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Biomedical subjects

N G Ducharme

Publications and source records attributed to N G Ducharme.

At least 19 recordsLinked to original sources

Surgical repair of atresia jejuni in two calves.

Two Holstein calves with similar histories of not defecating since birth were determined to have atresia jejuni. Resection of the distended blind end of the jejunum and the remaining jejunum and ileum followed by a jejunocecostomy was performed. One calf died 7 months after surgery of unknown causes. The second calf has survived for greater than 1 year, and has maintained a growth rate similar to other calves its age. Atresia jejuni has been reported to be a universally fatal disorder of unknown pathogenesis. It has been postulated that intestinal atresia is caused by palpation of the amniotic vesicle at the time of pregnancy diagnosis, between days 36 and 42 of gestation.

Anastomosis, Surgical

Thoracotomy in adult dairy cattle: 14 cases (1979-1991).

Fourteen cows were subjected to thoracotomy as an aid in the treatment of either septic pericarditis (n = 7) or unilateral pleuritis (fibrous or purulent; n = 7). Thoracic lesions were primary in 4 cows, secondary to traumatic reticuloperitonitis in 9 cows, and secondary to extension of a liver abscess in 1 cow. Thoracotomy was performed on 9 cows under local anesthesia. Surgery was performed on 5 cows under general anesthesia; 2 died during anesthesia, and 2 others were euthanatized. Of the 10 cows allowed to recover from surgery, 4 had pericarditis and 6 had pleuritis. Four cows with pleuritis had thoracic abscesses. All but 1 cow with pericarditis died or were euthanatized, and 5 of the 6 cows with pleuritis were discharged from the hospital. A year after surgery, 1 cow was culled because of infertility, and the other 5 cows were returned to production.

Anesthesia, General

Clinical management and surgical repair of atresia coli in calves: 66 cases (1977-1988).

The medical records of 66 calves with atresia coli were reviewed; 64 calves were examined at the New York State College of Veterinary Medicine, and 2 calves were examined at the New Bolton Center. In each case, the site of the atresia was within the spiral loop of the ascending colon. In 1 of these calves, a segment of jejunum was also atretic. Absence of feces, progressive weakness, and abdominal distension were the most common clinical signs observed. Other congenital abnormalities were detected in 12 (18%) of 66 calves. Of the 66 calves examined, 5 were euthanatized or died on admission, and 61 had an exploratory celiotomy performed. Eight calves were euthanatized or died during the surgery. In the remaining 53 calves, surgical treatment consisted of enterotomy followed by meconium evacuation, resection of the proximal blind end (in 30 calves), and restoration of intestinal continuity. Restoration of intestinal continuity was done either by side-to-side anastomosis of the proximal to distal blind ends (5 calves), or by side-to-side or end-to-side anastomosis of the proximal blind end to the descending colon (48 calves). Of the 66 calves seen, 27 (41%) were discharged from the hospital, and 11 of these reached reproductive age (11 calves were lost to follow-up before they were 2 years old). From the 11 calves reaching reproductive age, 33 calves were born, one of which may have had atresia coli. The owners should anticipate that long-term survivors likely will have loose feces and normal offspring, but may not grow as well as otherwise expected.

Animals

Xanthine oxidase formation during experimental ischemia of the equine small intestine.

We hypothesized that xanthine oxidase plays a role in the postischemic reperfusion injury in the equine small intestine. Under anesthesia, four horses and two ponies underwent ischemic strangulating obstructions of segments of the proximal jejunum, mid-jejunum and ileum. Prior to vascular occlusion, and at 1 h and 2 h of ischemia, full-thickness intestinal biopsies were collected for histopathological evaluation and for determination of combined xanthine dehydrogenase (XDH) plus xanthine oxidase (XO) activity, and XO activity alone. The level of XO activity was expressed in percentage according to the ratio of XO/(XDH + XO). We found a nearly threefold increase in the combined level of XDH plus XO activity from ileum to duodenum (p less than 0.04). However, the preischemic level of % XO activity did not vary significantly (p = 0.61) between segments of jejuno-ileum. Likewise, no significant difference was noted between intestinal segments after ischemia. Therefore, the data from all intestinal segments were pooled for each time and analyzed using Wilcoxon's signed rank test (one-tailed). Compared to the pre-ischemic level of % XO activity (median 27%), the % XO activity increased after 1 h of ischemia (median 37.0%), reaching statistical significance (p = 0.016). There were no statistical differences between the preischemic % XO activity and the % XO activity in non-ischemic bowel at the end of the anesthetic period. During ischemia, % XO activity increased, which lends credence to the importance of xanthine oxidase in previously-documented reperfusion injury in the equine small intestine.

