A ventral diaphragmatic advancement technique to repair a large congenital peritoneopericardial diaphragmatic hernia in a dog.

OBJECTIVE: To report a ventral diaphragmatic advancement technique to repair a large congenital peritoneopericardial diaphragmatic hernia in a dog. ANIMAL: A 5-month-old 15-kg entire male Labrador Retriever. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: The dog presented with a history of diarrhea for a week and acute-onset lethargy and vomiting for 3 days. Clinical examination revealed borborygmi on auscultation of the chest, and subsequent imaging showed a congenital peritoneopericardial diaphragmatic hernia. TREATMENT AND OUTCOME: The ventro-central diaphragmatic defect was repaired with a pericardial flap, which subsequently failed 7 months later. The revision surgery was performed with a novel surgical technique. The defect was closed by means of incising the ventral attachments of the diaphragm either side of the defect and sliding it medially to allow a tension-free closure. The ventral aspect of the incised diaphragm was reattached with circumcostal sutures and the central defect closed. The dog recovered rapidly and without complication. An excellent outcome was reported after surgery. CLINICAL RELEVANCE: This novel technique was a simple method to repair a peritoneopericardial diaphragmatic hernia and had good clinical results in this case.

Giant splenic myelolipoma in a cat with hyperthyroidism.

Case summary: A 15 shorthair cat presented after having fallen down the stairs. Examination by the referring veterinarian had demonstrated tachycardia and a large abdominal mass. The cat was referred for investigations. Blood tests demonstrated hyperthyroidism. A large, poorly vascularised abdominal mass was identified on ultrasonography. The mass was hyperechoic compared with the normal liver; however, the origin could not be determined. Fine-needle aspirate biopsies of the mass demonstrated extramedullary haematopoiesis. Surgical exploration revealed a 12 cm × 8 cm × 8 cm pale mass arising from the spleen. Histopathology determined this was a giant splenic myelolipoma. Relevance and novel information: Splenic myelolipoma is rarely reported in the domestic cat, with only five cases documented within the literature, and none of these having described giant myelolipoma. Indeed, giant myelolipomas are rarely reported in the human literature and are most commonly adrenal in origin. The pathogenesis of these masses is unclear; there have been several incidences in people with endocrine disorders, and it has been hypothesised that their occurrence may be related to endocrine stimulation. Here we report the first case of giant myelolipoma in a hyperthyroid cat.

Changes in chemical and ultrastructural composition of ameroid constrictors following in vitro expansion.

OBJECTIVE: To (1) characterise the chemical and ultra-structural composition of ameroid constrictors, at a native state and during in vitro expansion and (2) determine the presence of irritant compounds at the surface or within the bulk of the constrictor. METHODS: Twelve sterile, commercially packaged ameroid constrictors (3 repeats of 3.5 mm, 5 mm, 6 mm and 7 mm internal diameter) were analysed by time-of-flight secondary ion mass spectrometry, Raman spectroscopy, attenuated total reflectance Fourier transform infrared spectroscopy and scanning electron microscopy. RESULTS: Ameroid constrictors have a composition commensurate with casein with little-to-no intra- or inter- constrictor variation. Microscopic analysis indicated that the topographical features of the constrictor surfaces were consistent between all constrictors. Following in vitro expansion there was a reproducible decrease in Ca+ ion content, little-to-no variation in secondary protein structure and morphological changes including the presence of surface aggregates present only at the inner surface of the ameroid constrictor. The potential irritant polydimethylsiloxane was found on the constrictor surface. A trace quantity of an ion fragment assigned as formaldehyde was detected; however, the extremely low level is thought highly unlikely to play a role as an inflammatory trigger clinically. DISCUSSION: There is a high degree of inter- and intra-constrictor homogeneity from different batches, and reproducible ultrastructural changes following in vitro expansion. Variations occur in both the surface chemistry and topography of the device during closure, which can potentially affect the biomaterial-host interface. Ameroid constrictor closure mechanism is likely involving calcium-mediated inter-protein interactions rather than the imbibition of water only.

A survey of current practices and influences on the choice of suture material, pattern and size used in commonly performed procedures in UK small animal veterinary practice.

OBJECTIVES: A survey of UK veterinarians was conducted to determine factors influencing suture choice and current suture practice for common surgical procedures. METHODS: An online survey was designed and the survey was sent to central practice emails obtained from the 2011 Royal College of Veterinary Surgeons (RCVS) practice database. RESULTS: Two hundred and thirty-nine surveys were completed (203 with no additional postgraduate qualifications (NAQ), 16 with RCVS certificates and 19 with diplomas). Forty-seven per cent of veterinary surgeons reported they would benefit from Continued Professional Development (CPD) pertaining to suture material selection and techniques. The NAQ group ranked practice policy, colleague influence, cost of suture material and undergraduate teaching significantly greater than diploma and certificate holders. The widest differences between suture material selection, pattern and size were identified when comparing diploma holders and the NAQ group. Diploma holders tended to choose smaller sized suture material when compared with the NAQ group. CLINICAL SIGNIFICANCE: In conclusion, postgraduate qualifications have a significant effect on the choice, pattern and size of suture material used for many routine surgical procedures. Findings suggest that further postgraduate training pertaining to the selection and use of suture material is worthwhile and improved guidance of choice of suture material for commonly performed surgical procedures may be beneficial.

Effect of monocortical and bicortical screw numbers on the properties of a locking plate-intramedullary rod configuration. An in vitro study on a canine femoral fracture gap model.

OBJECTIVES: To evaluate the effect of varying the number and configuration of locking bicortical and monocortical screws on a plate-rod construct using a mid-diaphyseal femoral ostectomy model. METHODS: Thirty Greyhound femurs were assigned to six groups (A-F). An intramedullary pin was placed in each bone following which a 3.5 mm locking plate was applied with six differing locking screw configurations. Groups A to C had one bicortical screw in the most proximal and distal plate holes and one to three monocortical locking screws in the proximal and distal fragments. Groups D to F had no bicortical screws placed and two to four monocortical locking screws in proximal and distal fragments. Each construct was axially loaded at 4 Hz from a preload of 10 Newtons (N) to 72 N, increasing to 144 N and 216 N, each of 6000 cycles with a further 45,000 cycles at 216 N to simulate a three to six week postoperative convalescence period. Constructs were then loaded to failure. RESULTS: No construct suffered screw loosening or a significant change in construct stiffness during cyclic loading. There was no significant difference in load to failure of any construct (p = 0.34), however, less variation was seen with monocortical constructs. All constructs failed at greater than 2.5 times physiological load, and failure was by bending of the intramedullary pin and plate rather than screw loosening or pull-out. CLINICAL SIGNIFICANCE: Axially loaded locking monocortical plate-rod constructs applied to the canine femur may confer no difference biomechanically to those employing locking bicortical screws.