Publications by authors named "Janet A Grimes"

38 Publications

Effect of contrast agent viscosity and massage on success of computed tomography lymphangiography with aqueous contrast for sentinel lymph node identification in healthy dogs.

Vet Comp Oncol 2021 Apr 19. Epub 2021 Apr 19.

VetRad, Worthington, Ohio, USA.

Sentinel lymph node (SLN) evaluation is important for accurate cancer staging. Computed tomography (CT) lymphangiography with aqueous contrast is a feasible technique for SLN identification in dogs. Although most studies report success rates around 90%, success rates as low as 60% have been reported. One reason for low success rates may be the difference in viscosity of the various agents used in comparison to normal lymph viscosity. The objective of this study was to evaluate contrast agents of differing viscosities for use in CT lymphangiography for SLN identification and to determine the influence of massage on contrast flow rates. The hypothesis was that lower viscosity agents would have a higher success rate and faster time to identification of the SLN than higher viscosity agents and that massage would increase contrast flow rates. Dogs were anaesthetised and CT lymphangiography was performed with four contrast agents of differing viscosities in a randomized crossover design. Injections were made on the dorsal pes bilaterally on two study days and the popliteal lymph nodes were evaluated for contrast uptake. There was no significant difference in success of SLN identification or time to SLN identification among the four agents. Massage of the injection site increased rate of contrast flow through the lymphatics. No specific recommendation for one contrast agent over another can be made with these results. Massage is recommended to improve lymphatic flow when performing CT lymphangiography with aqueous contrast in dogs.
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http://dx.doi.org/10.1111/vco.12698DOI Listing
April 2021

Exploring the predictive value of lesion topology on motor function outcomes in a porcine ischemic stroke model.

Sci Rep 2021 Feb 15;11(1):3814. Epub 2021 Feb 15.

Regenerative Bioscience Center, University of Georgia, Athens, GA, USA.

Harnessing the maximum diagnostic potential of magnetic resonance imaging (MRI) by including stroke lesion location in relation to specific structures that are associated with particular functions will likely increase the potential to predict functional deficit type, severity, and recovery in stroke patients. This exploratory study aims to identify key structures lesioned by a middle cerebral artery occlusion (MCAO) that impact stroke recovery and to strengthen the predictive capacity of neuroimaging techniques that characterize stroke outcomes in a translational porcine model. Clinically relevant MRI measures showed significant lesion volumes, midline shifts, and decreased white matter integrity post-MCAO. Using a pig brain atlas, damaged brain structures included the insular cortex, somatosensory cortices, temporal gyri, claustrum, and visual cortices, among others. MCAO resulted in severely impaired spatiotemporal gait parameters, decreased voluntary movement in open field testing, and higher modified Rankin Scale scores at acute timepoints. Pearson correlation analyses at acute timepoints between standard MRI metrics (e.g., lesion volume) and functional outcomes displayed moderate R values to functional gait outcomes. Moreover, Pearson correlation analyses showed higher R values between functional gait deficits and increased lesioning of structures associated with motor function, such as the putamen, globus pallidus, and primary somatosensory cortex. This correlation analysis approach helped identify neuroanatomical structures predictive of stroke outcomes and may lead to the translation of this topological analysis approach from preclinical stroke assessment to a clinical biomarker.
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http://dx.doi.org/10.1038/s41598-021-83432-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884696PMC
February 2021

Semi-Automated Cell and Tissue Analyses Reveal Regionally Specific Morphological Alterations of Immune and Neural Cells in a Porcine Middle Cerebral Artery Occlusion Model of Stroke.

Front Cell Neurosci 2020 22;14:600441. Epub 2021 Jan 22.

Regenerative Bioscience Center, University of Georgia, Athens, GA, United States.

Histopathological analysis of cellular changes in the stroked brain provides critical information pertaining to inflammation, cell death, glial scarring, and other dynamic injury and recovery responses. However, commonly used manual approaches are hindered by limitations in speed, accuracy, bias, and the breadth of morphological information that can be obtained. Here, a semi-automated high-content imaging (HCI) and CellProfiler histological analysis method was developed and used in a Yucatan miniature pig permanent middle cerebral artery occlusion (pMCAO) model of ischemic stroke to overcome these limitations. Evaluation of 19 morphological parameters in IBA1 microglia/macrophages, GFAP astrocytes, NeuN neuronal, FactorVIII vascular endothelial, and DCX neuroblast cell areas was conducted on porcine brain tissue 4 weeks post pMCAO. Out of 19 morphological parameters assessed in the stroke perilesional and ipsilateral hemisphere regions (38 parameters), a significant change in measured IBA1 parameters, GFAP parameters, NeuN parameters, FactorVIII parameters, and DCX parameters were observed in stroked vs. non-stroked animals. Principal component analysis (PCA) and correlation analyses demonstrated that stroke-induced significant and predictable morphological changes that demonstrated strong relationships between IBA1, GFAP, and NeuN areas. Ultimately, this unbiased, semi-automated HCI and CellProfiler histopathological analysis approach revealed regional and cell specific morphological signatures of immune and neural cells after stroke in a highly translational porcine model. These identified features can provide information of disease pathogenesis and evolution with high resolution, as well as be used in therapeutic screening applications.
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http://dx.doi.org/10.3389/fncel.2020.600441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7862775PMC
January 2021

Management of a urethral tear with porcine small intestinal submucosa-augmented urethroplasty and balloon dilation for subsequent urethral stricture in a cat.

J Am Vet Med Assoc 2021 Jan;258(2):186-191

Case Description: As a result of vehicular trauma, a 3-year-old neutered male domestic shorthair cat sustained luxation of the sacrocaudal joint and a urethral tear.

Clinical Findings: Retrograde contrast urethrocystography revealed a urethral tear at the level of the ischiatic tuberosity. Conservative treatment for 7 days with a urethral catheter was unsuccessful.

