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To describe the technique and outcomes of the closure of maxillary lip defects using a buccal transposition flap and to identify potential routes of vascular supply to the flap.Five dogs treated clinically and 1 cadaveric dog head.Short case series and cadaveric study.A left maxillary labial defect and a buccal transposition flap were created on a cadaver head. Iodinated contrast was injected into the left common carotid artery and computed tomography was performed to assess the vascular supply. Medical records were reviewed for all dogs that underwent tumor excision with maxillary lip resection, reconstructed with a buccal transposition flap.The buccal transposition flap was perfused by branches of the angularis oris artery and superior labial artery. Five dogs were included in this study. All flaps survived. Three dogs developed postoperative complications, including oronasal fistula (n = 2) and partial flap dehiscence (n = 1). The cosmetic and functional outcomes were considered satisfactory in all cases.Buccal transposition flaps for the closure of large maxillary lip defects provided adequate functional and cosmetic outcomes. The buccal transposition flap had vascular contributions from the angularis oris artery and the superior labial artery.

The aim of this study was to determine the outcome of dogs with soft tissue sarcoma (STS) within the region of the ischiatic tuberosity (ITSTS) treated surgically. This was a multi-institutional retrospective study. Fifty-two dogs met the inclusion criteria, which were: histologically confirmed STS in the region of the IT treated with surgical resection between March 1st, 2009 and March 1st, 2021 with a minimum follow-up time of 6 months. Data collected included patient signalment, preoperative diagnostics, surgical intent/method, surgical complications, histopathology, margins, outcome and cause of death. Statistical analyses were performed to determine significant factors in the treatment and prognosis of ITSTS. Overall survival time (OST) and disease progression were negatively associated with tumour grade, while recurrence was positively associated with grade and incomplete margins. Of the 52 included dogs, there were 24 grade I, 20 grade II and 7 grade III tumours. Forty dogs had reported histopathologic margins of which 26 were reported to be complete and 14 were incomplete. OST and progression-free survival was not reached for tumours graded as I or II and was 255 and 268 days respectively, for grade III. Median time to recurrence was not reached for tumours excised with complete margins and was 398 days for those with incomplete margins. The surgical complication rate was 25%. ITSTS was not found to be a unique clinical entity in dogs as tumour behavior, treatment recommendations, and prognosis were similar to STS in other locations, with overall outcome and prognosis influenced by histologic grade and margins. While surgical complications were common, none resulted in significant morbidity or mortality.

OBJECTIVETo evaluate outcomes of dogs with parathyroid carcinoma (PTC) treated by surgical excision and to describe the incidence of postoperative hypocalcemia, degree of hypocalcemia, duration of hospitalization, duration of calcium supplementation, and survival timeANIMALS100 client-owned dogs with PTC admitted to academic, referral veterinary institutions.PROCEDURESIn a retrospective multi-institutional study, medical records of dogs undergoing surgical excision of PTC between 2010 to 2019 were reviewed. Signalment, relevant medical history, clinical signs, clinicopathologic testing, imaging, surgical findings, intraoperative complications, histologic examination, and survival time were recorded.RESULTS100 dogs with PTC were included, and 96 dogs had clinical or incidental hypercalcemia. Common clinical signs included polyuria (44%), polydipsia (43%), hind limb paresis (22%), lethargy (21%), and hyporexia (20%). Cervical ultrasonography detected a parathyroid nodule in 91 of 91 dogs, with a single nodule in 70.3% (64/91), 2 nodules in 25.3% (23/91), and ≥ 3 nodules in 4 (4/91)% of dogs. Hypercalcemia resolved in 89 of 96 dogs within 7 days after surgery. Thirty-four percent of dogs developed hypocalcemia, on the basis of individual analyzer ranges, within 1 week after surgery. One dog had metastatic PTC to the prescapular lymph node, and 3 dogs were euthanized for refractory postoperative hypocalcemia. Estimated 1-, 2-, and 3-year survival rates were 84%, 65%, and 51% respectively, with a median survival time of 2 years.CONCLUSIONS AND CLINICAL RELEVANCEExcision of PTC results in resolution of hypercalcemia and excellent long-term tumor control. Surgical excision of PTC is recommended because of resolution of hypercalcemia and a good long-term prognosis. Future prospective studies and long-term follow-up are needed to further assess primary tumor recurrence, metastasis, and incidence of postoperative hypocalcemia.

