Outcomes and postoperative complications after transpelvic urethrostomy used as first-line surgery in 38 male cats with obstructive lower urinary tract disease.

OBJECTIVES: This article aimed to report on the short- and long-term outcomes after transpelvic urethrostomy (TPU) as a first-line surgery to treat obstructive lower urinary tract disease (OLUTD) in male cats. METHODS: A retrospective review and follow-up owner telephone questionnaire for cats with OLUTD undergoing TPU as a first-line surgery between 2013 and 2019, at a single referral hospital, were performed. A minimum follow-up period of 1 year was required to be included in the study. Short- and long-term complications were defined as those that occurred, respectively, within or after the first 4 weeks postoperatively. RESULTS: Thirty-eight male cats were included. The short-term complication rate was 18%. Idiopathic lower urinary tract disease (ILUTD) and stomal stenosis (SS) were the two most frequent short-term complications. Long-term complications were reported in 34% of the cats and included ILUTD, urinary tract infection and SS. The mortality rate was 5%. Eighty-two percent of the owners were satisfied with the postoperative outcome. The most common reason for owner dissatisfaction was the occurrence of SS, especially because these complications required multiple surgical revisions to be definitively managed. The long-term quality of life was considered to be good to very good by 89% of the owners. Ninety-one percent of the cats were free of clinical urinary signs at the time of the questionnaire completion. CONCLUSIONS AND RELEVANCE: TPU can be an acceptable first-line surgical technique to treat cats with OLUTD. Most cats experienced a good to very good quality of life after TPU. Most complications were transient or manageable medically. Most of the major complications were SS, which can be technically challenging to address and may require multiple revision surgeries.

Double-cut center of rotation of angulation-based leveling osteotomy for treatment of cranial cruciate ligament deficiency and excessive tibial plateau angle secondary to growth anomaly in two dogs.

CASE DESCRIPTION: A 4-year-old female Staffordshire Bull Terrier (dog 1) and a 6-year-old male Yorkshire Terrier (dog 2) were evaluated because of left pelvic limb lameness. CLINICAL FINDINGS: Both dogs had a partial rupture of the left cranial cruciate ligament associated with a unilateral excessive tibial plateau angle (51° in dog 1 and 41° in dog 2) secondary to a growth anomaly. TREATMENT AND OUTCOME: Both dogs underwent a double-cut center of rotation of angulation-based leveling osteotomy combining rotation of the proximal fragment with a cranial closing wedge ostectomy. The procedure allowed leveling of the tibial plateau to a final angle of 11° in one dog and 10° in the other without perioperative complications. Both dogs had excellent functional outcomes ≤ 4 months after the surgery. No postoperative complications were reported during follow-up (12 months and 9 months for dogs 1 and 2, respectively). CLINICAL RELEVANCE: Results for these dogs suggested that double-cut center of rotation of angulation-based leveling osteotomy can be considered as a viable treatment option for cranial cruciate ligament deficiency associated with excessive tibial plateau angle.

Outcomes of nine cats with urinary retention after sacrocaudal luxation managed with long-term urinary diversion.

OBJECTIVE: To document the outcomes of cats with urinary retention (UR) after sacrocaudal luxation (SCL) and managed with a long-term cystostomy (LTC). STUDY DESIGN: Short case series. ANIMALS: Nine client-owned cats with SCL and subsequent UR. METHODS: Nine cats suffering from non-relievable UR secondary to SCL, between March 2013 and December 2020, had a LTC placed 4.5 days post-SCL (mean, range 3.5-6.0), until clinical evidence of normal urination recovery. The bladder was emptied at least twice daily. No antimicrobial was given during LTC. Indication for tube removal was voluntary micturition with complete emptying for a minimum of three consecutive days. Recheck examinations were scheduled for post-SCL days 7 and 14, as well as for LTC tube removal. Minor and major complications and length of LTC use were recorded. RESULTS: The LTC was removed 11-42 days (mean 26 days) after placement. All cats recovered normal micturition spontaneously within 17-47 days post-SCL (mean 30.7 days): 1 cat between the 2nd and 3rd weeks, 5 cats between the 3rd and 4th weeks, and 3 cats >30 days after the trauma. Major complications, such tube dislodgement, occurred in two cats, whereas complications resolving after tube removal were recorded in 6 cats. CONCLUSION: LTC was effective at managing UR post-SCL in 9 cats. All cats recovered normal urinary function within 7 weeks. CLINICAL SIGNIFICANCE: LTC can be an alternative to manual expression or bladder catheterization in cats with temporary UR after SCL.

