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1.
OBJECTIVE: To evaluate feasibility of performing laparoscopic-assisted placement of a jejunostomy feeding tube (J-tube) and compare complications associated with placement, short-term feedings, and medium-term healing with surgically placed tubes in dogs. DESIGN: Prospective study. ANIMALS: 15 healthy mixed-breed dogs. PROCEDURES: Dogs were randomly allocated to undergo open surgical or laparoscopic-assisted J-tube placement. Required nutrients were administered by a combination of enteric and oral feeding while monitoring for complications. Radiographic contrast studies documented tube direction and location, altered motility, or evidence of stricture. RESULTS: Jejunostomy tubes were successfully placed in the correct location and direction in all dogs. In the laparoscopic group, the ileum was initially selected in 2 dogs, 2 dogs developed moderate hemorrhage at a portal site, and 2 J-tubes kinked during placement but were successfully readjusted postoperatively. All dogs tolerated postoperative feedings. All dogs developed minor ostomy site inflammation, and 1 dog developed bile-induced dermatitis at the ostomy site. Despite mild, transient neutrophilia, no significant difference was noted in WBC counts between groups. No dog had altered gastric motility or evidence of stricture, although the jejunopexy site remained identifiable in several dogs at 30 days. CONCLUSIONS AND CLINICAL RELEVANCE: Requirements for successful J-tube placement were met by use of a laparoscopic-assisted technique, and postoperative complications were mild and comparable to those seen with surgical placement. Laparoscopic-assisted J-tube placement compares favorably to surgical placement in healthy dogs and should be considered as an option for dogs requiring enterostomy feeding but not requiring a celiotomy for other reasons.  相似文献   

2.
Objectives— To compare tissue specimens of canine abdominal organs collected by standard techniques (ST) and harmonic scalpel (HS) and to determine the effect of each technique on wound healing.
Study Design— Experimental.
Animals— Twelve dogs.
Methods— Paired biopsy samples (ST, HS) were collected from liver, spleen, adrenal gland, pancreas, stomach, jejunum, and bladder using laparoscopic or laparoscopic-assisted methods. Hemorrhage at biopsy sites was assessed (present or absent). Specimens were evaluated for diagnostic quality and histologic changes. Dogs were necropsied at 4 or 14 days postoperatively.
Results— HS incision caused less frequent hemorrhage of all organs except spleen. HS specimens had more coagulation necrosis than ST specimens, but both techniques yielded specimens that were sized similarly and were of diagnostic quality. At necropsy, HS biopsy sites of the stomach, jejunum, bladder, adrenal gland, and pancreas were more hyperemic than ST sites. There were more adhesions at jejunal and pancreatic ST biopsy sites. HS biopsy sites had more coagulation necrosis at days 4 and 14 postoperatively. Differences in fibrin deposition, inflammation, and fibrosis were present at biopsy sites of some organs at days 4 or 14 and in comparisons between days 4 and 14.
Conclusions— Diagnostic quality biopsy specimens were obtained with HS and ST. Although HS-induced gross and histologic changes during the first 2 postoperative weeks, no clinical complications were observed.
Clinical Relevance— Both HS and ST can yield specimens with minimal hemorrhage and HS resulted in no apparent postoperative problems in normal dogs. Although HS caused more inflammation and adhesions at biopsy sites of the pancreas, adrenal gland, and jejunum, no clinical complications occurred.  相似文献   

