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Objective: To describe a minimally invasive approach to the parathyroid gland for the treatment of primary hyperparathyroidism., Study Design: Surgical technique description and clinical case report., Animals: Five canine cadavers and 5 client-owned dogs with primary hyperparathyroidism., Methods: A surgical technique for minimally invasive video-assisted parathyroidectomy (MIVAP), described for humans, was adapted for dogs. With the dog in dorsal recumbency, a 15 mm incision was made on the midline, 1 finger width caudal to the cricoid cartilage of the larynx. A 5 mm 30° rigid endoscope was inserted into the peritracheal space with the aid of a blunt suction dissector, and fine elevators. The parathyroid was subsequently removed using electrocautery and blunt and sharp dissection. The technique was refined in 5 cadaver dogs to assess feasibility, and was subsequently performed in 5 clinical cases., Results: A minimally invasive approach to the parathyroid gland was possible and allowed successful removal of a parathyroid mass in 5 dogs without complication. The use of fluid ingress was trialed in 1 cadaver and not found to be helpful. The use of a blunt suction dissector greatly facilitated dissection of the peritracheal space., Conclusion: Minimally invasive video-assisted parathyroidectomy is feasible in dogs and was not associated with complications in 5 clinical cases., Clinical Significance: Minimally invasive techniques tend to reduce morbidity and are popular with pet owners. This study demonstrates that a minimally invasive technique may be considered for parathyroidectomy in dogs., (© 2022 American College of Veterinary Surgeons.)

Objective: To compare the effect of three methods of subcutaneous tissue closure on postoperative incisional complications and pain in cats., Study Design: Single-center, randomized, blinded, controlled trial conducted in a veterinary teaching hospital., Animals: Two hundred ninety-seven cats undergoing midline celiotomy for ovariohysterectomy (n = 280) or other abdominal procedure (n = 17)., Methods: Cats (n = 297) were assigned to one of three subcutaneous closure methods: simple continuous apposition with tacking to the rectus fascia (n = 108, quilting [Q] group); simple continuous apposition (SC; n = 94); no subcutaneous closure (NC; n = 95). Primary outcomes were incidence of seroma formation, postoperative pain, and surgical site infection or dehiscence. Active follow-up was obtained at 10 and 30 days postoperatively., Results: Baseline characteristics did not differ between groups. Seroma was less common in the Q group (13.0%) than in the NC (27.3%) and SC (25.9%) groups (P = .03). Compared with the other two groups, the relative risk of seroma formation in the Q group was 0.49 (95% CI = 0.28-0.86, P = .01). Median mechanical pain thresholds were higher (indicating greater comfort) in cats with subcutaneous sutures (Q and SC = 1.23 [interquartile range (IQR), 0.2-2.6 N], NC = 0.83 [IQR, 0-1.87 N], P = .04) on the day after surgery., Conclusion: Closing subcutaneous tissues with a quilting closure pattern reduced seroma formation in cats undergoing celiotomy., Clinical Significance: Placing a quilting suture pattern in the subcutaneous tissues after celiotomy is a simple low-cost measure that reduces seromas in cats. Abstaining from subcutaneous closure cannot be recommended because of increased seroma formation and pain., (© 2019 The American College of Veterinary Surgeons.)

Objective: To report intraoperative and major postoperative complications in dogs treated surgically for epiglottic retroversion (ER), compare the incidence of major postoperative complications between procedures, and report survival of surgically treated dogs., Study Design: Multi-institutional retrospective study., Sample Population: Fifty dogs treated with 78 procedures., Methods: Medical records of dogs diagnosed and surgically treated for ER from 2003 to 2017 at 11 institutions were reviewed. Complications were divided into intraoperative and major postoperative complications., Results: Intraoperative complications occurred during 2 of 78 (2.6%) procedures. Thirty-six major postoperative complications were documented in 22 dogs after 36 of 74 (48.7%) procedures. Postoperative complications occurred after 7 of 12 (58.3%) nonincisional epiglottopexy, 23 of 43 (53.5%) incisional epiglottopexy, 2 of 4 (50%) partial epiglottectomy, 2 of 12 (16.7%) subtotal epiglottectomy, and 2 of 3 (66.7%) other surgical procedures. Epiglottopexy failure was the most common major postoperative complication. The incidence of major postoperative complications did not differ between procedures (P = .1239), although, when combined, epiglottopexy procedures (30/55) had a higher incidence of complications than epiglottectomy procedures (4/16; P = .048). Thirty (60%) dogs were alive at a median of 928 days (range, 114-2805), 8 (16%) were lost to follow-up after 411 days (range, 43-1158), and 12 (24%) were dead/euthanized after 301.5 days (range, 3-1212). Median survival time was not reached after a median of 716 days., Conclusion: Although intraoperative complications were uncommon, major postoperative complications were common, especially after epiglottopexy procedures., Clinical Significance: Although surgical treatment of ER is associated with a high rate of major postoperative complications, especially epiglottopexy procedures, long-term survival can be achieved., (© 2019 The American College of Veterinary Surgeons.)