Treatment And Outcome: An approach for a perineal urethrostomy was performed and revealed a large urethral tear (4 mm in length in a craniocaudal orientation and encompassing approx 50% of the urethral circumference) proximal to the bulbourethral glands. Urethroplasty was performed with a graft of a rectangular section of single-layer porcine small intestinal submucosa. Perineal urethrostomy was then completed routinely, and a urethral catheter was left in place for 5 days. Two days after removal of the urethral catheter, stranguria was noted. Retrograde contrast urethrocystography revealed a urethral stricture. Balloon dilation of the urethral stricture was performed, and the cat's stranguria improved. Ten weeks following balloon dilation, the cat developed hematuria, and a urinary tract infection and urethral stricture were diagnosed. Balloon dilation was repeated with instillation of triamcinolone solution at the stricture site. Eighteen months later (approx 21 months after the initial surgery), the cat was urinating normally.

Clinical Relevance: The outcome for the cat of this report indicated that porcine small intestinal submucosa may be used to successfully augment urethroplasty for treatment of traumatic urethral tears in cats. Urethral balloon dilation with triamcinolone instillation may be used to treat postoperative urethral strictures.
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http://dx.doi.org/10.2460/javma.258.2.186DOI Listing
January 2021

Teaching Tip: A Simulated Tumor for Teaching Principles of Surgical Oncology for Biopsy and Excision of Skin and Subcutaneous Masses to Veterinary Students.

J Vet Med Educ 2020 Nov 21:e20200028. Epub 2020 Nov 21.

Tumors of the skin and subcutaneous tissues are commonly encountered in primary care practice. The most common of these tumors are mast cell tumors and soft tissue sarcomas, for which the primary treatment is most often surgical excision. Understanding surgical margins, particularly the deep fascial plane, can be difficult for veterinary students. Current techniques to teach these concepts typically rely on cadaver-based laboratories, which require simulated tumors to improve the realism of the laboratory. Tumors can be difficult to replicate in cadaver laboratories; thus a new technique for a simulated tumor was developed. A gelatin-based simulated tumor was injected into the subcutaneous space in two different sites in canine cadavers. Students then practiced incisional biopsy and wide excision of a subcutaneous mass. Students were able to appropriately perform both techniques using the simulated tumors. When the deep margin was not clean on the wide excision, students were able to understand the error by identifying the simulated tumor, reinforcing the concept of obtaining an appropriate deep fascial plane. In summary, this gelatin-based simulated tumor technique was cost-effective, easy to perform, and effective for the teaching laboratory.
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http://dx.doi.org/10.3138/jvme-2020-0028DOI Listing
November 2020

Dorsal offset rhinoplasty for treatment of stenotic nares in 34 brachycephalic dogs.

Vet Surg 2020 Dec 27;49(8):1497-1502. Epub 2020 Aug 27.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia.

Objective: To describe the technique, outcome, and owner satisfaction associated with dorsal offset rhinoplasty (DOR) to treat stenotic nares in brachycephalic dogs.

Study Design: Retrospective case series.

Animals: Thirty-four client-owned dogs.

Methods: Medical records of dogs treated with DOR at a veterinary teaching hospital over a 6-year period were identified. Dorsal offset rhinoplasty was defined as removal of a dorsal wedge of nasal planum from each naris with apposition of the rostral abaxial tissue to the caudal axial tissue, resulting in translocation of the alar cartilage in both median and dorsal planes. Immediate and postoperative complications were recorded. Owners were asked to report any complications with healing of the nares and to score their satisfaction with the appearance of the nares.

Results: Thirty-four dogs met the inclusion criteria. Twenty-nine (85%) dogs were examined a median of 402.5 days (range, 23-2042) postoperatively, with no major complications related to the rhinoplasty recorded. Eighteen owners responded a median of 701 days (range, 37-1622) postoperatively. One owner reported that self-trauma led to collapse of one naris. One owner reported collapse of both nares within 4 years; timing and cause were unknown. Sixteen of 17 responding owners reported that they were very satisfied with the outcome of the rhinoplasty. The owner of the dog with the collapsed naris was very unsatisfied. One owner did not provide a satisfaction score.

Conclusion: Owners were generally highly satisfied with DOR, and complications were uncommon.

Clinical Significance: This report describes an alternate technique to treat stenotic nares.
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http://dx.doi.org/10.1111/vsu.13504DOI Listing
December 2020

Outcomes associated with vaginectomy and vulvovaginectomy in 21 dogs.

Vet Surg 2020 Aug 9;49(6):1132-1143. Epub 2020 Jun 9.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio.

Objective: To report the outcomes of dogs with lesions of the genitourinary tract treated by vaginectomy or vulvovaginectomy.

Study Design: Multi-institutional retrospective study.

Animals: Female dogs that underwent vulvovaginectomy, complete vaginectomy, or subtotal vaginectomy from 2003 to 2018 with complete medical records and a minimum of 60 days follow-up.

Methods: Data collected from medical records included preoperative, intraoperative, and postoperative data, such as the occurrence of urinary incontinence (UIC), disease recurrence, and death/euthanasia.

Results: This study included 21 dogs. Four dogs had vulvovaginectomy, six had complete vaginectomy, and 11 had a subtotal vaginectomy performed. The mean age at surgery was 9.2 years (SD, 3.3). Thirteen dogs were intact at presentation. Smooth muscle tumors were diagnosed most commonly (10 leiomyomata, three leiomyosarcomas, two leiomyofibromas). The median duration of follow-up was 520 days (range, 71-1955). Major complications requiring revision surgery were recorded in two dogs. Postoperative UIC occurred in six of 21 dogs, resolving spontaneously within 60 days in three dogs. Dogs with malignant tumors (n = 6) survived at least 71 days (median, 626; 95% CI, 71-1245), and recurrence of disease occurred in two dogs. In dogs with benign tumors (n = 15), the median survival time was not reached. These dogs survived at least 104 days and had no recurrence of the disease.

Conclusion: Vaginectomy and vulvovaginectomy resulted in prolonged survival and low rates of major complications and UIC.

Clinical Significance: This study provides evidence to recommend that the risks of this procedure and expectations should be discussed with clients.
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http://dx.doi.org/10.1111/vsu.13466DOI Listing
August 2020

Clinical findings and outcomes of 153 dogs surgically treated for intestinal intussusceptions.