To report intraoperative and immediate postoperative complications associated with removal of metastatic iliosacral lymph nodes in dogs with apocrine gland anal sac adenocarcinoma.There were 136 client-owned dogs in the study.Retrospective multi-institutional study. The database of collaborating institutions was searched for dogs with metastatic apocrine gland anal sac adenocarcinoma that underwent lymphadenectomy for removal of one or more iliosacral lymph nodes. Information of signalment, hematological abnormalities, abdominal computed tomography or ultrasound findings, number and size of enlarged lymph nodes, intraoperative and postoperative complications, treatment and outcome were collected.The overall complication rate associated with metastatic iliosacral lymphadenectomy was 26.1%. The only intraoperative complication recorded was hemorrhage and was reported in 24 (17.6%) surgeries, 11 (45.8%) of which received a blood transfusion. Postoperative complications were reported in 10.4% of surgeries, and included edema formation (Complications associated with iliosacral lymphadenectomy for metastatic apocrine gland anal sac adenocarcinoma are relatively common and mostly relate to hemorrhage. These complications are significantly associated with the size of the extirpated metastatic lymph nodes.This retrospective study provides information for the clinician regarding the potential surgical complications for extirpation of metastatic iliosacral lymph nodes. These complications, although not common, can be severe and should be discussed with owners before surgery.Rapporter les complications peropératoires et postopératoires immédiates associées à l’ablation des ganglions lymphatiques ilio-sacrés métastatiques chez les chiens atteints d’un adénocarcinome des glandes apocrines des sacs anaux.Il y avait 136 chiens appartenant à des clients dans l’étude.Étude multi-institutionnelle rétrospective. La base de données des institutions collaboratrices a été recherchée pour les chiens atteints d’un adénocarcinome métastatique des glandes apocrines des sacs anaux qui ont subi une lymphadénectomie pour l’ablation d’un ou plusieurs ganglions lymphatiques ilio-sacrés. Des informations sur le signalement, les anomalies hématologiques, les résultats de la tomodensitométrie abdominale ou de l’échographie, le nombre et la taille des ganglions élargis, les complications peropératoires et postopératoires, le traitement et les résultats ont été recueillis.Le taux global de complications associées à la lymphadénectomie ilio-sacrée métastatique était de 26,1 %. La seule complication peropératoire enregistrée était une hémorragie et a été rapportée dans 24 (17,6 %) chirurgies, dont 11 (45,8 %) ont reçu une transfusion sanguine. Des complications postopératoires ont été signalées dans 10,4 % des interventions chirurgicales et comprenaient la formation d’oedème (Les complications associées à la lymphadénectomie ilio-sacrée pour l’adénocarcinome métastatique des glandes apocrines des sacs anaux sont relativement fréquentes et concernent principalement l’hémorragie. Ces complications sont significativement associées à la taille des ganglions lymphatiques métastatiques retirés.Cette étude rétrospective fournit des informations au clinicien concernant les complications chirurgicales potentielles pour le retrait des ganglions lymphatiques ilio-sacrés métastatiques. Ces complications, bien que rares, peuvent être graves et doivent être discutées avec les propriétaires avant la chirurgie.(Traduit par D

Objective To detail the qualitative fascial categories and fascial intersections of the forelimb of the dog to facilitate preoperative planning for superficial cancers. Study design Qualitative anatomical study. Sample population Three male and four female mixed breed canine cadavers weighing approximately 20-35 kg. Methods The skin and subcutaneous fat were excised. Fascial planes were incised and elevated to allow exploration of their quality and borders. Fascia was categorized as type I (discrete sheets), type II (tightly adhered to thin muscles), type III (tightly adhered to thick muscles), or type IV (associated with periosteum). Photographs of specimens were digitally modified with overlays to map tissue types. Results Differences between the cadavers used were largely based on muscle mass and sex, with minimal other subjective differences affecting fascial mapping. The fasciae of the forelimb were largely type II or type III, with type I fascia at the antebrachium and type IV fascia at the olecranon, scapular spine, and accessory carpal bone. Fascial integrity was often questionable or lacking distal to the distal quarter of the antebrachium. Conclusion The fascial types and integrity of the forelimb varied with anatomic location with thin or absent fascia for surgical use at the elbow, carpus, and manus. Clinical significance This study provides information for preoperative planning and excision of superficial tumors of the forelimb. Knowledge of the potential limitations of fascia to provide a deep margin may influence selection of treatment modalities.

Excellent outcomes have been reported following thyroidectomy for thyroid carcinoma in dogs, but outcomes for thyroid carcinomas with gross vascular invasion are poorly described. This study describes the clinical outcomes and complications in dogs with thyroid carcinomas with gross vascular invasion undergoing thyroidectomy. Medical records of dogs that underwent thyroidectomy between January 1st 2010 and December 31st 2019 were reviewed at 10 hospitals. Signalment, diagnostic data, primary and adjuvant treatments performed, and outcome were abstracted. Survival was calculated using Kaplan-Meier analysis. Multiple logistic regression was used to identify variables associated with disease-specific survival. Seventy-three dogs were included, of which 58 underwent unilateral thyroidectomy and 15 underwent bilateral thyroidectomy. Complications were reported in five dogs (three major, two minor; 6.8%) intraoperatively and 12 dogs (two major leading to death, 10 minor; 16.4%) postoperatively. Seven (9.6%) dogs developed locoregional recurrence at a median of 238 days postoperatively (range: 15-730 days). Distant metastasis was suspected or confirmed in nine dogs (12.3%) at a median of 375 days postoperatively (range: 50-890 days). Twenty-seven dogs (37%) received adjuvant therapy (chemotherapy: n = 21; radiotherapy: n = 6). Thirty-nine dogs were euthanized or died, with 20 deaths related to disease (n = 10) or of unknown cause (n = 10), 19 due to unrelated causes, and nine lost to follow-up. Median overall and disease-specific survival were 621 days and not reached respectively. One-year disease-specific survival rate was 82.5%. No variables were associated with disease-specific survival in our dataset. Surgery may be considered for loco-regional therapy in dogs with thyroid carcinoma with gross vascular invasion.