Objective: To determine the influence of a quilting suture pattern tacking the subcutaneous tissues to the deep fascia on complications after midline celiotomy in dogs., Study Design: Single-center, randomized, blinded, controlled trial conducted in a veterinary teaching hospital., Animals: Four hundred thirty-two dogs undergoing midline celiotomy for ovariohysterectomy (n = 249) or other abdominal procedures (n = 183)., Methods: Dogs were randomly assigned to (1) a quilting group, subcutaneous tissue with apposition plus tacking to the rectus fascia or (2) a nonquilting group, with apposition of subcutaneous tissue without tacking. Randomization was stratified on hospital admitting service. Primary outcome was the incidence of incisional seroma. Secondary outcomes included postoperative pain the day after surgery and surgical site infection (SSI). Outcomes were assessed during the first 30 postoperative days., Results: No differences were detected between the quilting group (n = 183) and the nonquilting group (n = 175) in terms of illness severity, surgical procedure performed, surgeon's experience, duration of surgery, intraoperative complications, or methods of surgical closure other than the intervention under study. In an intent-to-treat analysis, the incidence of incisional seroma was lower in the quilting group (odds ratio = 0.30, 95% CI = 0.13-0.67, P = .004). Pain assessed 24 hours postoperatively was lower in the quilting group (P = .03). The incidence of SSI did not differ between groups., Conclusion: Tacking the subcutaneous tissues to the deep fascia is indicated to reduce seroma during celiotomy closure., (© 2017 The American College of Veterinary Surgeons.)

Objective: To report the outcome of a modified total ear canal ablation (TECA) technique to maintain normal ear carriage in cats., Study Design: Case series., Animals: Six cats with external ear canal disease., Methods: Medical records were reviewed to identify cats in which a modified TECA using a single pedicle advancement flap was used to maintain normal ear carriage. Signalment, histopathologic diagnosis, complications, and outcome were retrieved. Owners were contacted to document long-term outcome., Results: Modified TECA procedures (7) were performed in 6 cats. Normal ear carriage was present immediately after surgery and was preserved at follow-up interview. Owners were satisfied with cosmetic appearance. Histopathologic diagnosis of excised ear masses included ceruminous gland adenocarcinoma (2 cats), ceruminous gland adenoma (2 cats, 3 ears), and inflammatory polyp (2 cats)., Conclusions: Modification of the TECA skin incision preserved normal ear carriage in all cats. Owners were satisfied with overall outcome and with cosmetic result. Rate and nature of complications were similar to previously published data., Clinical Relevance: A simple modification of the TECA skin incision to create a single pedicle advancement flap maintains normal ear carriage in cats.

Five modifications of a cricoarytenoid lateralization and two modifications of a thyroarytenoid lateralization laryngoplasty technique were evaluated for their effect on rima glottidis area. All procedures and evaluations were performed on canine cadaver larynges. Cricoarytenoid lateralization (CAL) techniques provided a greater increase of the size of the glottic opening than did any of the thyroarytenoid lateralization techniques. Cricoarytenoid and interarytenoid disarticulation associated with CAL did not significantly increase glottic size compared with normal. After disarticulation of the cricoarytenoid joint, there was no difference in glottic enlargement whether the suture was placed through the muscular process or through the articular facet of the arytenoid cartilage. Transection of the sesamoid band combined with cricoarytenoid diarticulation distorted the dorsal margin of the rima glottidis.

The biochemical holding strength and histological characteristics of a laparoscopic stapled gastropexy (LG) adhesion were compared with that of an incisional gastropexy (IG) adhesion. An LG was performed in 14 dogs and an IG was performed in six dogs. During the LG procedure, the abdomen was insufflated with carbon dioxide and three cannulae were placed in the caudal aspect of the right side of the abdomen. A 35 mm laparoscopic stapler was used to staple the gastric antrum to the adjacent right lateral abdominal wall. The IG procedure was performed through ventral midline celiotomy. A 35 mm IG was made by apposing the gastric antrum to the adjacent right lateral abdominal wall with two continuous rows of suture. Half of each group of dogs was euthanatized at 7 and 30 days after surgery. The mean tensile load to failure at 7 days was 44.86 +/- 18.54 N for the LG group and 85.33 +/- 23.59 N for the IG group (P < .05). At 30 days the values were 72.39 +/- 18.01 N for the LG group and 71.17 +/-12.11 N for the IG group (P = .41). The gastropexy adhesions in the 7-day postoperative group contained variable amounts of fibrin, hemorrhage, mononuclear cell inflammation, loose fibrovascular tissue, and mature collagenous connective tissue. Adhesions in the 7-day postoperative group were divided subjectively into three histological subgroups based on the relative amounts of mature connective tissue within the adhesion. The LG and IG adhesions were randomly distributed among these subgroups (P = 1.0). Adhesions in the 30-day postoperative group contained well-organized fibrous connective tissue. No difference in the amount of connective tissue could be detected histologically in the LG or IG adhesions. Complications with the LG procedure included stomach perforation (2 cases), splenic puncture (2 cases), and subcutaneous emphysema (4 cases).

