Rapid prototype modeling and customized titanium plate fabrication for correction of a persistent hard palate defect in a dog.

CASE DESCRIPTION: An 8-month-old crossbred dog was evaluated because of an oronasal fistula following 2 previous attempts to surgically correct a secondary palate defect. CLINICAL FINDINGS: Three months after initial evaluation and successful closure of the soft palate section of the secondary palate defect via 2 surgeries, an oronasal fistula was present. The oronasal fistula was predominantly right sided, involving the rostral third of the hard palate and, at the widest aspect, spanning the transverse palate at the level of the maxillary canine teeth. TREATMENT AND OUTCOME: Following CT of the rostral aspect of the skull, rapid prototyping technology was used to create a stereolithographic model of the skull, allowing fabrication of a customized titanium plate for intranasal stenting. The titanium plate was inserted via a rostral nasal approach and secured rostrally with 1.5-mm screws and caudally with 2.4-mm screws from the nasal bridge. An oronasal fistula formed laterally at the edge of the plate, but bonding of a dental glass ionomer product resulted in successful resolution of the fistula. CLINICAL RELEVANCE: Results suggested that rapid prototyping and creation of customized implants may provide an option for the management of large or nonreconstructible oronasal defects in dogs.

Intra-abdominal actinomycetoma in a cat.

A 5-year-old, female Ragdoll cat was diagnosed with an intra-abdominal mycetoma involving the ileocaecal region. Diagnosis was obtained via histopathological examination following surgical resection of the mass and an ileocolic anastomosis. The initial surgery was complicated by lymphangiectasia, chylous abdominal effusion and mild bacterial leakage from the anastomosis site. A second, exploratory laparotomy was performed to augment the anastomosis with serosal patching and omentalisation and to investigate a cystic structure observed on follow-up abdominal ultrasound. Initial amoxycillin clavulanate (Clavulox; Pfizer Animal Health) therapy was ineffective, but clindamycin (Antirobe; Pfizer Animal Health) proved successful in resolving the infection. Abdominal actinomycetoma in the cat may be an under-diagnosed condition due to its close resemblance to neoplastic disease. Standard diagnostic and therapeutic regimens are commonly ineffective in Actinomyces species infections. Surgical resection along with adjunctive, long-term, selective antimicrobial therapy is effective and prognosis is good for localised lesions.