Research Review July 2003

Stick injuries are a common nightmare in practice. The main problem is that stick foreign bodies tend to be radioloucent, and so can be hard to localize. Penninck and Mitchell¹ describe the use of ultrasonography to detect ingested and perforated wooden foreign bodies. A wooden foreign body appears as a linear bright interface, and often has associated uniform acoustic shadowing.

            Intestinal foreign bodies are one of the risk factors for leakage following intestinal anastamosis according to a paper by Ralphs et al² . They retrospectively studied the medical records of 90 dogs and 25 cats that underwent intestinal anastomosis. Leakage was identified in 13 of the 90 dogs but none of the cats. Low serum albumin concentrations and preoperative peritonitis were also associated with leakage, and presence of 2 or more of these factors was a high predictor of developing anastomotic leakage.

            Sticking with abdominal surgery, Steelman-Szymeczek et al³ discuss a new technique for prophylactic gastropexy to prevent GDV. A right-sided grid approach was used since it was was less invasive than a ventral midline approach. A pilot study was performed in 25 cadavers which showed comparable tensile strength between a traditional ventral midline approach and the grid approach. The procedure was then performed in 6 client owned dogs. One seroma and some post-operative discomfort was seen. In 5 out of 6 dogs, a stable gastropexy had formed by 4 weeks post-operatively.

            Austin et al⁴ describe another minimally invasive approach to a common procedure. Minimally invasive surgeries reduce pain, incidence of infections and duration of hospital stays. They performed ovariohysterectomies in 9 dogs using laparoscopy and a Harmonic scalpel. One dog developed a seroma, and another an omental hernia which needed repairing. The surgical time ranged from 35 to 100 minutes.

            Controversy exists over whether magnets can help with wound healing. Trostel et al⁵ studied the effects of a pico-tesla electromagnetic field (PTEF) treatment on wound healing in rats. An incision was made in the dorsal aspect of the neck of 64 rats. 32 were left open to heal and 32 were sutured. 16 rats in each group were treated with PTEF, and 16 were controls. The open wounds contracted more quickly in the treated group, the sutured wounds were stronger in the treated group, and histological evidence of healing was seen earlier in the treated group. The authors conclude that PTEF is a safe form of adjuvant treatment for wounds.

            Feline vaccine-associated sarcomas are a well-recognised, albeit rare complication of vaccination. Munday et al⁶ describe the histology of vaccine-site fibrosarcomas in ferrets. 10 fibrosarcomas were examined and seven of them were found to be from vaccination sites, suggesting that vaccination may promote local sarcoma development in ferrets. The authors believe this is the first species other than cats in which vaccination has been reported to be oncogenic.

            Two papers this month will be of interest to veterinary dentists. In the first, Legendre⁷ describes the use of intraoral acrylic splints for maxillofacial fracture repair. The main objective of repair is a return to normal function. Anatomic reduction, restoration of occlusion and stable fixation, together with the avoidance of iatrogenic dental trauma are required for this, and the author finds that this method is useful in these situations. The second paper, by Ruhnau et al⁸ describes the use of a new dental implant system to replace the mandibular first molar dog in an 11 month old working German Shepherd. There were no complications associated with the implant, although a traumatic oral wound 6 months post-operatively did cause some peri-implant osteomyelitis.  Some periodontal inflammation and vertical bone loss were noted 17 months post-implantation.

            A paper by Mikaelian and Wong⁹ describes the characteristics of a type of cutaneous tumour unique to dogs. Previously called a sebaceous carcinoma, they propose that it be renamed a follicular stem cell carcinoma. Features of the carcinoma were consistent with a follicular stem cell origin. In 4 out of 8 dogs available to follow up, metastasis to the local lymph node occurred.

            Hypertension is a common complication of diabetes mellitus in humans, which can lead to problems such as diabetic nephropathy and retinopathy. Sennello et al¹⁰ measured the systolic blood pressure in 14 cats with diabetes mellitus and 19 healthy control cats. They found that none of the diabetic cats had a systolic blood pressure > 180mmHg, nor evidence of proteinuria or hypertensive retinopathy. The results suggested that hypertension does not occur in diabetic cats or only occurs rarely.

            Raila et al¹¹ studied the effects of chronic renal disease on the transport of Vitamin A in the plasma and urine of dogs. They found that dogs with chronic renal disease had higher concentrations of retinol in the plasma and higher retinol:creatinine and retinol binding protein:creatinine ratios in the urine than controls. These dogs also had reduced urinary Tamm-Horsfall protein to creatinine ratios. The authors suggest, that, although this was only a small scale study, the use of urinary retinol binding protein and Tamm-Horsfall protein concentrations may be useful in the follow up monitoring of dogs with chronic renal disease.

            Finally, I would recommend an article by Doig in July’s Australian Veterinary Journal on evidence-based veterinary medicine. The article defines EBM, and discusses why it is useful and how to do it. It also notes that it is thought that medical knowledge grows by 7% per year, and that there is a significant lag between research being published and experts implementing the advice. An effective primary literature search could be conducted in 10 minutes in a clinical environment, and access to these search results led to changes in clinical decision making in 47% of the clinical queries. The author recommends the use of Medline (www.pubmed.org).

1. Penninck & Mitchell 2003, JAVMA; 223: 206

2. Ralphs et al 2003, JAVMA; 223: 73

3. Steelman-Szymeczek et al, JAAHA; 39: 397

4. Austin et al, 2003, JAAHA; 39: 391

5. Trostel et al, 2003, AJVR; 64: 845

6. Munday et al, 2003, Vet Pathol; 40: 288

7. Legendre, 2003, J Vet Dent; 20: 70

8. Ruhnau et al, 2003, J Vet Dent; 20: 84

9. Mikaelian and Wong, 2003, Vet Pathol; 40: 433

10. Sennello et al, 2003, JAVMA; 223: 198

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Last modified: December 08, 2003