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Biomedical subjects

Eric Monnet

Publications and source records attributed to Eric Monnet.

At least 19 recordsLinked to original sources

Evaluation of cellophane banding with and without intraoperative attenuation for treatment of congenital extrahepatic portosystemic shunts in dogs.

OBJECTIVE: To evaluate the effect of intraoperative attenuation of congenital extrahepatic portosystemic shunts (CEPSSs) during cellophane banding procedures in dogs. STUDY DESIGN: Retrospective case series and prospective study. ANIMALS: 18 cases evaluated retrospectively and 14 dogs evaluated prospectively. PROCEDURES: Gradual occlusion of CEPSSs was performed via cellophane banding. Shunts were occluded to a diameter < 3.0 mm during surgery in dogs prospectively enrolled in the partial attenuation group, whereas the shunt was not attenuated during surgery in dogs prospectively enrolled in the no-attenuation group or in dogs that had previously undergone surgery and were retrospectively evaluated. Postprandial serum bile acids (PPSBA) concentrations were measured before surgery and at various time points after surgery. RESULTS: Mean +/- SD PPSBA concentrations were 26.8 +/- 24.5 micromol/L at < 2.25 months after surgery (n = 16 dogs), 22.1 +/- 14.0 micromol/L from 2.25 to 6 months after surgery (12 dogs), and 34.9 +/- 32.5 micromol/L at > 6 months after surgery (22 dogs). In the prospectively enrolled dogs, mean PPSBA concentrations increased over time in dogs in the partial attenuation group, but not in dogs in the no-attenuation group. CONCLUSIONS AND CLINICAL RELEVANCE: Cellophane banding may be used to occlude larger CEPSSs and may decrease the need for intraoperative monitoring of portal vein blood pressure. The technique may facilitate minimally invasive treatment of CEPSSs in dogs. Intraoperative attenuation of CEPSSs to a diameter < 3.0 mm is not necessary and may result in a less favorable outcome.

Animals↗

Evaluation of laser Doppler flowmetry for measurement of capillary blood flow in the stomach wall of dogs during gastric dilatation-volvulus.

OBJECTIVES: To validate laser doppler flowmetry (LDF) for measurement of blood flow in the stomach wall of dogs with gastric dilatation-volvulus (GDV). ANIMALS: Six purpose-bred dogs and 24 dogs with naturally occurring GDV. STUDY DESIGN: Experimental and clinical. METHODS: Capillary blood flow in the body of the stomach and pyloric antrum was measured with LDF (tissue perfusion unit (TPU) before and after induction of portal hypertension (PH) and after PH plus gastric ischemia (GI; PH + GI) and compared with flow measured by colored microsphere technique. Capillary flow was measured by LDF in the stomach wall of dogs with GDV. RESULTS: PH and PH+GI induced a significant reduction in blood flow in the body of the stomach (P = .019). A significant positive correlation was present between percent changes in capillary blood flow measured by LDF and colored microspheres after induction of PH + GI in the body of the stomach (r = 0.94, P = .014) and in the pyloric antrum (r = 0.95, P = .049). Capillary blood flow measured in the body of the stomach of 6 dogs that required partial gastrectomy (5.00+/-3.30 TPU) was significantly lower than in dogs that did not (28.00+/-14.40 TPU, P = .013). CONCLUSIONS: LDF can detect variations in blood flow in the stomach wall of dogs. CLINICAL RELEVANCE: LDF may have application for evaluation of stomach wall viability during surgery in dogs with GDV.

Animals↗

Hemodynamic effects of interpleural lidocaine and bupivacaine combination in anesthetized dogs with and without an open pericardium.

