Postoperative injectable opioid use and incidence of surgical site complications after use of liposomal bupivacaine in canine gastrointestinal foreign body surgery

OBJECTIVE

To compare postoperative analgesic use and postoperative complications between dogs that received liposomal bupivacaine (LB) during surgical gastrointestinal foreign body (GIFB) removal and those that did not.

STUDY DESIGN

Retrospective study.

ANIMALS

Two hundred five dogs.

METHODS

Medical records for all dogs with GIFB removal at the Purdue University Veterinary Hospital between May 2017 and August 2021 were searched. Incomplete records and dogs with less than 2 weeks' veterinary follow up were excluded. Data collected included: patient information, time until surgery, intraoperative findings, surgical data (including perforation at time of surgery, linear vs. solid, enterotomy vs. enterectomy), use of LB (including time and manner of administration), time to extubation after surgery, in-hospital postoperative analgesic use and duration, and postoperative complications. Fentanyl was noted as used/not used, quantified as mean hourly rate over 12 h intervals. All analyses were performed using commercial statistical software with p < .05 as the significance level.

RESULTS

Dogs that received LB were heavier (n = 65, median 28.5 kg) than those that did not (n = 140, median 24.4 kg) (p = .005). Postoperative fentanyl use (p < .05 between 13 and 72 h) and hourly rates (p < .05 between 13 and 48 h) were less, and postoperative time in the intensive care unit (ICU) (p < .001) and hospital were shorter (p < .001) in dogs receiving LB. Postoperative wound complications were seen in 7/65 dogs (10.8%, 95% CI = 4.4-21.0%) with LB and 4/140 (2.9%, 95% CI = 0.8-7.2%) without LB (p = .039).

CONCLUSION

Use of LB was associated with reduced postoperative analgesic use, and shortened ICU and hospital stay but also with wound complications.

CLINICAL SIGNIFICANCE

Caution should be used when using LB in (clean) contaminated surgeries.

Endoscopic treatment of acute oropharyngeal stick injuries in dogs: 46 cases (2010-2020)

OBJECTIVES

To review long-term outcomes of dogs with acute oropharyngeal stick injuries managed with rigid endoscopy at a UK referral centre.

MATERIALS AND METHODS

Retrospective analysis and follow-up with referring veterinary surgeons and owners of patients treated between 2010 and 2020. A medical record search was performed and data regarding signalment, clinical presentation, treatment and long-term outcomes were recorded.

RESULTS

Sixty-six dogs with acute oropharyngeal stick injury were identified and 46 (70.0%) of these had endoscopy of the wound. The dogs were of various breeds, ages (median=3 years; range 0.6 to 11 years) and weights (median=20.4 kg; range 7.7 to 38.4 kg) and 58.7% of patients were male. The median time from injury to referral was 1 day (range 2 hours to 7 days). Patients were anaesthetised, and injury tracts were explored using 0° and 30° forward-oblique, 2.7 mm diameter, 18 cm length rigid endoscopes with a corresponding 14.5 French sheath using saline infusion via gravity. All foreign material that could be grasped was removed using forceps. Tracts were flushed with saline and reinspected to confirm removal of all visible foreign material. Out of 40 dogs with long-term follow-up, 38 (95.0%) had no major long-term complications. The remaining two dogs developed cervical abscessation after endoscopy, one of which resolved after repeat endoscopy and the other resolved after open surgery.

CLINICAL SIGNIFICANCE

Long-term follow-up of dogs with acute oropharyngeal stick injury managed with rigid endoscopy showed an excellent outcome in 95.0% of cases.

Preoperative computed tomography, surgical treatment and long-term outcomes of dogs with abscesses on migrating vegetal foreign bodies and oropharyngeal stick injuries: 39 cases (2010-2021)

OBJECTIVES

This study evaluated success rates of surgical treatment of head and neck abscesses and draining tracts for suspected migrating vegetal foreign body and oropharyngeal penetrating injuries, and compared the outcomes according to whether a vegetal foreign body was identified in preoperative computed tomography (CT) examination.

