Rapport de cas Surgical retrieval of a migrated vascular access port catheter in a dog.

A 4-year-old spayed female Boston terrier was diagnosed with a suspected meningioma involving the optic chiasm and resulting in vision loss. A vascular access port (VAP) was placed in the left medial saphenous vein to facilitate frequent anesthetic episodes for radiation therapy. Five days after placement, the VAP was nonfunctional with the silicone catheter still intact. During VAP removal surgery, it was discovered that the silicone catheter had migrated. Intraoperative focal ultrasound could not identify the migrated catheter within the pelvic limb. Thoracic computed tomography identified the migrated catheter retroflexed onto itself in the cranial vena cava and extending into the right pulmonary artery as it passed through the right side of the heart. The dog underwent a hybrid surgical approach consisting of an endovascular retrieval forceps technique with median sternotomy for intravenous non-radiopaque foreign body removal. Postoperative complications, including regurgitation and left atrial thrombus, were managed. The left atrial thrombus persisted for 10 mo after the hybrid surgery. Key clinical message: A hybrid approach consisting of an endovascular retrieval forceps technique with median sternotomy was effective in removing an intravenous non-radiopaque foreign body in a dog.

Récupération chirurgicale d'un cathéter de port d'accès vasculaire migré chez un chien. Une femelle terrier de Boston stérilisée âgée de 4 ans a reçu un diagnostic de méningiome présumé impliquant le chiasma optique et entraînant une perte de vision. Un port d'accès vasculaire (VAP) a été placé dans la veine saphène médiale gauche pour faciliter les épisodes fréquents d'anesthésie pour la radiothérapie. Cinq jours après la mise en place, le VAP était non fonctionnel avec le cathéter en silicone toujours intact. Au cours de la chirurgie de retrait du VAP, il a été découvert que le cathéter en silicone avait migré. L'échographie focale peropératoire n'a pas pu identifier le cathéter migré dans le membre pelvien. La tomodensitométrie thoracique a identifié le cathéter migré rétroflexé sur lui-même dans la veine cave crânienne et s'étendant dans l'artère pulmonaire droite lorsqu'il traversait le côté droit du coeur. Le chien a subi une approche chirurgicale hybride consistant en une technique de forceps de récupération endovasculaire avec sternotomie médiane pour l'extraction intraveineuse de corps étrangers nonradio-opaques. Les complications postopératoires, y compris la régurgitation et le thrombus auriculaire gauche, ont été prises en charge. Le thrombus auriculaire gauche a persisté pendant 10 mois après la chirurgie hybride.Message clinique clé :Une approche hybride consistant en une technique de forceps de récupération endovasculaire avec sternotomie médiane a été efficace pour retirer un corps étranger intraveineux non-radio-opaque chez un chien.(Traduit par Dr Serge Messier).

Influence of clipping on bacterial contamination of canine arthrocentesis sites before and after skin preparation.

OBJECTIVE: To determine the influence of hair removal as part of the aseptic skin preparation of canine arthrocentesis sites and to characterize the bacterial flora remaining after aseptic skin preparation. STUDY DESIGN: Randomized controlled trial. STUDY POPULATION: Thirteen shorthaired beagle-cross dogs. METHODS: A coin toss was used to randomly determine to have one carpus, elbow, tarsus, and stifle clipped. The contralateral side was left unclipped. Aseptic skin preparation was performed on all sites with 4% chlorhexidine followed by 70% isopropyl alcohol. The skin of each site was sampled for aerobic and anaerobic bacterial cultures before and after aseptic skin preparation. Bacterial cultures were submitted for laboratory testing to determine the colony-forming units (CFU) of bacteria and bacterial species isolated for each site. RESULTS: Each group (clipped and unclipped) included 52 sites. Aseptic skin preparation reduced bacterial CFU in both groups. There was no association between values for CFU per milliliter after skin preparation of dogs and side (P = .07), joint (P = .71), pre-aseptic skin preparation CFU (P = .94), or clipping (P = .42). Staphylococcus spp were the most common of the bacterial species cultured. CONCLUSION: In clean shorthaired dogs without visible evidence of dermatological disease, leaving arthrocentesis sites unclipped rather than performing traditional surgical clipping did not result in increased bacterial skin counts after aseptic skin preparation. CLINICAL SIGNIFICANCE: In this study we did not find evidence to support that clipping of canine arthrocentesis sites is required for effective aseptic skin preparation. A prospective clinical trial is required to determine whether a change in practice would be associated with increased morbidity.

