Stéphane Bureau

Effects of urinary bladder retroflexion and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia: 41 cases (2002–2009)

OBJECTIVE To evaluate the effects of urinary bladder retroflexion (UBR) and surgical technique on postoperative complication rates and long-term outcome in dogs with perineal hernia. DESIGN Retrospective case series. ANIMALS 41 client-owned dogs with perineal hernia that underwent surgery between November 2002 and November 2009. PROCEDURES Medical records were reviewed for information on dog signalment, history, physical examination findings, ultrasonographic findings, surgical techniques, intraoperative complications, duration of hospital stay, postoperative complications, and long-term outcome. RESULTS 31 dogs had no UBR, and 10 dogs had UBR. Internal obturator muscle transposition (IOMT) was performed in 20 dogs, and a cystopexy or colopexy was performed before the IOMT (LapIOMT) in 21. Postoperative complications included tenesmus (n = 8) and urinary incontinence (1). Rates of postoperative complications were not significantly different between the no-UBR and UBR groups or between the IOMT and LapIOMT groups. Thirty-two dogs were free of clinical signs at the time of the study. The median disease-free interval did not differ significantly between dogs in the no-UBR and UBR groups, but it was significantly lower in the LapIOMT group than in the IOMT group. None of the 7 dogs with UBR that were treated without cystopexy developed recurrence of UBR. CONCLUSIONS AND CLINICAL RELEVANCE UBR was not associated with an increased rate of postoperative complications relative to no UBR and had no effect on the long-term outcome in dogs with perineal hernia. The use of IOMT alone may be recommended for clinical use because LapIOMT offered no clear advantage.

Effects of Bilateral Arytenoid Cartilage Stenting on Canine Laryngeal Resistance Ex Vivo

OBJECTIVE To evaluate the effect of Nitinol stents for bilateral arytenoid lateralization on canine laryngeal resistance. STUDY DESIGN Ex vivo experimental study. ANIMALS Canine cadaver larynges (n=7). METHODS Laryngeal resistance was calculated in all specimens with the epiglottis in open and closed positions. Bilateral arytenoid stenting was performed, rima glottidis width measured, and laryngeal resistance calculated. The effects of stenting on laryngeal resistance were evaluated by repeated measures ANOVA. RESULTS Calculated laryngeal resistance in the 3 stented groups, 2 cm (0.034±0.059 cmH(2) O/L/s), 3 cm (0.034±0.059 cmH(2) O/L/s), and 4 cm (0.034±0.059 cm H(2) O/L/s), was significantly decreased versus the control (unstented) group (0.947±0.624 cmH(2) O/L/s; P=.0098) with an epiglottis in the normal position. Calculated laryngeal resistance in the 3 stented groups, 2 cm (43.407±17.348 cm H(2) O/L/s), 3 cm (70.659±34.705 cmH(2) O/L/s), and 4 cm (92.637±44.509 cm H(2) O/L/s), was significantly increased versus the control (unstented) group (29.561±14.499 cm H(2) O/L/s) (P=.0185) with an epiglottis in the closed position. The width of the rima glottidis correlated with the size of the stent (r=0.95, P<.001). CONCLUSIONS Bilateral arytenoid stenting significantly reduced calculated laryngeal resistance with an open epiglottis. Stenting resulted in a significant increase in laryngeal resistance versus the control with a closed epiglottis. Use of bilateral arytenoid stenting in clinical cases of laryngeal paralysis may provide an adequate decrease in open-epiglottis airway resistance to alleviate clinical signs, while increasing closed-epiglottis airway resistance. This could potentially lead to a decrease in the risk of postoperative aspiration pneumonia.