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Dogs presenting with brachycephalic obstructive airway syndrome suffer from multilevel obstruction of the airway as well as secondary structural collapse. Stenotic nares, aberrant turbinates, nasopharyngeal collapse, soft palate hyperplasia, macroglossia, tonsillar hypertrophy, laryngeal collapse, and left bronchial collapse are described as the most common associated anomalies. Rhinoplasty and palatoplasty as well as newer surgical techniques and prudent preoperative and postoperative care strategies have resulted in significant improvement even in middle-aged dogs.

OBJECTIVE To compare the prevalence of middle ear abnormalities in pugs and in French bulldogs and evaluate the influence of nasopharyngeal dimensions on middle ear effusion. STUDY DESIGN Retrospective study. ANIMALS Thirty pugs and 30 French bulldogs with brachycephalic airway syndrome and no known history of ear disease. METHODS Computed tomographic (CT) studies were reviewed for middle ear effusion, mucosal contrast enhancement, signs of osteitis, and tympanic wall thickness. Soft palate thickness and cross-sectional areas of the nasopharynx at the opening of the auditory tube were measured and normalized to each individual's skull index before statistical comparison between breeds. Statistical dependence of middle ear abnormalities and nasopharyngeal dimensions was assessed by using Spearman's rank correlation tests. RESULTS Middle ear effusion was observed in 17 of 30 (56.7%) French bulldogs and five of 30 (16.7%) pugs. Contrast enhancement of the tympanic bulla was noted in 25 of 60 (41.6%) French bulldog ears and three of 60 (5.0%) pug ears. The cross-sectional airway dimensions (difference [Δ] = 0.31 cm2 , P

Objective To compare three surgical approaches for excision of the zygomatic gland in dogs. Study design Cadaveric study. Animals Cadavers of mesocephalic dogs (n = 20). Methods Each skull was assigned to a lateral approach with zygomatic arch ostectomy on the left (n = 20) and one approach without ostectomy on the right, ventral (n = 10) or dorsal (n = 10) to the zygomatic arch. Approaches were evaluated for surgical exposure (rated on a scale of 1‐5 with one optimal exposure), tissue trauma, and completeness of gland removal. Glands from each side were weighed to compare as internal control. Results The ostectomy‐based approach offered excellent surgical view and good exposure of the zygomatic gland but caused more tissue trauma. The dorsal nonostectomy approach did not allow complete zygomatic gland extraction in nine of the 10 dogs, whereas the ventral nonostectomy approach enabled complete extraction in all 10 dogs. Conclusion The ventral zygomatic approach allowed complete removal of the zygomatic gland, with good surgical overview, while reducing tissue trauma and preserving the zygomatic arch. Clinical significance The ventral nonostectomy approach should be considered as an alternative to excise the zygomatic gland in dogs.

Background Recent advances in laparoscopy both in human and veterinary medicine have looked at means of being less invasive by using single-port access surgery as opposed to multiport access surgery. The glove port has gained popularity as a cost-effective alternative to commercially available single-port access devices. The primary aim of this study was to compare the glove port to the SILS™ port in a simulator model using the first two MISTELS (McGill inanimate system for training and evaluation of laparoscopic skills) tasks (peg transfer and pattern cutting). Methods Twenty-two novices were enrolled in this experimental study. Each participant had 60 min to practise both MISTELS tasks using two-port laparoscopy. Thereafter participants performed both tasks using the glove and SILS™ port with scores being calculated based on task completion time and errors. Higher scores were indicative of better performance. Participants were assigned into two groups with the starting order of the single ports being randomly selected. A self-evaluation questionnaire with three questions was completed by each participant after testing, rating each port. Results Significantly (p Implications of the study The glove port’s improved manoeuvrability and ease of use make it a cost-effective alternative to the SILS™ port, for use in single-port laparoscopic veterinary surgery.

Objective To describe a single‐port laparoscopic‐assisted ovariohysterectomy (LOHE) with a modified glove‐port technique in dogs and compare it with previously published laparoscopic techniques for LOHE in dogs. Study design Prospective clinical study and technique description. Animals Forty‐two healthy female dogs. Methods Laparoscopic‐assisted ovariohysterectomy was performed with a custom‐made single‐port device. The total duration of surgery from first incision to skin closure was compared with previously published durations of LOHE in dogs. Short‐term complications were recorded. Results The median total duration of surgery was 24 minutes (range, 17.5–39.5; mean, 25.73; SD, 6.12), which was shorter than that described in most previously reported studies of LOHE in dogs (range, 20.8 ± 4.00–60.0 ± 18.45 minutes; P

Background Several case series and case reports have been published about idiopathic hydrocephalus treatment in dogs and cats using ventriculoperitoneal shunts (VPS). Objectives To determine the risk and type of complications in dogs and cats after VPS placement. Animals Sixteen papers were included. Sixty dogs and 13 cats with idiopathic hydrocephalus treated by VPS placement were identified. Methods The databases CAB, Scopus, and Medline were used. Idiopathic/congenital hydrocephalus, feline/canine patients, ventriculoperitoneal shunting, complications, and outcomes were inclusion criteria. The focus was on complication type and time frame within which they arose. Results Complications in dogs (n = 60) were shunt obstruction (6/60; 10%), pain (4/60; 5.5%), shunt infection (3/60; 4.1%), disconnection (3/60; 4.1%), excessive shunting (2/60; 2.7%), and kinking (1/60; 1.6%). Complications in cats (n = 13) were coiling of the shunt in the SC tissue (2/13; 15.4%); kinking (1/13; 7.7%); and shunt obstruction (1/13; 7.7%). Complications were most likely during the first 6 months after shunt placement. Conclusion and clinical importance Ventriculoperitoneal shunting is considered a viable treatment option for patients with hydrocephalus. Potential complications should be discussed with the owner. Early diagnosis of complications is essential.