3.
Objective – To evaluate a method for endoscopically guided nasojejunal tube placement allowing short‐term postduodenal feeding and chyme withdrawal in dogs. Design – Pilot study. Setting – University teaching hospital. Animals – Three healthy Beagle dogs with jejunal nipple valve fistulas. Interventions – After the dogs were anesthetized, an 8 Fr, 250‐cm polyvinyl chloride catheter was advanced through a gastroscope into the jejunum. Correct jejunal placement was established using endoscopic visualization and confirmed by fluoroscopy and radiography. The proximal end of the tube was pulled out through 1 nostril and sutured to the skin of the forehead. Thereafter, jejunal feeding was administered for 4 days. Follow‐up examinations included daily confirmation of the tube's position using radiography, physical examination, and blood analyses. Withdrawal of jejunal chyme was performed after jejunal and oral feeding. Measurements and Main Results – Fluoroscopic examination confirmed that endoscopic visualization alone allowed correct jejunal placement. During a 4‐day postduodenal feeding period, repeated radiographic examination revealed stable positioning of the tubes within the jejunum with minor cranial displacement. The tubes were functional throughout the study without causing identifiable problems. Repeated physical examinations and blood analysis showed no abnormalities. We were able to administer the daily caloric requirements as a liquid diet. Jejunal chyme was successfully withdrawn via the tube. Conclusions – Endoscopically guided nasojejunal tube placement was shown to be a minimally invasive, well‐tolerated method for short‐term jejunal feeding in healthy dogs. This technique is a viable option for dogs requiring jejunal feeding but not laparotomy. The feasibility of chyme sampling is another unique application of the procedure.  相似文献   

4.
The feasibility of thoracoscopy for viewing the chest cavity and performing pulmonary lobectomy was assessed in 8 mongrel dogs. Previously, selective intubation had been performed in another group of dogs (n = 8) in order to monitor respiratory physiology and assess its safety. Each hemithorax was intubated using a double-barrelled endotracheal tube with one barrel placed in the left main bronchus and the other in the bifurcation of the trachea. The thoracoscope was introduced through a cannula inserted through a 2-cm incision at the ventral third of the left 5th intercostal space. The cranial, dorsal, and caudal surfaces of the pleura, lobes of the left lung, and the mediastinum were examined. A 2nd cannula was located in the dorsal 3rd of the 5th intercostal space with a prior incision and used for the introduction of forceps to separate the viscera. To biopsy, a 3rd cannula was inserted at the dorsal third of the 8th intercostal space with a prior incision, through which a 12-mm diameter stapler was introduced. Should a lobectomy be necessary, a 4th cannula is located in the middle third of the 4th intercostal space. Excision of the left caudal pulmonary lobe was performed through the incision made for the 12-mm diameter cannula (8th intercostal space); a twisting movement facilitated removal. Thoracoscopy is a procedure that can be used in dogs and is particularly suitable for examination, collection of biopsy specimens, and even lung lobectomies.  相似文献   

5.
A rapid and strong laparoscopic-assisted gastropexy in dogs   总被引：1，自引：0，他引：1  
OBJECTIVE: To develop a technique for laparoscopic gastropexy in dogs and evaluate effects on stomach position and strength of the adhesion between the stomach and abdominal wall. ANIMALS: 8 healthy dogs. PROCEDURE: Dogs were anesthetized, and the abdomen was insufflated with carbon dioxide. A laparoscope was placed through a cannula inserted on the abdominal midline caudal to the umbilicus. Babcock forceps placed through a cannula inserted lateral to the right margin of the rectus abdominus muscle were used to exteriorize the pyloric antrum, a longitudinal incision was made through the serosa and muscular layer of the pyloric antrum, and the seromuscular layer of the pyloric antrum was sutured to the transversus abdominus muscle. After surgery, positive-contrast gastrography was used to evaluate stomach position and the onset of gastric emptying, and ultrasonography was used to assess stomach wall activity and mobility. Dogs were euthanatized 1 month after surgery, and tensile strength of the adhesion was tested. RESULTS: In all dogs, stomach position and the onset of gastric emptying were normal 25 days after surgery, and the pyloric antrum was firmly attached to the abdominal wall 30 days after surgery. Mean +/- SD ultimate load of the adhesion in tension was 106.5 +/- 45.6 N. CONCLUSIONS AND CLINICAL RELEVANCE: The laparoscopic gastropexy technique described in the present study could be performed quickly and easily by an experienced surgeon, resulted in a strong fibrous adhesion between the stomach and abdominal wall, and appeared to cause minimal stress to the dogs.  相似文献   

