Recheck Examinations Research Articles

Invasive fungal infections and oomycoses in cats 2. Antifungal therapy.

Invasive fungal infections (IFIs) and oomycoses (hereafter termed invasive fungal-like infections [IFLIs]) are characterised by penetration of tissues by fungal elements. The environment is the most common reservoir of infection. IFIs and IFLIs can be frustrating to treat because long treatment times are usually required and, even after attaining clinical cure, there may be a risk of relapse. Owner compliance with medication administration and recheck examinations can also decline over time. In addition, some antifungal drugs are expensive, have variable interpatient pharmacokinetic properties, can only be administered parenterally and/or have common adverse effects (AEs). Despite these limitations, treatment can be very rewarding, especially when an otherwise progressive and fatal disease is cured. In the second of a two-part article series, the spectrum of activity, mechanisms of action, pharmacokinetic and pharmacodynamic properties, and AEs of antifungal drugs are reviewed, and the treatment and prognosis of specific IFIs/IFLIs - dermatophytic pseudomycetoma, cryptococcosis, sino-orbital aspergillosis, coccidioidomycosis, histoplasmosis, sporotrichosis, phaeohyphomycosis, mucormycosis and oomycosis - are discussed. Part 1 reviewed the diagnostic approach to IFIs and IFLIs. Information on antifungal drugs is drawn from pharmacokinetic studies in cats. Where such studies have not been performed, data from 'preclinical' animals (non-human studies) and human studies are reviewed. The review also draws on the wider published evidence and the authors' combined expertise in feline medicine, mycology, dermatology, clinical pathology and anatomical pathology. AMB (amphotericin B); FC (flucytosine); FCZ (fluconazole); ISA (isavuconazole); ITZ (itraconazole); KCZ (ketoconazole); PCZ (posaconazole); TRB (terbinafine); VCZ (voriconazole).

Evaluating video telemedicine for providing virtual health care for cats via mock spay recheck examinations

Cat caregivers face many potential barriers when accessing veterinary care, such as cat-related challenges with carriers, travel, and the clinic environment, as well as time away from home and/or work, distance to the veterinary clinic, and costs of veterinary care. A potential solution to overcoming some of these barriers may be the use of video telemedicine: using video technology to deliver health and behavior care, education, and information remotely. This study recruited companion cat caregivers and their cats (n = 30) to participate in two mock spay re-check examinations: an in-clinic appointment and a virtual video telemedicine appointment. During the mock examinations, cat behavioral and physiological responses were assessed. Order of appointment was counterbalanced, and caregivers completed a pre- and post- appointment questionnaire to assess attitudes and experience with the in-clinic versus video appointments before and after participation. The study results show that cats had a higher respiratory rate (p < 0.001), larger pupil dilation (p < 0.001), and more negative ear positions (p = 0.015) during the mock clinic appointment compared to the video appointment. Cats were also more likely to leave the handling area after the mock clinic examination compared to the video examination (p = 0.001). In addition, caregiver ratings of the video appointment were very positive (62.1%) or somewhat positive (34.5%), and participants stated it was very easy to access the technology (58.6%), internet (65.5%), and video conferencing platform (75.9%) needed. Post-survey participant ratings indicated that video telemedicine was perceived to be more helpful than in-clinic visits for reducing caregiver stress (p = 0.029) and cat stress (p < 0.0001). There was also a post-survey difference in caregiver ratings on accessibility of veterinary care between video telemedicine and clinic appointments (p < 0.0001), with results indicating that video telemedicine increases caregivers’ access to cat care. Thus, from cat caregiver perspectives, video telemedicine may reduce stress and increase accessibility to cat health care compared to clinic visits. Results also suggest that video appointments reduce negative responses in cats compared to in-clinic visits, and thus may be particularly useful for cats who show higher levels of stress in a clinic environment. More research is needed to evaluate cat responses during other appointment types for further assessment and replication of the study results.