Vet Surg 2020 Jul 16;49(5):870-878. Epub 2020 May 16.

VCA Canada - Alta Vista Animal Hospital, Ottawa, Ontario, Canada.

Objective: To describe perioperative characteristics and outcomes of dogs surgically treated for intestinal intussusception.

Study Design: Multi-institutional, retrospective study.

Animals: One hundred fifty-three client-owned dogs with intestinal intussusception.

Methods: Dogs were included when they had undergone surgical treatment of a confirmed intestinal intussusception. Medical records were reviewed for demographics and clinical data, including surgical complications (graded 1-4). Follow-up was obtained via telephone interview with owners and referring veterinarians.

Results: Dogs had a median age of 10 months (range, 2-156), and the most common location for intussusception was ileocolic (66/153 [43%]). Most cases had no identifiable cause (104/155 [67%]). Intestinal resection and anastomosis (IRA) was performed in 129 of 153 (84%) dogs; enteroplication was performed in 28 of 153 (18%) dogs, including 13 with and 15 without IRA. Intraoperative complications occurred in 10 of 153 (7%) dogs, all involving intestinal damage during attempted manual reduction. The median duration of follow-up after discharge was 334 days (interquartile range, 15-990; range, 1-3302). Postoperative complications occurred in 53 of 153 (35%) dogs, including 22 of 153 (14%) with severe (grade 3 or 4) events. Diarrhea, regurgitation, and septic peritonitis were the most common postoperative complications; intussusception recurred in four of 153 (3%) dogs, all within 72 hours postoperatively. Fourteen-day postoperative mortality rate was 6%.

Conclusion: Surgical treatment of intestinal intussusception was curative in most dogs, even when an underlying cause was not identified. Surgical complications were common, including a 14% risk of life-threatening short-term complications.

Clinical Significance: Surgical treatment of intestinal intussusception offers an excellent prognosis, but the potential life-threatening complications should be considered.
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http://dx.doi.org/10.1111/vsu.13442DOI Listing
July 2020

Characteristics and long-term outcomes of dogs with gastroesophageal intussusception.

J Am Vet Med Assoc 2020 Apr;256(8):914-920

Objective: To determine long-term outcomes and factors associated with those outcomes in dogs with gastroesophageal intussusception (GEI).

Animals: 36 dogs with GEI evaluated at 16 veterinary hospitals from January 2000 through January 2018.

Procedures: Medical records of included dogs were reviewed to collect information regarding signalment, clinical signs, physical examination findings, blood work and diagnostic imaging results, surgical findings, and outcome. Factors were evaluated for associations with various outcomes.

Results: Median age of dogs with GEI was 13.2 months, and males (72% [26/36]) and German Shepherd Dogs (33% [12/36]) were most common. Vomiting (67% [24/36]) and regurgitation (33% [12/36]) were the most common clinical signs. Ten of 36 (28%) dogs were euthanized without treatment, and 26 (72%) underwent treatment (25 surgically and 1 endoscopically). Twenty-three of the 26 (88%) treated dogs survived to discharge; median survival time was 995 days. At last follow-up, 15 of the 23 (65%) surviving dogs remained alive and 8 (35%) had died for reasons related to persistent regurgitation (n = 6) or reasons unrelated to GEI (2). Of the 10 dogs for which owners were contacted, 7 had persistent regurgitation, the severity of which was reduced through managed feedings. Dogs with acute (≤ 7 days) clinical signs or a previous diagnosis of megaesophagus were more likely to have persistent regurgitation than were dogs without these factors.

Conclusions And Clinical Relevance: Treatment should be considered for dogs with GEI given the high rate of survival to discharge and median survival time. Although persistent regurgitation was common after treatment, a satisfactory outcome was possible with medical management, including managed feedings and medications.
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http://dx.doi.org/10.2460/javma.256.8.914DOI Listing
April 2020

Use of indirect computed tomography lymphangiography to determine metastatic status of sentinel lymph nodes in dogs with a pre-operative diagnosis of melanoma or mast cell tumour.

Vet Comp Oncol 2020 Dec 30;18(4):818-824. Epub 2020 Mar 30.

Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia, USA.

Canine melanomas and mast cell tumours (MCTs) frequently metastasize to lymph nodes, worsening prognosis compared with dogs without metastasis. Sentinel lymph node (SLN) evaluation is more specific than evaluation of the lymph node closest to the tumour, which may not be the draining lymph node. Computed tomography lymphangiography (CTL) allows for SLN identification and one study of canine mammary tumours found that CTL was able to assist in determination of the metastatic status of inguinal SLNs prior to extirpation and histopathology. The objective of the present study was to evaluate CTL for use in determining metastasis to the SLN in dogs with a pre-operative diagnosis of melanoma or MCT in various locations by correlating CTL findings with histopathology. The hypothesis was that CTL would not be able to determine the metastatic status of lymph nodes, based on author experience. Dogs were prospectively enrolled and underwent CTL and subsequent SLN extirpation. Histopathology results for the primary tumour, SLN, and additional extirpated lymph nodes were recorded. Fifteen dogs were enrolled and 21 SLN were evaluated. The SLN enhancement pattern (heterogeneous, homogenous or peripheral) was not associated with metastasis, nor was the attenuation value at 1 minute, 5 minutes, or the change in attenuation value. No correlation was found between CTL findings and metastatic status of SLNs. Based on these results, CTL alone cannot be used to diagnose SLN metastasis. Extirpation of the SLN with histopathology is recommended to diagnose lymph node metastasis in dogs with melanoma and MCT.
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http://dx.doi.org/10.1111/vco.12592DOI Listing
December 2020

Influence of use of a bipolar vessel sealing device on short-term postoperative mortality after splenectomy: 203 dogs (2005-2018).

Vet Surg 2020 Feb 14;49(2):291-303. Epub 2019 Dec 14.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia.

Objective: To compare short-term postoperative mortality in dogs after splenectomy performed with or without a bipolar vessel sealing device (BVSD) and to identify variables associated with mortality.