Simple Summary Single-port access systems, used to perform endoscopic surgery through a single incision, are currently used in many human and veterinary surgeries. These systems present some technical challenges as they offer limited space for manipulation. No objective study has evaluated the degree of possible movement within different single-port access systems. This study aimed to measure and compare the possible movements of the endoscope and instruments within three single-port access systems: the Covidien SILS-port, Storz Endocone, and glove port. The glove port consists of a surgical glove and an O-ring retractor. A clear acrylic box with artificial skin was used to mimic the abdominal wall and cavity. A motion capture system with 18 cameras was used to trace the possible movements of the endoscope. The volume of the cone-shaped three-dimensional figure described by the scope when circled 360° was used to compare maneuverability across the three systems. The glove port showed higher maneuverability than the two commercially available ports when an endoscope alone, or an endoscope and instrument, was or were inserted. A higher degree of maneuverability is positively associated with easier handling of the endoscope and instruments during surgical procedures. The findings of this study may benefit students and young professionals by helping them to select an easy-to-use single-port access system when beginning single-incision endoscopic surgery. Abstract Single-port access systems (SPASs) are currently used in human and veterinary surgeries. However, they pose technical challenges, such as instrument crowding, intra- and extracorporeal instrument collision, and reduced maneuverability. Studies comparing the maneuverability of the scopes and instruments in different SPASs are lacking. This study aimed to compare the maneuverability of three different SPASs: the Covidien SILS-port, Storz Endocone, and glove port. A clear acrylic box with artificial skin placed at the bottom was used to mimic the abdominal wall and cavity. The three SPASs were placed from below, and a 10-mm endoscope and 5-mm instrument were introduced. A motion analysis system consisting of 18 cameras and motion analysis software were used to track the movement of the endoscope and instrument, to determine the volume of the cone-shaped, three-dimensional figures over which movement was possible, with higher values indicating greater maneuverability. The Mann–Whitney U test was used for the analysis. The maneuverability of the endoscope alone was significantly higher in the glove port system than in the other two SPASs. When inserting an additional instrument, the maneuverability significantly decreased in the SILS-port and Endocone, but not in the glove port. The highest maneuverability overall was found in the glove port.

Relative macroglossia has been identified in brachycephalic compared to mesaticephalic dogs. This study assessed the tongue volume comparing three common brachycephalic breeds, including 30 French bulldogs, 30 pugs, and 15 English bulldogs. Computed tomography scans of intubated dogs with the hard palate suspended were examined for total tongue volume and cross-sectional areas (CSAs) of the tongue, oropharynx, soft palate, and nasopharyngeal airways at three levels: 1, caudal tip of the hard palate, 2, caudal tip of the hamulus, 3 cranial to the basihyoid bone. Tongue volume normalized to bodyweight, was significantly higher in English and French bulldogs than in pugs. Normalized to skull length, CSA of the tongue was smaller in pugs than in French and English bulldogs. At level 3, French bulldogs had larger oropharyngeal CSA than English bulldogs and pugs. Soft palate CSA was the largest in English bulldogs at level 3. At levels 1 and 2, soft palate and nasopharyngeal CSA was the smallest in pugs. At level 3, French bulldogs had higher total airway/soft tissue ratios than pugs. The smaller tongue volume in pugs questions the accuracy of the term macroglossia in this breed and these findings should be considered if surgical correction is sought.

Laparoscopy is a growing field in veterinary medicine, although guidelines are lacking. The objective of this study was to evaluate the pressure&ndash, volume curve during capnoperitoneum in cats. A total of 59 female cats were scheduled for routine laparoscopy. Pressure and volume data were recorded and processed, and the yield point of the curve was calculated using a method based on a capacitor discharging function. For the remaining 40 cats, a linear-like pressure&ndash, volume curve was observed until a yield point with a mean cutoff pressure (COP) of 6.44 &plusmn, 1.7 mmHg (SD) (range, 2.72&ndash, 13.00 mmHg) and a mean cutoff volume (COV) of 387 &plusmn, 144.35 mL (SD) (range, 178.84&ndash, 968.43 mL) was reached. The mean mL/kg CO2 value in cats was 208 &plusmn, 34.69 mL/kg (range, 100.00&ndash, 288.46 mL/kg). The COV correlated with COP and body weight but not with body condition score (BCS). COP correlated only with the COV. This study suggests that feline patients have a pressure&ndash, volume curve similar to that of canine patients, and the same pressure limit recommendations can be used for both species. After a yield point of 6.44 mmHg is reached, the increment in volume decreases exponentially as the intra-abdominal pressure (IAP) increases.

A congenital extrahepatic porto-internal thoracic shunt was attenuated with cellophane banding in a cat with multiple embryogenetic anomalies. Changes in the postoperative shunt diameter were monitored using ultrasound and CT angiography. The patient improved clinically after cellophane banding, showing resolution of hepatic encephalopathy, weight gain and normalisation of serum ammonia and bile acid levels. The shunt vessel stopped narrowing at four postoperative weeks, and a complete closure was surgically achieved after 9 months. The patient stopped vomiting immediately after the second surgery. Additional histopathological results suggested lymphoplasmacytic enteritis, which was treated medically. The reason why complete closure with the cellophane banding was not attained remains unclear. However, it can be hypothesised that the material did not function as normal cellophanes or that placement of the cellophane within the falciform ligament did not result in the usual inflammatory reaction or closure of the vessel.

