Nasopharyngeal Vascular Hamartoma in a Dog.

An 8-year-old spayed female 32 kg Labrador retriever was presented for further investigation into the underlying cause of dyspnea, stertor, and sleep apnea present for three months and worsening over 30 days. There were significant reduction in airflow through the nares and loud inspiratory stridor. Thoracic and cervical radiographs made were normal. A skull CT and retrograde rhinoscopy showed a mass occluding the majority of the nasopharynx above the caudal third of the hard palate. The main differential diagnoses included a neoplastic mass vs. inflammatory mass vs. cyst vs. mucous obstruction. There was no destruction of nasal turbinates, making a benign etiology more likely. Biopsy of the mass showed an inflammatory process. En bloc excision of the mass was performed via ventral rhinotomy without complication. Histopathology of the excised mass revealed it to be a mucosal vascular hamartoma. The dog recovered uneventfully and had no further respiratory issues, short or long term. Although vascular hamartomas are a rare finding in veterinary medicine, they can be found in a wide variety of species and anatomic locations. They should be considered when naming differentials for benign mass lesions throughout the body, including the nasopharynx. Although they are benign masses in nature, they can be clinically significant and should be addressed. Prognosis after removal in this location is excellent.

A Comparison of Ex Vivo Leak Pressures for Four Enterotomy Closures in a Canine Model.

Initial and maximum intraluminal leak pressures of four enterotomy closures were compared. Closure patterns included a modified Gambee, simple interrupted, simple continuous, and skin staple closure. Forty-eight 3-cm enterotomy constructs were created from jejunal segments harvested from 12 dogs. Twelve each were randomly assigned to the four closure methods. Time of closure, as well as initial and maximum leak pressures, were measured and compared. The modified Gambee closure was the slowest closure to perform, with skin staple closure being the fastest. All suture patterns tested had higher mean initial leak pressures than reported physiologic intestinal pressures during peristalsis, although the skin staple closures resulted in leakage below normal physiologic pressure in several samples. The modified Gambee closure was able to sustain a significantly higher initial leak pressure than skin staple closures. The modified Gambee suture pattern had the greatest maximum leak pressure of all enterotomy closure patterns tested. Use of the modified Gambee suture pattern should be considered in enterotomy closure, although in vivo studies are required to determine if these differences are clinically significant.

Comparison of leak pressures for single-layer simple continuous suture pattern for cystotomy closure using barbed and monofilament suture material in an ex vivo canine model.

OBJECTIVE: To compare leak pressures following simple continuous closure of cystotomy with barbed suture to an analogous monofilament suture, in an ex vivo canine model. STUDY DESIGN: Ex vivo, simple randomized study. ANIMALS OR SAMPLE POPULATION: Urinary bladders harvested from canine cadavers (n = 21). METHODS: Urinary bladders were harvested from cadavers immediately following euthanasia. A 3-cm cystotomy was made on ventral midline of the urinary bladder. Urinary bladders were randomly assigned a suture for closure. A digital pressure transducer was inserted through 1 ureter, and the other ligated, while colored isotonic saline was infused into the urinary bladder via a Foley catheter inserted in the urethra. The initial leak pressure was defined as the pressure at which the colored saline solution first leaked from the cystotomy, and the maximum leak pressure was recorded when the pressure reached a plateau or catastrophic failure occurred. A Welch's 2-sample t test was used to compare leak pressure between the barbed and non-barbed closures, with significance set at P < .05. RESULTS: There was no significant difference in the initial or maximum leak pressure between the barbed and non-barbed closures. CONCLUSIONS: This study showed no difference in initial or maximum leak pressure between cystotomy closures with barbed or non-barbed suture under ex vivo conditions. This indicates barbed suture may be appropriate for cystotomy closure but in vivo studies are needed to support this finding.

Ex vivo biomechanical comparison of V-LOC 180® absorbable wound closure device and standard polyglyconate suture for diaphragmatic herniorrhaphy in a canine model.

OBJECTIVE: To compare 2-0 polyglyconate barbed suture (V-LOC™ 180 Absorbable Wound Closure Device, Covidien, Mansfield, MA) to standard 2-0 monofilament absorbable polyglyconate suture (Maxon™, Covidien) for maximum load to failure and failure mode when used to appose standardized defects in canine diaphragm muscle. STUDY DESIGN: Randomized, cadaveric ex vivo mechanical testing. SAMPLE POPULATION: Canine cadaveric hemi-diaphragmatic specimens (n = 32 pairs). METHODS: Thirty-two cadaveric diaphragm specimens were collected and divided to obtain 64 muscle specimens (9 cm × 4 cm). Paired specimens were bisected in the midpoint of their 9 cm length in the direction of the muscle fibers and apposed using either 2-0 polyglyconate or 2-0 barbed polyglyconate (V-LOC™ 180 Absorbable Wound Closure Device) in a simple continuous pattern. Increasing tension was applied perpendicular to the suture line until specimen failure. Failure mode and maximum load to failure were recorded for each specimen. RESULTS: Mean ± SD failure load of simulated herniorrhaphies performed with barbed polyglyconate suture (54.5 ± 10.27 N) was not significantly different than repair with polyglyconate (56.9 ± 10.87 N). Failure mode for both construct types was suture tear out rather than suture failure. CONCLUSIONS: Clinical application of 2-0 barbed polyglyconate suture can be considered as an alternative to the use of 2-0 polyglyconate for diaphragmatic herniorrhaphy.

Injection of the diaphragmatic crus with methylene blue for coloration of the canine thoracic duct.

OBJECTIVE: To describe and compare onset and intensity of thoracic duct (TD) coloration after injection of methylene blue into the diaphragmatic crus and mesenteric lymph node. STUDY DESIGN: Experimental study. ANIMALS: Adult dogs (n = 18). METHODS: Methylene blue (≤0.5 mg/kg 1% solution) was injected into the left (n = 9) or right (n = 9) diaphragmatic crus via right 10th intercostal thoracotomy. TD coloration was graded over 10 minutes. A right paracostal laparotomy was then performed in all dogs, and an equal volume of methylene blue injected into a mesenteric lymph node (n = 18). TD color grading was repeated. Statistical analysis was performed on subject weight, volume of contrast agent injected between left and right crus, and number of successful outcomes between diaphragmatic crus injection and mesenteric lymph node injection. RESULTS: TD coloration occurred in 6 dogs with left crus injection and 4 dogs with right crus injection with obvious staining present in 2 and 3 dogs, respectively. Successful outcome was noted in all dogs with mesenteric lymph node injection. The number of successful outcomes was significantly greater after mesenteric lymph node injection compared with diaphragmatic crus injection (P < .001). CONCLUSIONS: Methylene blue injected into the diaphragmatic crura and mesenteric lymph node was successful in coloring the TD; however, mean thoracic duct color grade and number of successful outcomes were significantly higher after mesenteric injection.