Animals

Third-degree perineal lacerations and rectovestibular fistulae in cattle: 20 cases (1981-1988).

The case records of 20 cows with either a third-degree perineal laceration or rectovestibular fistula were reviewed to ascertain the signalment, history, treatment, and long-term result of treatment. Fifteen cows, including 10 first-calf cows, had third-degree perineal lacerations that occurred at calving. Surgery was done in 14 of 15 cows; 10 of the 14 (71%) remained fertile. The cow that was not treated surgically was culled after 24 months because of infertility. Five cows had a rectovestibular fistula; 4 of these were treated surgically. The cow that did not have surgery healed by second intention and remained fertile, and 3 of the 4 cows in which surgery was performed were fertile. None of the cows that produced calves after the initial injury suffered a perineal laceration at subsequent calvings. Single-stage surgical repair of third-degree perineal laceration or rectovestibular fistula appeared to have a good prognosis for subsequent fertility in cows.

Animals

Treatment of right dorsal ulcerative colitis in a horse.

Excessive administration of phenylbutazone was associated with development of right dorsal ulcerative colitis. The clinical signs of right dorsal colitis include chronic colic and weight loss. The laboratory abnormalities include panhypoproteinemia and a high WBC count in the abdominal fluid. Medical management of the chronic colic and protein-losing enteropathy associated with the ulcerative lesions in the right dorsal colon and surgical bypass of the right dorsal colon did not result in long-term resolution of clinical signs. Resection of the ulcerated right dorsal colon through a right lateral approach at the 16th rib resulted in resolution of intestinal protein loss and colic. The results of this case suggest that surgical resection of the ulcerated right dorsal colon may be the recommended treatment for right dorsal ulcerative colitis.

Anastomosis, Surgical

Surgery of the bovine forestomach compartments.

Surgery of the forestomach compartments is performed in bovine practices for the diagnosis and treatment of many diseases, including traumatic reticuloperitonitis, perireticular abscess, vagal indigestion, and grain overload. Through a left flank laparotomy, the cranial abdomen is first explored by palpation for adhesions or masses. A rumenotomy allows thorough examination of the lumen of the rumen and reticulum. Surgical correction of disease may require emptying of the rumen, removal of a foreign body, or drainage of an abscess into the reticulum. With some abscesses, single aspiration and lavage of the abscess capsule or drainage of the abscess through the body wall, following a ventral celiotomy, is required. If adhesions associated with disease do not affect the innervation of the forestomach, the prognosis for return to functional status within the herd is good. Adhesions involving the medial wall of the reticulum or pericardial and myocardial disease due to extensions of traumatic reticuloperitonitis have a very poor prognosis, and thus slaughter should be considered in affected cases.

Animals

A computer-derived protocol using recursive partitioning to aid in estimating prognosis of horses with abdominal pain in referral hospitals.

In order to determine which variables are useful and accurate in estimating prognosis in horses with abdominal pain, data were analyzed from 231 horses presented at a veterinary teaching hospital. Using multiple stepwise discriminant analysis in a recursive partition model, we obtained a decision protocol that identified survivors and nonsurvivors. The prevalence of survivors was 61% in this population. The sensitivity, specificity, and positive and negative predictive values of this model were 71, 83, 87 and 65%, respectively. This decision protocol was validated by Jackknife classification and also by evaluation with a referral population of 100 horses in which the prevalence of survivors was 83%. This led to sensitivity, specificity, and positive and negative predictive values of 83, 78, 94 and 50%, respectively.

Abdominal Pain

Clinical evaluation of laryngeal sensation in horses.

Sensory innervation of the larynx was examined by tactile stimulation with a blunt biopsy forceps passed through a flexible videoendoscope. Twenty horses with no evidence of laryngeal motor deficit were stimulated on 10 sites by touch with the forceps. Unilateral neurectomies of the internal branch of the left cranial laryngeal nerve were performed on 5 other horses. These horses were stimulated by touch on the same sites preoperatively and up to 1 week postoperatively. In all 25 horses the motor response of the larynx was recorded on videotape and evaluated by 2 observers blind as to treatment and time of evaluation. Normal horses responded to touch by adduction of both arytenoid cartilages, swallowing or both. This response was not altered by sedation with xylazine hydrochloride. Left cranial laryngeal neurectomized horses failed to respond to tactile stimulation of the left side, while adduction of both cartilages, swallowing or both was observed following stimulation on the right side. Laryngeal stimulation by touch with a biopsy forceps was accurate in identifying horses with complete deficits of the internal branch of the cranial laryngeal nerve.

