Jon L. Hall

Prevalence and antimicrobial resistance of canine urinary tract pathogens

This study aims to describe the incidence and risk factors for positive urinary tract culture, the prevalence of urinary tract pathogens in single organism and mixed cultures and changes in their antimicrobial resistance over 10 years. A retrospective review of computer records detailing canine urine samples submitted between August 1999 and September 2009 for culture and sensitivity in a UK tertiary referral hospital is described. 17.5 per cent of 5923 samples (670 of 4530 dogs) were positive cultures. 85.3 per cent of cultures yielded a single isolate. The prevalence of bacterial species differed between mixed and single isolate cultures. Entire and neutered female dogs were more likely to return positive cultures than male dogs (OR=2.5 and 1.5, respectively). Escherichia coli was most commonly isolated (53.9 per cent) and affected female dogs, older dogs and neutered dogs more. There was an increase in the antimicrobial resistance of Enterococcus faecalis and Pseudomonas Aeruginosa, and a decrease in the effectiveness of enrofloxacin, cephalexin and oxytetracycline. The prevalence of urinary bacterial isolates is described for a large group of dogs. Monitoring changes in antimicrobial efficacy and microbial resistance guides the empirical use of antimicrobials for the treatment of urinary tract infection and helps formulate strategic plans to limit drug resistance.

Femoral fracture repair and sciatic and femoral nerve blocks in a guinea pig

A four-month-old, entire male guinea pig was presented for surgical repair of a closed oblique femoral fracture. Analgesia was provided with 30 µg/kg buprenorphine intramuscularly (im) four times a day and 0 · 3 mg/kg meloxicam subcutaneously once a day. The following day, anaesthesia was induced and maintained with 100 µg/kg medetomidine im, 20 mg/kg ketamine im, 30 µg/kg buprenorphine im and isoflurane in oxygen. Femoral and sciatic nerve blocks were performed with bupivacaine. The fracture was reduced and aligned using an intramedullary 1 · 4 mm K-wire and a 3 metric polydioxanone cerclage. Three weeks postoperatively remodelling and callus formation was documented, with no evidence of complications. Complete union was present 14 weeks postoperatively.

Canine Intrahepatic Vasculature: Is a Functional Anatomic Model Relevant to the Dog?

Objective To clarify canine intrahepatic portal and hepatic venous system anatomy using corrosion casting and advanced imaging and to devise a novel functional anatomic model of the canine liver to investigate whether this could help guide the planning and surgical procedure of partial hepatic lobectomy and interventional radiological procedures. Study Design Prospective experimental study. Animals Adult Greyhound cadavers (n = 8). Methods Portal and hepatic vein corrosion casts of healthy livers were assessed using computed tomography (CT). Results The hepatic lobes have a consistent hilar hepatic and portal vein supply with some variation in the number of intrahepatic branches. For all specimens, 3 surgically resectable areas were identified in the left lateral lobe and 2 surgically resectable areas were identified in the right medial lobe as defined by a functional anatomic model. Conclusions CT of detailed acrylic casts allowed complex intrahepatic vascular relationships to be investigated and compared with previous studies. Improving understanding of the intrahepatic vascular supply facilitates interpretation of advanced images in clinical patients, the planning and performance of surgical procedures, and may facilitate interventional vascular procedures, such as intravenous embolization of portosystemic shunts. Functional division of the canine liver similar to human models is possible. The left lateral and right medial lobes can be consistently divided into surgically resectable functional areas and partial lobectomies can be performed following a functional model; further study in clinically affected animals would be required to investigate the relevance of this functional model in the dog.OBJECTIVE To clarify canine intrahepatic portal and hepatic venous system anatomy using corrosion casting and advanced imaging and to devise a novel functional anatomic model of the canine liver to investigate whether this could help guide the planning and surgical procedure of partial hepatic lobectomy and interventional radiological procedures. STUDY DESIGN Prospective experimental study. ANIMALS Adult Greyhound cadavers (n = 8). METHODS Portal and hepatic vein corrosion casts of healthy livers were assessed using computed tomography (CT). RESULTS The hepatic lobes have a consistent hilar hepatic and portal vein supply with some variation in the number of intrahepatic branches. For all specimens, 3 surgically resectable areas were identified in the left lateral lobe and 2 surgically resectable areas were identified in the right medial lobe as defined by a functional anatomic model. CONCLUSIONS CT of detailed acrylic casts allowed complex intrahepatic vascular relationships to be investigated and compared with previous studies. Improving understanding of the intrahepatic vascular supply facilitates interpretation of advanced images in clinical patients, the planning and performance of surgical procedures, and may facilitate interventional vascular procedures, such as intravenous embolization of portosystemic shunts. Functional division of the canine liver similar to human models is possible. The left lateral and right medial lobes can be consistently divided into surgically resectable functional areas and partial lobectomies can be performed following a functional model; further study in clinically affected animals would be required to investigate the relevance of this functional model in the dog.