Cervical jerks as a sign of cervical pain or myelopathy in dogs.

To describe and classify cervical muscle jerks associated with cervical pain or myelopathy and evaluate their clinical and diagnostic relevance. 20 dogs with a history of unilateral or bilateral cervical jerks associated with cervical pain or myelopathy. A retrospective study. Detailed history, complete clinical and neurological examinations, CT studies, and outcome were available for each dog. All dogs received a treatment adapted to each diagnosis. The presence or absence of jerks was evaluated at short- and long-term recheck examinations. An immediate postoperative CT scan was obtained for all cases that were treated surgically. 20 dogs were selected for the study, 13 of which were French Bulldogs. Jerks all presented as focal repetitive rhythmic contractions on the lateral aspect of the neck (on one or both sides). All dogs had a diagnosis of cervical intervertebral disk extrusion (IVDE), half of them at the C2-C3 level. No dogs presented with extrusion caudal to the C4-C5 intervertebral disk space. The prevalence of myoclonia among all dogs diagnosed with IVDE was 3.77% (20/530) in our hospital. Cervical jerk associated with cervical pain or myelopathy may represent myoclonus and was exclusively secondary to cranial cervical IVDE in this study. Full recovery was observed following medical or surgical treatment of IVDE. The exact origin and classification of this involuntary movement has yet to be established.

Prospective Evaluation of Low-Fat Diet Monotherapy in Dogs with Presumptive Protein-Losing Enteropathy.

For dogs with protein-losing enteropathy (PLE) and evidence of lymphangiectasia, the efficacy of low-fat diet as monotherapy or combined with prednisone remains poorly characterized. In this prospective, observational cohort study of 14 dogs with presumptive PLE and ultrasonographic evidence of lymphangiectasia, subjects were placed on various low-fat diets as monotherapy and prednisone was added if response was deemed inadequate. Dogs were assessed and scored at four recheck examinations across a 6 mo study period, including a final recheck ultrasound. Clinical and clinicopathologic variables were collected and dogs were divided into three outcome groups: clinical remission on dietary monotherapy (LOF); clinical remission on dietary therapy plus immunosuppressive prednisone (LOP); and treatment failure (TXF). Eleven of 14 dogs were in clinical remission at the study end date (6 mo after enrollment): 6 LOF dogs and 5 LOP dogs. LOF dogs achieved a significant reduction in Canine Chronic Enteropathy Clinical Activity Index score and a significant increase in serum albumin within 2 wk of beginning dietary monotherapy. Four of 11 dogs in remission also had ultrasonographic evidence of resolution of linear striations. Low-fat diet appears to be an effective monotherapy in some dogs with presumptive PLE and ultrasonographic evidence of lymphangiectasia.

What are the causes of non-tolerance to new spectacles and how can they be avoided?

PurposeTo investigate non‐tolerance cases from several UK practices to determine their likely causes and how they might have been avoided.MethodsPatient complaint and refraction data were collected from non‐tolerance recheck examinations. For one practice, clinical data were also collected retrospectively to investigate the quality of the eye examinations.ResultsData for 279 rechecks were gathered from 10 practices and a recheck frequency of 2.3% was found. The mean patient age was 60 (SD 16) years, with cylinder changes responsible for 38% of prescription‐related causes of rechecks, overplusing or underminusing 26%, and underplusing or overminusing just 11%. An assessment of 242 recheck corrections found that 40% were unsatisfactory (e.g., failed to address initial or recheck symptoms, N = 45) and retrospective analysis of 217 case records showed many limitations (e.g., 61% or 28% recorded no uncorrected or habitual visual acuity (VA) at either initial examination or recheck).ConclusionsGiven that overplus‐underminus was a much bigger proportion of prescription‐related cases than overminus‐underplus (26% vs. 11%), the refraction mantra of “maximum plus for maximum VA” should be balanced by increased teaching of the problems of overplusing and underminusing, and the use of prescribing guidelines. In addition, continuing professional development regarding the basics of the recheck examination, refraction, visual acuity and prism determination is needed. Changes of oblique cylinders should be carefully considered in older patients as this is a common cause of non‐tolerance. In addition, if the “if it ain't broke, don't fix it” and related maxims had been applied to all patients who were asymptomatic at the original examination, one third of all non‐tolerance cases could have been avoided. Finally, it would seem appropriate for practices to develop a system to deal better with non‐tolerance cases. Perhaps an experienced clinician should examine all patients with non‐tolerance and provide feedback to the original clinician.

