Owner-assisted recovery and early discharge after surgical treatment in dogs with brachycephalic obstructive airway syndrome.

OBJECTIVES: This study aims to describe a perioperative protocol for dogs recovered from anaesthesia with the owners and discharged from the hospital on the same day after surgical management of brachycephalic obstructive airway syndrome and to determine whether implementation of this protocol was associated with reduced incidence of complications compared with standard anaesthesia recovery and 24 hours hospitalisation. MATERIALS AND METHODS: Medical records of dogs that underwent brachycephalic obstructive airway surgery over two consecutive years (June 2017 to May 2019) were reviewed retrospectively. Signalment, clinical signs, diagnostic findings, surgical procedures and postoperative respiratory complications were recorded. Data were compared using the chi-squared or Fisher's exact tests. RESULTS: Sixty-three dogs met the inclusion criteria for the study. Forty-two dogs underwent owner-assisted recovery and 21 dogs standard recovery. No statistical difference was found between groups in age, breed, gender, severity of respiratory or gastrointestinal clinical signs and surgical techniques employed. The incidence of postoperative complications was higher in dogs that received standard recovery (28%) compared to dogs recovered with the owners (2%). None of the dogs recovered with the owners and discharged the same day required veterinary assistance after discharge from the hospital. CLINICAL SIGNIFICANCE: Corrective surgery for brachycephalic obstructive airway syndrome was associated with lower postoperative respiratory complications when dogs were discharged on the same day after recovery with the owners. Owner-assisted recovery and early discharge are possible and safe and may decrease the incidence of postoperative complications. However, other unmeasured factors may have contributed to the lower complication rate in dogs recovered with the owners during the course of this study.

Outcome of surgical treatment of perineal hernia in cats: 36 cases (2013-2019).

OBJECTIVES: To report the clinical presentation, complications, and long-term outcomes of cats treated for perineal hernia with modified internal obturator muscle transposition. METHODS: The medical records of cats surgically treated for perineal hernia between 2013 and 2019 were reviewed and an owner questionnaire was conducted to determine long-term outcome. RESULTS: Thirty-six cats were included in the study: 34 had bilateral and two unilateral hernias. Of these 36, 24 (67%) were male neutered with a median age of 10 (range: 1 to 18) years. The complication rate was low, however, one cat experienced a major postoperative complication: rectal prolapse requiring revision surgery 48 hours postsurgery. Short-term outcomes were available for 32 of 36 (89%) cats. Of the 32, 23 were examined 6 weeks postoperatively, and a telephonic consultation was performed for an additional nine of 32. Of the 23 cats examined directly, none had recurrence. Overall 12 of 32 experienced short-term postoperative tenesmus which resolved in nine of 12 (75%). Long-term outcomes were available for 31 of 36 cats (86%), with a median of 18.5 (6 to 89) months follow-up. A good outcome was achieved in 23 of 31 (74%) whereas three of 31 (10%) had fair outcomes and five of 31 (16%) had a poor outcome. Of the five cats with a poor outcome, two required subtotal colectomy to manage clinical signs related to megacolon, two were euthanised following a return of clinical signs, and one developed unilateral recurrence. CLINICAL SIGNIFICANCE: Perineal hernia should be considered in cats presenting with tenesmus or recurrent obstipation. Surgical treatment of perineal hernias in cats can result in good owner-assessed long-term outcome.

The use of methylene blue to assist with parotid sialadenectomy in dogs.

INTRODUCTION: There is an important morbidity associated with parotidectomy. The most commonly reported permanent complication is facial nerve injury. Methylene blue staining has been used as an intra-operative tool to improve tissue visualisation and preserve facial nerve integrity. OBJECTIVES: To describe the functionality and feasibility of the use of methylene blue for parotidectomy in dogs. MATERIALS AND METHODS: Retrospective study included seven client-owned dogs that underwent parotidectomy after injection of methylene blue from 2016 to 2019 in a referral centre. Cross-sectional imaging was used to confirm parotid gland surgical disease and for staging purposes. All dogs underwent parotid resection and removal of the parotid duct after injection of methylene blue. Methylene blue was either administered via cannulation of the parotid duct or directly injected into the abnormal gland. RESULTS: In all cases, the gland stained dark blue within seconds without any evident leakage. Complete parotid gland resection and removal of the parotid duct was achieved successfully in all dogs with a mean surgical time of 97 minutes. Subjectively, the staining was useful to identify innervation outside the coloured gland and facilitated dissection. No complications, including facial nerve injury, were recorded. CLINICAL SIGNIFICANCE: Methylene blue staining for complete parotidectomy was feasible, rapid and easy in these dogs. It can be used as an indirect facial nerve identification technique, and can therefore facilitate dissection and possibly reduce the incidence of post-operative facial nerve paralysis.

