Diagnostic traction and dorsal locking plate stabilization of a fifth and sixth thoracic vertebral fracture/luxation in a golden retriever: Case report.

Traction was used to diagnose instability of a T5-T6 traumatic luxation that was stabilized with locking plates in the laminae and dorsal pedicles. A two-year-old, 27 kg, female spayed golden retriever was presented to a veterinary teaching hospital after being referred for possible mandibular and spinal fractures after being hit by a car. The dog presented non-ambulatory paraparetic with intact pain perception. Computed tomographic (CT) imaging showed a fifth and sixth thoracic vertebral fracture/luxation, with and without manual traction. Surgical stabilization of the spine was performed with bilateral dorsally placed locking plates (String-of-Pearls, Orthomed, UK) in the laminae and dorsal aspects of the vertebral pedicles. The dog recovered well, and neurologic status improved significantly overnight and continued to improve up until discharge, which was 6 days postoperatively. Upon recheck exam at 8 weeks postoperatively, the dog appeared neurologically normal with no obvious surgical complications. This case demonstrates that diagnostic traction-the process of pulling, during imaging, on the dog's pelvis while the forelimbs are secured in extension-demonstrated instability of the spine which was not readily apparent on initial CT imaging. Additionally, the dorsal locking plate stabilization is a viable fixation option that provided acceptable stabilization of the mid-thoracic vertebrae.

Short-term outcomes of 59 dogs treated for ilial body fractures with locking or non-locking plates.

OBJECTIVE: To determine the influence of plating systems on the clinical outcomes in dogs treated for ilial fractures. DESIGN: Retrospective study. ANIMALS: Fifty-nine dogs (63 hemipelves). METHODS: Radiographs and medical records of dogs with ilial fractures presented to Iowa State University between 2003 and 2019 were reviewed. After fracture reduction, fractures were fixed with a locking plate system (LPS) or non-locking plate system (NLS). Perioperative, long-term complications, and follow-up data were recorded. The frequency of implant failure and pelvic collapse were compared using a logistic and linear regression analysis, respectively. Where the univariate test was statistically significant, a multivariate analysis across categories was performed to identify statistically different categories. RESULTS: LPS and NLS implants were used in 25/63 and 38/63 hemipelves, respectively. Median follow-up time was 8 weeks (3-624 weeks). Implant failure occurred in 18/63 (29%) of fracture repairs, consisting of 17 with NLS and 1 with LPS. Revision surgery was recommended in five cases of implant failure, all with NLS. The probability of implant failure was higher when fractures were fixed with NLS (p = .0056). All other variables evaluated did not seem to influence outcome measures. CONCLUSION: The variable with the most influence on the outcomes of dogs treated for ilial fractures consisted of the fixation method (NLS vs. LPS). Fractures repaired with NLS were nearly 20 times more likely to fail than those repaired with LPS. CLINICAL RELEVANCE: Surgeons should consider repairing ilial body fractures in dogs with LPS to reduce the risk of short-term implant failure.

Radiation exposure associated with percutaneous fluoroscopically guided lag screw fixation for sacroiliac luxation in dogs.