Study Design: Retrospective study.

Sample Population: Client-owned dogs (n = 203).

Methods: Medical records of dogs that underwent splenectomy from 2005-2018 were reviewed. Mortality rates were compared between dogs that underwent splenectomy with or without BVSD. Causes of death and variables associated with short-term mortality were assessed.

Results: Fifteen of 203 (7.4%) dogs died prior to discharge, and seven (3.4%) dogs died prior to suture removal for a total short-term mortality rate of 22 of 203 (10.8%). The estimated difference in proportion of deaths prior to discharge between the BVSD and non-BVSD groups was -0.01 (95% confidence interval = -0.08 to 0.06). Duration of anesthesia was longer when splenectomy was performed without BVSD (median 168 vs 152 minutes; P = .03). Multivariate analysis identified intraoperative (odds ratio [OR] 5.7) or postoperative (OR 13.6) administration of blood products, increasing duration of anesthesia (OR 1.15 per additional 16 minutes), and intraoperative ventricular arrhythmias (OR 6.8) as significantly associated with death prior to discharge. Intraoperative (OR 3.2) or postoperative (OR 7.7) administration of blood products was associated with death prior to suture removal.

Conclusion: Use of a BVSD did not appear to increase short-term mortality after splenectomy.

Clinical Significance: Dogs undergoing splenectomy that require intraoperative or postoperative transfusions, experience intraoperative ventricular arrhythmias, or have prolonged anesthesia may be at risk for death in the short-term postoperative period.
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http://dx.doi.org/10.1111/vsu.13367DOI Listing
February 2020

Risk factors for gastrointestinal upset and evaluation of outcome following surgical resection of canine pancreatic β-cell tumors.

Can Vet J 2019 Dec;60(12):1312-1318

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30602, USA.

The objective of this study was to determine risk factors for vomiting and inappetence and evaluate long-term outcome after surgical treatment of pancreatic β-cell tumors in dogs. Records of 33 dogs that underwent surgery for such tumors were retrospectively evaluated. Inappetence and vomiting occurred in 27.3% and 24.2% of dogs, respectively. Risk factors for postoperative vomiting were longer duration of clinical signs before surgery, higher preoperative total protein concentration, and lack of liver metastasis. No significant risk factors for inappetence or survival were identified. Median survival time was 723 days. Dogs with a longer duration of clinical signs before surgery may have had greater pancreatic involvement or more pronounced systemic perturbations. Higher preoperative total protein concentration may reflect preoperative dehydration or inflammation. Significance of lack of liver metastasis is unknown. The long survival time indicates a good overall prognosis with surgical treatment, justifying surgical intervention in patients with advanced disease.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6855230PMC
December 2019

Outcome after surgical and conservative treatments of canine peritoneopericardial diaphragmatic hernia: A multi-institutional study of 128 dogs.

Vet Surg 2020 Jan 25;49(1):138-145. Epub 2019 Nov 25.

DMV Veterinary Centre, Surgical Department, Montreal, Quebec, Canada.

Objective: To compare demographics and disease characteristics in dogs in which peritoneopericardial diaphragmatic hernia (PPDH) had been diagnosed and report outcomes after surgical treatment (ST) or conservative treatment (CT).

Study Design: Retrospective study.

Sample Population: One hundred twenty-eight dogs (91 ST, 37 CT) in which PPDH had been diagnosed.

Methods: Medical records were reviewed for demographics, perioperative findings, and outcomes. Follow-up was obtained via telephone interview and email correspondence with owners and referring veterinarians. Baseline variables were compared between treatment groups.

Results: Dogs treated surgically were younger (P < .001), more likely to be sexually intact (P = .002), more likely to have clinical signs from PPDH vs an incidental diagnosis (P < .001), and more likely to have other congenital abnormalities (P = .003) compared with dogs treated conservatively. Ninety-seven percent of ST dogs were discharged from hospitals. Intraoperative and postoperative complications were reported in 22% and 41% of dogs, respectively, although most complications were classified as low grade (75% and 83%, respectively). Follow-up was available in 87 dogs, at a median of 1062 days. Hernia recurrence was not reported in any surgically treated dog. The deaths of nine dogs (five ST, four CT) could be attributed to PPDH, and long median survival times were observed in both the ST and CT groups (8.2 and 5 years, respectively).

Conclusion: Preoperative characteristics differed between dogs treated conservatively vs surgically. Surgical treatment was associated with low operative mortality, and both ST and CT dogs had good long-term survival.

Clinical Significance: A diagnosis of PPDH can confer a good long-term prognosis for both ST and CT dogs.
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http://dx.doi.org/10.1111/vsu.13360DOI Listing
January 2020

Evaluation of short-term outcomes and potential risk factors for death and intestinal dehiscence following full-thickness large intestinal incisions in dogs.

J Am Vet Med Assoc 2019 10;255(8):915-925

Objective: To determine complication rates for dogs in which full-thickness large intestinal incisions were performed, assess potential risk factors for death during hospitalization and for intestinal dehiscence following these surgeries, and report short-term mortality rates for these patients.

Animals: 90 dogs.

Procedures: Medical records of 4 veterinary referral hospitals were reviewed to identify dogs that underwent large intestinal surgery requiring full-thickness incisions. Signalment, history, clinicopathologic data, medical treatments, surgical procedures, complications, and outcomes were recorded. Descriptive statistics were calculated; data were analyzed for association with survival to discharge (with logistic regression analysis) and postoperative intestinal dehiscence (with Fisher exact or Wilcoxon rank sum tests).

Results: Overall 7-day postoperative intestinal dehiscence and mortality rates were 9 of 90 (10%) and 15 of 90 (17%). Dogs with preoperative anorexia, hypoglycemia, or neutrophils with toxic changes and those that received preoperative antimicrobial treatment had greater odds of death than did dogs without these findings. Preexisting colon trauma or dehiscence, preexisting peritonitis, administration of blood products, administration of > 2 classes of antimicrobials, positive microbial culture results for a surgical sample, and open abdominal management of peritonitis after surgery were associated with development of intestinal dehiscence. Five of 9 dogs with intestinal dehiscence died or were euthanized.