OBJECTIVE: To identify dysrhythmias and hemodynamic changes after lidocaine and bupivacaine infusion into the interpleural space with an open pericardium. STUDY DESIGN: Experimental study. ANIMALS: Six adult dogs. METHODS: Systemic arterial pressure and electrocardiogram were recorded. A 7.5 Fr Swan-Ganz catheter was advanced to the level of the main pulmonary artery to record pulmonary arterial pressure. Cardiac output was measured by a thermodilution technique. A pericardial window (PW) was performed in 3 dogs using thoracoscopy. Hemodynamic variables were recorded before and 15 minutes after injection of lidocaine (1.5 mg/kg) and bupivacaine (1.5 mg/kg) into the pleural space in the control group and in the pericardial space for the PW group. A randomized-block ANOVA for repeated measures was used to evaluate the effect of local anesthetic administration on hemodynamic and electrophysiologic variables in dogs with a pericardectomy. RESULTS: Each dog maintained sinus rhythm. Infusion of local anesthetic induced a significant increase in right ventricular diastolic pressure (P = .002) and a significant decrease in stroke volume (P = .047) in both groups; however, the effects were not significantly different between groups. CONCLUSIONS: Infusion of lidocaine and bupivacaine, either intrapleural or in the pericardial space, had a mild detrimental effect on cardiac output. CLINICAL RELEVANCE: Intrapleural administration of lidocaine and bupivacaine at a therapeutic dose can be used safely in healthy dogs with a pericardectomy.

Anesthesia, General↗

Evaluation of survival rate and prognostic indicators for surgical treatment of left-to-right patent ductus arteriosus in dogs: 52 cases (1995-2003).

OBJECTIVE: To determine factors associated with long-term survival in dogs treated surgically for patent ductus arteriosus (PDA). DESIGN: Retrospective case series. Animals-52 dogs treated surgically for left-to-right shunting PDA. PROCEDURE: Data pertaining to age, breed, sex, body weight, clinical examination findings, type and duration of medical treatment, results of thoracic radiography and echocardiography, and surgical and postoperative complications were collected from records. Follow-up information was obtained from medical records or telephone interviews with owners or referring veterinarians. RESULTS: 22 dogs had mitral valve regurgitation. Mean weight and age were not significantly different between dogs with or without mitral valve regurgitation. Twenty-four (46.2%) dogs had clinical signs related to cardiac insufficiency. Left atrial dilatation was observed in 56.3% of dogs that were radiographed. Sonographic imaging was used to diagnose left atrial dilatation in 23 dogs and left ventricular dilatation in 25 dogs. The 1- and 2-year survival rates were 92% and 87%, respectively. Diagnosis of mitral valve regurgitation before surgery was not associated with the probability of survival. Age, weight, lethargy, preoperative treatment with angiotensin-converting enzyme inhibitors, and right atrial dilatation on radiographs at the time of surgery were negatively associated with probability of survival. CONCLUSIONS AND CLINICAL RELEVANCE: Surgical treatment of PDA was curative in young dogs without clinical signs of heart failure. Surgical correction of PDA should be recommended as early as possible after diagnosis, and mitral valve regurgitation is not a contraindication for surgery.

Animals↗

Use of laparoscopic-assisted jejunostomy for fecal diversion in the management of a rectocutaneous fistula in a dog.

A 2-year-old female Siberian Husky was referred for evaluation of a rectocutaneous fistula of unknown etiology. On evaluation, a rectal tear and an associated perivulvar abscess and draining tract were identified. Several attempts were made to repair the rectocutaneous fistula and associated rectal tear. Primary repair and fascia lata graft repair failed. Successful management was achieved via a laparoscopic-assisted end-on jejunostomy for fecal diversion, and the wound healed readily by second intention. During the period of hospitalization, the dog lost a considerable amount of weight. Particular care should be taken regarding fluid therapy, administration of antimicrobials, and adequate nutrition in patients with rectocutaneous fistulas. Overall, the use of laparoscopic-assisted end-on jejunostomy for fecal diversion in the management of rectocutaneous fistulas in dogs appears to be feasible; end-on or loop jejunostomy may also be an option for the treatment of other diseases of the distal portion of the gastrointestinal tract.

Animals↗

Animal models of heart failure: what is new?

Heart failure is the major cause of mortality in Western countries. Medical treatment of heart failure is associated with 50% survival at 5 years. Experimental models are required to better understand the progression of the disease and elaborate new therapy. Heart transplantation, left ventricular assist devices, artificial hearts, and cardiac bioassist techniques require animal models for testing and optimizing before they are implemented on human patients. The perfect model of heart failure that reproduces every aspect of the natural disease does not exist. Acute and chronic heart failure models have been developed to reproduce different aspect of the pathology.

