Soft Tissue Surgery

matxillectomy for fibrosarcoma in a dog

Alasdair Hotston Moore — Mon, 06 Feb 2023 22:42:32 GMT

this Labrador had a matxillectomy for FSA. disease free survival of around 7 months

Removal of nasopharyngeal polyp in a cat

Alasdair Hotston Moore — Tue, 16 Nov 2021 13:29:53 GMT

In this film, I demonstrate how to remove a nasopharyngeal polyp in a cat.

Let's Talk About Small Animal Surgery

Arlo Guthrie — Thu, 17 Jun 2021 08:20:19 GMT

The following meeting, generously sponsored by Swann Morton, was held to give general practitioner vets an opportunity to put questions about small animal surgery to Alasdair Hotston Moore FRCVS, in a format where we could share the answers with veterinary colleagues elsewhere in the UK and beyond. Scroll down for a list of the questions and links to them in the timeline.

Swann Morton: A diverse range of Sheffield Made products incorporating the latest sharps safety solutions to protect the welfare of your in-house team. For more information, visit: www.swann-morton.com.

The Questions:

0:00 Introduction
2:02 Laura Dell'Abate: What has changed in time with suture patterns?
10:13 Manuel Vega: If you don’t discontinue the mucosa, can you give NSAIDS in a prophylactic gastropexy? And in a non-complicated GDV?
14:44 Francisco Gomez: I can neuter any female dog with a small 2-3 cm incision. Is there any added value to keyhole spay or is it owners' perception?
23:43 Chukwudi Ekwukoma: What is the future of small animal surgery?
30:15 Kate Murphy: What procedure do you think people view as “simple” or “routine” but actually isn’t really?
34:15 Stephen Butterton: Do you have any tips for insulinomectomy?
38:36 Ana Santos: Do you have any tips to maximize success of palate resection in BOAS surgery? I feel I'm not resecting enough.
47:30 Simon Vogel: How would you say people’s attitude towards surgery varies between continents, with respect to the animal, cost, and family?
51:49 Gabrielle Mitchell: How can you reduce tail lumpectomies/ amputations from breaking down?
55:53 Angie Henderson: Please advise on the best and safest suture pattern you use for git surgery eg: enterotomies. Thank you.
1:01:01 Clare Smith: Do you have any tips for preserving the parathyroid gland during feline thyroidectomy?
1:06:25 Julian Earl: Do you think there is still a case for the use of catgut in veterinary surgery?
08:56 Florin Delureanu: Can we reimplant the parathyroids in a muscle pouch at the surgical site if we remove them unintentionally because we were unable to identify at the time of thyroidectomy and we found them after?

Congenital defect complicating a case of septic peritonitis in a Labrador

David Barker — Thu, 19 Sep 2019 09:00:30 GMT

Pictures show

1 & 2 Images from the intercostal thoracotomy surgery

3, 4 and 5 – Annotated CT scans showing the extent of Sheldon’s conditions

The case

Sheldon, a seven-year-old Labrador, had a history of osteoarthritis and had been receiving nonsteroidal anti-inflammatory drug treatment (NSAID) for four years when he was first referred to us at Paragon Veterinary Referrals.

Investigations by the referring vet identified suspected cardiomegaly and anaemia, after his owners reported him being lethargic, reluctant to go for walks and off his food.

On presentation at Paragon, Sheldon was found to have a small amount of fluid around the heart and in his abdomen which, when tested, revealed septic peritonitis and septic pericardial effusion.

A CT scan was performed, where the omentum was seen within the pericardium, and a diagnosis of a pericardio-peritoneal diaphragmatic hernia (PPDH) was made.

Surgery was recommended as the cause of septic peritonitis in dogs is often due to rupture of the stomach or intestines.

An emergency exploratory coeliotomy was performed, where we identified a ruptured gastroduodenal ulcer, which was biopsied and repaired. The necrotic omentum was resected, and the hernia closed.

One week after surgery, Sheldon re-presented to us with recurrent pericardial effusion. This fluid accumulation causes a problem as pressure builds up in the sac, preventing the heart from working effectively, which can result in ascites and eventually the animal going into heart failure.

