Ivan Doran

Thoracoscopic resection of right auricular masses in dogs: 9 cases (2003–2011)

OBJECTIVE To determine the feasibility of thoracoscopic resection of masses located on the right auricle in dogs. DESIGN Retrospective case series. ANIMALS Dogs (n = 9) with a mass on the right auricle. PROCEDURES Hospital records from 2003 to 2011 were reviewed. Only dogs that underwent thoracoscopic resection of a mass on the right auricle were selected. Data collected included history, clinicopathologic findings, surgical technique, and outcome. RESULTS All dogs with pericardial effusion were examined by means of echocardiography. Cardiac masses on the right auricle were identified in 5 dogs. Eight dogs had clinical signs of cardiac tamponade and right-sided heart failure. All dogs underwent thoracoscopic resection of a mass on the right atrium. Eight hemangiosarcomas and 1 pyogranulomatous lesion were resected. One dog with a mass located at the base of the right auricle died during surgery. No postoperative complications were noted. CONCLUSIONS AND CLINICAL RELEVANCE Right auricular masses were successfully removed in 8 dogs. Masses close to the base of the right atrial appendage may not be amenable to resection with thoracoscopy. Resection of small masses at the tip of the right auricular appendage can be performed thoracoscopically.

Extensive Bilateral Odontogenic Cysts in the Mandible of a Dog

A 5-year-old female neutered Boxer dog was diagnosed with extensive odontogenic cysts that affected the left and right mandibles. Rostral mandibular swelling was detectable clinically, and bilateral cystic mandibular lesions were identified radiographically. The dogs owners elected for euthanasia. A full postmortem was performed. Cystic cavities were confirmed in the body of each mandible, extending from the incisor teeth to the mid premolar region. Incisor, canine, and premolar tooth roots indented each cavity. Histologic examination of the cystic cavities reflected an inner lining of attenuated stratified squamous epithelium overlying a fibrous layer infiltrated by a mixed, predominantly mononuclear, inflammatory infiltrate.

Extraction of urethral calculi by transabdominal cystoscopy and urethroscopy in nine dogs

OBJECTIVES To describe a minimally invasive technique for treating urethral obstructions in male dogs and to review the postoperative results. METHODS All dogs (n=9) had urethral obstruction due to calculi. Obstructions were verified by radiographic and ultrasonographic examinations. Dogs with impaired kidney function were not included in the study. A 5-mm diameter trocar and cannula were placed in the ventral midline, 2 cm cranial to the umbilicus, allowing placement of a 10-mm diameter cannula under visual guidance, adjacent to the apex of the bladder. The bladder was then partially exteriorised and sutured to the skin. A 5-mm diameter cystoscopy sheath was introduced into the bladder lumen and advanced into the urethra. Continuous retrograde flushing was used to dislodge the calculi from the site of obstruction and collect them upstream. RESULTS The nine dogs were followed up for a minimum of 6 months. No major postoperative complications were identified. One dog exhibited transient macroscopic haematuria (for 3 weeks postoperatively). All urethral calculi were removed in the nine dogs. No recurrence was found during the follow-up period. CLINICAL SIGNIFICANCE A minimally invasive approach is used to treat urethral obstructions resulting from calculi in the male dogs.

Successful surgical treatment of a suspected iatrogenic arytenoid cartilage fracture in a dog.

A 3-year-old, intact female golden retriever was presented with a sudden onset of inspiratory obstructive dyspnea following general anesthesia to perform a mastectomy. The cuneiform process of the left arytenoid cartilage was found to be extremely mobile on laryngeal examination. Fracture of the cuneiform process of the left arytenoid cartilage was diagnosed. A combined cricoarytenoid and thyroarytenoid caudolateralization procedure was performed on the left side, and no further dyspnea was observed during a follow-up period of 7 months. Fracture of the cuneiform process of the arytenoid cartilage has not been previously reported in dogs. The condition may respond favorably to cricoarytenoid and thyroarytenoid caudolateralization surgery.