Animals↗

Effect of protein concentration on rate of closure of ameroid constrictors in vitro.

OBJECTIVE: To evaluate the effect of protein concentration on rate of closure of ameroid constrictors in vitro. SAMPLE POPULATION: Twenty-four 3.5-mm ameroid constrictors. PROCEDURE: Ameroid constrictors were equally allocated into 4 treatment groups; constrictors were placed in saline (0.9% NaCl) solution (control) or plasma diluted with saline solution to obtain protein concentrations of 1.5, 3, or 6 g/dL. Ameroid constrictors were incubated for 27 days. A digital camera was used to image ameroid constrictors in culture at 1, 6, 11, 16, 21, and 27 days, and the lumen diameter of each constrictor was measured. RESULTS: None of the rings were completely closed at 27 days. Mean final lumen diameter was 0.205 +/- 0.22 mm. Mean final lumen diameter of constrictors in the control group was significantly larger than that of constrictors in the 1.5, 3, and 6 g/dL groups. Constrictors in the 1.5 g/dL group closed to a larger diameter than that of constrictors in the 6 g/dL group. Constrictors in the control group had the smallest overall change in lumen diameter, compared with constrictors in the 3 and 6 g/dL groups. Constrictors in the 1.5 g/dL group had a significant decrease in overall lumen diameter, compared with constrictors in the 3 and 6 g/dL groups. The diameter of the ameroid lumen was a function of time and protein concentration. CONCLUSIONS AND CLINICAL RELEVANCE: High plasma protein concentrations resulted in rapid closure of the ameroid constrictor lumen. Complete closure of ameroid constrictors may not be attributable to imbibition of casein.

Biocompatible Materials↗

Cardiopulmonary changes induced during one-lung ventilation in anesthetized dogs with a closed thoracic cavity.

OBJECTIVE: To evaluate the effects of one-lung ventilation (OLV) on oxygen delivery (DO2) in anesthetized dogs with a closed thoracic cavity. ANIMALS: 7 clinically normal adult Walker Hound dogs. PROCEDURE: Dogs were anesthetized. Catheters were inserted in a dorsal pedal artery and the pulmonary artery. Dogs were positioned in right lateral recumbency. Data were collected at baseline (Paco2 of 35 to 45 mm Hg), during two-lung ventilation, and 15 minutes after creating OLV. Hemodynamic and respiratory variables were analyzed and calculations performed to obtain DO2, and values were compared among the various time points by use of an ANOVA for repeated measures. RESULTS: OLV induced a significant augmentation of shunt fraction that resulted in a significant reduction in Pao2, arterial oxygen saturation, and arterial oxygen content. Cardiac index was not significantly changed. The net result was that DO2 was not significantly affected by OLV. CONCLUSIONS AND CLINICAL RELEVANCE: Use of OLV in healthy dogs does not induce significant changes in DO2, which is the ultimate variable to use when evaluating tissue oxygenation. One-lung ventilation can be initiated safely in dogs before entering the thoracic cavity during surgery. Additional studies are necessary to evaluate OLV in clinically affected patients and variations in age, body position, and type of anesthetic protocol.

Analysis of Variance↗

Cardiopulmonary effects of positive end-expiratory pressure during one-lung ventilation in anesthetized dogs with a closed thoracic cavity.

