No abstract

Background: Pulmonary aspiration of gastric content can result in intraoperative and postoperative complications, such as regurgitation, gastro-esophageal reflux and esophagitis. There are variations among authors about the ideal period of solid and liquid fasting. Determination of the appropriate amount of food abstinence in surgical patients is important, because of the metabolic disorders that interfere in response to anesthetic protocol or surgical intervention. Thereby, this research aimed to evaluate the appropriate period of fasting for elective anesthesia and surgical procedures in cats, by analysis of gastric emptying time based on the daily energy requirement.Materials, Methods & Results: Seven cats of mixed breed, health and with an average weight of 2.857 ± 0.3780 were evaluated by gastroscopy for the presence of food and obtaining tissue samples. To evaluate the gastric emptying time, dry and moist food were offered at two different times, 8 h and 4 h before each evaluation, with an interval of seven days between each food treatment (dry and moist). There was no significant difference in all biochemical parameters evaluated (cholesterol, glucose, and lactate) in both fasting times and food types (P > 0.05). All animals underwent gastric biopsy for histological evaluation and urease test, to discard morphological changes. After 4 h it was observed dry food in all cat’s stomach, however just five cats presented food in their stomach after eight hours. In other hand all the animals, which ate moist food, did not present any gastric content after four hours and eight hours of feeding. Gastric mucosa were considered normal in all cats with moderate amount of Helicobacter sp.Discussion: The difficulty of a consensus on the fast time in cats, and the great variability of the emptying time according to the feeding type, makes this study useful as basis for future studies on fasting with wet food, as well as providing immediate clinical application in surgical routine. Only a moderate gastritis related to helicobacter sp. was detected, but even healthy animals can carry Helicobacter sp.  Four h of fasting time if feed the patient with 80% humidity ration improve anesthetic security of the patient with typical biochemical values. As shown, the appropriate preoperative fasting directly implies on decrease in the number of complications related to full stomach. Thus, always should take into account the possibility to perform fast in an appropriate period to prevent vomiting and aspiration, without the risk of hypoglycemia benefiting the patient and reassuring the anesthesiologist, especially in situations requiring urgent or emergency intervention. As observed through endoscopy, even eight hours of fasting with dry feed is inappropriate due to significant gastric volume of food in almost all cats. This suggests that prolonged preoperative fasting is no guarantee of low stomach volume. Wet feed can be an option for elderly and debilitated patients requiring surgical intervention within a short period of fasting. The time varies with type and volume of food that is variable according patients and different species and digestive conditions. The research were conducted with none complications. By means, this experiment it was concluded that the fasting time of 4 h with 80% humidity moist food allows complete gastric emptying without any complication.

Background: Burns are uncommon in small animal surgery routine and represents a real therapeutic challenge. Skin can be affect in different degrees of deepness as superfcial, partial thickness, full thickness and full thickness affecting underlying tissues. Each degree has individual features. Progression through degrees can occur in the frst 24 h or if treatment is inadequate. This paper aims to describe therapeutic approach and surgical technique to treat a huge dorsal iatrogenic thermal burn injury. Case: A 4-year-old female German Shepard was referred to veterinary hospital after 11 days of elective ovariosalpingohisterectomy. The patient presented a severe skin injury with crusts, eschars, purulent discharge and myiasis on dorsal cervical, thoracic and lumbar region. Beside severity of the wound, animal present good general status and normal vital signs. Complete blood count and biochemical analysis were within normal ranges. Histopathologic analysis of a wound tissue sample revealed the presence of coagulation necrosis and inflammatory response. The absence of traumatic events, histopathologic result and wound features increased suspicious of an iatrogenic burn injury from a poorly regulated thermal mattress used during surgical intervention. “Rule of Nines” was estimated as 25% of total body surface area. Systemic antibiotics and topical treatment with 0.05% chlorhexidine digluconate and 2.5% silver sulfadiazine ointment followed by wet-wet bandage was performed after initial surgical debridement. Muscle and vertebral bone explosion were evident. Topical treatment with Silver Sulfadiazine and chlorhexidine persisted twice daily until granulation tissue formation. Pain killers and sedation were often necessary during bandage changes. At 65th day proceeded to en bloc excision of scar tissue and surgical reconstruction with skin advancement and recruitment technique. Tie-over dressing was applied to cover the fnal wound. After 14 days animal received hospital discharge, and was assessed bi-weekly for 60 days. Discussion: Besides great extension of the burn injury, patient’s age, absence of systemic involvement and fluid therapy or critical care the prognosis was good. Modifed “rule of nine” are used to estimate wound size in dogs. The wound was classifed as forth degree or full thickness injury due to exposed muscular layer and bone. Early debridement, standard topical and systemic treatment protocol applied granted good recovery of wound bed. Due to be uncommon in small animal routine, main diagnosis and therapeutic recommendations for veterinary patients are based on human data. Systemic antimicrobial drugs are usually not recommended due to low concentration in burned tissues, however, prophylactic use was necessary due to highly infected tissues and possible bacterial absorption from devitalized tissues. Delayed primary closure technique was necessary due to highly infection site and extension, which turns surgical approach hard to perform. After formation of a granulation tissue bed for wound reconstruction, surgical treatment was performed. Surgical reconstruction is indicated in large full thickness defects and for better cosmetic appearance. The correct use and regulation of thermal mattress can avoid burns that can be life threatening. This case report rises the important concept that even low contact temperatures when persistent for long time can cause burn injuries. Keywords: thermal, mattress, injury, dogs, plastic.

