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OBJECTIVE: To evaluate cardiopulmonary effects of one-lung ventilation (OLV) versus two-lung ventilation (TLV) in closed-chest anesthetized dogs. STUDY DESIGN: Controlled, randomized experiment. ANIMALS: Fourteen, 2- to 7-year-old adult dogs, weighing 23 +/- 6 kg. METHODS: The dogs were anesthetized with acepromazine, morphine, thiopental, and halothane in oxygen, ventilated, and paralyzed with vecuronium. Tidal volume was 10 mL/kg. Respiratory rate was set to maintain end-tidal CO2 (ETCO2) at 40 +/- 2 mm Hg before instrumentation then not changed. The left bronchus of 7 dogs was obstructed with a Univent bronchial blocker (Fuji Systems Corp, Tokyo, Japan). Blood gas analysis and hemodynamic measurements were taken at predetermined intervals for 1 hour in the TLV group and at baseline and following bronchial obstruction in the OLV group. RESULTS: Shunt fraction was not significantly different between groups, but in OLV shunt increased from baseline at 5 minutes. Arterial oxygen (PaO2) decreased after baseline in OLV compared with TLV. Arterial carbon dioxide (PaCO2) increased with OLV and decreased with TLV. In OLV, systemic vascular resistance was variable and decreased compared with TLV. Cardiac index increased over time in both groups but was not affected by treatment. Heart rate, mean arterial pressure, and diastolic arterial pressure increased with OLV compared with TLV but did not change over time. CONCLUSION: This study shows that OLV statistically decreases oxygen tension and transiently increases shunt fraction, but with 100% O2 it appears to be a feasible procedure with minimal cardiopulmonary side effects in healthy dogs. CLINICAL RELEVANCE: OLV is a feasible procedure in anesthetized dogs to better facilitate thoracic procedures such as bronchopleural fistula repair and thoracoscopy.

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OBJECTIVE: To evaluate postoperative pain and morbidity in dogs undergoing open thoracotomy and partial pericardectomy versus thoracoscopic pericardectomy. STUDY DESIGN: Research study in normal dogs. ANIMALS OR SAMPLE POPULATION: Fourteen mixed breed healthy dogs. METHODS: Seven dogs had a partial pericardectomy through a standard left lateral thoracotomy at the fifth intercostal space. The remaining seven dogs underwent selective lung ventilation and thoracoscopic partial pericardectomy. Surgery sites in both groups were bandaged and each dog received a single postoperative dose of morphine (0.2 mg/kg, intramuscularly [i.m.]). Postoperative pain was evaluated using a standard pain score table at 1, 5, 9, 17, 29, and 53 hours after surgery. Dogs receiving a pain score of six or greater received an additional dose of morphine. At each observation point, blood samples were taken to measure blood glucose and plasma cortisol concentrations. Pain scores, blood glucose, and plasma cortisol concentrations were compared between the two groups using two-way ANOVA. RESULTS: Blood glucose concentrations, plasma cortisol concentrations, and pain scores were significantly different between the two groups, with the thoracotomy dogs having higher values at 1, 5, and 9 hours postoperatively. Three of the open thoracotomy dogs required additional analgesia after the initial dose of morphine. In addition, two dogs that underwent open thoracotomy were lame in the left forelimb and two others developed dehiscence of their wounds. CONCLUSIONS AND CLINICAL RELEVANCE: Thoracoscopic partial pericardectomy has several advantages over open partial pericardectomy including decreased postoperative pain, fewer wound complications, and more rapid return to function.

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A dog treated for a pancreatic abscess inadvertently received 1800 ml of hyperosmolar solution within a two hour period. Blood glucose reached 44 mmol/litre and the plasma osmolality was estimated to be more than 334 mOsm/litre. Lipaemia was severe and persisted for several days. The dog developed nausea, vomiting, depression, severe hyperglycaemia, polyuria, glucosuria and hypokalaemia. These symptoms were consistent with a hyperosmolar hyperglycaemic syndrome. Treatment with insulin and intravenous fluid rapidly corrected the hyperglycaemia, electrolyte imbalances and water deficits. The dog recovered and no long-term sequelae were observed.

