Anatomical considerations for the surgical approach to the canine accessory lung lobe.

OBJECTIVE: To describe (1) the surgical anatomy of the accessory lung lobe (ALL) including vasculature and pulmonary ligamentous attachments and (2) lobectomy through a right thoracotomy and median sternotomy. STUDY DESIGN: Cadaveric anatomical study. ANIMALS: Nine adult canine cadavers, free of disease affecting the thoracic cavity and lung parenchyma. METHODS: Median sternotomy and right and left lateral thoracotomies were performed to describe and image relevant variations in anatomy using accompanying photographs and thorough voice notes. Consideration for ALL removal via right thoracotomy at the fifth through seventh intercostal spaces and median sternotomy were documented and compared. RESULTS: The median weight of the cadavers was 20.85 kg (6.9-45.5 kg). Variation in the configuration of venous drainage of the ALL was identified. The lateral vein varied in its location and was also observed to combine with the medial vein in one cadaver. The pulmonary ligament attached to the ALL in a caudally pointing apex on the dorsal process of the lobe. Medial and lateral extensions of the ALL parenchyma were found. The ALL was most easily accessed by a right lateral thoracotomy at the sixth intercostal space. Although not optimal, removal of this lung lobe via median sternotomy was feasible. CONCLUSION: Significant variations were found in the blood supply to the ALL. A right lateral thoracotomy at the sixth intercostal space was preferred for a surgical approach to the ALL. CLINICAL SIGNIFICANCE: Surgeons should be aware of several anatomical particularities including the venous drainage, ligamentous attachments, and parenchymal extensions of the ALL.

The effect of flushing of the common bile duct on hepatobiliary markers and short-term outcomes in dogs undergoing cholecystectomy for the management of gall bladder mucocele: A randomized controlled prospective study.

OBJECTIVE: To determine the effect of flushing of the common bile duct (CBD) on hepatobiliary markers and short-term outcome in dogs undergoing cholecystectomy for the management of gallbladder mucocele (GBM). STUDY DESIGN: Randomized, controlled, prospective study. ANIMALS: Thirty-two client-owned dogs. METHODS: Dogs were allocated randomly to either a "flush" group or a "non-flush group." Flushing was performed in a normograde fashion, followed by a routine cholecystectomy. Data collected included presenting clinical signs, preoperative and 3-day postoperative hepatobiliary markers (alkaline phosphatase, ALP; alanine aminotransferase, ALT; gamma glumatyl-transferase, GGT; bilirubin; cholesterol; triglycerides), duration of hospitalization, and complications. These data were compared between groups. RESULTS: Sixteen dogs were enrolled in each group. One dog (in the flush group) was excluded following diagnosis of hepatic lymphoma. Border terriers were overrepresented (20/31). Overall, there were marked reductions from preoperative to 3 days postoperative in serum bilirubin (p = .004), ALP (p = .020), ALT (p < .001), GGT (p = .025), and cholesterol (p < .001) values. There was no difference in any marker between groups. Survival to discharge was 90.3% (28/31 dogs). CONCLUSION: Cholestatic markers decreased significantly 3 days postcholecystectomy. No short-term clinical or clinico-pathological benefits were identified when flushing the CBD in dogs undergoing cholecystectomy for GBM. CLINICAL SIGNIFICANCE: The findings of the study do not support routine flushing of the CBD during cholecystectomy for GBM in dogs.

Clinical use and complications of percutaneous cystostomy pigtail catheters in 25 cats.

OBJECTIVES: The aims of this study were to describe the indications for percutaneous pigtail catheter placement in cats requiring urine diversion, and to report the associated intra- and postoperative complications. METHODS: The medical records of cats that underwent percutaneous pigtail catheter placement for urine diversion between January 2011 and May 2021 were retrospectively reviewed. RESULTS: Twenty-five cats were included. Indications for pigtail catheter placement were medical management of obstructive urinary tract disease (n = 12), urinary tract damage after traumatic injury (n = 8) and neurological bladder dysfunction (n = 5). Catheters were in place for a median time of 8.28 days (range 3-27), and the duration of the catheter placement was not different between the medical, traumatic and neurological groups. Ten cats (40%) developed pigtail catheter complications including dislodgement, urine leakage, urinary tract infection and bladder rupture. The majority of complications were easily resolved and did not require surgical intervention. CONCLUSIONS AND RELEVANCE: The results suggest that percutaneous pigtail catheter placement can facilitate urine diversion in both the emergency setting and in the long-term management of urine retention without many complications.

