F. A. Mann

Effects of general anesthesia on plasma colloid oncotic pressure in dogs

OBJECTIVE To determine the magnitude of the change in colloid oncotic pressure (COP) associated with general anesthesia in dogs undergoing a variety of elective procedures. DESIGN Cohort study. ANIMALS 50 client-owned dogs. PROCEDURES For each dog, preanesthetic and postanesthetic PCV, plasma total solids (TS) concentration, and COP were determined. The procedures requiring anesthesia, volume of crystalloid fluids administered IV, duration of anesthesia, age, weight, and sex were recorded. RESULTS Postanesthetic PCV (mean +/- SD, 41.8 +/- 5.4%), TS concentration (6.3 +/- 0.8 g/dL), and COP (19.4 +/- 3.6 mm Hg) were significantly decreased, compared with preanesthetic values (48.8 +/- 5.9%, 7.2 +/- 0.7 g/dL, and 24.4 +/- 4.2 mm Hg, respectively). None of the variables tested could be used to reliably predict changes in COP. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that COP in healthy dogs may decrease by 5 mm Hg on average after general anesthesia and that this decrease may not be reliably predicted by the volume of fluids administered IV during anesthesia or by the concurrent measured decrease in TS concentration.

Major Glossectomy in Dogs: A Case Series and Proposed Classification System

Major resections of the tongue have not been commonly performed in animals because of concerns about the unfavorable postoperative effects of diminished lingual function. Five dogs were retrospectively reviewed to determine prehensile function and quality of life after glossectomies. Examinations were performed 1 week to 8 years after glossectomy, and owner interviews were conducted 10 months to 8 years after the surgery. All five dogs had acceptable and functional outcomes. Based on these five cases, glossectomy was well tolerated by dogs and may be a viable treatment option for aggressive tongue tumors and other conditions that render the tongue unsalvageable.

Long-term survival of dogs after cholecystoenterostomy: a retrospective study of 15 cases (1981-2005).

Fifteen dogs with extrahepatic biliary tract disease underwent cholecystoenterostomy. Long-term survivors were significantly older at presentation (mean age 140.5 months) than dogs that survived the first 20 days after surgery but subsequently died from causes related to the surgery or hepatobiliary disease (mean age 72 months). Dogs that died during the first 20 days had significantly more complications in the hospital than dogs that survived this period. The type of underlying hepatobiliary disease (i.e., benign or malignant) was not associated with either short-term outcome or long-term survival. Eight dogs died from causes related to surgery or hepatobiliary disease. Long-term complications included hepatic abscesses, acquired portosystemic shunts, pancreatitis, and vomiting.

Comparison of Two Portable Lactate Meters in Dogs

The objective of this study was to compare two portable lactate analyzers for testing canine patients in a clinical setting with a previously accepted methodology for measuring plasma lactate. Between Jan 1, 2005 and Jun 1, 2006, all samples were analyzed using two different portable analyzers (devices A and B), and 86 of those samples were also analyzed by a reference laboratory (REF). The concordance correlation coefficient (CCC) for device A and the REF was 0.949 (95% confidence interval [95% CI], 0.923-0.966). For device B and REF, the CCC was 0.990 (95% CI, 0.985-0.993). Only 8 of 85 samples (9.4%) exceeded a relative difference of 20% for device B (note that 1 of the 86 samples was not included because the lactate level fell below the detectable limit of device B), but 48 of 85 samples (56.5%) exceeded a relative difference of 20% for device A. Both portable lactate analyzers appeared to be effective in detecting clinically significant elevations in plasma lactate compared with the REF but device B had better agreement. A positive correlation among all three analyzers existed; however, the analyzers do not yield directly interchangeable results.

Bilateral ureteral ectopia with renal dysplasia and urolithiasis in a dog.

A 7-month-old, 4.3-kg, spayed female bichon frise was referred for evaluation of chronic urinary incontinence. Abdominal radiographs revealed calculi within the right kidney and ureter. An ultrasound revealed a small right kidney. An abdominal computed tomography scan with contrast revealed that the left ureter was extramurally ectopic, inserting into the proximal urethra. A right intramural ectopic ureter was identified during cystotomy. Ureteronephrectomy was performed on the right, and ureteroneocystostomy was performed on the left. A telephone conversation with the owner 4 months after surgery revealed that the dog exhibited no evidence of urine dribbling, and urinary continence was maintained well on phenyl-propanolamine (1.75 mg/kg orally q 12 hours). This is the first report of successful surgical management of bilateral ureteral ectopia with concurrent, unilateral, renal dysplasia and urolithiasis.

