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1.
Reasons for performing study: Obtaining data on emergency admission survival rates is important to provide clients with an estimate of prognosis and to identify areas in which improvements in case management can be achieved. Objective: To determine the short‐term outcome of equine emergency admissions to a university referral hospital during a 12 month period. Methods: Short‐term outcome was defined as survival to discharge or died/euthanasia during hospitalisation. The overall death (euthanasia) rate was calculated; and rate for horses with different categories of: age; admission month, day and time; presenting complaint (PC); duration of clinical signs prior to presentation; clinical pathology abnormalities; and therapy/therapeutic‐related procedures performed was recorded. Results: There were 918 admissions. The overall death rate was 24%. Foals (34%) and geriatric (40%) subjects had a death rate that was higher than that for mature horses (21%, referent). The death rate was highest in March (37%). Horses with a PC categorised as neurological (46%) or neonatal (41%) had the highest and as ophthalmological (5%) or trauma/skin (13%) the lowest death rates. There was no difference in death rate between different admission days or times or the duration of clinical signs prior to presentation. The death rates for horses with abnormal peritoneal fluid (71%), coagulopathy (63%), acid‐base abnormalities (52%), hypoproteinaemia (47%), dehydration (43%), hypoxia/hypercapnia (48%), leucopenia (44%), electrolyte abnormalities (39%), hyperlactataemia (39%) or azotaemia (35%) were high. The death rate for horses treated with intranasal oxygen (57%), plasma (34%) or polymixin B (35%) was high and for horses undergoing laceration repair/joint (0%) or synovial cavity lavage (4%) was low. Conclusions: Age and critical illness were important contributing factors to a higher death rate. Potential relevance: Improving the understanding of disease processes in and developing treatment strategies for neonatal and geriatric patients as well as critically ill patients is required.  相似文献   

2.
Clinical use of diagnostic ultrasound at point-of-care or emergency situations, although common, has not been well documented in veterinary medicine. Medical records of after-hour emergency equine admissions during a 10-year period were reviewed and horses that received ultrasound scans were identified. Data sheets for each ultrasound scan performed during emergency clinical evaluation were collected and reviewed. Data extracted included anatomical region imaged, body system affected, documented ultrasonographic diagnosis and final diagnosis. Six hundred and nine records were available of which 108 horses had an ultrasound diagnostic procedure performed. The most common reason for emergency ultrasonography was to investigate gastrointestinal abnormalities, the largest proportion of these being large intestinal disorders. A complete ultrasound report was documented in 57% of evaluations, of which 79% correlated with a final diagnosis. Incomplete reporting made accurate interpretation of records difficult. Results indicate that the use of ultrasound in the emergency setting may be of diagnostic benefit and impact on patient management. Ultrasound training should be provided to residents in order to gain proficiency, especially with regard to the gastrointestinal system.  相似文献   

3.
A retrospective study was designed to assess the prevalence and clinical presentation of canine aggression problems in a referral practice in Spain. One thousand forty canine aggression cases seen at the Animal Behavior Clinic (Barcelona School of Veterinary Medicine) were analyzed. Each aggression problem was characterized according to 7 predefined diagnostic categories. Breed and sex-related risk factors were calculated by comparing the aggressive dogs to a control population. Aggression problems were the most common behavior complaint (52.28% of all canine behavior cases). Owner-directed aggression was the most frequent of the aggression complaints (38.55%), followed by aggression towards other dogs (34.85%) and unfamiliar people (21.95%). A mean of 1.4 diagnoses of aggression per dog were established. Social conflict aggression towards family members was the most common diagnostic category (35.34%). Sixty nine per cent of aggressive dogs were males and 31% were females, from which only 11 and 12 percent were neutered respectively. Two breeds, the English cocker spaniel and the Catalan sheepdog, presented a particularly high risk for aggression in the studied population.  相似文献   