Conclusions And Clinical Relevance: Factors associated with failure to survive to discharge were considered suggestive of sepsis. Results suggested the dehiscence rate for full-thickness large intestinal incisions may not be as high as previously reported, but several factors may influence this outcome and larger, longer-term studies are needed to confirm these findings.
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http://dx.doi.org/10.2460/javma.255.8.915DOI Listing
October 2019

Inappropriate Secondary Erythrocytosis in a Dog With Renal Sarcoma.

Top Companion Anim Med 2019 Sep 15;36:9-11. Epub 2019 May 15.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.

A 7-year-old mixed breed dog was evaluated for erythrocytosis with an initial hematocrit of 82.3%. Abdominal ultrasound revealed a 6 cm mass on the cranial pole of the right kidney. Daily therapeutic phlebotomies were performed, reducing the hematocrit to 54%. The dog underwent a right nephroureterectomy, recovered without complications, and was discharged 3 days after surgery. Histopathologic evaluation revealed a completely excised grade II soft tissue sarcoma. The preoperative erythropoietin level was 7.00 mU/mL (RI 1.90-22.90 mU/mL) and the 3-day postoperative erythropoietin level was 0.99 mU/mL, supporting a diagnosis of inappropriate secondary erythrocytosis due to the renal tumor. Secondary erythrocytosis resulting from renal soft tissue sarcoma is rare. Confirmatory testing with erythropoietin levels can assist in the diagnosis of secondary erythrocytosis. Erythropoietin levels that are normal or increased in the face of erythrocytosis indicate a source of inappropriate erythropoietin production.
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http://dx.doi.org/10.1053/j.tcam.2019.05.002DOI Listing
September 2019

Abdominal lymphatic drainage after thoracic duct ligation and cisterna chyli ablation in clinically normal cats.

Am J Vet Res 2019 Sep;80(9):885-890

Objective: To characterize abdominal lymphatic drainage in cats after thoracic duct ligation (TDL) and cisterna chyli ablation (CCA).

Animals: 7 purpose-bred research cats.

Procedures: Baseline CT lymphangiography was performed. A popliteal lymph node was injected with iohexol, and images were acquired at 5-minute intervals for 15 minutes. Cats underwent TDL and CCA; methylene blue was used to aid in identifying lymphatic vessels. The CT lymphangiography was repeated immediately after and 30 days after surgery. All cats were euthanized and necropsied.

Results: Results of baseline CT lymphangiography were unremarkable for all 7 cats. Only 5 cats completed the study. Leakage of contrast medium at the level of the cisterna chyli was seen on CT lymphangiography images obtained from all cats immediately after surgery. Evaluation of 30-day postoperative CT lymphangiography images revealed small branches entering the caudal vena cava in 2 cats, leakage of contrast medium into the caudal vena cava with no visible branches in 1 cat, and no contrast medium in the caudal vena cava in 2 cats. Contrast medium did not flow beyond the level of the cisterna chyli in any cat. Gross examination during necropsy revealed that all cats had small lymphatic vessels that appeared to connect to local vasculature identified in the region of the cisterna chyli.

Conclusions And Clinical Relevance: Abdominal lymphaticovenous anastomoses formed after TDL and CCA in cats. This would support use of these procedures for treatment of cats with idiopathic chylothorax, although additional studies with clinically affected cats are warranted.
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http://dx.doi.org/10.2460/ajvr.80.9.885DOI Listing
September 2019

Effect of Acute Ingestion of Green Tea Extract and Lemon Juice on Oxidative Stress and Lipid Profile in Pigs Fed a High-Fat Diet.

Antioxidants (Basel) 2019 Jun 23;8(6). Epub 2019 Jun 23.

Department of Foods and Nutrition, University of Georgia, Athens, GA 30602, USA.

Green tea and its catechins have been shown to ameliorate high fat diet-induced oxidative stress and hyperlipidemia. However, low bioavailability of catechins limits their therapeutic potential. Lemon juice (LJ) has been suggested to enhance the bioavailability of catechins in vitro. This study investigated the antioxidative and hypolipidemic efficacy of a single dose of green tea extract (GTE) or GTE plus LJ (GTE + LJ) in high-fat diet fed pigs. Sixteen pigs ingested a single dose of GTE (190 mg/kg/day) or GTE + LJ (0.75 mL/kg/day) mixed with low-fat (LF; 5% fat) or high-fat (HF; 22% fat) diets and blood samples were collected for 24 h. Plasma catechin level peaked at two hours, and gradually returned to baseline after six hours following the intake. The addition of LJ significantly increased plasma catechin level. The diet containing GTE did not lower plasma cholesterol and triacylglycerol (TG) concentrations, superoxide dismutase (SOD) and catalase activity, or malondialdehyde concentration in 24 h in HF-fed pigs. Addition of a single dose of LJ, however, significantly decreased plasma TG level in LF groups but did not cause further changes on any other markers compared to the GTE alone. Our findings indicate limited effect of a single meal containing GTE on plasma antioxidant enzymes, lipid profile, and lipid peroxidation in pigs and no significant synergistic/additive action of adding LJ to GTE within 24 h in pigs. A study with a longer treatment period is warranted to further understand the potential role of GTE in reducing HF diet-induced oxidative stress and the possible synergistic role of LJ.
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http://dx.doi.org/10.3390/antiox8060195DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6617406PMC
June 2019

Evaluation of surgical models for training veterinary students to perform enterotomies.

Vet Surg 2019 Aug 17;48(6):985-996. Epub 2019 May 17.

Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, Georgia.

Objective: To compare surgical models for teaching enterotomies to students.

Study Design: Prospective, randomized study.

Sample Population: Second-year veterinary students (n = 59) and faculty surgeons/surgery residents (n = 19).

Methods: Participants performed an enterotomy on each of 3 models (equine cadaver intestine, SurgiReal small intestine simulator, and SynDaver canine bowel) and completed a survey comparing them to either an enterotomy on an anesthetized pig (students) or intestinal surgery experience (faculty/residents). Surveys results were compiled and analyzed.

