Les nerfs du membre pelvien du chien (rapports anatomiques et fonctionnels)

La connaissance des rapports anatomiques et fonctionnels des nerfs du membre pelvien rend leur repérage plus aisé, tout en diminuant le risque de les endommager. Ainsi, après un rappel des principales notions d'anatomie et d'histologie de la fibre et des plexus nerveux, l'auteur étudie le trajet des nerfs du membre pelvien chez le chien en soulignant les rapports anatomiques qu'ils entretiennent avec les éléments les plus visibles (os, muscles, vaisseaux, ligaments...).NANTES-Ecole Nat.Vétérinaire (441092302) / SudocSudocFranceF

Preliminary experience of a modified Maquet technique for repair of cranial cruciate ligament rupture in dogs

SummaryThe modified Maquet technique (MMT) uses the same principle as the tibial tuberosity advancement (TTA) for stabilization of the cranial cruciate ligament-deficient stifle in the dog. In the MMT, the tibial tuberosity is advanced in a similar manner to that used in the TTA, however the means by which the tibial crest is stabilized differs. The plate and fork originally described by Montavon et al. are not used (7). The MMT was first described by Maquet for use on humans it leaves intact a distal bony attachment to the tibial shaft, and the tuberosity is either reinforced or not by a figure-of-eight wire. In this paper, we describe the MMT, and we report the results of our first 20 canine patients with cranial cruciate ligament rupture that were treated by the MMT. Mean clinical bone healing time was 6.8 weeks (range 4 to 12 weeks).The evidence provided by this Clinical Communication suggests that it is technically possible to achieve an advancement of the tibial tuberosity without the need for a plate. The MMT deserves consideration as a primary treatment option for cranial cruciate ligament rupture in dogs, and further evaluation in large clinical studies. Long-term follow-up and force plate analysis would be necessary to compare the MMT to both the TTA and the tibial plateau levelling osteotomy.</jats:p

Recanalisation of a congenital extrahepatic portosystemic shunt previously attenuated with cellophane banding in a cat

Case summary A congenital extrahepatic portosystemic shunt was attenuated with commercial roll cellophane banding in a cat and postoperative liver changes were monitored using CT angiography (CTA). The patient clinically improved after cellophane banding, characterised by resolution of hepatic encephalopathy, weight gain, reference interval (RI) bile acid stimulation tests, as well as CTA-documented increased liver size, increased hepatic vasculature and shunt attenuation. Six months later the cat re-presented with recurrence of clinical signs and increased bile acids. CTA confirmed recanalisation of the shunt. Shunt attenuation was repeated using pure cellophane banding and nearly complete closure of the shunt was later documented by CTA. Seven months later, recanalisation was again documented via CTA and associated with clinical signs and increased bile acids. Complete ligation of the shunt was achieved using a polypropylene ligature and a titanium ligating clip. At long-term follow-up, the cat was clinically well, and bile acids and biochemistry were within the RIs. Relevance and novel information This is the first report of CTA-documented recanalisation of an extrahepatic portosystemic shunt previously attenuated with cellophane banding. Recanalisation should be considered as a differential for recurrence of hepatic encephalopathy following cellophane banding

Caecocolic intussusception associated with a caecal polyp and concurrent hepatocellular carcinoma in a cat

Case summary A 17-year-old female neutered domestic shorthair cat presented for several days of reduced faecal volume and a rectal prolapse. Physical examination revealed a 2 cm rectal prolapse, hepatomegaly and a low body condition score of 3/9. Haematology and biochemistry revealed a mild non-regenerative anaemia (haematocrit 24.5%; reference interval [RI] 30.3–52.3%), a mild mature neutrophilia (16.21 × 10 9 /l; RI 1.48–10.29 × 10 9 /l) and a mild increase in alanine aminotransferase activity (222 IU/l; RI 12–130 IU/l). Abdominal radiographs identified hepatomegaly. The rectal prolapse was reduced under general anaesthesia. Abdominal ultrasound identified a caecocolic intussusception and a large hepatic mass. Thoracic radiographs were unremarkable. Hepatic fine-needle aspirate cytology revealed well-differentiated hepatocytes. A typhlectomy was performed and the quadrate liver lobe, with mass, was resected. Gross examination of the caecum identified a focal polyp; histopathology showed moderate plasmacytic–lymphocytic typhlitis and reactive mucosal-associated lymphoid tissue. The hepatic mass was diagnosed as a well-differentiated hepatocellular carcinoma. Six weeks postoperatively the cat had gained 0.5 kg, had an improved body condition score of 5/9 and resolution of clinical signs. The cat died acutely 1 year later from an unknown cause. Relevance and novel information Caecocolic intussusception is rare in cats and uncommon in dogs. This is the third report in a cat and the first associated with a caecal polyp. As reported in dogs, the outcome following surgery was good. Hepatocellular carcinoma is a rarely reported feline neoplasm, which may have a good prognosis with surgical resection