The left lateral projection is comparable to horizontal beam radiography for identifying experimental small volume pneumoperitoneum in the canine abdomen.

Nontraumatic spontaneous pneumoperitoneum suggests the presence of gastrointestinal perforation; early detection can be lifesaving. Horizontal beam projections have been reported to be more sensitive than standard radiographic views for detecting small volumes of free peritoneal gas. This prospective, experimental, analytical study compared both left lateral (LL) and ventrodorsal (VD) standard views to horizontal beam projections for detecting small volumes of artificially induced pneumoperitoneum in live dogs. The effect of radiology training on accurate detection of small amounts of free peritoneal air was also assessed. Fourteen dogs had four radiographic projections taken after injection of 0, 2.5, 5, and 10 mL of cumulative air into their abdominal cavities. Radiographs were interpreted individually by three American College of Veterinary Radiology-certified radiologists and three small animal internship-trained veterinarians who were blinded to the air volume injected. At 2.5 and 10 mL of air injected, the LL projection had highest odds of an accurate response (odds ratio [OR] = 2.4 and 99.0 when compared to VD horizontal and VD projections, respectively). At 5 mL of air injected, the lateral horizontal (LH) projection had the highest odds of an accurate response (OR = 3.2 compared to VD horizontal). The LL projection was not significantly different from the LH projection at all volumes of air injected. Board certification led to higher odds of accurate responses at volumes of 5 (OR = 2.2) and 10 mL (OR = 3.6), as compared to nonspecialist veterinarians. Overall, LH and standard LL appeared to be the most useful radiographic projections for detection of small amounts of free peritoneal gas.

Juvenile Pubic Symphysiodesis.

In properly selected dogs, juvenile pubic symphysiodesis improves joint congruity, decreases hip laxity, and can reverse or prevent progression of degenerative joint disease in the hips. To be effective, surgery must be done at a young age and in hips that are only mildly to moderately lax. Juvenile pubic symphysiodesis is best viewed more as a preemptive procedure than as a strictly therapeutic one. Dogs considered to be at risk for hip dysplasia should be screened with Ortolani testing at 12 weeks of age, with further imaging and perhaps surgery to follow for those who have a positive Ortolani sign.

Imperforated cor triatriatum dexter in a dog with concurrent caudal vena cava wall mineralization.

BACKGROUND: Cor triatriatum dexter (CTD) is a rare congenital cardiac malformation with various manifestations and has been sporadically described in dogs. Clinically the dogs present with nonspecific signs of right heart failure or Budd-Chiari-like syndrome. Other associated concurrent cardiovascular anomalies are commonly reported. Diagnosis and full characterization of this complex malformation requires careful investigation and often a multimodal imaging approach. CASE PRESENTATION: A 10-week-old, male intact, Golden Retriever was presented with clinical signs of stunted growth, anorexia, and progressive ascites. CTD imperforate with sole separation of the caudal vena cava (CdVC) and concurrent venous wall mineralization was conjointly diagnosed and fully characterized by echocardiography, non-selective angiography, computed tomography angiography and cardiac magnetic resonance imaging (MRI). This was successfully treated surgically and the dog returned to normal activity. CONCLUSION: To the author's knowledge, this is the first case of CTD imperforate separating the CdVC from the right atrium (RA) with presumed secondary CdCV wall and hepatic parenchyma mineralization reported in a dog. CTD is an important and potentially correctable cause for the development of ascites in a young puppy. Accurate diagnosis of this complex cardiac anomaly is important for selection of the most appropriate curative treatment option.

Ex vivo evaluation of the effect of various surgical procedures on blood delivery to the patellar tendon of dogs.

OBJECTIVE To determine the effect of arthrotomy alone or in combination with osteotomy of the proximal portion of the tibia on blood delivery to the patellar tendon of dogs. SAMPLE 24 canine cadavers. PROCEDURES One hind limb from each cadaver was assigned to 1 of 4 treatment groups: medial arthrotomy (MA; MA group), lateral arthrotomy (LA; LA group), MA and LA with tibial tuberosity transposition (MALA group), and MA with tibial plateau leveling osteotomy (TPLO; TPLO group). The contralateral hind limb served as the control sample. Contrast solution (barium [33%], India ink [17%], and saline [0.9% NaCl] solution [50%]) was injected through an 8F catheter inserted in the caudal portion of the abdominal aorta. Limbs were radiographed to allow examination of vascular filling. The patella, patellar tendon, and tibial crest were harvested, radiographed to allow examination of tissue vascular filling, and fixed in 4% paraformaldehyde. Vessels perfused with contrast solution were counted in sections obtained from the proximal, middle, and distal regions of each patellar tendon. RESULTS Vessel counts did not differ significantly among the 3 tendon regions. Compared with results for the control group, delivery of contrast solution to the patellar tendon was significantly decreased in the MALA and TPLO groups but was not changed in the MA or LA groups. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that surgical procedures used to treat cranial cruciate injuries (ie, TPLO) and patellar luxation decreased blood delivery to the patellar tendon of canine cadavers, at least acutely.

