Use of a caudal auricular axial pattern flap in cats.

A caudal auricular axial pattern flap was used in 3 cats to successfully reconstruct large cutaneous defects of the head that were a result of trauma or surgical excision of neoplasms. The technique was a convenient, practical, one-stage procedure for closure of the defects, and flaps up to 7.0 x 12.0 cm were developed. All flaps healed without complications. Anatomic landmarks and surgical guidelines for developing the flap were determined through anatomic dissections and angiographic studies of the cutaneous vasculature of the head and neck in feline cadavers. This report confirms findings of a previous study describing a platysma myocutaneous flap.

Use of a carbon dioxide laser for treatment of elongated soft palate in dogs.

Use of a CO2 laser to resect the soft palate in 6 dogs with elongated soft palate is described. The technique was rapid and uncomplicated; hemostasis was not a problem. Breathing was noticeably improved in all dogs immediately after surgery. Use of the CO2 laser represents a new option for surgical treatment of elongated soft palate in dogs.

Stapled typhlectomy via colotomy for treatment of cecal inversion in a dog.

A 13-year-old Weimaraner was examined because of chronic diarrhea, hematochezia, and moderate weight loss. Cecal inversion was diagnosed by use of colonoscopy. Exploratory surgery was performed, and the inverted cecum was exteriorized through a colotomy. Typhlectomy was performed by use of a stapling instrument that formed a full-thickness division of the cecum with a double row of staples on each side. This stapling technique provides a rapid, reliable method for treatment of cecal inversion when the cecum cannot be reduced manually.

Gastric surgery with surgical stapling instruments.

The use of stapling instruments to perform gastric surgery in small animal patients provides alternative techniques that are often more reliable and are usually performed more quickly than conventional techniques with manual sutures. In addition to reducing anesthetic and operating times, the risk of contamination of the abdominal cavity may be decreased significantly.

Controlled tissue expansion in the distal extremities of dogs.

Controlled tissue expansion using a 100 cc rectangular silicone elastomer expander was performed in the mid-antebrachium and mid-crus of eight adult mixed-breed dogs. Two expander inflation schedules were followed. Group 1 dogs (n = 4) underwent expander inflation using 10 cc sterile saline every other day, and group 2 dogs (n = 4) underwent expander inflation using 15 cc sterile saline every other day until the nominal volume (100 cc) was attained. Significant mean postexpansion increases in skin surface area of 94.1 cm2 (35.9%) and 108.9 cm2 (37.3%) were measured in the antebrachium and crus, respectively (p < .05). In a second procedure, the expanders were removed and skin flaps were developed from the redundant tissue generated during the expansion process. Single pedicle advancement flaps and transposition flaps were used to cover surgically created defects measuring 5 x 10 cm in the antebrachium and crus. Single pedicle advancement flaps consistently measured 10 x 10 cm and could be advanced to cover defects involving one third of the mid-antebrachial or mid-crural circumference. Transposition flaps were rotated up to 170 degrees and the donor site defects were easily closed under minimal or no tension. Complications included an abscess in one dog and seroma formation in four dogs. Differences in success or complication rates between group 1 dogs and group 2 dogs were not observed; an accelerated inflation schedule using 15 cc sterile saline every other day was recommended.

Traumatic luxation of the cubital joint (elbow) in dogs: 44 cases (1978-1988).

The medical records from 44 dogs with traumatic luxation of the cubital joint were reviewed. Closed reduction was performed in 35 dogs, and open reduction in 9 dogs. Excellent or good results were achieved in 31 of 35 dogs (88.6%) treated by closed reduction and in 5 of 9 dogs (55.6%) treated by open reduction. Collateral ligament repair, performed in 5 dogs, did not appear to affect the prognosis. Factors such as body weight and type and duration of external coaptation also did not appear to influence the outcome. Increased dysfunction associated with open reduction most likely was caused by the chronic nature of the dislocation, iatrogenic damage to the articular cartilage during reduction, or both. A good prognosis for return to normal function with minimal gait abnormality can be expected in most cases of traumatic luxation of the cubital joint treated by early closed reduction.

Belt loop gastropexy in the management of gastroesophageal intussusception in a pup.

Gastroesophageal intussusception and megaesophagus were diagnosed in a 5-week-old German Shepherd Dog. Exploratory surgery was performed, and belt loop gastropexy was used to maintain proper gastric position after manual reduction of the intussusception. The pup survived surgery and was clinically normal when it was 6 months old. Follow-up contrast radiography revealed resolution of the megaesophagus and apparent permanent gastropexy. Previous reports have indicated extremely high mortality for gastroesophageal intussusception, and resolution of megaesophagus in the dog is unusual.

