occurred variably after surgery. Histological findings consisted of smooth epithelialization of the NCT and degenerative changes in the caudal pole of the kidney. CONCLUSION: Bladder cuff NCT was feasible in normal cats and remained patent for 90 days. Methods to limit nephrostomy track hemorrhage should be investigated. Degenerative changes may be related to vascular impairment from the bladder cuff sutures. CLINICAL SIGNIFICANCE: Complete ureteral bypass was possible in cats using only native tissues.

Dogs ≥ five years of age at the time of congenital extrahepatic portosystemic shunt diagnosis have better long-term outcomes with surgical attenuation than with medical management alone.

OBJECTIVE: To determine the outcome in dogs diagnosed with congenital extrahepatic portosystemic shunts (EHPSS) at ≥ 5 years of age treated with medical management only (M) or with surgical attenuation (S). The hypothesis was that dogs undergoing surgical attenuation would have a longer survival time than dogs undergoing medical management only. ANIMALS: 351 dogs definitively diagnosed with EHPSS at ≥ 5 years of age. PROCEDURES: Medical records from 2009 to 2019 at 16 veterinary teaching hospitals were evaluated. Data collected included signalment, clinical signs at diagnosis, clinicopathologic data, surgical and medical treatments, shunt morphology, clinical signs and medical treatments at 6 to 12 months after diagnosis, and survival time. RESULTS: 351 dogs (M, 119 [33.9%]; S, 232 [66.1%]) were included in the study. Survival time was longer with surgery than medical management (hazard ratio, 4.2; M, 3.4 years; S, 10.9 years). Continued clinical signs at 6 to 12 months after diagnosis were more common with medical management (M, 40% [33/88]; S, 14% [21/155]). Continued medical treatments at 6 to 12 months after diagnosis were more common in the medical management group (M, 78% [69/88]; S, 34% [53/155]). Perioperative mortality rate was 7.3%. CLINICAL RELEVANCE: Dogs diagnosed at ≥ 5 years of age with EHPSS have significantly better survival times and fewer clinical signs with surgical attenuation, compared with medical management. Older dogs have similar surgical mortality rates to dogs of all ages after surgical EHPSS attenuation.

Retroperitoneal fibrosis as a postoperative complication following renal transplantation in cats.

OBJECTIVES: The aim of this report was to describe the clinical signs, diagnostic imaging findings, surgical management, histopathological findings, outcome and possible risk factors for cats that developed retroperitoneal fibrosis (RPF) following renal transplantation. METHODS: Medical records of cats that underwent renal transplantation and developed clinically significant RPF between 1995 and 2019 were reviewed. RESULTS: Eighty-one cats underwent 83 renal transplantations. Of these 81 cats, six developed clinically significant RPF. For all six cats, renal transplantation was performed using cold organ preservation solution and ureteral papilla implantation. Immunosuppression protocol included ciclosporin and prednisolone. All cats had at least one subtherapeutic trough ciclosporin level (<250 ng/ml) in the postoperative period. Cats presented with moderate-to-severe azotemia 39-210 days following renal transplantation. Abdominal ultrasonography and contrast pyelography revealed various degrees of hydroureter and hydronephrosis of the transplanted kidney. Surgical examination revealed a layer of dense fibrous tissue surrounding the transplanted kidney, ureter and bladder resulting in ureteral obstruction. Ureteral obstruction was managed by reimplantation of the proximal ureter or renal pelvis to the bladder. Histopathologic examination of the fibrous tissue and affected portion of the distal ureter revealed fibrous connective tissue with lymphoplasmacytic infiltration and perivascular inflammation suggestive of an autoimmune type reaction. Of the six cats, two died within 5 days after revision surgery, two developed signs consistent with recurrent partial ureteral obstruction (40 and 41 days after revision), one was euthanized 6 years later for an unrelated disease and one was lost to follow-up. CONCLUSIONS AND RELEVANCE: The incidence of RPF in this population of cats was relatively low (7%), but still represents a significant cause of morbidity and mortality. The cause of RPF remains unknown, although investigation into suboptimal immunosuppression as a potential cause for local rejection reaction is warranted.

Lymphaticovenous anastomosis of the caudal thoracic duct to an intercostal vein: A canine cadaver study.

