JAAHA 56.6 Abstracts

Abstracts from issue 56.6 of JAAHA, Journal of the American Animal Hospital Association.

56.6 NOV/DEC 2020

Editor in Chief

Alan H. Rebar, DVM, PhD, DACVP, Purdue University, West Lafayette, Indiana

Associate Editor

Linda Ross, DVM, MS, DACVIM (SAIM), Tufts University, North Grafton, Massachusetts

Managing Editor

Karie Simpson

JAAHA, Journal of the American Animal Hospital Association, is published as an official scientific and educational publication of the American Animal Hospital Association. The purpose of the journal is to publish accurate, timely scientific and technical information pertaining to the practice of small animal medicine and surgery. JAAHA is available in print and online. Log onto jaaha.org for more information. If you are interested in becoming a reviewer for JAAHA, please contact jaaha@aaha.org.

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ORIGINAL STUDIES

Evaluation of Contamination of Multiuse Suture Cassettes in an HQHVSN Environment

Alyssa J. Comroe, James K. Roush

Historically, it has been thought that suture cassettes become contaminated by bacteria through multiuse. However, High-Quality, High-Volume Spay/Neuter (HQHVSN) veterinarians have been using them for years without issue because of their significantly lower cost. The objective of this study was to determine if absorbable suture cassettes are contaminated through multiuse in an HQHVSN environment. A total of 101 suture samples from suture cassettes were collected from 25 HQHVSN clinics or shelters. The suture samples were placed in an enrichment broth tube and aerobic and anaerobic culture with microbe ID were performed. A total of 17/101 samples were positive for microbial growth, with 11/25 clinics having at least one positive sample. Based on these results, there is a significant risk to using suture cassettes that must be balanced against cost savings. Although HQHVSN veterinarians do not report an increase in infection using suture cassettes, based on the results of this study, there is likely contaminated suture being used during sterilization surgeries at these surgery sites. Read the full article

RETROSPECTIVE STUDIES

Retrospective Study on Clinical Features and Treatment Outcomes of Nontraumatic Inguinal Hernias in 41 Dogs

Teruo Itoh, Atsuko Kojimoto, Kentaro Kojima, Hiroki Shii

Several factors are suggested to be involved in the development of nontraumatic inguinal hernias (NTIHs) in dogs, but case series studies focusing on the etiology and treatment outcomes are limited. The aim of this study was to retrospectively evaluate the clinical characteristics and treatment outcomes of NTIHs in dogs. Medical records of 42 dogs with surgically treated NTIHs were reviewed. Forty-one dogs were included in the study, all dogs were small breeds weighing <10 kg, and middle to older age (>5 yr old; 33 cases), female sex (34 cases), and miniature dachshunds (26 cases) predominated. Left-sided occurrence was common (30 left, 9 right, 2 bilateral), and organ protrusion was seen in 22 cases (15 uteri, 9 small intestines, 1 colon). Fourteen of 15 uterine herniations (93%) were located left side. Ovariohysterectomy was performed with herniorrhaphy in 27/30 intact bitches, two of whom also underwent resection and anastomosis of a devitalized portion of the small intestine. Recurrence was seen in only one male dog. These results suggest that NTIHs are more likely to occur in small-breed female dogs, and that age may increase the risk of left-sided uterine protrusion; however, the long-term results after herniorrhaphy with ovariohysterectomy are excellent. Read the full article

CASE SERIES

Mefenoxam, Itraconazole, and Terbinafine Combination Therapy for Management of Pythiosis in Dogs (Six Cases)

Harry Cridge, Samantha M. Hughes, Vernon C. Langston, Andrew J. Mackin

Pythium insidiosum is an oomycete that encysts in the skin or gastrointestinal tract, leading to pythiosis. Pythiosis is reported in tropical and subtropical climates, affecting dogs and rarely cats. Surgical resection is the treatment of choice; however, cases present late in the disease and lesions are often nonresectable. Medical management is typically unsuccessful, with uncommon exceptions; however, mefenoxam, an agricultural fungicide, has in vitro efficacy against P insidiosum. We describe the use of mefenoxam, itraconazole, and terbinafine (MIT) in five dogs with gastrointestinal pythiosis and one dog with cutaneous pythiosis. Two of the gastrointestinal cases had disease extending to surgical margins and received MIT: resolution of clinical signs and seronegativity occurred after 189–193 days. Another case underwent surgical resection and MIT. The dog improved but subsequently developed a rectal mass, which responded to addition of prednisone and immunotherapy. Two cases were treated with MIT alone, and response varied. Efficacy of MIT in cutaneous pythiosis could not be determined. MIT may result in improved survival and seronegativity in dogs with incompletely resected gastrointestinal pythiosis. Mefenoxam is EPA registered, and extralabel use under the Animal Medicinal Drug Use Clarification Act does not apply. Additional research is recommended before use. Read the full article

CASE REPORTS

Use of Frozen Tendon Allograft in Two Clinical Cases: Common Calcaneal Tendon and Patellar Ligament Rupture

