George M. Kazakos

Hypervitaminosis A in the cat: A case report and review of the literature

A case of hypervitaminosis A with secondary entrapment and compression of the left brachial plexus nerve roots is described. A 9-year-old male castrated domestic shorthair, fed a home-made diet based on raw pork liver, was submitted for examination for a left forelimb lameness that evolved to paralysis over a 2-month period. Clinical examination revealed a flaccid paralysis and atrophy of all left forelimb muscles. An ipsilateral Horners syndrome was also noted. Radiological examination of the cervical and thoracic spine showed massive new bone formation at the ventral aspect of the second cervical to sixth thoracic vertebra. The diagnosis of hypervitaminosis A was made, based on the clinical and radiographic findings, as well as the determination of serum vitamin A concentration, which was 630 μg/dl, three times above the upper normal limit for this species. Despite the unfavourable initial prognosis, the cat progressively regained function of the affected limb approximately 6 months after the diet was changed to a commercial canned food.

Ultrasonographic Signs of Intestinal Intussusception Associated With Acute Enteritis or Gastroenteritis in 19 Young Dogs

The ultrasonographic pattern of intestinal intussusception was studied in 19 young dogs with acute enteritis or gastroenteritis. The intussusception was observed to be a target-like mass consisting of a hyperechoic or anechoic center surrounded by multiple hyperechoic and hypoechoic concentric rings in transverse sections. In longitudinal sections, the intussusception appeared as multiple hyperechoic and hypoechoic parallel lines, as a tumor-like or pseudokidney mass, and as a trident-like configuration. Ultrasonography may provide a sensitive, specific, and accurate method of diagnosing intestinal intussusception in young dogs.

Ultrasonographic findings of intestinal intussusception in seven cats

The medical records of seven cats with intestinal intussusception that were diagnosed by abdominal ultrasonography and exploratory laparotomy were reviewed. In transverse ultrasonographic sections the intussusception appeared as a target-like mass consisting of one, two or more hyperechoic and hypoechoic concentric rings surrounding a C-shaped, circular or non-specific shaped hyperechoic centre. Part of the intestine representing the inner intussusceptum, located close to the hyperechoic centre and surrounded by concentric rings, was also detected. In longitudinal sections the intussusception appeared as multiple hyperechoic and hypoechoic parallel lines in four cases and as an ovoid mass in three cases. In one case the ovoid mass had a ‘kidney’ configuration. Additional ultrasonographic findings associated with intestinal intussusception included an intestinal neoplasm in one cat. The results of the present study demonstrate that the ultrasonographic findings of intestinal intussusception in cats bear some similarities to those described in dogs and humans, are relatively consistent, and facilitate a specific diagnosis.

Incisional Block With Bupivacaine for Analgesia After Celiotomy in Dogs

A blind, placebo-controlled clinical trial was performed to evaluate the postoperative analgesic effect of preoperative infiltration of the incision site with bupivacaine in dogs undergoing celiotomy. Sixty dogs were randomly allocated into four groups: preoperative bupivacaine, postoperative bupivacaine, preoperative saline, and postoperative saline. All dogs were premedicated with acepromazine and meperidine; then they were anesthetized with thiopentone and isoflurane. Each group received either bupivacaine or normal saline before midline incision or just before skin closure. After surgery, pain scores were assigned using a numerical rating scale. Preoperative bupivacaine was associated with significantly lower pain scores and a significantly lower need for opioid administration. The authors conclude that a preoperative incisional block with bupivacaine seems to be a useful adjunct for controlling pain after celiotomy in dogs.

Use of the laryngeal mask airway in rabbits : placement and efficacy

The laryngeal mask airway (LMA) has been used in various animal species anesthetized for the purpose of device evaluation, but the device has not been evaluated in rabbits during surgery. The authors tested the feasibility and potential advantages of using the LMA in 50 rabbits undergoing surgery under spontaneous-breathing inhalational anesthesia, focusing mainly on the technique of insertion and its efficacy. The LMA was easily inserted and no air leakage at the larynx was detected. Although four rabbits developed lingual cyanosis, this was reversible and most likely due to lingual vascular compression by the LMA. The authors conclude that the LMA is an attractive alternative to endotracheal intubation, as the mask can be inserted easily and rapidly and its correct placement is easily confirmed.

