Factors affecting survival to discharge in 53 cats diagnosed with uroabdomen: a single-centre retrospective analysis

Objectives The aim of this study was to assess outcomes in cats diagnosed with uroabdomen at a single referral centre. Methods Fifty-three cats diagnosed with uroabdomen at a veterinary teaching hospital were identified between June 2003 and September 2016. Data collected included signalment, presenting signs, aetiology, location of rupture, presence of concurrent injury, outcome of urine culture, presence of uroliths and packed cell volume (PCV)/creatinine/potassium levels at presentation. Cats managed medically and surgically were included, and the use of urinary catheters, cystotomy tubes and abdominal drains were recorded. It was determined if patients survived to discharge or if they were euthanased or died. Results Seventy-four percent (n = 39) of cats survived to discharge. Elevations in creatinine (P = 0.03) were shown to be significantly correlated with survival to discharge. Sex, age, location of rupture, presence of uroliths, outcome of urine culture, presence of concurrent injury, potassium at presentation and PCV at presentation were not associated with survival to discharge. There was no difference in survival between cats that were medically or surgically managed. Conclusions and relevance Cats that develop uroabdomen have a good chance of survival. Electrolyte and biochemistry values should be assessed at the time of presentation, in addition to the presence of concurrent injury

Survival and complications in cats treated with subcutaneous ureteral bypass.

To report the complications and factors affecting outcome for cats following placement of a subcutaneous ureteral bypass (SUB™). In this retrospective study, complications, the presence of a urinary tract infection and survival time were recorded following subctutaneous ureteral bypass placement. Factors affecting survival time were assessed using a Kaplan Meier curve and log rank test. Ninety-five cats had 130 subcutaneous ureteral bypasses placed. Ten cats did not survive to discharge. Forty cats died or were euthanised after discharge (42%); the median survival time of these cats was 530 days (range 7 to 1915). Minor complications occurred in 18 cats (19%) and major complications occurred in 46 cats (48%), the majority of which were after hospital discharge. Twenty-seven cats were diagnosed with a urinary tract infection (UTI) post-operatively. A significant association between long-term survival and creatinine at presentation was identified. The median survival time for cats presenting with creatinine concentration ≥440 μmol/L (International Renal Interest Society stage acute kidney injury (AKI) 4 and 5) was 530 days (95% CI 273-787 days), compared to a median survival time of 949 days (95% CI 655-1243 days; Log Rank P=0.024) for those cats presenting with creatinine <440 μmol/L (International Renal Interest Society stage AKI 1-3). In this population of cats, subcutaneous ureteral bypass placement was associated with an approximately 10% in-hospital mortality and a high complication rate. Most complications were manageable, resulting in an overall median survival time of over 2 years. [Abstract copyright: © 2020 British Small Animal Veterinary Association.

Bicipital Tendinopathy and Carpal Valgus Following a Distant Direct Thoracoabdominal Skin Flap in a German Shepherd with Necrotizing Fasciitis

A 4 mo old German shepherd dog was presented following an acute onset lameness and swelling of the thoracic limb. Clinical signs, surgical findings, and culture results were consistent with a diagnosis of necrotizing fasciitis. Initial management consisted of extensive surgical debridement, wound lavage, and bandaging. Surgical closure was achieved with an axillary fold flap and distant direct single-pedicle thoracoabdominal flap. Three mo later, following deterioration of the lameness that was associated with carpal valgus, carpal subluxation, and tendinopathy of the distal radial insertion of the biceps brachii tendon, a closing wedge pancarpal arthrodesis and tenotomy of the biceps brachii tendon was performed. We hypothesize that extensive soft tissue trauma and subsequent fibrosis and tendon contracture following soft tissue reconstruction contributed to the complications seen. To the authors’ knowledge, this is the first report of carpal valgus deformity and biceps brachii tendinopathy following a distant direct skin flap and axillary skin fold flap

Delayed presentation of a swallowed partial denture

We report a unique case of a young patient who accidentally swallowed his partial denture and alarmingly only presented to our ear, nose and throat (ENT) department 4 weeks later despite several previous presentations to primary and secondary care. The partial denture was successfully removed under general anaesthetic using direct laryngoscopy following admission. He was discharged on a normal diet 6 days later after oesophageal perforation was excluded using a contrast swallow