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Anatomic and experimental evaluation of the feline latissimus dorsi muscle was performed to assess its potential use as a free muscle flap. In the anatomic study, nonselective angiography of the subscapular artery was performed in nine heparinized feline cadavers. The muscle dimensions and vascular anatomy of the dissected latissimus dorsi muscle were recorded. In the experimental study four cats underwent heterotopic transplantation of a partial latissimus dorsi flap, and three cats underwent orthotopic transplantation of a complete latissimus dorsi flap. The mean length and width of the latissimus dorsi muscle was 19.0 and 5.4 cm, respectively. The dominant vascular pedicle was the thoracodorsal artery and vein. The average length and diameter of the thoracodorsal artery was 2.7 cm and 0.6 mm, respectively. Minor vascular pedicles were provided by branches of the intercostal arteries. Numerous choke anastomoses existed between the two pedicle systems. Viability of muscle flaps based on subjective evaluation, angiography, and histopathology, was 66% and 100% in the heterotopic and orthotopic studies, respectively. Flap failure seemed to be caused by both arterial and venous thrombosis. The latissimus dorsi muscle flap met criteria required for application in microvascular reconstruction. The vascular pattern was appropriate and consistent. Donor site morbidity was low, whereas surgical accessibility was high. The muscle satisfied the physical criteria of a free flap. Long-term anastomotic patency and flap viability was shown.

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Cardiopulmonary effects of laparoscopic surgery were investigated in five crossbred dogs (21 +/- 1.9 kg). Premedicated dogs were anesthetized with thiopental and maintained with halothane at 1.5 times minimum alveolar concentration in oxygen. Controlled ventilation maintained partial pressure of end-tidal CO2 at 40 +/- 2 mm Hg. Vecuronium was used for skeletal muscle relaxation. After instrumentation and stabilization, baseline measurements were made of cardiac output (thermodilution technique), mean systemic, mean pulmonary arterial and pulmonary wedge pressures, heart rate, saphenous vein and central venous pressures, and minute ventilation. Baseline arterial and mixed venous blood samples were drawn for analysis of pH, PaO2, PaCO2, PvO2, PvCO2, and bicarbonate concentrations. Systemic and pulmonary vascular resistances, oxygen delivery and consumption, shunt fraction, and dead space ventilation were calculated using standard formulas. Abdominal insufflation using CO2 to a pressure of 15 mm Hg for 180 minutes resulted in significant (P < .05) increases in heart rate (15 to 180 minutes), minute ventilation (75 to 135 minutes), and saphenous vein pressure (15 to 180 minutes), and decreases in pH (60 to 180 minutes) and PaO2 (60 to 180 minutes). For 30 minutes after desufflation, there was a significant decrease in PaO2, and increases in cardiac output, O2 delivery, and heart rate, compared with baseline. There was a significant increase in shunt fraction and decrease in pH at 15 minutes after desufflation only. The changes were within physiologically acceptable limits in these healthy, ventilated dogs.

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Hip dysplasia is a common developmental problem affecting the canine population. Despite extensive research into the condition, many questions remain unanswered and numerous misconceptions are present among the general public. The purpose of this paper is to review the current knowledge on the development of hip dysplasia, factors modifying its development, and current diagnostic techniques.A computerized literature search was conducted for the period of January 1983 to April 1985 using the MEDLINE and CAB databases, and the keywords hip dysplasia, hip, dog, and canine. Other articles,wherever possible original research articles, published before 1983 were also reviewed. Animals affected by hip dysplasia are born with normal hips, but quickly develop subluxation of the femoral head. Degenerative joint disease follows. Hip dysplasia is a complex, inherited, polygenic trait. Selective breeding of only normal dogs with normal littermates, parents, and grandparents is there commended method of reducing the incidence in the general population.Gene expression in affected individuals may be modified by a number of environmental factors. These factors do not cause hip dysplasia, but they alter manifestations of the trait and its severity. Nutrition is a major environmental factor. Excess energy consumption increases the frequency and severity of hip dysplasia in genetically predisposed dogs. Food intake should be regulated to maintain a slender figure with the ribs and dorsal vertebral spines easily palpable, but not visible. Excess dietary calcium and vitamin D contribute to hip dysplasia in genetically predisposed individuals and should be avoided. High dose vitamin C supplementation ingrowing puppies does not prevent hip dysplasia, and this practice should be discontinued. Animals must be 2 years old before they can be certified as normal, but the disease may be diagnosed earlier. Earlier diagnosis of the condition would be very useful for the selection of breeding stock, but palpation techniques and the standard extended view radiographs have unacceptably high rates of error in young puppies. Stress radiography techniques may improve the accuracy of early diagnosis in the future.