Use of a T'LIFT transabdominal organ retraction device in two-portal laparoscopic ovariectomy in dogs.

OBJECTIVE: To describe the use of the T'LIFT transabdominal organ retraction device to suspend ovaries during canine laparoscopic ovariectomy (LapOVE) and compare its use to a transabdominal suspension suture (TSS). DESIGN: Randomized clinical trial. ANIMALS: Client-owned intact bitches (n = 30). METHODS: Dogs were randomly assigned either to group T, in which LapOVE was performed with the T'LIFT, or to group S, in which a TSS was used. Laparoscopic ovariectomy was performed by using a standard two-portal protocol. Signalment (age, weight, body condition score [BCS], fat score of the ovarian pedicle [FSOP]), overall operative time, ovarian resection time, and perioperative complications were compared between groups. RESULTS: No significant differences were found between groups regarding age, weight, BCS, or FSOP. Surgical times were not significantly different between groups. No significant differences in major or minor complications were recorded. Overall operative time was significantly shorter for the last half of the cases compared with the first half, for the overall population, and within each group. Ovarian resection time for the last cases was significantly shorter compared with that for the first ones only in group T. CONCLUSION: The T'LIFT was used to suspend ovaries for two-portal LapOVE, with no major complications noted. There was no significant difference in surgical times or complications compared with transabdominal suturing. CLINICAL SIGNIFICANCE: The T'LIFT can be considered as an alternative to transabdominal suture for ovarian suspension in dogs undergoing LapOVE.

Radical cystectomy and subsequent ureterohysterostomy in a bitch.

OBJECTIVE: To describe and report the outcome of a ureterouterine anastomosis after unilateral dehiscence of a ureterovaginal anastomosis after total cystectomy in a bitch. STUDY DESIGN: Case report. ANIMAL: A 10-year-old intact female border collie with a urinary bladder leiomyosarcoma. METHODS: The dog was diagnosed with an invasive urinary bladder tumor, treated by radical cystectomy and bilateral ureterovaginal anastomosis. Postoperative necrosis of the distal ureter led to dehiscence of the anastomosis on the right side. To preserve the right kidney, the right ureter was anastomosed to the right uterine horn, and a stent was placed across the uterine cervix. RESULTS: The dog recovered from surgery and regained satisfactory urine output. Both ureteral anastomoses were patent at 10 months postoperatively. At 12 months postoperatively, intraluminal obstruction of the uterine stent, loss of patency of the right ureter, and severe right renal hydronephrosis were noted. The owner declined nephrectomy, and the dog died 2 months later. CONCLUSION: This is the first published report of a ureterouterine anastomosis and stenting of the uterine cervix in a dog. The functional outcome was satisfactory for 1 year postoperatively. The uterine stent and distal ureter were eventually obstructed by soft tissue. CLINICAL SIGNIFICANCE: Ureterouterine anastomosis can be considered as a salvage procedure when other surgical techniques have failed.

Control of hemorrhage through the osteotomy gap during tibial plateau leveling osteotomy: 9 cases.