Results: Both student and faculty/resident groups rated cadaver intestine as more similar to live intestine compared with the synthetic models for incision, tissue handling, mucosal eversion, needle passage, knot tying, and best preparing for live intestine. Students rated SynDaver as more similar to live intestine than SurgiReal for incision and ranked SurgiReal as more similar to live intestine than SynDaver for mucosal eversion. There was no difference between the ranks assigned to SurgiReal and SynDaver for faculty/residents. Faculty/residents responded most often that cadaver intestine would be the model they recommend for training students.

Conclusion: Cadaver intestine was the model most similar to live intestine for all variables tested. SurgiReal and SynDaver models were comparable to each other but did not simulate live intestine as well as cadaver intestine.

Clinical Significance: Cadaver intestine more closely approximated live intestine compared with either synthetic model. SurgiReal and SynDaver may be adequate alternatives if cadaver intestine is unavailable.
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http://dx.doi.org/10.1111/vsu.13228DOI Listing
August 2019

Long-term outcome and risk factors associated with death or the need for revision surgery in dogs with permanent tracheostomies.

J Am Vet Med Assoc 2019 May;254(9):1086-1093

Objective: To evaluate long-term outcomes and identify factors associated with death or the need for revision surgery in dogs with permanent tracheostomies (PTs).

Design: Retrospective cohort study.

Animals: 69 client-owned dogs that received a PT between January 2002 and June 2016 at 1 of 4 veterinary teaching hospitals.

Procedures: Medical records were reviewed, and data extracted included signalment, history, clinical signs, radiographic and laryngeal examination findings, presence of esophageal abnormalities, date and reason for receiving a PT, postoperative complications, cause of death, and survival time. Dogs surviving < 2 weeks after receiving a PT were excluded.

Results: Major complications occurred in 42 of 69 (61%) dogs, with aspiration pneumonia (13 [19%]), skinfold occlusion (13 [19%]), and stoma stenosis (12 [17%]) being most common. Revision surgery was performed in 24 of 69 (35%) dogs, most commonly because of stoma stenosis or skinfold occlusion (9/24 [38%] each). Brachycephalic dogs were more likely (OR, 3.5; 95% confidence interval, 1.2 to 10.2) to require revision surgery than were nonbrachycephalic dogs. The overall median survival time was 1,825 days, and dogs that received corticosteroids before receiving a PT, had tracheal collapse, or were older had shorter survival times.

Conclusions And Clinical Relevance: Results of the present study indicated that creation of a PT was a viable treatment option for obstructive upper airway diseases in dogs and that long-term survival after receiving a PT was possible; however, a PT may not reduce the risk of aspiration pneumonia in dogs.
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http://dx.doi.org/10.2460/javma.254.9.1086DOI Listing
May 2019

Histologic evaluation of mandibular and medial retropharyngeal lymph nodes during staging of oral malignant melanoma and squamous cell carcinoma in dogs.

J Am Vet Med Assoc 2019 Apr;254(8):938-943

Objective: To assess histologic evaluation of mandibular lymph nodes (MLNs) and medial retropharyngeal lymph nodes (MRLNs) for metastatic disease during tumor staging for dogs with oral malignant melanoma (OMM) and oral squamous cell carcinoma (OSCC).

Design: Retrospective multi-institutional study.

Animals: 27 dogs with OMM and 21 dogs with OSCC.

Procedures: Medical record databases of 8 institutions were searched to identify dogs with OMM or OSCC that underwent unilateral or bilateral extirpation of the MLNs and MRLNs during the same procedure between January 2004 and April 2016. Information extracted from the records included signalment, primary mass location and size, diagnostic imaging results, histologic results for the primary tumor and all lymph nodes evaluated, and whether distant metastasis developed.

Results: Prevalence of lymph node metastasis did not differ significantly between dogs with OMM (10/27 [37%]) and dogs with OSCC (6/21 [29%]). Distant metastasis was identified in 11 (41%) dogs with OMM and was suspected in 1 dog with OSCC. The MRLN was affected in 13 of 16 dogs with lymph node metastasis, and 3 of those dogs had metastasis to the MRLN without concurrent metastasis to an MLN. Metastasis was identified in lymph nodes contralateral to the primary tumor in 4 of 17 dogs that underwent contralateral lymph node removal.

Conclusions And Clinical Relevance: Results indicated histologic evaluation of only 1 MLN was insufficient to definitively rule out lymph node metastasis in dogs with OMM or OSCC; therefore, bilateral lymphadenectomy of the MLN and MRLN lymphocentra is recommended for such dogs.
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http://dx.doi.org/10.2460/javma.254.8.938DOI Listing
April 2019

Outcomes and prognostic variables associated with primary abdominal visceral soft tissue sarcomas in dogs: A Veterinary Society of Surgical Oncology retrospective study.

Vet Comp Oncol 2019 Sep 27;17(3):265-270. Epub 2019 Mar 27.

Department of Clinical Sciences for Matz, Auburn University College of Veterinary Medicine, Auburn, Alabama.

Primary abdominal visceral soft tissue sarcomas (STSs) are rare tumours in dogs with little information available on outcomes. The goal of this retrospective, multi-institutional study was to describe the common tumour types, location and prognostic factors associated with primary abdominal visceral STSs. Medical records were searched for dogs with primary abdominal visceral STSs at six institutions and were retrospectively reviewed. Tumours were graded using the previously described grading scheme for STSs of the skin and subcutis when information in the histopathology report contained adequate details. Forty-two dogs were included in the study. Five dogs had grade I tumours, 11 had grade II and 15 had grade III tumours. The most common tumour type was leiomyosarcoma (38.1%). The most common tumour locations were the spleen (47.6%) and small intestine (23.8%). The local recurrence rate was low (4.7%). Metastasis was present at the time of surgery in 23.8%, and the overall metastatic rate was 40.4%. Mitotic index of ≥9 was associated with significantly shorter survival time (MST 269 days) compared with a mitotic index of <9 (MST not reached). The MST for grade I STSs was not reached, was 589 days for grade II and 158 days for grade III. Dogs with grade III tumours were more likely to develop metastatic disease. Neither location of the primary tumour nor the histologic subtype was associated with survival time. Histologic grading of abdominal visceral STSs using the previously described scheme is prognostic and should be provided on histopathology reports.
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http://dx.doi.org/10.1111/vco.12456DOI Listing
September 2019

Outcome following cosmetic rostral nasal reconstruction after planectomy in 26 dogs.

