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Biomedical subjects

Eric Monnet

Publications and source records attributed to Eric Monnet.

28 records · Page 2Linked to original sources

Inhibition of intimal hyperplasia using the selective estrogen receptor modulator raloxifene.

HYPOTHESIS: The selective estrogen receptor modulator raloxifene hydrochloride inhibits intimal hyperplasia. DESIGN: Controlled laboratory experiment. SETTING: Experimental animal model. INTERVENTION AND MAIN OUTCOME MEASURES: Forty-three senile female sheep were randomized to sham operation, ovariectomy, or ovariectomy followed by treatment with 17beta-estradiol or raloxifene. Six months after initial operation, we performed necropsy with histological assessment of the aortic bifurcation and bone mineral densitometry and assayed serum lipids. RESULTS: After 6 months, serum triglyceride and total and high-density lipoprotein cholesterol levels were similar among groups and within the reference range. Ovarian ablation alone resulted in intimal hyperplasia, which was attenuated with estradiol and raloxifene therapy. Furthermore, estradiol and raloxifene therapy reversed ovariectomy-induced decreases in bone mineral density measured using spine morphometry. CONCLUSIONS: Raloxifene attenuates ovariectomy-induced aortic intimal hyperplasia independent of serum lipid levels. These data suggest that raloxifene, in addition to its beneficial influence on bone density, has direct, beneficial cardiovascular effects.

Animals↗

Evaluation of splanchnic oxygen extraction ratio as an index of portal vein pressure in dogs.

OBJECTIVE: To determine changes in splanchnic oxygen extraction ratio during experimentally induced portal hypertension in dogs. ANIMALS: 6 clinically normal dogs. PROCEDURE: Standard midline laparotomy and median sternotomy were performed in anesthetized dogs. Baseline measurements of arterial blood pressure, aortic blood flow, portal vein blood flow, and portal vein pressure were acquired, and arterial, venous, and portal vein blood samples were obtained to determine systemic and splanchnic oxygen extraction ratios. The portal vein was gradually occluded until a pressure of 18 cm of H2O was reached; this pressure was maintained for 30 minutes, and measurements and collection of blood samples were repeated. RESULTS: Portal vein blood flow decreased significantly from 457 +/- 136 ml/min before to 266 +/- 83 ml/min after induction of portal hypertension. Oxygen content in the portal vein significantly decreased from 12.3 +/- 1.85 to 8.2 +/- 2.31%, and splanchnic oxygen extraction ratio significantly increased from 15.8 +/- 6.2 to 37.4 +/- 10.9% during portal hypertension. There was a significant inverse correlation between portal vein blood flow and splanchnic oxygen extraction ratio at baseline and during portal hypertension. CONCLUSIONS AND CLINICAL RELEVANCE: An increase in splanchnic oxygen extraction ratio is evident with partial attenuation of the portal vein and the concurrent decrease in portal vein blood flow. Correlation of oxygen extraction ratio with portal vein blood flow may be a more important indicator for determination of an endpoint to prevent congestion and ischemia of the gastrointestinal tract and pancreas during ligation of portosystemic shunts.

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Open peritoneal drainage versus primary closure for the treatment of septic peritonitis in dogs and cats: 42 cases (1993-1999).

OBJECTIVE: To determine survival rates in dogs and cats with septic peritonitis treated with open peritoneal drainage (OPD) versus primary closure (PC) after laparotomy. STUDY DESIGN: Retrospective analysis of medical records from Colorado State University Veterinary Teaching Hospital from 1993 to 1999. SAMPLE POPULATION: Thirty-six dogs and 6 cats with septic peritonitis documented by cytological examination or microbiological culture of abdominal fluid. METHODS: Medical records of dogs and cats with septic peritonitis treated by OPD or PC were reviewed. Age, weight, species, white blood cell (WBC) count, band neutrophil count, platelet count, serum glucose concentration, heart rate, body temperature, duration of hospitalization, and clinical outcome were recorded for each animal. Differences in treatments administered between the OPD and PC groups as well as the underlying cause of septic peritonitis were determined. RESULTS: There was no significant difference in survival between animals in the OPD versus PC groups (P =.26) with an overall survival rate of 71%. White blood cell count, band neutrophil count, platelet count, serum glucose and total bilirubin concentrations, heart rate, age, and weight were not significantly different between groups (P >.05). A significantly greater number of animals in the OPD group received plasma (P =.009), blood (P =.037), and a jejunostomy tube (P =.02) than animals in the PC group. There was a significant difference in the number of days spent in critical care unit with a mean of 6.0 +/- 4.1 days for the OPD group and 3.5 +/- 2.3 days for the PC group (P =.02). CONCLUSIONS: Open peritoneal drainage for the management of septic peritonitis in dogs and cats is an acceptable alternative to PC.

Animals↗

Survival and prognostic indicators for dogs with intrahepatic portosystemic shunts: 32 cases (1990-2000).