Two calves and two foals presented with episodic clinical signs of diffuse central nervous system disease. Portosystemic anomalies were tentatively diagnosed based on the history, clinical signs and increased serum concentrations of blood ammonia and total serum bile acids with normal concentrations of liver derived enzymes. one calf died before intraoperative contrast portography, whereas the other calf and both foals had marked clinical improvement after intensive medical therapy. Surgical correction was attempted in these three animals and was successful in one foal. A right paracostal celiotomy was superior to a ventral median approach for exposure to the portal vascular system and shunt access.

Articular cartilage exposure and immediate postoperative stability provided by three medial surgical approaches in canine cadaver elbows were compared. The approaches evaluated were a desmotomy of the medial collateral ligament (DMCL) that included a tenotomy of the pronator teres muscle, a longitudinal myotomy of the flexor carpi radialis (MFCR), and an osteotomy of the medial epicondyle (OME). Nondestructive biomechanical testing was performed before the surgical approach and repeated after surgery. The stiffness at 13 degrees valgus deviation of the elbow and energy absorption up to 13 degrees valgus deviation of the elbow were determined from the preoperative and postoperative torque-rotation curves. The perimeters of the ulnar and humeral articular cartilage that were visualized through the approach were scored with a dental pick. Latex casts were made of articular surfaces of the elbow. The humeral and ulnar articular exposures were determined by computerized planimetric analysis of latex cast photocopies. The humeral cartilage exposure of the OME approach was significantly greater than either the MFCR or DMCL approaches. The DMCL approach provided a significantly greater humeral cartilage exposure than the MFCR approach. All three approaches provided statistically similar percentages of ulnar cartilage exposure. The stiffness and energy absorption of the OME and MFCR approaches were similar and significantly greater than the DMCL approach. The OME approach provided the best combination of exposure and immediate postoperative stability.

This study was divided into two phases. In the in vitro phase, a stainless steel bone plate was applied to the cranial surface of the radius in 14 canine limbs. The effect of the presence of a bone plate on bone density analysis using radiographic photodensitometry (RP) was evaluated by comparing the density measurement of the unplated limb to the density measurement of the plated limb. The optical density of the plated bones was 12% greater than that of the unplated bones. This information was used as a correction factor for the in vivo study. In the in vivo phase, 23 dogs with radial and ulnar fractures were examined for complications associated with the long-term application of a stainless steel plate applied to the cranial surface of the radius. In 14 dogs, RP analysis was used to compare the plated limb with the normal, contralateral limb. No significant differences in radial cortical bone density existed between the plated limb and the contralateral limb after taking into account the effect a bone plate had on photodensitometry readings. There was no significant correlation between the change in radial cortical density and the duration of bone plate application, suggesting that a steady state between bone loss and bone production occurs after long-term plate fixation of the fractured canine radius. The majority (87%) of the dogs with a plate applied to the radius greater than 1 year had normal limb usage when standing, walking, or running.

Cecal-colic volvulus was confirmed by surgery in two dogs. Both dogs were intact, male Great Danes. The clinical and diagnostic findings were not specific for large bowel volvulus. Clinical signs included peracute to acute onset of vomiting, mild abdominal distention and pain, lack of feces, and tenesmus. Abdominal radiographs demonstrated severe dilatation of bowel loops in both dogs. One dog survived.

Objective: To describe sacroiliac luxation stabilization in cats using two screws and to report clinical and radiographic short-term outcomes., Study Design: Retrospective clinical cohort study., Sample Population: Cats (n = 67) with sacroiliac luxation., Methods: Case records of cats presented for sacroiliac luxation stabilized using two screws per side affected, one lag and one positional, between 2014 and 2023 were reviewed. The percentage of sacral purchase (PoSP) for each screw, percentage of reduction (PoR), and pelvic canal width ratio (PCWR) were measured and calculated., Results: Eighty-two sacroiliac luxations were stabilized. Two 2.0 mm screws were used in 69 cases; two 2.4-mm screws in nine cases, and one 2.4 mm with one 2.0 mm screw in four cases. The mean PoSPs for lag and positional screws were 46% ± 12 and 31% ± 11, respectively. The median PoR was 89% (41 to 100). The mean PCWR was 1.23 ± 0.11. Clinical follow up was available for 42 cats with 53 sacroiliac luxations at a median of 87 days (36 to 2503). The full function was noted in 34 patients (81%). Screw failure occurred in five sacroiliac joints (4.7%), including loosening (n = 3), and breakage (n = 2) of the positional screws (n = 1). Pelvic canal diameter was maintained in all cases., Conclusion: Excellent functional and radiographic outcomes were obtained for cats with sacroiliac luxation stabilized with two sacroiliac screws., Clinical Significance: Feline sacroiliac luxation can be stabilized using two sacroiliac screws., (© 2024 American College of Veterinary Surgeons.)