Animals

Surgical treatment of septic pedal osteitis in horses: nine cases (1980-1987).

Over an 8-year period, 9 horses with septic pedal osteitis were admitted to the New York State College of Veterinary Medicine. Septic pedal osteitis was defined by the presence of purulent exudate combined with radiographic evidence of lysis of the distal phalanx. The condition described involved only the distal phalanx, the laminae and hoofwall, and the soft tissues of the sole. Treatment included curettage and removal of the affected portion of the distal phalanx through a ventral approach to the foot, combined with systemic administration of antibodies. Of the 9 horses, 7 returned to soundness and original function within 12 weeks after surgery. During the early postoperative period, 2 horses died from causes unrelated to the surgery or to septic pedal osteitis.

Animals

Factors affecting incisional complication rates associated with colic surgery in horses: 78 cases (1983-1985).

From May 1, 1983 to April 1, 1985, 142 operations were performed on horses with signs of acute abdominal pain (colic), using a ventral midline incision. Seventy-eight horses lived for at least 15 days after surgery or had acute dehiscence and were included in the study. Seventy horses had surgery once, and 8 horses had surgery 2 or more times. Six-month follow-up evaluation was obtained for 66 horses that had 1 surgery and for 6 horses that had multiple surgeries. Incisional complications included drainage (including infection), acute dehiscence, hernia, and suture sinus formation. The effects of preoperative peritoneal fluid presence, enterotomy or resection, suture material and pattern used in the linea alba, type of skin closure and use of a sutured-on stent bandage on the incidence of incisional complications were investigated. The complication of incisional infection rate associated with a near-far-far-near suture pattern vs simple interrupted pattern in the linea alba was the only statistically significant (P less than 0.05) difference observed.

Animals

Failure of omasal transport attributable to perireticular abscess formation in cattle: 29 cases (1980-1986).

During a 7-year period, failure of omasal transport attributable to a perireticular abscess was diagnosed in 29 cows. Affected cattle were examined because of anorexia, hypogalactia, and bilateral abdominal distention. The cows were all female Holsteins, 15 months to 10 years old. The abscess was identified during exploratory celiotomy and rumenotomy or at necropsy. Traumatic reticuloperitonitis was believed to be the cause. Twenty-seven cattle (93%) were treated surgically. The abscess was drained into the reticulum or omasum in 25 cows (86%). Twenty-four cows (83%) survived to the time of discharge from the hospital, and 20 (69%) survived for at least 1 year and became productive members of the herd. This is a better survival rate than that reported for other causes of vagal indigestion.

Abscess

Idiopathic gonitis in heifers: 34 cases (1976-1986).

Acute suppurative arthritis of the stifle joint was diagnosed in 34 Holstein heifers between 1976 and 1986. Only 1 stifle joint was affected in each heifer; however, 1 heifer also had involvement of the contralateral radiocarpal joint. In each heifer, there was marked lameness and synovitis characterized by an effusion with high synovial fluid nucleated cell counts and total protein concentration. Seventy-four percent (25/34) of the heifers had radiographic evidence of an osteolytic lesion involving the lateral tibial plateau. Bacteriologic cultures of synovial fluid, synovial membrane, and bone yielded no growth. Eighteen of 23 (78%) affected heifers for which follow-up data was obtained became productive herd members after treatment.

Animals

A computer-derived protocol to aid in selecting medical versus surgical treatment of horses with abdominal pain.

In order to determine which variables are useful in identifying horses with abdominal pain requiring surgery, data were analysed from 219 horses presented at one veterinary teaching hospital. Using multiple stepwise discriminant analysis with a recursive partitioning algorithm, we obtained a decision tree that identifies surgical and non-surgical patients. The prevalence of surgical patients was 79 per cent in this population. The sensitivity, specificity, and positive and negative predictive values of this decision tree were 99 per cent, 55 per cent, 90 per cent and 99 per cent respectively. Compared to the clinical decision, this decision tree yielded more false positives (11 per cent) but almost eliminated false negatives (1 per cent). This decision tree was validated by the jack-knife method and also by evaluation using a new sample in a second veterinary teaching hospital in which the prevalence of surgical patients was 55 per cent. This led to sensitivity, specificity and positive and negative predictive values of 93 per cent, 73 per cent, 81 per cent and 89 per cent respectively.