Regression of a vaginal leiomyoma after ovariohysterectomy in a dog: a case report.

An 11 yr old female mixed-breed Siberian husky was presented with a history of sanguineous vaginal discharge, swelling of the perineal area, decreased appetite, and lethargy. A single, large vaginal leiomyoma and multiple mammary tumors were diagnosed. Mastectomy and ovariohysterectomy were performed. The vaginal leiomyoma regressed completely after ovariohysterectomy. This is the first reported case of spontaneous regression of a vaginal leiomyoma after ovariohysterectomy in a dog.

Increase in gene-transcript levels as indicators of up-regulation of the unfolded protein response in spontaneous canine tumors.

The unfolded protein response (UPR), a conserved cellular response to stressors such as hypoxia and nutrient deprivation, is associated with angiogenesis and metastasis in tumor cells. This article discusses a pilot study conducted to determine whether components of the UPR could be identified in spontaneous canine tumors and whether they were up-regulated within tumor tissue compared with adjacent normal tissue. Tissue samples of various spontaneous canine neoplasms were taken from 13 dogs shortly after surgical excision or euthanasia; control samples were taken from adjacent normal tissue. RNA purification and real-time quantitative reverse-transcription polymerase chain reaction were done to measure the expression of 4 genes associated with the UPR (HERP, CHOP, GRP78, and XBP1s). The results indicated that UPR gene expression can be identified in spontaneous canine tumors and that the UPR is up-regulated, as indicated by significantly increased expression of CHOP and GRP78 within the tumor.

La réponse de la protéine non-repliée (UPR), une réponse cellulaire conservée à des stress tels que l'hypoxie et la privation de nutriments, est associée avec l'angiogénèse et les métastases chez les cellules tumorales. Cet article rapporte une étude pilote menée afin de déterminer si les composantes de l'UPR pourraient être identifiées dans des tumeurs canines spontanées et si elles sont surproduites à l'intérieur du tissu tumoral comparativement au tissu normal adjacent. Des échantillons de tissu provenant de divers néoplasmes spontanés canins ont été prélevés de 13 chiens peu de temps après exérèse chirurgicale ou euthanasie; des échantillons témoins ont été pris de tissu normal adjacent. La purification de l'ARN et une réaction d'amplification en chaine en temps réel quantitative utilisant la transcriptase réverse furent réalisées afin de mesurer l'expression de quatre gènes associés avec l'UPR (HERP, CHOP, GRP78, et XBP1s). Les résultats ont montré que l'expression du gène UPR peut être identifiée dans des tumeurs spontanées canines et que l'UPR est surproduit, tel que l'indique l'augmentation significative de l'expression de CHOP et GRP78 à l'intérieur de la tumeur.(Traduit par Docteur Serge Messier).

Prevalence of circumcaval ureters and double caudal vena cava in cats.

OBJECTIVE: To determine the prevalence of circumcaval ureters and other caudal vena cava variations in cats and determine whether circumcaval ureters were associated with macroscopic evidence of ureteral obstruction. SAMPLE: 301 domestic cat cadavers obtained from an animal shelter. PROCEDURES: All cat cadavers were examined, and anatomic variations of the ureters and caudal vena cava were recorded. In cadavers with a circumcaval ureter, kidney length, width, and height were measured, and the ureters were examined macroscopically to determine whether there was gross evidence of ureteral obstruction in cats with circumcaval ureters. RESULTS: At least 1 circumcaval ureter was present in 106 of the 301 (35.2%) cats, with a right circumcaval ureter identified in 92 (30.6%) cats, a left circumcaval ureter identified in 4 (1.3%), and bilateral circumcaval ureters identified in 10 (3.3%). Twenty-one (7.0%) cats had a double caudal vena cava, including 2 cats in which the double caudal vena cava was the only anatomic abnormality identified. No sex predilection for anatomic abnormalities was found. Mean right kidney length was significantly greater than mean left kidney length in cats with a right circumcaval ureter. CONCLUSIONS AND CLINICAL RELEVANCE: Circumcaval ureter was present in approximately a third of cats in this study. Variation in the development of the caudal vena cava is the proposed cause. The clinical relevance of this variation is unknown.