Radial Artery Pseudoaneurysm in a Maine Coon Cat

OBJECTIVE To report the diagnosis and treatment of a radial artery pseudoaneurysm in a cat. STUDY DESIGN Clinical report. ANIMAL Maine Coon cat (8-year-old neutered male). METHODS Ultrasonographic and angiographic examination of a fluctuant, nonpainful, 3 cm × 1.5 cm subcutaneous swelling on the craniomedial distal aspect of the right radius that occurred 40 days after suspected cat bite trauma was consistent with a radial artery pseudoaneurysm. After ligation of the radial artery proximal to the lesion, the pseudoaneurysm was surgically excised. RESULTS The excised tissue had hemorrhage and fibrin surrounded by a thick fibrous granulating capsule of variably mature fibroblasts and focal areas of inflammatory cells (lymphocytes, plasma cells, and macrophages) consistent with a pseudoaneurysm. Surgical excision resulted in resolution of clinical signs. CONCLUSIONS Ultrasonography enabled prompt, noninvasive diagnosis of pseudoaneurysm. Angiography or computed tomography may be useful to aid diagnosis and assess the collateral blood supply to the manus before surgical treatment.

Urinary incontinence in bitches under primary veterinary care in England:: prevalence and risk factors

OBJECTIVES To estimate prevalence and demographic risk factors for urinary incontinence in bitches under primary veterinary care in England. METHODS The study population included all bitches within the VetCompass database from September 1, 2009 to July 7, 2013. Electronic patient records were searched for urinary incontinence cases and additional demographic and clinical information was extracted. RESULTS Of 100,397 bitches attending 119 clinics in England, an estimated 3108 were diagnosed with urinary incontinence. The prevalence of urinary incontinence was 3·14% (95% confidence intervals: 2·97 to 3·33). Medical therapy was prescribed to 45·6% cases. Predisposed breeds included the Irish setter (odds ratio: 8·09; 95% confidence intervals: 3·15 to 20·80; P< 0·001) and Dobermann (odds ratio: 7·98; 95% confidence intervals: 4·38 to 14·54; P< 0·001). Increased odds of a diagnosis of urinary incontinence were associated with: (1) weight at or above the mean adult bodyweight for the breed (odds ratio: 1·31; 95% confidence intervals: 1·12 to 1·54; P< 0·001), (2) age 9 to 12 years (odds ratio: 3·86; 95% confidence intervals: 2·86 to 5·20, P< 0·001), (3) neuter status (odds ratio: 2·23; 95% confidence intervals: 1·52 to 3·25, P< 0·001) and (4) being insured (odds ratio: 1·59; 95% confidence intervals: 1·34 to 1·88, P< 0·001). CLINICAL IMPACT Clinical Impact: Urinary incontinence affects just over 3% of bitches overall but affects more than 15% of bitches in high-risk breeds including the Irish setter, Dobermann, bearded collie, rough collie and Dalmatian. These results provide an evidence base for clinicians to enhance clinical recommendations on neutering and weight control, especially in high-risk breeds.

Emergency diagnosis and treatment of congenital lobar emphysema in a puppy

Congenital lobar emphysema is a rare condition in dogs. A three-month-old pug presented with acute dyspnoea and radiographic findings diagnosed congenital lobar emphysema. Due to the patient’s rapidly deteriorating ventilation, an emergency right middle lung lobectomy was performed and recovery was uneventful. This case report describes the importance of making a prompt and accurate diagnosis of this condition, based on radiographic findings, to facilitate immediate treatment.