Presumed localized tetanus in two cats.

In this report two cases of localised tetanus in two young (<1 year) intact male and outdoor DSH cats, which had been missing, are described. Clinical examination revealed severe muscular spasms on the right (case 1) or both thoracic limbs (case 2). In the latter cat, wrinkling of the forehead and mild trismus were also seen. The routine diagnostic workup (CBC, survey radiographs of the spine, CSF analysis) did not reveal any abnormalities in both cats. EMG testing on the affected muscles in the second animal showed persistent spontaneous motor unit potentials, strongly indicating tetanus. The treatment, that was symptomatic (diazepam, metronidazole) and supportive (physical therapy, assist feeding and intravenous fluid therapy) resulted in the progressive improvement of limb rigidity and the restoration of motor dysfunction in a period of 5- (case 1) and 2- (case 2) month duration.

The Lymph Drainage Pattern of the Mammary Glands in the Cat: A Lymphographic and Computerized Tomography Lymphographic Study

Seventy‐three clinically normal, lactating cats were used to investigate the lymph drainage of 73 mammary glands. In 50 cats of the first group, the number of lymphatic vessels emerging from the examined mammary gland, their course and the lymph nodes into which they are drained were studied by indirect lymphography (IL) after intramammary injection of an oily contrast medium. In 23 cats of the second group, the lymph drainage of the mammary glands was studied by computerized tomography indirect lymphography (CT‐IL) after intramammary injection of a water soluble contrast medium. The following day, the lymph drainage of the mammary gland examined by CT‐IL was studied by IL, as it was described in the first group, for comparison purposes. The main conclusions drawn after this study were as follows: lymph drains from the first and second mammary glands with one or rarely two or three lymphatic vessels to the accessory axillary lymph nodes. Lymph drains from the third mammary gland with one or two and rarely three lymphatic vessels usually to the accessory inguinal lymph nodes or to the accessory axillary lymph nodes. In some cases, it drains to both lymph nodes simultaneously or it may rarely drain only to the medial iliac lymph nodes. The fourth mammary gland with one or two and rarely three lymphatic vessels usually drains to the accessory inguinal lymph nodes. It may rarely drain only to the medial iliac lymph nodes. Mammary lymphatic vessels that cross the midline and lymphatic connection between the mammary glands were not demonstrated. No differences in the mammary lymph drainage pattern between IL and CT‐IL were found.

Remifentanil/isoflurane anesthesia in five dogs with liver disease undergoing liver biopsy.

Remifentanil is a synthetic opioid with direct action on μ opioid receptors. It has an ultrashort duration of action, and its elimination is independent of hepatic or renal function. The anesthetic management of five dogs with nonuniform liver disease and requiring liver biopsy via celiotomy is described. Remifentanil and isoflurane were used for induction and maintenance of anesthesia. Intraoperative analgesia was provided by a constant rate infusion of remifentanil. Remifentanil, in combination with isoflurane, was safely and successfully used in five cases for the balanced anesthesia of dogs with hepatic diseases requiring liver biopsy via celiotomy.

Effect of endogenous progesterone and oestradiol‐17β on the incidence of gastro‐oesophageal reflux and on the barrier pressure during general anaesthesia in the female dog

