David L. Holmberg

Comparison of the effect of single-site and multiple-site disk fenestration on the rate of recurrence of thoracolumbar intervertebral disk herniation in dogs

OBJECTIVE To prospectively assess whether multiple-site disk fenestration decreases the incidence of recurrent thoracolumbar intervertebral disk herniation (IVDH), compared with single-site disk fenestration, in small-breed dogs treated for IVDH. DESIGN Randomized controlled clinical trial. ANIMALS 207 client-owned dogs. PROCEDURES Dogs undergoing decompressive surgery of the spinal cord because of thoracolumbar IVDH between 2001 and 2004 were randomly assigned to receive single-site disk fenestration at the level of surgical decompression (n = 103) or multiple-site disk fenestration of all disks from T11 through L4 (104). Follow-up consisted of complete reevaluation of patients, telephone surveys, and further surgery if signs indicative of recurrence occurred. RESULTS 189 dogs were available for long-term follow-up: 95 dogs in the single-site disk fenestration group and 94 in the multiple-site disk fenestration group. Twenty-four dogs developed 28 confirmed episodes of recurrent thoracolumbar IVDH. The rate for first-time recurrence was 12.7% (24/189). First-time recurrence rates for single-and multiple-site disk fenestration groups were 17.89% (17/95) and 7.45% (7/94), respectively. Dogs undergoing single-site disk fenestration were significantly more likely to have recurrent thoracolumbar IVDH than were dogs undergoing multiple-site disk fenestration. Disk mineralization at the time of first surgery was associated with recurrence, and 87.5% (21/24) of recurrences occurred at a disk space adjacent to or 1 disk away from the initial lesion. Regardless of disk fenestration group, 22 of 24 (91.7%) recurrences occurred at a nonfenestrated disk space. CONCLUSIONS AND CLINICAL RELEVANCE Multiple-site disk fenestration decreased the rate of recurrent IVDH in small-breed dogs, compared with the use of single-site disk fenestration.

Outcome of medical and surgical treatment in dogs with cervical spondylomyelopathy : 104 cases (1988-2004)

OBJECTIVE To compare outcomes and survival times for dogs with cervical spondylomyelopathy (CSM; wobbler syndrome) treated medically or surgically. DESIGN Retrospective case series. ANIMALS 104 dogs. PROCEDURES Medical records of dogs were included if the diagnosis of CSM had been made on the basis of results of diagnostic imaging and follow-up information (minimum, 6 months) was available. Ordinal logistic regression was used to compare outcomes and the product-limit method was used to compare survival times between dogs treated surgically and dogs treated medically. RESULTS 37 dogs were treated surgically, and 67 were treated medically. Owners reported that 30 (81%) dogs treated surgically were improved, 1 (3%) was unchanged, and 6 (16%) were worse and that 36 (54%) dogs treated medically were improved, 18 (27%) were unchanged, and 13 (19%) were worse. Outcome was not significantly different between groups. Information on survival time was available for 33 dogs treated surgically and 43 dogs treated medically. Forty of the 76 (53%) dogs were euthanized because of CSM. Median and mean survival times were 36 and 48 months, respectively, for dogs treated medically and 36 and 46.5 months, respectively, for dogs treated surgically. Survival times did not differ significantly between groups. CONCLUSIONS AND CLINICAL RELEVANCE In the present study, neither outcome nor survival time was significantly different between dogs with CSM treated medically and dogs treated surgically, suggesting that medical treatment is a viable and valuable option for management of dogs with CSM.

Evaluation of risk factors associated with suture-nidus cystoliths in dogs and cats: 176 cases (1999–2006)

OBJECTIVE To characterize and evaluate risk factors for suture-associated cystoliths in dogs and cats. DESIGN Retrospective case-control study. Animals-163 dogs and 13 cats with suture-associated cystoliths and 326 control dogs and 26 control cats with non-suture-associated cystoliths. PROCEDURES Submissions to the Canadian Veterinary Urolith Centre received from 1999 to 2006 were reviewed. Case dogs and cats had cystoliths associated with visible suture or with hollow, cylindrical channels or suture knot impressions consistent with dissolved suture. Control dogs and cats had at least a single recurrent non-suture-associated cystolith submitted closest in time to the sample case. Associations among cystolith composition, recurrence times, sex, age, and breed were evaluated. RESULTS Cases consisted of 92 dogs and 7 cats with visible suture and 71 dogs and 6 cats with dissolved suture. Suture-associated cystoliths represented 0.6% of canine cystoliths, 9.4% of recurrent canine cystoliths, 0.17% of feline cystoliths, and 4% of recurrent feline cystoliths. Sexually intact and neutered males were at increased odds of suture-associated cystoliths, relative to spayed female dogs. Shih Tzus, Lhasa Apsos, and Pomeranians were significantly predisposed to form suture-associated cystoliths. In dogs, compound suture-associated cystoliths were significantly more likely than other cystolith types (OR, 8.6). Dogs with suture-associated cystoliths had significantly shorter recurrence times than did control dogs. CONCLUSIONS AND CLINICAL RELEVANCE Suture remnants in the bladder have an important role in recurrent cystolithiasis in dogs. Identification of risk factors is important for avoiding recurrence of iatrogenic cystoliths.

Anesthetic management of an off-pump open-heart surgery in a dog.

OBSERVATIONS A 9 year-old, 40 kg, female spayed Bouvier des Flandres was anesthetized for surgical removal of an intra-cardiac mass. Pre-anesthetic work-up included thoracic radiographs, which revealed moderate pleural effusion, and cardiac ultrasound, which identified a mass attached to the wall of the right ventricular outflow tract (RVOT). The mass caused dynamic obstruction of the RVOT during systole. The dog was pre-medicated with intravenous (IV) hydromorphone (0.05 mg kg(-1)). Following pre-oxygenation, anesthesia was induced with ketamine (3.75 mg kg(-1), IV) and diazepam (0.18 mg kg(-1), IV). Anesthesia was maintained with isoflurane in oxygen, an intravenous constant rate infusion (CRI) of fentanyl (10-30 microg kg(-1) hour(-1)) and a CRI of lidocaine (50-200 microg kg(-1) minute(-1)). A right lateral thoracotomy was performed. The heart was stopped transiently with a cold cardioplegic solution for 7.83 minutes to allow the removal of the mass through an open-heart procedure. No cardiopulmonary bypass was used. The heart was successfully restarted after cardiopulmonary resuscitation with internal cardiac massage and internal defibrillation. The dog recovered uneventfully from anesthesia without any apparent neurological sequelae. Post-operative analgesia consisted of intercostal nerve blocks with bupivacaine, CRIs of fentanyl (2-5 microg kg(-1) hour(-1)) and lidocaine (40 microg kg(-1) minute(-1)) and with oral meloxicam (0.1 mg kg(-1)). Five days following surgery, the dog was discharged from the hospital. Histopathology and immunohistochemistry of the mass identified an ectopic thyroid carcinoma. CONCLUSIONS This case showed the feasibility of whole body hypothermia and using a cold cardioplegic solution to induce cardiac arrest for a short open-heart procedure.

Cianose e metahemoglobinemia associada à deficiência de NADH-metahemoglobina redutase em um cão sob anestesia

This study reports the occurrence of cyanosis in a dog under general anesthesia. The patient didn’t present any sign of heart or respiratory disease, the accidental ingestion of oxidizers agents wasn’t possible. Therefore resulting the suspicion of metahemoglobinemia associated to the deficiency of NADH-metahemoglobina redutase. This was confirmed after suggestive test and laboratorial specific test.