Thoracoscopic Subphrenic Pericardectomy Using Double‐Lumen Endobronchial Intubation for Alternating One‐Lung Ventilation     

KELLI N. MAYHEW VMD  DIPLOMATE ACVS  PHILIPP D. MAYHEW BVM&S  DIPLOMATE ACVS  LAURIE SORRELL‐RASCHI DVM  DIPLOMATE ACVA  DOROTHY CIMINO BROWN DVM  MSCE  DIPLOMATE ACVS 《Veterinary surgery : VS》2009,38(8):961-966

Objective— To report the technique, complications, and effectiveness of thoracoscopic subphrenic pericardectomy (SPP) using double‐lumen endobronchial intubation for alternating 1‐lung (OLV) in healthy dogs. Study Design— Prospective cohort study. Animals— Mature purpose‐bred dogs (n=7). Methods— Bronchoscope‐assisted placement of a left‐sided double‐lumen endobronchial tube, immediately before surgery, allowed intraoperative alternation of ventilation between lung fields. A camera portal was established in a subxyphoid location. Two instrument portals were established at the 4th–6th intercostal spaces on the right and left sides. A vessel‐sealing device was used to create the subphrenic pericardectomy. After termination of the procedure, dogs were humanely euthanatized under anesthesia and necropsy performed. In each dog, the extent of pericardectomy and any complications were evaluated. Results— Technical difficulties with tube placement occurred in 4 dogs, but alternating OLV was achieved in all dogs and SPP completed successfully. Median surgical time was 87.5 minutes (range, 80–105 minutes). At necropsy, 0.5–2 cm of pericardial tissue remained ventral to the intact phrenic nerve in 6 dogs; in 1 dog, the phrenic nerve was transected on the left side only. Conclusions— Thoracoscopic subphrenic pericardectomy is a technically feasible procedure in healthy dogs. Double‐lumen endobronchial intubation allowed alternating OLV without intraoperative bronchoscopically guided tube manipulation in all but 1 dog. Clinical Relevance— Thoracoscopic subphrenic pericardectomy could potentially be used for management of conditions where relief of pericardial constriction or access to intrapericardial structures is desired.  相似文献   

Tissue Engineering in Wound Repair: The three “R”s—Repair,Replace, Regenerate     

CHRISTINE THEORET DMV  PhD  Diplomate ACVS 《Veterinary surgery : VS》2009,38(8):905-913

Horses are predisposed to traumatic wounds that can be labor intensive and expensive to manage. Skin has a considerable potential for efficient and functional repair however, while cutaneous repair is a regenerative process in the fetus, this capability declines in late gestation as inflammation and scarring alter the outcome of healing. The historical gold standard for replacement of lost skin is the autologous skin graft. However, the horse's lack of redundant donor skin limits the practicality of full‐thickness grafting to smaller wounds; moreover, graft failure is relatively common in equine patients as a result of infection, inflammation, fluid accumulation beneath the graft, and motion. Tissue engineering has emerged as an interdisciplinary field with the aim to regenerate new biological material for replacing diseased or damaged tissues or organs. In the case of skin, the ultimate goal is to rapidly create a construct that effects the complete regeneration of functional skin, including all its layers and appendages. Moreover, an operational vascular and nervous network, with scar‐free integration within the surrounding host tissue, is desirable. For this to be achieved, not only is an appropriate source of cells required, but also a scaffold designed from natural or synthetic polymers. The newly created tissue might finally meet the numerous needs and expectations of practitioners and surgeons managing a catastrophic wound in a horse  相似文献   

Biologic Behavior and Clinical Outcome of 25 Dogs with Canine Appendicular Chondrosarcoma Treated by Amputation: A Veterinary Society of Surgical Oncology Retrospective Study     

JAMES P. FARESE DVM  Diplomate ACVS  MARJA KIK DVM  PhD  Diplomate Vet Path  BERNARD SEGUIN DVM Diplomate ACVS  ROD STRAW BVSc  Diplomate ACVS  MACVSc  MYRON N. CHANG PhD  YANG JIANG 《Veterinary surgery : VS》2009,38(8):914-919

