Bernard Bouvy

Laparoscopic adrenalectomy for treatment of unilateral adrenocortical carcinomas: technique, complications, and results in seven dogs.

OBJECTIVE To investigate the feasibility of, and outcome after, laparoscopic adrenalectomy in dogs with unilateral adrenocortical carcinoma. STUDY DESIGN Case series. ANIMALS Dogs (n=7) with Cushings syndrome caused by unilateral adrenocortical carcinoma. METHODS Laparoscopic adrenalectomy with the dog in lateral recumbency on the unaffected side. Three 5-mm portals (1 laparoscopic portal, 2 instrument portals) were placed in the paralumbar fossa. A fourth instrumental portal (5-12 mm) was placed above the kidney. After dissection and hemostatic control of the phrenicoabdominal vein, the adrenal gland was carefully dissected or when there was capsule fragility, necrotic content was partially aspirated. The remaining glandular tissue was removed through the 12-mm trocar site. RESULTS Dogs with unilateral adrenocortical carcinoma (3 right-sided, 4 left-sided) without invasion of the caudal vena cava were successfully operated by laparoscopic approach. There were no significant intraoperative complications; 2 dogs died within 48 hours of surgery because of respiratory complications. Five dogs were discharged 72 hours after surgery, and signs of hyperadrenocorticism disappeared thereafter (survival time ranged from 7 to 25 months). CONCLUSIONS Laparoscopic adrenalectomy is feasible in dogs with either right- or left-sided adrenocortical carcinoma not involving the caudal vena cava. CLINICAL RELEVANCE When performed by experienced surgeons, laparoscopic adrenalectomy offers a minimally invasive alternative to open laparotomy or retroperitoneal surgery for the treatment of unilateral adrenocortical carcinoma in dogs.

Anatomic study of the canine stifle using low-field magnetic resonance imaging (MRI) and MRI arthrography.

OBJECTIVE To investigate the use of low-field magnetic resonance imaging (MRI) and MR arthrography in normal canine stifles and to compare MRI images to gross dissection. STUDY DESIGN Descriptive study. SAMPLE POPULATION Adult canine pelvic limbs (n=17). METHODS Stifle joints from 12 dogs were examined by orthopedic and radiographic examination, synovial fluid analysis, and MRI performed using a 0.2 T system. Limbs 1 to 7 were used to develop the MR and MR arthrography imaging protocol. Limbs 8-17 were studied with the developed MR and MR arthrography protocol and by gross dissection. Three sequences were obtained: T1-weighted spin echo (SE) in sagittal, dorsal, and transverse plane; T2-weighted SE in sagittal plane and T1-gradient echo in sagittal plane. RESULTS Specific bony and soft tissue structures were easily identifiable with the exception of articular cartilage. The cranial and caudal cruciate ligaments were identified. Medial and lateral menisci were seen as wedge-shaped hypointense areas. MR arthrography permitted further delineation of specific structures. MR images corresponded with gross dissection morphology. CONCLUSIONS With the exception of poor delineation of articular cartilage, a low-field MRI and MR arthrography protocol provides images of adequate quality to assess the normal canine stifle joint.

Zygomatic Salivary Gland Diseases in the Dog: Three Cases Diagnosed by MRI

This article describes three original cases of zygomatic gland disease in the dog diagnosed by low-field MRI and treated by a modified lateral orbitotomy with zygomatic osteotomy. Presenting complaints included exophthalmia, protrusion of the third eyelid, and periorbital swelling without any history of trauma. Low-field MRI allowed for adequate diagnosis of zygomatic gland disease in all cases and provided detailed information about both the specific tissue characteristics of each lesion and extension into surrounding structures. MRI findings were also helpful for surgical planning and dictated the choice of a modified lateral orbitotomy without removal of the orbital ligament. Histopathologic diagnosis for each of the three dogs was a mucocele, a malignant mixed salivary tumor, and sialadenitis.

Use of the Kishigami Atlantoaxial Tension Band in Eight Toy Breed Dogs with Atlantoaxial Subluxation

OBJECTIVE To determine the applicability, complications, and long-term functional outcome of the Kishigami Atlantoaxial Tension Band (Kishigami AATB) for management of congenital and traumatic atlantoaxial (AA) instability in toy breed dogs. STUDY DESIGN; Case series. ANIMALS Toy breed dogs (n=8) with congenital or traumatic AA instability. METHODS The AA joint of each dog was surgically stabilized through a dorsal approach using the original or a modified version of the Kishigami AATB. Pre- and postoperative neurologic status, radiographs, and complications were reviewed. Follow-up examination was performed at 1 and 12 months. RESULTS Functional improvement occurred in 5 dogs; 1 dog did not improve or worsen and 2 dogs were euthanatized at owner request. Adequate reduction and stabilization was achieved in 7 dogs based on immediate postoperative radiographs; failure of reduction was evident in 1 dog. No relevant complications occurred. CONCLUSIONS Kishigami AATB may be acceptable as an alternative method for dorsal stabilization of AA subluxation in toy breed dogs in which use of ventral screws or pins is challenging. Experience with this technique in a larger population is necessary to compare our results to those reported by ventral approach. CLINICAL RELEVANCE; The surgical technique described is effective, safe, and simple in the surgical treatment of AA subluxation in toy breed dogs.

49-Month Survival Following Caval Venectomy Without Nephrectomy in a Dog with a Pheochromocytoma

An 11 yr old spayed female Labrador retriever was diagnosed with a right adrenal tumor. At surgery, adhesions to the right kidney were dissected, allowing the right kidney to be preserved. The tumor showed extensive invasion into the suprarenal vena cava. It was felt that thrombus removal via venotomy could not be performed. Instead, the vena cava was ligated caudal to the liver and cranial to the right renal vein. The neoplastic gland was then excised en bloc together with the portion of the invaded caudal vena cava. Hind limb edema had developed preoperatively and increased transiently in the first days postoperatively. The animal was discharged 6 days postoperatively with no other clinical disorders, and hind limb edema resolved over time. Histopathology identified a pheochromocytoma. The dog died 49 mo later. A neoplastic thrombus of the vena cava may require venotomy to allow thrombus removal. Occasionally, removal of the thrombus by venotomy may prove impossible. In such a situation, en bloc removal of the concerned portion of the vena cava may be performed with a good long-term outcome provided that gradual occlusion of the vena cava by the thrombus has allowed time for collateral circulation to develop.