4.
Objective: To identify and describe the physical, historical, and clinicopathologic characteristics of diseases requiring emergency treatment in postpartum mares, and to evaluate the utility of these characteristics in making an accurate diagnosis in these mares. Design: Retrospective study. Setting: University large animal hospital. Animals: One hundred and sixty‐three mares admitted for emergency treatment within 30 days following parturition between the years 1992 and 2002. Interventions: None. Measurements and main results: Information obtained from the medical records included age, breed, date of admission, sex of the foal from this parturition, time from parturition to admission, duration of clinical signs prior to admission, and any report of dystocia or normal attended delivery, physical examination and clinicopathologic findings and diagnosis. Urogenital hemorrhage and large colon volvulus were the most common diagnoses, comprising 16.6% and 15.9% of total cases, respectively. Older mares were more likely to have a diagnosis of urogenital hemorrhage than younger mares. Mares with urogenital hemorrhage had a median age of 13 years and were admitted to the hospital significantly closer to parturition than mares with other diagnoses. Anemia, hypoproteinemia, and hypofibrinogenemia were significantly associated with a diagnosis of urogenital hemorrhage and occurred in 32%, 36%, and 26% of the mares with urogenital hemorrhage, respectively. Dystocia was more commonly reported (70%) in mares with metritis. Leukopenia was more common (88%) in mares with uterine tears. Conclusions: Careful evaluation of clinicopathologic data can aid the emergency clinician in making a correct diagnosis in postpartum mares with emergent problems.  相似文献   

5.
Objective – To examine serum sodium, glucose, and tonicity in cats with diabetic ketosis. Design – Retrospective study. Setting – A university‐based referral hospital. Animals – Cats admitted to the ICU during the period 1998 to 2002 with a diagnosis of diabetic ketosis. Interventions – None. Routine clinical management of diabetes and associated conditions. Measurements – Serum biochemistry assessments. Main Results – Abnormalities of glucose, sodium and serum tonicity (ST) were common in the study group. Serum sodium but not glucose correlated closely with ST. A subset of cats treated with intravenous insulin and an isotonic sodium‐containing solution for 72 hours showed a significant decrease in glucose from admission values at 48 and 72 hours (but not at 24 hours). Serum sodium, potassium, and ST were not significantly different from admission values at any time over the 72‐hour period. However, the relative contribution of individual osmolytes varied over the course of treatment. Although glucose decreased >120% from admission values over the 72‐hour treatment period, the approximately 5% rise in serum sodium that occurred offset the osmotic effect of falling glucose and the overall ST change was <3%. Conclusions – The incidence of osmotic‐mediated neurologic complications during treatment of cats with diabetic ketosis is low in part because the minimal fluctuation in ST during treatment likely prevents the development of osmotic gradients between serum and central nervous system tissues. The use of isotonic sodium‐containing fluids in the treatment of feline diabetes acts to minimize large osmotic shifts by adding sodium to the serum compartment as the glucose concentration falls.  相似文献   

6.
OBJECTIVES: To analyse the demographic information of dogs referred for investigation of fever, to determine the usefulness of various diagnostic investigations and to assess the effect of treatment before referral on the presence of fever at referral, the duration of the investigation and the ability to reach a final diagnosis. METHODS: The clinical records of 66 dogs, in which fever was part of the clinical signs documented by the referring veterinary surgeon, were reviewed. The effects of treatment 24 hours before referral on temperature at initial consultation and on time to diagnosis were evaluated. The effect of body temperature at initial consultation on cost and on time to diagnosis was also determined. The effect of insurance on costs incurred was assessed. The utility of different diagnostic investigations was recorded, and cases were classified according to the final diagnosis. RESULTS: Only 34.8 per cent of dogs were diagnosed with immune-mediated disease, with most frequent diagnoses being steroid-responsive meningitis and polyarthritis. Treatment 24 hours before referral significantly increased the time to diagnosis (P = 0.004) and affected the presence of fever at referral (P = 0.006). Insurance status did not significantly affect cost incurred by the owner. CLINICAL SIGNIFICANCE: This study documents a high incidence of immune-mediated disease in dogs referred for investigation of fever. It also documents a higher incidence of inflammatory central nervous system disease in febrile dogs than that reported previously. Of the diagnostic modalities employed in the majority of cases, radiography, cytology and bacteriological and fungal cultures (fluids/tissues) were the most useful. It is suggested that treatment is withdrawn or withheld before commencing diagnostic investigation of fever.  相似文献   