MATERIALS AND METHODS

This retrospective study involved 39 dogs that underwent CT and subsequent surgical exploration of abscesses and/or draining tracts in the head and neck, in a single institution between 2010 and 2021. Recorded data included signalment, history, physical examination, CT and surgical findings. The postoperative follow-up period was at least 8 months. Cases were classified according to whether a foreign body was identified on CT or was only suspected because of the presence of cavities and/or draining tracts on CT.

RESULTS

A vegetal foreign body was identified on CT in 11 of 39 cases and later confirmed at surgery in 10 cases. In 28 of 39 cases, a vegetal foreign body was not identified on CT, but in seven of these 28 cases it was found at surgery. Resolution of clinical signs was achieved in 11 of 11 cases when a vegetal foreign body was identified on CT and in 26 of 28 cases without a foreign body identified on CT. Two cases of recurrence were observed in animals in which no foreign body was detected.

CLINICAL SIGNIFICANCE

In this population of dogs undergoing surgery after preoperative CT scan, we observed resolution of clinical signs after a single surgical procedure in 95% of the cases. All animals in which a foreign body was identified were cured.

Ultrasonographic appearance of retained surgical sponges and gauzes in the acute postoperative period: a phantom and cadaveric study

Retained surgical sponges or gauzes (RSS) are an uncommon complication of exploratory laparotomy surgery and pose a clinically significant risk to the patient. The purpose of this two-part, prospective, descriptive study was to describe the previously uncharacterized ultrasonographic appearance of RSS in phantom and cadaveric models of the acute postoperative period (24-48 h). For the first part of the study, a gelatin phantom containing a woven gauze with a radiopaque marker (radiopaque gauze), a woven gauze with no marker (nonradiopaque gauze), and a laparotomy sponge with a radiopaque marker (radiopaque sponge) was evaluated with ultrasonography. For the second part of the study, a total of 23 gauzes and sponges (of the aforementioned three types) were placed within the peritoneal cavity of 20 cadavers in one of three randomized locations during an exploratory laparotomy laboratory. The cadavers were imaged with ultrasonography 17 h later and still images and video clips were reviewed. The retained surgical sponges and gauzes in the gelatin phantom displayed multiple hyperechoic layers and variable degrees of distal acoustic shadowing. In cadavers, 100% (23/23) of the retained surgical sponges and gauzes displayed a single hyperechoic layer of variable thickness and distal acoustic shadowing. In 95.6% (22/23) retained sponges and gauzes, there was a thin hypoechoic layer noted superficially to the hyperechoic layer. An improved understanding of the ultrasonographic appearance of retained sponges or gauzes in the acute postoperative period may assist in the identification of these objects.

Emesis induction is successful for recovery of gastric foreign objects in cats

OBJECTIVE

To prospectively assess the efficacy of emesis induction for the recovery of gastric foreign objects in cats and to determine if any factors influenced recovery.

ANIMALS

22 client-owned cats.

PROCEDURES

Cats for which emesis induction was deemed appropriate were administered an emetic agent by the attending clinician between October 2018 and April 2021. Data collected included whether emesis was successful in recovery in some or all of the foreign object, time from administration to emesis, number of emetic events, and type, length, width, and surface area of the material ingested.

RESULTS

Of the 22 cats that had emesis attempted, 11 (50%) vomited some or all of the foreign object. The time from ingestion to presentation, time from the last meal, presence of food in the vomitus, type of the object, and length, width, and surface area of the object did not influence the likelihood of successful recovery with emesis induction. The most common object cats ingested were rubber bands.

CLINICAL RELEVANCE

Recovery of gastric foreign objects in cats with emesis induction alone may be successful 50% of the time. The type and size of the object is unlikely to influence whether or not emesis will be successful. This information can help prepare cat-owners for expectations and outcomes following attempts at emesis induction.

Outcomes following combined median sternotomy and ventral midline laparotomy for bicavitary penetrating wooden foreign bodies

Combined abdominal and thoracic pathology caused by extra-gastrointestinal migration of an ingested wooden foreign body (WFB) is an uncommon but serious injury. Presenting clinical signs are typically nonspecific and, in the absence of observed WFB ingestion, diagnosis is challenging. Treatment requires concurrent abdominal and thoracic surgical exploration to remove the WFB and address injuries caused by its migration. This case series describes perioperative characteristics and outcomes in 4 dogs following combined median sternotomy and ventral midline laparotomy (CMSVML) for bicavitary penetrating WFBs. Key clinical message: Treatment of bicavitary penetrating WFBs with CMSVML provided postoperative outcomes similar to those in previous reports; however, high-grade complications and prolonged hospitalization were commonly encountered.