Objective To provide qualitative fascial categories and classify the intersections of various fascial planes of the trunk of the dog to facilitate preoperative planning for superficial cancers. Study design Qualitative anatomical study. Sample population Two male and three female mixed breed canine cadavers weighing approximately 15 to 35 kg. Methods The skin and subcutaneous fat were excised. Fascial planes were incised and elevated to allow exploration of their quality and borders. Fascia was categorized as type I (discrete sheets), type II (tightly adhered to thin muscles), type III (tightly adhered to thick muscles), or type IV (associated with periosteum). Photographs of specimens were digitally modified with overlays to map tissue types. Results Differences between cadavers were largely associated with muscle mass or sex, with only minor anatomical differences and enough subjective similarity among specimens to allow mapping. The fasciae of the neck and trunk were predominantly type I or type II, with type III fascia at the shoulder and type IV fascia at the scapular spine, 13th rib, dorsal spinous processes, and the wing of the ilium. Conclusion The superficial fasciae of the canine trunk were consistent among the dogs evaluated and can be classified as four broad fascial types. The population used was small, and individual variation should be considered when using these images in a clinical setting. Clinical significance The images and categorization of fascia and transitions between fascial layers detailed here provide a visual and written reference for surgeons to facilitate preoperative planning and excision of superficial cancers.

Objective To report the surgical technique for iliectomy and outcome in a single clinical case. Study design Case report. Animal A 10-year-old female spayed Rottweiler. Methods A dog presented with left pelvic limb lameness due to a mass involving the left ilium. Fine needle aspirates were indicative of a sarcoma and suspicious for osteosarcoma. Computed tomography of thorax, abdomen, and pelvis was performed as well as skeletal scintigraphy, with no evidence of metastasis seen. The dog underwent iliectomy with preservation of the ipsilateral limb and was ambulatory 24 hours after surgery. Results of histopathology confirmed the diagnosis of an osteosarcoma. Results A right ischial fracture was noted 8 days postoperatively and was conservatively managed. Local recurrence was reported 385 days postoperatively, with no overt metastatic disease revealed by computed tomography of the thorax and abdomen. The dog was euthanized because of local recurrence 430 days after surgery. Conclusion Iliectomy was well tolerated in this dog and afforded good function of the pelvic limbs. Local recurrence developed with no evidence of metastasis at the last follow-up. Iliectomy can be considered for a mass confined to the ilium when preservation of the limb is desired. Additional studies are required to determine the local recurrence and complication rates associated with this procedure in dogs with axial skeletal osteosarcoma. Clinical significance To the authors' knowledge, this case report represents the fist surgical description and clinical outcome for an iliectomy in dogs.

The axillary lymph center drains a large area; however, axillary lymphadenectomy is rarely reported in series detailing lymph node extirpation in dogs. No surgical technique has yet been described for axillary and superficial axillary lymphadenectomy. This study describes a technique for excision of nodes in the axillary lymph center of the dog. Two male neutered and two male intact cadavers weighing between 6.3 and 36.1 kg were used. With cadavers in dorsal recumbency and the shoulder extended, an incision was made in the caudal axillary region. Blunt dissection was used to separate the pectoralis profundus and latissimus dorsi muscles and loose connective tissue was dissected until the axillary lymph node was identified caudal to the brachial vein. The axillary lymphatic trunk was followed caudad from the axillary lymph node to identify the accessory axillary lymph node, deep to the lateral border of the pectoralis profundus muscle, for subsequent extirpation. Axillary lymph nodes were successfully removed in all axillae, and accessory axillary lymph nodes were located in 6/7 axillae and could not be visualized within the axillary lymphatic trunk in the remaining axilla. The described surgical technique allowed consistent identification of the axillary lymph node and the lymphatic trunk associated with the accessory axillary lymph node. This technique description provides a guide for surgeons to facilitate axillary and accessory axillary lymphadenectomy in the dog. While anatomic variation must be considered, the use of the axillary lymphatic trunk as a landmark may simplify identification of the small and inconsistent accessory axillary lymph node.