OBJECTIVE: To determine prognostic indicators for short-term outcome and long-term survival for dogs with intrahepatic portosystemic shunts (IPSS). STUDY DESIGN: Retrospective study. ANIMALS: Thirty-two dogs of various breeds. METHODS: Clinical data extracted from medical records of dogs with IPSS were reviewed and included gender, age at surgery, weight, preoperative packed cell volume (PCV), total plasma protein concentration (TP), albumin (ALB), serum activities of alanine aminotransferase (ALT) and alkaline phosphatase (ALP), preprandial and postprandial bile acid concentrations (pre-BA, post-BA), blood urea nitrogen (BUN), glucose concentration, band neutrophils, per-rectal nuclear scintigraphy shunt fraction, whether an angiogram was performed, shunt location at surgery, whether a partial or complete attenuation of the shunt was performed, rectal temperature at the end of surgery, and duration of surgical procedure. Follow-up was determined from visits to the veterinary teaching hospital or by telephone communications with the owner or referring veterinarian. RESULTS: Median survival time was 35.68 months, and 1- and 2-year probabilities of survival were 60% and 55%, respectively. Body weight, TP, ALB, and BUN were identified as prognostic indicators for short-term outcome. PCV and TP were identified as prognostic indicators for long-term survival. CONCLUSIONS: PCV and TP were identified as prognostic indicators for long-term survival, whereas body weight, TP, ALB, and BUN were identified as indicators for short-term outcome in dogs with IPSS. Shunt location at surgery did not have any effect on short-term outcome and long-term survival. CLINICAL RELEVANCE: Total protein, ALB, BUN, and PCV can be used to determine prognosis of dogs with intrahepatic shunt.

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Effects of suture tension and surgical approach during unilateral arytenoid lateralization on the rima glottidis in the canine larynx.

OBJECTIVES: To evaluate the effect of abduction suture tension and cricothyroid (CT) joint disarticulation on the area, height, and width of the rima glottidis (RG) during unilateral arytenoid lateralization. STUDY DESIGN: Experimental study. ANIMALS: Nine canine cadaver larynges. METHODS: Left arytenoid lateralization was performed with high or low abduction suture tension. RG area, height, and width were measured by computerized planimetric analysis with the epiglottis in an open and closed position. The experiment was performed with the CT joint intact and disarticulated. The effects of suture tension, CT disarticulation, and their interaction on RG area with the epiglottis closed or open were evaluated by repeated measures analysis of variance (ANOVA). RESULTS: RG area increased by 82% and 129% (P <.0001) with low and high suture tension, respectively. The aperture not covered by the epiglottis in a closed position was 467% larger with high suture tension than with low tension (P <.0001). CT disarticulation had no significant effect on RG geometry with either low or high suture tension (P =.4970). CONCLUSIONS: Low suture tension increased RG area when the epiglottis was in an open position without increasing RG aperture when the epiglottis was closed. Suture tension had a significant effect on RG opening when the epiglottis was closed. CT disarticulation did not modify the geometry of the RG. CLINICAL RELEVANCE: Use of a low-suture tension should be considered during arytenoid lateralization because it has the potential to reduce the risk of aspiration pneumonia.

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Intercostal thoracotomy closure: transcostal sutures as a less painful alternative to circumcostal suture placement.

OBJECTIVE: To determine if transcostal thoracotomy closure resulted in less pain than circumcostal closure. STUDY DESIGN: Experimental cadaver and prospective clinical study. ANIMALS: Two canine cadavers and 13 adult, 22-29 kg dogs. METHODS: Phase 1: In 2 cadavers, 4 suture passage techniques were evaluated to determine the incidence of nerve entrapment in circumcostal intercostal thoracotomy closure. Phase 2: Pain after circumcostal closure (7 dogs) or transcostal closure (6 dogs) of a 4th intercostal space thoracotomy was evaluated by use of pain threshold scores, fentanyl administration rates, heart and respiratory rates, and numerical ratings for behavior. Arterial blood gas analyses were obtained 4 hours postoperatively. Transcostal closure was accomplished by drilling 5-6 small holes in the 5th rib and passing sutures through the holes and around the 4th rib to achieve closure. Pain threshold scores (PTS) were measured by an observer unaware of closure assignment, at 2, 4, 12, and 24 hours after closure by applying slowly increasing pressure to the incision line using a load cell. Rates of fentanyl administration were adjusted based on subjective impressions of dog comfort by a second observer unaware of closure assignment. RESULTS: A 70-100% incidence of nerve entrapment was found for all circumcostal techniques. PTS was higher (P=.045) and fentanyl infusion rates were lower (P=.001) for the transcostal group at 2, 4, 12, and 24 hour postoperatively compared with the circumcostal group. CONCLUSION: There is a high incidence of nerve entrapment using circumcostal closure techniques. A transcostal technique appears to be associated with less pain during the first 24 hours postoperatively. CLINICAL RELEVANCE: Based on lower pain scores, transcostal thoracotomy closure may be preferable to circumcostal closure techniques.

Analgesics, Opioid↗

Transurethral resection in the management of urethral and prostatic neoplasia in 6 dogs.