Objective— To characterize biologic behavior, clinical outcome, and effect of histologic grade on prognosis for dogs with appendicular chondrosarcoma treated by amputation alone. Study Design— Case series. Animals— Dogs (n=25) with appendicular chondrosarcoma. Methods— Medical records were searched to identify dogs with appendicular chondrosarcoma treated by limb amputation alone. Information recorded included signalment, anatomic location, radiographic appearance, and development of metastasis. Histopathologic diagnosis was confirmed and graded (1, 2, or 3). Survival curves were generated by the Kaplan–Meier method and the association between covariates (gender, age, weight, and tumor grade) and survival were evaluated using the univariate proportional hazards model. Results— Histopathology slides were available for 25 dogs. Rates of pulmonary metastasis were as follows: grade 1–0%, grade 2–31%, and grade 3–50%. Overall median survival time (MST) was 979 days. Age, weight, and sex were not significantly associated with survival (P=.16; .33; and .31, respectively). Survival was significantly associated with tumor grade (P=.008), with dogs with tumor grade of 1, 2, and 3 having MSTs of 6, 2.7, and 0.9 years, respectively. Conclusion— Canine appendicular chondrosarcoma can be treated effectively with amputation alone. Low to intermediate grade chondrosarcoma has a good prognosis, whereas high‐grade tumors appear to behave aggressively. Clinical Relevance— The overall prognosis for appendicular chondrosarcoma is better than that of appendicular osteosarcoma treated by amputation alone or in combination with chemotherapy.  相似文献   

Use of a wireless system to measure invasive arterial blood pressure in ponies – preliminary study     

Carolina H Ricco DVM  MS  Diplomate ACVA    Jane E Quandt DVM  MS  Diplomate ACVA  Diplomate ACVECC    Roberto E Novo DVM  MS  Diplomate ACVS    Maria Killos DVM  & Lynelle Graham DVM  MS  Diplomate ACVA 《Veterinary anaesthesia and analgesia》2009,36(1):1-8

Objective  To evaluate the feasibility and functionality of intra-carotid wireless device implantation in ponies, and to investigate its short-term complications.
Study design  Prospective preliminary study.
Animals  Five mixed breed, adult, intact male ponies weighing 104 ± 28.8 kg (mean ± SD) underwent surgery. Arterial blood pressure data were continuously collected from four animals.
Methods  General anesthesia was induced on two consecutive days. On the first day, an intra-arterial wireless device was implanted in the right carotid artery. On the next day, a transcutaneous intra-arterial catheter was placed in the left facial artery. Data from both sources were collected. Post-mortem examination was performed.
Results  Surgical time was 27.1 ± 11.85 minutes. All catheters remained in place with some extra vascular migration. Complications included mild seroma and hematoma.
Conclusion  The wireless system allowed continuous monitoring in ponies throughout anesthesia and at rest and may allow for the recording of arterial blood pressure and heart rate when it would be difficult to achieve with a conventional system (e.g. during recovery from anesthesia).
Clinical relevance  The wireless invasive blood pressure monitor may allow continuous measurements when only intermittent measurements would be feasible with a wired system.  相似文献   

A comparison of epidural buprenorphine plus detomidine with morphine plus detomidine in horses undergoing bilateral stifle arthroscopy     

Berit L Fischer DVM  Diplomate ACVA    John W Ludders DVM  Diplomate  ACVA    Makoto Asakawa BVSc    Lisa A Fortier DVM  PhD  Diplomate ACVS    Susan L Fubini DVM  Diplomate ACVS    Alan J Nixon DVM  PhD  Diplomate ACVS    Rolfe M Radcliffe DVM  Diplomate ACVS  & Hollis N Erb† DVM  MS  PhD 《Veterinary anaesthesia and analgesia》2009,36(1):67-76