OBJECTIVE: To describe a technique for anastomosis of the thoracic duct (TD) to the 11th or 12th intercostal vein (ICV) using a microvascular anastomotic coupler (MAC) in the dog. STUDY DESIGN: Cadaveric study. ANIMALS: Eight beagles. METHODS: A right paracostal laparotomy and 10th intercostal thoracotomy were performed in each dog. Mesenteric contrast lymphography was used to identify the TD and its branches on fluoroscopy. The TD and adjacent 11th or 12th ICV were isolated, double ligated, and divided using a surgical microscope. The caudal TD and proximal ICV were anastomosed in an end-to-end fashion using a 1.5 mm or 2 mm MAC. Mesenteric lymphography was repeated to document patency of the anastomosis. RESULTS: The TD was identified via lymphography in all dogs; five dogs had a single duct, and three dogs had additional branches. The anastomosis was successful in all eight dogs, and flow into the azygos vein without leakage was confirmed via lymphography. CONCLUSION: End-to-end anastomosis of the TD to an ICV using a MAC was technically feasible in the canine cadaver. CLINICAL SIGNIFICANCE: Lymphaticovenous anastomosis combined with TD ligation may have application as a treatment for idiopathic chylothorax. By maintaining the flow of chyle from the abdominal lymphatics to the systemic circulation, this procedure may reduce the stimulus for collateral circulation and persistent flow to the cranial mediastinal lymphatics.

Evaluation of a microvascular anastomotic coupler for end-to-side arterial and venous anastomosis for feline renal transplantation.

OBJECTIVE: To describe the technique and determine the feasibility of an end-to-side (ETS) anastomosis of the renal vein to vena cava and renal artery to aorta using a microvascular anastomotic coupler (MAC) for feline renal transplantation. STUDY DESIGN: In vivo experimental study. ANIMALS: Six purpose-bred domestic shorthair cats. METHODS: The left kidney was autotransplanted using a MAC for ETS vascular anastomosis. Outcomes included intraoperative hemorrhage from the anastomosis sites, duration of anastomoses, surgical complications, postoperative renal perfusion (including resistive index (RI)) measured by Doppler ultrasonography and computed tomography angiography, and histopathological examination of the left kidney and anastomosis sites (30 days). RESULTS: Anastomosis was successful in all cats, and intraoperative hemorrhage was negligible. Intraoperative renal perfusion was considered excellent. Venous and arterial anastomoses were completed in 11 minutes 20 seconds (range, 6:38-13:27) and 21 minutes 50 seconds (range, 11:05-30:24), respectively. Vascular occlusion time was 32 minutes (17:43-42:03). One cat was euthanized 5 hours postoperatively because of bleeding from a muscular arterial branch of the dorsal aorta causing hemoabdomen. Renal perfusion and RI of the remaining five cats were within normal range (<0.8) and similar to the contralateral kidney at all time points. Endothelialization of the anastomosis was complete with mild-to-moderate fibrosis surrounding the MAC in all cats. CONCLUSION: End-to-side anastomosis of the renal vein and artery to the vena cava and aorta, respectively, was consistently achieved in all six cats with the MAC. CLINICAL SIGNIFICANCE: The use of the MAC may be considered as an alternative to hand suturing for ETS anastomoses for feline renal transplantation.

Late-onset laryngeal paralysis: Owner perception of quality of life and cause of death.

BACKGROUND: Late-onset laryngeal paralysis (LoLP) is an idiopathic disease of older dogs, and is common in the Labrador Retriever. Owner perspective of how LoLP affects their pet's quality of life (QOL), the degree to which LoLP is perceived to be a life-limiting disease, and how a glottic opening procedure affects these perceptions is not known. OBJECTIVES: (a) To determine owner's perception of late-onset laryngeal paralysis (LoLP) with respect to their dog's QOL; (b) To determine whether LoLP is considered by owners to be a life-limiting disease; (c) To evaluate whether a glottic opening procedure altered QOL and perceived cause of death in affected dogs. METHODS: Owners of Labrador Retrievers with LoLP completed a questionnaire. Questions were asked pertaining to a dog's LoLP, including clinical progression and perception of cause of death, and whether a glottic opening procedure was undertaken. Owners also completed a pet-owner administered QOL survey. RESULTS: Seventy-six owners participated. Overall, 94% of owners felt their dog's LoLP affected QOL, and 47% of owners felt LoLP was a large contributing factor in their dog's death. Dogs that underwent a glottic opening procedure were reported to have a better QOL, and the contribution of LoLP towards their death was less than dogs that did not have surgery. CONCLUSION: Owners of Labrador Retrievers with LoLP perceive LoLP to be a life-limiting disease that negatively impacts their dog's QOL. Arytenoid lateralization surgery had a positive impact on QOL in affected dogs.