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This article discusses the treatment approaches and recommendations for canine hip dysplasia. A search of the literature database MEDLINE (1969-1994) was conducted and relevant journal articles regarding the medical and surgical treatment of hip dysplasia were selected and reviewed. Dysplastic dogs can be divided, for treatment purposes, into those with no or minimal osteoarthrosis, and those with moderate to severe osteoarthrosis. In young animals with joint laxity and pain, but with no or minimal radiographic evidence of osteoarthrosis, the treatment approach is controversial. Conservative management may be effective in the short term, but progressive development of osteoarthrosis occurs and clinical signs may manifest at an older age. Options for surgical treatments in these young dogs include pectineal myectomy, lengthening of the femoral neck, and corrective osteotomies. Corrective osteotomies are advocated to reestablish joint congruency and prevent development of osteoarthrosis. In the mature osteoarthritic dog, effective conservative management depends on the severity of the degenerative joint disease. Proposed surgical treatments for clinically debilitating hip dysplasia include biocompatible osteoconductive/shelf arthroplasty; femoral head and neck excision arthroplasty, with or without muscle sling interposition; and total hip replacement. Although research directly comparing the salvage procedures has not been reported, studies suggest that total hip replacement is more effective in returning large dogs to full functional weight bearing.

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STUDY DESIGN: This study described and compared retroperitoneal and transperitoneal laparoscopic approaches to the lumbar vertebrae in pigs. Technical and perioperative complications were evaluated for each approach. OBJECTIVES: The objective of this study was to develop a laparoscopic approach to the lumbar vertebrae that is associated with minimal technical and perioperative complications. SUMMARY OF BACKGROUND DATA: Laparoscopic techniques have been used extensively in many surgical fields. Recently, thoracoscopy has been used to perform a number of thoracic spinal procedures, including thoracic discectomy, and anterior osteotomy, release, and fusion. To date, there have been no published reports describing laparoscopic approaches to the lumbar vertebrae. METHODS: With all pigs positioned in left lateral recumbency, retroperitoneal and transperitoneal laparoscopic approaches to the lumbar vertebrae were performed in three pigs. Placement of the insufflation needles and trocar ports were determined for each approach. Dissection of the lumbar vertebrae were performed, and the technical and perioperative complications recorded. Radio-opaque markers were placed to identify the dissected lumbar intervertebral disc spaces, and intraoperative fluoroscopy was used to confirm marker placement. Gross anatomic dissections were performed after the pigs were killed. RESULTS: Loss of pneumoretroperitoneum resulted in surgical termination in two of three pigs undergoing retroperitoneal laparoscopic approach to the lumbar vertebrae. In the remaining pig, difficulty was encountered in mobilization of the psoas major muscle from the lumbar vertebrae, and significant bleeding occurred. The transperitoneal approach to the lumbar vertebrae resulted in rapid mobilization of the psoas musculature and exposure of the lumbar vertebral bodies and discs of L1-L6/L7. Intraoperative complications included minimal bleeding and difficulty encountered in mobilization of the renal vascular pedicle. CONCLUSIONS: The retroperitoneal approach was difficult because of the degree of muscle dissection required for exposure of the lumbar vertebrae. Complications associated with the retroperitoneal approach included loss of pneumoretroperitoneum because of entry into the peritoneal cavity, hemorrhage, and limited exposure of the lumbar vertebrae. The transperitoneal approach was easier technically, allowing identification and access to lumbar vertebral bodies and intervertebral discs from L1-L6/L7. Operative complications associated with the transperitoneal laparoscopic approach were minimal.

