The objectives of this study were to define the acute and chronic effects of 1-hour unilateral in vivo renal ischemia on renal function and histology in cats. Twenty-one adult purpose-bred research cats were anesthetized, and 1 kidney underwent renal artery and vein occlusion for 1 hour. Serum creatinine and urea concentrations, urine protein:creatinine ratio, urine-specific gravity, glomerular filtration rate, hematocrit, platelet concentration and function, and white blood cell count were measured at baseline and variable time points after ischemia. Renal histopathology was evaluated on days 3, 6, 12, 21, 42, and 70 postischemia; changes in smooth muscle actin and interstitial collagen were examined. Following ischemia, whole animal glomerular filtration rate was significantly reduced (57% of baseline on day 6; P < .05). At the early time points, the ischemic kidneys exhibited severe acute epithelial necrosis accompanied by evidence of regeneration of tubules predominantly within the corticomedullary junction. At later periods, postischemic kidneys had evidence of tubular atrophy and interstitial inflammation with significantly more smooth muscle actin and interstitial collagen staining and interstitial fibrosis when compared with the contralateral control kidneys. This study characterizes the course of ischemic acute kidney injury in cats and demonstrates that ischemic acute kidney injury triggers chronic fibrosis, interstitial inflammation, and tubular atrophy in feline kidneys. These late changes are typical of those observed in cats with naturally occurring chronic kidney disease.
Objective: To investigate the frequency, source, and risk factors of intraoperative (IO) surgeon and patient bacterial contamination during clean orthopedic surgeries, and to investigate the relationship between IO contamination and surgical site infection (SSI) in dogs. Study Design: Prospective clinical study. Sample Population: Client-owned dogs undergoing stifle surgery (n ¼ 100). Methods: IO cultures were taken in each case from surgical foot wrap, peri-incisional skin, surgical gloves, and the surgical team's hands. The environment (operating room [OR] lights, computers, scrub sink faucet, anesthesia gurney, and radiology table) was sampled every 5 months. Bacteria were identified and the contamination of each case was categorized. All gloves from the surgical team were collected and tested for perforations using a water infusion test. Cases were followed for at least 8 weeks to determine the presence or absence of SSI. Perioperative variables were evaluated for association with IO contamination and SSI. Results: Bacterial isolates were yielded from 81% of procedures from 1 or more sources; 58% had positive hand cultures, 46% had positive glove cultures, 23% had positive patient skin cultures, and 12% had positive foot wrap cultures. Staphylococcus spp. was the most commonly recovered bacteria. There was no apparent association between IO contamination and SSI. The highest level of environmental contamination was associated with the scrub sink faucet, followed by the radiology table, anesthesia gurney, and OR computers. The IO glove perforation rate was 18%. Conclusion: Clean orthopedic procedures commonly had clinically insignificant bacterial contamination. In our study, bacteria responsible for SSI did not appear to colonize the patient in the OR. In the veterinary literature, surgical site infection (SSI) rates for patients undergoing clean surgical procedures range from 3.6-5.8%. 1-3 Infection occurs despite adherence to well-accepted standards of surgical technique and environmental control designed to maintain a sterile surgical field. 4 Little objective information is available to validate how successfully these techniques control intraoperative contamination of surgical gloves, patient wraps, patient skin, and surgeon skin. In addition, it is not known how bacteria associated with surgical procedures influence complications. Understanding the bacterial ecology of veterinary operating rooms during the intraoperative period is critical in the search for the source of SSI, and allows for the development of evidence-based strategies to control the impact of pathogenic microbes in the surgical environment. In human surgical practice, published intraoperative glove contamination rates range from 14-56%. 5,6 Studies have not reported a clear primary source of contamination. One study reported surgical personnel, followed by the patient, and operating room environment as the most common sources of contamination 7 ; however, another study reported the operating room environment as the major source, followe...