OBJECTIVE: To determine radiation exposure to surgical personnel and to evaluate the accuracy of a modified percutaneous lag screw fixation technique for sacroiliac luxation (SIL) under fluoroscopic guidance in dogs. STUDY DESIGN: Cadaveric experimental study. SAMPLE POPULATION: Seventeen beagle cadavers with iatrogenic SIL. METHODS: Seventeen beagles with iatrogenic SIL underwent reduction and stabilization with 3.5-mm screws. Hypodermic needles (14 gauge) and fluoroscopy were used to orient two Kirschner wires for temporary stabilization and to guide drilling of glide and pilot holes using cannulated drill bits. Duration of surgery and radiation exposure were recorded. Postoperative computed tomographic evaluation of screw position and angulation was performed. RESULTS: Average time for fixation was 15.85 minutes (range, 6.37-33.5). Cumulative radiation doses of 0.4 mrem for the dominant arm of the assistant and 0 mrem for the primary surgeon were recorded. The mean dorsoventral and craniocaudal screw angles were 0.68° ± 3.4° (range - 5.4° to 9.5°) and 1.9° ± 3.2° (range - 4.3° to 9.1°), respectively. Sixteen of the 17 dogs had 100% sacral screw purchase, with the remaining case achieving 93.4% purchase. CONCLUSION: Fluoroscopy-assisted percutaneous placement of 3.5-mm cortical screws in lag fashion performed with 14-gauge needles in conjunction with Kirschner wires and cannulated drill bits yielded repeatable accurate screw placement with low levels of ionizing radiation exposure to the surgical team. CLINICAL SIGNIFICANCE: The described technique may be a viable method for minimally invasive osteosynthesis fixation of SIL with low levels of radiation exposure to the surgical team. These results provide evidence to support further evaluation of radiation exposure in clinical cases and can aid in study design and sample size determination.

Outcomes of dogs undergoing immediate or delayed surgical treatment for gastrointestinal foreign body obstruction: A retrospective study by the Society of Veterinary Soft Tissue Surgery.

OBJECTIVE: To evaluate gastrointestinal injury and outcomes between dogs treated with immediate surgical intervention vs those treated with delayed surgical intervention for gastrointestinal foreign body obstruction (GIFBO). STUDY DESIGN: Retrospective cohort study. SAMPLE POPULATION: Client-owned dogs (n = 855) from five referral hospitals. METHODS: Medical records of dogs in which GIFBO had been diagnosed between 2007 and 2017 were reviewed for preoperative management, timing of surgery, intraoperative findings, postoperative management, outcome, and survival. Surgical intervention was classified as immediate when it occurred within 6 hours of presentation and delayed when it occurred >6 hours after presentation. RESULTS: Outcomes did not differ between dogs treated immediately (n = 584) or over 6 hours after presentation (n = 210). Intestinal necrosis and perforations were more common when surgery was delayed (P = .008; P = .019) but became nonsignificant after controlling for preoperative differences. Risk factors for necrosis and perforations included duration of clinical signs, increased lactate, linear foreign material, and timing of surgery. Enterectomies (P = .004) as well as the duration of surgery (P = .004) and anesthesia (P = .001) were increased when surgery was delayed. Immediate surgery was associated with earlier return to feeding (P = .004) and discharge from the hospital (P < .001); (5%) dogs in each group (n = 33 immediate; n = 11 delayed) either had a negative explore or the foreign body was milked aborally into the colon at the time of surgery. CONCLUSION: Although outcomes were not associated with surgical timing, the unadjusted prevalence of gastrointestinal injury and, thus, the requirement for complex surgical procedures was higher in the delayed group. CLINICAL SIGNIFICANCE: Earlier surgical treatment of stabilized dogs with GIFBO may involve fewer complex procedures and accelerate recovery.

Endoscopic nephrolithotomy for the removal of complicated nephroliths in dogs and cats: 16 kidneys in 12 patients (2005-2017).