Objective: To compare the outcome of the laparotomy-assisted endoscopic removal (LAER) of gastrointestinal foreign bodies (FBs) with traditional enterotomy, and to determine which factors affected the ability to remove FBs., Study Design: Retrospective observational study., Sample Population: Dogs and cats (n = 81) with gastrointestinal FBs., Methods: Dogs and cats were divided into Group 1 (LAER, n = 40) and Group 2 (Enterotomy, n = 41). The localization and characteristics of the FBs (sharp or blunt; discrete or linear; single or multiple) were evaluated statistically to identify the factors that affected the ability of LAER to remove, partially or completely, the FBs (χ 2 test). The length of the postoperative stay, postoperative analgesia, and resumption of spontaneous feeding were compared between groups (Mann-Whitney U-test). Short-term follow up (14 days) was recorded., Results: Laparotomy-assisted endoscopic removal allowed complete or partial removal of FBs in 35/40 dogs and cats, regardless of the characteristics or the localization of the FBs. The presence of intestinal wall damage (p = .043) was associated with the conversion to an enterotomy. Group 1 required a shorter postoperative hospital stay (p = .006), less need for analgesia (p < .001), and experienced a faster resumption of spontaneous feeding (p = .012), and similar complication rate to Group 2., Conclusion: Laparotomy-assisted endoscopic removal resulted in a faster postoperative recovery when compared with an enterotomy. The FBs' characteristics or localization did not affect the efficacy of the technique to remove FBs., Clinical Significance: Laparotomy-assisted endoscopic removal allows the removal of a variety of FBs, avoiding intestinal incision and resulting in a fast postoperative recovery., (© 2024 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.)

Objective: To report the technique and the outcome for the repair of pelvic fractures in cats using external skeletal fixation (ESF)., Study Design: Retrospective case series., Animals: Client-owned cats (n = 125)., Methods: Medical records of cats with pelvic fractures, treated with an ESF between June 2001 and June 2009, were reviewed. Preoperative, immediate postoperative, and more than 4 weeks' postoperative radiographs were compared. Clinical examination was performed 4 to 9 weeks following surgery. Longer term follow up (4 to 80 months) was conducted by client questionnaire., Results: No intraoperative complications occurred. There was no change in the pelvic canal width observed on follow-up radiographs (p = .16). Implant loosening was noted on follow-up radiographs in 16/125 (13%) of cases, and 67/803 (8%) pins were palpably loose at the time of frame removal. The mean time to frame removal was 37 ± 9 days. No long-term complications were reported. Long-term mean mobility score was 95 ± 5 and median lameness was 0 (range: 0-2)., Conclusion: An ESF may be successfully applied for the stabilization of various pelvic fractures in cats., Clinical Significance: The application of an ESF for the management of pelvic fractures in cats provides good outcomes., (© 2024 American College of Veterinary Surgeons.)

Nuclear medical bone imaging was used in combination with targeted radiography to detect metastatic or multicentric lesions in 23 dogs with skeletal neoplasms. Each dog with a radiographically diagnosed skeletal neoplasm was injected with Technetium-99m labeled methylene diphosphonate (99mTc-MDP) (15.0 mCi intravenously) for whole body imaging. All areas with increased uptake of 99mTc-MDP were radiographed. In 19 dogs, the amount of bone shaft involvement in primary sites indicated by bone imaging was larger than the amount indicated by radiography. Eighteen dogs had secondary areas of increased 99mTc-MDP uptake, six of which had secondary areas that were suspected radiographically to be neoplastic. Four dogs had lesions characterized histologically as neoplasia, one as bone infarction and one as normal cortical bone. Positive predictive value for this strategy was 66.7%. Results of this study suggest that nuclear medical bone imaging with targeted radiography is a quick, noninvasive technique with a good positive predictive value for evaluation of the skeleton for metastatic or multicentric sites of neoplasia.