To describe the clinical characteristics, perioperative protocols, and outcomes in dogs diagnosed with ventricular fibrillation (VF) while undergoing pericardiectomy.Retrospective, multi-institutional study.Sixteen client-owned dogs.Cases were accrued through a listserve request posted to 3 subspecialty veterinary societies. Dogs were included if they developed VF during a pericardiectomy performed through an open or thoracoscopic approach. Data collected included signalment, history and physical examination, surgical approach, histopathology, treatment, and outcome.Indications for pericardiectomy included idiopathic chylothorax (n = 7), neoplasia (4), idiopathic pericardial effusion (4), and foreign body granuloma (1). Surgical approaches included thoracoscopy (12), intercostal thoracotomy (3) and median sternotomy (1). Electrosurgical devices were used to complete at least part of the pericardiectomy in 15 of 16 dogs. Ventricular fibrillation appeared to be initiated during electrosurgical use in 8/15 dogs. However, in 5/15 dogs it was not obviously associated with electrosurgical use. In 3/16 dogs the timing of initiation of VF was unclear. In 7/16 dogs, cardiac arrhythmias were noted prior to the development of VF. Fourteen of 16 dogs died from intraoperative VF.In most dogs ventricular fibrillation was a fatal complication of pericardiectomy. Ventricular fibrillation might be associated with the use of electrosurgical devices and cardiac manipulation during pericardiectomy although a causal link could not be established from the data in this study.Surgeons must be aware of the risk of VF during pericardial surgery. Electrosurgery might need to be used judiciously during pericardiectomy, particularly in dogs exhibiting cardiac arrythmias.

Objective To report surgical and postoperative management of complicated total cystectomy in a dog with transitional cell carcinoma (TCC). Study design Case report. Animals One male neutered Shetland sheepdog. Methods The dog was presented after a 1-month history of stranguria, unresponsive to oral antibiotic therapy. A craniodorsal bladder mass was identified by computed tomography (CT), and partial cystectomy was performed with 1-cm gross lateral margins (day 1). Results of histopathology provided evidence for a diagnosis of TCC, and the dog was treated with adjuvant mitoxantrone. The dog presented with uroperitoneum on day 67 after recurrence and spontaneous perforation. Total cystectomy and ureterourethral anastomosis were performed. Ureteral obstruction developed after removal of catheters that had been placed intraoperatively. Surgical revision included resection of the anastomosis site, bilateral ureteral stenting, and transection and reorientation of the distal urethra to facilitate tension-free closure. Postoperative leakage was managed with bilateral percutaneous nephrostomy tube placement. Results The dog was discharged on day 88. Adjuvant treatment with vinblastine was pursued. Local recurrence was noted at day 154. Subcutaneous ureteral bypass was performed on day 247 to manage repeat obstruction. Repeated urinary tract infections were subsequently encountered. The dog was euthanized on day 368 because of abdominal discomfort and inappetence, with evidence of progressive urethral, ureteric, and abdominal wall TCC. Conclusion Complicated cystectomy can be managed to provide survival comparable to previous reports regarding total cystectomy. Clinical significance Nephrostomy tube placement, ureteral stenting, and subcutaneous ureteral bypass may be considered to manage complicated cystectomy. Preemptive stenting or urinary diversion may help prevent complications.

OBJECTIVES To determine the influence of intraoperative glove exchange on glove contamination during clean soft tissue surgery. STUDY DESIGN Prospective clinical study. SAMPLE POPULATION Two hundred pairs of gloves and gowns from 50 clean soft tissue surgeries. METHODS Gloves and gown cuffs were cultured from the primary surgeon and first assistant using a standardized protocol. Cultures were taken from outer surface of both gown cuffs prior to surgery and after gloves were removed at the end of surgery; gloves were cultured prior to surgery, at end of surgery and after a new pair was donned after closed glove exchange. Cultures were evaluated for colony-forming units after 72 h of inoculation. RESULTS Bacterial contamination was documented in 41 of the 50 surgeries (82%). The most common species cultured was Streptocococcus spp. There was no difference (p = .719) in the bacterial contamination rate of gown cuffs prior to surgery (10%; 20/200) compared to after surgery (9.5%; 19/200). The bacterial contamination rate for gloves was 10.5% (21/200) prior to surgery, 19.5% (39/196) after surgery, and 11% (22/200) after regloving. Gloves cultured following surgery were significantly more contaminated than gloves cultured preoperatively (p = .010) or gloves cultured following regloving (p = .018). CONCLUSION Glove exchange did not increase bacterial contamination of gloves during the clean soft tissue surgeries tested here. CLINICAL SIGNIFICANCE The outside of the gown cuff does not seem to represent a major source of contamination during clean procedures. This study does not provide evidence to support a change in current practices for intraoperative closed glove exchange.