OBJECTIVE: To assess cystoscopic transurethral resection (TUR) for the palliative management of dogs with neoplastic infiltration of the urethra. STUDY DESIGN: Prospective clinical trial. ANIMALS: Six client-owned dogs. METHODS: Cystoscopic examination and electrosurgical TUR were performed in dogs with urination difficulties caused by prostatic or urethral neoplasia. TUR was performed in a retrograde manner in female dogs and antegrade in male dogs via exploratory celiotomy and ventral cystotomy. Cystoscopic examination was used to determine the extent of neoplastic involvement of the urethra. TUR involved piecemeal removal of neoplastic tissue from the urethral lumen using an electrocautery cutting loop. Hemorrhage was controlled with a cystoscopic cauterized roller-ball. In 2 male dogs, intraoperative radiation therapy (IORT) was used to treat both prostatic neoplasia and the sublumbar lymph node bed. Surgical technique, complications, adjuvant treatment, and outcome were recorded. RESULTS: TUR was performed in 3 male dogs with prostatic carcinoma and 2 female dogs with urethral transitional cell carcinoma (TCC). In 1 female dog, TUR was attempted but not successful because of cystoscope diameter. Iatrogenic urethral perforation occurred during TUR in 3 dogs. In 2 dogs, prolonged exposure to lavage fluid resulted in clinical and biochemical abnormalities consistent with TUR syndrome. Dysuria resolved in 5 dogs within 10 days of TUR. Treatment-related complications included urinary tract infection and tumor seeding. Local tumor progression and metastasis occurred in all dogs. CONCLUSIONS: TUR (in combination with chemotherapy+/-IORT) resulted in rapid palliation of urination difficulties in male dogs with prostatic carcinoma. In female dogs with urethral TCC, however, electrosurgical TUR cannot be recommended because of a high intra- and postoperative complication rate with no improvement in postoperative management compared with historical reports of tube cystostomy. CLINICAL RELEVANCE: TUR is a novel alternative for the palliation of male dogs with prostatic carcinoma. In female dogs with urethral TCC, electrosurgical TUR does not provide any advantages compared with tube cystostomy.

Animals↗

Thoracoscopic lung lobectomy for treatment of lung tumors in dogs.

OBJECTIVE: To report use of thoracoscopic lung lobectomy (TLL) for treatment of lung tumors (LT) in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Nine dogs. METHODS: Dogs that had TLL for tumor removal were included. Using general anesthesia and 1-lung ventilation, TLL was performed using a 30-60 mm endoscopic gastrointestinal anastomosis stapler. If the visual field was obscured, lobe resection was completed via thoracotomy. RESULTS: Metastatic and primary LT were resected by thoracoscopic lobectomy in 9 dogs (6 male, 3 female; mean (+/-SD) weight, 29+/-7 kg; mean age, 10.7+/-1.9 years). Six dogs had a solitary mass and 3 dogs had 2 masses within a single lobe. The left caudal lobe was removed in 3 dogs. In 5 dogs, TLL was used alone whereas conversion to thoracotomy was required in 4 dogs because of poor visibility. There were 7 metastatic LT and 2 primary LT. Mean duration of thoracoscopic surgery was 108.8+/-30.3 minutes compared with 150.75+/-55.4 minutes in dogs requiring conversion to thoracotomy. Mean hospitalization was 3.1+/-1.3 days. CONCLUSION: Provided the visual field is not obscured, TLL can be performed effectively in dogs. CLINICAL RELEVANCE: Dogs with metastatic or primary LTs should be considered for TLL, particularly for small masses positioned away from the hilus in the left caudal lung lobe.

Animals↗

Clinical management of flail chest in dogs and cats: a retrospective study of 24 cases (1989-1999).

Cases of flail chest injury for 24 client-owned companion animals following various traumas were evaluated. Concurrently sustained injuries, initial emergency treatments, and definitive treatment and outcome for regimens that utilize stabilization of the flail segment were compared with cases treated with no stabilization. Flail chest was confirmed in 24 animals: 21 dogs and three cats. There was an even division (12 each) of right and left flail segments. The median number of ribs involved was three (range, two to seven). Flail segment stabilization was performed in nine, and 15 were treated with no stabilization. Statistical analysis using multiple data permutations evaluating all combinations failed to reveal a significant difference in outcome between stabilized and unstabilized cases.

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Closure of median sternotomy in dogs: suture versus wire.

Twenty normal, large-breed dogs underwent median sternotomy. Median sternotomies were closed with 20-gauge orthopedic wire in 10 dogs and no. 2 polybutester in 10 dogs. Closure with suture was faster than with wire (6.7 +/- 1.8 minutes versus 9.1 +/- 1.9 minutes, respectively). Significant differences were not observed in degree of postoperative pain or wound complication rates. Sternotomies closed with wire showed a trend to be more stable and had significantly less displacement on radiographic evaluation at 28 days. All sterna closed with wire examined histopathologically showed evidence of chondral or osteochondral bridging, while sterna closed with suture only showed fibrous union.

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