OBJECTIVE To investigate the potential effect of increased blood progesterone (P4) and oestradiol-17β (E2) concentrations on the barrier pressure (BrP) and the incidence of gastro-oesophageal reflux (GOR) in female dogs under general anaesthesia. STUDY DESIGN Prospective, blinded experimental trial. ANIMALS Seven female, adult, healthy dogs weighing 14-21 kg and aged 1-7 years. METHODS Each of the animals was studied under the influence of high blood E2 and basal P4 (study O), basal E2 and high P4 (study P) and basal E2 and P4 (study C) concentrations. Animals were premedicated with acepromazine and anaesthesia was induced with thiopental and maintained with halothane. Lower oesophageal pH was monitored continuously for 1 hour after induction. GOR was defined as oesophageal pH >7.5 or <4. Manometry of the posterior oesophageal sphincter (POS) was then performed using the slow pull-through technique. RESULTS Acid GOR was detected in only one animal of study O. The three studies did not differ significantly in GOR. Mean BrP was 11.2 (study O), 9.1 (study P) and 11.6 mmHg (study C). No significant differences were detected with respect to mean BrP, intra-gastric pressure and POS pressure. CONCLUSIONS It is unlikely that the increased concentrations of E2 or P4 during the normal ovarian cycle influence the functional efficiency of the POS as a major barrier to GOR in healthy, female dogs under general anaesthesia. CLINICAL RELEVANCE The fact that female dogs undergoing obstetrical surgery represented a substantial sub-group of the animals which developed postoperative benign oesophageal stricture, should probably not be attributed to the effects of increased concentrations of female sex steroid hormones.OBJECTIVE To investigate the potential effect of increased blood progesterone (P(4)) and oestradiol-17beta (E(2)) concentrations on the barrier pressure (BrP) and the incidence of gastro-oesophageal reflux (GOR) in female dogs under general anaesthesia. STUDY DESIGN Prospective, blinded experimental trial. ANIMALS Seven female, adult, healthy dogs weighing 14-21 kg and aged 1-7 years. METHODS Each of the animals was studied under the influence of high blood E(2) and basal P(4) (study O), basal E(2) and high P(4) (study P) and basal E(2) and P(4) (study C) concentrations. Animals were premedicated with acepromazine and anaesthesia was induced with thiopental and maintained with halothane. Lower oesophageal pH was monitored continuously for 1 hour after induction. GOR was defined as oesophageal pH >7.5 or <4. Manometry of the posterior oesophageal sphincter (POS) was then performed using the slow pull-through technique. RESULTS Acid GOR was detected in only one animal of study O. The three studies did not differ significantly in GOR. Mean BrP was 11.2 (study O), 9.1 (study P) and 11.6 mmHg (study C). No significant differences were detected with respect to mean BrP, intra-gastric pressure and POS pressure. CONCLUSIONS It is unlikely that the increased concentrations of E(2) or P(4) during the normal ovarian cycle influence the functional efficiency of the POS as a major barrier to GOR in healthy, female dogs under general anaesthesia. CLINICAL RELEVANCE The fact that female dogs undergoing obstetrical surgery represented a substantial sub-group of the animals which developed postoperative benign oesophageal stricture, should probably not be attributed to the effects of increased concentrations of female sex steroid hormones.

Effect of locally injected autologous platelet-rich plasma on second intention wound healing of acute full-thickness skin defects in dogs

OBJECTIVES Second intention wound healing may be impaired by wound and host factors and thus more advanced therapies are required for a fast and satisfactory outcome. Platelet-rich plasma (PRP), rich in growth factors and cytokines essential for tissue repair, could improve wound healing. The purpose of this experimental study was to evaluate the effect of locally injected autologous PRP on second intention healing of acute full-thickness skin defects in dogs. METHODS Three 2 x 2 cm full-thickness skin defects were created bilaterally on the dorsolateral area of the trunk of six Beagle dogs. The wounds of one randomly selected side received PRP treatment, whereas the contralateral wounds were left untreated (controls). Wound healing was evaluated by planimetry, laser-Doppler flowmetry measurements of tissue perfusion, and histologically. RESULTS The rate of wound healing did not differ significantly between the two groups. Tissue perfusion was significantly higher in the PRP-treated group (p = 0.008) compared to controls on day 10. Histological evaluation revealed a trend towards greater collagen production and a significantly better collagen orientation (p = 0.019) in PRP-treated wounds on day 20. CLINICAL SIGNIFICANCE Locally injected autologous PRP does not accelerate the healing process, but increases tissue perfusion and may promote the formation of organized collagen bundles in acute full-thickness skin defects in dogs.