The invasive, locally aggressive nature of feline injection-site sarcomas (FISSs) poses a unique challenge for surgeons to obtain complete margins with surgical excision. Optical coherence tomography (OCT), an imaging technology that uses light waves to generate real-time views of tissue architecture, provides an emerging solution to this dilemma by allowing fast, high-resolution scanning of surgical margins. The purpose of this study was to use OCT to assess surgical margins of FISS and to evaluate the diagnostic accuracy of OCT for detecting residual cancer using six evaluators of varying experience. Five FISSs were imaged with OCT to create a training set of OCT images that were compared with histopathology. Next, 25 FISSs were imaged with OCT prior to histopathology. Six evaluators of varying experience participated in a training session on OCT imaging after which each of the evaluators was given a dataset that included OCT images and videos to score on a scale from cancerous to non-cancerous. Diagnostic accuracy statistics were calculated. The overall sensitivity and specificity for classification of OCT images by evaluators were 78.9% and 77.6%, respectively. Correct classification rate of OCT images was associated with experience, while individual sensitivities and specificities had more variation between experience groups. This study demonstrates the ability of evaluators to correctly classify OCT images with overall low levels of experience and training and also illustrates areas where increased training can improve accuracy of evaluators in interpretation of OCT surgical margin images.

Objective To determine the rate of nodal metastasis to the medial retropharyngeal (MRP) and deep cervical lymph nodes in dogs surgically treated for thyroid carcinoma. Study design Retrospective study. Animals Twenty-two client-owned dogs. Methods Medical records between July 2015 and October 2019 at the Universities of Missouri and Florida were reviewed. Dogs that underwent thyroidectomy with concurrent elective MRP lymphadenectomy ± deep cervical lymphadenectomy were included. Tumor site, preoperative staging, and histopathological findings were recorded. Results Twenty-two dogs with 26 total thyroid carcinomas were included. Primary tumors were lateralized in 19 dogs, bilateral in two dogs, and bilateral and midline ectopic in one dog. All dogs underwent ipsilateral MRP resection, including bilateral resection in dogs with bilateral tumors. Three contralateral MRP lymph nodes were excised from dogs with unilateral carcinomas. Four deep cervical lymph nodes and one superficial cervical lymph node were excised. Metastases were identified in 14 lymph nodes in 10 of 22 (45%) dogs. All four excised deep cervical lymph nodes and one contralateral MRP lymph node were identified as metastatic. Size of deposit could be classified in 13 of 14 metastatic lymph nodes. Macrometastasis was detected in seven lymph nodes, micrometastasis was detected in one node, and isolated tumor cells were detected in five lymph nodes. Conclusion Regional metastasis was common within the lymph nodes sampled in this population of dogs with thyroid carcinoma. Clinical significance These results provide evidence to justify further exploration of a larger population to verify the rate of regional metastasis and determine the prognostic impact of nodal metastasis.

Objective To develop and report a novel limb sparing technique for the distal radius in a dog. Study design Case report. Animal A 14-year-old, female spayed Labrador Retriever with an osteosarcoma of the right distal radius and a pathological fracture. A previous mast cell tumor had been treated 5 years prior to presentation with marginal excision and a full-course radiation over the right metacarpal bones. The dog had received 2 doses of palliative radiation just prior to presentation. Methods A standard resection of the distal radius was used as a strategy to salvage the limb. Instead of replacing the 6-cm bone defect with an endoprosthesis, the limb was acutely shortened and a carpal arthrodesis plate was applied. Results Postoperative function was good and limb shortening was well-tolerated. Radiographic evidence of early bone healing was noted at the osteotomy site. The dog experienced 3 postoperative complications: a focal area of skin necrosis managed successfully via surgical revision; infection resolving after long-term antibiotherapy; and a fracture of the third metacarpal bone through a screw hole, managed via screw removal and a custom external prosthesis. The patient was euthanatized due to presumptive chemotherapy complications 127 days after the procedure. Conclusion Limb shortening limb salvage is technically feasible and can result in excellent limb use postoperatively, in spite of a significant loss in limb length.

Objective To evaluate whether formality of introduction differed between male vs female speakers at the 2018 American College of Veterinary Surgeons (ACVS) scientific meeting and identify other variables that predisposed introducers or chairs to informal introduction. Study design Observational study. Sample population Thirteen session chairs introducing 68 lectures (41 by females, 27 by males) by 63 speakers. Methods Observers recorded the session introducer, speaker, and whether speakers were introduced with a formal or informal title. Information evaluated included type of oral presentation; introducer gender, year, and country of graduation from veterinary school; speaker gender; whether the speaker was a resident; and speaker's year of graduation. Results Female speakers were introduced by their first name in 9 of 41 introductions compared to in 1 of 27 introductions for male speakers. This difference reached statistical significance when data independence was assumed (P = .043); however, this significance was narrowly lost when data clustering on session introducer was controlled for (P = .067). Conclusion In this study, female speakers were more likely than male speakers to be introduced by their first and last names rather than with their professional title at a recent ACVS scientific meeting. Impact Additional research is required to determine the effect of this type of subordinate language and gender bias in veterinary surgery.