Ropinirole has similar efficacy to apomorphine for induction of emesis and removal of foreign and toxic gastric material in dogs

OBJECTIVE

Assess efficacy of ropinirole versus apomorphine in inducing vomiting in dogs.

ANIMALS

279 client-owned dogs with known or suspected ingestion of a foreign material (n = 129) or toxin (150) between August 2021 and February 2022.

PROCEDURES

In this non-randomized non-controlled clinical trial, ropinirole topical ophthalmic solution was applied to dogs' eyes, with a target dose of 3.75 mg/m2. A second dose was administered after 15 minutes based on clinician discretion. Reversal with metoclopramide was provided based on clinician discretion. Results of ropinirole's efficacy were compared to previous literature assessing the efficacy of apomorphine.

RESULTS

Of 279 dogs, 255 (91.4%) vomited after ropinirole administration, including 116 of the 129 dogs (89.9%) dogs that ingested foreign material and 139 of the 150 dogs (92.7%) that ingested toxins. Success of emesis did not differ between groups. With a single dose of ropinirole, 78.9% produced vomit. Fifty-nine dogs received 2 doses of ropinirole, resulting in 79.7% that produced vomit. Overall, 74.2% of the dogs vomited all the expected ingested material. Average time to emesis was 11.0 minutes with 50% of dogs vomiting within 7 to 18 minutes. Adverse effects were observed for 17.0% of dog and were self-limiting. Ropinirole was less effective than apomorphine in inducing vomiting (91.4% ropinirole, 95.6% apomorphine [P < .0001]) and equally effective at evacuating all ingested material (74.2% ropinirole, 75.6% apomorphine [P = .245]).

CLINICAL RELEVANCE

Ropinirole ophthalmic solution is a safe and effective emetic for use in dogs. It has a small but statistically significant decrease in efficacy compared to IV apomorphine.

Delay of definitive care in cats and dogs with gastrointestinal foreign body obstruction following antiemetic administration: 537 cases (2012-2020)

OBJECTIVE

To determine whether administration of antiemetic medication to dogs and cats with gastrointestinal foreign body obstruction (GIFBO) delays time to definitive care (surgery or endoscopy) and increases the risk of complications.

DESIGN

Retrospective study (January 2012-July 2020).

SETTING

Private referral center.

ANIMALS

Five hundred and thirty-seven (440 dogs and 97 cats).

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Medical records of dogs and cats with GIFBO were reviewed for antiemetic administration at the onset of clinical signs, time from onset of clinical signs to first intervention and definitive care, GIFBO-related complications, and length of hospitalization. Antiemetics were prescribed for 200 of 537 patients (158 dogs, 42 cats). Antiemetic administration was associated with an increased time between the onset of clinical signs and definitive care (3.2 days [95% confidence interval, CI, 2.8-3.5] vs. 1.6 days [95% CI, 1.4-2.0]; P < 0.001) but not with GIFBO-associated complications (P = 0.45). Antiemetic administration was associated with an increased length of hospitalization (1.6 days [95% CI, 1.4-1.7] vs. 1.1 days [95% CI, 1.1-1.2]; P < 0.001). A longer duration of clinical signs prior to intervention was associated with GIFBO-related complications (P < 0.001) regardless of antiemetic administration.

CONCLUSIONS

Antiemetic administration in patients with GIFBO was associated with increased time to definitive care and length of hospitalization but not GIFBO-associated complications. Antiemetics are not inherently contraindicated in patients for whom GIFBO is a differential, but clients should be counseled to monitor for progression of clinical signs and follow-up accordingly.

Retrospective evaluation of surgical treatment of linear and discrete gastrointestinal foreign bodies in cats: 2009-2021

OBJECTIVES

Gastrointestinal foreign bodies (FBs) are an important cause of emergency surgical intervention in cats, but little information exists in the literature evaluating the risks and outcomes in this species. The study purpose was to describe cases of feline FBs and compare perioperative factors and outcomes between linear foreign body (LFB) and discrete foreign body (DFB) surgery in cats.

