Osteomyelitis of the fibula due to septic embolism: a rare complication of a graft enteric erosion. Case report.

We report the case of a 70-year-old female who experienced a graft enteric erosion (GEE) three years after a right aorto-femoral bypass. She was treated by right axillo-femoral bypass, removal of the aortic prosthesis and direct aortic suture. The duodenum was stitched up and separated from the aorta by omentoplasty. Bacteriological culture of the removed graft identified Escherichia coli and Peptostreptococcus. Antibiotic therapy consisting of Amoxicillin and Gentamycin was given for seven days. A month later this patient developed a fibula osteomyelitis due to the same germs. She was then treated by surgical excision of the infected tissues and by antibiotics: Amoxicillin, Metronidazole and Gentamycin for one month. This case of embolism into bone due to GEE is a rare complication which indisputably establishes a link between the spontaneously septic cavity of the bowel and bone tissue by way of blood via the interstices of the fabric. The prosthesis may be responsible for blood seeding infection and not only a mere victim. The prosthesis acts as a porous membrane which allows two opposite flows: the passage of blood from graft to bowel and germ migration from naturally septic bowel to blood. When a GEE is encountered, a rigorous management is required to prevent septic embolism. The precise timing of each step of the surgical procedure remains difficult to codify.

Peripheral and central distal axonopathy of suspected inherited origin in Birman cats.

Three female cats, littermates born from clinically normal parents, were examined at 8 to 10 weeks of age because of a slowly progressive posterior ataxia. Another cat from a previous litter from the same parents suffered from similar neurological symptoms. Histopathological examination of the nervous tissues of these animals revealed degeneration of axons and myelinopathy in a distal distribution pattern. Both peripheral nerves and central nervous system were involved. The central nervous system lesions were most prominent in the lateral pyramidal tracts of the spinal cord, the fasciculi gracili of the dorsal column in the cervical spinal cord and the cerebellar vermian white matter. In the PNS numerous degenerating nerve fibers were found in the sciatic nerves but not in the spinal nerve roots. Our findings show that these cats were suffering from a hereditary multisystem degeneration with a distribution pattern of the lesions suggestive of a distal axonopathy.

Simultaneous cystometry and uroflowmetry for evaluation of micturition in two dogs.

A recently developed urodynamic testing procedure was used to evaluate disorders of micturition in 2 dogs. The procedure simultaneously recorded intravesical pressure and urine flow during micturition. In an 11-year-old spayed female Sheltie that could not urinate normally, a micturition study demonstrated functional outflow obstruction of the urinary bladder. Although the urethra was patent, the urethral resistance factor, as calculated from pressure and flow data, was extremely high during voiding efforts. A urethral transitional cell carcinoma along with secondary infection, inflammation, and fibrosis were found to be responsible for the dog's problem. Ability to urinate was restored following removal of the affected portion of the urethra. In a 6-year-old spayed female Doberman Pinscher with urinary incontinence during sleep, a micturition study demonstrated urethral incompetence. During infusion of 0.9% NaCl solution into the bladder, the fluid flowed through the urethra before the detrusor muscle contracted, and urethral resistance during voiding was low. The dog's incontinence was responsive to estrogen administration.

Simultaneous cystometry and uroflowmetry (micturition study) for evaluation of the caudal part of the urinary tract in dogs: studies of the technique.

A procedure similar to one used for urodynamic evaluation of persons was adapted for simultaneous cystometry and uroflowmetry in dogs. Percutaneous transabdominal urinary bladder catheterizations were used for bladder infusion and cystometry, so that urine flow during voiding would not be altered by urethra instrumentation. The technique was evaluated twice in each of 12 healthy dogs (6 males and 6 females). Studies of individual dogs were performed 1 week apart. Comparisons were made between xylazine and oxymorphone for sedation to accomplish the procedure. Although the 2 drugs provided adequate sedation, oxymorphone was unsatisfactory because it interfered with micturition, whereas xylazine generally did not. Adverse consequences of the procedure occurred infrequently and were minor. According to results of urinalyses, hematuria or pyuria, or both, appeared during the week after the procedure was done in a few dogs, and staphylococcal bacteriuria was induced in 4 dogs. Fluid leakage from urinary bladders was not demonstrated by abdominal paracentesis immediately after each procedure or by contrast radiography performed the day after the 2nd study for each animal. Micturition studies were concluded to be reasonably safe to do, especially when performed by experienced individuals. The studies were judged to have considerable potential value as a means to evaluate lower urinary tract function in dogs.

Simultaneous cystometry and uroflowmetry (micturition study) for evaluation of the caudal part of the urinary tract in dogs: reference values for healthy animals sedated with xylazine.