Objective To evaluate the penetration depth (VNPD) of 2 disposable Veress needles (VN) at 4 insertion sites in the abdomen. Study design Descriptive study. Sample population Canine cadavers (n = 22, 6 for confirmation of the test methods and 16 for the comparative study). Methods Two disposable VN (VN A and VN B) were inserted at 4 sites (9th intercostal space [ICS] and preumbilical, paraumbilical, and subumbilical sites) in dorsally recumbent dogs by using a hand‐cranked jig. The VNPD was measured as the distance traveled by the VN between the subcutaneous tissue and the perforation of the peritoneum on the basis of audible clicks and visible feedback from the VN. The effects of the VN type and insertion site on the VNPD were analyzed by using a linear mixed‐effects model. Results VNPD varied between insertion sites (P = .01) and VN (P

Objectives The aim of this study was to report complications, as well as short- and long-term clinical outcomes of cats suffering from surgically reduced intussusception with and without enteroplication. Methods Medical records of cats presented at our institution with intussusception between 2001 and 2016 were reviewed. The following data were retrieved: signalment; history; physical examination; diagnostic imaging, surgical and histological findings; and outcomes. Animals were grouped as with or without enteroplication. Duration of surgery, survival, complication and recurrence rates, duration of hospitalisation, and short- and long-term outcomes were compared. Results Cats with intussusception presented with unspecific type and duration of clinical signs. Male or male castrated cats and Maine Coons were over-represented in both groups. Enteroplication was performed in 48% (10/21) of the cats. Cats in the enteroplication group were significantly younger than those in the non-enteroplication group ( P = 0.023). Duration of surgery, time of hospitalisation, complication rate and outcomes did not differ between the two groups. Two complications in the short term and one complication in the long term were possibly associated with enteroplication. A recurrence of intussusception was seen in 2/17 cats approximately 12 months after initial surgery, both previously treated with enteroplication. Conclusions and relevance Although the number of cases was limited, our results suggest that enteroplication should be cautiously performed in cats with intussusception as it may be associated with major complications in the short and long term, and its efficacy remains unclear. Based on this study, the need for enteroplication in cats following a correction of intussusception could be questioned.

Objective To compare design features and mechanical properties of 13 commercially available Veress needles (VN). Study design In vitro biomechanical study. Sample population Veress needles from 9 manufacturers (6 reusable, 6 disposable, and 1 with a reusable stylet combined with a disposable cannula) were included in the study. Methods Veress needles are designed with a spring-loaded stylet to protect the tip of the cannula following insertion into the abdomen. Stylet forces were measured with a scale in a test jig by moving the stylet in 0.5 mm steps into the hollow cannula. Forces and spring rates were derived from force-displacement plots. Mass, mechanical dimensions, and the bevel angle and geometry were assessed. Differences between VN models were analyzed with a univariate analysis of variance. Results are reported as mean ± SD or median (range). Results Physical and mechanical parameters differed between models. The exposed stylet length was 3.5 mm (2-7). Three bevel geometries (bias, lancet type, and back-cut) with angles between 20° and 40° were identified. Reusable VN weigh more (24.9 ± 2.2 g) than disposable designs (6.0 ± 2.3 g). The mean values for the spring rate and the residual stylet force were 0.23 ± 0.08 Nmm−1 and 0.94 ± 0.28 N, respectively. The mean force required to move the stylet to the cannula tip was 1.81 ± 0.29 N and 2.77 ± 0.54 N to move to the proximal end of the bevel. Conclusion Commercially available VN use diverse bevel geometries and have different mechanical characteristics. Studies investigating laparoscopic entry complications should explicitly report the type of VN model used.

OBJECTIVE To evaluate the pressure-volume relationship during capnoperitoneum in dogs and effects of body weight and body conformation. ANIMALS 86 dogs scheduled for routine laparoscopy. PROCEDURES Dogs were allocated into 3 groups on the basis of body weight. Body measurements, body condition score, and body conformation indices were calculated. Carbon dioxide was insufflated into the abdomen with a syringe, and pressure was measured at the laparoscopic cannula. Volume and pressure data were processed, and the yield point, defined by use of a cutoff volume (COV) and cutoff pressure (COP), was calculated. RESULTS 20 dogs were excluded because of recording errors, air leakage attributable to surgical flaws, or trocar defects. For the remaining 66 dogs, the pressure-volume curve was linear-like until the yield point was reached, and then it became visibly exponential. Mean ± SD COP was 5.99 ± 0.805 mm Hg. No correlation was detected between yield point, body variables, or body weight. Mean COV was 1,196.2 ± 697.9 mL (65.15 ± 20.83 mL of CO2/kg), and COV was correlated significantly with body weight and one of the body condition indices but not with other variables. CONCLUSION AND CLINICAL RELEVANCE In this study, there was a similar COP for all dogs of all sizes. In addition, results suggested that increasing the abdominal pressure after the yield point was reached did not contribute to a substantial increase in working space in the abdomen. No correlation was found between yield point, body variables, and body weight.

Ovariectomy and ovariohysterectomy are the two most commonly used techniques for sterilisation of female small animals. In the past decade, there has been a trend towards using minimally invasive techniques in small animal surgery, and laparoscopic ovariectomy (LapOVE) has emerged as one of the most common clinical applications of laparoscopy in small animals. LapOVE offers several advantages over the open method conducted through the median coeliotomy, including reduced postoperative pain, faster recovery and less patient immobilisation. Important advantages for the operator include magnification and better visualisation of the surgical field, which increase the procedure9s safety. However, high costs for the laparoscopic equipment and a rather steep learning curve may be discouraging to many veterinarians. This article outlines the most relevant aspects of LapOVE for clinical application in small animal surgery.

Experimental and human studies have reported the advantages of a suture length to wound length (SL:WL) ratio greater than 4:1 in midline abdominal closure. This is achieved when the tissue bite (TB) is equal to or larger than the stitch interval (SI). Although TB and SI values are recommended in some textbooks, SL:WL ratios are rarely reported in veterinary textbooks. Additionally, no clinical data regarding these parameters could be found in small animals. Therefore, the aim of this study was to evaluate the SL:WL ratio of midline laparotomy closure in dogs and cats performed by surgeons with different levels of expertise and to compare the findings with current textbook recommendations. Midline laparotomy incisions of 100 dogs and 75 cats were closed in continuous pattern by diplomates and residents of both the European College of Veterinary Surgeons (ECVS) and the European College of Animal Reproduction (ECAR). The mean SL:WL ratio was 2.5 ± 0.7:1. The surgeons´ level of experience and the species and body weights of the animals did not have any significant influence on the SL:WL ratio. A moderate negative correlation was observed between the mean SI to mean TB (SI:TB) ratio and the SL:WL ratio. In this study, the mean SI matched the textbook recommendations both in feline and canine species, whereas the TB in cats was different. In this study, the SL:WL ratio was less than 4:1 without apparent complications. Because of the low prevalence of incisional hernia in dogs and cats larger studies are necessary to evaluate clinical significance of the presented data.