METHODS

The medical records from the University of Georgia Veterinary Teaching Hospital were searched for cats that had undergone surgery for FB removal between August 2009 and August 2021. Perioperative data were collected and described. Data were compared between cats with an LFB and cats with a DFB. A binomial probability series was used to estimate the likelihood of postoperative septic peritonitis or mortality in an additional cat in the series.

RESULTS

A total of 56 cats were included in this study; 38 cats had a DFB and 18 had an LFB. No cats developed postoperative septic peritonitis, and all cats survived. The likelihood of postoperative septic peritonitis or mortality in an additional cat was estimated to be <5.2%. Cats with an LFB were found to have a significantly higher body condition score (P = 0.047), albumin (P = 0.025), American Society of Anesthesiologists status (P = 0.027), surgery length (P <0.001) and total cost of visit (P = 0.006) when compared with cats with a DFB. Cats with LFBs were more likely to develop a surgical site infection (SSI; P = 0.007) and be administered postoperative antibiotics (P = 0.017).

CONCLUSIONS AND RELEVANCE

Cats undergoing surgery for gastrointestinal FBs had a low incidence of postoperative complications. Cats with LFBs had longer surgeries and were more likely to develop postoperative SSIs.

Bronchoscopic findings in dogs with bronchial vegetal foreign bodies: 84 cases (2010-2020)

OBJECTIVES

To describe endoscopic findings, foreign body location, success rate of removal and complications in dogs with bronchial vegetal foreign bodies.

MATERIALS AND METHODS

The current study retrospectively evaluated the case records of dogs diagnosed with bronchial vegetal foreign bodies at a veterinary hospital centre between January 2010 and April 2020. Information retrieved included breed, sex, age, bodyweight, the season of presentation, presentation and duration of clinical signs, previous removal attempts performed by the referring veterinarian, foreign body location and endoscopic and imaging findings.

RESULTS

Eighty-four cases were included. Fifty-nine dogs (70%) presented during spring and summer. Cough (77 of 84; 92%) and fever (15 of 84; 18%) were the main clinical signs. One to 10 bronchial vegetal foreign bodies were removed from each dog. Purulent exudate was observed in the ventral larynx, trachea and bronchi in 49 (65%), 61 (81%) and 71 (95%) dogs, respectively. In most cases, only the barbules of the vegetal foreign bodies were initially observed during endoscopy. The presence of large bronchial nodules or an irregular mucosal surface was a frequent finding (62 of 75; 83%). Mild bleeding was the main complication (58 of 75; 77%) of endoscopic removal, which was successful in 67 of the 84 (80%) cases.

CLINICAL SIGNIFICANCE

Mucosal nodules associated with purulent material within the airways are frequent endoscopic findings in dogs with bronchial vegetal foreign bodies. Bronchoscopy is a relatively safe and useful technique for diagnosis and treatment of bronchial vegetal foreign bodies in dogs.

Clinical findings and patient outcomes following surgical treatment of chronic gastrointestinal foreign body obstructions in dogs and cats: 72 cases (2010-2020)

The objective of this study was to characterize clinicopathologic factors and outcomes for dogs and cats with chronic small intestinal foreign body obstructions (CFBO). Medical records of 72 dogs and cats diagnosed with CFBO between 2010 to 2020 were reviewed for duration of clinical signs, pre-surgical and intraoperative findings, complications, and outcomes. A chronic foreign body was defined as clinical signs, or the observation of foreign material ingestion, at least 7 days prior to presentation. Twenty-two (31%) patients had a small intestinal resection and anastomosis (SIRA) and were more likely to have longer duration of clinical signs (P = 0.01). Eleven (15%) patients developed major post-operative complications. Sixty-eight (94%) patients survived to follow-up. Although all patients that did not survive (n = 4, 100%) had a SIRA, patients with CFBO had a high survival rate. Therefore, clients should not be deterred from pursuing surgical intervention.

