Inflation Pressures for Ex Vivo Lung Biopsies After Application of Graduated Compression Staples.

OBJECTIVE: To compare 2 graduated compression staples (Tri-Staple™, Covidien, Norwalk, CT) and standard staples (Endo GIA™, Covidien) for lung biopsy in dogs. STUDY DESIGN: Ex vivo experimental study, randomized, unblocked. ANIMALS: Lung lobes (n = 18) from 4 canine cadavers. METHODS: Eighteen lung lobes were harvested from 4 dogs immediately after euthanasia and randomized to 1 of 3 staples (n = 6 per stapler type). Each lung lobe was intubated and maintained inflated at 10 cmH2O. A biopsy of the periphery of each lung lobe was taken approximately 3 cm from the edge with a stapling device; the Tri-Staple™ medium/thick (TST), Tri-Staple™ vascular/medium (TSV), and Endo GIA™ 45-2.5 (EG). Each lobe was inflated to a maximum of 45 cmH2O of water to determine the pressure at which air leakage occurred (leak pressure). RESULTS: The mean (95% confidence interval) leak pressure was 38.0 cmH2O (33.1-42.9) for EG, 29.2 (24.3-34.0) for TSV, and 26.0 (21.1-30.9) for TST. The mean leak pressure was significantly higher for EG than TSV (P = .016) and for EG than TST (P = .002), but was not different between TSV and TST (P = .344). One TSV leaked at 20 cmH2O and 1 TST leaked at 17 cmH2O. The surface area of the biopsy samples was not significantly different for staple types (P = .183). CONCLUSION: Both TST and TSV leaked at significantly lower airway pressures than EG and may not be suitable for canine lung biopsy as some specimens leaked at pressures of 20 cmH2O or less.

Comparison of surgical variables and pain in cats undergoing ovariohysterectomy, laparoscopic-assisted ovariohysterectomy, and laparoscopic ovariectomy.

Laparoscopy is an established modality in veterinary medicine. To date, laparoscopy in feline surgery is rarely reported. The objectives of this study were to compare surgical time, complications, and postoperative pain in a group of cats undergoing laparoscopic ovariectomy (LOVE), laparoscopic-assisted ovariohysterectomy (LAOVH), and ovariohysterectomy via celiotomy (COVH). Eighteen healthy cats were randomly assigned to undergo LOVE, LAOVH, or COVH. Severity of pain was monitored 1, 2, 3, and 4 hr after surgery. Surgical time was significantly longer for LAOVH (mean ± standard deviation [SD], 51.6 ± 7.7 min) compared to COVH (mean ± SD, 21.0 ± 7.1 min) and LOVE (mean ± SD, 34.2 ± 11.2 min). There were no major intraoperative complications, although minor complications were more common in both laparoscopic groups. Cats sterilized via laparoscopy (LOVE and LAOVH) were statistically less painful than cats spayed via celiotomy (COVH) 4 hr following surgery. Results suggested that LOVE in cats is safe, can be performed in a comparable amount of time as COVH, and may result in less postoperative discomfort.

Biomechanical Analysis of Laparoscopic Incisional Gastropexy With Intracorporeal Suturing Using Knotless Polyglyconate.

OBJECTIVE: To evaluate load to failure of laparoscopic incisional gastropexy performed with intracorporeal suturing using knotless polyglyconate (KP). STUDY DESIGN: Cadaveric study. ANIMALS: Canine cadavers (n = 12). METHODS: Laparoscopic incisional gastropexy using 2 strands of KP was performed in 6 canine cadavers and by an open approach in 6 cadavers. Length of the gastropexy, number of suture bites on each side of the gastropexy, and number of inadvertent full thickness gastric suture bites were recorded. Load to failure was measured. RESULTS: There was no significant difference in mean (±SD) gastropexy load to failure for the open (46.3 ± 19.6 N) and laparoscopic (69.0 ± 26.0 N) approaches (P = .123). No significant differences between laparoscopic and open approaches were detected for mean stomach (3.1 ± 0.1 cm; 3.0 ± 0.2 cm; P = .353) or abdominal wall (3.1 ± 0.2 cm; 3.0 ± 0.2 cm; P = .553) incision lengths. There was no significant difference between groups for number of suture bites medially (P = .448) or laterally (P = .363). There were 3 instances of a single gastric intraluminal suture for the laparoscopic group and none for the open approach (P = .023). CONCLUSION: Incisional gastropexy performed with laparoscopic intracorporeal suturing and KP has a load to failure that is comparable with an open method. Load to failure was similar to reported values for open incisional gastropexy with knotless glycomer 631.

