CASE STUDY: MANAGEMENT OF VENTRAL HERNIA IN A 2-YEAR-OLD MIXED BREED FEMALE CAT WITH LAPAROTOMY

To determine whether jejunal serosal patches could securely seal large, open defects in duodenal segments harvested from canine cadavers and to compare intraluminal pressures at which leakage first occurred and maximal intraluminal pressures for repaired duodenal segments between 2 suture patterns. Duodenal and jejunal segments from 9 canine cadavers. 20 constructs were created through repair of large, open duodenal defects with circumferential suturing of an intact jejunal segment (jejunal serosal patch). Constructs were randomly assigned to have the serosal patch anastomosed to the duodenal segment by a simple continuous or simple interrupted suture pattern. The pressure at which the first leakage was observed and the maximum pressure obtained during testing were recorded and compared between suture patterns. Initial leakage pressure was significantly higher with the simple interrupted pattern (mean ± SD, 68.89 ± 5.62 mm Hg), compared with the simple continuous pattern (59.8 ± 20.03 mm Hg). Maximum intraluminal pressures did not significantly differ between the simple interrupted (91 ± 8.27 mm Hg) and simple continuous patterns (90.7 ± 16.91 mm Hg). All constructs, regardless of suture pattern, withstood supraphysiologic pressures. Jejunal serosal patches adequately sealed large, open duodenal defects and prevented leakage in these constructs. Constructs with simple continuous or simple interrupted suture patterns withstood physiologic and supraphysiologic intraluminal pressures, although constructs with a simple interrupted suture pattern initially leaked at higher pressures. (Am J Vet Res 2020;81:985-991).

Inguinal hernia is the protrusion of an organ, part of an organ, fat, or tissue through the inguinal ring, located between the groin and abdominal muscles. This case study aims to understand the diagnostic methods and management of inguinal hernia in a domestic cat. A three-month-old male domestic cat weighing 1 kg presented with a lump in the inguinal area. After clinical and radiographic examinations, the cat was diagnosed with an inguinal hernia with a favorable prognosis. Treatment was performed surgically using the herniorrhaphy technique to reposition the herniated contents into the abdominal cavity. Before surgery, the cat was given premedication with atropine (V-tropine® 0.02 mg/kg BW SC), followed by anesthesia using a combination of xylazine (xylazine® 1 mg/kg BW) and ketamine (ketamine® 11 mg/kg BW) intravenously. The surgical procedure involved repositioning the herniated contents and modifying the hernia ring to allow tissue adhesion. Layered suturing was performed using polyglycolic acid 3.0 for the peritoneum (simple interrupted pattern), catgut 3.0 for the subcutaneous layer (simple continuous pattern), and silk 2.0 for the skin (simple interrupted pattern). Postoperatively, the cat was administered cefotaxime (cefotaxime® 20 mg/kg BW q12h IM) for three days and tolfenamic acid (tolfedine® 4 mg/kg BW q24h IM) for four days, followed by cefixime (cefixime® 10 mg/kg BW q12h PO). On the eighth day, the cat was declared fully recovered with stable clinical conditions, good appetite, and normal urination and defecation. Surgical intervention using the herniorrhaphy technique proved effective in treating inguinal hernia in domestic cats, ensuring a fast recovery and a high success rate. Early diagnosis and prompt treatment are crucial to prevent serious complications, such as organ strangulation, which can lead to necrosis and systemic infection. Therefore, pet owners need to be more vigilant about the symptoms of inguinal hernia and promptly take their pets to a veterinarian for proper diagnosis and treatment