Ultrasonographic and computed tomographic features of a true gastro-gastric intussusception with concurrent foreign bodies in a dog

A 2-year-old intact male Cane Corso dog was presented for acute weakness, vomiting, and diarrhea. Abdominal ultrasound revealed the stomach had severe wall edema and a target appearance. Computed tomography was consistent with a gastro-gastric intussusception and concurrent mineral-like gastric foreign bodies. After reduction of the intussusception, bilateral incisional gastropexy was performed to prevent recurrence. True gastrogastric intussusception is a rare condition and should be considered if the stomach has severe wall edema with a target sign on abdominal ultrasound. Computed tomography was useful to confirm this rare diagnosis and screen the entire abdomen for concurrent lesions. Key clinical message: This case highlights the usefulness of a CT examination to confirm this rare diagnosis, to determine the position of gastric compartments, and to detect potential concurrent lesions prior to surgery.

Seasonality and risk factors for grass seed foreign bodies in dogs

Grass seed foreign bodies (GSFBs) are a familiar presentation, especially in dogs, associated with a variety of clinical signs depending on site of penetration and extent of migration. Seasonality and risk factors for GSFB occurrence were investigated using electronic health records from a sentinel voluntary network of 245 veterinary practices in the United Kingdom between 17th March 2014 and 18th September 2020. Clinical narrative text mining of 4,580,503 canine consultations produced a final case dataset of 1,037 consultations where GSFBs had been recorded in individual dogs. Cases of GSFBs were recorded in all months, with 940 (90.6 %) recorded between June and September. In particular, the odds of GSFBs in July was almost 176 times more than that of January (Odds ratio, OR, 175.6, 95 % Confidence interval, CI, 43.5-707.7, P < 0.001). Compared to the retriever breed type, spaniel breed types were 7.7 times more likely to present with a GSFB (CI 5.4-11.0, P < 0.001). Other significant risk factors associated with recorded GSFBs for this population included being male (OR = 1.4, CI 1.2-1.6, P < 0.001), and geographical location. When compared to the South East of England, risk was lowest in Wales (OR = 0.1, CI 0.0-0.3, P=<0.001), and highest in the East of England (OR = 1.9, 1.2-2.9, P = 0.003), and overall risk in urban areas was reduced (OR = 0.8, CI 0.7-1.0, P = 0.024). These observations provide a number of areas for temporally targeted health campaigns at specific types of dogs, to reduce the impact of GSFBs on canine welfare.

Tracheal stenosis following endotracheal intubation in a dog

A 2-month-old intact female Rottweiler was presented for investigation of coughing and respiratory distress 9 d after an exploratory laparotomy for intestinal foreign body removal. Tracheal stenosis was suspected by radiography and confirmed with computed tomography (CT) and tracheoscopy. After 1 wk of medical management, clinical signs had resolved and the severity of the tracheal narrowing was markedly improved, as confirmed by radiography and tracheoscopy. Tracheal stenosis is a considerable complication of endotracheal intubation in veterinary medicine and may be medically managed, depending on the severity of the tracheal injury. Key clinical message: To our knowledge, this is the first clinical case report of tracheal stenosis resulting from endotracheal intubation in a dog and its resolution after medical management.

Comparison of computed tomography and surgical findings and investigation of their associations with outcomes for dogs with sublumbar abscesses

OBJECTIVE

To describe and compare the results of preoperative CT and surgical findings in dogs with sublumbar abscesses and investigate potential associations between these variables and the outcome of abscess recurrence.

ANIMALS

51 client-owned dogs.

PROCEDURES

A retrospective, records-based study was performed of dogs undergoing surgery for treatment of sublumbar abscesses diagnosed by use of CT between January 2010 and December 2018. Signalment, clinical signs, clinicopathologic data, CT findings, surgical techniques and findings, duration of hospitalization, postoperative treatment, and complications were recorded. Long-term follow-up was performed through telephone interviews. Logistic regression analysis was used to investigate associations between the variables of interest and abscess recurrence.