En bloc resection of primary rib tumors in 40 dogs.

Single or multiple rib resection was performed in 40 dogs for the treatment of primary osteosarcoma or chondrosarcoma. The resulting thoracic wall defect was closed with polypropylene (12 dogs), primary muscle flap (16 dogs), diaphragmatic advancement (10 dogs), or a combination (2 dogs). Few immediate (less than 2 weeks) postoperative complications were observed. Twenty dogs with osteosarcoma had a median survival time of 3.3 months (range, 0.5 to 23 months), with a 20% 6-month survival time. Metastases occurred in all the dogs. Fourteen dogs with chondrosarcoma followed up longer than 2 weeks had a median survival time of 10.7 months (range, 0.5 to 36 months) with a 64% 6-month survival time. Eight dogs developed metastases, five died from concurrent disease, and one dog is alive. Dogs with chondrosarcoma survived significantly longer than dogs with osteosarcoma. Survival time was not related to tumor size or number of ribs resected.

Open intestinal anastomosis with surgical stapling equipment in 24 dogs and cats.

Surgical stapling equipment was used to perform open antiperistaltic side-to-side ("functional end-to-end") entero-anastomoses in 20 dogs and 4 cats. Twenty-one anastomoses healed uneventfully. Seven animals with severe bacterial peritonitis required open peritoneal drainage and delayed abdominal closure. There was postoperative leakage at the anastomotic site in two dogs and a localized abscess at the staple line in one cat. No long-term complications occurred in follow-up periods of 3 to 29 months.

Positive effects of interaction coaching on infants with developmental disabilities and their mothers.

Modification of maternal responsivity was attempted in a study of the effects of interaction coaching. Twenty-three mothers and their infants with developmental disabilities participated in an interaction coaching component that consisted of six sessions of providing feedback to mothers about incidence of overstimulation observed on videotapes. Suggestions were given for ways to interact in a more contingently responsive manner. Compared with a control group of 17 mother-infant pairs, the interaction coaching group mothers increased responsibility and decreased stimulation. The infants were less fussy and performed better on standardized developmental assessments.

Open nasal cavity and frontal sinus treatment of chronic canine aspergillosis.

Five dogs with nasal aspergillosis were treated by surgical exposure and delayed closure of the nasal cavity and involved frontal sinus. Diseased tissue was excised, and 10% povidone-iodine solution was applied three times daily with cotton-tipped applicators. Skin wounds were closed at weeks 6 through 8. In one dog, the frontal sinus was partially obliterated with a temporalis muscle flap before skin closure. At months 6 through 34, all dogs were clinically free of aspergillosis. Open treatment has potential clinical application as a primary approach to nasal aspergillosis or for cases that are unresponsive to previous medical management.

Partial gastrectomy with an automatic stapling instrument for treatment of gastric necrosis secondary to gastric dilatation-volvulus.

A gastrointestinal anastomosis stapling instrument was used to perform partial gastrectomy in nine dogs undergoing emergency surgery for gastric dilatation-volvulus. The amount of necrotic stomach resected was 20% to 50%. Permanent gastropexy was performed, and six dogs also required partial or total splenectomy. Six dogs (67%) were normal after surgery, with follow-up periods of 6 to 16 months for five dogs. One dog died and two dogs were euthanatized because of postoperative complications unrelated to the surgical technique. There were no complications involving the partial gastrectomy staple line.

Phase I clinical and pharmacokinetic trial of flavone acetic acid.

Flavone acetic acid is a synthetic benzopyrone derivative with an unknown mechanism of action. Thirty-eight patients (30 men and 8 women) were treated once a week for 4 weeks every 5 weeks with doses of flavone acetic acid ranging from 0.33 to 12.5 g/m2. At doses less than or equal to 3.9 g/m2, the drug was administered intravenously over 1 hour; at doses greater than or equal to 5.28 g/m2, the infusion period was lengthened to 6 hours. Treatment of all patients included hydration before and after treatment and alkalization to maintain urine pH at greater than or equal to 6.5. A dose-limiting toxic effect was hypotension at 10 g/m2. Pharmacokinetic studies revealed linear behavior in the eight patients studied, beginning at 3.9 g/m2. Peak plasma levels ranged from 125 to 630 micrograms/mL, with a mean terminal half-life of 22.4 hours. Immunologic monitoring was performed in three patients at 10 g/m2. A transient increase in CD16- and/or Leu-19-positive cells was noted in all three patients. In one patient, this increase correlated with a 10-fold increase in K562 cell killing. There were no objective tumor responses seen in this trial. The recommended phase II dose on this schedule is 8 g/m2. Further studies to elucidate the drug's mechanism of action and to define its immunologic properties are recommended.