OBJECTIVE To compare the leak pressure and amount of time required to perform closure for 2 double-layer esophagotomy closure techniques. SAMPLE 28 intrathoracic esophageal segments harvested from 38 porcine cadavers. PROCEDURES Longitudinal 3-cm esophagotomy incisions made in porcine cadaveric esophagi were closed with 2 double-layer closure techniques. Fifteen incisions were closed with a simple interrupted pattern, and 13 incisions were closed with a simple continuous pattern. Leak pressure, bursting wall tension, and closure time were compared between suture patterns by use of a t test or Mann-Whitney rank sum test. RESULTS Median leak pressures differed significantly between segments closed with the simple interrupted pattern (16.0 mm Hg; range, 5.4 to 54.9 mm Hg) and the simple continuous pattern (38.7 mm Hg; range, 11.3 to 81.9 mm Hg). Median bursting wall tension differed significantly between the simple interrupted pattern (0.63 × 105 dynes/cm; range, 0.16 × 105 dynes/cm to 2.89 × 105 dynes/cm) and the simple continuous pattern (1.79 × 105 dynes/cm; range, 0.44 × 105 dynes/cm to 4.70 × 105 dynes/cm). Mean ± SD closure time differed significantly between the simple interrupted pattern (19.2 ± 2.0 minutes) and the simple continuous pattern (14.7 ± 1.5 minutes). CONCLUSIONS AND CLINICAL RELEVANCE In the study reported here, double-layer simple continuous closure resulted in a higher median postoperative leak pressure and higher median postoperative bursting wall tension and could be performed more rapidly than the double-layer simple interrupted closure on these porcine cadaveric specimens.

Occurrence of Incisional Complications After Closure of Equine Ventral Midline Celiotomies With 2 Polyglycolic Acid in Simple Interrupted Suture Pattern

OBJECTIVE To compare tensile strength and time to completion of body wall closure among 3 suture patterns. SAMPLE Eighteen 5 × 5-cm leather specimens and sixty-eight 5 × 5-cm full-thickness tissue specimens from the ventral portion of the abdominal body wall of 17 canine cadavers. PROCEDURES During experiment 1 of a 2-experiment study, each leather specimen was cut in half and sutured with a simple interrupted or simple continuous pattern or continuous pattern with intermittent Aberdeen knots (intermittent Aberdeen pattern). During experiment 2, 4 tissue specimens were obtained from each cadaver; the linea alba of 3 specimens was incised and closed with 1 of the 3 suture patterns evaluated in experiment 1, and the fourth specimen was left intact as a control. All leather and tissue specimens underwent mechanical testing. Time to completion, mode of failure, and maximum force at failure (Fmax) were compared among the suture patterns. RESULTS In experiment 1, the mean Fmax for the simple continuous and intermittent Aberdeen patterns was significantly greater than that for the simple interrupted pattern. In experiment 2, the mean Fmax for specimens obtained cranial to the umbilicus was greater than that for specimens obtained caudal to the umbilicus, and the mean time to completion for both continuous suture patterns was significantly less than that for the simple interrupted pattern. Most (34/51) sutured tissue specimens failed because the suture cut through the tissue at the suture-tissue interface. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the intermittent Aberdeen pattern may be an alternative for body wall closure in dogs.

The paper reports teat fistula and its surgical repair in four goats. Four goats with teat fistula following full thickness lacerated teat wound were presented to the surgery unit of VCC, VCRI, Tirunelveli and were operated under 2% lignocaine anaesthesia by ring block. Suturing of the fistula was done in three layers after debridement. The mucosa was sutured alone in one layer, whereas muscularis and connective tissues were sutured in the second layer by simple continuous pattern with polyglycolic acid 3-0. The skin wound was sutured by simple interrupted pattern using polypropylene 2-0. All the cases recovered successfully.