OBJECTIVE: To describe techniques and outcomes for dogs and cats undergoing endoscopic nephrolithotomy (ENL) for the removal of complicated nephroliths. ANIMALS: 11 dogs and 1 cat (n = 16 renal units) with complicated nephroliths that underwent ENL via a surgically assisted ENL approach (12 renal units) or a percutaneous nephrolithotomy approach (4 renal units) between December 2005 and June 2017. PROCEDURES: Data were obtained from the medical records regarding preoperative, operative, and postoperative findings. Follow-up information on complications and outcomes was also collected. RESULTS: Indications for nephrolith removal included massive calculi displacing parenchyma (n = 7), recurrent urinary tract infections (5), and ureteral outflow obstruction (4). Median nephrolith diameter was 2.5 cm (range, 0.5 to 5.7 cm). Nephrolith composition differed among patients; calcium oxalate was the most common type (n = 7 [including 2 mixed nephroliths containing ≥ 60% calcium oxalate]). Following ENL (median duration, 180 minutes), 15 of 16 renal units were completely nephrolith free. Procedure-related complications included renal puncture-associated hemorrhage requiring a blood transfusion (n = 1), renal capsule tear (1), and ureteral puncture (1); all were managed without adverse consequence. Five of 12 patients remained alive at the final follow-up (median, 557 days after ENL), and none died from the procedure. CONCLUSIONS AND CLINICAL RELEVANCE: ENL as performed was safe and effective in removing complicated nephroliths in a renal-sparing manner for the patients in this study. This procedure requires technical training and could be considered for the treatment of complicated nephrolithiasis in dogs and possibly cats.

Median sternotomy versus intercostal thoracotomy for lung lobectomy: A comparison of short-term outcome in 134 dogs.

OBJECTIVE: To compare short-term outcomes between dogs undergoing lung lobectomy via median sternotomy (MS) or intercostal thoracotomy (ICT). STUDY DESIGN: Retrospective case control study. METHODS: Medical records of dogs that underwent lung lobectomy via MS or ICT at a single institution were reviewed for demographics, intraoperative findings, and postoperative management and outcomes. Dogs with pleural effusion, pneumonia, migrating foreign body, lung abscess, spontaneous pneumothorax, or lung lobe torsion were excluded. Short-term outcome factors up were compared up to the time of death, euthanasia, or discharge from the hospital. RESULTS: One hundred and thirty-four dogs met the inclusion criteria. Forty-one (31%) dogs underwent MS and 93 dogs (69%) underwent ICT. Fluid production from the chest tube (P = .0061), alveolar arterial pressure gradient (P = .0001), and complications requiring intervention (P = .0245) were more common in the MS group than the ICT group. Pain management and all other short-term outcome factors did not differ between procedures. Five dogs from the MS group and 4 from the ICT group were euthanized in the postoperative period (P = .0925). CONCLUSION: In a surgical procedure that does not preclude either approach, ICT may be more desirable than MS in terms of postoperative pain, oxygenation, and complications. However, since no other short-term measure of outcome differed, we can state that both MS and ICT are well tolerated by dogs.

Evaluation of efficacy of repeated decontamination and sterilization of single-incision laparoscopic surgery ports intended for 1-time use.

OBJECTIVE: To determine the efficacy of repeated decontamination and sterilization of a disposable port intended for 1-time use during single-incision laparoscopy. STUDY DESIGN: Experimental; prospective, controlled design. METHODS: Six single-access ports used 4 times and 6 single-access ports used 8 times to perform various clean, minimally invasive surgeries were evaluated. Ports were decontaminated in an enzymatic cleaner (dilution, 3:100) and cleaned with a scrub brush for 5 minutes. The ports were then sterilized with hydrogen peroxide vapor for 50 minutes using a standard protocol at a concentration of 6 mg/L, followed by a vapor diffusion phase. Samples taken from the foam, insufflating tubing, and rigid cannula portion of each port were collected with aseptic technique for aerobic-anaerobic cultures. Port material samples were set up on a tryptic soy agar plate with 5% sheep blood, a MacConkey agar plate, and a Columbia agar plate with 5% sheep blood (CAP). Anaerobic isolate cultures were set up on Centers for Disease Control and Prevention (CDC) blood agar and CAP. RESULTS: None of the ports used 4 times had positive bacteriologic culture. Two of the ports used 8 times had a light growth of bacteria. The first positive sample cultured Staphylococcus spp. and Micrococcus spp. The second positive sample cultured Staphylococcus epidermidis. The positive cultures were obtained from the foam component in an enriched broth. CONCLUSION: Single-incision ports could be used safely 4 times and pose a low risk of infection to the patient under conditions of this study.