Vet Surg 2019 Jan 9;48(1):64-69. Epub 2018 Nov 9.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia.

Objective: To report the outcome and owner satisfaction after planectomy for nasal planum neoplasia with cosmetic reconstruction with bilateral labial mucocutaneous rotation flaps in dogs.

Study Design: Multi-institutional, retrospective case series.

Animals: Twenty-six client-owned dogs.

Methods: Medical records were searched for dogs that had undergone the procedure. Signalment, diagnosis, surgery, complications, requirement for revision surgery, recurrence, and survival information were recorded. Owners were contacted by telephone about their dog's quality of life after the procedure and their satisfaction with their dog's outcome.

Results: Twenty-five dogs underwent radical planectomy, and 1 dog underwent resection of the nasal planum. Twenty-four dogs had a diagnosis of squamous cell carcinoma, 1 had a diagnosis of atypical adenocarcinoma, and 1 had a diagnosis of a mast cell tumor. Complications occurred in 19 (73%) dogs, with 9 dogs requiring revision surgery; 1 dog not surviving to discharge. Median survival time was 1542 days (range, 3-2010). Recurrence of the primary tumor was suspected in 2 (7.7%) dogs, both with narrow or incomplete excision. Among 11 owners interviewed, 10 were satisfied with their dog's appearance, and 8 reported they would consent to the procedure again.

Conclusion: Dehiscence was common after this procedure, but local tumor control and survival times were excellent. Owner satisfaction was high, although preoperative client education is vital.

Clinical Significance: This technique should be considered as a viable option for dogs with nasal planum neoplasia given the high rate of recurrence with less aggressive treatment. Complications common following surgery, but do not persist long term and survival times were excellent.
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http://dx.doi.org/10.1111/vsu.13120DOI Listing
January 2019

Risk factors for temporary tracheostomy tube placement following surgery to alleviate signs of brachycephalic obstructive airway syndrome in dogs.

J Am Vet Med Assoc 2018 Nov;253(9):1158-1163

OBJECTIVE To identify risk factors for temporary tracheostomy tube placement (TTTP) following surgery for alleviation of signs associated with brachycephalic obstructive airway syndrome (BOAS) in dogs. DESIGN Retrospective case-control study. ANIMALS 122 client-owned dogs with BOAS that underwent surgery to alleviate clinical signs (BOAS surgery). PROCEDURES The medical records database of a veterinary teaching hospital was searched to identify dogs that underwent BOAS surgery from January 2007 through March 2016. Of the 198 dogs identified, 12 required postoperative TTTP (cases); 110 of the remaining 186 dogs were randomly selected as controls. Data regarding signalment and select preoperative, intraoperative, and postoperative variables were extracted from the medical record of each dog. Variables were compared between cases and controls and evaluated for an association with the odds of postoperative TTTP. RESULTS Body condition score, tracheal diameter-to-thoracic inlet ratio, staphylectomy technique, and mortality rate did not differ significantly between cases and controls. The odds of postoperative TTTP increased approximately 30% (OR, 1.3) for each 1-year increase in patient age. Postoperative administration of corticosteroids and presence of pneumonia were also positively associated with the odds of postoperative TTTP. Median duration of hospitalization was significantly longer for cases than controls. CONCLUSIONS AND CLINICAL RELEVANCE Age was positively associated with the odds of TTTP in dogs after BOAS surgery, and TTTP led to prolonged hospitalization. Thus, early identification and intervention may be beneficial for dogs with BOAS. The associations between TTTP and postoperative corticosteroid use or pneumonia were likely not causal, but reflective of patient disease severity.
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http://dx.doi.org/10.2460/javma.253.9.1158DOI Listing
November 2018

Lung lobe torsion in dogs: 52 cases (2005-2017).

Vet Surg 2018 Nov 10;47(8):1002-1008. Epub 2018 Oct 10.

Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia.

Objective: To report outcomes and risk factors for mortality in dogs that underwent surgical management of lung lobe torsion.

Study Design: Retrospective case series from 5 veterinary teaching hospitals (2005-2017).

Animals: Fifty dogs with 52 instances of lung lobe torsion.

Methods: Data collected from medical records included signalment, clinical findings, results of clinicopathologic testing and diagnostic imaging, surgical treatment, lung lobe affected, intraoperative and postoperative complications, histopathologic and microbiologic findings, and outcome. Follow-up was obtained from medical records and telephone contact with primary care veterinarians.

Results: Fifty-two instances of lung lobe torsion were identified in 50 dogs, with a median follow-up of 453 days (range, 0-3075). Forty-six (92%) dogs survived to discharge. Dogs with concurrent torsion of the right cranial and middle lung lobes were less likely to survive (2/4) than those with torsion of the left cranial lung lobe (22/22). No other risk factors for mortality prior to hospital discharge were identified. Overall median survival time after hospital discharge was 1369 days. Four dogs had >1 episode of lung lobe torsion.

Conclusion: The percentage of dogs surviving to discharge after surgical treatment of lung lobe torsion was higher than previously reported. The short- and long-term prognosis was excellent with surgical treatment of lung lobe torsion.

Clinical Significance: Surgery should be recommended when lung lobe torsion is suspected because of the high survival to discharge rate and excellent long-term prognosis.
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http://dx.doi.org/10.1111/vsu.13108DOI Listing
November 2018

Primary appendicular hemangiosarcoma and telangiectatic osteosarcoma in 70 dogs: A Veterinary Society of Surgical Oncology retrospective study.

Vet Surg 2018 Aug 26;47(6):774-783. Epub 2018 Jul 26.

