Successful minimally invasive simple hepatic cyst ablation via ethanol sclerotherapy in a cat.

Case summary: A 12-year-old neutered male domestic shorthair cat was evaluated at the Michigan State University Veterinary Medical Center (MSU-VMC) for an abdominal cyst that was initially noted on ultrasound 1 year prior by the referring veterinarian. The cystic mass was causing clinical signs, including vomiting, diarrhea, hyporexia and abdominal pain. Cyst drainage had originally been performed every few months, but by referral, the required frequency of drainage had increased to every 2 weeks for a total of eight drainage events; therefore, a more definitive curative option was sought. CT evaluation revealed a large simple hepatic cyst - largest diameter 7.2 cm - likely associated with the right medial liver lobe. Minimally invasive ethanol sclerotherapy was performed. A locking-loop catheter was placed percutaneously and transhepatically into the cyst using ultrasound guidance. The cyst was drained, and contrast injected under fluoroscopic guidance to ensure no communication between the cyst and liver. Sclerotherapy was performed using a volume of 99.5% ethanol calculated from the volume of cyst fluid removed. The patient was discharged on the same day and had complete resolution of clinical signs. At a 6-month follow-up, the cyst had decreased in volume by an estimated 95%. The patient remains asymptomatic more than 1 year postoperatively. Relevance and novel information: To our knowledge, this is the first report of a feline hepatic cyst treated via percutaneous transhepatic ethanol ablation. Minimally invasive simple hepatic cyst ablation is a viable treatment option in cats that could avoid the need for a more invasive surgical intervention.

The effect of an aiming device on the accuracy of humeral transcondylar screw placement.

OBJECTIVES: (1) To evaluate the accuracy of an aiming device on placement of humeral transcondylar screws compared to fluoroscopic methods. (2) To compare experience level on outcome. STUDY DESIGN: Randomized, match pair, prospective ex-vivo study. SAMPLE POPULATION: A total of 68 dogs. METHODS: Canine cadaveric forelimbs were randomly assigned to either aiming device or fluoroscopic-guided groups, and to diplomate or resident. Digital radiography was used to evaluate screw trajectory deviation and eccentricity on the humeral condyle. Procedure time, outcome based on experience, and complications were recorded. RESULTS: The aiming device screw trajectory angle was decreased in the right limb (1.9 ± 1.1°) compared with the left (3.6 ± 1.1°, p = .0178), and compared to fluoroscopy (3.4 ± 1.1° p = .0128). There was no difference between leg laterality with fluoroscopy (p = .9979). Trajectory angle was increased with resident versus diplomate (3.4 ± 1.1° and 2.5 ± 1.1° respectively, p = .0366). Eccentricity deviation was decreased using fluoroscopy versus aiming device (3.1 ± 0.36 mm, 4.2 ± 0.36 mm, respectively, p = .0017). The risk of joint involvement was 8 times greater in aiming device groups, though not significant (p = .0575). Significant complications included increased drill attempts in fluoroscopic groups (p = .0237). CONCLUSION: The aiming device provided accurate placement of transcondylar screws, in terms of both position on the condyle and trajectory angle. Results were similar to fluoroscopic-guided method. CLINICAL SIGNIFICANCE: An aiming device is an acceptable means of placing humeral transcondylar screws. The use of the aiming device had an eight times increased risk of joint involvement compared to fluoroscopy.

Effects of short- and long-term administration of nonsteroidal anti-inflammatory drugs on osteotomy healing in dogs.

OBJECTIVE: To determine the influence of short-term administration of carprofen on bone healing in dogs. STUDY DESIGN: Randomized controlled experimental study. ANIMALS: Eighteen purpose-bred sexually mature hound dogs. METHODS: Tibial osteotomies were performed, and dogs were divided into three groups: no carprofen (n = 6), 2-week administration of carprofen at 2.2 mg/kg twice daily (n = 6), and 8-week administration of carprofen at 2.2 mg/kg twice daily (n = 5). Bone healing was evaluated radiographically at 4 and 8 weeks postoperatively. Postmortem, fracture healing was assessed via biomechanical testing (three-point bending), histological cartilage:callus ratio, and bone mineral density (BMD) with quantitative computed tomography. RESULTS: No biomechanical difference was detected between dogs that received no carprofen and those that received 2 weeks of carprofen or between those that received 2 weeks vs 8 weeks of carprofen. Stiffness (P = .035) and maximum stress (P = .042) were higher in dogs that received no carprofen than in those that received 8 weeks of carprofen. Radiographic healing did not differ between dogs without carprofen and those with 2-week administration of carprofen (P = .9923). However, tibias of dogs without carprofen and those with 2-week administration of carprofen were more healed compared with those in the 8-week-carprofen group at 4 and 8 weeks after surgery (P = .0011). No treatment effect was detected by cartilage:callus ratio or BMD. CONCLUSION: Long-term administration of carprofen had a negative effect on bone healing compared with short-term or no administration of carprofen. CLINICAL SIGNIFICANCE: Nonsteroidal anti-inflammatory drugs should be used cautiously in dogs at risk for delayed bone healing, and administration should be discontinued beyond the perioperative period in dogs with fractures or osteotomies.