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ABSTRACT: An 11-month-old female dog was evaluated because of a 3- to 4-day history of stranguria and hematuria.
Rectal and vaginal examination and abdominal radiography revealed a large (4 x 2 cm), firm, ovoid object in the area of the pelvic inlet, between the vagina and colon.
Surgical exploration revealed an abscess and moderate amount of seropurulent fluid in the left caudal abdominal quadrant. A large urethrolith (3.7 x 2.0 x 1.5 cm) was evident in the proximal portion of the urethra. The urethrolith was associated with a 3 x 1-cm area of necrosis in the ventral aspect of the proximal portion of the urethra and a 3 x 3-cm area of necrosis in the area of the bladder trigone. The necrotic areas were débrided, and the defect was repaired with an axial pattern flap constructed from the rectus abdominis muscle. During a follow-up examination 2.5 years after surgery, the dog was clinically normal with no history of urinary incontinence. During rigid cystoscopy, the ure-thral mucosa appeared grossly normal, and there was no evidence of stricture.
Findings suggested that axial pattern flaps constructed from the rectus abdominis muscle flap may be useful in reconstructing large urinary bladder and urethral defects.
Journal of the American Veterinary Medical Association 05/2009; 234(8):1038-40. · 1.79 Impact Factor
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ABSTRACT: To describe hepatic vasculobiliary anatomy important to hilar liver lobe resection in the dog.
Experimental study.
Canine cadavers (n=7).
The vasculobiliary system of 7 fresh canine livers was injected with a polymer. The parenchyma was dissected at the level of the hilus to determine the vascular and biliary supply to each liver lobe, and then macerated with a corrosion preparation. The information gathered was used to describe a surgical approach for hilar liver lobe resection.
Each liver lobe had a single hepatic artery and biliary duct. The location of these structures was consistent, although minor variations existed (dorsal versus ventral to the lobar portal vein) in the left lateral lobe and papillary process in 2 specimens. Most liver lobes (34/49) were supplied by 1 lobar portal vein and drained by 1 lobar hepatic vein (39/49). The location of the portal and hepatic veins was consistent among specimens.
The left division is the most mobile of the liver lobes and each lobe can be removed separately or en bloc. Because of the location of the hepatic veins, the central division is best removed as a single unit. The right lateral lobe can be removed individually or together with the caudate process. The papillary process is removed by itself.
A hilar liver lobectomy technique can provide an alternative approach to conventional procedures for tumors that encroach upon the hilus of the liver.
Veterinary Surgery 02/2009; 38(1):104-11. · 1.26 Impact Factor
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ABSTRACT: A 6-year-old, neutered male, mixed-breed dog was presented for a chronic draining tract and cough. A contrast fistulogram demonstrated a cutaneopulmonary fistula. Excision of the fistulous tract retrieved a migrating foreign body (i.e., a toothpick) within the tract. Clinical signs resolved 2 weeks following surgery. Foreign body migration is a common problem seen in dogs, resulting in many different clinical syndromes. Definitive surgery depends upon complete removal of the foreign body and the diseased tissue. Sinography is an inexpensive, readily available diagnostic tool that can help define a draining tract and confirm a foreign body.
Journal of the American Animal Hospital Association 38(6):545-7. · 0.96 Impact Factor
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ABSTRACT: To evaluate the primary critical ischemia time for the deep circumflex iliac (DCI) cutaneous flap in cats.
In vivo model.
Thirteen young adult female cats.
An island skin flap was created on the right side of each cat based on the angiosome of the ventral branches of the DCI vessels. The cats were randomly assigned to a flap ischemia time ranging from 1 to 3 hours in 10-minute intervals. Microvascular clamps were used to occlude the artery and vein for the designated time. Flaps were sutured into position after the ischemic period. On day 3, fluorescein dye was administered and the flaps were evaluated under ultraviolet light to assess percent area of perfusion. On days 7 and 14, the percent area of survival was determined for each flap based on cutaneous morphometry.
All flaps had 100 percent area of survival throughout the study. On day 3, all flaps fluoresced uniformly compared with the surrounding skin. On days 7 and 14, all flaps were uniformly viable as confirmed by skin color, consistency, bleeding, and hair re-growth.
The DCI cutaneous flap in cats can withstand up to 3 hours of ischemia with predictable survival.
In a clinical setting, high success rates can be expected with microvascular transfer of the DCI cutaneous flap in cats when the ischemia time is <3 hours and precise surgical technique is used.
