000011..iinndddd 33 99//2299//22001122 1111::5522::5577 AAMM Small Animal Soft Tissue Surgery Companion DVD-ROM This book is accompanied by a companion DVD with:     • Video clips and slideshows demonstrating soft tissue procedures     • All videos are referenced in the text where you see this logo: Note on access Wiley publishes in a variety of print and electronic formats and by print-on-demand.  some materials included with standard print versions of this book may not be included  in e-books or in print-on-demand. If this book refers to media such as a CD or DVD  that is not included in the version you purchased, you may download this materials at  http://booksupport.wiley.com. For more information about Wiley products, visit www.wiley.com Small Animal Soft Tissue Surgery Edited by Eric Monnet, DVM, PhD, FAHA Diplomate ACVS, ECVS Professor, Small Animal Surgery Colorado State University Colorado A John Wiley & Sons, Inc., Publication This edition first published 2013 © 2013 by John Wiley & Sons, Inc Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s global Scientific,  Technical and Medical business with Blackwell Publishing. 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Library of Congress Cataloging-in-Publication Data Small animal soft tissue surgery / edited by Eric Monnet.     p. ; cm.   Includes bibliographical references and index.   ISBN 978-0-8138-0782-9 (hardcover : alk. paper)  1. Pet medicine.  2. Veterinary surgery.  3. Soft tissue injuries–Surgery.  I. Monnet, Eric.   [DNLM:  1. Soft Tissue Injuries–veterinary.  2. Surgery, Veterinary–methods.  3. Pets–surgery.  SF 914.3]   SF981.S64 2012   636.089′7–dc23 2012005065 A catalogue record for this book is available from the British Library. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may  not be available in electronic books. Cover design by Modern Alchemy LLC Set in 10.5/12.5pt Minion by SPi Publisher Services, Pondicherry, India 1  2013 Contents Preface xiv Signalment  33 Clinical signs  33 Contributors xv Physical examination  34 Clinical pathology  34 Section 1: Endocrine System 1 Differential diagnoses  34 Section editor: James P. Farese Diagnosis  35 Treatment  37 1 Primary Hyperparathyroidism 3 Prognosis  41 Nicholas J. Bacon Feline insulinoma  41 Anatomy  3 References  41 Physiology  3 History and clinical signs  4 5 Adrenal Tumors 43 Diagnosis  5 Pierre Amsellem, Michael Schaer Differential diagnosis  7 and James P. Farese Surgical therapy  8 Adrenocortical adenocarcinoma,  Nonsurgical therapy  12 adrenal adenoma, and adrenocortical  Recurrent/persistent hypercalcemia  12 adenomatous hyperplasia  43 Prognosis  12 Adrenal medullary tumor  References  13 (pheochromocytoma)  48 Aldosteronoma  50 2 Feline Hyperthyroidism 17 Histopathology  55 Marijke E. Peeters Prognosis  56 Clinical features  17 References  57 Biochemical and hematologic effects  of hyperthyroidism  18 Section 2: Hematopoietic System 59 Diagnosis  18 Section editor: William T.N. Culp Treatment  20 6 Surgical Treatment of Prognosis  24 Splenic Disease 61 References  24 William T.N. Culp 3 Canine Thyroid Neoplasia 27 Splenic diseases  61 Marijke E. Peeters Diagnostics  64 Clinical features  28 Management of splenic disease  67 Diagnostic procedures  28 References  69 Treatment  29 Prognosis  30 7 Surgical Treatment of References  30 Thymic Disease 72 William T.N. Culp 4 Canine and Feline Insulinoma 32 Thymic anatomy  72 Floryne O. Buishand and Diagnostics  73 Jolle Kirpensteijn Thymic diseases  75 Pathology  32 Surgical management of thymic disease  77 Pathophysiology  33 References  79 v vi Contents Section 3: Surgery of the Ear 83 Clinical signs  123 Section editor: Jamie R. Bellah Diagnosis  123 Treatment  124 8 Anatomy of the Ear 85 References  124 Jamie R. Bellah Pinna  85 14 Surgery of the Vertical Ear Canal 126 External ear canal  86 Anne Sylvestre Middle ear  88 Lateral ear canal ablation  126 Inner ear  89 Vertical canal resection  129 Innervation of the ear  90 References  131 Blood supply to the ear  91 References  92 15 Total Ear Canal Ablation and Lateral Bulla Osteotomy 132 9 Imaging of the Ear for Daniel D. Smeak Surgical Evaluation 93 John Hathcock Owner education  133 Preoperative work-up  133 Radiology  93 Preoperative antibiotic and  Ultrasonography  94 analgesia regimens  134 Computed tomography  94 Surgical treatment  135 Magnetic resonance imaging  96 Postoperative care  140 References  98 Complications and treatment  141 References  142 10 Surgery of the Pinna 100 Jamie R. Bellah 16 Subtotal Ear Canal Ablation 145 Lacerations  100 Kyle G. Mathews Resection of portions of the pinna  101 Indications  145 Aural hematoma  103 Surgical technique  145 Ear canal separation  105 Outcome  146 References  107 References  148 11 Aural Neoplasia 108 Jamie R. Bellah 17 Surgical Diseases of the Middle Ear 149 Origins, occurrence, and clinical signs  108 Elizabeth M. Hardie Tumors of the canine ear  109 Tumors