6.
OBJECTIVE: To evaluate the use of laparoscopic-assisted jejunostomy feeding tube (J-tube) placement in healthy dogs under sedation with epidural and local anesthesia and compare cardiopulmonary responses during this epidural anesthetic protocol with cardiopulmonary responses during general anesthesia for laparoscopic-assisted or open surgical J-tube placement. ANIMALS: 15 healthy mixed-breed dogs. PROCEDURES: Dogs were randomly assigned to receive open surgical J-tube placement under general anesthesia (n = 5 dogs; group 1), laparoscopic-assisted J-tube placement under general anesthesia (5; group 2), or laparoscopic-assisted J-tube placement under sedation with epidural and local anesthesia (5; group 3). Cardiopulmonary responses were measured at baseline (time 0), every 5 minutes during the procedure (times 5 to 30 minutes), and after the procedure (after desufflation [groups 2 and 3] or at the start of abdominal closure [group 1]). Stroke volume, cardiac index, and O(2) delivery were calculated. RESULTS: All group 3 dogs tolerated laparoscopic-assisted J-tube placement under sedation with epidural and local anesthesia. Comparison of cardiovascular parameters revealed a significantly higher cardiac index, mean arterial pressure, and O(2) delivery in group 3 dogs, compared with group 1 and 2 dogs. Minimal differences in hemodynamic parameters were found between groups undergoing laparoscopic-assisted and open surgical J-tube placement under general anesthesia (ie, groups 1 and 2); these differences were not considered to be clinically important in healthy research dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Sedation with epidural and local anesthesia provided satisfactory conditions for laparoscopic-assisted J-tube placement in healthy dogs; this anesthetic protocol caused less cardiopulmonary depression than general anesthesia and may represent a better choice for J-tube placement in critically ill patients.  相似文献   

7.
OBJECTIVE: To evaluate the clinical use and outcome of a rectus abdominis microvascular free flap for wound closure in dogs. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs (n=9) with complex extremity or oral wounds. METHODS: Medical records (2002-2006) of dogs that had a rectus abdominis free tissue transfer to close an extremity or oral wound were reviewed. RESULTS: Nine dogs were identified: 5 had distal extremity wounds, 3 had oral palatal defects, and 1 had a large hygroma excised. A rectus abdominis free tissue transfer with a caudal epigastric vascular pedicle was successfully used for management of these wounds. No major complications occurred with the donor site and a good cosmetic and functional outcome occurred in all dogs. CONCLUSION: The rectus abdominis is a versatile muscle that can be used for reconstructing cutaneous and oral defects with repeatable success. CLINICAL RELEVANCE: Free tissue transfer of the rectus abdominis muscle is a clinically useful technique for closure of a variety of difficult soft tissue wounds.  相似文献   

8.
This project was designed to develop a standardized cannulation technique which would allow repeated jejunal mucosal biopsy. Three intestinal cannulas of various designs were evaluated in a total of 25 neonatal calves. Cannula A, a T-design made of acrylic plastic, was implanted into the jejunum (2) or duodenum (7). Cannula A did not allow proper directional passage of the biopsy instrument. Peritonitis was diagnosed at necropsy in 4 calves. Cannula B, a modification of A with an angled port to facilitate the directional passage of the biopsy instrument, also proved unsatisfactory. This cannula required a larger enterotomy for placement and resulted in the death of 1 calf. Cannula C was made of tygon tubing with a proxplast mesh flange which was sutured to the serosal surface of the intestine. No intestinal leakage was observed in 14 calves fitted with this cannula. This cannula was the least expensive and allowed the biopsy instrument to be easily directed. Surgical implantation of this cannula (C) in the descending duodenum proved to be an excellent method to obtain successive mucosal biopsies of the jejunum in the neonatal calf.  相似文献   

