Use of indocyanine green near-infrared lymphography to detect sentinel lymph nodes in a dog with a malignant insulinoma: a case report

Malignant insulinoma is the most common type of neuroendocrine tumor found in the pancreas of dogs. Canine insulinoma displays malignant behavior with a high rate of metastasis. The most common sites of metastases are the draining lymph nodes, which are also the primary location sites for the recurrence of functional disease. However, identifying metastatic nodes can often be complicated, as the pancreas is drained by numerous lymphatic centers, and clinical enlargement or structural changes may not always be present in metastatic nodes. Additionally, unaltered nodes are frequently small (a few millimeters) and can be hard to distinguish from the surrounding tissues. Therefore, lymphadenectomy is generally recommended for affected dogs. Unlike in human medicine, there are currently no established strategies for lymph node resection in dogs with malignant insulinoma. This report presents a technique for identifying and removing sentinel nodes using indocyanine green and near-infrared lymphography (NIRFL) during surgery. A total of six sentinel nodes were detected and resected with this method. This technique could provide a more structured approach for lymph node resection in affected dogs and potentially in humans in the future. However, its therapeutic benefits must be evaluated in a larger cohort of cases

Near‐infrared fluorescent image‐guided lymph node dissection compared with locoregional lymphadenectomies in dogs with mast cell tumours

Objectives: Near-infrared fluorescent imaging has been described for intraoperative mapping of the draining lymph nodes in human cancer and canine oral tumours. The aim of this study was to retrospectively describe the results of lymphadenectomies in dogs with mast cell tumours treated either by standard unguided locoregional lymph node dissection or near-infrared fluorescent image-guided lymph node dissection. Methods: Medical records between 2012 and 2020 were reviewed for dogs that were presented for surgical resection of mast cell tumours with concurrent lymphadenectomy either with (near-infrared fluorescent image-guided lymph node dissection) or without near-infrared fluorescence image guidance (lymph node dissection). The number and location of lymph nodes planned for surgical dissection and actually dissected nodes, presence of metastases and perioperative complications were recorded. Results: Thirty-five patients underwent near-infrared fluorescent image-guided lymph node dissection, and 43 lymph node dissections. The number of nodes preoperatively planned for resection were 70 and 68, respectively. Fifty-eight of those (83%) were identified during near-infrared fluorescent image-guided lymph node dissection procedures, compared with 50 (74%) during lymph node dissection. near-infrared fluorescent image-guided lymph node dissection resulted in resection of additional fluorescent nodes not corresponding to locoregional nodes in 15 of 35 dogs. Using near-infrared fluorescent image-guided lymph node dissection, we identified at least one metastatic node in 68% of dogs (24 of 35) compared with 33% (14 of 43) when lymph node dissection was used without imaging. No complications related to near-infrared fluorescent imaging were reported. Clinical significance: The present study suggests that near-infrared imaging is a promising technique for intraoperative detection of the draining lymph nodes in dogs with mast cell tumours. Further validation of the technique is required to assess if near-infrared fluorescent imaging can detect the true sentinel lymph node

Assessment of wound bio-burden and prevalence of multi-drug resistant bacteria during open wound management

Objective: To describe the bacterial bio-burden of open-treated wounds and make comparisons with bite wounds. Design: Retrospective multicentre study. Sample: Microbial culture between 2011 and 2013 from open-treated wounds in dogs and cats (initiation of therapy n=88, follow-up n=52) were compared to those from bite wounds (n=184). Procedures: Bacteria were identified and tested for antibiotic susceptibility by two accredited laboratories. Results: In total, 77/88 (88%) of open-treated wounds yielded positive bacterial cultures at the beginning of treatment, decreasing to 27/52 (52%) during treatment. Upon initial evaluation, 42/88 (48 %) of open-treated wounds were considered infected with multi-drug-resistant bacteria, with a drop to 22/52 (41%) during therapy. Bite wounds yielded fewer positive cultures 88/184 (48%) with only 11/182 (6%) being affected by multi-drug-resistant bacteria. Bacteria found most commonly in open-treated wounds were Enterococcus subspecies, Escherichia coli, Staphylococcus pseudintermedius and Pseudomonas aeruginosa. Conclusion: The bacterial populations of open-treated wounds differed markedly from the bite wounds. The high incidence of multi-drug-resistant strains in open wounds highlights the need for alternatives to antibiotics

Prospektive Analyse von Risikofaktoren für perioperative Infektionen bei sauberen und sauber-kontaminierten Eingriffen bei Hund und Katze unter besonderer Berücksichtigung des perioperativen und postoperativen Antibiotikaeinsatzes

With every surgical procedure there is a risk of postoperative infection (surgical site infection = SSI). This risk of infection can be influenced by various factors, including perioperative antibiotic prophylaxis. In terms of antibiotic stewardship, antibiotics should only be used if there is a proven benefit for the patient. However, this advantage has not yet been conclusively proven, especially for clean and clean-contaminated surgeries. The aim of our study was to document various relevant influencing factors on the infection rate after clean and clean-contaminated surgeries in dogs and cats. In particular, it was documented to what extent a reduced use of antibiotics affects the infection rate in the context of all influencing factors. Over a period of eleven months, 807 clean and clean-contaminated surgeries in dogs and cats were prospectively analyzed with possible influencing factors (gender, ASA classification, underlying endocrinological diseases, duration of anesthesia, duration of surgery, type of surgery, perioperative antibiotic prophylaxis (POA), duration of hospitalization) affecting the infection rate. After surgery all cases were followed up either 30 or 90 days, if implants were used. The effect of the various factors was evaluated using multivariable logistic regression analysis. SSI was detected in 25/664 clean and 10/143 clean-contaminated surgeries. Longer hospitalization, without antimicrobial prophylaxis, and male animals had a significantly higher risk of SSI. In clean surgeries, SSI occurred in 2,3 % of all cases with POA and 5,3 % without POA. The SSI in clean-contaminated was 3,6 % with POA and 9 % without. This difference resulted mainly from the results of osteosynthesis, gastrointestinal and skin surgeries. However, other types of surgeries, such as castrations, neurological interventions, abdominal and thoracic surgeries, and surgeries in the head and neck region, showed comparable infection rates with and without POA