Clinical characteristics of, prognostic factors for, and long-term outcome of dogs with multiple acquired portosystemic shunts: 72 cases (2000-2018).

To identify clinical characteristics of, prognostic factors for, and long-term outcome of dogs with multiple acquired portosystemic shunts (MAPSSs) and determine whether survival time was associated with previous portosystemic shunt attenuation. 72 client-owned dogs with MAPSSs. Medical records of dogs in which MAPSSs had been diagnosed between January 2000 and August 2018 were reviewed for signalment, historic and diagnostic findings, management methods, and outcome. Median survival time of dogs (n = 23) that died of causes related to MAPSSs was 580 days (range, 156 to 1,363 days). Factors significantly associated with dying of MAPSS-related versus unrelated causes included body weight, albumin concentration at the first and last recheck examinations, and cholesterol, total solids, and glucose concentrations at the last recheck examination. Dogs not receiving medical management or without signs of depressed mentation at the time of initial presentation were less likely to die of causes related to MAPSSs. Patient status (alive vs dead of causes related to MAPSSs vs dead of causes unrelated to MAPSSs vs dead of unknown causes) was not significantly associated with survival time. Survival time for dogs with MAPSSs was not shortened by previous portosystemic shunt attenuation surgery and was not different when death was versus was not related to MAPSSs. Dogs with MAPSSs that had progression of biochemical changes consistent with liver dysfunction were more likely to die of causes related to MAPSSs and were unlikely to live a normal lifespan.

Success of Feather Margin Preparation for Full Metal Prosthodontic Crowns in the Canine Teeth in 84 Pet and Working Dogs (2005-2017).

Medical and dental records of Veterinary Dental Specialties and Oral Surgery were searched to identify dogs that received full metal prosthodontic crowns on canine teeth, using a feather or knife edge preparation between 2005 and 2017. A total of 160 teeth in 84 dogs were included in the study. Current follow-up by telephone, electronic mail, or electronic messaging was conducted, in addition to thorough record review for in-person recheck examinations. Treatment was considered successful if the prosthodontic crown was in place and no further or additional injury to the tooth had occurred at the time of reexamination, owner contact, or patient death. Tooth fracture apical to the prosthodontic crown occurred in 2 (1.25%) cases, bond failure between the tooth and the cement or the cement and the crown occurred in a single case (0.625%), and one metal crown required replacement after 3 years due to wear (0.625%), for an overall failure rate of 2.5%. These results suggest that feather preparation of the margin is at least as, if not more, successful as the more commonly accepted and performed chamfer margin, and thus is a successful, practical and durable option for prosthodontic crown treatment in dog canine teeth.

Evaluation of the clinical value of routine radiographic examination during convalescence for tibial plateau‐leveling osteotomy