Feasibility of the single-incision subxiphoid approach for video-assisted thoracoscopic surgery in dogs.

OBJECTIVES: To report early results of uniportal video-assisted thoracoscopic surgery in dogs using a single-incision subxiphoid approach. MATERIALS AND METHODS: Retrospective study of 10 client-owned dogs with: pyothorax (n=5), pericardial effusion (n=2), bilateral pneumothorax (n=1), retained surgical swab (n=1), cranial mediastinal mass (n=1). With the dog in dorsal recumbency a 3-4 cm incision was made over the xiphoid process. After resection of the xiphoid process, a tunnel was created towards the pleura and open access maintained with an Alexis™ wound retractor. The pleural cavity was explored with a 10 mm 30° or 5 mm 0° telescope and straight laparoscopic instruments. RESULTS: Median surgical time was 75 minutes. The SISA technique was performed successfully in five of 10 cases and allowed easy and adequate inspection of the intra-thoracic structures. One case was converted to lateral thoracotomy after laceration of the vena cava and one converted to median sternotomy because of adhesions. An additional port was placed in three cases to facilitate triangulation and surgical manipulation. No other intra-operative complications were encountered. CLINICAL SIGNIFICANCE: In this initial report of uniportal thoracic approach in dogs, this technique allowed excellent access and treatment of mediastinal structures. Further cases are required to assess its suitability for pulmonary surgery.

Long-term clinical outcomes following surgery for spontaneous pneumothorax caused by pulmonary blebs and bullae in dogs - a multicentre (AVSTS Research Cooperative) retrospective study.

OBJECTIVES: To report the clinical characteristics and recurrence rate of spontaneous pneumothorax secondary to pulmonary blebs and bullae following surgical management in a large cohort of dogs. To explore potential risk factors for recurrence and describe outcome. MATERIALS AND METHODS: Medical records were retrospectively reviewed for cases with spontaneous pneumothorax managed surgically between 2000 and 2017. Signalment, clinical presentation, diagnostic imaging, surgery, histopathology findings and patient outcomes were recorded. Follow-up was performed via patient records and telephone contact. RESULTS: Records of 120 dogs with surgically treated pneumothorax were identified and reviewed, with 99 cases appropriate for exploratory statistical analysis. Median follow-up was 850 days (range: 9-5105 days). Two- and 5-year survival rates were 88.4% and 83.5%, respectively. There was recurrence in 14 of 99 dogs (14.1%) with adequate follow-up, with a median time to recurrence of 25 days (1-1719 days). Univariable Cox regression analysis suggested increased risk for recurrence in giant breeds (hazard ratio = 11.05, 95% confidence interval: 2.82-43.35) and with increasing bodyweight (HR = 1.04, 95% confidence interval: 1.00-1.09). Of 14 dogs with recurrence, six were euthanased, two died of causes related to pneumothorax and six underwent further treatment, of which five were resolved. CLINICAL SIGNIFICANCE: Long-term survival for dogs with surgically managed spontaneous pneumothorax was good and associated with a low risk of recurrence. Giant breed dogs and increased bodyweight were the only variables identified as possible risk factors for recurrence. The outcome for dogs with recurrence undergoing a second intervention was also favourable.

Use of indirect lymphography to identify sentinel lymph node in dogs: a pilot study in 30 tumours.

This study reports the clinical value of sentinel lymph node (SLN) mapping with indirect lymphography (IL) using iodized oil (IO) as a marker injected preoperatively around the site of the primary tumour and radiography or tomodensitometry for imaging. Surgical extirpation of the node was performed following peritumoural injection of methylene blue (MB). Twenty nine dogs affected by 30 palpable solid tumours were prospectively studied. SLNs were identified by IL in 96.6% of the IL studies. IL followed by MB studies were performed in 25 dogs (26 studies). In these studies, agreement between IL and MB was observed in 84.6%. One dog had a minor complication following IO injection. This protocol represents an attractive alternative to scintigraphy for SLN mapping. This less technically demanding protocol may provide a wider access to SLN identification for application in veterinary oncology.