Background: The giant anteater is considered a species vulnerable to trauma due to being slow and, therefore, vulnerable to long bone fractures, such as femoral fracture. Locking plates have the potential to restore and maintain fractured bone stability, as well as reduce damage to the vascular supply. This study aims at reporting cases of two giant anteaters subjected to femoral osteosynthesis using locking plates. Cases:Two giant anteaters presenting non-weight bearing lameness on the right pelvic limbs were evaluated, diagnosed with femoral fracture of unknown etiology and submitted to osteosynthesis. A clinical evaluation was performed under chemical restraint for the adult animal and physical restraint for the young one. Crepitation and swelling in the right femur topography led to a radiographic examination, which showed a complete and transverse diaphyseal fracture of the right femur in both cases. The first one was an adult male and was subjected to osteosynthesis of the right femur using a locking plate. Once anesthetized, the animal was placed in left lateral recumbency, and the right pelvic limb was clipped and sterilized. A craniolateral incision was made to expose the femoral diaphysis. A large amount of fibrous-looking tissue was found and removed. Subsequently, the fracture was reduced and the locking plate system was positioned on the craniolateral side of the femur. An osteotomy of the femoral trochanteric crest was required to position the implant. The overlying fascia lata was closed using monofilament suture in a simple continuous pattern. The closure of the subcutaneous tissue and skin was performed using a Cushing pattern and simple interrupted pattern, respectively. Immediate postoperative radiographic examinations showed fracture reduction and bone axis alignment, with a properly positioned implant. The surgical wound was cleaned daily with 0.5% aqueous chlorhexidine solution. Seven days after surgery, the animal had a partial dehiscence at the suture site, with bone and plate exposure. Wound healing by second intention was initiated. At 127 days after surgery, a radiographic examination showed periosteal bone proliferation in the middle third of the right femur and that the bone implants were well-positioned. The second case was of a young 3.68 kg female anteater. The surgery was performed as described for the adult one, but there was no fibrosis at the fracture site and the osteotomy of the femoral trochanteric crest was not required. Closure of the fascia lata, subcutaneous tissue, and skin was performed as in Case 1. An immediate postoperative radiographic examination showed fracture reduction, bone axis alignment, and a properly positioned implant. The surgical wound was cleaned daily with 0.5% aqueous chlorhexidine solution. On the day of the surgery, the animal could already bear weight on its right pelvic limb, presenting discrete lameness with gradual improvement. Twenty-three days after surgery, a radiographic examination showed moderate periosteal bone proliferation in the middle third of the right femur. The bone implant was still well-positioned and bone healing was achieved around the 40th post-operative day.Discussion:The cases are very similar, but the younger anteater's femoral trochanteric crest didn't prevent positioning the plate. The fibrosis observed on the adult specimen is indicative of a chronic fracture, which may explain, in conjunction with the post-surgical complications, the longer time required for bone healing in the adult animal. Even so, both animals recovered fully and it's safe to deduce that the locking plate is an adequate option for internal fixation in transverse diaphyseal femoral fractures in both adult and young giant anteaters.

Bu çalışma, Van kedilerinde humerus, radius ve ulna’nın bilgisayarlı tomografi (BT) aracılığıyla üç boyutlu (3B) rekonstrüksiyonu yapmak, anatomik özelliklerinin belirlenmesini sağlamak, morfometrik ve volümetrik ölçülerini elde etmek ve bu ölçüm değerlerinin seksüel dimorfizm bakımından biyometrik farklılıklarının belirlenmesi amacıyla yapıldı. Çalışmada 8 dişi, 8 erkek olmak üzere 16 adet Van kedisi kullanıldı. Kediler dissosiyatif ajanlar (ketamine ve xylazine kombinasyonu) kullanılarak anesteziye alındı. Anestezi altındaki hayvanlar BT ile taranarak görüntüleri elde edildi. Elde edilen imajlar DICOM formatında işlenmek üzere iş istasyonuna aktarıldı ve 3B modelleme programı olan Syngo CT kullanılarak rekonstrüksiyon işlemi yapıldı. Daha sonra bu kemiklerin anatomik yapıları incelenerek, morfometrik ve volümetrik ölçümleri hesaplandı ve istatistiki analizi yapıldı. Yapılan çalışmadaki 3B rekonstrüksiyon görüntülerinde, humerus’un distal’inde hem foramen (for.) supracondylare hem de for. supratrochleare’ye rastlanıldı. Morfometrik analiz sonuçlarına bakıldığında, humerus, radius ve ulna’nın ölçüm değerleri bakımından erkek ve dişi Van kedileri arasında istatistiksel olarak önemli farklılıklar olduğu görüldü (P<0.05). Erkek ve dişi kedilere ait humerus, radius ve ulna’nın volüm ölçüm değerleri sırasıyla 11.22±0.86 cm3, 8.01±1.16 cm3; 3.85±0.57 cm3, 2.37±0.20 cm3; 26±0.66 cm3, 2.99±0.26 cm3 olarak tespit edildi. Erkek ve dişi kedilerin volümetrik ölçüm değerleri arasında görülen bu farklılıkların istatistiksel olarak anlamlı seviyede olduğu bulundu (P<0.05). Sonuç olarak, Van kedilerinde humerus, radius ve ulna’ya ait ölçüm parametrelerinin istatistiksel olarak cinsiyetler arasındaki farklılıkları BT ve 3B modelleme programı kullanılarak tespit edildi. Ayrıca çalışmadan elde edilen morfolojik bilgilerin ve osteometrik ölçüm değerlerinin bu kemiklerle ilgili anatomi eğitimi başta olmak üzere, patoloji, cerrahi, klinik uygulama ve zooarkeoloji gibi birçok alandaki çalışmalara faydalı olacağı düşünülmektedir.