7.
BACKGROUND: Hyperglycemia in critically ill humans is associated with increased glucose production and insulin resistance and is associated with death. This might also be true in horses presenting with acute abdominal disease. HYPOTHESIS: Throughout hospitalization, hyperglycemia will be common in adult horses presenting with acute abdominal disease. Hyperglycemia will be associated with a worse prognosis for survival to hospital discharge. ANIMALS: Two hundred sixty-nine adult horses with acute abdominal disease. METHODS: Observational retrospective study. Records were reviewed for 269 horses that had glucose data analysed and recorded at the time of hospital admission: 154 horses had a first sample after admission; 110 horses at 24 hours after admission; 74 horses at 36 hours after admission; and 49 horses at 48 hours after admission. Logistic regression analyses were performed to investigate the association of glucose concentrations with survival, in addition to the association of glucose concentrations with surgical, small intestinal, strangulating lesions, and lesions requiring a resection. RESULTS: Of 269 horses presenting with acute abdominal disease, 50.2% had blood glucose concentrations greater than the reference range (75.6-131.4 mg/dL); 0.4%, below the reference range; and 49.4%, within the reference range at admission. Of 269 horses, 2.3% had blood glucose concentrations below the reference range at some point during the first 48 hours of hospitalization, all of which had strangulating intestinal lesions. Horses that did not survive to hospital discharge had a higher mean blood glucose concentration at admission; at the first sample after admission; at 24, 36, and 48 hours after admission; and higher maximum and minimum blood glucose concentrations in the first 24 hours after admission. CONCLUSIONS AND CLINICAL IMPORTANCE: Derangements of blood glucose concentration are common in horses with acute abdominal disease. Hyperglycemia is much more common than hypoglycemia in these animals. Hyperglycemia in the first 48 hours of hospitalization is associated with a worse prognosis for survival to hospital discharge.  相似文献   

8.
Even though the respiratory system is one of the most accessible organs for diagnostic testing, it is not always easy to define chronic lower airway disease in the horse. Diagnostic procedures performed by first opinion veterinarians in the field are often restricted to taking the history and performing clinical examination. Respiratory tract endoscopy, tracheal or bronchoalveolar lavage, and blood sampling are sometimes used but other specific ancillary examinations are seldom performed in stable settings. Therefore, our objectives were to evaluate the diagnostic value of different techniques and examination types routinely used in the diagnostic workup of chronic equine lower airway cases in both stable and clinical circumstances. Another aim of this study was to estimate the prevalence of different chronic pulmonary disorders among horses admitted to a Hungarian referral clinic. According to the conditional inference tree method, age of the horse, history, clinical examination, respiratory tract endoscopy, and bronchoalveolar lavage cytology proved to be the most valuable tools to define pathology. It was also concluded that in 22% of cases, more specific ancillary diagnostic modalities, unavailable for the field veterinarian, were needed to establish the final diagnosis. According to our study, the most frequently diagnosed chronic pulmonary disorders in Hungary are of noninfectious origin, principally recurrent airway obstruction. Regardless of the cause, and interestingly including recurrent airway obstruction as well, these diseases occur primarily during the warm months.  相似文献   