Electrosurgery reduces blood loss and immediate postoperative inflammation compared to cold instruments for midline celiotomy in dogs: A randomized controlled trial

Objectives: To compare the use of an electrosurgical device with traditional cold instruments (scalpel and scissors) for midline celiotomy incision. Study design: Prospective randomized controlled clinical trial. Sample population: One hundred and twenty client‐owned dogs undergoing abdominal surgery. Methods: Dogs were prospectively recruited and randomized to receive electroincision or cold instrument incision. For cold incision, surgeons used basic surgical instruments including scalpel and scissors. For electroincision, surgeons only used the electrosurgical device in cutting mode. Time for the approach, blood loss, and the incision length were recorded. A blinded observer assessed pain and incision redness, swelling, and discharge at 24 and 48 hours postoperative (graded 0‐3). Owner assessment of incision healing was recorded by telephone interview. Results: Blood loss during surgery was significantly lower for electroincision (mean 0.7, SD 1.7 mL) than cold incision (mean 3.0, SD 4.3 mL, P < .0001) with no significant difference in incision length or time for approach. Electroincision was associated with significantly less incision redness (cold median 1, range 0‐3; electroincision median 0, range 0‐2, P = .02) and less incision discharge (cold median 0.5 range 0‐3; electroincision median 0, range 0‐1, P = .006) at 24 hours postoperative. There was no significant difference in pain scores or incision healing in dogs receiving the two techniques. No incisional hernias were reported. A surgical site infection occurred in 1 dog (cold incision). Conclusions: Electroincision for a celiotomy approach in the dog reduces blood loss, and incision redness and discharge in the immediate postoperative period without affecting the occurrence of wound complications such as infection and dehiscence (including linea alba).

Tensile Comparison of Polydioxanone, Polyglyconate, and Barbed Glycolide-Trimethylene Carbonate Suture in Canine Cadaveric Tensor Fascia Lata

OBJECTIVE To compare the mode of failure, load at yield, ultimate load to failure and stiffness of non-barbed polydioxanone, non-barbed polyglyconate and barbed glycolide-trimethylene carbonate (GTC) suture in canine cadaveric fascia. STUDY DESIGN Ex vivo biomechanical study. SAMPLE POPULATION 18 fascia lata specimens from 9 canine cadavers. METHODS 6 fascia lata specimens were sutured with polydioxanone, 6 with polyglyconate, and 6 with barbed GTC suture. Load at yield, stiffness, ultimate load to failure were measured using tensile strength testing. Statistical analysis was used to compare outcomes between suture materials. The mode of failure was recorded and described. RESULTS The load at yield and ultimate load to failure were significantly greater for polydioxanone than barbed GTC (P=.045 and P=.016, respectively). The load at yield and ultimate load to failure was not significantly different between polydioxanone and polyglyconate (P=.687 and P=.586, respectively). The load at yield and the ultimate load to failure was not significantly different between polyglyconate and barbed GTC (P=.194 and P=.109, respectively). Stiffness was not different between constructs (P=.103). Polydioxanone and polyglyconate failed by suture breakage and suture pullout. Barbed GTC failed by suture slippage and suture breakage. CONCLUSION Our results showed that under the conditions of this study, 4-0 monofilament polydioxanone had a greater load at yield and load to failure than similarly sized, barbed copolymer suture in the fascia lata. This finding may help direct suture choice for fascial closure.

Polypoid cystitis in a male entire springer spaniel puppy

A 14-week-old entire male springer spaniel was presented for haematuria. Investigations identified polypoid cystitis. Medical management failed to improve the clinical signs, and the dog underwent surgical excision of the bladder polyps at eight months old. Histopathological examination of the polyps identified granulomatous foci containing crystalline material. Eighteen months after surgery, the dog has had no further episode of haematuria and repeat ultrasound-documented resolution of the lesions. This is the youngest reported case of polypoid cystitis in dogs and the first report of this lesion associated with crystal inclusions within the polyps.