Veterinary Surgery 33(5):440-5. · 1.26 Impact Factor
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ABSTRACT: A 2-year-old, intact male Newfoundland was presented for evaluation of a 1- to 2-day history of coughing, retching, and progressive lethargy. Thoracic radiographs demonstrated right-sided pleural effusion and lobar vesicular emphysema. An exploratory thoracotomy revealed midlobar torsion of the right caudal lung lobe. A partial lung lobectomy was performed, and following surgery, the dog recovered without complications. Lung lobe torsions in dogs typically occur at the hilus of the affected lung lobe. This report documents that midlobar lung lobe torsions occur in dogs and should be considered as a differential diagnosis in cases of lobar vesicular emphysema and pleural effusion.
Journal of the American Animal Hospital Association 40(3):220-3. · 0.96 Impact Factor
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ABSTRACT: Reducing reperfusion injury to skin flaps is an effective means to improve the survival of the flap. By enhancing oxygen delivery to the microcirculation within the flap, ischemia-reperfusion injury should be decreased, improving the flap's survival. This study evaluated the effects of a hemoglobin-based oxygen carrier (Oxyglobin) on the development of necrosis and survival of ischemic rat island groin flaps. Sprague-Dawley rats were randomly assigned to one of three treatment groups. A groin flap was elevated on each rat and subjected to 9 h of ischemia. Rats in group I were given an intravenous infusion of 0.9% saline prior to elevation of the skin flap. Rats in group II were given an intravenous infusion of Oxyglobin prior to elevation of the skin flap. Rats in group III were given a low-dose intravenous infusion of Oxyglobin following the 9 h of ischemia, just prior to reperfusion. The flaps were monitored for 7 days postoperatively for necrosis. The percentage of flap necrosis was recorded at the end of 7 days. All rats were euthanized at the completion of the study and the flaps were harvested for histopathological analysis. No significant difference was noted in the survival of the flaps or the degree of necrosis in the rats treated with Oxyglobin compared to the control group. Thus, pre-reperfusion treatment with Oxyglobin did not improve the percentage of flap survival, or the degree of severity of necrosis in rat groin flaps subjected to 9 h of ischemia.
Journal of Investigative Surgery 19(5):299-305. · 1.09 Impact Factor
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ABSTRACT: To develop and assess the survival of a microvascular cutaneous free flap based on the ventral branch of the deep circumflex iliac (DCI) artery and vein in cats.
Experimental study.
Phase 1: 6 feline cadavers; Phase 2: 2 adult cats; Phase 3: 10 adult cats.
Phase 1: Selective angiographic study of the deep circumflex iliac artery was completed in 6 feline cadavers. After injection of the DCI artery with barium, high-detail radiographs were made of skin flaps harvested from the lateral flank and thigh region. The extent of the cutaneous angiosome was mapped with regard to the underlying anatomical landmarks. Phase 2: An island flap based on anatomic boundaries of the DCI angiosome derived from phase 1 of the study was elevated in 2 cats. Flaps were observed for 3 weeks for survival. Phase 3: Free skin flaps based on the DCI vessels were harvested in 10 cats and transferred to the dorsal interscapular region. Flaps were evaluated for 2 weeks for survival. Tissue samples were collected for histopathology, and angiograms of the flaps were completed.
Phase 1: Angiograms revealed a large primary cutaneous angiosome of the DCI artery located over the lateral femoral region, which extended from the iliac crest to the level of the patella. Phase 2: All island flaps survived for 3 weeks. Phase 3: Six free flaps survived for 2 weeks, and 4 flaps failed completely. Failure of 1 flap occurred because of avulsion of the venous and arterial anastomosis postoperatively. Another cat had intraoperative hemorrhage, which resulted in anemia and hypovolemia and likely caused the flap to fail. The other 2 flaps that failed had poor perfusion intraoperatively and had the longest ischemia times.
The cutaneous DCI free flap in cats may be clinically useful in reconstruction of large cutaneous wounds. The length of ischemia time for successful cutaneous free flap transfer in the cat may be shorter than in other species.
Large wounds created by trauma or oncologic ablative surgery in cats could be reconstructed with cutaneous microvascular free flap. Additional studies assessing the critical ischemia time of cutaneous flaps in cats and evaluating the use of this flap clinically are needed.
Veterinary Surgery 32(4):341-9. · 1.26 Impact Factor