To compare pullout strength of 3 suture patterns used for canine tracheal anastomosis. Experimental study. Cadaveric canine tracheae (n = 20). Tracheal segments were anastomosed with 1 of 3 suture patterns: simple continuous, simple interrupted, and simple interrupted reinforced with horizontal mattress, each encircling annular cartilage rings adjacent to the transection site. Horizontal mattress sutures encircled the annular rings proximal and distal to the rings closest to the anastomosis. Each construct was distracted (0.5 mm/s) in a materials testing machine to failure. Load-displacement curves were generated and failure load (pullout strength) determined and mode of failure recorded. Tracheal anastomosis with a simple interrupted pattern was significantly weaker (mean+/-SD pullout strength, 102.55+/-30.14 N) than simple continuous (135.53+/-15.47 N) or simple interrupted plus horizontal mattress (132.39+/-21.46 N), which were not different from each other. Mode of failure was consistently by suture tear out. Both simple continuous and simple interrupted reinforced with horizontal mattress suture patterns have significant biomechanical advantage over a simple interrupted pattern alone in canine cadaveric tracheal anastomosis. The simple continuous pattern had the least variability in pullout strength. A simple continuous technique should be considered when selecting a tension-relieving pattern for canine tracheal anastomosis. It offers the same biomechanical advantage as a simple interrupted pattern reinforced with a horizontal mattress pattern and its strength appears to be reliably maintained when tested in canine cadaver tracheae.

A 2‐year‐old, neutered, female Yorkshire Terrier was presented for investigation of chronic vomiting and inappetence. A hand‐sewn end‐to‐end anastomosis using polydioxanone in a modified simple continuous pattern had been performed 8 weeks earlier for management of intestinal foreign body obstruction. Abdominal ultrasound showed an intestinal linear foreign body, and exploratory coeliotomy revealed focal jejunal plication aborad to the previous enterectomy site. An enterotomy revealed plant foreign material anchored to a strand of persistent polydioxanone suture material extruding into the jejunal lumen, and both were removed. The enterotomy was apposed with poliglecaprone 25 sutures in a simple continuous pattern. However, septic peritonitis developed 72 hours postoperatively. Slowly absorbable suture material can be associated with intestinal foreign body entrapment following intestinal anastomosis apposed with a simple continuous pattern. A shorter duration absorbable material or simple interrupted pattern may be considered for apposition of intestinal wound anastomosis to avoid this complication.