Temporary abdominal packing for management of persistent hemorrhage after liver lobectomy in three dogs with hepatic neoplasia.

OBJECTIVE: To describe the technique and outcome of temporary abdominal packing for control of persistent hemorrhage from liver lobectomy sites in 3 dogs with hepatic neoplasia. SERIES SUMMARY: Three dogs were treated with massive transfusion for hemoperitoneum secondary to bleeding hepatic tumors. Surgical resection of the affected liver lobe(s) was performed but hemostasis could not be achieved through conventional methods. All 3 dogs demonstrated acidosis, hypothermia, and coagulopathy. Temporary abdominal packing of liver lobectomy sites was performed and hemostasis was achieved in all dogs. One dog died prior to removal of the packing. The other 2 dogs had the packing removed with no evidence of rebleeding. One dog was euthanized after removal of the packing due to acute kidney injury and the remaining dog survived to discharge. NEW OR UNIQUE INFORMATION PROVIDED: Temporary abdominal packing combined with medical management was successful in achieving hemostasis in all 3 dogs, however, 2 dogs died of complications related to multiple organ dysfunction syndrome. Temporary abdominal packing may be considered when definitive surgical hemostasis cannot be achieved or in unstable patients not able to tolerate prolonged surgical times. Further research is needed to better define efficacy, optimal patient selection, packing technique, timing of removal, and complications associated with temporary abdominal packing.

Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003-2017).

OBJECTIVE: To report intraoperative and major postoperative complications in dogs treated surgically for epiglottic retroversion (ER), compare the incidence of major postoperative complications between procedures, and report survival of surgically treated dogs. STUDY DESIGN: Multi-institutional retrospective study. SAMPLE POPULATION: Fifty dogs treated with 78 procedures. METHODS: Medical records of dogs diagnosed and surgically treated for ER from 2003 to 2017 at 11 institutions were reviewed. Complications were divided into intraoperative and major postoperative complications. RESULTS: Intraoperative complications occurred during 2 of 78 (2.6%) procedures. Thirty-six major postoperative complications were documented in 22 dogs after 36 of 74 (48.7%) procedures. Postoperative complications occurred after 7 of 12 (58.3%) nonincisional epiglottopexy, 23 of 43 (53.5%) incisional epiglottopexy, 2 of 4 (50%) partial epiglottectomy, 2 of 12 (16.7%) subtotal epiglottectomy, and 2 of 3 (66.7%) other surgical procedures. Epiglottopexy failure was the most common major postoperative complication. The incidence of major postoperative complications did not differ between procedures (P = .1239), although, when combined, epiglottopexy procedures (30/55) had a higher incidence of complications than epiglottectomy procedures (4/16; P = .048). Thirty (60%) dogs were alive at a median of 928 days (range, 114-2805), 8 (16%) were lost to follow-up after 411 days (range, 43-1158), and 12 (24%) were dead/euthanized after 301.5 days (range, 3-1212). Median survival time was not reached after a median of 716 days. CONCLUSION: Although intraoperative complications were uncommon, major postoperative complications were common, especially after epiglottopexy procedures. CLINICAL SIGNIFICANCE: Although surgical treatment of ER is associated with a high rate of major postoperative complications, especially epiglottopexy procedures, long-term survival can be achieved.

Use of a subcutaneous ureteral bypass device for treatment of bilateral proximal ureteral injury in a 9-month-old cat.

CASE SUMMARY: A 9-month-old male domestic longhair cat presented following iatrogenic ureteral trauma after an attempted laparoscopic ovariectomy. Prior to identifying that the cat was male, both ureters were transected approximately 4 mm from the renal pelves. Initial management involved a left-sided Boari flap neoureterocystostomy, cystonephropexy and right ureteronephrectomy. Thirty-six hours later, the cat developed uroabdomen due to leakage from the neoureterocystostomy site. At a tertiary referral institution, the ureter was reconstructed via end-to-end anastomosis and a left-sided subcutaneous ureteral bypass (SUB) device was placed in the event the anastomosis failed. Five weeks after SUB placement, the cat was dysuric and stranguric. A urine culture was negative and clinical signs were attributed to sterile cystitis secondary to device placement. Blood urea nitrogen (BUN) was 22 mg/dl and creatinine was 1.2 mg/dl. Contrast pyelography confirmed device patency, but no contrast was identified through the ureteral anastomosis. At 12 months, BUN and creatinine were 1.5 mg/dl and 25 mg/dl, respectively, and a subclinical urinary tract infection was identified (Enterococcus faecalis). Antibiotic therapy was not prescribed in order to prevent multidrug resistance. At 42 months, BUN was 38 mg/dl and creatinine was 2.0 mg/dl. The cat had occasional and intermittent signs of pollakiuria and stranguria but was otherwise doing well. RELEVANCE AND NOVEL INFORMATION: To our knowledge, this is the first case report to describe the use of a SUB device for management of traumatic proximal ureteral injury in a cat with one kidney. The case outcome provides valuable information about the direct effect of the SUB device and the presence of chronic Enterococcus species infection on long-term renal function.