RESULTS

51 dogs met the study inclusion criteria; 48 were included in outcome analysis. The CT findings agreed with surgical findings for identification of a migrating vegetal foreign body for 39 of 51 (77%) dogs. All dogs survived to hospital discharge; 1 dog died of hemoabdomen 3 days after surgery, and 6 had minor (surgical wound) complications reported. Abscess recurrence developed in 12 of 48 (25%) dogs with a median time to recurrence of 6 months. Identification of diskospondylitis on CT examination was the only investigated factor significantly associated with recurrence; odds of recurrence in dogs with this finding were 8.4 times those for dogs without this finding.

CONCLUSIONS AND CLINICAL RELEVANCE

Our results suggested dogs with sublumbar abscesses have a good prognosis after surgery, although recurrence can develop. Preoperative identification of diskospondylitis was significantly associated with abscess recurrence in this study sample.

Surgical removal of an intramedullary chopstick fragment penetrating the spinal cord in a cat

A 3-year-old male domestic shorthair cat presented with sudden ataxia. Neurologic examination showed complete loss of proprioception in the thoracic and pelvic limbs. Computed tomography and magnetic resonance imaging revealed a non-metallic foreign body penetrating the spinal cord. The foreign body was removed by the ventral approach to the atlanto-occipital junction. Mild improvement of proprioception was observed the day after surgery. In a follow-up two months after surgery, the owner reported a complete recovery of the patient, showing a normal gait. To the author's knowledge, this is the first case report describing successful removal of an intramedullary foreign body penetrating cervical spinal cord by ventral approach in a cat.

Comparison of patient outcomes following enterotomy versus intestinal resection and anastomosis for treatment of intestinal foreign bodies in dogs

OBJECTIVE

To quantify the relative risk of intestinal dehiscence in dogs undergoing intestinal resection and anastomosis (IRA), compared with enterotomy, for surgical management of small intestinal foreign bodies, and to evaluate the association between nasogastric tube placement for early enteral nutrition (EEN) and hospitalization time.

ANIMALS

211 dogs undergoing 227 surgeries for intestinal foreign body removal.

PROCEDURES

Medical records were reviewed for dogs undergoing a single-site sutured enterotomy or IRA for foreign body intestinal obstruction between May 2008 and April 2018. Multivariable logistic regression was used to quantify the association between surgical procedure and dehiscence. Multiple linear regression was used to quantify the association of nasogastric tube placement with total hospitalization time.

RESULTS

Dehiscence rates were 3.8% (7/183) and 18.2% (8/44) for enterotomy and IRA, respectively. Overall dehiscence rate for all surgeries was 6.6% (15/227). The odds of intestinal dehiscence for IRA were 6.09 times (95% CI, 1.89 to 19.58) the odds for enterotomy. An American Society of Anesthesiologists score > 3 (OR, 4.49; 95% CI, 1.43 to 14.11) and an older age (OR, 1.02 [95% CI, 1.01 to 1.02] for each 1-month increase in age) were significantly associated with greater odds of intestinal dehiscence, regardless of surgical procedure. Placement of a nasogastric tube was not associated with intestinal dehiscence or decreased total hospitalization time when controlling for the year of surgery.

CONCLUSIONS AND CLINICAL RELEVANCE

Patients undergoing IRA were at a significantly higher risk of intestinal dehiscence, compared with patients undergoing enterotomy. Although this finding should not be used to recommend enterotomy over IRA, this information may be useful in guiding owner expectations and postoperative monitoring.

Successful and unsuccessful nonsurgical removal of ingested golf balls and an artificial egg in four rat snakes (Pantherophis alleghaniensis)

CASE DESCRIPTION

4 wild adult rat snakes (Pantherophis alleghaniensis) were evaluated after ingesting spherical or ovoid foreign bodies.

CLINICAL FINDINGS

Physical examination revealed a large, firm mass at the level of the stomach in each snake. Radiographic findings were consistent with ingestion of a golf ball (3 snakes) or an artificial egg (1 snake). Signs consistent with prolonged impaction included scale loss, dermal abrasions, and apparent loss of body condition in one snake and regional skin ulceration, dehydration, and generalized muscle atrophy in another.