Three bilateral thyroidectomy techniques used in 41 hyperthyroid cats over a 7 year period were compared for rates of postoperative hypocalcemia. Extracapsular dissection of the thyroid glands resulted in an 82% rate of postoperative hypocalcemia. An intracapsular dissection technique produced a 36% rate of postoperative hypocalcemia. The incidence of postoperative hypocalcemia was reduced to 11% when bilateral thyroidectomies were done asynchronously (staged), 3 to 4 weeks apart. Immediate postoperative treatment with dihydrotachysterol did not reduce the incidence of postoperative hypocalcemia. Because the incidence of hypocalcemia did not differ significantly between intracapsular and staged intracapsular dissection, the authors concluded that staged bilateral thyroidectomy in hyperthyroid cats had limited benefit over simultaneous bilateral thyroidectomy.

Objective: To report the clinical outcomes of gastrointestinal surgery using unidirectional barbed sutures in single-layer appositional closure in dogs and cats., Study Design: Retrospective and descriptive study., Sample Population: Twenty-six client-owned dogs; three client-owned cats., Methods: Medical records of dogs and cats that received gastrointestinal surgery closed with unidirectional barbed sutures were reviewed to collect information on signalment, physical examinations, diagnostics, surgical procedures, and complications. Short- and long-term follow-up information was collected from the medical records, the owners, or the referring veterinarians., Results: Six gastrotomies, 21 enterotomies, and nine enterectomies were closed with a simple continuous pattern with unidirectional barbed glycomer 631 sutures. Nine dogs had multiple surgical sites closed with unidirectional barbed sutures. None of the cases in the study developed leakage, dehiscence, or septic peritonitis during the 14-day short-term follow up. Long-term follow up information was collected for 19 patients. The median long-term follow-up time was 1076 days (range: 20-2179 days). Two dogs had intestinal obstruction due to strictures at the surgical site 20 and 27 days after surgery. Both were resolved with an enterectomy of the original surgical site., Conclusion: Unidirectional barbed suture was not associated with a risk of leakage or dehiscence after gastrointestinal surgery in dogs and cats. However, strictures may develop in the long term., Clinical Significance: Unidirectional barbed sutures can be used during gastrointestinal surgery in client-owned dogs and cats. Further investigation of the role of unidirectional barbed sutures leading to abscess, fibrosis, or stricture is necessary., (© 2023 American College of Veterinary Surgeons.)

Objective: To report a surgical technique and outcomes of transiliosacral toggle suture repair to treat feline bilateral sacroiliac luxation/fracture (SILF)., Study Design: Retrospective study., Animals: Fifteen client-owned cats., Methods: The medical records of cats with bilateral SILF treated using a transiliosacral toggle suture repair were reviewed. Short- and medium-term outcomes were assessed through standard postoperative clinical evaluation and radiographs, including measurements of angle of deviation (AoD), percentage of reduction (PoR), and pelvic canal width ratio (PCWR). Long-term functional follow up was obtained from a questionnaire derived from the Feline Musculoskeletal Pain Index (FMPI)., Results: Fifteen cats were enrolled retrospectively, among which 13 survived to discharge. One minor wound complication, treated by secondary intention healing, was encountered. No major complication was reported. Immediately postoperatively, the mean absolute PoR values were 88.1 ± 11.2% and 91 ± 11.6% on the right and left side, respectively. The mean absolute AoD was 3.1 ± 2.8°, and the mean PCWR was 1.24 ± 0.08. The medium-term radiographic follow up at a median of 205 (71-682) days postsurgery revealed the good stability of the repair. Excellent functional outcomes were identified upon the analysis of 12 long-term questionnaires at a median of 365 (119-798) days postsurgery., Conclusion: Anatomic reduction was satisfactory and comparable with previously described techniques with good implant placement documented. Functional outcomes based on FMPI-derived questionnaires were good to excellent in our population., Clinical Significance: Transiliosacral toggle suture stabilization of bilateral SILF was associated with good outcomes in cats. Further studies are required to compare biomechanical properties and outcomes between this technique and previously described transiliosacral stabilization., (© 2023 The American College of Veterinary Surgeons.)

Objective: The objective of this study was to describe the clinical features, prognostic factors, and outcomes in dogs with surgically treated salivary gland carcinoma., Study Design: Multi-institutional retrospective case series., Animals: Seventy-two client-owned dogs from 16 institutions with surgically excised salivary gland carcinoma., Methods: Medical records of dogs undergoing sialoadenectomy from January 1, 2000 to January 1, 2020 were reviewed for signalment, clinical signs, preoperative staging results, preoperative mass evaluation, complications, histopathologic diagnosis, local recurrence, metastatic disease, and survival times. Survival functions were estimated using the Kaplan-Meier estimator. Factors related to survival were individually tested using the log-rank test., Results: The overall median survival time (MST) associated with salivary carcinoma was 1886 days. Local recurrence occurred in 29/69 (42%) dogs with an overall disease-free interval (DFI) of 191 days. Metastatic disease occurred in 22/69 (31.9%) dogs, with an overall DFI of 299 days. Lymph node metastasis was present at the time of surgery in 11/38 (28.9%) dogs in which lymphadenectomy was performed at the time of surgery; these dogs had a shorter DFI at 98 days (P = .03) and MST at 248 days (P < .001)., Conclusion: The prognosis for dogs with salivary gland carcinoma treated surgically was more favorable than previously reported. Nodal metastasis was a negative prognostic factor for canine salivary gland carcinoma., Clinical Significance: Surgical intervention should be considered for dogs with salivary carcinoma., (© 2023 American College of Veterinary Surgeons.)