To determine how frequently routine follow-up radiographic findings would result in a change to the postoperative plan following tibial plateau-leveling osteotomy (TPLO) in dogs. Retrospective study SAMPLE POPULATION: Short-term group: 100 cases; intermediate-term group: 50 cases. Medical records of 100 consecutive cases meeting the inclusion criteria were reviewed (the short-term group). The cases had no owner-perceived issues and underwent routinely prescribed radiographic follow up between 40 and 60 postoperative days after TPLO performed by one experienced surgeon. Complications identified on physical examination (PE) and radiographic examination (RE) were recorded, along with any changes to the postoperative plan. Medical records of 50 consecutive cases that had short-term and intermediate-term (≥180 days) REs and PEs were reviewed similarly (intermediate-term group). Fifty-one cases in the short-term group had no complications on PE or RE. Forty-nine dogs were diagnosed with minor complications (patellar ligament desmitis, patella or fibula fracture, gait abnormalities): 42 on RE only; 6 on PE and RE; 1 on PE only. Exercise restriction was extended for 2 weeks in 2 cases with radiographic patellar ligament desmitis. Two cases in the intermediate-term group had minor complications at intermediate-term RE. No new PE or RE complications developed between short-term and intermediate-term evaluations. At routine rechecks of dogs with no owner-perceived issues after TPLO, 49% had minor complications but only 2% were deemed significant enough to alter patient management. The likelihood of new radiographic complications developing after short-term evaluation is low. Routine radiographic recheck examinations rarely altered the postoperative plan in TPLO cases with unremarkable clinical recoveries.

Outcomes of nine cats with urinary retention after sacrocaudal luxation managed with long‐term urinary diversion

To document the outcomes of cats with urinary retention (UR) after sacrocaudal luxation (SCL) and managed with a long-term cystostomy (LTC). Short case series. Nine client-owned cats with SCL and subsequent UR. Nine cats suffering from non-relievable UR secondary to SCL, between March 2013 and December 2020, had a LTC placed 4.5 days post-SCL (mean, range 3.5-6.0), until clinical evidence of normal urination recovery. The bladder was emptied at least twice daily. No antimicrobial was given during LTC. Indication for tube removal was voluntary micturition with complete emptying for a minimum of three consecutive days. Recheck examinations were scheduled for post-SCL days 7 and 14, as well as for LTC tube removal. Minor and major complications and length of LTC use were recorded. The LTC was removed 11-42 days (mean 26 days) after placement. All cats recovered normal micturition spontaneously within 17-47 days post-SCL (mean 30.7 days): 1 cat between the 2nd and 3rd weeks, 5 cats between the 3rd and 4th weeks, and 3 cats >30 days after the trauma. Major complications, such tube dislodgement, occurred in two cats, whereas complications resolving after tube removal were recorded in 6 cats. LTC was effective at managing UR post-SCL in 9 cats. All cats recovered normal urinary function within 7 weeks. LTC can be an alternative to manual expression or bladder catheterization in cats with temporary UR after SCL.

Mucocutaneous nasal histoplasmosis in an immunocompetent dog

BackgroundHistoplasma (H.) capsulatum is a dimorphic fungus, and infection is typically via inhalation of microconidia. After conversion to the yeast phase within the lung, the organism is subsequently disseminated to other tissues by macrophages. Nasal histoplasmosis appears to be a rare condition in dogs.Case presentationWe report the clinical case of a 4.5-year-old male neutered Cocker spaniel/Poodle mix, 7.7 kg, body condition score 6/9, that presented with a 3-month history of sneezing and left-sided mucoid nasal discharge. The history also included a mild swelling (transient) of the right carpus with a lameness (grade II-III/IV), coinciding with the onset of sneezing and nasal discharge. The dog lived primarily indoors in the Texas Gulf Coast area. On physical examination, the dog was febrile, and the left nostril was swollen, ulcerative, deformed, and hypopigmented. Mandibular lymph nodes were firm and mildly enlarged bilaterally. Mild lymphopenia, thrombocytopenia, and hyperglobulinemia were noted. Thoracic radiographs were unremarkable. Computed tomography and rhinoscopy revealed swelling of the rostral portion of the left and right nasal passages. Cytology and histology of biopsies of the affected nasal tissue showed pyogranulomatous inflammation and yeast organisms consistent with H. capsulatum. Weak antigenuria was detected on the MVista H. capsulatum antigen test. Treatment with oral itraconazole led to a resolution of the nasal signs and normalization of the appearance of the nostril over 13 weeks, and neither antigenuria nor antigenemia was detected on several recheck examinations. The dog remained in good general and physical condition and showed no signs of disease recurrence more than 6 years after the last examination.ConclusionWe report a rare case of nasal mucocutaneous histoplasmosis in an immunocompetent dog, with an excellent clinical response to oral itraconazole. This case documents that histoplasmosis in dogs can affect primarily the nasal cavity, which responds rapidly to triazole antifungal therapy and has a good prognosis. A similar case has only been reported in human medicine in a young adult.

