Laura Owen

Vacuum-assisted wound closure following urine-induced skin and thigh muscle necrosis in a cat

Vacuum-assisted closure (VAC) is a relatively new technique for wound management in dogs and cats. It was successfully used in this cat to treat severe urine-induced skin and thigh muscle necrosis, resulting from a traumatic urethral rupture. No complications were encountered with application of the VAC technique and production of a healthy granulation bed, suitable for wound reconstruction, was achieved after only five days of VAC treatment. The marked wound contraction (40.3%) obtained after eight days of treatment, was sufficient to allow closure of the defect using a simple, rotational subdermal plexus flap. This was a safe, effective and efficient treatment for a challenging wound in a difficult anatomical location.

A retrospective study of surgically treated cases of septic peritonitis in the cat (2000–2007)

OBJECTIVES To review aetiology, clinical signs and outcome of cats surgically treated for septic peritonitis (2000-2007). METHODS A retrospective study. Inclusion criteria were the identification of intracellular bacteria and degenerate neutrophils and/or a positive culture from abdominal fluid and exploratory coeliotomy. Aetiology, clinical signs, haematological and biochemical parameters, surgical treatment and outcome were recorded and analysed. RESULTS Twenty-six cats fulfilled the inclusion criteria. Abdominal pain was reported in 10 (38 per cent) and vomiting was reported in 11 (42 per cent) of the cats. The most common aetiology was trauma (31 per cent). The principal source of contamination was the gastrointestinal tract. Hyperlactataemia, hypoproteinaemia and hyperglycaemia were reported in 9, 13 and 14 of the 26 cases, respectively. Non-survivors had significantly higher blood lactate concentrations than survivors (P=0.02). Nineteen cats were managed with primary closure, two with closed suction drains and three with open peritoneal drainage. Twelve (46 per cent) cats survived to discharge. CLINICAL SIGNIFICANCE In cats, lethargy, depression and anorexia were more common clinical signs than abdominal pain. Lactate level at the time of diagnosis may be a useful prognostic indicator in cats. The proportion of cats that survived was lower than previously reported and owners should be given a guarded prognosis.

Efficacy of Adhesive Incise Drapes in Preventing Bacterial Contamination of Clean Canine Surgical Wounds

OBJECTIVE To investigate the efficacy of adhesive incise drapes in reducing bacterial contamination of clean canine surgical wounds. STUDY DESIGN Randomized clinical trial. ANIMALS Dogs (n=100) having elective ovariohysterectomy or stifle surgery. METHODS Dogs were randomly assigned to 1 of 2 groups: drape or no drape. Swabs obtained from the inner edge of the surgical wound at the beginning (swab 1) and end (swab 2) of surgery were submitted for microbial culture. Number of colony forming units was counted for all positive cultures and change in bacterial counts between swabs 1 and 2 was calculated. Percentage adhesive drape adherence at the end of surgery was calculated from a digital photograph of the surgical site. duration of surgery/anesthesia and the anesthetic induction agent used were recorded. RESULTS There was a significant increase in bacterial counts between swabs 1 and 2 (P=.001). Wound contamination was 14% (6 drape; 8 no drape; P=0.78) with Staphylococcus spp. most commonly isolated. Median percentage drape adherence at the end of surgery was 89.3% (0-100%). Duration of anesthesia was significantly related to wound contamination (P=.013), but duration of surgery and anesthesia induction agent were not. CONCLUSIONS Adhesive incise drapes did not reduce wound contamination of clean canine surgical wounds. CLINICAL RELEVANCE Use of adhesive incise drapes in clean surgical procedures is of questionable benefit in dogs.

Unilateral hydronephrosis and hydroureter secondary to ureteric atresia, and uterus unicornis in a young terrier.

A nine-month-old entire female terrier cross was presented with intermittent anorexia, vomiting and recent onset of abdominal pain and distension. A diagnosis of unilateral hydronephrosis was made following ultrasound examination and intravenous urography, but no cause was identified. Subsequent ureteronephrectomy and histology of the affected kidney showed ureteric atresia as the cause of obstruction. Uterus unicornis was also identified and ovariohysterectomy was performed. The combination of structural abnormalities can be explained by an in-utero developmental error of their common embryological precursor, the mesonephric duct.

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.

Evaluation of an Axial Pattern Flap Based on the Cranial Cutaneous Branch of the Saphenous Artery: A Cadaveric Perfusion Study.

OBJECTIVES To confirm the anatomic location of the cranial cutaneous branch of the saphenous artery (CCSA), delineate the angiosome of the CCSA, and provide guidelines for clinical use of an axial pattern flap based on the CCSA. STUDY DESIGN Anatomic study. ANIMALS Greyhound cadavers (n=10). METHODS Shortly after euthanasia, the CCSA was identified and isolated in each hindlimb. Methylene blue and radiographic perfusion studies were performed. The skin was freed from the thigh for photographic and radiographic images. The dimensions of the skin area suitable for use as an axial pattern flap were related to anatomical landmarks. Mock surgical elevation and transposition of the flap in 2 dogs allowed assessment of flap mobility and ease of donor site closure for clinical use. RESULTS The CCSA was reliably identified in all dogs branching from the saphenous artery as it became superficial to the sartorius muscle, immediately distal to the caudal cutaneous branch and proximal to the genicular branches. Genicular branches were variably paired or singular. Perfusion studies defined the CCSA angiosome as the area cranial to the saphenous artery and caudal to the cranial border of the thigh, extending proximally from the level of the medial tibial condyle to two-thirds of the distance to the inguinal ring. CONCLUSION An axial pattern flap based on the CCSA could be expected to cover skin defects of the cranial aspect of the distal thigh and stifle, the popliteal region caudal to the stifle, and the proximal medial crus.

Idiopathic sterile pyogranuloma in three domestic cats: Idiopathic sterile pyogranuloma in cats

Pyogranulomatous inflammation has been extensively described in cats, in particular in cases of feline infectious peritonitis and also associated with Mycobacteria, Actinomyces, Nocardia, Rhodococcus and fungal infections. Idiopathic sterile pyogranulomatous dermatitis has also been described. In this case series we describe the clinical presentation, histopathology and outcome of three cases of feline idiopathic sterile steroid‐responsive pyogranuloma with different presentation and different locations of the lesion, but with the common feature of having a mass with no superficial skin involvement.

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.

Urinary incontinence in dogs

COLPOSUSPENSION surgery has been the mainstay of surgical treatment of urethral sphincter mechanism incompetence (USMI) in dogs since the 1980s and the success of this procedure is reported as 56 per cent complete continence, 34 per cent improved continence, 10 per cent no improvement (Holt 1990). Artificial urethral sphincters were developed for the veterinary market …