Objective: To describe the surgical technique and clinical outcome of minimally invasive parathyroidectomy for primary hyperparathyroidism (PHPT) in the dog., Animals: Fifty client-owned dogs with PHPT that underwent minimally invasive parathyroidectomy., Study Design: Retrospective cohort study., Methods: An ultrasound-guided mini lateral approach was made via a plane established between the sternocephalicus muscle and sternohyoideus muscles to expose the thyroid gland and enlarged parathyroid gland. Abnormal parathyroid glands were removed en bloc via partial thyroidectomy. The technique for bilateral disease was similar, the skin incision was made on midline and moved laterally to develop the above-mentioned plane of dissection. Age, sex, breed, bodyweight, ultrasound findings, histopathological diagnosis, surgical time, preoperative clinical signs, and clinical outcome were extracted from the records for descriptive statistics., Results: A total of 62 glands were surgically removed, including 17 hyperplastic glands (17/62, 27.4%), 34 adenomas (34/62, 54.8%), and two carcinomas (2/62, 3.2%). Hypercalcemia resolved shortly after surgery in 44 dogs (44/45, 97.8%). One dog had recurrent hypercalcemia (1/45, 2.2%), one dog had persistent hypercalcemia (1/45, 2.2%), two dogs had permanent hypocalcemia requiring life-long calcitriol supplementation (2/45, 4.4%), and one dog died from clinical hypocalcemia (1/45, 2.2%)., Conclusion: Minimally invasive parathyroidectomy was associated with a low morbidity and led to favorable outcomes in 44/45 dogs in this series., Clinical Significance: The results of this study supports the use of minimally invasive parathyroidectomy to treat PHPT in dogs., (© 2022 American College of Veterinary Surgeons.)

Objective: To report outcomes and complications after placement of a subcutaneous vascular access port (SVAP) in the jugular (jSVAP), axillary (aSVAP), and femoral or external iliac vein (fSVAP) in dogs., Study Design: Retrospective., Methods: Medical records from a single hospital, covering a period between September 2015 and October 2020, were reviewed to identify dogs that had an SVAP placed. Complications and outcomes for dogs who had an SVAP placed in the axillary vein, or femoral/external iliac vein during amputation for appendicular skeletal neoplasm, and in the external jugular vein were recorded and analyzed statistically., Results: Subcutaneous vascular access ports were placed in the axillary vein in 13 dogs, femoral/external veins in 4 dogs, and in the jugular vein in 19 dogs. The SVAPs fulfilled their purpose throughout treatment in 12/13 aSVAP, 4/4 fSVAP, and 15/19 jSVAP. Dogs were followed for a median of 145.5 days (range 30-945 days). Minor and major complications were recorded in 1/13 and 2/13 aSVAPs, 0/4 and 0/4 fSVAPs, and 3/19 and 4/19 of jSVAPs. Two dogs with jSVAPs were euthanized due to SVAP-related complications. No difference in complication rate was detected between groups (P = .12)., Conclusion: No difference in short-term outcome was detected between implantation sites for subcutaneous vascular access ports., Clinical Significance: The axillary or femoral/external iliac veins offer alternative sites for placement of SVAP in dogs undergoing limb amputation., (© 2022 American College of Veterinary Surgeons.)

Objective: To describe the transoral endoscopic arytenopexy (TEA) and evaluate its effects on the rima glottis area (RGA) and laryngeal epiglottic-glottic seal (LEGS). We hypothesize the TEA will be a feasible surgical technique and the TEA will provide a significant increase in RGA with minimal change to the LEGS., Study Design: Canine cadaveric model., Animals: Fifteen medium- to large-breed canine cadavers., Methods: Endoscopic photos of the larynx were taken with the epiglottis open for baseline RGA measurement and closed for baseline measurement of exposed RGA and LEGS. A custom endoscopic gag port (EGP) facilitated the TEA, performed by suturing the lateral aspect of the left arytenoid soft tissues to adjacent pharyngeal wall across the piriform recess. Endoscopic photos were repeated to measure changes in RGA and LEGS. A computerized planimetric analysis program was used to calculate baseline RGA and LEGS. The RGA was reported in % change from baseline. The LEGS was reported as intact or altered. A nonparametric Wilcoxon signed-rank test was used to compare baseline to post-TEA RGA., Results: The mean baseline RGA was 0.52 ± 0.28 cm 3 and mean post-TEA RGA was 0.78 ± 0.37 cm 3 (p-value < .0001). The LEGS remained intact post-TEA in all cadavers., Conclusions: The TEA was technically feasible and resulted in an increase in RGA while maintaining the LEGS., Clinical Significance: The TEA may provide a minimally invasive addition to the established techniques for reducing airway resistance while minimizing the impact on the LEGS., (© 2022 American College of Veterinary Surgeons.)