OBJECTIVE: To describe a new technique to control intraoperative hemorrhage during tibial plateau leveling osteotomy (TPLO) and report subsequent short-term and long-term complications. STUDY DESIGN: Retrospective case series. ANIMALS: Nine dogs with arterial hemorrhage during TPLO. METHODS: Medical records of dogs with hemorrhage controlled through the osteotomy gap of a TPLO were reviewed at 2 institutions over 8 years. Inclusion criteria included diagnosis of single cranial cruciate ligament rupture, intraoperative arterial hemorrhage during the radial osteotomy controlled with bipolar electrocautery or hemostatic clips placed along the cranial tibial artery through the osteotomy, complete medical records, radiographic follow-up for at least 8 weeks postoperatively, and completion of long-term follow-up questionnaire by the owner. RESULTS: Dogs were 4.6 ± 1.8 years old and weighed 36.6 ± 9.7 kg. In total, 3 ± 1 hemostatic clips were placed per stifle. Intraoperative hemostasis was achieved in all cases. One of the first dogs received a blood transfusion during the procedure and had a postoperative packed cell volume of 37%. The only complication consisted of fibular fracture, which was noticed on radiographs of 1 dog 8 weeks after TPLO. CONCLUSION: Arterial hemorrhage during the radial osteotomy of a TPLO can be controlled by occlusion of the compromised artery through distraction of the osteotomy gap. This technique was not associated with long-term complications.

Video-assisted removal of metal pellet fragments from the vertebral canal following gunshot injury and long-term outcome in a cat.

OBJECTIVE:  To describe the surgical management and long-term outcome of a spinal gunshot injury in a cat. CLINICAL REPORT: A two-year-old, 4.2 kg castrated European Shorthair male cat was referred for evaluation of bilateral acute hindlimb paralysis with loss of deep pain perception in the right hindlimb associated with a perforating gunshot wound in the left side of the flank. Based on the clinical findings, the injury was localized to the fourth lumbar-first sacral spinal cord segment. The orthogonal spinal radiographs and computed tomography examination showed several metal pellet fragments within the vertebral canal of the sixth lumbar vertebra. A left mini-hemilaminectomy of the sixth lumbar vertebra pedicle combined with a mini dorsal laminectomy over the sixth to seventh lumbar vertebrae disc space were performed. A 2.4 mm 30° arthroscope was then introduced within the spinal canal to improve visibility and help with the fragment extraction. The cat was discharged from the hospital five days after surgery and the owners were encouraged to continue passive and active physiotherapy movements. RESULTS: The cat was ambulatory with a plantigrade stance eight weeks following surgery. At the last follow-up examination (24 months postoperatively), the cat was able to jump on chairs, although intermittent urinary and faecal incontinence, proprioceptive deficits, and plantigrade stance were still present. CLINICAL SIGNIFICANCE:  Decompressive surgery may promote neurological status improvement following spinal gunshot injury.

Biomechanical Comparison of Locking Compression Plate and Limited Contact Dynamic Compression Plate Combined with an Intramedullary Rod in a Canine Femoral Fracture-Gap Model.

OBJECTIVE: To compare the biomechanical properties of locking compression plate (LCP) and a limited contact dynamic compression plate combined with an intramedullary rod (LC-DCP-R) in a cadaveric, canine, femoral fracture-gap model. STUDY DESIGN: In vitro biomechanical study; nonrandomized, complete block (dog). SAMPLE POPULATION: Paired cadaveric canine femora (n = 10 dogs). METHODS: Paired femurs with a mid-diaphyseal 20 mm gap were stabilized with either LCP or LC-DCP-R. Nondestructive testing up to 60% of body weight (BW) was followed by a continuous destructive test. Comparative structural properties, 3-dimensional (3D) interfragmentary motion, and plate linear strain were evaluated. Paired comparisons were made between LCP and LC-DCP-R. RESULTS: Stiffness after nondestructive testing was significantly lower for LCP with a mean (95% confidence interval [CI]) of 61 N/mm (46-76) versus 89 N/mm (67-110) for LC-DCP-R (P = .0072). Ultimate load to failure was significantly lower for LCP with a median (interquartile range [IQR]) of 270 N (247-286) versus 371.5 (353-385) for LC-DCP-R (P = .002). Axial motion at 60% BW was significantly higher for LCP with a median (IQR) of 1.01 mm (0.71-1.26) versus 0.36 mm (0.20-0.49) for LC-DCP-R (P = .002). Shear motion was significantly higher for LCP with a median (IQR) of 1.18 (0.78-1.58) versus 0.72 mm (0.45-1.00) for LC-DCP-R (P = .018). Strain was significantly higher for mid-LCP surface with a mean (95%CI) at 60% BW of 979 µdef (579-1378) versus 583 µdef (365-801) at mid-LC-DCP-R surface (P = .0153). The elastic limit strain of the plates was not different and was reached at a mean (95%CI) load of 241 N (190-292) for LCP versus 290 N (245-336) for LC-DCP-R (P = .12). CONCLUSION: The LC-DCP-R showed higher stiffness and resistance to failure, lower interfragmentary motion, and lower plate strain and stress compared to LCP.