9.
REASONS FOR PERFORMING STUDY: The period between the onset of dystocia and its resolution has an important bearing on fetal outcome. There are few published data on which to base decisions regarding optimum management of cases in practice. OBJECTIVES: To evaluate and compare the effects of a coordinated dystocia management protocol (CDMP) with that of a previous protocol of random management on time to resolution and outcome in both an emergency dystocia referral population of mares (referred emergency cases: EM) and in a population of mares residing in hospital due to high risk pregnancy (HRP) concerns that then experience dystocia at parturition. METHODS: Retrospective study performed at a university hospital referral centre of cases presenting from 1991-2004 divided into Group 1 (pre-CDMP) and Group 2 (CDMP). RESULTS: Medical records of 71 cases with dystocia were retrieved and data recorded. For referred emergency cases (EM), time from hospital presentation to resolution decreased significantly by 32 min (P = 0.03) after institution of CDMP. Survival rate of mares at discharge was 86%. Survival of EM foals was low, with 10% in Group 1 and 13% in Group 2, surviving to discharge. For EM foals delivered alive, survival to discharge was 30% and 43% in Groups 1 and 2, respectively. Median Stage II was significantly (P < 0.001) different at 71 and 282 min for EM foals delivered alive vs. those not alive at delivery, respectively. Median duration of Stage II was also significantly (P < 0.001) different between EM foals surviving and not surviving to discharge, at 44 and 249 min, respectively. Survival of HRP dystocia foals to discharge was 79%. CONCLUSIONS: Although CDMP reduced the time from presentation at the hospital to resolution significantly for EM, total duration of Stage II for EM was unchanged, as was foal outcome. POTENTIAL RELEVANCE: Very early referral of mares with dystocia to referral centres with dystocia management protocols may improve fetal outcome as increased duration of Stage II in the horse affects fetal outcome negatively.  相似文献   

10.
Objective – To investigate the association between blood lactate concentration, measured at admission and following 12–36 hours of treatment, and age, diagnosis, and survival in neonatal foals. Design – Retrospective, observational study. Setting – Two equine referral hospitals. Animals – One hundred and twelve foals ≤96 hours of age were included. Interventions – Arterial or venous blood samples were obtained from all foals at admission and surviving foals at 12–36 hours. Measurements – The lactate concentration (LAC) was recorded at 2 time points: admission (LAC‐Admission) and 12–36 hours following treatment (LAC‐24 hours). Main Results – LAC decreased by 0.05 mmol/L for each increased hour of age at presentation. Premature/dysmature foals demonstrated increased odds of nonsurvival of 55% for each 1 mmol/L increase in LAC‐Admission while foals with major diagnoses of neonatal encephalopathy (NE), enteritis and ‘Other’ had increased odds of nonsurvival of 52%, 113%, and 247%, respectively, for each 1.0 mmol/L increase in LAC. Blood‐culture positive foals had significantly lower LAC than blood culture negative foals. LAC‐Admission and LAC‐24 hours were significantly larger in nonsurviving foals. LAC‐Admission of >6.9 mmol/L and LAC‐24 hours >3.2 mmol/L, respectively, correctly classified 85.6% and 94.1% of cases as survivors or nonsurvivors. No differences were found when the 24‐hour change in LAC was investigated in terms of outcome, age at admission, or major diagnosis; however, LAC‐24 hours remained significantly associated with survival. Conclusions – Admission or persistent hyperlactatemia is associated with a nonsurvival. Younger foals, premature/dysmature foals, and foals with neonatal encephalopathy had the largest LAC.  相似文献   