Stem cell transplantation is expected to be an effective treatment for intractable skin ulcers by promoting angiogenesis; however, it is challenging to quickly realize a sufficient bloodstream for the ulcers. For this treatment, sheet-like materials with monolayer cells such as cell sheets have been investigated. However, they have a limitation of cell number that can be transplanted at one time due to the two-dimensional, monolayer cell structure, and sufficient secretion of growth factors cannot be expected. In this regard, cellular aggregates, such as spheroids, can reproduce three-dimensional cell-cell interactions that cause biological functions of living tissues more representative than monolayer cells, which is important to achieving efficient secretion of growth factors. In this study, we focused on free-standing porous polymer ultrathin films ("porous nanosheets") comprising poly(d,l-lactic acid) (PDLLA) and succeeded in developing a spheroid-covered nanosheet, on which more than 1000 spheroids from adipose-tissue derived stem cells (ASCs) were loaded. The porous structure with an average pore diameter of 4 μm allowed for facile filtration and carrying spheroids on the nanosheet, as well as sufficient oxygen and nutrients inflow to the cells. The spheroid-covered nanosheet achieved homogeneous transference of spheroids to a whole skin defect in diabetic model mice. Given the continuous release of vascular endothelial growth factor (VEGF) from the spheroids, the transplanted spheroids promoted healing with more accelerated angiogenesis than a nanosheet with a monolayer of cells. The spheroid-covered nanosheet may be a new regenerative material for promoting intractable skin ulcer healing., (© 2021 Wiley Periodicals LLC.)

Objective: To compare the immediate and short-term outcomes of thyroarytenoid lateralization (TAL) and cricoarytenoid lateralization (CAL) for the treatment of canine laryngeal paralysis in dogs., Study Design: A prospective, clinical trial., Animals: Fourteen client-owned dogs referred to our hospital because of bilateral laryngeal paralysis., Methods: Dogs with confirmed laryngeal paralysis were randomly assigned to the CAL or TAL group. Video images of the rima glottidis obtained preoperatively, immediately postoperatively (t0), and 15 days postoperatively (t1) were digitized. The rima glottidis area was measured using image-analysis software. An increase in the rima glottidis area was expressed as a percentage of the preoperative area., Results: The rima glottidis area increased by a mean of 152% at t0 and 127% at t1 for the TAL group and 205% at t0 and 199% at t1 for the CAL group compared with preoperative values. The increase in the rima glottidis area differed (P < .05) between the 2 groups at all postoperative time points. A reduction of the area occurred at t1 in both groups. There was no difference between t0 and t1 (P > .05) in the CAL group but there was a large difference (P < .05) in the TAL group., Conclusion: Cricoarytenoid lateralization and TAL were both effective for surgical abduction of the arytenoid cartilage. Although a reduction (P < .05) in the rima glottidis area occurred in the TAL group at t1, we observed no associated clinical signs., Clinical Significance: Cricoarytenoid lateralization and TAL result in good short-term outcomes in dogs with laryngeal paralysis., (© 2022 American College of Veterinary Surgeons.)

Objective: To determine the biomechanical behavior of different plate systems used for oblique ilial fracture fixation in cats., Study Design: Ex vivo biomechanical study., Sample Population: Fifty fresh-frozen feline hemipelvises., Methods: Standardized simple oblique ilial fractures were created and fixed via lateral plating, using different implant systems (10 fractures in each group) The systems were: (1) the Advanced Locking Plate System (ALPS-5); (2) the Advanced Locking Plate System (ALPS-6.5); (3) the Locking Compression Plate 2.0 (LCP); (4) the FIXIN 1.9-2.5 Series (FIXIN), and (5) the Dynamic Compression Plate 2.0 (DCP). Stepwise sinusoidal cyclic loading was applied until failure (10-mm displacement). The groups were compared with regard to construct stiffness and the number of cycles withstood before 1-, 2-, 5-, and 10-mm displacement., Results: Bending stiffness was lower in ALPS-5 than in other specimens (P < .05). The ALPS-6.5 specimens withstood more cycles (P < .05) before 2-, 5-, and 10-mm displacement than the ALPS-5 and DCP specimens . The LCP and FIXIN specimens endured more cycles than DCP specimens before displaying 5- and 10-mm displacement (P < .05). The ALPS-6.5, FIXIN, and LCP specimens endured higher loads before failure than the DCP specimens (P < .05). Screw loosening occurred in all nonlocking specimens, and bone slicing occurred in all locking specimens., Conclusion: The DCP and ALPS-5 constructs are less resistant to cyclic loading. Failure in nonlocking specimens involved screw loosening. It involved bone slicing in locking specimens., Clinical Significance: Both the plate size and the plate-screw interface are key to lateral plating success in cases of feline ilial fractures. The use of locking plates reduces the risk of the screw loosening in such cases., (© 2021 American College of Veterinary Surgeons.)