The objective of the study was to describe the feasibility of a glove port technique for laparoscopic-assisted surgical treatment of canine pyometra. In this retrospective case series, a total of 10 female dogs (median age 7 years, range 5.5-10.5 years; median weight 37.0 kg, range 12.9-64.0 kg) with pyometra were included. A multiaccess port was created from a surgical glove attached to an Alexis wound retractor and placed in the ventral midline between the middle and caudal third of the distance between umbilicus and pubic rim. A vessel sealing device was used for transection of the ovarian pedicle. The port size was selected on the basis of maximum uterine diameter determined by ultrasound. Median incision length was 5.0 cm (range 3.1-7.7 cm) for a maximum uterine diameter of 4.0 cm (range 2.0-7.0 cm). Median surgical time was 57 minutes (range 48-65 minutes). No case had to be converted to open celiotomy. Complications included one case of minor, self-limiting splenic trauma by the endoscope. In eight dogs, the distended uterine horns endangered safe access to the ovarian pedicle, and the vessel sealing device was inserted through a second cannula placed periumbilically. Extension of the original incision was necessary to exteriorize organs in two dogs. All dogs recovered quickly and were discharged either on the day of surgery or 1 day thereafter. In conclusion, a surgical glove port technique in combination with an Alexis wound retractor is feasible for surgical laparoscopic treatment of canine pyometra up to a diameter of 7 cm.

Objective To describe the nasopharyngeal airway dimensions of two brachycephalic breeds and to localize the area of smallest airway dimensions. Study Design Prospective, descriptive, computed tomographic imaging study. Animals Thirty pugs and 30 French bulldogs with brachycephalic upper airway syndrome. Methods The thickness and length of the soft palate, cross-sectional area of the airway passage dorsal to the soft and hard palates, and cross-sectional area of the frontal sinus were measured and normalized to each dog's skull index and body weight before statistical comparison between breeds. Nasopharyngeal turbinates and surrounding airway space, and a possible relationship between the canine tooth angulation and the severity of airway obstruction were assessed. Results Pugs had significantly smaller cross-sectional areas of the airway dorsal to the soft and hard palates than French bulldogs. In both breeds, the smallest nasopharyngeal cross-sectional areas were located dorsal to the caudal end of the soft palate. The soft palate of pugs was significantly shorter than that of French bulldogs and also significantly thinner when normalized to each dog's skull index. Pugs more commonly exhibited nasopharyngeal turbinates. Pugs had significantly smaller air-filled cavities at the location of the frontal sinus. No correlation between the nasopharyngeal dimensions and canine tooth angulation was observed. Conclusion Computed tomographic assessment of the upper airway morphology showed the smallest nasopharyngeal cross-sectional areas were located dorsal to the caudal end of the soft palate in both breeds. Pugs had a smaller nasopharyngeal cross-sectional area despite smaller soft palate dimensions than French bulldogs.

OBJECTIVES To describe a modified temporary tracheostomy that included placing a Penrose drain sling dorsal to the trachea. To report outcomes and complications in brachycephalic versus non-brachycephalic breeds. MATERIALS AND METHODS Retrospective review of signalment, diagnosis, outcome, complications and management of dogs that underwent modified temporary tracheostomy. RESULTS Twenty-one dogs were included. Tracheostomy tubes were maintained for periods ranging from 1 to 21 days (median 4 days). There were no intraoperative complications or complications related to the placement of the Penrose drain. Postoperative complications occurred in eight dogs, including dislodgement of the tracheostomy tube (n=6), obstruction of the tracheostomy tube (n=1), subcutaneous emphysema and pneumomediastinum (n=1). Twenty dogs survived until discharge; one was euthanised due to persistence of primary disease. The complication rate in brachycephalic breeds and non-brachycephalic was 37∙5 and 40%, respectively. Tube dwell duration of 4 days or longer was associated with a higher complication rate. CLINICAL SIGNIFICANCE The modified temporary tracheostomy appears to simplify tracheostomy care, improve tracheostomy outcome and reduce tube-associated mortality compared with standard tracheostomy. In this study, brachycephalic dogs did not have a higher complication rate than non-brachycephalic dogs.

The objective of the study was to review current literature to determine whether the topical application of platelet-rich plasma (PRP) promotes healing in experimentally-induced full-thickness skin wounds in animals. The hypothesis was that the adjunct of PRP has a positive effect on wound healing. An electronic search was carried out on the following databases: Web of Science, Cochrane Library, PubMed, Research Gate, Cochrane Wounds Group, Veterinary Information Network. No publication date nor language restrictions were applied. Randomised and not randomised controlled clinical trials comparing PRP with placebo or with other treatments were included. The reduction of open wound area in PRP-treated (test) wounds compared to control wounds was the primary outcome. Secondary outcomes were healing time and number of healed cases in test group compared to control. The following effect sizes were calculated: the Hedges' g for continuous variables; the odds ratio for binary data. Eighteen controlled clinical trials were included in the qualitative and quantitative synthesis, with a total of 661 wounds. All studies were published in the period 2007-2016. Eight studies were carried out on rodent/lagomorph mammals and 10 on non-rodent/lagomorph mammals. In all included studies, control wounds underwent placebo or were left untreated. The PRP group showed a better healing performance than the control group in each outcome. The effect size was statistically significant considering the primary outcome and the overall aggregation of the three outcomes. The effect size, although in favour of the treatment with PRP, was not significant considering the healing time and the number of healings. The overall heterogeneity was mild or moderate. Five studies reported a high risk of selection bias. The publication bias was always mild or absent. The results support the hypothesis of the positive effects of the PRP when compared to control groups in the treatment of experimentally-induced full-thickness skin wounds in animals. PRP can therefore be considered an effective adjunctive therapy in stimulating second intention healing of acute wounds in healthy animals.