9.
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.  相似文献   

10.
Objective— To report a technique for tube cystostomy placement via a minimally invasive inguinal approach and outcome in 9 dogs and 6 cats with urinary tract obstruction or detrusor atony.
Study Design— Case series.
Animals— Dogs (n=9) and cats (6).
Methods— Medical records (January 2004–January 2008) of dogs and cats that had tube cystostomy via an inguinal approach were reviewed. Retrieved data included signalment, diagnosis, surgical technique, and complications. Access to the bladder was through a muscle splitting approach in the inguinal region with the cystostomy tube placed through a skin incision made several centimeters proximal to this incision and secured in the bladder by a purse string suture. Cystopexy during closure of the muscle layers ensured secure closure and minimized the likelihood of uroabdomen if tube dislodgment occurred.
Results— Cystostomy tubes were placed in 5 cats as an emergency procedure for treatment of acute urinary tract obstruction or urethral rupture, and as an elective procedure in 9 dogs and 1 cat. No complications occurred during cystostomy tube placement. Postprocedural complications were minor (peristomal irritation in 2 dogs with latex catheters, catheter laceration, premature removal) and only occurred when tubes were retained for >4 weeks. Urinary tract infection at catheter removal in 6 dogs resolved with antibiotic administration.
Conclusions— An inguinal approach for cystostomy tube placement facilitated rapid catheter placement into the bladder with minimal soft tissue dissection. Cystopexy during abdominal wall closure provided peritoneal protection should premature dislodgement of the cystostomy tube occur.
Clinical Relevance— An inguinal approach should be considered for rapid tube cystostomy particularly in metabolically compromised animals.  相似文献   

11.
Objective – To describe the clinical use of a novel, minimally invasive fluoroscopic technique for the wire‐guided placement of nasojejunal tubes (NJT) in dogs. Design – Retrospective study (September 22, 2006–October 2, 2010). Setting – University veterinary teaching hospital. Animals – Twenty‐six consecutive dogs with intolerance of, or contraindications to gastric feeding that underwent attempted fluoroscopic NJT placement. No dogs were excluded from analysis. Interventions – All dogs underwent attempted fluoroscopic NJT placement using a novel fluoroscopic wire‐guided technique. Measurements and Main Results – Patient data were collected in concert with information about the NJT placement procedure as well as the maintenance and utilization of the tube. The primary diagnosis in dogs undergoing NJT placement was pancreatitis in 60%. The ability to achieve transpyloric passage of the tube was 92.3% (24/26) and the ability to achieve jejunal access was 78.2%. In the second half of the study period, the ability to achieve jejunal access was significantly higher than in the first half of the study period suggesting that technical proficiency improves over time. Mean duration of the procedure was 35.3±20 minutes. Significant oral migration was a complication of NJT placement in some dogs. The median duration of feeding was 3.3 days (range 0.3–10.5). Conclusions – Fluoroscopic wire‐guided NJT placement is a viable method for sustained postpyloric feeding in dogs. Success in acquiring jejunal access improves with experience. The NJT may be utilized as a strategy to provide enteral nutritional support to the population of dogs with contraindications to, or intolerance of gastric feeding.  相似文献   

12.
The records of 30 dogs that were hypoalbuminemic and had undergone full-thickness biopsy of the small bowel, and the records of 22 dogs with normal albumin levels and small bowel biopsy, were reviewed. Plasma albumin concentrations for the former group were 30 to 93% of contemporary normals. There were no serious healing difficulties in the hypoalbuminemic dogs during the 7 day postoperative period examined. Nine dogs developed mild to moderate truncal and peripheral edema. The most common occurrences in the dogs with normal plasma albumin levels were edema and seroma formation adjacent to the skin incision. There was one death resulting from peritonitis subsequent to enterotomy dehiscence. Another dog developed peritonitis even though biopsy sites were intact when examined at a second surgery.  相似文献   

