Safe gastric wall closure in dogs using a single-layer full-thickness simple continuous suture pattern.

OBJECTIVE: To evaluate different suture patterns for gastrostomy closure, with a focus on major complications and survival time. We hypothesized that using a full-thickness single-layer simple continuous pattern would be as safe as the traditional double-layer pattern and would not be associated with more major complications. To our knowledge, this is the first study to compare the suture patterns used for gastric closure in clinical situations. ANIMALS: 60 dogs that underwent gastrostomy for foreign body removal, with 20 dogs in each group. METHODS: Dogs treated with gastrotomy from January 1, 2018, to January 1, 2023, were randomly assigned to groups based on the suture pattern used at the gastrotomy site. Gastrotomies were closed with a double-layer inverting continuous pattern (DLI) in the DLI group. Gastrotomies were closed using a double-layer simple continuous pattern (DLS) in the DLS group. Gastrotomies were closed with a full-thickness single-layer simple continuous pattern (SLS) in the SLS group. RESULTS: All dogs were discharged from hospitalization. The survival rate did not differ among the 3 groups 1 month postoperatively, and major complications were not observed. CLINICAL RELEVANCE: Using a full-thickness single-layer pattern is a safe alternative for gastrotomy closure.

Outcomes of dogs undergoing surgery for gastric dilatation volvulus after rapid versus prolonged medical stabilization.

OBJECTIVE: To compare the outcomes of dogs surgically treated for gastric dilatation volvulus (GDV) after rapid versus prolonged medical stabilization. STUDY DESIGN: Prospective cohort study, monoinstitutional. SAMPLE POPULATION: One hundred and sixty-two dogs with GDV. METHODS: Dogs presenting with a GDV were allocated to 1 of 2 groups, immediate or delayed. In the immediate group, dogs were stabilized for 90 min prior to undergoing surgery. In the delayed group, dogs underwent surgery after at least 5 h of stabilization. Medical stabilization included gastric decompression and placement of an indwelling nasogastric tube to prevent further gastric dilatation in all dogs. Short-term outcomes were compared between surgical timings by univariate and multivariate analyses. RESULTS: Dogs (n = 89) in the immediate group underwent surgery a median time of 2.1 h after presentation (range 1.9-2.5 h), whereas those in the delayed surgery group (n = 73) were operated a median time of 9.8 h (range 5.4-13.7 h) after presentation. Survival rates did not differ between dogs undergoing immediate or delayed surgery at discharge (70/89 and 60/73, respectively) or at 1 month postoperatively (68/89 and 55/73, respectively). The degree of gastric torsion was differently distributed between the 2 groups (P = .05). In the immediate group, 19, 52, and 9 dogs had a 0°, 180° and 270° gastric torsion respectively, whereas in the delayed group, 27, 32, and 5 dogs had a 0°, 180° and 270° gastric torsion respectively. Hyperlactatemia 24 h after initiation of fluid therapy was associated with an increased in-hospital mortality risk and at 1 month postoperatively. CONCLUSION: No survival benefit was detected as a result of proceeding to surgery after either a rapid or a prolonged medical stabilization. CLINICAL SIGNIFICANCE: The aggressive stabilization and monitoring protocol described here can be considered as an alternative to stabilize dogs with GDV prior to surgery within 13.7 h of presentation. Further research is required to investigate the potential risks and benefits of prolonged over rapid stabilization and to identify candidates for each approach.

An evidence-based medicine approach to small animal anaesthetic mortality in a referral practice: the influence of initiating three recommendations on subsequent anaesthetic deaths.

OBJECTIVE: To evaluate anaesthetic death after implementation of recommendations and its risk factors in a small animal practice. STUDY DESIGN: Observational cohort study. ANIMALS: All cats and dogs anaesthetized at the Centre Hospitalier Vétérinaire des Cordeliers during two periods, from April 15th, 2008 to April 15th, 2010 (period 1) and from June 15th, 2010 to August 24th, 2011 (period 2). METHODS: Death occurring during or before full recovery from anaesthesia was recorded. At the end of period 1, a logistic regression model was generated to describe anaesthetic death and identify risk factors. Potential risk factors in our practice setting were identified, and three recommendations, relating to improving physical status and anaesthetic/analgesic regimen implemented for period 2. The relationship between anaesthetic death and recorded variables were analyzed, and where relevant, compared between periods. RESULTS: Six thousand two hundred and thirty-one animals underwent general anaesthesia. The overall death rate during period 1 was 1.35% (48 in 3546, 95% CI [1.0-1.7%]) and during period 2 was 0.8% (21 in 2685, 95% CI [0.6-1.2%]). For sick animals (ASA status 3 and over), the overall death rate was 4.8% (45 of 944 95% [CI 3.5-6.4%]) during period 1 and 2.2% (18 of 834 95% CI [1.3-3.5%]) during period 2; this represented a significant decrease in death rate in period 2 (p = 0.002). In period 2, the main factors associated with an increased odds ratio of anaesthetic death were poor health status (ASA physical status classification) and old age. Species, gender, anaesthetic regimen, the nature and urgency of the procedure were not associated with risk. CONCLUSION AND CLINICAL RELEVANCE: Following evidence based recommendations, the death rate related to anaesthesia was significantly decreased during period 2 compared to period 1. Application of evidence-based medicine may contribute to an effective approach to decrease death rates. Other factors, not monitored in this study, may also have had an impact.