OBJECTIVE To compare clinical features of brachycephalic airway syndrome and long-term surgical outcomes between pugs and French bulldogs and evaluate the influence of laryngeal collapse. METHODS This retrospective study included 72 dogs that underwent wedge rhinoplasty and folded flap palatoplasty for brachycephalic airway syndrome. Epidemiological data, clinical signs, postoperative complications and owners’ responses to a questionnaire at least six months after surgery were compared between pugs and French bulldogs. Spearman's rank correlation tests were used for associating laryngeal collapse with age and respiratory signs before and after surgery. RESULTS On the basis of the results of the owners’ questionnaires (available in 52/72 dogs), French bulldogs presented with lower activity levels and more severe digestive signs than pugs. Owners perceived clinical improvement in 88 · 5% of all dogs. The grades of respiratory and digestive signs were not different between the breeds in the long-term follow-up, and the grade of laryngeal collapse did not influence the grade of respiratory signs or surgical outcome. CLINICAL SIGNIFICANCE Surgical treatment resulted in improved clinical signs in pugs and French bulldogs with brachycephalic airway syndrome, with a high owner satisfaction rate. There were no correlations between the severity of laryngeal collapse and overall respiratory signs or prognosis.

BackgroundAdvanced bipolar vessel sealing devices are widely used in human and veterinary medicine to reduce the operation time and intraoperative blood loss. Because most devices are made for a single use, their application is cost intensive. The aim of this study was to investigate the influence of multiple uses and sterilization on the performance of bipolar vessel sealing devices.MethodsThe burst pressure of sealed porcine renal arteries was compared between the disposable devices "LigaSure"(Valleylab) and "Caiman"(Braun Vetcare) and the reuseable device "MarSeal"(KLS Martin). Additionally, the influence of the sterilization process was investigated, and the sealing time, number of cutting activations and tissue sticking were noted.ResultsThe disposable devices showed reliable performances over multiple activations and sterilization cycles, except for one Caiman device. Seals created with all devices achieved supra-physiologic burst pressures, with the highest pressure measured in a cycle using a MarSeal device.DiscussionDuring 25 activations with and without intermittent sterilization, no correlation was found between increasing seal numbers and decreasing burst pressure. However, the number of cycles in our study was limited to five.ConclusionFor limited numbers of cycles and sterilization procedures, seals created with the disposable vessel sealing devices LigaSure and Caiman achieved burst pressures comparaable to those produced with the reuseable MarSeal.

ObjectiveThis study aimed to investigate the suture length to wound length ratio (SL:WL) in an in vitro model of abdominal wall closure. Effects of the surgeon's experience level on the SL:WL ratio were evaluated, hypothesizing that small animal surgeons do not spontaneously apply SL:WL ratios equal to or larger than 4:1.ProceduresThree groups of surgeons with varying levels of experience performed 4 simple continuous sutures before (3 sutures) and after (1 suture) being educated on principles of the SL:WL ratio. All sutures were evaluated for their gaping, number of stitches, stitch intervals, tissue bite size and suture length.ResultsNo significant differences in suture parameters or SL:WL ratios were found among the 3 groups, and 60.5% of control sutures and 77.0% of test sutures had SL:WL ratios above 4:1. There was a significant improvement in the mean ratio after the information was provided (p = 0.003). Overall, the SL:WL ratios ranged from 1.54:1 to 6.81:1, with 36.3% falling between 4:1 and 5:1 (5.17 mm mean stitch interval, 5.52 mm mean tissue bite size). A significant negative correlation was observed between the SL:WL ratio and the stitch interval to tissue bite ratio (r = -0.886). Forty-nine of 120 sutures fulfilled the current recommendations for abdominal wall closure with a mean SL:WL ratio of 4.1:1.ConclusionA SL:WL ratio larger than 4:1 was achieved in 60% of the control sutures and in 77% of test sutures. Additional animal studies are necessary to evaluate the SL/WL ratio in small animal surgery.

The aim of this retrospective study and owner survey was to record the postoperative complication rate, pain score and owners' satisfaction rates of single portal laparoscopic ovariectomy in dogs using an operating laparoscope and to compare our results with data in the veterinary literature on other laparoscopic methods. Therefore, the medical records of all bitches that were spayed using a laparoscopic single port ovariectomy with an operating laparoscope between November 2007 and November 2014 were reviewed. A minimum follow-up period of 12 months was required for study inclusion. One hundred and thirty two adult, healthy, femal dogs were included in our study. The information collected included breed, bodyweight, age at ovariectomy and postoperative complications detected during follow-up 9-14 days after surgery. Furthermore, an electronic questionnaire was implemented, and the owners of the dogs were asked to report on long-term complications and to retrospectively evaluate postoperative pain and overall satisfaction. Sixty-two different and mixed breed dogs with weights ranging from 1.9 to 50 kg and ages ranging from 0.5 to 10.8 years were included. Short-term complications were detected in 21 out of 132 cases, mostly at the surgical site (15.9 per cent). According to our questionnaire (n=65), 10 dogs developed urinary incontinence categorised as a major complication (15.4 per cent). The owner's evaluated pain score was less than 300 on a 1000-unit visual analogue scale for 56 out of 65 dogs (86.2 per cent) and less than 500 in 63 dogs (96.9 per cent). The dog owners' satisfaction rate was 95.3 per cent (87.5 per cent evaluated the surgery as excellent and 7.8 per cent as good). Altogether, our study suggests that single port access using an operating laparoscope for ovariectomy has minor complication rates comparable to other laparoscopic techniques but has the advantages of a low postoperative pain level as evaluated by the owner and a very high owner's satisfaction rate.