Large segmental mandibulectomy for treatment of an undifferentiated sarcoma in a horse.

OBJECTIVE: To describe a large segmental (sub-total) mandibulectomy for removal of an undifferentiated sarcoma in a horse. STUDY DESIGN: Clinical report. ANIMALS: A 10-year-old mare. METHODS: A combination of methods including computed tomography (CT) were used to diagnose a large undifferentiated sarcoma of the right mandible. A large segmental mandibulectomy extending from 3 cm below the right temporomandibular joint to immediately caudal to tooth 407 was used to perform an en-bloc resection of the mass under general anesthesia. RESULTS: Surgery time was 11 hours and 35 minutes and total anesthesia time, 12 hours and 40 minutes. The mare was eating well 3 days after surgery. Some postoperative skin sloughing occurred, but the cosmetic and functional outcome was good. The mare continued to do well, with no evidence of disease recurrence, 24 months after surgery. CONCLUSIONS: Three-dimensional reconstruction of the CT images was instrumental in surgical planning. A very large portion of the mandible can be removed in a horse with acceptable cosmetic and functional outcome.

Use of a hard palate mucoperiosteal flap for rostral muzzle reconstruction in a dog after a traumatic premaxillary degloving injury.

OBJECTIVE: To describe a technique for reconstruction of the rostral aspect of the muzzle of a dog after traumatic amputation. STUDY DESIGN: Clinical report. ANIMALS: Adult female dog. METHODS: A 6-year-old, intact, female, mixed-breed dog was admitted for facial reconstructive surgery after traumatic amputation of the rostral aspect of the muzzle. The nasal planum and the rostral portion of the upper lips were missing. A hard palate mucoperiosteal flap and lateral labial advancement flaps were used to reconstruct the nasal philtrum and borders of the nares. RESULTS: This reconstructive technique resulted in adequate nostril function and an acceptable cosmetic outcome. One naris developed partial obstruction with granulation tissue that may have occurred because of a lack of circumferential nasal mucosa to appose the skin on that side. CONCLUSION: The mucoperiosteum of the hard palate can be used to reconstruct the rostral aspect of the muzzle after traumatic amputation, resulting in an acceptable cosmetic outcome.

Congenital deformity of the paw in a captive tiger: case report.

BACKGROUND: The aim of this report was to describe the clinical signs, diagnostic approach, treatment and outcome in the case of a tiger with a deformity of the paw. CASE PRESENTATION: A 1.5-year-old tiger (Panthera tigris) was presented with lameness of the left thoracic limb. A deformity involving the first and second metacarpal bones, and a soft tissue separation between the second and third metacarpal bones of the left front paw were observed. The second digit constantly struck the ground during locomotion. Based on the physical and radiographic evaluations, a diagnosis of ectrodactyly was made. A soft tissue reconstruction of the cleft with excision of both the second digit and distal portion of the second metacarpal bone was performed. Marked improvement of the locomotion was observed after surgical treatment, although the tiger showed a low degree of lameness probably associated with the discrepancy in length between the thoracic limbs. CONCLUSION: This report shows a rare deformity in an exotic feline that it is compatible to ectrodactyly. Reconstructive surgery of the cleft resulted in significant improvement of limb function.

A practical, one-pot synthesis of sulfonylated pyridines.

A concise and efficient one-pot synthesis of functionalized sulfonylated pyridines via an S(N)Ar reaction of readily available pyridines and sodium sulfinate salts in the presence of tetrabutylammonium chloride is presented.

Chronic mesenteric volvulus in a dog.

A chronic, partial mesenteric volvulus was found on laparotomy of an adult Bernese mountain dog with a 4-month history of intermittent vomiting, diarrhea, and weight loss. The dog had elevated cholestatic and hepatocellular leakage enzymes, increased bile acids, azotemia, isosthenuria, and a hypokalemic, hypochloremic, metabolic alkalosis. The dog recovered fully following reduction of the volvulus.

A dog with squamous cell carcinoma in the middle ear.