Myelomeningocoele and a dermoid sinus-like lesion in a French bulldog.

A 2-year-old male French bulldog was presented for investigation of lumbosacral pain and hindlimb ataxia associated with urinary and fecal incontinence. Survey radiography, myelography, and computed tomography images were suggestive of a dermoid sinus with associated spina bifida. Surgical intervention led to a resolution of pain and neurological deficits. Histopathological analysis of the excised tissue was compatible with a myelomeningocoele of the 7th lumbar vertebra.

Méningo-myélocèle et lésion dermoïde s'apparentant à un sinus chez un Bouledogue français. Un Bouledogue français mâle âgé de deux ans a été présenté pour faire enquête sur une douleur lombo-sacrée et une ataxie des jambes postérieures associée à une incontinence urinaire et fécale. La radiographie, la myélographie et les images par tomodensitométrie pour faire enquête sur les symptômes suggéraient un sinus dermoïde avec spina-bifida connexe. L'intervention chirurgicale a donné lieu à une résolution de la douleur et des autres déficits neurologiques. L'analyse histopathologique du tissu excisé était compatible avec un méningo-myélocèle de la 7e vertèbre lombaire.(Traduit par Isabelle Vallières).

Thoracoscopic resection of right auricular masses in dogs: 9 cases (2003-2011).

OBJECTIVE: To determine the feasibility of thoracoscopic resection of masses located on the right auricle in dogs. DESIGN: Retrospective case series. ANIMALS: Dogs (n = 9) with a mass on the right auricle. PROCEDURES: Hospital records from 2003 to 2011 were reviewed. Only dogs that underwent thoracoscopic resection of a mass on the right auricle were selected. Data collected included history, clinicopathologic findings, surgical technique, and outcome. RESULTS: All dogs with pericardial effusion were examined by means of echocardiography. Cardiac masses on the right auricle were identified in 5 dogs. Eight dogs had clinical signs of cardiac tamponade and right-sided heart failure. All dogs underwent thoracoscopic resection of a mass on the right atrium. Eight hemangiosarcomas and 1 pyogranulomatous lesion were resected. One dog with a mass located at the base of the right auricle died during surgery. No postoperative complications were noted. CONCLUSIONS AND CLINICAL RELEVANCE: Right auricular masses were successfully removed in 8 dogs. Masses close to the base of the right atrial appendage may not be amenable to resection with thoracoscopy. Resection of small masses at the tip of the right auricular appendage can be performed thoracoscopically.

Risk of anaesthetic mortality in dogs and cats: an observational cohort study of 3546 cases.

OBJECTIVE: To evaluate the anaesthetic death risk for dogs and cats in a French private practice. STUDY DESIGN: Observational cohort study. ANIMAL POPULATION: All small animals anesthetized at the Centre Hospitalier Vétérinaire des Cordeliers between April 15th, 2008 and April 15th, 2010. METHODS: General anaesthesia was defined as a drug-induced unconsciousness characterised by a controlled and reversible depression of the central nervous system and analgesia, sufficient to allow endotracheal intubation. Patient outcome (alive or dead) was assessed at the end of anaesthesia defined as the meeting point of the return of consciousness, rectal temperature >36 °C and ability to maintain sternal recumbency. Death occurring during anaesthesia was recorded. Relationship between anaesthetic death and ASA status, species, age, nature of the procedure, anaesthetic protocol and occurrence of epidural administration of a combination of morphine and bupivacaine were analysed. RESULTS: During the study period 3546 animals underwent general anaesthesia. The overall death rate in the present study was 1.35% (48 in 3546, 95% CI 0.96-1.75). The death rate of healthy animals (ASA 1 and 2) was 0.12% (3 in 2602 95% CI 0.02-0.34). For sick animals (ASA status 3 and over), the overall death rate was 4.77% (45 in 944 95% CI 3.36-6.18). The death rates in the ASA 3, 4 and 5 categories were 2.90%, 7.58% and 17.33%, respectively. The main factor associated with increased odds of anaesthetic death in ASA categories 3 and over was poor health status (ASA physical status classification). The nature of the procedure the patient underwent and epidural administration of a combination of morphine and bupivacaine were not correlated with the occurrence of death during anaesthesia. Neither species nor age effects were detected. CONCLUSION AND CLINICAL RELEVANCE: Specific factors were associated with increased odds of anaesthetic death, especially poor health status. Efforts must be directed towards thorough preoperative patient evaluation and improvement of clinical conditions if possible. Identification of risk factors before anaesthesia should lead to increased surveillance by trained staff. This could result in better outcomes.