Objective To report a technique for, and short-term outcome of unilateral laparoscopic adrenalectomy in dogs positioned in sternal recumbency without abdominal support. Study Design Experimental and prospective clinical study. Animals Healthy dogs (n = 5) and dogs with unilateral adrenal gland tumor (n = 9). Methods Anesthetized dogs were positioned in sternal recumbency with 2 cushions placed under the dog to elevate the chest and pelvic area so that the abdomen was not in contact with the surgical table allowing gravitational displacement of the abdominal viscera. Three 5-mm portals were located in the paralumbar fossa. Adrenal glands were carefully dissected and surrounding tissues sealed and cut using a vessel-sealing device. A retrieval bag or part of a surgical glove finger was used to remove the adrenal gland from the abdomen. Surgical time and complications were recorded, and short-term outcome assessed. Results Adrenal glands in normal dogs and unilateral adrenal tumors (8 left, 1 right) not involving the caudal vena cava in affected dogs were successfully removed laparoscopically. There were no major intraoperative complications. Of the dogs with adrenal tumors, 1 dog died within 24 hours of surgery from unrelated causes. Eight dogs recovered within 1 day and were discharged within 72 hours. Surgical times ranged from 42 to 117 minutes and were significantly shorter than those reported previously. Conclusions Positioning anesthetized dogs in sternal recumbency with the abdomen suspended to facilitate gravitational displacement of the abdominal viscera improves access to, and visibility of, the adrenal gland for laparoscopic removal.

Pulmonary permeability oedema is a frequent complication in a number of life-threatening lung conditions, such as ALI and ARDS. Apart from ventilation strategies, no specific therapy yet exists for treatment of these potentially fatal illnesses. The oedema-reducing capacity of the lectin-like domain of TNF (TIP) and of synthetic peptides, mTIP and hTIP, which mimic the TIP domain of mouse and human TNF, have been demonstrated in various studies in rodents. Cell-based electrophysiological studies have revealed that the alveolar fluid clearing capacity of TNF and the TIP peptides is due to activation of the amiloride-sensitive Na+ current in alveolar epithelial cells and that the primary site of action is on the apical side of these cells. AP301, a synthetic cyclic peptide mimicking the TIP domain of human TNF is currently undergoing clinical trials as a therapy for pulmonary permeability oedema. AP301 has been shown to improve alveolar liquid clearance and lung function in a porcine model of ALI. For non-clinical regulatory assessment, dog, pig and rat are standard animal models; accordingly, pre-clinical toxicological and pharmacological safety studies have been conducted with AP301 in dogs and rats. Hitherto, no studies have assessed the pharmacodynamic effect of AP301 on primary canine or porcine type II AEC. The current study describes the effect of AP301 on the amiloride-sensitive Na+ current in type II AEC isolated from dog, pig and rat lungs. In whole cell patch clamp experiments with dog type II AEC, an increase in the amiloride-sensitive Na+ current from 3.7 pA to 49.4 pA was observed in the presence of AP301; in pig type II AEC, an increase from 10.0 pA to 159.6 pA was observed, and in rat AEC, from 6.9 pA to 62.4 pA. In whole cell patch clamp experiments in A549 cells, AP301-induced enhancement of the amiloride-sensitive current was eliminated when Na+ in the bath solution was replaced with N-methyl- d -glucamine (NMDG), and when the cells were pre-incubated with 5-aminoimidazole-4-carboxamide-1-s- d -ribofuranoside (AICAR), an inhibitor of ENaC, but enhancement was unaffected by addition of cyclic nucleotide-gated (CNG) channel inhibitors Zn2+ or l -cis-diltiazem prior to AP301. These results provide strong evidence that AP301 activates the amiloride-sensitive Na+ current through ENaC in type II AEC from dog, pig and rat. To our knowledge, this is the first cell-based analysis of the oedema-clearing effect of AP301 observed in the porcine model of pulmonary oedema. Furthermore, the results validate the dog and pig models in non-clinical assessment of AP301.

Objective—To evaluate serum feline-specific pancreatic lipase immunoreactivity (fPLI) concentrations and abdominal ultrasonographic findings in cats with trauma resulting from high-rise syndrome. Design—Prospective case series. Animals—34 client-owned cats. Procedures—From cats evaluated because of high-rise syndrome between March and October 2009, a blood sample was obtained for measurement of serum fPLI concentration within 12 hours after the fall and at 24, 48, and 72 hours after the first blood collection. Pancreatitis was diagnosed in cats with an fPLI concentration > 5.4 μg/L. Each cat had abdominal ultrasonography performed twice 48 hours apart, and pancreatic trauma was assessed via detection of pancreatic enlargement, hypoechoic or heteroechoic pancreatic parenchyma, hyperechoic mesentery, and peritoneal effusion. Cats were assigned 1 point for each abnormality present, and a cumulative score ≥ 3 was considered suggestive of traumatic pancreatitis. Results—Traumatic pancreatitis was diagnosed in 9 and 8 cats on the basis of serum fPLI concentration and ultrasonographic findings, respectively. For cats with pancreatitis, fPLI concentration was significantly higher at 12 and 24 hours after the fall than at 48 and 72 hours after the fall, and serum fPLI concentration decreased as time after the fall increased. Significant agreement existed between the use of serum fPLI concentration and abdominal ultrasonography for the diagnosis of traumatic pancreatitis. Conclusions and Clinical Relevance—Cats with high-rise syndrome often had serum fPLI concentrations > 5.4 μg/L within 12 hours after the fall, and concurrent evaluation of those cats via abdominal ultrasonography twice, 48 hours apart, improved detection of traumatic pancreatitis.