11.
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12.
Background: Because of the serious disease sequelae associated with equine herpesvirus type 1 (EHV‐1) infections, awareness and control measures used to control outbreaks are important issues for all horse populations. Objectives: Describe the occurrence and management of an outbreak of EHV‐1 infection at a veterinary hospital. Animals: Horses hospitalized at a referral veterinary hospital. Methods: A horse with myeloencephalopathy associated with EHV‐1 infection (EHM) was admitted for diagnostic evaluation and treatment under strict infection control procedures. We describe the occurrence and management of a nosocomial outbreak of EHV‐1 infections associated with admission of this patient. Results: Despite institution of rigorous biosecurity precautions at the time of admission of the index case, EHV‐1 infections spread to 6 other horses that were hospitalized at the James L. Voss Veterinary Teaching Hopsital, including 2 that served as sources of infection for horses on their home premises after discharge. Infection with EHV‐1 was confirmed by polymerase chain reaction (PCR) and by seroconversion documented by glycoprotein G ELISA. A voluntary quarantine was imposed and admissions were restricted to prevent additional horses from being exposed. Quarantine duration was abbreviated by serial testing of all horses with PCR. Conclusions and Clinical Importance: These findings illustrate the contagious disease risk that can accompany management of horses with EHM. Horses with active nasal EHV‐1 shedding should be isolated in an airspace that is separate from other horses by strictly enforced biosecurity and isolation procedures. Serial testing with PCR may be a useful adjunct to determine when the risk of transmission has been minimized.  相似文献   

13.
Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging equine pathogen. To attempt to control nosocomial and zoonotic transmission, an MRSA screening program was established for all horses admitted to the Ontario Veterinary College Veterinary Teaching Hospital, whereby nasal screening swabs were collected at admission, weekly during hospitalization, and at discharge. MRSA was isolated from 120 (5.3%) of 2,283 horses: 61 (50.8%) at the time of admission, 53 (44.2%) during hospitalization, and 6 from which the origin was unclear because an admission swab had not been collected. Clinical infections attributable to MRSA were present or developed in 14 (11.7%) of 120 horses. The overall rate of community-associated colonization was 27 per 1,000 admissions. Horses colonized at admission were more likely to develop clinical MRSA infection than those not colonized at admission (OR 38.9, 95% CI 9.49 160, P < 0.0001). The overall nosocomial MRSA colonization incidence rate was 23 per 1,000 admissions. The incidence rate of nosocomial MRSA infection was at the rate of 1.8 per 1,000 admissions, with an incidence density of 0.88 per 1,000 patient days. Administration of ceftiofur or aminoglycosides during hospitalization was the only risk factor associated with nosocomial MRSA colonization. MRSA screening of horses admitted to a veterinary hospital was useful for identification of community-associated and nosocomial colonization and infection, and for monitoring of infection control practices.  相似文献   

14.
OBJECTIVE: To determine the survival rates of dogs and cats that underwent surgical treatment for traumatic diaphragmatic hernia within 24 hours of admission and determine whether timing of surgery affected perioperative survival rate. DESIGN: Retrospective study. ANIMALS: 63 dogs and 29 cats treated surgically for traumatic diaphragmatic hernia. PROCEDURE: Medical records were reviewed to evaluate associations between perioperative survival rates and variables including timing of surgery in relation to admission and acute versus chronic diaphragmatic hernia. RESULTS: Among the 92 animals, 82 (89.1%) were discharged alive after surgery. Sixty-four (69.6%) patients received surgical intervention within 12 hours of admission, and 84 (91.3%) received surgical intervention within 24 hours of admission. Median time from admission to discharge was 4 days (2 to 33 days). Data for acute cases (68 dogs and cats) were analyzed separately. Sixty-three (92.6%) patients with acute diaphragmatic hernia received surgical intervention within 24 hours of admission to the hospital, and 59 (93.7%) of these patients were discharged alive. Twenty-nine (42.6%) patients with acute diaphragmatic hernia received surgical intervention within 24 hours of trauma, and 26 of 29 (89.7%) patients were discharged alive. An overall acute and chronic perioperative survival rate of 89.7% was observed in dogs and cats that received surgical intervention within 24 hours of admission. CONCLUSIONS AND CLINICAL RELEVANCE: Results in 68 dogs and cats that underwent surgery within 24 hours of admission suggested that early surgical intervention for acute diaphragmatic hernia was associated with good perioperative survival rates.  相似文献   