of the feline ear  111 Polyps  149 Alternative or adjunctive therapy  Cholesteatoma  150 for ear neoplasia  113 Cholesterol granuloma  151 References  114 Neoplasia  152 Surgical recommendations  152 12 Otitis Externa 116 References  155 Robert A. Kennis Section 4: Respiratory Surgery 157 Etiology  116 Section editor: Eric Monnet Diagnosis  117 Indications for surgical treatment  119 18 Cleft Lip and Palate 159 References  120 Yoav Bar-Am Classification  159 13 Feline and Canine Otitis Media 121 Embryology  159 Dawn Logas Causative factors  160 Causes  121 Problems associated with facial clefting  160 Pathogenesis  122 Diagnosis  161 Contents vii Management of cleft lip and palate  161 Palliative tracheal surgery  206 References  166 References  208 19 Brachycephalic Airway Syndrome 167 24 Surgical Diseases of the Lungs 210 Gilles Dupré, Laurent Findji Eric Monnet and Gerhard Oechtering Cyst, bullae, and bleb  210 The brachycephalic syndrome  167 Bronchoesophageal fistulas  211 What is a brachycephalic dog?  167 Consolidated lung lobe and abscess  212 Anatomic and functional changes in  Bronchiectasis  214 the airways of the brachycephalic breeds  168 Lung laceration  214 Pathophysiology of obstructive airway  Lung lobe torsion  215 disease in the brachycephalic dog  171 Neoplasia  216 Gastroesophageal disease  172 Surgery of the lungs  217 Gastrointestinal and respiratory signs:  References  221 a common pathophysiologic pathway  172 Section 5: Peritoneal Cavity 225 Diagnosis  172 Section editor: Lori Ludwig Medical therapy  173 Surgical therapy  174 25 Peritonitis 227 Prognosis  180 Lori Ludwig References  180 Etiology  227 20 Laryngeal Paralysis 184 Pathophysiology  228 Eric Monnet Diagnosis  229 Treatment  233 Etiology  184 Prognosis  239 Clinical findings  185 References  240 Treatment  187 Prognosis  194 26 Hemoperitoneum 243 References  194 Jennifer Prittie and Lori Ludwig 21 Laryngeal Neoplasia 196 Etiology  243 Eric Monnet Diagnosis  243 Emergency treatment  246 Clinical signs  196 Surgical intervention  251 Diagnosis  196 Prognosis  252 Surgical treatment  196 References  253 References  197 27 Pneumoperitoneum 256 22 Devocalization 198 Jennifer Prittie and Lori Ludwig Eric Monnet Etiology  256 Vocal cordectomy: per os  198 Presentation  257 Vocal cordectomy: ventral laryngotomy  Diagnosis  257 (laryngofissure)  198 Sequelae  258 Postoperative care  199 Definitive treatment  258 References  199 Prognosis  259 References  260 23 Tracheal Surgery 200 Catriona M. MacPhail 28 Retroperitoneal Diseases 261 Amelia M. Simpson Tracheal collapse  200 Tracheal obstruction  204 Pathogenesis  261 Tracheal trauma  205 History and clinical signs  262 Tracheal resection and anastomosis  206 Diagnostics  262 viii Contents Treatment  263 Diagnostics  309 Prognosis  263 Esophageal disease  311 References  264 References  317 29 Congenital Abdominal Wall Hernia 265 35 Hiatal Hernia 321 Amelia M. Simpson Ronald Bright Umbilical and ventral midline hernias  265 Anatomy and physiology  321 Inguinal, scrotal, and femoral hernias  267 Pathophysiology  322 References  272 History and clinical signs  323 Diagnosis  324 30 Acquired Abdominal Wall Hernia 273 Treatment  324 Amelia M. Simpson References  327 Traumatic hernias  273 36 Gastroduodenal Ulceration 329 Incisional hernias in abdominal  Tracy L. Hill, B. Duncan X. Lascelles wall closures  276 and Anthony Blikslager References  277 Pathophysiology  329 31 Diaphragmatic and Pathogenesis of gastroduodenal  Peritoneopericardial ulcers in dogs  331 Diaphragmatic Hernias 278 NSAIDs and gastroduodenal ulcers  332 Janet Kovak McClaran Pathogenesis of gastroduodenal  ulceration in cats  333 Diaphragmatic hernia  278 Clinical presentation of dogs and cats  Peritoneopericardial diaphragmatic hernia  283 with gastroduodenal ulceration  333 References  285 Diagnosis of gastroduodenal  32 Perineal Hernias 286 ulceration  334 Carlos Henrique de Mello Souza Treatment of gastroduodenal ulceration  336 and Tony Mann Outcome  338 References  338 Etiology  286 Pathogenesis  287 37 Gastric Dilatation Volvulus 341 Historical findings and clinical signs  288 Eliza M. Mazzaferro and Eric Monnet Diagnosis  288 Treatment  289 Etiology  341 References  295 Pathophysiology  342 Clinical signs  344 Section 6: Gastrointestinal Immediate diagnostics and  Surgery 297 treatment/stabilization  345 Section editor: Catriona M. MacPhail Exploratory laparotomy  350 References  355 33 Disorders of the Salivary Gland 299 Catriona M. MacPhail 38 Focal and Linear Gastrointestinal Anatomy  299 Obstructions 360 Pathophysiology  299 Barbro Nordquist and Specific disorders  300 William T.N. Culp References  303 Pathophysiology  360 Clinical signs and physical  34 Surgical Treatment of Esophageal examination  361 Disease 304 Diagnostics  361 Jeffrey J. Runge and William T.N. Culp Surgical management  364 Surgical principles  304 Summary  371 Surgical technique  305 References  371