13.
The objective of this study was to determine if experimental gastric dilatation volvulus (GDV) would decrease adenosine triphosphate (ATP) concentration and increase membrane conductance of the canine gastric and jejunal mucosa. Male dogs (n = 15) weighing between 20 and 30 kg were used. Dogs were randomly assigned to 1 of 3 equal groups: Group 1 was control, group 2 was GDV, and group 3 was ischemia. All dogs were anesthetized for 210 min. Group 1 had no manipulation. Group 2 had GDV experimentally induced for 120 min followed by decompression, derotation, and reperfusion for 90 min. Group 3 had GDV experimentally induced for 210 min. Gastric (fundus and pylorus) and jejunal tissue was taken at 0, 120, and 210 min from all of the dogs. Tissue was analyzed for ATP concentration, mucosal conductance, and microscopic changes. The ATP concentration in the fundus did not change significantly from baseline in group 2, but decreased significantly below baseline at 210 min in group 3. The ATP concentration in the jejunum decreased significantly below baseline in groups 2 and 3 at 120 min, remaining significantly decreased in group 3 but returning to baseline at 210 min in group 2. Mucosal conductance of the fundus did not change significantly in any dog. Mucosal conductance of the jejunum increased at 120 min in groups 2 and 3, and became significantly increased above baseline at 210 min. The jejunal mucosa showed more profound cellular changes than the gastric mucosa. The jejunum showed substantial decreases in ATP concentration with an increase in mucosal conductance, suggesting cell membrane dysfunction. Dogs sustaining a GDV are likely to have a change in the activity of mucosal cells in the jejunum, which may be important in the pathophysiology of GDV.  相似文献   

14.
Objective: To determine the volume of saline needed to achieve targeted intraluminal pressures during leak testing of closed jejunal biopsy sites in the dog. Study Design: Experimental. Animals: Dogs (n=38). Methods: Jejunal biopsies in dogs were performed and closed using 3–4 full thickness simple interrupted sutures. Saline volumes needed to achieve 2 predetermined intraluminal pressures (20 and 34 cm water [15 and 25 mmHg]) in a 10 cm canine jejunal segment containing a closed biopsy site using 2 methods of luminal occlusion were recorded. Results: The 95% confidence intervals for the volume of saline needed to achieve 20 and 34 cm water intraluminal pressure were 10.9–13.6 and 16.3–19.0 mL, respectively with digital occlusion and 8.5–11.1 and 12.1–14.8 mL, respectively with Doyen occlusion. Correlation between volume of saline instilled and the pressure achieved was 0.76 for digital occlusion and 0.86 for Doyen occlusion. Conclusion: Correlation between volume of saline instilled and pressure achieved was greater with Doyen than digital occlusion. Clinical Relevance: For canine jejunum, saline volumes of 16.3–19 mL (digital occlusion) and 12.1–14.8 mL (Doyen occlusion) can be used to achieve intraluminal pressures of 34 cm water during leak testing of a 10 cm segment containing a closed biopsy site.  相似文献   

15.
Five male crossbred dogs successfully underwent surgical placement of button enterostomy tubes to evaluate the placement technique, maintenance and complications of these tubes. Surgical placement was quick, technically straightforward and similar to techniques used for other feeding tubes. None of the dogs experienced life-threatening complications during the 10 month follow-up period. One device required replacement as it was removed by the dog before a permanent fistula had formed. Open tubes due to loose safety plugs and focal cellulitis surrounding the exit sites of these tubes were noted in all dogs. The button tube may be a feasible option for long-term nutritional support in patients with pancreatic, hepatobiliary or gastrointestinal conditions.  相似文献   

16.
The clinical use and outcome of the rectus abdominis muscle flap to repair prepubic hernias were evaluated retrospectively. Medical records (2002-2007) of 8 dogs that had a rectus abdominis muscle flap to repair traumatic prepubic tendon rupture were reviewed. Only minor donor site complications were noted, including self-limiting ventral and hind-limb swelling. No long-term complications including recurrence of hernia were noted. The results of this study indicate that the rectus abdominis muscle flap is a clinically useful option for repairing prepubic tendon rupture in dogs.  相似文献   