Subcutaneous fluid port-associated soft tissue sarcoma in a cat.

A 20-year-old male castrated domestic longhair cat was evaluated for assessment of its chronic kidney disease (CKD) and a non-healing ulcerated mass at the site of a previously placed and subsequently removed GIF tube. The cat had been diagnosed with CKD 10 years prior and two GIF tubes had been placed over a 5-year period, the second of which was associated with secondary infection. Biopsy of the non-healing ulcerated mass was consistent with grade 2 soft tissue sarcoma. At necropsy there was a discrete, serpentine, subcutaneous mass measuring approximately 8 mm in diameter that extended approximately 20 cm along the dorsum to the caudal thorax, following the path of the GIF tube, from the main intrascapular, ulcerated mass where the fluid port injection site was located. This is the first report of a fibrosarcoma arising at the site of a subcutaneous fluid port in a cat. Although the cat's owners were pleased with the 4 years of quality of life provided by this device, this complication should be considered when a decision to place ports for long-term management of disease is made.

Evaluation of S-adenosyl l-methionine in a double-blinded, randomized, placebo-controlled, clinical trial for treatment of presumptive osteoarthritis in the dog.

OBJECTIVE: To evaluate the efficacy of S-adenosyl l-methionine (SAMe) in the treatment of clinically inferred canine osteoarthritis (OA). STUDY DESIGN: Six weeks, double-blinded, placebo-controlled, clinical trial. ANIMALS: Dogs (n=33) with clinical signs, history, and orthopedic exams consistent with OA. METHODS: Dogs were block randomized by body condition score (<6/9, or ≥6/9) into either the placebo or SAMe group. Outcome was assessed using pressure platform gait analysis, examination score, goniometry, and the Canine Brief Pain Inventory (CBPI) at the time of study entrance and at 3 and 6 weeks after entry. Groups were compared using parametric and nonparametric paired tests as appropriate, and numbers needed to treat (NNT) were calculated for the CBPI and peak vertical force (PVF). RESULTS: Both groups (n=15 placebo, n=18 SAMe) had a reduction in mean PVF (P=.02) and vertical impulse (VI; P=.06) from the 1st to 3rd visit. There was no significant difference between the placebo group and SAMe group for PVF, VI, or either part of the CBPI (Severity or Impact). The NNT at 6 weeks for the Severity score was 3, Impact score was 25, and PVF was 45. CONCLUSIONS: These data do not support the use of SAMe as an effective stand alone treatment for reducing clinical signs of OA, as measured by PVF, VI, goniometry, CBPI (both Severity and Impact), and examination score within 6 weeks of treatment.

Characterization of spatiotemporal gait characteristics in clinically normal dogs and dogs with spinal cord disease.

OBJECTIVE-To determine the spatiotemporal gait characteristics and associated covariates of clinically normal dogs and dogs with spinal cord disease. ANIMALS-42 clinically normal dogs and 24 dogs with myelopathy at spinal cord segment T3-L3. PROCEDURES-Gait was analyzed for velocity, stride length, stride time, stance time, and swing time and compared between groups with consideration of covariates, including height, weight, velocity, sex, and age. RESULTS-By use of multivariate regression, dogs with neurologic signs, compared with clinically normal dogs, had decreased stride time, stance time, and stride length in the forelimbs and increased swing time in the hind limbs. CONCLUSIONS AND CLINICAL RELEVANCE-Use of spatiotemporal gait characteristics appears to have potential for use as an outcome measure for dogs with neurologic disease.