Primary ureteral urothelial (transitional cell) carcinoma in a boxer dog

An eight-year-old male entire boxer dog was presented by the owner with a four-week history of haematuria. Abdominal ultrasound identified a moderately dilated left ureter from immediately distal to the renal pelvis to a focal stenosis at the level of L5. Intravenous urography showed a diffusely tortuous proximal left ureter with irregular contrast borders and focal stenosis distally. Left ureteronephrectomy was performed and histology of the left ureter revealed a primary ureteral urothelial (transitional cell) carcinoma infiltrating the ureteral wall. This is the first imaging description of a primary ureteral urothelial carcinoma and only the second description of a primary ureteral urothelial carcinoma in veterinary literature.

Novel application of internal obturator and semitendinosus muscle flaps for rectal wall repair or reinforcement

Internal obturator and/or semitendinosus muscle flaps were used to reinforce primary appositional rectal wall repair in three dogs and one cat in this case series. All three dogs incurred rectal wall compromise during surgical excision of anal sac tumours. The cat sustained bite wounds to the perianal region resulting in abscessation and a rectal tear. Our results indicate that application of an internal obturator and/or semitendinosus muscle flap can reduce the risk of rectal wall dehiscence after primary repair, and consequently the risk of pararectal abscess or rectocutaneous fistula formation.

The mechanical properties of six finger trap suture techniques

OBJECTIVE To identify the most common methods used by surgeons to place finger-trap sutures (FTS), and determine their influence on the biomechanical properties of constructs. STUDY DESIGN Questionnaire and experimental study. METHODS Six commonly used FTS methods (A-F) were identified from literature review and questionnaire. Constructs made with 3-metric nylon suture and 18-French polyurethane esophagostomy tubing were tested in axial loading to failure. Two patterns (B and D) selected based on common use and biomechanical performance were further tested, with 2, 4, and 8 repeats along the tube. Displacement, load, and energy at failure were compared between constructs, and failure mode was video recorded. RESULTS Patterns E and F were susceptible to slipping (P < .001). Patterns A and D were stiffer than pattern E, and patterns A-D were stiffer than pattern F (P = .012). Patterns A and B had less extension than pattern E and F, and patterns A-D had less extension than pattern F (P = .002). 87.5% of FTS failed by breaking at the first suture knot. The number of repeats had no effect on FTS performance, but catastrophic failure occurred in 2 constructs with 2 repeats. CONCLUSION The mechanical behavior of suture-tube constructs and failure mode is affected by the FTS pattern. Patterns E and F are not advocated due to suture slippage. The number of repeats may not affect the FTS performance, but a minimum of 4 repeats is recommended. Overall, patterns B, C, and D performed the best in axial loading.

Mechanical properties of 6 finger-trap suture techniques*

OBJECTIVE To identify the most common methods used by surgeons to place finger-trap sutures (FTS), and determine their influence on the biomechanical properties of constructs. STUDY DESIGN Questionnaire and experimental study. METHODS Six commonly used FTS methods (A-F) were identified from literature review and questionnaire. Constructs made with 3-metric nylon suture and 18-French polyurethane esophagostomy tubing were tested in axial loading to failure. Two patterns (B and D) selected based on common use and biomechanical performance were further tested, with 2, 4, and 8 repeats along the tube. Displacement, load, and energy at failure were compared between constructs, and failure mode was video recorded. RESULTS Patterns E and F were susceptible to slipping (P < .001). Patterns A and D were stiffer than pattern E, and patterns A-D were stiffer than pattern F (P = .012). Patterns A and B had less extension than pattern E and F, and patterns A-D had less extension than pattern F (P = .002). 87.5% of FTS failed by breaking at the first suture knot. The number of repeats had no effect on FTS performance, but catastrophic failure occurred in 2 constructs with 2 repeats. CONCLUSION The mechanical behavior of suture-tube constructs and failure mode is affected by the FTS pattern. Patterns E and F are not advocated due to suture slippage. The number of repeats may not affect the FTS performance, but a minimum of 4 repeats is recommended. Overall, patterns B, C, and D performed the best in axial loading.