Erin A. Gibson

Objective: To report on placement and perioperative outcomes associated with one-lung ventilation (OLV) devices utilized in dogs undergoing thoracoscopic surgery. Methods: This multi-institutional retrospective study included dogs undergoing OLV for elective thoracoscopic surgery between January 2013 and December 2023. Patient data, OLV technique, surgical and anesthetic complications, and perioperative blood gases were recorded. Success of OLV was defined as sustained collapse of the intended lung. Complications were graded from 1 (mild) to 5 (death or euthanasia). Results: 93 dogs (47 female, 46 male) were included. The median age was 9.5 years (range, 0.08 to 14.7 years) and median weight was 26.8 kg (range, 2.5 to 62.8 kg). Devices used for OLV included endobronchial blockers (n = 71), double-lumen tubes (15), selective intubation with an endotracheal tube (1), or unspecified (6). One-lung ventilation was successful in 90 dogs. Conversion to an open approach occurred in 23 cases and was secondary to complications of OLV in 4 cases. Grade 2 (moderate) and 3 (severe) hypercapnia were recorded in 62 of 93 dogs and 11 of 93 dogs, respectively. Grade 2 and 3 hypoxemia were recorded in 10 of 93 dogs and 6 of 93 dogs, respectively. Dogs with left bronchus blockade had significantly lower odds of grade 2 hypoxemia compared to dogs with right bronchus blockade. Conclusions: OLV was successful in most cases. Intraoperative hypercapnia and hypoxemia were commonly reported, but rarely led to conversion and typically resolved postoperatively. Clinical Relevance: OLV is a well-tolerated technique in dogs undergoing thoracoscopic procedures with excellent short-term outcomes.

Background: Risk of recurrent lower urinary tract infection and bacterial prostatitis (BP) after prostate artery embolization in dogs diagnosed with concurrent BP and prostatic carcinoma (PC) is unknown. Hypothesis/Objectives: To report short- and long-term outcomes of dogs with PC and BP undergoing prostatic artery embolization (PAE). Animals: Six clients owned dogs with a concurrent diagnoses of BP and PC that subsequently underwent PAE and had a minimum follow-up of 4 months after PAE. Methods: Medical records of 6 dogs diagnosed with PC and BP and treated with PAE were retrospectively reviewed. Physical exams, clinicopathologic and imaging results, procedural details, and short- and long-term outcome data were evaluated. Results: Prostatic carcinoma was diagnosed via imaging findings (6/6), cadet-B-Raf protein (BRAF) testing (3/6), ultrasound-guided aspirates (2/6), and cystoscopic biopsy (1/6). BP was diagnosed based on clinical signs (6/6), imaging (6/6), urinalysis and positive urine culture (6/6), and concurrent positive prostatic wash cultures (2/6). All dogs received antibiotics based on urine culture and sensitivity testing (UCS) for a median of 7 weeks (range 2-13) before PAE. Two dogs had positive UCS at the time of PAE. One dog developed a prostatic abscess and 2/6 had positive UCS after PAE. Median survival was 13 months (4.5-17), and no dog died from infection. Conclusions and clinical importance: Urinary tract infection, BP, or a combination of both occurred in a minority of dogs undergoing PAE in this cohort and were not life-limiting complications. In dogs, concurrent BP and PC should not prevent treatment with PAE.