Veterinary studies have reported the outcome of adrenalectomies in dogs; however, these studies typically include a wide variety of adrenal tumour sizes, including cases with or without vascular invasion. The purpose of this study was to report outcome in a cohort of dogs with histologically confirmed small adrenal tumours without vascular invasion treated with adrenalectomy. This retrospective study was conducted using data from the University of Florida and University of California-Davis databases between 2010 and 2017. Dogs were included if they underwent excision of an adrenal gland tumour with a maximal diameter ≤ 3 cm, without evidence of vascular invasion to any location as assessed via computed tomography. Fifty-one dogs met the inclusion criteria. The short-term survival rate of dogs undergoing adrenalectomy was 92.2%, and one-year disease-specific survival was 83.3%. Twenty-eight of 51 (54.9%) dogs were diagnosed with a malignancy. Minor complications were observed commonly intra-operatively and post-operatively. Major complications were observed in six dogs, and included sudden death, respiratory arrest, acute kidney injury, haemorrhage, hypotension and aspiration pneumonia. Short-term mortality occurred in four dogs. Sudden death and haemorrhage were the most common major complications leading to death. While adrenalectomy is sometimes controversial because of the high perioperative mortality rates previously reported, the results of this study support that adrenalectomy for small tumours with no vascular invasion can be performed with low risk.

Objectives To assess agreement between measurement of primary apocrine gland anal sac adenocarcinoma tumours using digital palpation, CT and formalin-fixed tissue and to look for associations with metastasis at presentation. Materials and methods Retrospective study of different methods of measuring primary tumour size in histopathologically-confirmed canine apocrine gland anal sac adenocarcinoma. Results One hundred sixteen tumours from 107 dogs were included. There was moderate agreement between maximal dimension of the primary tumour measured by CT compared to formalin-fixed tissue and digital palpation. There was no significant difference in median maximum dimension between the measurement methods. Vascular invasion, CT stage, digital rectal examination stage and formalin-fixed tissue stage were significantly associated with metastasis at presentation, while mitotic index of the primary tumour was not. Dogs with tumours >2.5 cm (tumour-stage 2) were significantly more likely to present with metastatic disease. Clinical significance In canine apocrine gland anal sac adenocarcinoma, primary tumour size, tumour-stage and vascular invasion are strong predictors of metastasis at presentation.

Objective To determine the extent of subcutaneous involvement after primary closure of experimental skin defects. Study design Experimental study. Animals Eight large, mixed breed dog cadavers. Methods Standardized, circular skin defects with diameters of 2, 4, 6, or 8 cm were created at the lateral thorax or abdomen by using a matrix to ensure even distribution, with eight defects of each diameter. The wound beds were covered in 60% barium sulfate paste prior to primary closure. Computed tomography and a dedicated viewing program were used to measure the distance from the edge of the subcutaneous defect to the incision at set intervals along the incision. Results The mean ± SD maximum lateral extension was 6.4 ± 1.9, 14.1 ± 4.9, 18.5 ± 6.9, and 26.0 ± 9.6 mm for 2-, 4-, 6-, and 8-cm defects, respectively. Extension >2 cm from the incision occurred in zero of eight, one of eight, five of eight, and six of eight defects after closure of 2-, 4-, 6-, and 8-cm defects, respectively. Extension >3 cm from the incision occurred in zero of eight, zero of eight, two of eight, and five of eight defects after closure of 2-, 4-, 6-, and 8-cm defects, respectively. Conclusion The lateral extent of the subcutaneous wound bed extended past previously recommended revision margins of 2 to 3 cm in some defects measuring greater than 4 cm in diameter. Clinical significance Surgeons and radiation oncologists should consider the potential extent of the subcutaneous defect when planning revision therapy, especially after large resections.

Perineal wounds in dogs present a challenge due to limited local availability of skin for closure and constant exposure to fecal contaminants. This report describes temporary rectal stenting in two dogs following severe perineal wounds. Dog 1 presented with a 4 × 4 cm full-thickness perineal slough secondary to multiple rectal perforations. A 12 mm internal diameter endotracheal tube was placed per-rectum as a temporary stent to minimize fecal contamination. The stent was removed 18 days after placement, and the perineal wound had healed at 32 days post-stent placement, when a minor rectal stricture associated with mild, intermittent tenesmus was detected. Long-term outcome was deemed good. Dog 2 presented with multiple necrotic wounds with myiasis, circumferentially surrounding the anus and extending along the tail. A 14 mm internal diameter endotracheal tube was placed per-rectum. The perineal and tail wounds were managed with surgical debridement and wet-to-dry and honey dressings prior to caudectomy and negative pressure wound therapy (NPWT). Delayed secondary wound closure and stent removal were performed on day six without complication. Long-term outcome was deemed excellent. Temporary rectal stenting may be a useful technique for fecal diversion to facilitate resolution of complex perineal injuries, including rectal perforation.