Colonic malignant peripheral nerve sheath tumour in a cat

Case summary A 14-year-old male neutered domestic mediumhair cat presented with a 4 month history of inappetence and weight loss. Pertinent abnormalities on haematology and biochemistry included a mild microcytic regenerative anaemia (packed cell volume [PCV] 24% [reference interval (RI) 30–45%], mean cell volume 30.8 fl [RI 40–45 fl], absolute reticulocyte count 326.8 × 10 12 ) and increased alkaline phosphatase activity (76 IU/l; RI 300 s [RI 65–119 s]). Abdominal ultrasound identified multiple renal and hepatic nodules. Euthanasia was performed and post-mortem examination confirmed metastasis of the MPNST. Relevance and novel information This report describes the treatment of a metastatic colonic peripheral nerve sheath tumour in a cat. Feline visceral MPNSTs are rare and little is known about prognosis or optimal treatment

Acute adrenal haemorrhage in two cats with aldosterone-secreting adenocarcinomas

Case summary Two 13-year-old domestic shorthair cats were diagnosed with unilateral right adrenocortical carcinomas (ACCs) and primary hyperaldosteronism (PHA). Both had polyuria, polydipsia and weight loss, and developed severe anaemia from an episode of acute adrenal haemorrhage. In one case, this occurred during hospitalisation and treatment of severe muscle weakness with cervical ventroflexion, while the other cat had acute collapse at home. A diagnosis of PHA was confirmed in both cases based on measurement of plasma aldosterone and renin activity. In one case, basal progesterone was also measured and was elevated. On ultrasonography and CT in one case, haemorrhage into the right retroperitoneal space was identified. Unilateral adrenalectomy was performed in both cases and there was no evidence of venous tumoral invasion in either. On histopathology of the excised adrenal glands both were ACCs with tumour necrosis, and one had extensive intratumoral haemorrhage. Both cats were diagnosed with International Renal Interest Society stage 2 or 3 chronic kidney disease postoperatively; one survived for 18 months and the other was well 8 months postoperatively. Relevance and novel information Acute adrenal haemorrhage secondary to adrenal neoplasia has been reported in only one other cat, in which tumour type and function were not specified. Acute adrenal haemorrhage can occur as a consequence of tumour necrosis and rupture and can cause severe hypovolaemia and anaemia in cats with primary hyperaldosteronism

Implantation of Impella CP left ventricular assist device under the guidance of three-dimensional intracardiac echocardiography.

Impella CP is a percutaneously inserted left ventricular assist device indicated for temporary mechanical cardiac support during high risk percutaneous coronary interventions and for cardiogenic shock. The potential application of Impella has become particularly relevant during the current COVID-19 pandemic, for patients with acute severe heart failure complicating viral illness. Standard implantation of the Impella CP is performed under fluoroscopic guidance. Positioning of the Impella CP can be confirmed with transthoracic or transoesophageal echocardiography. We describe an alternative approach to guide intracardiac implantation of the Impella CP using two-dimensional and three-dimensional intracardiac echocardiography. This new technique can be useful in selected groups of patients when fluoroscopy, transthoracic and transoesophageal echocardiography is deemed inapplicable or limited for epidemiological or clinical reasons. Intracardiac three-dimensional echocardiography is a feasible alternative to the traditional techniques for implantation of an Impella CP device but careful consideration must be given to the potential limitations and complications of this technique

Implantation of Impella CP left ventricular assist device under the guidance of three-dimensional intracardiac echocardiography

Impella CP is a percutaneously inserted left ventricular assist device indicated for temporary mechanical cardiac support during high risk percutaneous coronary interventions and for cardiogenic shock. The potential application of Impella has become particularly relevant during the current COVID-19 pandemic, for patients with acute severe heart failure complicating viral illness. Standard implantation of the Impella CP® is performed under fluoroscopic guidance. Positioning of the Impella CP® can be confirmed with transthoracic or transoesophageal echocardiography. We conducted translational study in ovine model describing an alternative approach to guide implantation of the Impella CP® using two-dimensional and three-dimensional intracardiac echocardiography. This new technique can be useful in selected groups of patients when fluoroscopy, transthoracic and transoesophageal echocardiography is deemed inapplicable or limited for epidemiological or clinical reasons. Intracardiac three-dimensional echocardiography is a feasible alternative to the traditional techniques for implantation of an Impella device