OBJECTIVE: To determine the prevalence and severity of gastrointestinal mucosal lesions in dogs with intrahepatic portosystemic shunts (IHPSS), and to compare the prevalence and severity of gastrointestinal mucosal lesions in dogs with IHPSS before and after treatment with percutaneous transvenous coil embolization (PTCE) based on capsule endoscopy (CE). METHODS: A prospective clinical trial was performed from June 1, 2020, to March 1, 2022. Ten client-owned dogs diagnosed with IHPSS by use of CT angiography were included. Dogs were administered a capsule endoscopy device prior to and 1 month following PTCE. Outcomes compared before and after PTCE included gastrointestinal mucosal lesions as observed via CE, serum biochemistry changes, and client-reported clinical metrology data. RESULTS: All dogs underwent pre- and postprocedure CE without adverse events. Six and 5 dogs each had gastric and intestinal mucosal lesions on pre-PTCE CE images, whereas 8 and 4 dogs each had gastric and intestinal mucosal lesions after PTCE. Six of 7 dogs with pre-PTCE lesions had post-PTCE lesions, and 3 of 4 dogs without pre-PTCE lesions had post-PTCE lesions. There was no significant difference in mucosal severity scores of gastric or small intestinal segments before PTCE or 1 month after PTCE. There was significant improvement in owner-reported symptom assessment scores 1 month after PTCE compared to before PTCE. CONCLUSIONS: Abnormalities of the gastric and small intestinal mucosal surface were common on the basis of CE images within this population of dogs with IHPSS. Severity of mucosal lesions was not associated with PTCE treatment short-term. CLINICAL RELEVANCE: Dogs with IHPSS prior to and following PTCE may require ongoing management for subclinical gastrointestinal lesions. Further investigation to understand clinical relevance of these lesions is indicated.

Objective: To describe the syndrome of suspected gastroduodenal ulceration/erosion (GUE) in dogs with intrahepatic portosystemic shunts (IHPSS) before and after percutaneous transvenous coil embolization (PTCE). Methods: In a multi-institutional, retrospective case series, medical records from 7 specialty hospitals were reviewed to identify dogs with IHPSS diagnosed with suspected GUE prior to or following PTCE from July 31, 2013, to August 1, 2023. Eleven client-owned dogs were divided into 2 groups based on ulcer grade as determined by the Veterinary Cooperative Oncology Group—Common Terminology Criteria for Adverse Events guidelines for gastric ulceration. Factors were evaluated for association with GUE severity. Results: At the time of GUE diagnosis, the median age and weight of dogs were 20 months (range, 2 to 48 months) and 20.9 kg (range, 6.6 to 36.5 kg). Five and 6 dogs were diagnosed with suspected GUE before and after PTCE, respectively. High- and low-grade suspected GUEs were diagnosed in 6 and 5 dogs, respectively. Common clinical signs included vomiting with or without hematemesis (n = 8), lethargy (7), and inappetence (6). Dogs were receiving omeprazole (n = 2) and a steroid (1) or NSAID (5) at the time of suspected GUE diagnosis. No dogs receiving an NSAID were concurrently being treated with omeprazole. No factors evaluated were significantly associated with increased severity of suspected GUE. Conclusions: Dogs with IHPSS experience GUE despite prophylactic medical management and treatment via PTCE. Clinical Relevance: Cautious use of medications associated with GUE should be considered in dogs with IHPSS. The pathophysiology of GUE in dogs with IHPSS remains incompletely understood.

Urothelial carcinoma (UC) occurs uncommonly in cats and no association has previously been observed with long-term indwelling urinary implants. An 18-year-old male castrated domestic shorthair cat initially was presented for hematuria, leading to the diagnosis of a right-sided ureterolithiasis and severe pyelectasia on ultrasound examination, prompting right-sided subcutaneous ureteral bypass (SUB) device placement. The cat subsequently had intermittent hematuria and dysuria, without ultrasonographic abnormality of the bladder or positive urine culture. Thirteen months later the patient developed refractory lower urinary tract signs, azotemia, a proliferative mass in the region of the cystostomy tube component of the SUB device and evidence of left ureteral obstruction. Cystostomy tube revision and left-sided SUB device placement were performed, as well as a partial cystectomy for removal of the mass. Upon histopathology, the mass was diagnosed as a UC. To our knowledge, UC associated with a long-term indwelling cystostomy catheter component of a SUB device has not been reported in veterinary medicine.