17.
The use of ultrasound to measure small bowel thickness is an important part of any ultrasound examination of the abdomen. Increased thickness of the intestinal wall is a hallmark for the detection of diseases ranging from inflammatory bowel disease to neoplasia. Our subjective impression has been that dogs with no clinical signs of gastrointestinal disease often have sonographic measurements greater than published norms. The purpose of this study was to prospectively reevaluate these norms. The clinical history on all dogs receiving an abdominal ultrasound examination was evaluated for signs of gastrointestinal disease. Those without clinical signs were entered into this study. The documentation of body weight, breed, jejunal thickness, and duodenal thickness was made in 231 dogs. Dogs were placed into five groups based on their weight. Sixty-nine breeds were represented with weight ranging from 2.1 to 64 kg. A statistically significant (P < or = 0.05) correlation between body weight and both jejunal and duodenal thickness was observed. We also found that the maximum thickness in both jejunum and duodenum in healthy dogs was larger than previously reported. These data indicate norms for the jejunum of < or = 4.1 mm for dogs up to 20 kg, < or = 4.4 mm for dogs between 20 and 39.9 kg, and < or = 4.7 mm for dogs over 40 kg. The data indicate norms for the duodenum < or = 5.1 mm for dogs up to 20 kg, < or = 5.3 kg for dogs between 20 and 29.9 kg, and < or = 6.0 mm for dogs over 30 kg.  相似文献   

18.
A new type of intestinal re-entrant cannula for the small intestine of pigs is described. It consisted of an intestinal tube joined to a stem bearing a flange and two perspex plugs ("maintenance plug" and "collection plug"). The cannula was inserted in the intestine through the incision on the antimesenteric side of the intestine and no transection of the intestine was required. No outside connection was present and the cannula extended only 1 to 2cm beyond the body. Cannulae were inserted in the duodenum and ileum of 5 pigs and these functioned satisfactorily for up to 3 months.  相似文献   

19.
Dogs and cats that had a percutaneous endoscopic gastrostomy (PEG) tube or surgically placed gastrostomy (SPG) tube inserted were retrospectively analyzed to compare complication rates and the severity of complications. Complication rates and severity scores were not significantly different when the PEG tube group was compared to the SPG tube group in either dogs or cats. Only when data from dogs and cats were combined did PEG tubes have a significantly higher complication rate and significantly greater complication severity scores.  相似文献   

20.
Laparoscopic-assisted cystopexy in dogs   总被引：1，自引：0，他引：1  
OBJECTIVE: To develop a laparoscopic-assisted technique for cystopexy in dogs. ANIMALS: 8 healthy male dogs, 7 healthy female dogs, and 3 client-owned dogs with retroflexion of the urinary bladder secondary to perineal herniation. PROCEDURES: Dogs were anesthetized, and positive pressure ventilation was provided. In the healthy male dogs, the serosal surface of the bladder was sutured to the abdominal wall. In the healthy female dogs, the serosa and muscular layer of the bladder were incised and sutured to the aponeurosis of the external and internal abdominal oblique muscles. Dogs were monitored daily for 30 days after surgery. RESULTS: All dogs recovered rapidly after surgery and voided normally. In the female dogs, results of urodynamic (leak point pressure and urethral pressure profilometry) and contrast radiographic studies performed 30 days after surgery were similar to results obtained before surgery. Cystopexy was successful in all 3 client-owned dogs, but 1 of these dogs was subsequently euthanatized because of leakage from a colopexy performed at the same time as the cystopexy. CONCLUSIONS AND CLINICAL RELEVANCE: The laparoscopic-assisted cystopexy technique was quick, easy to perform, and not associated with urinary tract infection or abnormalities of urination.  相似文献   

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