Minimally invasive ethyl cellulose ethanol ablation in domesticated cats with naturally occurring head and neck cancers: Six cats.

It is difficult to retain tumoricidal doses of ethanol in large or unencapsulated tumours without causing intoxication or damaging surrounding tissue. Ethyl cellulose-ethanol ablation (ECEA) overcomes this limitation by trapping ethanol intratumorally. To evaluate the safety of ECEA and to develop a clinically feasible workflow, a single-arm pilot study was performed in cats with lingual/sublingual squamous cell carcinoma (SCC). Six cats underwent intratumoral injection of 6% ethyl cellulose in ethanol. Subjects were observed overnight. There was mild bleeding and transient hyperthermia, and injection site pain and swelling that improved with anti-inflammatory drugs. Serum ethanol was minimally elevated; the mean concentration peaked 1 hour after injection (129 +/- 15.1nM). Cats were rechecked at weeks 1 and 2; booster treatments were given in cats (n=3) with stable quality of life and partial response to therapy. Recheck examinations were then performed monthly. The longest tumour dimension increased in each animal (progressive disease via cRECIST); however, estimated tumour volume was reduced in 3 of 6 cats, within 1 week of ECEA. All cats were euthanized (median survival time 70 days) because of local tumour progression and/or lingual dysfunction that was likely hastened by ECEA. ECEA is not a viable treatment for feline lingual/sublingual SCC; tumour volume was effectively reduced in some cats, but the simultaneous loss of lingual function was poorly tolerated. Further optimization may make ECEA a useful option for SCC at other oral sites in the cat, and for head and neck malignancies in other species.

Utility of point-of-care lung ultrasound for monitoring cardiogenic pulmonary edema in dogs.

BackgroundPoint‐of‐care lung ultrasound (LUS) is an effective tool to diagnose left‐sided congestive heart failure (L‐CHF) in dogs via detection of ultrasound artifacts (B‐lines) caused by increased lung water.Hypothesis/ObjectivesTo determine whether LUS can be used to monitor resolution of cardiogenic pulmonary edema in dogs, and to compare LUS to other indicators of L‐CHF control.AnimalsTwenty‐five client‐owned dogs hospitalized for treatment of first‐onset L‐CHF.MethodsProtocolized LUS, thoracic radiographs (TXR), and plasma N‐terminal pro‐B‐type natriuretic peptide were performed at hospital admission, hospital discharge, and recheck examinations. Lung ultrasound findings were compared between timepoints and to other clinical measures of L‐CHF.ResultsFrom time of hospital admission to discharge (mean 19.6 hours), median number of LUS sites strongly positive for B‐lines (>3 B‐lines per site) decreased from 5 (range, 1‐8) to 1 (range, 0‐5; P < .001), and median total B‐line score decreased from 37 (range, 6‐74) to 5 (range, 0‐32; P = .002). Lung ultrasound indices remained improved at first recheck (P < .001). Number of strong positive sites correlated positively with respiratory rate (r = 0.52, P = .008) and TXR edema score (r = 0.51, P = .009) at hospital admission. Patterns of edema resolution differed between LUS and TXR, with cranial quadrants showing more significant reduction in B‐lines compared to TXR edema score (80% vs 29% reduction, respectively; P = .003).Conclusions and Clinical ImportanceLung ultrasound could be a useful tool for monitoring resolution of pulmonary edema in dogs with L‐CHF.