Lymph node metastasis in feline cutaneous low-grade mast cell tumours

Objectives This retrospective study aimed to determine the incidence of nodal metastatic disease in cats affected by low-grade cutaneous mast cell tumours (MCTs) in our study population. Methods The clinical records of two centres were retrospectively searched for cats with cutaneous MCTs that had undergone lymphadenectomy of enlarged and non-enlarged lymph nodes. All primary tumours were histologically reviewed by two experienced pathologists and graded as high- or low-grade based on the grading system for feline cutaneous MCT. We graded the lymph nodes based on the grading scheme used for canine MCTs and considered HN2 and HN3 nodes to be metastatic. The number of patients with nodal metastasis was calculated. Results We identified 17 cats with cutaneous MCT resection and concurrent lymphadenectomy. All 21 MCTs were graded as low grade and 30 nodes were removed, with 12 being considered early or overtly metastatic (HN2 or HN3, respectively). Based on nodal status, 10/17 (59%) cats were affected by nodal metastasis in our population. Conclusions and relevance In contrast to previous reports, high percentage of cats with cutaneous MCTs in which lymphadenectomy was performed were presented with metastatic lymph nodes. The clinical relevance of this finding and a potential benefit of lymphadenectomy must be determined in future studies

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Assessment of wound bio-burden and prevalence of multi-drug resistant bacteria during open wound management

Objective: To describe the bacterial bio-burden of open-treated wounds and make comparisons with bite wounds. Design: Retrospective multicentre study. Sample: Microbial culture between 2011 and 2013 from open-treated wounds in dogs and cats (initiation of therapy n=88, follow-up n=52) were compared to those from bite wounds (n=184). Procedures: Bacteria were identified and tested for antibiotic susceptibility by two accredited laboratories. Results: In total, 77/88 (88%) of open-treated wounds yielded positive bacterial cultures at the beginning of treatment, decreasing to 27/52 (52%) during treatment. Upon initial evaluation, 42/88 (48 %) of open-treated wounds were considered infected with multi-drug-resistant bacteria, with a drop to 22/52 (41%) during therapy. Bite wounds yielded fewer positive cultures 88/184 (48%) with only 11/182 (6%) being affected by multi-drug-resistant bacteria. Bacteria found most commonly in open-treated wounds were Enterococcus subspecies, Escherichia coli, Staphylococcus pseudintermedius and Pseudomonas aeruginosa. Conclusion: The bacterial populations of open-treated wounds differed markedly from the bite wounds. The high incidence of multi-drug-resistant strains in open wounds highlights the need for alternatives to antibiotics

Case Report: Indocyanine Green-Based Angiography for Real-Time Assessment of Superficial Brachialis Axial Pattern Flap Vascularization in Two Dogs

This case report describes the method and feasibility of near-infrared angiography (NIRA) to improve the surgical procedure of two superficial brachial axial pattern flaps intraoperatively using two camera systems. Two client-owned dogs were treated for tumors on their antebrachia with wide surgical excision. The defects were closed with a superficial brachial flap in both cases. A different NIRA camera system was used for each case to identify the perforator vessel and flap margins accordingly. Case 1 developed a seroma and healed without further complications. Case 2 developed partial flap necrosis, underwent revision surgery, and healed by secondary intent. NIRA proved useful intraoperatively in identifying the perforator vessel and determining flap margins. As these are only two cases, caution should be used in extrapolating the results

In vitro evaluation of the decontamination effect of cold atmospheric argon plasma on selected bacteria frequently encountered in small animal bite injuries

Beneficial effects of cold atmospheric argon plasma (CAAP) on wound healing and its capacity for bacterial decontamination has recently been documented. First, in vivo studies in small animals did not prove any decontamination effect in canine bite wounds. The present study evaluated the overall decontamination effect of CAAP for different bacteria frequently encountered in canine bite wounds with respect to growth phase, initial bacteria concentration and treatment duration. Standard strains of Escherichia (E.) coli, Staphylococcus (S.) pseudintermedius, S. aureus, Streptococcus (S.) canis, Pseudomonas (P.) aeruginosa and Pasteurella multocida were investigated. To evaluate the influence of the bacterial growth phase, each bacterium was incubated for three and eight hours, before CAAP treatment. Three different bacterial concentrations were created per bacterium and growth phase, and were exposed to CAAP for 30 s, 1 min and 2 min. CAAP treatment resulted in acceptable decontamination rates (range 98.9-99.9%) in all bacteria species in vitro; however, differences in susceptibility were detected. Decontamination rate was mainly influenced by initial bacterial concentration and treatment time. Growth phase only influenced decontamination in S. pseudintermedius. Treatment time significantly (P < .05) correlated with the decontamination rate in E. coli, S. canis and S. aureus, with an exposure time of 2 min being most effective. Initial bacterial concentration significantly (P < .05) influenced decontamination in Pasteurella multocida and P. aeruginosa, in which treatment time was not as important. CAAP exerts effective antibacterial activity against the tested bacteria strains in vitro, with species specific effects of treatment time, growth phase and concentration