Fitzpatrick Referrals Oncology and Soft Tissue Ltd, Surrey, United Kingdom.

Objective: To define and compare clinical characteristics of canine primary appendicular hemangiosarcoma (HSA) and telangiectatic osteosarcoma (tOSA), including signalment, presentation, response to treatment, and prognosis.

Study Design: Multi-institutional retrospective study.

Animals: Seventy dogs with primary appendicular HSA or tOSA.

Methods: Patient data were obtained from institutions' medical records. Immunohistochemistry was applied to archived tissues to establish tumor type. Patient characteristics, treatment responses, and outcomes were described and compared by tumor type.

Results: Forty-one HSA and 29 tOSA were identified. Dogs with HSA were more likely than dogs with tOSA to be male and have hind limb tumors; 78% of HSA occurred in hind limbs, particularly the tibia. Dogs with tOSA weighed a median of 9.9 kg (95% CI 4.6-15.3) more than dogs with HSA. Most dogs received antineoplastic treatment, predominantly amputation with or without adjuvant chemotherapy. Overall survival with local treatment and chemotherapy was 299 days (95% CI 123-750) for HSA and 213 days (95% CI 77-310) for tOSA. Younger age and more aggressive treatment were associated with longer survival in dogs with HSA but not tOSA. One-year survival rates did not differ between dogs with HSA (28%) and those with tOSA (7%).

Conclusion: Distinct clinical features were identified between HSA and tOSA in this population. Both tumors were aggressive, with a high incidence of pulmonary metastases. However, local treatment combined with chemotherapy led to an average survival 7 months for tOSA and 10 months for HSA.

Clinical Significance: HSA should be considered as a differential in dogs with aggressive lytic bone lesions, particularly medium-sized dogs with tibial lesions. HSA has a unique clinical presentation but similar therapeutic response and outcome to OSA. Amputation and chemotherapy appear to prolong survival in some dogs with HSA and tOSA.
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http://dx.doi.org/10.1111/vsu.12926DOI Listing
August 2018

Owner Perception of Outcome Following Permanent Tracheostomy in Dogs.

J Am Anim Hosp Assoc 2018 Sep/Oct;54(5):285-290. Epub 2018 Jul 24.

From the College of Veterinary Medicine, University of Georgia, Athens, Georgia (A.M.D., J.A.G., M.L.W., C.A.M.V., C.W.S.); College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas (A.S., K.T.M., K.K.C.); College of Veterinary Medicine, Auburn University, Auburn, Alabama (K.C.H., B.M.M.); and College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina (S.L., V.F.S.).

The purpose of this study was to evaluate owner perception of outcome following permanent tracheostomy (PT) in dogs. Medical records of dogs who received PT from 2002 to 2016 were reviewed. A questionnaire was given to owners verbally or by e-mail to ascertain their perception of their dog's outcome after PT. Median time to questionnaire administration from PT surgery was 608 days (64-3,708). Owner satisfaction after PT was high (89.7%), with the majority stating they would have the procedure performed again (79.5%). Owners reported an improvement in their dog's personality (30.8%) and increased activity (41%). Median survival time was 1,825 days (64-2,663), with 6 of 39 dogs (15.4%) alive at study end. Of the 33 dogs who died, 11 (33.3%) died from underlying respiratory conditions suspected to be related to the PT. The overall complication rate was 82.1%, with mucus secretion being the most common. Revision surgery was required in 30.8% of dogs (most commonly due to skin occlusion), and aspiration pneumonia occurred in 17.9% of dogs. Overall, owner satisfaction after PT in dogs is high despite intensive postoperative management, and long survival times can be achieved.
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http://dx.doi.org/10.5326/JAAHA-MS-6738DOI Listing
November 2018

Os clitoris in dogs: 17 cases (2009-2017).

Can Vet J 2018 06;59(6):606-610

Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, 2200 College Station Road, Athens, Georgia 30602, USA.

Medical records of 17 client-owned dogs diagnosed with os clitoris on physical examination or diagnostic imaging were reviewed to describe the clinical signs and surgical management of this condition. All dogs were phenotypically female. The most common presenting complaints included an enlarged clitoris ( = 10), urinary tract infection ( = 5), and licking of the vulva ( = 3). Other frequently reported clinical signs included vaginal discharge and/or lower urinary tract signs such as pollakiuria. Ten dogs were surgically managed with os clitorectomy. Concurrent related procedures included gonadohysterectomy ( = 7), and episioplasty ( = 3). Clitorectomy in the surgically managed dogs created a more normal female anatomy and resolved clinical signs associated with the exposed clitoris.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949945PMC
June 2018

A Case of Parasitic Twinning or Caudal Duplication in a Dog.

J Am Anim Hosp Assoc 2018 Jul/Aug;54(4):219-225. Epub 2018 May 14.

From the Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama.

A 6 mo old 13.5 kg (29.7 lb) male intact American Staffordshire terrier was evaluated for a history of supernumerary pelvic limbs, with malodorous discharge from a supernumerary penis. Imaging (radiographs, abdominal ultrasound, and computed tomography with excretory urogram) showed a supernumerary pelvis with associated pelvic limbs, no osseous continuity with the primary spinal column, a colonic diverticulum extending to the supernumerary pelvis, an enlarged left kidney with a ureter connecting to a single bladder, right renal aplasia, a single descended testicle in the primary scrotum, an intra-abdominal cryptorchid testicle, and two unidentifiable soft tissue masses. At surgery, a single ileum was present with a primary and accessory cecum and colon and the accessory colon entering the supernumerary pelvis. The accessory cecum and colon, right kidney, two unknown soft tissue masses, and the single descended testicle were removed. The right kidney had a ureter that anastomosed with the accessory colon at its entry into the supernumerary pelvis. The supernumerary pelvis and hind limbs were not removed. Five months after surgery, the dog was reported to be doing well clinically. Caudal duplication is extremely rare in veterinary medicine. The appearance of supernumerary external structures may indicate internal connections as well.
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http://dx.doi.org/10.5326/JAAHA-MS-6559DOI Listing
September 2018