TREATMENT AND OUTCOME

Nonsurgical removal of the foreign body was attempted in anesthetized or heavily sedated snakes by external manipulation in the orad direction. A golf ball was removed through the oral cavity without complications in 1 snake. In the other 3 snakes, tension caused by the advancing foreign body resulted in full-thickness skin rupture in the cervical region. The procedure was completed with the use of a balloon catheter to aid foreign body advancement for 1 of the 3 snakes, and the skin defect was closed. The procedure was converted to esophagotomy for the other 2 snakes. Three snakes recovered and were released; 1 died of complications from prolonged impaction and esophageal perforation.

CLINICAL RELEVANCE

The described nonsurgical techniques for removal of ingested round or ovoid foreign bodies were associated with substantial complications in 3 of 4 treated rat snakes. Although a nonsurgical method for removal of ingested objects such as golf balls could benefit snakes, the methods used for these patients did not appear to be more beneficial than traditional gastrotomy.

Post-mortem analysis of gunshot wounds to the head and thorax in dogs by computed tomography, radiography and forensic necropsy

In view of the scarcity of literature data on the use of radiological imaging techniques in forensic veterinary medicine, while at the same time the number of reported crimes against animals involving the use of firearms is rising, this paper attempts to assess the usefulness of radiography and computed tomography (CT) in the post-mortem diagnosis of gunshot wounds (GSW) in comparison to classic necropsy. The design of the experiment was as follows: preparation of the research material (13 dog carcasses), shooting of the material from different distances (1.5 and 12 m, plus one contact shot to the head) and using different types of ammunition, followed by X-rays and CT scans in each case to examine the injuries resulting from the shot. The final steps of the experiment were photographic documentation and autopsy by the Virchow method. In the examined material, post-traumatic bone lesions and the presence of metallic foreign bodies were successfully imaged by both radiography and CT. GSW analysis using CT provided much better data quality and some additional information. Two general conclusions can be drawn from the results of the experiment. First, damage caused by gunshots is correlated with the calibre, initial velocity and kinetic energy of the projectile, as well as the distance from the muzzle of the gun to the object shot. Second, radiological examination is useful in preparing forensic veterinary opinions. Used as a complement to classic necropsy, they increase the possibility of an accurate post-mortem diagnosis of shooting victims.

Disseminated pancreatic adenocarcinoma in an eclectus parrot (Eclectus roratus)

CASE DESCRIPTION

A 15-year-old 0.412-kg (0.906-lb) sexually intact male eclectus parrot (Eclectus roratus) was evaluated because its owners found it lethargic and dyspneic at the bottom of its cage.

CLINICAL FINDINGS

The parrot was thin and had generalized muscle wasting, diffuse feather loss, pale mucous membranes, and melena. The coelomic cavity was distended and soft on palpation, with coelomic effusion suspected. Results of a CBC indicated leukocytosis with left shift heterophilia, including toxic heterophils, lymphopenia, and anemia. Plasma biochemical analyses revealed severe hyperamylasemia.

TREATMENT AND OUTCOME

Radiography revealed no evidence of a metallic foreign body but severe loss of coelomic detail, suggestive of a coelomic mass, coelomic effusion with coelomitis, or both. Ultrasonography and CT revealed severe accumulation of coelomic fluid; a large, heterogeneous, irregularly marginated, and moderately vascularized mass in the caudal aspect of the coelomic cavity; and multiple hepatic, coelomic, and pulmonary nodules. On the basis of a poor prognosis, the parrot was euthanized. Necropsy results confirmed exocrine pancreatic adenocarcinoma, with disseminated metastases in the liver, gastrointestinal tract, coelomic cavity, and lungs.

CLINICAL RELEVANCE

In birds, pancreatic adenocarcinoma is rarely reported but should be considered a differential diagnosis for hyperamylasemia, coelomic mass, coelomic effusion, or abnormal gastrointestinal signs, alone or in combination. Ultrasonography and CT can be useful in further evaluating such patients and should be considered in the diagnostic plan.

Safety and efficacy of cold atmospheric plasma for the sterilization of a Pasteurella multocida-contaminated subcutaneously implanted foreign body in rabbits

OBJECTIVE

To determine whether a stainless steel implant sterilized with a novel cold atmospheric plasma sterilization (CAPS) device adversely affects local tissues in rabbits and whether CAPS was as effective as steam sterilization with an autoclave to inactivate Pasteurella multocida.