Objective: To evaluate the effect of three-dimensional (3D) laparoscopy compared to two-dimensional (2D) laparoscopy when evaluating duration of surgery for canine intracorporeally sutured gastropexy., Study Design: Randomized controlled clinical trial., Animals: Thirty client-owned dogs., Methods: Dogs were randomized into 2D or 3D groups and underwent a three-port laparoscopic intracorporeally sutured incisional gastropexy with barbed suture. Procedures were performed by a single board-certified surgeon. Duration of surgery was recorded and workload was assessed immediately after surgery using the NASA Task Load Index (TLX)., Results: Median duration of surgery was 3 min shorter for 3D versus 2D (95%CI -10 to 13; p = .51). Surgical component durations, total and component TLX scores, and intraoperative complications also did not differ between groups. In a subgroup analysis excluding the first eight cases due to presumption of a learning curve with suturing technique, total TLX score (p = .004) and all component scores were lower for 3D as compared to 2D laparoscopy, although duration of surgery did not differ (p = .20)., Conclusion: The use of 3D laparoscopy was not associated with shorter duration of surgery when compared to 2D laparoscopy., Clinical Significance: 3D laparoscopy requires further investigation in veterinary medicine to determine its utility in decreasing surgical duration, surgical complications or surgeon mental or physical workload., (© 2021 The American College of Veterinary Surgeons.)

Objective: To characterize and evaluate risk factors for comorbidities and death of cats with pelvic fractures., Study Design: Retrospective case study., Animals: Cats (n = 280)., Methods: Medical records were reviewed for cats in which pelvic fractures had been diagnosed (January 2003 to November 2016). Retrieved data included signalment, mechanism of injury, clinical findings, diagnostic imaging investigations, type and number of concurrent injuries based on anatomical location, type of therapy, and survival. Pelvic fractures were classified according to location and severity. Descriptive statistics were performed, and logistic regression models were constructed to examine associations between risk factors and outcome., Results: Cases consisted of 280 cats with no (9%), unilateral (43%), and bilateral (48%) involvement of the weight-bearing axis. Sacral fractures were found in 12% of cats. Surgical treatment and mortality rates increased progressively with the severity of the pelvic fractures (P < .001). Mean number of concurrent body regions injured was 2.4 ± 1.2 and was associated with mortality (P < .01). Twenty percent of cats did not survive to discharge. Cats with neurologic injuries were more likely not to survive (P = .02)., Conclusion: Concurrent injuries to at least one body region, especially the abdomen and thorax, were observed in cats sustaining pelvic fractures. Mortality was associated with increased severity of the fractures, neurologic injuries, and increased number of concurrent injuries., Clinical Significance: Concurrent injuries are common in cats with pelvic fractures, and comorbidities may be associated with mortality., (© 2019 The American College of Veterinary Surgeons.)

Objective: To evaluate the evidence published on the treatment of idiopathic chylothorax (IC) in small animals., Study Design: Systematic literature review., Sample Population: Dogs and cats with IC., Methods: A literature search was performed in three bibliographic databases in July 2018 for publications on IC in dogs and cats. Articles meeting criteria for inclusion were evaluated for treatment, survival, outcome data, and level of evidence (LoE) with a modified Oxford Level of Evidence (mOLE) and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) system., Results: Eleven of 313 identified articles met the inclusion criteria. Only one study was identified in dogs as having higher LoE by using the mOLE system, whereas no study was identified as such in either species with the GRADE system. Surgery was the primary treatment in all dogs and in 93% (68/73) of cats. Medical therapy was the primary treatment in 7% (5/73) of cats. The most common surgical treatment combined thoracic duct ligation (TDL) and subtotal pericardiectomy (SP; 40%; 34/84) in dogs and TDL in cats (51% [37/73])., Conclusion: The body of literature for IC treatment in small animals was limited to one higher LoE study in dogs and none in cats. No strong conclusion could be drawn regarding the effectiveness of any one surgical method in dogs or cats, and no evidence was found to support medical therapy as a primary treatment., Clinical Significance: The best available evidence regarding the treatment of IC is published in dogs and provides some support for surgical treatment with either TDL + cisterna chyli ablation or TDL + SP. Additional evidence is required to confirm this finding., (© 2019 The American College of Veterinary Surgeons.)