Abdominal Pain

Attempts to restore abduction of the paralyzed equine arytenoid cartilage. I. Nerve-muscle pedicle transplants.

The purpose of this project was to adapt a surgical technique from humans and dogs to horses in which a portion of an accessory muscle of respiration and its nerve supply is transplanted to a denervated dorsal cricoarytenoid muscle. Anatomical dissections in seven horses revealed two possible donor nerve-pedicle grafts: the omohyoid and the sternothyrohyoid, both innervated by a branch of the first and second cervical nerves. Histochemical evaluations in two ponies of the dorsal cricoarytenoid, omohyoid and sternothyrohyoid muscles revealed similar proportions of fiber types 1 and 2 in all three muscles. Electromyographic studies in these two ponies revealed that the omohyoid and sternothyrohyoid muscles contract synchronously with respirations during forced inspiration under general anesthesia. Based on surgical ease of access, a 1 cm2 portion of the omohyoid muscle at the point of penetration of the second cervical nerve was used as a nerve-muscle pedicle graft in an attempt to reinnervate the left dorsal cricoarytenoid muscle in four ponies. These four ponies (as well as three others which served as controls) had previously undergone left recurrent laryngeal nerve transection. All seven ponies endoscopically showed signs of complete left laryngeal hemiplegia immediately postoperatively. Animals were monitored endoscopically for 30 weeks after surgery. The three control ponies showed no abduction of the arytenoid cartilage. In addition, in these three ponies, histological and histochemical expected changes of muscle fiber atrophy and fibrosis were present in the dorsal cricoarytenoid muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Attempts to restore abduction of the paralyzed equine arytenoid cartilage. II. Nerve implantation (pilot study).

The purpose of this project was to attempt restoration of abduction of a recently experimentally denervated left dorsal cricoarytenoid muscle by implanting a transected nerve-end into the paralyzed muscle. In six ponies the cut end of the second cervical nerve was implanted into a slit made in the left dorsal cricoarytenoid muscle. The nerve end was secured in place with one 5-0 polypropylene suture connecting the epineurium to the epimysium. The left recurrent laryngeal nerve was transected during this procedure. All six ponies showed signs of complete left laryngeal hemiplegia immediately after surgery. Postoperatively all ponies were evaluated qualitatively on a monthly basis by subjective examination for evidence of abduction of the arytenoid cartilages on endoscopy and quantitatively by measurement of the cross sectional area of the left and right half of the rima glottidis. Subjective endoscopic evidence of partial abduction was seen in four of the six ponies six months postoperatively. Measurement of the cross sectional area of the rima glottidis revealed a total loss of 38% of the area immediately postoperatively. There were no significant changes in cross sectional areas of the rima glottidis between the immediate postoperative evaluation to the six months postoperative evaluation. Gross postmortem examination revealed partial dorsal cricoarytenoid muscle atrophy as evidenced by a 24-55% decrease in muscle mass compared to the right dorsal cricoarytenoid muscle. Histopathological studies revealed regions with clusters of large muscle fibers.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Attempts to restore abduction of the paralyzed equine arytenoid cartilage. III. Nerve anastomosis.

The purpose of this project was to attempt restoration of abduction of a recently denervated left dorsal cricoarytenoid muscle in the horse by anastomosing the first cervical nerve to the abductor branch of the left recurrent laryngeal nerve. Ten horses were used in the study. In six horses the left recurrent laryngeal nerve was transected and ligated while the ventral branch of the left first cervical nerve was anastomosed to the abductor branch of the left recurrent laryngeal nerve. The remaining four horses also had the left recurrent laryngeal nerve transected and ligated but had no nerve anastomosis performed. Each horse was evaluated preoperatively, and at one week, three and six months after surgery, by endoscopy and determination of upper airway resistance. The endoscopy was performed with the horses breathing room air and while breathing 10% carbon dioxide. All ten horses showed endoscopic signs of complete laryngeal hemiplegia immediately postoperatively. Starting at three months postoperatively clonic movements of the left arytenoid cartilage were observed in four of the six reinnervated horses but not in the sham operated horses. At the sixth postoperative month five reinnervated horses had clonic movements of the left arytenoid cartilage. The comparison of upper airway resistance measurements before surgery and at one week, three and six months after surgery showed no significant differences in either control or experimental horses. Following euthanasia at six months postoperatively, the left and right dorsal crioarytenoid muscles were compared for evidence of reinnervation. No significant difference in weight was noted in the reinnervated horses but the left dorsal cricoarytenoid muscle weighed less than the control horses.

Anastomosis, Surgical