C. Iván Serra, Paula Navarro, Ricardo Guillem, Carme Soler

Many surgical techniques have been described in the literature to repair chronic tendon or ligament ruptures. Although direct approximation of the edges is the surgical technique of choice, the use of synthetic, fascia lata, semitendinosus muscle, and small intestinal submucosa grafts has been described to repair large defects or augment tenous repairs. The aim of this paper was to present the long-term outcome of two clinical cases using a common calcaneal tendon cadaver allograft with subsequent application of platelet-rich plasma for chronic ruptures diagnosed by ultrasound, with a chronic defect between both edges. Twenty-four months after common calcaneal tendon rupture and 12 mo after patellar ligament rupture, orthopedic follow-up of both patients showed complete functional recovery and ultrasound findings were consistent with correct integration of the graft in both. Read the full article

CASE REPORTS

Transient Megaesophagus Following Coral Snake Envenomation in Three Dogs (2013–2018)

Justin Andrew Heinz, Joseph Mankin, Medora Pashmakova

A 12 yr old dachshund, a 7 yr old English springer spaniel, and a 1.5 yr old French bulldog presented following envenomation by a coral snake. Each patient displayed evidence of varying degrees of lower motor neuron dysfunction, but all three developed transient megaesophagus. Two patients developed secondary aspiration pneumonia, with one requiring mechanical ventilation, which the owners declined, resulting in euthanasia. The third developed hypoventilation without aspiration pneumonia, was mechanically ventilated, and was successfully weaned. In the two surviving patients, the megaesophagus resolved by time of discharge. Coral snake envenomation is an uncommon occurrence, and these are the first documented cases of transient megaesophagus secondary to a North American species. Read the full article

CASE REPORTS

Local Administration of Carboplatin in Poloxamer 407 After an Ulnar Osteosarcoma Removal in a Dog

Marije Risselada, Joanne L. Tuohy, Mac Law, Mindi L. James, B. Duncan X. Lascelles

An 8 yr old male castrated hound presented for a left distal ulnar osteosarcoma. Staging (computed tomography and nuclear scintigraphy) did not reveal any metastases. A limb-sparing ulnectomy with local adjunctive carboplatin in a poloxamer copolymer gel (poloxamer 407) was performed. The patient recovered without complications after surgery. No wound healing complications or adverse effects occurred after local use of carboplatin in poloxamer 407. The local recurrence-free interval was 296 days from surgery, and the survival time was 445 days from initial diagnosis. This is the first report in the veterinary literature of using poloxamer 407 as a carrier for local delivery of chemotherapeutic drugs in a clinical patient. Read the full article

CASE REPORTS

Arteriovenous Malformation of the Tongue Resulting in Recurrent Severe Hemorrhage in a Young Dog

Maheeka Seneviratne, Camille Longue, Norelene Harrington, Poppy Bristow

An 8 mo old male entire beagle was presented to the emergency and critical care service following several severe bleeding episodes from the oral cavity. Oral examination revealed a purple, spongy, pulsatile lesion on the rostral two-thirds of the tongue. Computed tomography angiography revealed a severely distended right linguofacial vein with numerous, tortuous branching vessels within the tongue, consistent with an arteriovenous (AV) malformation. A cervical surgical approach was performed, and the right lingual artery was isolated and catheterized. A direct arteriogram confirmed this was the main feeder artery to the lesion, and it was ligated. Although the bleeding episodes initially resolved, a moderate bleeding episode occurred 6 days postoperatively, and a partial glossectomy was performed. Histopathology was consistent with an AV malformation. The dog had a good recovery from surgery and remains free of clinical signs 13 mo later. Following extensive review of the veterinary literature, this is the only reported case of a lingual AV malformation in the dog. Partial glossectomy resulted in resolution of the clinical signs and was well tolerated. Although rare, AV malformations should be considered as a differential diagnosis for spontaneous oropharyngeal bleeding. Read the full article

CASE REPORTS

Single-Incision Laparoscopic Deroofing and Omentalization of a Cystic Renal Adenoma in a Dog

Nikesh J. Patel, Rachel Brady, Valery F. Scharf

A 12 yr old 13.5 kg male castrated Pembroke Welsh corgi was presented for evaluation of a suspected renal cyst following multiple episodes of lethargy and abdominal pain. Abdominal imaging revealed a large, thin-walled, hypoechoic cystic lesion associated with the cranial pole of the left kidney and a second smaller cystic lesion on the caudal pole. The larger cystic lesion was repeatedly drained percutaneously, but the lesion returned to initial size and clinical signs returned within weeks. Percutaneous ethanol sclerotherapy achieved only transient improvement in lesion size and abdominal discomfort. Laparoscopic deroofing and omentalization of the larger left renal cystic lesion was performed. The resected cystic wall was histopathologically consistent with a renal adenoma. Abdominal ultrasonography performed 1 mo postoperatively found no recurrence of the cystic renal adenoma. Repeated ultrasonography at 3 mo postoperatively detected a small cystic lesion at the cranial pole of the left kidney, which remained static in appearance at 11 and 18 mo postoperatively. During all follow-up visits, the dog was reported to be doing well with no recurrence of clinical signs. Renal cysts causing clinical signs and renal adenomas are rare in veterinary medicine; laparoscopic deroofing and omentalization provides a minimally invasive treatment approach. Read the full article

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