Comparison of the effects of alfaxalone and propofol with acepromazine, butorphanol and/or doxapram on laryngeal motion and quality of examination in dogs.

OBJECTIVE: To compare the effects of alfaxalone and propofol, with and without acepromazine and butorphanol followed by doxapram, on laryngeal motion and quality of laryngeal examination in dogs. STUDY DESIGN: Randomized, crossover, blinded study. ANIMALS: Ten female Beagle dogs, aged 11-13 months and weighing 7.2-8.6 kg. METHODS: The dogs were administered four intravenous (IV) treatments: alfaxalone (ALF), alfaxalone+acepromazine and butorphanol (ALF-AB), propofol (PRO) and propofol+AB (PRO-AB). AB doses were standardized. Dogs were anesthetized 5 minutes later by administration of alfaxalone or propofol IV to effect. Arytenoid motion during maximal inspiration and expiration was captured on video before and after IV doxapram (0.25 mg kg-1). The change in rima glottidis surface area (RGSA) was calculated to measure arytenoid motion. An investigator blinded to the treatment scored laryngeal examination quality. RESULTS: A 20% increase in RGSA was the minimal arytenoid motion that was detectable. RGSA was significantly less in ALF before doxapram compared with all other treatments. A <20% increase in RGSA was measured in eight of 10 dogs in PRO and in all dogs in ALF before doxapram. After doxapram, RGSA was significantly increased for PRO and ALF; however, 20% of dogs in PRO and 50% of dogs in ALF still had <20% increase in RGSA. A <20% increase in RGSA was measured in five of 10 dogs in PRO-AB and ALF-AB before doxapram. All dogs in PRO-AB and ALF-AB with <20% increase in RGSA before doxapram had ≥20% increase in RGSA after doxapram. Examination quality was significantly better in PRO-AB and ALF-AB. CONCLUSIONS AND CLINICAL RELEVANCE: The use of acepromazine and butorphanol improved the quality of laryngeal examination. Any negative impact on arytenoid motion caused by these premedications was overcome with doxapram. Using either propofol or alfaxalone alone is not recommended for the evaluation of arytenoid motion.

Evaluation of Translaryngeal Percutaneous Arytenoid Lateralization (TPAL) in dogs with experimentally created laryngeal paralysis.

The aim of this experimental study was to evaluate the effect of Translaryngeal Percutaneous Arytenoid Lateralization (TPAL) in dogs with experimentally created laryngeal paralysis. All dogs (n=5) underwent bilateral recurrent laryngeal neurectomy before TPAL. Two TPAL suture techniques were evaluated. TPAL-CranialCaudal (TPAL-CC) was performed first, followed 11 to 14days later by TPAL-DorsalVentral (TPAL-DV). For both techniques, a mattress suture was placed through the arytenoid cartilage via an oral approach. Laryngeal examination was performed before, immediately after, and on days 1, 3 and 7 for both TPAL techniques. Ipsilateral hemiglottic surface area and the degree of laryngeal swelling or reaction to the suture were recorded. Laryngeal tissue was evaluated by histopathology at the end of the study. For both TPAL techniques, hemiglottic surface area was increased immediately after suture placement (P<0.05). At all other times, hemiglottic area was not statistically different from preoperative value (P>0.05). TPAL-DV resulted in less laryngeal swelling compared to TPAL-CC. Histopathology of the arytenoid cartilage surrounding the mattress suture revealed mucosal ulceration and inflammation consistent with the presence of the suture material. Both TPAL techniques were effective at lateralizing the arytenoid cartilage and significantly increasing hemiglottic surface area immediately after suture placement. However, mucosal swelling and loss of tension on the mattress suture lead to a decrease in glottic area within 24h. Further refinements in suture placement technique are warranted to minimize swelling and improve the duration of arytenoid lateralization prior to clinical application.

Diagnosis and management of inflammatory bowel disease in a harpy eagle (Harpia harpyja) with suspected fenbendazole toxicosis.