Effects of temperature and handling conditions on lipid emulsion stability in veterinary parenteral nutrition admixtures during simulated intravenous administration

OBJECTIVE To determine whether lipid particle coalescence develops in veterinary parenteral nutrition (PN) admixture preparations that are kept at room temperature (23 degrees C) for > 48 hours and whether that coalescence is prevented by admixture filtration, refrigeration, or agitation. SAMPLE POPULATION 15 bags of veterinary PN solutions. PROCEDURES Bags of a PN admixture preparation containing a lipid emulsion were suspended and maintained under different experimental conditions (3 bags/group) for 96 hours while admixtures were dispensed to simulate IV fluid administration (rate, 16 mL/h). Bags were kept static at 4 degrees C (refrigeration); kept at 23 degrees C (room temperature) and continuously agitated; kept at room temperature and agitated for 5 minutes every 4 hours; kept static at room temperature and filtered during delivery; or kept static at room temperature (control conditions). Admixture samples were collected at 0, 24, 48, 72, and 96 hours and examined via transmission electron microscopy to determine lipid particle diameters. At 96 hours, 2 samples were collected at a location distal to the filter from each bag in that group for bacterial culture. RESULTS Distribution of lipid particle size in the control preparations and experimentally treated preparations did not differ significantly. A visible oil layer developed in continuously agitated preparations by 72 hours. Bacterial cultures of filtered samples yielded no growth. CONCLUSIONS AND CLINICAL RELEVANCE Data indicated that the veterinary PN admixtures kept static at 23 degrees C are suitable for use for at least 48 hours. Manipulations of PN admixtures appear unnecessary to prolong lipid particle stability, and continuous agitation may hasten lipid breakdown.

Comparison of the amounts of air leakage into the thoracic cavity associated with four thoracostomy tube placement techniques in canine cadavers

OBJECTIVE To compare the amount of air leakage into the thoracic cavity associated with each of 4 thoracostomy tube placement techniques in canine cadavers. SAMPLE POPULATION 28 canine cadavers. PROCEDURES Thoracostomy tube placement techniques (7 cadavers/technique) included subcutaneous tunneling with a silicone tube by use of Carmalt forceps or with a polyvinyl chloride tube by use of a trocar (SC-CARM and SC-TRO, respectively) and tunneling under the latissimus dorsi muscle with similar tube-instrument techniques (LD-CARM and LD-TRO, respectively). Differences in intrapleural pressures (IPPs) measured before and after tube placement and before and after tube removal were calculated; duration of air leakage around the tubes was assessed by use of a 3-chamber thoracic drainage system. RESULTS Tunneling method and depth had no interaction effect on the difference in IPP measured before and after tube placement; the IPP difference for both forceps technique groups was significantly greater than findings for both trocar technique groups. Tunneling method and depth had an interaction effect on the difference in IPP measured before and after tube removal; compared with SC-TRO and LD-CARM group differences, the SC-CARM group difference was significantly greater, but the LD-TRO group difference was similar. More intermittent air leakage was associated with the 2 forceps techniques than with the 2 trocar techniques. CONCLUSIONS AND CLINICAL RELEVANCE Trocar-implemented thoracostomy tube placement in canine cadavers resulted in less air leakage than the forceps method. Air leakage upon tube removal was less pronounced for the LD-CARM technique than the SC-CARM technique. The LD-TRO technique is recommended to prevent iatrogenic pneumothorax in dogs.