Background: Hermaphroditism is a rare congenital disease that causes ambiguous sexual features. True hermaphrodites have testicular and ovarian tissue, whereas pseudohermaphrodites have only one type of gonadal tissue, genitalia, but secondary characteristics of the opposite sex. Pseudohermaphrodites are classified as male or female according to their gonads. Treatment of pseudohermaphroditism consists of surgical removal of the gonads including reconstruction of abnormal genitalia, especially if the urethra is involved. Therefore, the objective of this report is to describe a case of a male pseudohermaphrodite in a dog treated with clitoridectomy with urethrostomy.Case: A 7-month-old, mixed-breed dog was referred due to the presence of a flaccid structure similar to a small penis, containing an os clitoris, bulbourethral glands, and urethra protruding from the vulva. Physical examination, complete blood count and serum biochemistry were within normal ranges. Hormonal levels of estradiol, testosterone, and progesterone were 56.39 pg/mL, 127.9 ng/mL, and 0.892 ng/mL, respectively. The abdominal ultrasound and posteriorly the exploratory celiotomy found a normal size prostate and two round organs resembling testicles connected to a uterus-like tubular structure. The patient underwent surgical abdominal exploration that confirmed the ultrasonographic findings and led to gonadohysterectomy. Also, clitoridectomy and urethrostomy were performed to excise the protruded structure and maintain normal urethral patency. The histopathological examination of the clitoris and penis confirmed it was a male genital organ, however, the abdominal structures were compatible with the testicles, epididymis, uterus, and even a broad ligament. These organs are normally found in cases of male pseudohermaphroditism. The testicles were histologically composed of regular seminiferous tubules, single layer Sertoli cells but there were no spermatogenic cells. After ten months of follow-up, the patient was alive, without urination impairment or any other clinical signs.Discussion: The animal presented the protrusion of the penile structure as the sole clinical sign. The reproductive system had a female origin, been possible its masculinization due to high testosterone concentration that induced the development of Wolff ducts, resulting in the formation of the epididymis, deferent ducts, and seminal vesicles. In these cases, it led to an enlarged clitoris. The patient described had hormonal levels compatible with a neutered male/female or a female in anestrus. The clinical signs become evident as the clitoris gets hypertrophied increasing the sensibility, resulting in constant licking of the mucosa, chronic inflammation, and mucopurulent discharge. This patient was diagnosed with male pseudohermaphroditism as it had cryptorchid male gonads along with the uterus and external genitalia of a female dog but containing traces of male genitals such as the os clitoris. Surgery is indicated when there are clinical signs or when the clitoris had an os clitoris or urethra due to an intersex abnormality. The surgical resection of the external male genitalia associated with the excision of the internal reproductive tract treated while preserving the urethra in this animal. Clitorectomy is a simple technique and creates a normal female anatomy ending the clinical signs of the exposed clitoris and improving the quality of life.Clitoridectomy and Urethrostomy in a Pseudohermaphrodite Dog

Objective: To evaluate outcomes associated with the use of an angularis oris axial pattern flap (AOAPF) for rostral facial reconstruction in cats.Animals: Nine adult client-owned cats. Study Design: Short case series.Methods: Ten AOAPF were performed in nine cats after resection of a tumor. Wounds were located at the nose, infraorbital, supraorbital, frontal, eye, and ear canal region. Orbital exenteration (n = 3), pinnectomy (n = 2), nasal planum resection, total ear canal ablation (n = 2), and partial eyelid reconstruction (n = 3) were performed.Results: Short-term postoperative complications included flap edema (n = 10), suture dehiscence (n = 3), and distal tip necrosis (n = 3). All wounds resulting from minor complications healed by second intention in 5-15 days.Long-term complications included epiphora (n = 2), frequent grooming around the eyes (n = 2), and enucleation due to corneal ulcer secondary to impaired postoperative eyelid function (n = 1). Tumor recurrence occurred in 3 cases. Conclusion:The AOAPF was a versatile and reliable option for rostral facial reconstruction in cats with acceptable long-term outcomes.