CASE DESCRIPTION A 14-year-old 4.1-kg (9.02-lb) male harpy eagle (Harpia harpyja) was evaluated because of vomiting, anorexia, lethargy, and weight loss (decrease of 0.35 kg [0.77 lb]) of 4 weeks' duration. The bird had previously been treated orally with fenbendazole after the initial onset of clinical signs. CLINICAL FINDINGS An initial CBC revealed marked heteropenia and anemia, but whole-body contrast-enhanced CT images and other diagnostic test findings were unremarkable. Clinical signs persisted, and additional diagnostic testing failed to reveal the cause. During celiotomy, a biopsy specimen of the duodenum was obtained for histologic examination, which revealed lymphoplasmacytic inflammation, consistent with inflammatory bowel disease (IBD). TREATMENT AND OUTCOME Prior to histopathologic diagnosis of IBD, barium sulfate administered via gavage resulted in a temporary improvement of clinical signs. Following diagnosis of IBD, corticosteroid administration was initiated in conjunction with antifungal prophylaxis. Cessation of vomiting and a return to normal appetite occurred within 3 days. Fifteen months after cessation of corticosteroid treatment, the eagle continued to do well. CLINICAL RELEVANCE To our knowledge, this was the first report of diagnosis and management of IBD in an avian species. For the eagle of the present report, results of several diagnostic tests increased clinical suspicion of IBD, but histologic examination of an intestinal biopsy specimen was required for definitive diagnosis. Although successful in this case, steroid administration in avian species must be carefully considered. Conclusive evidence of fenbendazole toxicosis was not obtained, although it was highly suspected in this bird.

Urethral diverticulum and urolithiasis in a female guinea pig (Cavia porcellus).

CASE DESCRIPTION A 5-year-old sexually intact female guinea pig was evaluated because of mild dysuria and a subcutaneous mass located cranioventral to the urogenital openings. CLINICAL FINDINGS Non-contrast-enhanced CT and surgical exploration of the distal aspect of the urethra revealed a urethral diverticulum with an intraluminal urolith. Analysis revealed that the urolith was composed of calcium carbonate and struvite. TREATMENT AND OUTCOME The urolith was surgically removed and ablation of the urethral diverticulum was attempted. Approximately 3 months later, the guinea pig was reevaluated for masses in the perineal region, and positive-contrast urethrocystography revealed 2 uroliths present in the same diverticulum. Uroliths were manually expressed with the patient under general anesthesia. Approximately 2 weeks later, urethroplasty was performed to create an enlarged stoma with the diverticulum, thereby preventing urine from pooling in the diverticulum and potentially reducing the risk of future urolith formation. The urethroplasty site healed well with no reported complications or evidence of urolith recurrence 6 months after surgery. CLINICAL RELEVANCE Urolithiasis is common in guinea pigs, and urethral diverticulum and intraluminal urolith formation should be considered as a potential differential diagnosis for a subcutaneous mass along the distal aspect of the urethra. Creation of a urethral stoma from a urethral diverticulum via urethroplasty achieved a successful outcome in this patient.

A Carrel patch technique for renal transplantation in cats.

OBJECTIVE: To evaluate the feasibility of a Carrel patch method in feline renal transplantation. STUDY DESIGN: Descriptive case series. ANIMALS: Nine healthy donor cats and 9 client recipient cats with chronic renal failure. METHODS: Renal transplantation was performed in 9 cats with chronic renal failure after collection of a donor's left kidney with a Carrel patch technique. A patch of donor aortic wall was removed with either 2 or 1 renal artery (ies) (n = 1 and 8 cats, respectively) central to the patch, with a cuff of tissue (≤1 mm) protruding from the base of the vessels. The Carrel patch was implanted in recipient cats with an end-to-side artery-to-aorta anastomosis, in a simple-continuous pattern of 9-0 nylon. The renal vein and ureter were implanted as previously described. RESULTS: All donors and recipients survived surgery without vascular complication. CONCLUSION: The Carrel patch is a novel approach allowing the harvest of kidneys with multiple renal arteries. The technique also simplified the implant procedure, potentially decreasing the risks of bleeding and thrombosis.

Effect of cold storage on immediate graft function in an experimental model of renal transplantation in cats.