Objective To describe a technique of laparoscopic-assisted placement of a peritoneal dialysis (PD) catheter with simultaneously performed partial omentectomy and omentopexy. Study Design Pilot experimental study. Animals Beagle dogs (n = 6). Methods After placement of 1 sub-umbilical laparoscope portal and 1 instrument portal in the left cranial abdominal quadrant, laparoscopic-assisted partial omentectomy, and omentopexy were performed, and a modified Tenckhoff PD catheter was placed under laparoscopic guidance. A modified dialysis protocol was used twice daily for 4 days. The feasibility of the procedure, surgical duration, operative complications, and dialysis efficacy were evaluated. Postoperative pain and inflammation were graded (0–3). Results The procedure was successfully performed in all dogs with a median operating time of 25 minutes. No operative complications occurred. Procedure-related postoperative pain and inflammation were minimal. Eight consecutive PD procedures were successfully performed, and no leakage or obstruction was observed. Conclusions Laparoscopic-assisted partial omentectomy and omentopexy can be performed at the same time as PD catheter placement with minimal morbidity.

Objective To evaluate the influence of rotation of the tibial tuberosity (TT) in the sagittal plane and angulation of osteotomy in the frontal plane (FPA) on the displacement of patellar tendon (PT) insertion. Study Design Ex vivo biomechanical study. Sample Population Canine tibiae (n = 36). Methods Nine groups of 4 tibiae each had a circular osteotomy of the TT at an FPA from –20° to +20° with increments of 5° for each group. The osteotomized TT was rotated by angles of rotation (AORs) of 10°, 20°, or 30° in the sagittal plane. The craniocaudal (CCD), distoproximal (DPD), and mediolateral (MLD) displacements of a marker located at the PT insertion on the TT were evaluated radiographically. Differences between groups were analyzed by Mann–Whitney U test and Friedman 2-way ANOVA. Results There was a significant correlation between the AOR and CCD. A positive FPA resulted in a high CCD and lateral shift of the TT at every AOR. Performing an osteotomy at an FPA of 0° produced the maximum amount of DPD. Conclusions FPA and AOR during circular osteotomy of the TT influence the final displacement of the PT insertion in all 3 planes.

Although endoscopic surgery entered its "golden era" in the mid-1980s, it is still advancing at a tremendous pace. Novel surgical techniques and devices are continuously developed and applied, and new indications (and/or contraindications) for the use of endoscopic surgery are routinely reported in the literature and subjected to systematic assessments. Although endoscopic surgery (laparoscopy in particular) has already become established as the gold standard in human medicine, it has yet to be proven as a viable alternative to open surgery in the field of veterinary medicine. The advantages of minimally invasive surgery include better intra-operative visualization, reduced postoperative pain, reduced scar formation and increased postoperative mobility. Therefore, it is reasonable to expect that the application of this will continue to expand. Small animal reproduction, a field within the broad discipline of veterinary medicine, has already recognized and begun to reap the benefits of endoscopic surgery. Herein, we retrospectively review the most recent successful novel applications of endoscopic surgery in the small animal reproduction system to provide small animal reproductive surgeons with important knowledge to help improve their own veterinarian medical practice.

Animals presenting with brachycephalic syndrome suffer from multilevel obstruction of the airways as well as secondary structural collapse. Stenotic nares, aberrant turbinates, nasopharyngeal collapse, soft palate elongation and hyperplasia, laryngeal collapse, and left bronchus collapse are being described as the most common associated anomalies. Rhinoplasty and palatoplasty as well as newer surgical techniques and postoperative care strategies have resulted in significant improvement of the prognosis even in middle-aged dogs.

Objectives Influence of neurological status on the mortality rate of paraparetic/paralysed cats presenting after entrapment in a bottom-hung window was evaluated. It was hypothesised that (1) loss of deep pain sensation at admission would not be a negative prognostic factor for regaining motor function and that (2) mortality rate would be influenced by the severity of neurological grade upon admission. Methods Clinical and pathological data of affected cats that presented at our institution between 2001 and 2012 for this specific trauma were collected retrospectively: breed, age, sex, last contact with owner (3 hours), whether the cat was suffering from monoparesis or paraparesis/paraplegia, duration of hospitalisation, rectal temperature, surface temperature of the skin of the hindlimbs, femoral pulse and tone of the pelvic musculature. Neurological status was categorised according to Scott’s classification scheme with neurological grade 1 representing spinal pain on manipulation down to neurological grade 5 representing paraplegia with no deep pain sensation. Results Data were collected for 98 cats that had been caught in the thoracolumbar area. A total of 71 cats were included in the statistical analysis after excluding 27 cats for the following reasons: monoparesis/monoplegia by getting one limb caught only (15), no initial neurological examination (5), was dead on arrival (1), caught within the thoracolumbar area but no clinical or neurological abnormalities (6). The proportional mortality rate overall was 35% (25/71) with 65% of these (16/25) dying with clinical signs of respiratory distress. The proportional mortality rate of patients with a neurological grade of 5 on admission was 55% (17/31). Conclusions Mortality was influenced by the severity of neurological grade on admission, with the majority of cats having a neurological grade of 5 (paraplegia with loss of deep pain perception) at admission dying (11/31) rather than undergoing euthanasia on admission at the owner’s request (6/31). In the survivors’ group, loss of deep pain perception was not a negative prognostic factor for regaining motor function although it was associated with mortality.

OBJECTIVE To describe the optimal recumbency for laparoscopic ovariectomy (LapOVE) in dogs. STUDY DESIGN Prospective clinical trial. ANIMALS Sixteen healthy client-owned female dogs undergoing routine single-port LapOVE. METHODS Anesthetized dogs were placed in dorsal recumbency on a tilting operation table. The operating laparoscope was introduced and, after inspection of abdominal organs, directed toward the randomly assigned ovary. Fifteen-second video recordings were taken at each table rotation of 0°, 22.5°, and 45°. LapOVE was performed using the single-port technique. The procedure was repeated on the contralateral side. Blinded observers (3 inexperienced [IO], 3 experienced [EO], 1 expert [EE]) evaluated the recordings postoperatively for visibility of ovary/ovarian bursa, ovario-uterine transition, and other organs. RESULTS In the 0° position, ovarian structures were rarely visualized (IO, 13/96 [13.5%]; EO, 7/96 [7.3%]; EE, 5/32 [15.6%]). In the 22.5° position, visualization improved significantly for EO (26/96 [27.1%], P < .001). There was a marked improvement in visualization for all groups when the positioning angle was altered to 45° (IO, 62/96 [64.6%]; EO, 67/96 [69.8%]; EE, 25/32 [78.1%]). The differences between 0° and 45° and between 22.5° and 45° were significant for all groups of observers (all P < .001). There was an advantage for ovary visualization when procedures were started with left ovariectomy. CONCLUSION The 45° table rotation provided the best ovary visualization, regardless of body side or observer experience. There is evidence that procedures should be started with the left ovary when body side declination is used for organ retraction from the ovaries.