Bilateral Anterior Uveitis in a Northern Saw-whet Owl (Aegolius acadicus) With a Metastatic Pectoral Malignant Mesenchymoma

A captive, adult, male northern saw-whet owl (Aegolius acadicus) was examined for blepharospasm of the left eye. The owl was diagnosed with bilateral anterior uveitis and a corneal ulceration in the left eye. It was treated with oral and topical nonsteroidal anti-inflammatory medications and a topical antibiotic. Multiple recheck examinations and medication adjustments were performed over the next 4 months, at the end of which time the bilateral anterior uveitis was controlled with a topical nonsteroidal anti-inflammatory applied 3 times per week to both eyes. The owl was re-examined 2 months later after 2 suspected neurologic episodes. On physical examination, the owl was quiet and had difficulty standing and ambulating. Five firm multilobular and immobile masses were identified overlying the pectoral muscle and sternum. Fine-needle aspiration from 1 mass revealed neoplastic cells consistent with a sarcoma. The owl was euthanatized. On the basis of results of histopathologic examination, the mass was diagnosed as a pleomorphic spindle cell sarcoma with features of rhabdomyosarcoma, liposarcoma, and osteosarcoma. Numerous tumor cells were immunopositive for myoglobin and desmin, indicating striated muscle origin. Although a metastatic lesion was present in 1 adrenal gland, lesions of inflammation or neoplasia were absent in either eye on histopathologic examination. This report describes an apparent ocular manifestation of systemic disease in an avian species with clinically diagnosed recurrent anterior uveitis.

Maxillary and Mandibular Peripheral Odontogenic Fibromas (Fibromatous Epulides of Periodontal Ligament Origin) in a Cat

Peripheral odontogenic fibroma (POF) is an uncommon finding in the mouth of cats. Few cases have been reported in the literature. The present report describes an adolescent, male-castrated domestic shorthair cat with POFs at the rostral upper and lower jaws that were treated via marginal excision including removal of underlying bone. Despite the high incidence of recurrence reported in the literature, recheck examinations up to 11 months postoperatively did not show regrowth of the gingival masses. Thus, marginal excision including removal of underlying bone appears to be a viable treatment option for POF in cats.

Owner satisfaction with use of videoconferencing for recheck examinations following routine surgical sterilization in dogs.

OBJECTIVE To evaluate owner satisfaction with a home-based, synchronous videoconferencing telemedicine application as an alternative to in-clinic appointments for conducting recheck examinations after surgical sterilization in dogs. DESIGN Randomized controlled clinical trial. ANIMALS 30 client-owned dogs undergoing elective surgical sterilization and postsurgical recheck examination between September 27, 2017, and February 23, 2018. PROCEDURES Dogs were randomly assigned to have their recheck examinations performed remotely (the telemedicine group) or at the veterinary clinic (the control group). After the recheck examination, owners completed a survey regarding their satisfaction with the recheck examination and their dogs' behavior during it. Information regarding the surgery and recheck examination was obtained from the electronic medical record. Mann-Whitney U tests were used to compare results between the telemedicine and control groups. RESULTS Owners were equally satisfied with recheck examinations performed by videoconference and in-clinic appointments. Owners of dogs in the telemedicine group indicated that their dogs were less afraid during the virtual appointment, compared with what was typical for them during in-clinic appointments, but the difference was not statistically significant. Most owners who completed a postsurgical recheck examination by videoconferencing preferred this method for similar appointments in the future. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that owners were satisfied with videoconferencing as a means of conducting a postsurgical recheck examination. Further research is needed to assess videoconferencing's ability to reduce signs of fear in dogs during veterinary examinations, its economic feasibility, and the willingness of veterinarians and animal owners to adopt the technology.