OBJECTIVE: To evaluate the effects on oxygen delivery (DO2) of 2.5 and 5 cm H2O of positive end-expiratory pressure (PEEP) applied to the dependent lung during one-lung ventilation (OLV) in anesthetized dogs with a closed thoracic cavity. ANIMALS: 7 clinically normal adult Walker Hound dogs. PROCEDURE: Dogs were anesthetized, and catheters were inserted in a dorsal pedal artery and the pulmonary artery. Dogs were positioned in right lateral recumbency, and data were collected during OLV (baseline), after application of 2.5 cm H2O of PEEP for 15 minutes during OLV, and after application of 5 cm H2O of PEEP for 15 minutes during OLV. Hemodynamic and respiratory variables were analyzed and calculations performed to obtain DO2, and values were compared among the various time points by use of an ANOVA for repeated measures. RESULTS: PEEP induced a significant decrease in shunt fraction that resulted in a significant increase in arterial oxygen saturation. However, it failed to significantly affect arterial oxygen content (CaO2) or cardiac output. Thus, DO2 was not affected in healthy normoxemic dogs as a net result of the application of PEEP. CONCLUSIONS AND CLINICAL RELEVANCE: The use of PEEP during OLV in anesthetized dogs with a closed thoracic cavity did not affect DO2. Use of PEEP during OLV in dogs with a closed thoracic cavity is recommended because it does not affect cardiac output and any gain in CaO2 will be beneficial for DO2 in critically ill patients.

Analysis of Variance↗

Massive hepatocellular carcinoma in dogs: 48 cases (1992-2002).

OBJECTIVE: To determine clinical signs, diagnostic findings, outcome, and prognostic factors in dogs treated surgically for massive hepatocellular carcinoma (HCC) and compare survival times of surgically and conservatively treated dogs. DESIGN: Retrospective study. ANIMALS: 48 dogs. PROCEDURE: Medical records were examined for clinical signs, diagnostic and surgical findings, and postoperative outcome. Dogs were allocated into surgery and nonsurgery groups depending on whether curative-intent liver lobectomy was performed. Data from the surgical and nonsurgical groups were analyzed to identify prognostic factors and determine and compare rates of tumor control and survival time. RESULTS: 42 dogs were treated surgically, and 6 were managed conservatively. In the surgery group, intraoperative mortality rate was 4.8% with no local recurrence, metastatic rate was 4.8%, and median survival time was > 1,460 days (range, 1 to 1,460 days). High alanine aminotransferase and aspartate aminotransferase activities were associated with poor prognosis. Median survival time for the nonsurgery group was 270 days (range, 0 to 415 days), which was significantly less than that of surgically treated dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Liver lobectomy is recommended for dogs with massive HCC because tumor-related mortality rate was 15.4 times higher in dogs in the nonsurgery group, compared with the surgery group. Tumor control was excellent after surgical resection with no local recurrence and a low metastatic rate. Prognostic factors were identified, but their clinical relevance was uncertain because only 9.5% of dogs in the surgery group died as a result of their disease.

Alanine Transaminase↗

Cardiopulmonary effects of thoracoscopy in anesthetized normal dogs.

OBJECTIVE: To evaluate the effect of an open-chest condition on oxygen delivery in anesthetized dogs. STUDY DESIGN: Prospective, controlled experimental study. ANIMALS: Eight clinically normal adult Walker Hound dogs weighing 25.6-29.2 kg. METHODS: Eight anesthetized dogs underwent an open-chest operation after the insertion of thoracoscopy cannulae in the lateral chest walls. A Swan Ganz catheter was used to both measure hemodynamic parameters and obtain mixed venous blood samples for blood gas analysis. A dorsal pedal catheter was placed to both measure arterial blood pressure and obtain blood samples for blood gas analysis. Oxygen delivery index and oxygen extraction ratio were calculated. A randomized block anova for repeated measures was used to evaluate the effect of the treatment on hemodynamic and pulmonary parameters. RESULTS: Creation of an open chest did not significantly affect oxygen delivery index (DO(2)I; p = 0.545). It induced a significant decrease in arterial oxygen partial pressure (PaO(2); p = 0.018) and arterial oxygen content (CaO(2); p = 0.025). It induced a significant increase in shunt fraction (p = 0.023), physiologic dead space (p = 0.015), and alveolar-arterial oxygen difference (p = 0.019). Arterial partial pressure of carbon dioxide (PaCO(2); p = 0.766) and arterial hemoglobin oxygen saturation (SaO(2); p = 0.178) were not significantly affected. Diastolic (DPAP; p = 0.050) and mean (MPAP; p = 0.033) pulmonary arterial pressures were significantly increased by opening the chest. Other hemodynamic parameters were not significantly affected. CONCLUSIONS: Opening the thoracic cavity is not detrimental to hemodynamic function and oxygen delivery in normal dogs, although impaired gas exchange does occur. CLINICAL RELEVANCE: Close monitoring of patients is recommended during open-chest thoracoscopy as adverse effects on gas exchange can contribute to hypoxemia.