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The analgesic effects of fentanyl (4 micrograms/kg) and medetomidine (10 micrograms/kg) in 1 mL saline injected epidurally were measured in 15 cats. The response to an electrical cutaneous stimulus from a constant current generator was used as the index of analgesia. The stimulus was applied to a forelimb before epidural injection, and at 15, 30, 60, 90, 120, 180, 240, and 300 minutes post-injection (PI). The hindlimb was tested 5 minutes later. One mL saline only was used to control for volume of injection and saline. Medetomidine significantly increased the pain threshold for the hindlimb at 20 to 245 minutes PI compared with the preinjection level. Fentanyl significantly increased the pain threshold at 20 minutes PI only compared with preinjection levels. Medetomidine significantly increased the pain threshold of the forelimb at 15 to 120 minutes PI compared with the preinjection levels. Fentanyl did not significantly increase the pain threshold of the forelimb. Administration of medetomidine produced emesis in 12 of 15 cats in an average of 6.4 minutes PI (range, 3 to 11 minutes) and mild sedation in all cats. Injection of fentanyl produced no visible side effects in any of the cats.

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The cardiopulmonary effects of fentanyl (4 micrograms/kg) or medetomidine (10 micrograms/kg) in saline injected epidurally were measured for 2 hours in 15 isoflurane (2.4%)-anesthetized cats. One milliliter of saline without drug was used to control for saline and volume of injection. Baseline was taken as preinjection time 0. Medetomidine significantly increased (P < .05) mean arterial blood pressure (MAP) 5 to 20 minutes postinjection (PI) compared with baseline. MAP significantly decreased 30 to 120 minutes PI compared with baseline. Fentanyl significantly decreased MAP 5 to 120 minutes PI compared with baseline. Heart rate and respiratory rates significantly decreased in the medetomidine and fentanyl groups 5 to 120 minutes PI compared with baseline. Arterial pCO2 significantly increased while arterial pH significantly decreased 15 to 120 minutes PI in the fentanyl and medetomidine groups compared with baseline. Blood bicarbonate concentration significantly increased 90 to 120 minutes PI in the medetomidine group compared with baseline.

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Unilateral medial patellar luxation was diagnosed in 10, and bilateral medial patellar luxation in six, large and giant-breed dogs (22 stifles). Lameness occurred in five dogs after trauma or surgery, and 11 dogs had no known predisposing history. The mean age at presentation was 25 months, and the mean time from initial onset of clinical signs to diagnosis was 13 weeks. All traumatic or iatrogenic luxations (five dogs) were unilateral. Luxations presumed to be congenital were unilateral in five dogs and bilateral in six. The grades of medial patellar luxation were I (1 stifle), II (11 stifles), III (9 stifles), and IV (1 stifle). Preoperative function was good (1 dog), fair (9 dogs), and poor (6 dogs). Surgical correction was performed in dogs with grades II, III, and IV luxations (21 stifles). Complications included one wound dehiscence and trochlear wedge migration, one pin loosening, and one persistent lameness caused by lymphoplasmacytic synovitis. Long-term follow-up was available in 13 dogs (18 stifles). Function was judged by owners to be excellent in seven dogs, good in five dogs, and poor in one dog. Surgical treatment of grades II and III luxations yielded good (8 stifles) and excellent (9 stifles) results, while one grade IV luxation had a poor long-term outcome.

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The major direct cutaneous vessels identified in the cat include the omocervical, thoracodorsal, deep circumflex iliac, and caudal superficial epigastric arteries. Axial pattern skin flaps based on the thoracodorsal and caudal superficial epigastric arteries have been developed in cats. Rotation of these flaps as islands allows skin coverage to the carpus and metatarsus, respectively. The thoracodorsal and caudal superficial epigastric flaps provide a practical, one-step option in the reconstruction of large skin defects involving the distal extremities of cats.

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Nonselective angiography, selective angiography, and gross dissection of 15 cadavers were performed to delineate direct cutaneous arteries in the cat. The omocervical, deep circumflex iliac, thoracodorsal, and caudal superficial epigastric arteries were identified by nonselective angiography. Selective angiography and gross dissection allowed assessment of the origin and vascular territories of the thoracodorsal and caudal superficial epigastric arteries. Orthotopic and heterotopic transfers of thoracodorsal and caudal superficial epigastric island flaps were performed on eight cats. All flaps were successful although areas of necrosis at the caudodistal tips were evident in most of the thoracodorsal flaps. The rotated thoracodorsal flaps extended to the carpi. Caudal superficial epigastric flaps enabled coverage to the metatarsus. Seroma formation and partial dehiscence were minor complications.

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