Clinical trial of adjunctive autologous platelet-rich plasma treatment following diamond-burr debridement for spontaneous chronic corneal epithelial defects in dogs.

OBJECTIVE To evaluate the effects of adjunctive treatment with autologous platelet-rich plasma (PRP) on corneal reepithelialization, vascularization, and fibrosis in dogs with spontaneous chronic corneal epithelial defects (SCCEDs). DESIGN Randomized, controlled, double-masked clinical trial. ANIMALS 40 client-owned dogs with uncomplicated SCCEDs. PROCEDURES All dogs were treated with diamond-burr epithelial debridement (DBD) of affected eyes, topical tobramycin solution and atropine sulfate ointment application, and Elizabethan collar placement for 4 weeks. Dogs were randomly assigned to topical ocular administration of autologous PRP (n = 20) or artificial tear solution (control group; 20) 4 times daily for 28 days. Recheck examinations were performed approximately 2 and 4 weeks after treatment began to evaluate SCCEDs for corneal reepithelialization, and semiquantitative corneal vascularization and corneal fibrosis scores were assigned according to affected corneal surface area. Results were compared between groups. RESULTS All dogs completed the study. The SCCEDs had completely reepithelialized in 11 (55%) control dogs and 12 (60%) PRP-treated dogs by the 2-week reevaluation, and in 15 (75%) control dogs and 18 (90%) PRP-treated dogs by the 4-week reevaluation. No significant differences were identified between groups in these proportions nor in mean differences from pretreatment scores for corneal vascularization and fibrosis. CONCLUSIONS AND CLINICAL RELEVANCE In this preliminary study involving dogs with uncomplicated SCCEDs, topical PRP administered as an adjunctive treatment following DBD had no significant effect on healing. A larger study is warranted to support or refute these findings and to determine the effects of adjunctive PRP treatment for dogs with complicated SCCEDs.

EVALUATION OF ORCHIECTOMY AND OVARIECTOMY SURGICAL TECHNIQUES IN DEGUS (OCTODON DEGUS)

In this study, 2 previously described surgical techniques for performing an orchiectomy in the adult male degu (Octodon degus) were evaluated: (1) prescrotal open technique and (2) scrotal open technique. Additionally, an ovariectomy procedure was assessed in female degus using the bilateral (dorsolateral) technique similar to that performed in related species. Twenty two animals (n = 14 males; 8 females) from a local small mammal shelter group, that were presented for routine surgical castration for population control measures, were included in this study. There was a significant difference in mean surgical time for the prescrotal and scrotal approach of 16.46 ± 4.28 and 23.83 ± 2.09 minutes, respectively. No significant differences were noted on anesthesia and recovery times for the orchiectomy procedures. Overall, the prescrotal approach was a faster procedure and required less anesthesia time. One male degu undergoing the scrotal open technique died during surgery, this was believed to be related to anesthesia complications (increased saliva secretions). No other complications were reported perioperatively in any other animals. All animals were observed to have sufficient pain management using an in-house visual analogue scale. The bilateral flank (dorsolateral) ovariectomy approach in female degus yielded a short total procedure time with no adverse events. No over grooming and or self-injurious behaviors were reported during both the 24 hours and 14 days recheck examinations.

Outcomes of nonsurgical treatment for congenital thoracic vertebral body malformations in dogs: 13 cases (2009-2016).