ObjectiveTo compare the analgesic efficacy of buprenorphine plus detomidine with that of morphine plus detomidine when administered epidurally in horses undergoing bilateral stifle arthroscopy.Study designProspective, randomized, blinded clinical trial.AnimalsTwelve healthy adult horses participating in an orthopedic research study. Group M (n = 6) received morphine (0.2 mg kg^?1) and detomidine (0.15 mg kg^?1) epidurally; group B (n = 6) received buprenorphine (0.005 mg kg^?1) and detomidine (0.15 mg kg^?1) epidurally.MethodsHorses received one of two epidural treatments following induction of general anesthesia for bilateral stifle arthroscopy. Heart rate (HR), mean arterial blood pressure (MAP), end-tidal CO₂ (Pe’CO₂), and end-tidal isoflurane concentrations (E’Iso%) were recorded every 15 minutes following epidural administration. Post-operative assessment was performed at 1, 2, 3, 6, 9, 12, and 24 hours after standing; variables recorded included HR, respiratory rate (f_R), abdominal borborygmi, defecation, and the presence of undesirable side effects. At the same times post-operatively, each horse was videotaped at a walk and subsequently assigned a lameness score (0-4) by three ACVS diplomates blinded to treatment and who followed previously published guidelines. Nonparametric data were analyzed using Wilcoxon’s rank-sum test. Inter- and intra-rater agreement were determined using weighted kappa coefficients. Statistical significance was set at p = 0.05.ResultsNo statistically significant differences were found between groups with respect to intra-operative HR, MAP, E’Iso%, or post-operative HR, gastrointestinal function and cumulative median lameness scores. Post-operative f_R in group B [24 (12-30), median (range)] breaths per minute was significantly higher than in group M [18 (15-20)] breaths per minute, p = 0.04.Conclusions and clinical relevanceIn horses undergoing bilateral stifle arthroscopy, these doses of buprenorphine plus detomidine injected epidurally produced analgesia similar in intensity and duration to that of morphine plus detomidine injected epidurally.  相似文献   

Antinociceptive, cardiopulmonary, and sedative effects of five intravenous infusion rates of lidocaine in conscious dogs     

Lori M MacDougall DVM    James A Hethey BSc    Alex Livingston† BSc  BVetMed  PhD  Diplomate ECVPT  FRCVS    Christopher Clark‡ BA  VetMB  MVetSc  Diplomate ACVIM    Cindy L Shmon DVM  MVSc  Diplomate ACVS  & Tanya Duke-Novakovski BVetMed  DVA  Diplomate ACVA  Diplomate ECVAA 《Veterinary anaesthesia and analgesia》2009,36(5):512-522

  相似文献   

Successful Management of Traumatic Right Atrial Rupture     

Angela L. Witt DVM  Karol A. Mathews DVM  DVSc  Diplomate ACVECC  David L. Holmberg DVM  MVSc  Diplomate ACVS 《Journal of Veterinary Emergency and Critical Care》2000,10(2):85-89

A 2 year old male mixed breed dog presented with clinical signs of acute cardiac tamponade after being hit by a car. Echocardiography confirmed the presence of pericardial effusion. Pericardiocentesis revealed venous blood that clotted normally, suggestive of an acute lesion involving the right side of the heart. An emergency thoracotomy was performed, and a laceration of the right atrium was identified and repaired. Postoperatively, the dog developed traumatic myocarditis that improved with time and medical management. Six months after surgery, the dog was healthy with no adverse effects of the trauma. The importance of early recognition and the necessity for expeditious surgical management of traumatic right atrial rupture in the dog is illustrated in this report.  相似文献   

Possible Hemolytic Uremic Syndrome in Three Cats After Renal Transplantation and Cyclosporine Therapy     

Lillian R. Aronson  VMD  Diplomate ACVS    Clare Gregory  DVM  Diplomate ACVS 《Veterinary surgery : VS》1999,28(3):135-140

OBJECTIVE: To describe the clinical history of 3 cats with possible hemolytic uremic syndrome (HUS) after renal transplantation. STUDY DESIGN: This case series documents historical findings, physical examination findings, clinical pathologic features, necropsy and histopathologic findings of 3 cats with possible HUS. RESULTS: Two cats had chronic renal failure; 1 cat had acute renal failure secondary to ethylene glycol toxicity. A renal transplant was performed in each of the 3 cats without obvious problems. Complications that would support a diagnosis of HUS, including anemia, thrombocytopenia, and azotemia occurred within 24 hours in 1 cat, within 8 days in a second cat, and 2 months after transplantation in the third cat. In 2 cats, HUS was likely secondary to cyclosporine immunosuppression. In the third cat, HUS may have been secondary to allograft rejection. Renal biopsies from all 3 cats were suggestive of HUS. CONCLUSION AND CLINICAL RELEVANCE: In human beings, HUS in transplant recipients may occur secondary to immunosuppressive drugs, vascular rejection, or recurrence of original disease. Graft loss occurred in all 3 cats in this study and the mortality rate was 100%. Clinicians caring for these patients need to be aware of this disorder because early recognition and treatment is critical in the management of post-transplant HUS.  相似文献   