Biomechanical comparison of 4.0-mm short-threaded cannulated screws and 4.0-mm short-threaded cancellous screws in a canine humeral condylar fracture model.

OBJECTIVE: To compare biomechanical properties of a humeral condylar fracture model stabilized either with a 4.0-mm short-threaded cancellous screw (CCS) or with a 4.0-mm short-threaded cannulated screw (CNS). STUDY DESIGN: In vitro biomechanical study. SAMPLE POPULATION: Bilateral cadaveric canine humeri (n = 20). METHODS: Fractures of the lateral portion of the humeral condyle were simulated by standardized osteotomies; 10 condyles were each stabilized with CCS and 10 with CNS. Axial compression load was applied to each specimen until failure and force-displacement curves generated. Testing data for each construct were determined and compared using either a Student's paired t-test (quantitative data) or a χ(2) test (qualitative data) with statistical significance set at P < .05. RESULTS: Yield load (elastic limit), ultimate load at failure, and displacements at loads corresponding to walk and trot were determined from each curve. Mean ± SD ultimate load at failure was significantly higher (P = .01) for CCS constructs (1261 ± 261 N) than for CNS constructs (1078 ± 231 N). Yield loads were not significantly different (P = .10) between construct types, and exceeded all expected loads supported by the humeral condyle at walk. The risk of having a yield load below the expected physiologic load at trot was not statistically higher with a CNS construct compared with a CCS construct (P = .26). CONCLUSION: Humeral condylar fracture repaired either by a 4.0-mm cannulated screw or a 4.0-mm cancellous screw have comparable stability in this condylar fracture model.

Juvenile pubic symphysiodesis and juvenile pubic symphysiodesis associated with pectineus myotomy: short-term outcome in 56 dysplastic puppies.

OBJECTIVES: (1) To compare short-term outcome of juvenile pubic symphysiodesis (JPS) in puppies aged 12-17 weeks with lax hips (group JPS1), in puppies aged 18-22 weeks (group JPS2), and control (group C) puppies; and (2) to document outcome of bilateral pectineus myotomy (PM) associated with JPS in 18-22-week-old puppies (group JPS-PM). STUDY DESIGN: Prospective study. METHODS: Puppies (12-22 weeks) from large and giant breed dogs with a combination of a positive Ortolani sign, poor acetabular coverage (Norberg angle [NA]0.5 for one or both hips were selected. Puppies aged <18 weeks were randomly assigned to group JPS1 or C. Puppies aged 18-22 weeks were randomly assigned to group JPS2, JPS-PM, or C. Three to 4 months later, surgery was considered successful in pain-free dogs with negative Ortolani sign, normalized acetabular coverage (NA>or=105 degrees ), and SI>0.5. Success rates were compared using Fisher's exact tests: JPS1 versus JPS2 versus C; JPS2 versus JPS-PM. Significance was set at P<.05. RESULTS: All dysplastic hips from nonoperated (C) groups were dysplastic at follow-up, meaning that our criteria for case selection were accurate. JPS1 had significantly better success rate than JPS2 (85 versus 17.8%, respectively). JPS-PM dysplastic hips failed to demonstrate a better outcome than JPS2 hips. CLINICAL RELEVANCE: This study confirms, on a large series of dysplastic hips, the age-dependent effects of JPS, with better results if performed before 18 weeks of age. There is no benefit of adding PM to the procedure in candidates >18 weeks at surgery.