OBJECTIVE To characterize outcomes following nonsurgical treatment of congenital thoracic vertebral body malformations causing neurologic deficits in dogs. DESIGN Retrospective case series. ANIMALS 13 client-owned dogs treated nonsurgically for congenital thoracic vertebral body malformations at 3 veterinary referral hospitals from June 2009 through May 2016. PROCEDURES Data were extracted from the medical records regarding dog signalment, duration and type of clinical signs before referral, general physical and neurologic examination findings, radiographic and MRI findings, and treatments provided after diagnosis. Follow-up data were obtained from records of recheck examinations and via a standardized owner questionnaire. RESULTS All included dogs were screw-tail brachycephalic breeds with a median age of 6 months. All dogs had ambulatory paraparesis and ataxia, and in 1 dog, signs of spinal hyperesthesia could be elicited. Nonsurgical treatments consisted of restricted exercise without (n = 5) or with (3) physiotherapy, physiotherapy without restricted exercise (3), and no exercise modification (2). Seven dogs received additional nonsurgical treatment consisting of prednisolone (n = 5) or gabapentin (2). Four dogs were eventually euthanized because of progressive neurologic deterioration, 2 underwent surgery for the same reason, and the remaining 7 dogs survived for ≥ 170 days after diagnosis, despite progressive neurologic deterioration. CONCLUSIONS AND CLINICAL RELEVANCE Nonsurgical treatment of congenital thoracic vertebral body malformations was associated with an unfavorable outcome in this group of dogs. Despite this treatment, all dogs had progression of clinical signs.

Medical management of deep ulcerative keratitis in cats: 13 cases.

Described are 13 cats diagnosed with deep ulcerative keratitis and successfully managed medically without grafting procedures. Typical treatment involved frequent topical application of serum and antibiotics (usually a fluoroquinolone and a cephalosporin). Seven cats also received systemic antibiotics. Analgesia was achieved using various combinations of topical atropine and systemic buprenorphine, robenacoxib or corticosteroids. Six cats were hospitalized for a median (range) period of 2.5 (1-8) days, typically because of frequent medication administration. Median (range) follow-up time was 41.5 (9-103) days. Median (range) number of recheck examinations was 4 (2-6). Median (range) time to corneal re-epithelialization was 21 (9-103) days. Median (range) topical antibiotic course was 29.5 (16-103) days. Median (range) duration of Elizabethan collar use was 28 (13-73) days. At the time of writing, no further recheck examinations were recommended for 10 cats; median (range) time between initial to final examinations in these cats was 35 (20-103) days. All cats retained the affected globes and were apparently comfortable and visual at the latest recheck examination. These cases reveal that aggressive medical management is highly successful in select cats with deep ulcerative keratitis, and can result in a cosmetically acceptable, apparently comfortable and visual globe. However, therapy is intensive with frequent administration of multiple topical and sometimes systemic medications, and requires multiple veterinary visits over many weeks. Referral to a veterinary ophthalmologist for consideration of surgical stabilization is recommended, as not all cases may be amenable to the medical therapy described here.

Scrotal stalk ablation and orchiectomy using electrosurgery in the male sugar glider (Petaurus breviceps) and histologic anatomy of the testes and associated scrotal structures

This report describes an alternative surgical technique for performing scrotal ablation and orchiectomy in the adult male sugar glider (Petaurus breviceps) using electrosurgery. Eight animals from a local small mammal shelter group that presented for routine surgical castration for population control measures were included in this study. Mean surgical time was 4.37 ± 2.13 seconds. Mean anesthesia time was 12.32 ± 5.63 minutes. Mean recovery time was 8.37 ± 3.68 minutes. Mean total procedure time was 22.24 ± 5.69 minutes. No perioperative complications were reported. All animals appeared to have sufficient pain management with an analgesia and anti-inflammatory protocol using butorphanol and meloxicam. No over grooming and or self-injurious behaviors were reported by the local shelter during both the 24-hour and 14-day recheck examinations. Electrosurgery scrotal ablation and orchiectomy therefore offers an alternate route for the practicing veterinarian to perform safe and efficient castrations in male sugar gliders. Histologically, in the epididymis, 3 of the 8 sugar gliders had evidence of a well-defined region in the head, between the efferent ducts and the remaining epididymis. The lining cells differed morphologically from those constituting the remaining epithelial lining. The presence of eosinophilic vacuoles in the cytoplasm of the cells in this region suggests a secretory activity.