To describe the nasopharyngeal airway dimensions of two brachycephalic breeds and to localize the area of smallest airway dimensions.Prospective, descriptive, computed tomographic imaging study.Thirty pugs and 30 French bulldogs with brachycephalic upper airway syndrome.The thickness and length of the soft palate, cross-sectional area of the airway passage dorsal to the soft and hard palates, and cross-sectional area of the frontal sinus were measured and normalized to each dog's skull index and body weight before statistical comparison between breeds. Nasopharyngeal turbinates and surrounding airway space, and a possible relationship between the canine tooth angulation and the severity of airway obstruction were assessed.Pugs had significantly smaller cross-sectional areas of the airway dorsal to the soft and hard palates than French bulldogs. In both breeds, the smallest nasopharyngeal cross-sectional areas were located dorsal to the caudal end of the soft palate. The soft palate of pugs was significantly shorter than that of French bulldogs and also significantly thinner when normalized to each dog's skull index. Pugs more commonly exhibited nasopharyngeal turbinates. Pugs had significantly smaller air-filled cavities at the location of the frontal sinus. No correlation between the nasopharyngeal dimensions and canine tooth angulation was observed.Computed tomographic assessment of the upper airway morphology showed the smallest nasopharyngeal cross-sectional areas were located dorsal to the caudal end of the soft palate in both breeds. Pugs had a smaller nasopharyngeal cross-sectional area despite smaller soft palate dimensions than French bulldogs.

Two cats with intractable idiopathic chylothorax and a history of unsuccessful medical management were treated thoracoscopically with en bloc thoracic duct sealing and subtotal pericardectomy using a bipolar feedback-controlled vessel sealing device. No surgical complications were observed. Twenty-four and 26 months after surgery, both cats were free of thoracic effusion and clinical signs.

The involvement of the greater omentum in reconstructive, abdominal and thoracic surgery is based on its manifold qualities, which include immunological support, lymphatic drainage, angiogenesis, adhesion, haemostasis and fat storage. The purpose of this study was to determine whether the greater omentum could be extended to the head. In addition, we evaluated the surgical procedures necessary for this extension. Our study reveals that specific surgical lengthening techniques of the greater omentum, such as dorsal extension and inverted L-shape elongation, are necessary to successfully transpose the omentum to the head in cats. As the survival of the omentum after transposition procedures is still unknown, its application in chronic non-healing wounds of the head in cats warrants further investigation.

Aim: To describe a technique of laparoscopic-assisted cystotomy in male sheep. Experimental ani- mals: five healthy male sheep aged approximately nine months (mean weight: 39.6 ± 1.51 kg). Laparoscopy was performed on sheep placed under general anaesthesia in dorsal recumbency. A 10-mm laparoscope was inserted through the right paramedian region between the xiphoid and preputial orifice. After creation of a capnoperi- toneum, grasping forceps were inserted through the left paramedian region close to the last pair of teats. The urinary bladder was elevated using grasping forceps and exteriorized through an abdominal incision. The bladder was opened extracorporeally, lavaged, closed, and then repositioned. A pigtail balloon catheter was subsequently inserted percutaneously under laparoscopic control and removed ten days later. A repeat laparoscopy was per - formed at 14 days after the first procedure to assess gross pathological changes. Laparoscopic-assisted cystotomy was successfully performed on all sheep. In one sheep, both the ventral and dorsal bladder walls were inadvert - ently perforated when placing the urinary catheter. The postoperative course was favourable: all sheep had a good appetite and showed no pathological findings during physical examination. During the repeat laparoscopy, it was observed that one sheep had developed a focal adhesion of the parietal peritoneum to the bladder catheter portal site. Laparoscopic-assisted cystotomy with catheter implantation is shown to be feasible in male sheep. This technique may be useful for removal of uroliths in patients suffering from obstructive urolithiasis opening the urinary bladder and for performing urinary diversion.

Objective— To investigate the feasibility of, and outcome after, laparoscopic adrenalectomy in dogs with unilateral adrenocortical carcinoma. Study Design— Case series. Animals— Dogs (n=7) with Cushing's syndrome caused by unilateral adrenocortical carcinoma. Methods— Laparoscopic adrenalectomy with the dog in lateral recumbency on the unaffected side. Three 5-mm portals (1 laparoscopic portal, 2 instrument portals) were placed in the paralumbar fossa. A fourth instrumental portal (5–12 mm) was placed above the kidney. After dissection and hemostatic control of the phrenicoabdominal vein, the adrenal gland was carefully dissected or when there was capsule fragility, necrotic content was partially aspirated. The remaining glandular tissue was removed through the 12-mm trocar site. Results— Dogs with unilateral adrenocortical carcinoma (3 right-sided, 4 left-sided) without invasion of the caudal vena cava were successfully operated by laparoscopic approach. There were no significant intraoperative complications; 2 dogs died within 48 hours of surgery because of respiratory complications. Five dogs were discharged 72 hours after surgery, and signs of hyperadrenocorticism disappeared thereafter (survival time ranged from 7 to 25 months). Conclusions— Laparoscopic adrenalectomy is feasible in dogs with either right- or left-sided adrenocortical carcinoma not involving the caudal vena cava. Clinical Relevance— When performed by experienced surgeons, laparoscopic adrenalectomy offers a minimally invasive alternative to open laparotomy or retroperitoneal surgery for the treatment of unilateral adrenocortical carcinoma in dogs.