OBJECTIVE To assess the effect of cold storage (CS) on immediate posttransplantation function of renal autografts in cats. ANIMALS 15 healthy 1-year-old cats. PROCEDURES Cats were assigned to 2 groups and underwent autotransplantation of the left kidney followed by nephrectomy of the right kidney. The left kidney was autotransplanted either immediately (IT group; n = 6) or after being flushed with a cold sucrose phosphate solution and stored on ice while the implant site was prepared (CS group; 9). Serum creatinine and BUN concentrations were monitored daily and autografts were ultrasonographically examined intermittently for 14 days after surgery. RESULTS Mean duration of CS was 24 minutes for the CS group. Posttransplantation serum creatinine and BUN concentrations for the CS group had lower peak values, returned to the respective reference ranges quicker, and were generally significantly lower than those for the IT group. Mean posttransplantation autograft size for the CS group was smaller than that for the IT group. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that immediate posttransplantation function of renal autografts following a short period of CS was better than that of renal autografts that did not undergo CS, which suggested CS protected grafts from ischemic injury and may decrease perioperative complications, speed recovery, and improve the long-term outcome for cats with renal transplants. IMPACT FOR HUMAN MEDICINE Cats metabolize immunosuppressive drugs in a manner similar to humans; therefore, renal transplantation in cats may serve as a desirable model for investigating the effects of renal transplantation in human patients.

Translaryngeal percutaneous arytenoid lateralization technique in a canine cadaveric study.

OBJECTIVE: To describe the technique for translaryngeal percutaneous arytenoid lateralization (TPAL) and the effect on rima glottidis cross-sectional area using a canine cadaveric model. STUDY DESIGN: Ex vivo study. ANIMALS: Canine cadavers (n = 9). MATERIALS AND METHODS: With the aid of a laryngoscope, the larynx was visualized and a mattress suture (double-armed 2-0 polypropylene) was placed through the right arytenoid cartilage and exited the skin ventral to the jugular vein. The ends of the suture were passed through a button and tied on the skin to lateralize the right arytenoid cartilage. Digital images of the larynx were made before and after suture placement. Mean (±SD) rima glottidis cross-sectional area (mm(2) ) was calculated from the digital images and values before and after suture placement were compared using a paired t-test. A P value < 0.05 was considered significant. Change in cross-sectional area was expressed as percent increase. RESULTS: Suture placement and the degree of arytenoid lateralization was relatively consistent in all dogs. Mean (±SD) cross-sectional area of the rima glottidis was 126.3 mm(2) (±7.74) before and 172.1 mm(2) (±24.7) after suture placement (P = 0.004). Mean percent increase in cross-sectional area was 25%. CONCLUSION: The TPAL technique was effective at enlarging the rima glottidis in this canine cadaveric model. TPAL is rapid to perform and does not require specialized instrumentation. Results of this study support further investigation of the TPAL technique as an alternative to temporary tracheostomy for dogs in severe respiratory distress due to laryngeal paralysis.

Ureteral Papilla Implantation as a Technique for Neoureterocystostomy in Cats Undergoing Renal Transplantation: 30 Cases.

OBJECTIVE: To describe the clinical outcome of donor and recipient cats undergoing ureteral papilla harvest and implantation as a technique for neoureterocystostomy in clinical kidney transplant. STUDY DESIGN: Retrospective case series. ANIMALS: Donor (n=31) and recipient (n=30) cats that underwent kidney harvest and transplantation using ureteral papilla implantation technique for neoureterocystostomy. METHODS: Medical records for donor and recipient cats presented to the University of Wisconsin Veterinary Teaching Hospital from January 2003 to December 2014 were reviewed. Data recorded included complete blood count, serum chemistry panel, surgical technique, diagnostic imaging results, short- and long-term complications, and anesthetic survival. RESULTS: All 30 recipients recovered from anesthesia. Four died within 24 hours and 26 survived to hospital discharge. Serum creatinine was within the reference interval by 72 hours in 22/26 cats (85%). Complications related to the ureteral papilla implantation technique were seen in only 1 cat (3%). Uroabdomen diagnosed on day 3 ultimately resolved over the following 24 hours without surgical intervention. All 31 donor cats survived to discharge. Four donors (13%) experienced mild, transiently increased serum creatinine. CONCLUSION: Ureteral papilla implantation is a viable technique for neoureterocystostomy in cats undergoing kidney transplantation. Proposed benefits for the recipient include a less technically challenging anastomosis, decreased risk of ureteral obstruction at the anastomosis site, and reduced risk of leakage compared to previous reports. Benefits for recipients should be weighed against risks to donors, including a more complex ureteral harvest, increased surgical time, and potential injury or obstruction of the contralateral ureteral papilla.