Anesthesia, General↗

Effect of sevoflurane on hemodynamic and cardiac energetic parameters in ferrets.

OBJECTIVE: To determine the effect of sevoflurane on cardiac energetic and hemodynamic parameters in ferrets. ANIMALS: 7 healthy domesticated ferrets. PROCEDURE: Sevoflurane was used as the sole anesthetic agent for general anesthesia in ferrets. Standard midline laparotomy and median sternotomy were performed to permit instrumentation. Myocardial blood flow was determined by use of colored microsphere technology. Measurements and blood samples were obtained at 1.25%, 2.5%, and 3.75% expired concentration of sevoflurane. RESULTS: A dose-dependent decrease in arterial blood pressure, left ventricular pressure, systemic vascular resistance, aortic flow, and dp/dt (an index of contractility) was detected as expired concentration of sevoflurane increased. Heart rate, central venous pressure, coronary vascular resistance, myocardial oxygen extraction ratio, and tau (the time constant of relaxation) were unchanged. Cardiac external work decreased, as did myocardial oxygen consumption, causing increased cardiac efficiency at higher concentrations of sevoflurane. CONCLUSIONS AND CLINICAL RELEVANCE: Sevoflurane caused minimal and predictable cardiovascular effects in ferrets without increasing myocardial metabolic demands. Data obtained from this study have not been previously reported for a species that is being commonly used in cardiovascular research. These findings also support use of sevoflurane as a safe inhalant anesthetic in ferrets for clinical and research settings.

Animals↗

Use of positive contrast rhinography and intranasal sinography for diagnosis of a nasofacial sinus tract in a dog.

Twelve days after a dog fight, a 2-year-old sexually intact female Bulldog was evaluated because of subcutaneous emphysema of increasing severity throughout the dogs body. Thoracic radiography revealed severe pneumomediastinum from which free air had extended into the retroperitoneal space, resulting in pneumoperitoneum. Tracheoscopic examination did not reveal a discontinuity of the trachea, pharynx, or larynx. A breach between the nasal cavity and subcutaneous tissues of the nasal region was suspected. Further diagnostic investigations included positive contrast rhinography and intranasal sinography. Via an angiographic catheter inserted into the left naris, positive contrast intranasal sinography revealed a sinus tract extending between the left nasal cavity and the subcutaneous tissue of the dorsal aspect of the nasal planum. Resolution of subcutaneous emphysema, pneumomediastinum, and pneumoretroperitoneum began 1 day after surgical closure of the intranasal opening of the sinus tract. To the authors' knowledge, this radiographic technique has not been reported.

Animals↗

Laparoscopy.

Laparoscopy is a minimally invasive technique for both diagnostic biopsy and surgical procedures. After the basic technique of laparoscopy is mastered and the appropriate indications are learned, these procedures become an easy and rewarding addition to any small animal veterinary practice.

Animals↗

Gastric dilatation-volvulus syndrome in dogs.

Gastric dilatation-volvulus is a medical and surgical emergency that principally affects large-breed dogs. Surgical treatment should be undertaken as soon as the patient has been stabilized with fluid therapy and decompression. A gastrectomy might be required if the stomach is becoming necrotic. A gastropexy is required to prevent recurrence.

Animals↗

In vitro evaluation of the distribution of blood flow within a canine bipedicled latissimus dorsi muscle flap.