15.
ObjectiveTo design a holistic audit tool to assess the effectiveness of anaesthesia teaching strategies, and thereby to study veterinary undergraduate teaching methods in different geographical areas.Study designQualitative study using interviews of university staff and students to identify common themes and differences in teaching veterinary anaesthesia.MethodsAn audit was performed using an audit tool in four veterinary universities (École Nationale Vétérinaire d'Alfort, France; Royal Veterinary College, UK; University of Buenos Aires, Argentina; and Alma mater studiorum - Università di Bologna, Italy). First, an open-question interview of anaesthesia head of service (60–90 minutes) identified the pedagogical strategies in order to conceive a subsequent semi-directive interview formulated as a SWOT analysis (Strength/Weaknesses/Opportunity/Threats). Second, the SWOT reflection was conducted by a second staff member and focussed on: 1) general organization; 2) topics for pre-rotation teaching; 3) teaching methods for clinical rotation; and 4) assessment methods. Qualitative analysis of the interview responses was performed with semi-structured interviews. Finally, the students evaluated their teaching through a students’ questionnaire generated from the output of both interviews.ResultsA group of nine lecturers and 106 students participated in the study at four different sites. Preclinical teaching ranged from 13 to 24 hours (median 15 hours). Clinical teaching ranged from 4 to 80 hours (median 60 hours). Overall, all faculties perceived time as a limitation and attempted to design strategies to achieve the curriculum expectations and optimize teaching using more time-efficient exercises. Large animal anaesthesia teaching was found to be a common area of weakness. Internal feedback was delivered to each university, whereas generalized results were shared globally.ConclusionsThis preliminary study proved the generalizability of the protocol used. Recruiting a larger pool of universities would help to identify and promote efficient teaching strategies and innovations for training competent new graduates in an ever-expanding curriculum.  相似文献   

16.
Reasons for Performing Study: Critical illness is associated with hyperglycemia in humans, and a greater degree and duration of hyperglycemia is associated with nonsurvival. Hypoglycemia is also seen in critically ill humans, and is associated with nonsurvival. This might also be true in the critically ill foal.
Objectives: To investigate the association of blood glucose concentrations with survival, sepsis, and the systemic inflammatory response syndrome (SIRS).
Methods: Blood glucose concentrations at admission (515 foals) and 24 hours (159 foals), 36 hours (95), 48 hours (82), and 60 hours (45) after admission were analyzed. Logistic regression analyses were performed to investigate the association of glucose concentrations with survival, sepsis, a positive blood culture, or SIRS.
Results: 29.1% of foals had blood glucose concentrations within the reference range (76–131 mg/dL) at admission, 36.5% were hyperglycemic, and 34.4% were hypoglycaemic. Foals that did not survive to hospital discharge had lower mean blood glucose concentrations at admission, as well as higher maximum and lower minimum blood glucose concentrations in the 1st 24 hours of hospitalization, and higher blood glucose at 24 and 36 hours. Foals with blood glucose concentrations <2.8 mmol/L (50 mg/dL) or >10 mmol/L (180 mg/dL) at admission were less likely to survive. Hypoglycemia at admission was associated with sepsis, a positive blood culture, and SIRS.
Conclusions and Potential Relevance: Derangements of blood glucose concentration are common in critically ill foals. Controlling blood glucose concentrations may therefore be beneficial in the critically ill neonatal foal, and this warrants further investigation.  相似文献   

17.
Oesophageal diseases are less frequently reported in equine veterinary practice in comparison with other alimentary pathologies. This paper describes the prevalence, age, breed and sex distribution, the duration of clinical presentation before admission, the diagnosis, aetiology, treatment course, complications, length of hospitalisation, and the short‐term and long‐term survival of 39 cases with equine oesophageal disorders at a referral clinic. Prevalence of oesophageal disorders was significantly higher in the group of horses up to 4 years of age in comparison with other age groups. The most common oesophageal disorder was simple obstruction represented by 22/39 cases (56.41%). The common complications of the oesophageal disorder were oesophagitis (16/39, 41.02%) and aspiration pneumonia (11/39, 28.20%); 31/39 (79.49%) of all oesophageal cases survived up to clinical discharge. Long‐term survival was 65.78% in this group of cases.  相似文献   