Long-term outcome of female dogs treated for intramural ectopic ureters with cystoscopic-guided laser ablation.

OBJECTIVE: To report the complications and long-term outcome of female dogs with intramural ectopic ureter(s) (iEU) undergoing cystoscopic-guided laser ablation (CLA) and determine the effect of post-CLA neutering on urinary continence. STUDY DESIGN: Retrospective clinical study. ANIMALS OR SAMPLE POPULATION: Thirty-four client-owned dogs. METHODS: Medical records of female dogs that had iEU-CLA were reviewed. A 10-point continence score was assigned before, immediately after, and at a minimum of 12 months postprocedure via owner telephone contact. Neutering status prior to and postprocedure was recorded. RESULTS: Continence scores increased in all dogs after CLA (p < .0001, mean duration of follow-up: 63.9 ± 5.7 months) with an increase of the median score from 2 (preprocedure) to 10 (postprocedure). A urethral tear occurred in 2/34 dogs immediately after the procedure, successfully managed conservatively. Mild hematuria was present in 2/34, lasting less than 48 h. Postoperative urinary tract infections were documented in 6/34 dogs. Two dogs died of urinary-related issues at 1 and 5 months after CLA. Complete and near-complete urinary continence (scores 9 and 10/10) was achieved in 26/32 dogs including 3 dogs requiring medical (2) or surgical interventions (1). Post-CLA neutering did not affect continence scores (p = .44). CONCLUSION: A large proportion of dogs regained and maintained full continence after CLA alone. Subsequent medical or surgical therapy allowed further improvements when needed. Post-CLA neutering did not negatively impact urinary continence score. CLINICAL SIGNIFICANCE: The beneficial effect of iEU-CLA in female dogs is long standing and not affected by postprocedural neutering.

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.

Tensile Comparison of Polydioxanone, Polyglyconate, and Barbed Glycolide-Trimethylene Carbonate Suture in Canine Cadaveric Tensor Fascia Lata.

OBJECTIVE: To compare the mode of failure, load at yield, ultimate load to failure and stiffness of non-barbed polydioxanone, non-barbed polyglyconate and barbed glycolide-trimethylene carbonate (GTC) suture in canine cadaveric fascia. STUDY DESIGN: Ex vivo biomechanical study. SAMPLE POPULATION: 18 fascia lata specimens from 9 canine cadavers. METHODS: 6 fascia lata specimens were sutured with polydioxanone, 6 with polyglyconate, and 6 with barbed GTC suture. Load at yield, stiffness, ultimate load to failure were measured using tensile strength testing. Statistical analysis was used to compare outcomes between suture materials. The mode of failure was recorded and described. RESULTS: The load at yield and ultimate load to failure were significantly greater for polydioxanone than barbed GTC (P=.045 and P=.016, respectively). The load at yield and ultimate load to failure was not significantly different between polydioxanone and polyglyconate (P=.687 and P=.586, respectively). The load at yield and the ultimate load to failure was not significantly different between polyglyconate and barbed GTC (P=.194 and P=.109, respectively). Stiffness was not different between constructs (P=.103). Polydioxanone and polyglyconate failed by suture breakage and suture pullout. Barbed GTC failed by suture slippage and suture breakage. CONCLUSION: Our results showed that under the conditions of this study, 4-0 monofilament polydioxanone had a greater load at yield and load to failure than similarly sized, barbed copolymer suture in the fascia lata. This finding may help direct suture choice for fascial closure.

Canine Ovariohysterectomy: A Survey of Surgeon Concerns and Surgical Complications Encountered by Newly Graduated Veterinarians.