Micturition studies were performed in 12 healthy dogs (6 females and 6 males). The animals were sedated with xylazine given either IV (1.1 mg/kg) or IM (2.2 mg/kg). Separate antepubic catheters were used to perform bladder infusions and record intravesical pressures. Instantaneous urine flow measurements were obtained, using an apparatus specially designed and constructed for small animals. A total of 45 simultaneous cystometric and uroflowmetric recordings were obtained, and numerical values for 16 different micturition variables were tabulated. The variables were analyzed separately on the basis of sex of the animal, route of administration of the sedative, and the fact of having had a previous bladder instrumentation-micturition study performed. Significant differences within individual dogs were not seen in these analyses. Intravesical pressures, urine flow rates, compliances, and urethral resistance were significantly different (P less than 0.05) between male and female dogs. The micturition study was a simple and reliable urodynamic testing method that could be clinically useful in dogs. In contrast to urodynamic tests previously described in veterinary medicine, this method provided evaluation of the bladder and urethra as a functional unit during both the filling and the emptying phases of micturition. A micturition study should not be regarded as an absolute measure of the physiologic activity of the caudal part of the urinary tract. However, it can provide important additional information for clinical assessment when the lower part of the urinary tract is affected by disease, injury, or drugs.

Hemodynamic effects of lactated Ringer's solution on hemorrhagic shock during exposure to hyperbaric air and hyperbaric hyperoxia.

Three groups of six dogs each were instrumented with an electromagnetic flow-meter around the pulmonary artery, and indwelling silastic cannulas in the pulmonary artery, the left ventricle, the ascending aorta and the right atrium. After allowing 5-7 d for recovery the dogs were studied under normobaric conditions, breathing air, at 2.8 atmospheres absolute (ATA) breathing 100% oxygen (PO2 approximately equal to 2128 mm Hg) and at 6 ATA breathing air (PO2 approximately equal to 960 mm Hg). Baseline recordings were made at 1 ATA and repeated after arrival at depth. The dogs were hemorrhaged until the mean aortic pressure fell to 40 mm Hg. Mean aortic pressure was maintained between 40-50 mm Hg for 30 min. Enough lactated Ringer's solution was then infused to stabilize the aortic pressure to within 90% of its original 1 ATA baseline value. Hemodynamic parameters were measured or calculated at eight different times. There were statistically significant differences in some of the measured parameters due to the effects of hemorrhage but no differences between the three groups attributable to either of the hyperbaric conditions or the effects of lactated Ringer's solution.

Drug disposition under hyperbaric and hyperbaric hyperoxic conditions: meperidine in the dog.

Patients being treated for a variety of conditions with hyperbaria or hyperbaric hyperoxia, and ill or injured deep sea divers being decompressed, may require concomitant drug therapy. This study examined the possible effects of those conditions on the distribution and elimination of meperidine, using the dog as a model. The drug was administered to six mixed-breed dogs as a 1.4 mg/kg i.v. bolus at 1 ATA breathing air, at 2.8 ATA breathing 100% O2, and at 6 ATA breathing air, and followed by serial blood sampling for 3 h. Statistical analysis showed no effects of hyperbaria or hyperbaric hyperoxia on the elimination half-life, total plasma clearance, or volume of distribution. These studies demonstrated marked differences between man and the dog in the elimination of meperidine. This probably means these results cannot be extrapolated to man.

Hemodynamic effects of Dextran 40 on hemorrhagic shock during hyperbaria and hyperbaric hyperoxia.

Three groups of six dogs each were instrumented with an electromagnetic flow-meter around the pulmonary artery, and indwelling silastic cannulas in the pulmonary artery, the left ventricle, the ascending aorta and the right atrium. After 7-10 d, dogs were studied under normobaric conditions, breathing air, at 2.8 atmospheres absolute (ATA) breathing 100% oxygen (PO2 approximately equal to 2128 mm Hg), and at 6 ATA breathing air (PO2 approximately equal to 960 mm Hg). Baseline recordings were made at 1 ATA and repeated after arrival at depth. The dogs were hemorrhaged until the mean aortic pressure fell to 40 mm Hg. Pressure was maintained between 40-50 mm Hg for 30 min. Enough Dextran 40 was then infused to stabilize the aortic pressure to within 90% of its original 1 ATA baseline value. Hemodynamic parameters were measured or calculated at eight different times. More than twice the amount of Dextran 40 was required at depth than at 1 ATA. There were statistically significant differences due to the effects of hemorrhage but no differences between the three groups attributable to either of the hyperbaric conditions or the effects of Dextran 40.

Disseminated necrotizing panniculitis and pancreatic nodular hyperplasia in a dog.

An 8-year-old female Poodle had severe necrotizing skin disease characterized by numerous large red-purple, nonpruritic lesions. The larger lesions had soft, intensely discolored centers that contained sterile viscous blood-tinged material. Biopsies of the lesions revealed necrotizing panniculitis (subcutaneous fat necrosis). The dog did not respond to intensive therapy and euthanasia was performed. Necropsy findings included diffuse fat necrosis and pancreatic nodular hyperplasia. A pathoetiologic relation between pancreatic disease and diffuse fat necrosis in this dog was suggested.