OBJECTIVE: To identify the predominant perforating artery in the canine latissimus dorsi muscle and demonstrate that perfusion of the predominant perforating artery improves blood flow in segments of the latissimus dorsi muscle that are located distally from the thoracodorsal artery. SAMPLE POPULATION: Latissimus dorsi muscles dissected from 7 dogs. PROCEDURES: Colored microspheres were used to determine the degree of perfusion of the latissimus dorsi muscle via the thoracodorsal artery, predominant perforating artery, or the thoracodorsal artery and predominant perforating artery together. The latissimus dorsi muscle was divided into 4 proximal to distal segments relative to the thoracodorsal artery (segments A, B, C, and D, respectively). RESULTS: The perforating artery, located at the level of the fifth intercostal space, predominantly supplied perfusion to segments B, C, and D. The number of microspheres received by segment C was significantly higher when the thoracodorsal artery and perforating artery were used for muscle perfusion (181.40 +/- 44.90 microspheres/300 g of tissue for every 3,000 spheres injected), compared with use of the thoracodorsal artery alone (60.00 +/- 13.70 microspheres/300 g of tissue for every 3,000 spheres injected). CONCLUSIONS AND CLINICAL RELEVANCE: Blood flow via the predominant perforating artery improves perfusion to the middle part of the latissimus dorsi muscle in dogs. A bipedicled latissimus dorsi muscle flap would provide a healthier muscle for cardiac assist in the treatment of dilated cardiomyopathy in dogs.

Animals↗

Effect of one-lung ventilation on oxygen delivery in anesthetized dogs with an open thoracic cavity.

OBJECTIVE: To evaluate effects of one-lung ventilation on oxygen delivery in anesthetized dogs with an open thoracic cavity. ANIMALS: 8 clinically normal adult Walker Hound dogs. PROCEDURE: Each dog was anesthetized and subjected to one-lung ventilation during a period when it had an open thoracic cavity. A Swan-Ganz catheter was used to measure hemodynamic variables and obtain mixed-venous blood samples. A catheter was inserted in the dorsal pedal artery to measure arterial pressure and obtain arterial blood samples. Oxygen delivery index was calculated and used to assess effects of one-lung ventilation on cardiopulmonary function. Effects on hemodynamic and pulmonary variables were analyzed. RESULTS: One-lung ventilation caused significant decreases in PaO2, arterial oxygen saturation (SaO2), mixed-venous oxygen saturation, and arterial oxygen content (CaO2). One-lung ventilation caused significant increases in PaCO2, physiologic dead space, and alveolar-arterial oxygen difference. Changes in SaO2, CaO2, and PaCO2, although significantly different, were not considered to be of clinical importance. One-lung ventilation induced a significant increase in pulmonary arterial wedge pressure, mean pulmonary artery pressure, and shunt fraction. One-lung ventilation did not have a significant effect on cardiac index, systemic vascular resistance index, pulmonary vascular resistance index, and oxygen delivery index. CONCLUSIONS AND CLINICAL RELEVANCE: One-lung ventilation affected gas exchange and hemodynamic function, although oxygen delivery in clinically normal dogs was not affected during a period with an open thoracic cavity. One-lung ventilation can be used safely in healthy dogs with an open thoracic cavity during surgery.

Anesthesia, Inhalation↗

Medical and surgical treatment of pyothorax in dogs: 26 cases (1991-2001).

OBJECTIVE: To compare outcomes of dogs with pyothorax treated medically versus surgically and to identify prognostic indicators for dogs with pyothorax. DESIGN: Retrospective study. ANIMALS: 26 dogs. PROCEDURE: Medical records were reviewed to obtain information regarding signalment, results of physical and laboratory evaluations at the time of initial examination, results of bacterial culture of pleural fluid, radiographic abnormalities, treatment (surgical vs medical), complications, whether the disease recurred, disease-free interval, survival time, and cause of death. RESULTS: Calculated proportions of dogs free from disease 1 year after treatment were 25 and 78%, respectively, for dogs treated medically and surgically. Treatment was 5.4 times as likely to fail in dogs treated medically as in dogs treated surgically. Two regression models relating treatment group (medical vs surgical) to disease-free interval were found to be significant. The first contained terms for medical treatment and isolation of Actinomyces spp from pleural fluid; the second contained terms for medical treatment and radiographic detection of mediastinal or pulmonary lesions at the time of initial examination. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that surgical treatment is associated with a better outcome than medical treatment in dogs with pyothorax. In addition, surgery should be considered if radiographic evidence of mediastinal or pulmonary lesions is detected or if Actinomyces spp is isolated from the pleural fluid.

Actinomyces↗