We drained this effusion on two occasions but when it happened for a third time, we recommended surgery to remove the sac.

We therefore performed an intercostal thoracotomy and a subtotal pericardiectomy. Sheldon recovered quickly from this and has had no further recurrence of fluid around the heart or chest.

This was a slightly unusual case as PPDH is congenital in cats and dogs. Sheldon has had his since birth with no adverse effects until recently.

Usually dogs recover well without requiring further treatment once the hernia is sealed but this was not the case with Sheldon.

We believe the fluid inflammation was secondary to ongoing inflammation in the pericardium, as there was no evidence of infection or neoplasia on multiple samples.

For more information about Paragon Veterinary Referrals, visit www.paragonreferrals.co.uk.

Surgically managed pythorax in a cat

David Barker — Tue, 30 Apr 2019 09:16:18 GMT

Pictures show:

Cross-section CT scan showing the large abscess next to the heart and below the lung
Full CT scan showing the large abscess next to the heart and liver
Intraoperative image showing the abscess to the left of the incision, with inflamed tissue around the lungs
Tommie the cat recovering after the operation at Paragon Veterinary Referrals

The case

Tommie, an 11-year-old domestic short-haired cat, had a history of weight loss, anorexia and increased respiratory rate when he was first referred to us at Paragon Veterinary Referrals.

He was initially diagnosed with pyothorax by cardiologist Debra Hyman, who managed the condition with chest drains.

Unfortunately, Tommie’s clinical signs returned despite a good initial response to treatment and he was sent for a CT scan.

The scans revealed a series of large abscesses attached to his thoracic viscera, which required urgent surgery, which I carried out with soft tissue specialist Mickey Tivers.

It was the most extensively-affected case of surgically-managed pyothorax I have seen.

The scans showed abscesses in the right caudal and accessory lobes, involving the mediastinum and the pleura. The extent of Tommie's problem was exceptionally severe and the operation was extremely complicated.

Precise and gentle tissue handling was required to prevent inadvertent damage to the heart, lungs and major blood vessels. A midline sternotomy was performed, and the ventral mediastinum was resected.

The abscess was identified in the right hemithorax, traversing from the cupula to the diaphragm. The capsule was resected from the cranial vena cava, cranial and middle lung lobes, the pericardium and diaphragm.

The pleura was partially resected from the thoracic wall. I then performed a right caudal and accessory lung lobectomy, where the accessory lung lobe was adhered to the caudal vena cava.

Superficial damage to the cranial and middle lobes required repair of tears in the parenchyma, and after a thorough lavage, a narrow bore thoracostomy was then placed, and the sternum and skin were closed routinely.

Tommie recovered well from anaesthesia and surgery in Paragon’s cat-specific ward, and was eating normally the same evening. He was discharged a few days later.

For more information on Paragon Veterinary Referrals, visit www.paragonreferrals.co.uk.

Foreign body: An eight inch skewer in nine-year-old Labradoodle

Henry L'Eplattenier — Wed, 09 Jan 2019 13:24:56 GMT

Bessie, a nine-and-a-half-year old Labradoodle, was referred to Southfields Veterinary Specialists to see Internal Medicine Specialist Chris Scudder, as her owners reported she had not been herself for around five months previously.

She had been quieter and eating a bit less than normal, which had, in turn, caused her to lose some weight.

Also, the owner had noticed that she was panting more than normal, as well as drinking and urinating more frequently.

A couple of weeks prior to her visit to Southfields, two lumps had appeared on her chest, one in the front of her chest at the base of her neck, and the other on the left side of her chest.

These lumps did not seem painful. Several diagnostic tests were performed but the most striking finding was seen on the CT scan of Bessie’s chest, where a long straight object could be seen in the lower portion of her chest, causing lots of reaction around it (see CT scan).

Suspecting this could be a foreign body, Bessie was taken to surgery the following day, when I opened her chest bone and removed an eight-inch long kebab stick!

[View:https://www.youtube.com/watch?v=IxtF7jh513I:696:0]

After spending a few days in hospital to recover from her operation, Bessie returned home in good shape and the owners report she is back to her joyful normal self.