An 8-year-old, castrated male golden retriever was referred for lethargy and inappetance. Severe pain was elicited on palpation of the left temporomandibular joint region. Computed tomography revealed aggressive bone destruction of the left bulla. Squamous cell carcinoma was diagnosed. Malignant tumor in the canine middle ear is rare.

Long-term outcome of juvenile pubic symphysiodesis and triple pelvic osteotomy in dogs with hip dysplasia.

OBJECTIVE: To compare long-term outcomes of juvenile pubic symphysiodesis (JPS) and triple pelvic osteotomy (TPO) in dogs with hip dysplasia. DESIGN: Prospective clinical trial. ANIMALS: 18 dogs with hip dysplasia (ie, distraction index > or = 0.5 in at least 1 hip joint and no, mild, or moderate radiographic evidence of degenerative joint disease [DJD]). PROCEDURES: Dogs between 4 and 5.5 months old at enrollment were assigned to undergo JPS, and dogs between 5 and 12 months old were assigned to undergo TPO. All dogs were reexamined at 2 years of age. RESULTS: At 2 years of age, there were no significant differences between groups in regard to lameness scores, angle of extension of the hip joints, distraction index, peak vertical force, acetabular angle, radiographic DJD score, or owner-assigned scores of clinical function. Dorsal acetabular rim angle was significantly higher in dogs that underwent JPS than in dogs that underwent TPO. For dogs that underwent TPO, dorsal acetabular rim angle was significantly decreased and acetabular angle was significantly increased at 2 years of age, compared with values obtained prior to surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that JPS and TPO have similar effects on hip joint conformation in dogs with moderate to severe hip dysplasia but that neither procedure eliminates the hip joint laxity characteristic of hip dysplasia or the progression of degenerative changes.

Ultrasonographic imaging of the sandhill crane (Grus canadensis) intertarsal joint.

Tendon ossification in the crus and tarsometatarsal regions of cranes makes ultrasonography difficult everywhere except for joints, where ossification is absent. Normal ultrasonographic anatomy of the adult Florida sandhill crane (Grus canadensis pratensis) intertarsal joint is described on the basis of ultrasonography that was performed on the limbs of a cadaver, which were dissected and cross-sectioned subsequently, to correlate ultrasonographic images with anatomic structures. Intertarsal joints of five normal sandhill cranes and two cranes with known intertarsal abnormalities were then imaged bilaterally in transverse and sagittal planes. Ultrasonographic imaging can be used to evaluate the soft-tissue structures on the dorsal and plantar aspects of the intertarsal joint of cranes, and it is a useful adjunct to physical and radiographic examination for localizing injuries to this area.

Juvenile pubic symphysiodesis in dysplastic puppies at 15 and 20 weeks of age.

OBJECTIVE: To examine the effects of juvenile pubic symphysiodesis (JPS) on hip joint conformation, hip laxity, gait, and the development of degenerative joint disease (DJD) in dysplastic puppies operated at 15 and 20 weeks of age. STUDY DESIGN: Randomized controlled prospective study. ANIMALS-Eighteen female hound puppies with increased hip laxity. METHODS: Puppies were randomized to 1 of 4 treatment groups: JPS at 15 weeks of age (n = 6), sham-operated control at 15 weeks of age (n = 3), JPS at 20 weeks of age (n = 6), and sham-operated control at 20 weeks of age (n = 3). Hip extension with pain scoring, Ortolani palpation, hip reduction angle measurement (HRA), PennHIP radiography (University of Pennsylvania) with measurement of distraction index, Norberg angle measurement, and transverse computed tomographic imaging to measure acetabular angle (AA) and dorsal acetabular rim angle (DARA), were tested preoperatively, and at 1 and 2 years of age. RESULTS: JPS resulted in significant changes in AA, HRA, DARA, and conversion to Ortolani negative status. Larger and more rapid changes in hip conformation were seen when surgery was performed at 15 weeks of age. No significant changes were identified in control dogs. Twenty-five percent of JPS dogs developed DJD whereas 83% of control dogs developed DJD. CONCLUSIONS: JPS resulted in significant improvements in hip joint conformation and hip laxity in dysplastic puppies treated at 15 and 20 weeks of age. Improvements in conformation were significantly greater when surgery was performed at 15 weeks of age. CLINICAL RELEVANCE: JPS appears to be a promising treatment for hip dysplasia and is a safe and technically simple procedure to perform.