Variable pathways of lymphatic drainage have been described in the dog head and neck. The aim of this study was to retrospectively assess the patterns of lymph node metastasis in dogs with malignancies of the head following bilateral mandibular and medial retropharyngeal lymphadenectomy. Thirty-one dogs were included. Median age at surgery was 10 years (range: 5 months to 14 years) and mean bodyweight was 21.4 ± 11.9 kg. Lymph node metastasis occurred in 14 dogs (45%), with spread to mandibular lymph nodes in 14 dogs and medial retropharyngeal metastasis in 11 dogs. Eight of 13 dogs (62%) with lymphatic metastasis and a lateralised lesion showed contralateral dissemination, while 12/13 (92%) showed ipsilateral metastasis. Of 13 dogs with oral malignant melanoma, four showed metastasis to all four lymph centres. Contralateral metastasis may occur in dogs with malignancies of the head and should be considered during staging and management.

This report describes a domestic shorthair cat with fracture-associated osteosarcoma 11 years after injury. A left hind limb amputation was performed using coxofemoral disarticulation. No intravenous cytotoxic chemotherapy was used after surgery. Pulmonary metastasis was identified 3 months after amputation. Fracture-associated osteosarcoma may occur in the cat more than 10 years after initial injury.

The objectives of this study were to describe the sartorius muscle flap for body wall reconstruction, including description of the anatomy and surgical technique and to report its clinical application for abdominal wall reconstruction in dogs and cats. The descriptive report involves a retrospective case series for 2 dogs and 3 cats. Inclusion criteria were cats or dogs that had a tumor resection resulting in an abdominal wall defect that was reconstructed using an ipsilateral or contralateral sartorius muscle flap. Signalment, pre-operative clinical signs, location and tumor extent, diagnostic imaging and clinical pathology findings, surgical methods, and complications were recorded. Abdominal wall defect reconstructions using the sartorius muscle flap were successfully performed in all 5 patients with good return to function. All complications were minor and were successfully medically managed. This case series demonstrates that the sartorius muscle flap is a feasible option for the closure of large caudal abdominal wall defects.

The purpose of this retrospective study is to describe in detail a novel ventral approach for mandibulectomy and the results in 19 dogs. The medical records of 19 dogs that received a partial or total unilateral mandibulectomy with the new ventral approach were reviewed. Information obtained included signalment, tumour type, extent of mandibulectomy, removal of regional lymph nodes, intrasurgical complications, immediate postoperative complications, histopathological diagnosis and study of margins. Intrasurgical complication occurred in one dog (haemorrhage) and required a blood transfusion. Postoperative morbidity was minor and included transient ventral cervical swelling and self-limiting sublingual swelling (two dogs). All 19 animals were discharged between 24 and 48 hours of the procedure, and appetite was considered normal at discharge. Some perceived advantages of this procedure include easy identification of all the important anatomic structures in the area, including the inferior alveolar artery and temporo-mandibular joint, and the fact that osteotomy of the zygomatic arch is not necessary (in case of caudal mandibulectomy). In addition, dissection of both mandibular and retropharyngeal lymph nodes is easily achieved by caudal extension of the same skin incision.

The diagnostic accuracy of contrast-enhanced CT for detection of cervical lymph node metastasis in dogs is unknown. The purpose of this retrospective, observational, diagnostic accuracy study was to assess the efficacy of CT for detection of mandibular and medial retropharyngeal lymph node metastasis in dogs. Histopathology of dogs with cancer of the head, CT and bilateral mandibular and medial retropharyngeal lymphadenectomy was reviewed. A single radiologist measured lymph nodes to derive short axis width and long-short axis ratios. Two blinded radiologists separately assessed lymph node margins, attenuation and contrast enhancement and each provided a final subjective interpretation of each node site as benign or neoplastic. Where radiologists' opinions differed, a consensus was reached. Sensitivity, specificity and accuracy were calculated for mandibular and medial retropharyngeal sites. Agreement between radiologists was assessed. Fisher's exact test and the Kruskal-Wallis H-test were used to assess associations between variables. Forty-one primary tumours were recorded in 40 dogs. Metastasis to mandibular or retropharyngeal lymph nodes occurred in 16 out of 40 dogs (43/160 nodes). Agreement between radiologists was almost perfect for margination, attenuation and enhancement, strong for interpretation of mandibular lymph node metastasis, and weak for interpretation of medial retropharyngeal lymph node metastasis. Sensitivity of CT was 12.5% and 10.5%, specificity was 91.1% and 96.7%, and accuracy was 67.5% and 76.3% for mandibular and medial retropharyngeal lymph nodes respectively. No individual CT findings were predictive of nodal metastasis. Given the low sensitivity of CT, this modality cannot be relied upon alone for assessment of cervical lymph node metastasis in dogs.