The objective of this study was to document newly qualified veterinarians' concerns and surgical complications encountered during canine ovariohysterectomy (cOVH) during the first year of general practice. A questionnaire investigating concerns about cOVH procedures was sent to all final-year veterinary students (group 1) enrolled at five UK universities. Participants were later asked to complete a similar questionnaire 6 months (group 2) and 12 months (group 3) after graduation, which involved grading their concern about different aspects of the cOVH procedure and reporting surgical complications encountered after completing three cOVHs. Responses were compared between different time points. There were 196 respondents in group 1, 55 in group 2, and 36 in group 3. Between groups 1 and 2, there was a statistically significant reduction in the respondents' levels of concern in every aspect of cOVH (p<.05). Between groups 2 and 3, there was no statistically significant change in respondents' levels of concern in any aspect of cOVH (p≥.21). There was a significant reduction in the number of complications encountered by veterinarians in group 3 (39/102, 38.2%) compared to those in group 2 (117/206, 56.8%) (p=.002). Employers should anticipate high levels of concern regarding all aspects of cOVHs in new graduates, and supervision during the first 6 months may be particularly useful.

Outcome of full-thickness skin grafts used to close skin defects involving the distal aspects of the limbs in cats and dogs: 52 cases (2005-2012).

OBJECTIVE: To describe the outcome of full-thickness skin grafts used to close skin defects involving the distal aspects of the limbs in cats and dogs and identify factors associated with outcome. DESIGN: Retrospective case series. ANIMALS: 20 cats and 32 dogs with a skin defect involving the distal aspect of a limb that received 58 full-thickness skin grafts between 2005 and 2012. PROCEDURES: Data regarding patient signalment, location and cause of the skin defect, surgical and anesthetic duration, and postoperative bandaging protocol were obtained from the medical records. Graft outcome was assessed by interpreting descriptions in the records; skin viability over ≥ 75% of the graft area between 7 and 14 days after surgery was considered a successful outcome. RESULTS: For 4 of the 58 grafts, graft outcome could not be determined from the medical record. For the remaining grafts, success rate was significantly higher for grafts placed in cats (17/22 [77%]) than in dogs (12/32 [38%]). The overall complication rate was 50%; complications included skin graft failure, donor site dehiscence, and bandage-induced sloughing of skin adjacent to the graft recipient site. In addition to species, anatomic location of the skin defect was identified as a prognostic indicator of graft outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Full-thickness skin grafting had a higher success rate in cats than in dogs. Skin grafts applied to the antebrachium, compared with other locations on the distal aspects of the limbs, were associated with a poorer prognosis.

Biomechanical comparison of canine fascia lata and thoracolumbar fascia: an in vitro evaluation of replacement tissues for body wall reconstruction.

OBJECTIVES: To compare the suitability of thoracolumbar fascia (TLF) and fascia lata (FL) for body wall defect repair in dogs, by examining their biomechanical properties and useable surface area. STUDY DESIGN: Experimental. ANIMALS: Dogs (n = 8). METHODS: Fresh TLF and FL grafts were obtained, surface area was calculated before testing to failure in 2 different modes: tensile testing and resistance to suture pullout, in 2 perpendicular orientations. RESULTS: Useable TLF surface area was significantly greater than for FL. Maximum load, energy to break, and elastic modulus of FL was significantly greater than that of TLF in tensile testing, but no apparent difference in the ultimate stress or strain was identified. There was no overall difference in suture pullout load between TLF and FL. During tensile testing, tissue orientation had a significant influence on ultimate load, stress, and elastic modulus for both tissue types, with strain and energy to break only having significant effects for TLF and FL, respectively. CONCLUSIONS: The greater tensile strength and stiffness of FL compared to TLF was not reflected in its material properties, implying any difference was a consequence of greater thickness. Suture pullout was not significantly different between the 2 tissues, perhaps limiting the clinical significance of the tissue mechanics. Tissues were anisotropic with respect to mechanical properties, thus orientation may be an important factor.