This study compares the healing of oronasal defects created by partial maxillectomy when closed using two different suture materials and two different suture patterns. In experiment 1, 24 dogs were divided into four equal groups. Partial maxillectomy was performed on each dog and was closed using either a two‐layer simple interrupted suture pattern (12 dogs) or a modified Mayo mattress pattern (12 dogs) with either polyglactin 910 (12 dogs) or polypropylene (12 dogs) sutures. On the seventh postoperative day, the dogs were euthanized, suture line bursting pressures were measured, and wound healing was evaluated grossly and histopathologically. Suture line dehiscence occurred in one dog from each of the four groups. These were the only dogs in which electrocoagulation had been used. The healing of suture lines closed with the two‐layer simple interrupted pattern was superior to that of those closed with the modified Mayo mattress pattern based on the degree of gross oral ulceration, suppurative inflammation, fibrosis and oral epithelial covering at the suture line, and the number of necrotic sites in the adjacent tissue. The healing of suture lines closed with polypropylene was superior to that of those closed with polyglactin 910 based on suture line bursting pressures and the degree of suppurative inflammation and tissue necrosis at the suture sites. In Experiment 2, partial maxillectomies were performed on four dogs, and closure was achieved using a two‐layer simple interrupted suture pattern with either polyglactin 910 (two dogs) or polypropylene (two dogs). On the 30th postoperative day, the dogs were euthanized, and wound healing was evaluated grossly and histopathologically. All suture lines were well healed. All polyglactin 910 oral sutures were absent, while all polypropylene oral sutures were still present.

This study was conducted to obtain the morphometric and volumetric measurements of bulbus oculi of Van cats, growing around the city of Van in Turkey and named after here, by using computed tomography (CT) and magnetic resonance imaging (MRI), and to reveal the biometric differences of these measurement values between the sexes. A total of 16 adult Van cats including 8 females and 8 males were used in the study. The animals were anesthetized with the combination of xylazine and ketamine. The anesthetized animals were scanned by using CT and MRI devices and their images were obtained. Then, the morphometric and volumetric measurements of bulbus oculi were calculated from these images using the software (Syngo CT Software) in the workstation and their statistical analysis was performed. Upon the examination of the morphometric and volumetric analysis results, it was determined that while W (bodyweight) and ACL (Left Anterior Chamber) values were higher in male cats, DVLL (Dorsoventral length of the left lens) value was higher in female cats. These differences between the sexes were statistically significant (P<0.05). The volumetric measurement values of bulbus oculi and lens were determined to be averagely 4.60 ± 0.27 cm3 and 0.67 ± 0.09 cm3, respectively. In conclusion, the statistical differences of biometric values of bulbus oculi between male and female Van cats were determined by using CT and MRI. It is thought that the present study would contribute to the ophthalmological applications and the students receiving anatomy education.

ABSTRACTAims: To describe the variation in surgical techniques used by veterinarians to perform routine dog and cat spays in first-opinion veterinary practice in New Zealand, and how these techniques differed with the number of years since the veterinarian graduated.Methods: A cross-sectional survey of veterinarians registered to practice in New Zealand was conducted online between 1 April and 30 May 2018. Respondents were asked their year of graduation and about the procedures, they would use to perform a routine spay of a healthy, 5 kg, young adult, female domestic shorthair cat, and a healthy, 20 kg, young adult, female mixed-breed dog. The number of years since graduation was calculated by subtracting the reported year of graduation from 2018.Results: Overall, 282 respondents provided details about dog spays, and 361 about cat spays, and the median number of years since graduation was 14 (min 0, max 50). Only 54/282 (19.1%) respondents performing dog spays and 43/361 (11.9%) performing cat spays wore a surgical cap, gown, mask, and gloves. For dog spays, 278 (98.6%) respondents used a ventral midline approach and 147 (52.1%) used manual exteriorisation of the uterus. Most used two clamps (168; 59.6%) and used two encircling ligatures (152; 53.9%) for removal of the uterus. For cat spays, 254 (70.4%) respondents used a ventral midline approach and 313 (86.7%) used a spay hook for exteriorising the uterus. Most used two clamps (250; 69.3%) with one encircling ligature (213; 59.0%) for removal of the uterus. Simple interrupted external or intradermal patterns were mostly used for skin closure for both dog and cat spays. For cat spays, the percentage of respondents using the ventral midline approach decreased with increasing years since graduation (p < 0.001). For both dog and cat spays, the percentage of respondents using two encircling ligatures and transfixation ligation of the uterus, and using a simple continuous suture pattern for the closure of the abdomen, decreased with number of years since graduation (p < 0.05).Conclusions and clinical relevance: Veterinarians responding to this survey used a wide range of techniques to perform routine dog and cat spays, some of which were associated with the number of years since graduation. It may be beneficial to provide veterinarians with resources to reflect on their current approaches for performing routine spays. However further research is needed to determine whether any surgical techniques are superior to others.