The owners have no idea how the stick could have got into Bessie’s chest, but the most likely explanation is that she ate it during a barbecue in the summer and that the stick perforated the oesophagus and migrated into the chest, where it remained lodged.

By Henry L’Eplattenier, Dr. Med. Vet PhD DiplECVS MRCVS
Southfields Veterinary Specialists Clinical Director
RCVS Specialist in Small Animal Surgery
European Specialist in Small Animal Surgery

www.southfields.co.uk

Double intra-hepatic shunt in Jack Russell Terrier

gerard mclauchlan — Mon, 07 Jan 2019 16:45:43 GMT

CT scan showing the double intrahepatic shunt entering the caudal vena cava.
3D reconstruction of the CT scan.
Image of a fluoroscopy that was performed during the procedure – showing the stent placed within the caudal vena cava and multiple platinum coils placed within both shunts.
Teddy after the procedure.

Full news story here.

Fitzpatrick Referrals
www.fitzpatrickreferrals.co.uk

Retropharyngeal polyp

Liz Barton — Sun, 30 Dec 2018 22:50:17 GMT

This cat presented gagging and with dyspnoea. The large polyp came out really easily with a simple tug and pull from this young adult cat. What is the likelihood of regrowth? Does anybody attempt to cauterise the stump?

Liver Cyst

Liz Barton — Sun, 16 Dec 2018 21:16:55 GMT

I scanned this cystic lesion in a severely PUPD stray geriatric Staffie. The only changes on bloods was elevated ALP. It was drinking 6-9 litres/day. The watery fluid that came out of this cystic lesion was acellular. It had other liver masses and a very nodular spleen (hence was PTS'd and this was post mortem). Has anyone seen anything like this before? Benign or otherwise? Related to PUPD???

Nasal Aspergillus

Stephen Ashman — Tue, 27 Nov 2018 09:14:00 GMT

Rhinoscopy image of nasal aspergillus in a dog

This image was first uploaded Dec 5 2010, re-uploaded Nov 26 2018 after site upgrade.

Screw tail surgery

Niall Taylor — Mon, 26 Nov 2018 18:21:50 GMT

An operation to remove a screw tail in a retriever cross. Not as deeply inset as some extreme bulldog cases but completely obscuring the anus and a major problem for the dog. Did extremely well post op.

This image was first uploaded May 21 2012, re-uploaded Nov 26 2018 after site upgrade.

Uterus filled with blood

Aurelijus vet — Mon, 26 Nov 2018 17:42:44 GMT

Bitch 3 years, 3 kg. body weight. After surgery uterus filled with blood and weight 1 kg.

These images were first uploaded Nov 25th 2010, re-uploaded Nov 26 2018 after site upgrade.

Lingual Calcinosis Circumscripta in young GSD

Alex Allen — Mon, 26 Nov 2018 17:29:20 GMT

Pictures 1 & 2: A quirky case from when I was a practising vet!

12mth old male, entire, GSD presented with halitosis and unilateral dental arcade staining. On examination the tongue had infected ulcers oozing a milky substance. Excellent condition otherwise and this time no other lesions detected.

Picture 3. Biopsy confirmed Calcinosis circumscripta and excision of the affected tissue was performed.

Picture 4. Used inverting simple interrupted suture pattern (Gambee) and 4/0 vicryl. Healed very quickly within 7ds. Infection treated with amox/clav uneventfully.

These images were first uploaded Oct 7 2010, re-uploaded Nov 26 2018 after site upgrade.

Tumour

Aurelijus vet — Mon, 26 Nov 2018 14:56:27 GMT

Clinical case. This Doberman pinscher, Female, 11 years, not spayed. I would like to ask colleagues. What do you think about this case? What can be good prognosis?

This image was first uploaded May 7 2010, re-uploaded Nov 26 2018 after site upgrade.

Burns treated with manuka

Arlo Guthrie — Mon, 26 Nov 2018 14:08:25 GMT

Photos shared by Amanda Manley MRCVS. Full story reported here.

Initial examination.
Post debridement / Pre treatment
Post debridement / Post treatment

These images first uploaded Oct 15, 2009, re-uploaded Nov 26 2018 after site upgrade.