Objective To compare the pericardioscopic cardiovascular anatomy visible between apical pericardial window (PW) and sub-phrenic pericardectomy (SPP). Study Design Experimental study. Animals Canine cadavers (n = 5). Methods Thoracoscopy was performed using a transdiaphragmatic subxyphoid and right and left intercostal portals. A 4 cm × 4 cm apical PW was created with endoscopic scissors. The intra-pericardiac structures were then pericardioscopically assessed using a subjective ordinal scale (0: not visible, 1: 50% seen) before SPP. Assessment was repeated after SPP. Results An apical PW provided limited access to the cardiac structures, with only the right ventricle >50% visible in all cadavers. The right atrium, right auricle, left ventricle, right coronary artery, and interventricular paraconal branch of the left coronary artery were observed but were typically

Variable pathways of lymphatic drainage have been described in the dog head and neck. The aim of this study was to retrospectively assess the patterns of lymph node metastasis in dogs with malignancies of the head following bilateral mandibular and medial retropharyngeal lymphadenectomy. Thirty-one dogs were included. Median age at surgery was 10 years (range: 5 months to 14 years) and mean bodyweight was 21.4 ± 11.9 kg. Lymph node metastasis occurred in 14 dogs (45%), with spread to mandibular lymph nodes in 14 dogs and medial retropharyngeal metastasis in 11 dogs. Eight of 13 dogs (62%) with lymphatic metastasis and a lateralised lesion showed contralateral dissemination, while 12/13 (92%) showed ipsilateral metastasis. Of 13 dogs with oral malignant melanoma, four showed metastasis to all four lymph centres. Contralateral metastasis may occur in dogs with malignancies of the head and should be considered during staging and management.

SummaryObjective: To assess the effect of arthro-scope insertion, using a carbon-fibre rod model, on humero-radial, humero-ulnar and radio-ulnar congruity, as assessed by computed tomography (CT).Methods: Cadaveric Greyhound elbow joints were assessed at a flexion angle of 135 ± 5° using CT. For condition 1, a 36 mm fulcrum induced cubital valgus, as used to aid arthro-scope insertion. For conditions 2 and 3, a single 1.8 or 2.5 mm diameter rod was inserted under arthroscopic guidance to simulate arthroscope position for assessment of the medial coronoid process. Repeat CT scans were obtained for all conditions and parasagittal sections were reconstructed to evaluate medial, axial and lateral positions within the elbow. Humero-radial, humeroulnar, and radio-ulnar congruity measurements were obtained. Differences between groups were assessed using repeated measures analysis of variance.Results: Mean (±SD) change in radio-ulnar step between conditions 1 and 3 was 0.6 ± 0.3 mm (axial), 0.8 ± 0.6 mm (medial), and 0.5 ± 0.1 mm (lateral). Insertion of rods induced a significant decrease in radio-ulnar step in all planes. Significant differences were also identified between groups for humero-radial, humero-ulnar, and radio-ulnar congruity.Clinical significance: Insertion of carbon-fibre rods as a model for elbow arthroscope insertion induces elbow incongruity. Changes in radio-ulnar congruity are small but the effect of arthroscope diameter should be considered when assessing elbow congruity.

To compare the pericardioscopic cardiovascular anatomy visible between apical pericardial window (PW) and sub-phrenic pericardectomy (SPP).Experimental study.Canine cadavers (n = 5).Thoracoscopy was performed using a transdiaphragmatic subxyphoid and right and left intercostal portals. A 4 cm × 4 cm apical PW was created with endoscopic scissors. The intra-pericardiac structures were then pericardioscopically assessed using a subjective ordinal scale (0: not visible, 1:50% seen, 2:50% seen) before SPP. Assessment was repeated after SPP.An apical PW provided limited access to the cardiac structures, with only the right ventricle50% visible in all cadavers. The right atrium, right auricle, left ventricle, right coronary artery, and interventricular paraconal branch of the left coronary artery were observed but were typically50% visible after apical PW. The left atrium and auricle, and heart base could not be consistently seen through an apical PW. Sub-phrenic pericardectomy significantly improved observation of all intrapericardiac structures assessed, except for the right atrium and right ventricle.PW centered over the cardiac apex limits evaluation of the pericardial space during pericardioscopy compared to SPP in cadaveric dogs.

Ex vivo studies have been used extensively to investigate the mechanisms of tibial osteotomies but few have explored femorotibial alignment in vivo. The aim of this study was to assess femorotibial joint alignment under static weight-bearing conditions (and subsequent outcome) in dogs treated for cranial cruciate ligament (CrCL) insufficiency with tibial tuberosity advancement (TTA). Twenty-five dogs (30 stifles) with CrCL insufficiency treated by TTA were included. The distance from the origin to insertion of the CrCL (CrCLd) was measured on non-weight-bearing immediate post-operative radiographs and weight-bearing follow-up radiographs. CrCLd values were compared using a paired t test. The relationship between change in CrCLd (ΔCrCLd) and post-operative patellar tendon angle according to the common tangent method (PTACT) was assessed using Pearson's correlation. Outcome was assessed with an owner-completed questionnaire, and peak vertical force (PVF) and vertical impulse (VI) as percentages of bodyweight (BW). Following TTA, 21/30 stifles were persistently subluxated at a follow-up of 18 ± 14 months (mean ± SD). Follow-up weight-bearing CrCLd was greater (P