To describe a technique for, and outcome after, left- or right-sided laparoscopic-assisted nephrectomy in standing horses with unilateral renal disease. Clinical report. Horses (n=3) with unilateral renal disease. Horses were sedated with detomidine (0.01 mg/kg intravenously [IV]) and levomethadone (0.05 mg/kg IV). Paravertebral anesthesia and infiltration-anesthesia with 2% lidocaine were used to create a surgical field incorporating the 17th intercostal space and paralumbar fossa. Two separate, ipsilateral portals and a mini-laparotomy were used. The perirenal peritoneum was horizontally incised (10-15 cm) using endoscissors and the incision digitally enlarged for manual dissection of the perirenal fat and kidney mobilization. The renal vessels and ureter were individually dissected, ligated, and transected under laparoscopic observation and the kidney removed. The perirenal and laparotomy peritoneal defects were not closed; and the laparotomy was closed in a multilayered fashion. The transverse abdominal muscle was apposed in a continuous pattern using 1 polyglactin 910, the subcutaneous tissue (simple continuous pattern) and skin (simple interrupted pattern) with 2-0 polyglactin 910. Left (2) and right (1) sided laparoscopic-assisted nephrectomy (1 nephrolithiasis, 2 hydronephrosis) was performed successfully. Sedation and local anesthesia was adequate for intraoperative immobilization and analgesia. No intraoperative complications occurred. Incisional seroma formation and fever occurred on days 3 and 4 in 1 horse and resolved with medical management. Laparoscopic-assisted nephrectomy can be used for removal of the left or right kidney in standing horses with unilateral kidney disease. To avoid risks associated with general anesthesia and to reduce surgical trauma, laparoscopic-assisted nephrectomy can be performed in the standing sedated horse using a 2 portal technique and a mini-laparotomy.

The aim of this study was to compare the healing intervals among simple interrupted (SI), ford interlocking (FI) and subcuticular (SC) suture patterns in goats. We hypothesized that these common suture patterns used for closure of incisional skin wounds may have effect on the healing interval. To test this hypothesis, two parameters (subjective healing interval and histologic objective healing interval) were used to investigate the healing interval of the three suture patterns. Our findings showed that, there was significant differences (P<0.05) in subjective healing interval between subcuticular (SC) withford interlocking (FI), but there was no significant difference between subcuticular with simple interrupted patterns. There were also no significant differences between ford-interlocking and simple interrupted. Histologic findings at seventh day post surgery revealed low polymorphonuclear leukocytes (PMNL) infiltrations and early fibroblast, collagen fibers and epidermal keratinization in the subcuticular group in comparison with the two other groups. At fourteen day post-surgery, there was marked reduction of inflammatory infiltrates in the subcuticular group when compare with the two other groups, while the collagen fiber density and epidermal keratinization increased in the subcuticular group. At twenty first-day post - surgery , there were no inflammatory cells in subcuticular group, while collagen density was higher, and the orientation of the collagen fibers were horizontal, suggestive of faster healing in comparison with the simple interrupted and ford interlocking groups. It was concluded as measured by subjective healing interval and histologic objective healing interval that surgical skin-wound closed by subcuticular suture pattern alone healed faster than simple interrupted and ford interlocking suture patterns reinforced after subcuticular closure, on the other hand simple interrupted pattern healed faster than ford interlocking. Keywords: Incisional wound healing, histology, goat, suture patterns, healing interval