ANIMALS

31 healthy New Zealand White rabbits.

PROCEDURES

Steam-autoclaved stainless steel implants inoculated with P multocida underwent a second steam autoclave sterilization (AIA) or CAPS (AICAPS). One AIA implant and 3 AICAPS implants were randomly placed subcutaneously at 4 sites in 21 rabbits (84 implants). These rabbits were monitored daily for 5 days for evidence of systemic illness and local tissue reactions at the implantation sites and then euthanized. Samples were taken from each implant site for bacterial culture and histologic examination.

RESULTS

Cultures of samples obtained from all sites were negative for bacterial growth. No significant difference was observed in mean skin thickness or erythema between AIA and AICAPS implant sites on any observed day. Also, individual histologic grades for the epidermis, dermis, subcutis, and muscle and total histologic grade were not significantly different between AIA and AICAPS implant sites.

CONCLUSIONS AND CLINICAL RELEVANCE

Cold atmospheric plasma sterilization was noninferior to steam sterilization of P multocida-contaminated stainless steel implants in the rabbits in the present study. However, studies of the efficacy of CAPS for inactivation of other important bacteria are needed.

Severe intermittent lameness secondary to a migrating metallic foreign body in a dog

CASE DESCRIPTION

An 11-month-old mixed-breed dog was evaluated because of a 2-day history of acute-onset, intermittent vocalization and collapse several days after ingesting metallic wire foreign material.

CLINICAL FINDINGS

Physical examination findings were initially unremarkable. After a brief period of hospitalization, the patient acutely developed non-weight-bearing lameness with signs of severe pain localized to the left thoracic limb and inability or refusal to rise. Results of cervical, thoracic, and abdominal radiography revealed a linear metallic foreign body at the thoracic inlet and a single metallic foreign body in the cranial aspect of the abdomen. Neuropathic pain at the level of the left brachial plexus was suspected. Results of a subsequent CT scan were consistent with a metallic foreign body in the left axilla with associated abscess formation and neuritis and an additional metallic foreign body within the omental fat near the pyloroduodenal junction.

TREATMENT AND OUTCOME

Intraoperative fluoroscopy was used to facilitate localization and surgical removal of the axillary foreign body. The intra-abdominal foreign body was removed laparoscopically. Complete resolution of clinical signs was observed before discharge from the hospital the following day. On telephone follow-up 8 months after surgery, the owners reported the patient had no signs of lameness or complications.

CLINICAL RELEVANCE

Migrating metallic foreign bodies may be identified as incidental findings with the potential to cause harm in the future or may be a cause for severe clinical signs. Migrating foreign bodies should be considered as a differential diagnosis for patients reported to have acute collapse or lameness and consistent clinical history.

Intestinal incisional dehiscence rate following enterotomy for foreign body removal in 247 dogs

OBJECTIVE

To report the intestinal incisional dehiscence rate following enterotomy for foreign body removal in dogs.

ANIMALS

247 client-owned dogs with intestinal foreign bodies treated with enterotomy between November 2001 and September 2017.

PROCEDURES

Medical records were reviewed, and data were collected regarding signalment, history, surgery, clinicopathologic findings, hospitalization, intestinal incisional dehiscence, and survival to hospital discharge. Dogs were grouped according to whether intestinal incisional dehiscence occurred (dehiscence group) or did not occur (nondehiscence group) following enterotomy, and the rate of dehiscence for the total number of enterotomies during the study period was calculated. Univariable analysis was performed to identify variables associated with intestinal incisional dehiscence.

RESULTS

8 of the 247 (3.2%) dogs had preoperative septic peritonitis, and all 8 dogs survived to hospital discharge. Incisional dehiscence occurred following 5 of the 247 (2.0%) enterotomies, and only 2 dogs in the dehiscence group did not survive to hospital discharge. Duration of hospitalization was longer for dogs in the dehiscence group than for dogs in the nondehiscence group.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that enterotomy for intestinal foreign body removal had a lower rate of dehiscence in dogs during the study period, compared with rates previously reported; however, the low rate should not be used as a reason to perform an enterotomy rather than an enterectomy when needed. Surgeons should thoroughly evaluate the bowel and perform an enterotomy only when indicated.