OBJECTIVE To describe clinical findings and survival times for dogs with functional thyroid tumors treated with surgery alone and investigate potential prognostic factors for outcome in these patients. ANIMALS 27 client-owned dogs. PROCEDURES Medical records of 9 institutions were reviewed to identify dogs with hyperthyroidism secondary to thyroid neoplasia that were treated with surgery alone between 2005 and 2015. Data collected included signalment, hematologic and physical examination findings, tumor staging results, time from diagnosis to treatment, surgical procedure performed, histologic findings, evidence of recurrence or metastatic disease, and date of death or last follow-up. Median survival time and 1-, 2-, and 3-year survival rates were assessed by Kaplan-Meier analysis. Associations between variables of interest and the outcome of death were assessed with Cox proportional hazards models. RESULTS Dogs from 8 institutions met inclusion criteria. Median age at diagnosis was 10 years (range, 8 to 13 years). Golden Retrievers and Labrador Retrievers were commonly represented (5 dogs each). Polyuria with polydipsia (15/27 [56%]) and weight loss (12 [44%]) were the most common clinical signs; 2 dogs without clinical signs had hyperthyroidism identified by routine hematologic analysis. One dog had metastatic disease at the time of diagnosis. Most tumors (23/27 [85%]) were malignant. Estimated median survival time was 1,072 days. No significant prognostic factors were identified. CONCLUSIONS AND CLINICAL RELEVANCE Dogs with resectable functional thyroid tumors had a good prognosis with surgical excision alone. Survival times for these dogs were similar to those in previous studies that included dogs with nonfunctional thyroid tumors.
Objective To report a case of bilateral radial head osteochondritis dissecans (OCD) in a dog treated via lateral elbow arthroscopy portals. Study design Case report. Animals Six month old female spayed English bulldog. Methods The dog was presented for a left thoracic limb lameness localized to the elbow. Computed tomography revealed bilaterally symmetrical mineralized fragments in the lateral compartment of the elbow joint and blunting of the medial coronoid processes. The fragments were associated with a thin donation bed along the caudolateral articular surface of the radial head with moderate surrounding subchondral bone sclerosis. Bilateral elbow arthroscopy was pursued. Arthroscopy was initiated via a standard medial approach, which allowed for abrasion arthroplasty of the radial incisure and medial coronoid process but provided insufficient access to the radial head lesions. A lateral arthroscopic approach was subsequently performed and provided excellent access to the radial head for fragment retrieval and abrasion arthroplasty. Results Histopathology of the radial head fragments revealed mild cartilage degeneration and retention of cartilaginous cores within subchondral bone, consistent with OCD. Complete resolution of lameness and elbow pain were observed on clinical examination 5 months postoperatively. Conclusion Radial head OCD can occur as a rare component of elbow dysplasia in growing dogs, and fragment retrieval with abrasion arthroplasty via lateral arthroscopic portals may be an effective treatment option.
ObjectiveTo determine the ability of cell salvage washing and leukoreduction filtration to remove bacterial contamination from canine whole blood.Study designEx vivo nested cohort study.Sample populationCommercially purchased fresh canine whole blood (n = 33 units).MethodsCommercially obtained canine whole blood was inoculated with known concentrations of one of three species of bacteria, Escherichia coli (ATCC 25922), Staphylococcus pseudintermedius (quality control strain; Texas A&M University), or Pseudomonas aeruginosa (ATCC 27853). Negative controls were inoculated with sterile saline. The inoculated blood was processed through a cell salvage system and filtered through a series of two leukocyte reduction filters. Samples were aseptically collected at five points during processing (inoculum, prewash, postwash, post–first filtration, and post–second filtration) for bacterial enumeration.ResultsBacterial concentrations were reduced by 85.2%, 91.5%, and 93.9% for E coli, S pseudintermedius, and P aeruginosa, respectively, after washing (P < .0001), and bacterial concentrations were reduced by 99.9%, 100%, and 100%, respectively, after the first filtration (P < .0001). After the second filtration, none of the three species of bacteria could be isolated (100% reduction). No bacterial growth was obtained from negative controls throughout the study. The type of bacteria (P = .29) did not allow prediction of bacterial reduction.ConclusionCell salvage washing combined with leukoreduction filtration eliminated bacterial contamination of whole dog blood (P < .0001).Clinical significanceCell salvage washing and leukoreduction filtration could be applied to intraoperative autotransfusion in clinical animals, especially those treated for trauma or hemorrhage with concurrent bacterial contamination.
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