ObjectiveTo report technical feasibility and describe procedural details of a novel single incision minimally invasive approach to the mediastinum in cadaver dogs.Study designCadaveric study.AnimalsLarge breed (25-40 kg) cadaver dogs (n = 10).MethodsThree of 10 cadavers were used for preliminary technique development without data recording. Cadaver specimens underwent pre- and postoperative thoracic computed tomographic scans. Seven dogs were placed in dorsal recumbency and mediastinoscopy was performed via a SILS port placed cranial to the thoracic inlet with CO2 insufflation of the mediastinum at 2-4 mmHg. Retrieval of all CT and visually identified mediastinal lymph nodes (LN) was attempted; endoscopic compartmental and individual LN dissection times and subjective operative challenges were recorded. Procedural success scores for visualization and dissection as well as NASA-task force index scores were recorded per lymph node, per cadaver.ResultsMedian time required for initial approach including SILS placement was 5 min (range 5-10 min). Individual LN retrieval times ranged from 2 to 32 min. Mediastinoscopic retrieval of LNs was most commonly successful for the left tracheobronchial LN (7/7), followed by the right tracheobronchial LN (4/7), the left and right sternal LNs (3/7 each), and the cranial mediastinal LNs (1/7). Post-procedure pleural gas was identified on CT in 4/7 cadavers.ConclusionsMediastinoscopy as reported was feasible in large breed canine cadavers and retrieval or cup biopsy of a variety of lymph nodes is possible from the described approach. Application in living animals and its associated challenges should be further investigated.Clinical significanceMediastinoscopy may provide a novel minimally invasive approach to the evaluation and oncologic staging of the cranial mediastinum in dogs.

Prostate carcinoma is one of the most common cancers worldwide in men, with over 3 million men currently living with prostate carcinoma. In men, routine screening and successful treatment schemes, including radiation, prostatectomy, or hormone therapy, have allowed for high survivability. Dogs are recognized as one of the only mammals to spontaneously develop prostate neoplasia and are an important translational model. Within veterinary medicine, treatment options have historically been limited in efficacy or paired with high morbidity. Recently, less invasive treatment modalities have been investigated in dogs and people and demonstrated promise. Below, current treatment options available in dogs and people are reviewed, as well as a discussion of current and future trends within interventional treatment for canine PC.

A 6-year-old neutered male German shepherd dog was evaluated for obtundation, blindness, and bilateral exophthalmos. A magnetic resonance imaging scan of the brain was performed and identified an arteriovenous malformation (AVM) with several feeding arterial branches, and venous drainage through the cavernous sinus. Venous vessels rostral to the AVM were severely distended and extended into the retrobulbar spaces. Liquid embolization by injection of ethylene vinyl alcohol copolymer was performed from access points in the maxillary arteries and internal carotid arteries. No intraprocedural complications were encountered, and the dog was discharged the next day. Bilateral enucleation eventually was performed because of exposure keratopathy. At 31 months post-embolization, owners reported that the dog was doing very well clinically with high activity level and normal appetite, and the dog also appeared to be pain free. Although intracranial AVMs are very rare in companion animals, successful treatment using liquid embolization is possible and should be considered.

OBJECTIVE: To report the fluoroscopic removal or repositioning of urinary tract implants in dogs and cats by use of an endovascular snare system (ESS) and to report procedural usefulness and complications in dogs and cats. ANIMALS: 3 cats and 14 dogs. PROCEDURES: A medical records review was performed to identify dogs and cats that underwent removal or repositioning of urinary tract foreign bodies or implants by use of an ESS with fluoroscopic guidance at a veterinary teaching hospital from 2013 to 2019. RESULTS: Dogs had a median weight of 25 kg (55 lb) with a range of 3.5 to 60.6 kg (7.7 to 133.3 lb), and cats had a median weight of 5 kg (11 lb) with a range of 4.2 to 5.4 kg (9.2 to 11.9 lb). By use of an ESS, 12 patients (2 cats and 10 dogs) underwent transurethral retrieval of retained vesicourethral implants or ureteral stents, 2 dogs underwent transurethral ureteral stent repositioning, 1 cat and 2 dogs underwent transnephric retrieval of ureteral stents, and 1 dog underwent cystoscopic-assisted transureteral ureteral stent retrieval. All procedures were successfully performed, and there were no associated procedural complications. CONCLUSIONS AND CLINICAL RELEVANCE: Retained vesicourethral implants or ureteral stents were successfully retrieved by use of an ESS in dogs and cats transurethrally or with an open or percutaneous transnephric approach and fluoroscopic guidance. These techniques should be considered as an alternative or adjunct to more invasive methods for implant retrieval or manipulation.