Perioperative red blood cell transfusion requirement for various surgical procedures in dogs: 207 cases (2004–2013)

OBJECTIVE To compare perioperative RBC transfusion among dogs undergoing liver lobectomy, splenectomy, partial gastrectomy, rhinotomy, thyroidectomy, perineal herniorrhaphy, and intrathoracic surgery. DESIGN Retrospective case series. ANIMALS 207 client-owned dogs that underwent various surgeries. PROCEDURES Medical records were reviewed for dogs that had undergone liver lobectomy, splenectomy, partial gastrectomy, rhinotomy, neoplastic thyroidectomy, perineal herniorrhaphy, or intrathoracic surgery. Transfusion requirement (packed RBC, whole blood, and bovine hemoglobin-based oxygen carrier) and survival rate at 2 weeks after surgery were compared among dogs undergoing the various surgeries. RESULTS Patients undergoing splenectomy and liver lobectomy were significantly more likely to receive RBC transfusion when each was compared with patients undergoing all other procedures. A significant association was found between body weight and perioperative RBC transfusion, with greater odds of transfusion as body weight increased. Dogs receiving perioperative RBC transfusions were significantly less likely to survive to 2 weeks after surgery. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs undergoing splenectomy and liver lobectomy may require RBC transfusion perioperatively. Veterinarians who perform these procedures should plan accordingly and have packed RBCs or whole blood donors readily available.

Comparison of enterotomy leak pressure among fresh, cooled, and frozen-thawed porcine jejunal segments

OBJECTIVE To determine whether stored (cooled or frozen-thawed) jejunal segments can be used to obtain dependable leak pressure data after enterotomy closure. SAMPLE 36 jejunal segments from 3 juvenile pigs. PROCEDURES Jejunal segments were harvested from euthanized pigs and assigned to 1 of 3 treatment groups (n = 12 segments/group) as follows: fresh (used within 4 hours after collection), cooled (stored overnight at 5°C before use), and frozen-thawed (frozen at -12°C for 8 days and thawed at room temperature [23°C] for 1 hour before use). Jejunal segments were suspended and 2-cm enterotomy incisions were made on the antimesenteric border. Enterotomies were closed with a simple continuous suture pattern. Lactated Ringer solution was infused into each segment until failure at the suture line was detected. Leak pressure was measured by use of a digital transducer. RESULTS Mean ± SD leak pressure for fresh, cooled, and frozen-thawed segments was 68.3 ± 23.7 mm Hg, 55.3 ± 28.1 mm Hg, and 14.4 ± 14.8 mm Hg, respectively. Overall, there were no significant differences in mean leak pressure among pigs, but a significant difference in mean leak pressure was detected among treatment groups. Mean leak pressure was significantly lower for frozen-thawed segments than for fresh or cooled segments, but mean leak pressure did not differ significantly between fresh and cooled segments. CONCLUSIONS AND CLINICAL RELEVANCE Fresh porcine jejunal segments or segments cooled overnight may be used for determining intestinal leak pressure, but frozen-thawed segments should not be used.

Evaluation of leak pressure and closure time for double-layer esophagotomy closure with an interrupted or a continuous suture pattern

OBJECTIVE To compare the leak pressure and amount of time required to perform closure for 2 double-layer esophagotomy closure techniques. SAMPLE 28 intrathoracic esophageal segments harvested from 38 porcine cadavers. PROCEDURES Longitudinal 3-cm esophagotomy incisions made in porcine cadaveric esophagi were closed with 2 double-layer closure techniques. Fifteen incisions were closed with a simple interrupted pattern, and 13 incisions were closed with a simple continuous pattern. Leak pressure, bursting wall tension, and closure time were compared between suture patterns by use of a t test or Mann-Whitney rank sum test. RESULTS Median leak pressures differed significantly between segments closed with the simple interrupted pattern (16.0 mm Hg; range, 5.4 to 54.9 mm Hg) and the simple continuous pattern (38.7 mm Hg; range, 11.3 to 81.9 mm Hg). Median bursting wall tension differed significantly between the simple interrupted pattern (0.63 × 105 dynes/cm; range, 0.16 × 105 dynes/cm to 2.89 × 105 dynes/cm) and the simple continuous pattern (1.79 × 105 dynes/cm; range, 0.44 × 105 dynes/cm to 4.70 × 105 dynes/cm). Mean ± SD closure time differed significantly between the simple interrupted pattern (19.2 ± 2.0 minutes) and the simple continuous pattern (14.7 ± 1.5 minutes). CONCLUSIONS AND CLINICAL RELEVANCE In the study reported here, double-layer simple continuous closure resulted in a higher median postoperative leak pressure and higher median postoperative bursting wall tension and could be performed more rapidly than the double-layer simple interrupted closure on these porcine cadaveric specimens.