Long-term outcome of female dogs treated with static hydraulic urethral sphincter for urethral sphincter mechanism incompetence

The purpose of the study was to report the postoperative outcome, complications, and long-term follow-up of the use of a static hydraulic urethral sphincter for the management of urethral sphincter mechanism incompetence in female dogs. Medical records were reviewed to extract information on long-term (>365 days) outcome data. Telephone owner questionnaire was performed to assess postoperative urinary continence scores (scale 1-10, where 10 is complete continence) and the presence and frequency of complications. Twenty female dogs were included. Mean (±standard deviation) time to follow-up was 1,205.1 (±627.4) days. Median continence score/10 (range) was 3.5 (2-6) preoperatively, and 9.0 (7-10) at the last follow-up. Median continence score was significantly higher at all time points postoperatively compared with before surgery (P < .001). Complete continence was achieved in 90% of bitches. Minor complications occurred in 13 bitches and included dysuria (8), bacterial cystitis (8), longer urination time (10), incisional seroma (5), urinary retention (3), hematuria (2), and pain when urinating (2). Major complications occurred in one dog (static hydraulic urethral sphincter removed 28 mo after placement). Continence scores were sustainably improved in the long-term. Complications were mostly minor. Urinary tract infections were the most common but resolved with conventional antibiotic treatment.

The incidence of surgical site dehiscence following full thickness gastrointestinal biopsy in dogs and cats and associated risk factors

OBJECTIVES The objectives of this study were to: (1) document the incidence of surgical site dehiscence after full-thickness gastrointestinal biopsy in dogs and cats and (2) identify potential risk factors. METHODS Data relating to dogs and cats undergoing full-thickness gastrointestinal biopsy were reviewed retrospectively following submission of a completed questionnaire by 12 referral institutions. Outcome measures were definite dehiscence, possible dehiscence (clinical records suggestive of dehiscence but not confirmed), suspected dehiscence (definite and possible combined) and death within 14 days. Logistic regression was planned for analysis of association of dehiscence with low preoperative serum albumin, biopsy through neoplastic tissue, biopsy alongside another major abdominal surgical procedure and biopsy of the colon. RESULTS Of 172 cats, two (1·2%) had definite dehiscence, and four (2·3%) had possible dehiscence. Low preoperative serum albumin was significantly associated with definite dehiscence in univariable analysis and with suspected dehiscence and death within 14 days in univariable analysis, but all odds ratios had wide 95% confidence intervals. A histopathological diagnosis of neoplasia was significantly associated with death within 14 days in univariable analysis. Of 195 dogs, two (1·0%) had definite dehiscence, and three (1·5%) had possible dehiscence. In dogs, there was no association between any outcome measure and the putative risk factors. CLINICAL SIGNIFICANCE Incidence of dehiscence following full-thickness gastrointestinal biopsy was low in this study. When determining the appropriateness of biopsy in individual cases, this information should be balanced against the potentially life-threatening consequences of dehiscence.

Surgical resolution of an oesophageal duplication cyst causing regurgitation in a domestic shorthair cat

Case summary An 18-month-old female domestic shorthair cat was referred for investigation of a 6 month period of regurgitation. Contrast radiography indicated an intramural oesophageal structure. Ultrasound-guided fine-needle aspiration of the area retrieved viscous fluid containing high numbers of squamous epithelial cells. Computed tomography disclosed a thin-walled contrast-enhancing structure containing non-enhancing homogenous contents. Exploratory thoracotomy confirmed an intramural cystic oesophageal structure, which was resected. Histopathological analysis of the resected tissue demonstrated an intramural oesophageal duplication cyst. A 12 month follow-up period has seen complete resolution of the cat’s clinical signs. Relevance and novel information This is the first report of successful oesophageal duplication cyst removal in a cat. Oesophageal duplication cysts should be included on the differential list for dysphagia and regurgitation in cats. Complete surgical removal in this cat carried a good long-term outcome.