In Vitro Effects of Epidermal Growth Factor or Insulin-Like Growth Factor on Tenoblast Migration on Absorbable Suture Material   总被引：7，自引：0，他引：7  

H.W. Jann  DVM  MS  Diplomate ACVS    Larry E. Stein  Ph.D.    Donna A. Slater  DVM 《Veterinary surgery : VS》1999,28(4):268-278

OBJECTIVE: To determine the effects of epidermal growth factor (EGF) or insulin-like growth factor (IGF) on tenoblast migration on absorbable suture material using an in vitro model. STUDY DESIGN: An in vitro evaluation of tenoblast migration. ANIMAL OR SAMPLE POPULATION: Segments of the long digital flexor tendon were obtained from Cobb chickens (9-11 weeks old) immediately after the birds were euthanatized. METHODS: Tissue culture explants of tendons containing absorbable suture material were treated with either EGF or IGF. Tenoblast migration was assessed daily using an inverted microscope equipped with bright field and phase optics. Tenoblast migration was assessed according to the following criteria: time of first cell appearance, percent of explant interfaces producing cells, migration distance, and terminal migration index at 120 and 168 hours. RESULTS: EGF had a stimulatory effect on tenoblast migration for cells originating from the endotenon interfaces. No significant effect was noted on migration distance for cells originating from epitenon interfaces. A stimulatory effect on the percentage of interfaces producing cells and a significant decrease in time of first cell appearance were also observed after EGF treatment. IGF-stimulated cell migration distance for epitenon interfaces but this stimulatory effect did not occur at a higher concentration. IGF was inhibitory to percent of epitenon and endotenon interfaces producing cells but decreased time of first cell appearance at low concentration. CONCLUSIONS: Using an in vitro model, EGF had a stimulatory effect on tenoblast migration. IGF was stimulatory at low concentration levels but inhibitory at a higher concentration. Increased migration distance was observed for endotenon interfaces after EGF treatment and for epitenon interfaces after IGF treatment. CLINICAL RELEVANCE: EGF or IGF might enhance tendon repair if they could be delivered to the repair site. Incorporation of EGF or IGF into suture material would allow slow release and prolonged exposure of migrating tenoblasts to growth factors.  相似文献   

Fluoroscopically Guided Closed Reduction and Internal Fixation of Fractures of the Lateral Portion of the Humeral Condyle: Prospective Clinical Study of the Technique and Results in Ten Dogs     

James L. Cook  DVM  PhD  Diplomate ACVS    James L. Tomlinson  DVM  MVSc  Diplomate ACVS    Ann L. Reed  DVM  MS  Diplomate ACVR 《Veterinary surgery : VS》1999,28(5):315-321

OBJECTIVE: To report a technique for fluoroscopically guided closed reduction with internal fixation of fractures of the lateral portion of the humeral condyle (FLHC) and determine the long-term results in 10 clinical cases. STUDY DESIGN: Prospective clinical case study. ANIMALS: Ten dogs with 11 fractures. METHODS: Fractures of the lateral portion of the humeral condyle were stabilized with transcondylar screws and Kirschner wires. Closed reduction and implant placement were achieved using intraoperative fluoroscopic guidance. After fracture repair, postoperative radiographs were evaluated for articular alignment and implant placement. Dogs were evaluated after surgery by means of lameness scores, elbow range of motion (ROM), radiographic assessment, and owner evaluation of function. RESULTS: Postoperative reduction was considered anatomic in 6 fractures with all other fractures having <1.5 mm of malreduction. Follow-up was available for 9 patients from 9 to 21 months after surgery. All of the fractures had healed. One minor (wire migration) and one major (implant failure) complication occurred. Mean lameness scores were 0 (n = 6), 0.5 (n = 2), and 1 (n = 1) at the time of final follow-up. No significant differences were found in follow-up ROM values between affected and unaffected elbows. All of the dogs in this study regained 90-100% of full function, based on owner assessment. CONCLUSIONS AND CLINICAL RELEVANCE: Fluoroscopic guidance for closed reduction and internal fixation of FLHC in dogs is an effective technique.  相似文献