18.
Rodents are commonly owned exotic animal pets that may be seen by veterinary practitioners. Although most owners presenting their animals do care about their pets, they may not be aware of the diagnostic possibilities and challenges that can be offered by rodents to the veterinarian. Understanding clinical anatomy, proper hand-ling technique, realistic management of emergency presentations,correct and feasible diagnostic sampling, anesthesia, and humane euthanasia procedures is important to enhancing the doctor-client-patient relationship, especially when financial constraints may be imposed by the owner.  相似文献   

19.
The objective of this retrospective case series was to determine the clinical signs, diagnostic test results, treatment protocols, and outcomes of rabbits treated for liver lobe torsion during a 5-year period at a large referral institution. A total of 16 rabbits diagnosed with liver lobe torsion at Angell Animal Medical Center (Boston, MA USA) during January 2007 to March 2012 were included in the study. The diagnosis of liver lobe torsion was made at surgery, during abdominal ultrasound, or on postmortem examination. Medical records of the subject animals were reviewed for signalment, history, clinical signs, results of clinical pathology testing, diagnostic imaging findings, treatment, surgical and histopathology findings, hospitalization time, and outcome. The most common clinical signs of rabbits diagnosed with liver lobe torsion in this study included anorexia, lethargy, and decreased fecal production lasting 1 day. Lop breeds, particularly mini lops, were overrepresented. Anemia was the most common hematologic abnormality, while elevated levels of alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, blood urea nitrogen, and creatinine were the most common serum biochemical abnormalities. Abdominal ultrasonography with Doppler assessment was used in 14 rabbits and provided a diagnosis of liver lobe torsion in all cases. The caudate lobe was involved in 10 rabbits (62.5%, 95% CI: 38.8 to 86.2), followed by the right lateral lobe (n = 5; 31.25%, 95% CI: 8.6 to 53.9), the left lateral lobe (n = 2; 12.5%, 95% CI: 3.7 to 28.7), and the right medial lobe (n = 1; 6.25%, 95% CI: 5.6 to 18.1). Two rabbits had more than 1 torsed liver lobe. Exploratory laparotomy and liver lobectomy were performed in 9 rabbits, and all of them survived. Supportive care alone was provided for 7 rabbits, 3 of which survived. The results suggest that nonspecific clinical signs of anorexia, lethargy, and decreased fecal production, in conjunction with anemia and high serum hepatic enzyme activities, should increase the index of suspicion for liver lobe torsion in rabbits. Abdominal ultrasonography with Doppler assessment is useful to confirm the diagnosis. The long-term prognosis for rabbits undergoing liver lobectomy and surviving the hospitalization period is excellent.  相似文献   

20.
Total or partial orbitectomy were used to treat 24 dogs and six cats with invasive periorbital tumors. The surgical procedure and clinical results were evaluated in this retrospective study. The most common types of tumors treated in this series of patients were multilobular osteochondrosarcoma and squamous cell carcinoma. Two patients died of cardiopulmonary arrest within 24 hours after surgery. One patient developed neurological signs after total orbitectomy that resolved with conservative therapy. Minor complications, which included infection, strabismus, and conjunctivitis, occurred in seven patients. Regrowth of tumor in the periorbital region occurred in 11 patients (36.7%). Tumor resection by orbitectomy provided local disease-free interval of more than 1 year in more than 50% of patients. Survival rate for the first year was 70.4% in this series of patients as determined by life table analysis. Orbitectomy requires detailed knowledge of regional anatomy and experience with performing a combination of surgical procedures. Preoperative diagnostic tests should include imaging techniques to define the extent of the disease. When performed properly, orbitectomy is a valuable procedure that can be used to effectively treat invasive tumors of the orbit.  相似文献   

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