P. 250

An Urban Experience
pacemaker. Once closed and warmed, the heart was gently massaged manually for a couple of minutes and then hit with a direct pediatric de brillator. We used 5 to 20J of energy shocks and got a slow and then faster rhythm after the 9th try. The external pacemaker was switched on and put on a 100 bpm rate for the next
12 hours. The surgical closure was uncomplicated and no signi cant bleeding was noted. The patient received slowly iv Protamin (1mg/100IU Heparin) as a Heparin antidote and the heart-lung machine was gradually restricted and then switched off. Two chest drains were put and connected to a sterile active suction. The total machine time was 130 min, the sinus arrest time – 22 min, total surgery time – close to 5 hours. Immediately after the CPB machine was stopped a hemotransfusion with two units of fresh blood was done.
Lucko, 7-month-old shorthair male mix breed cat,
was represented to the clinic with uveitis, alopecia and multiple skin ulcerative wounds, located in the regions of the dorsum, thorax and head. He was treated for few months with antibiotics, ointments and corticosteroids with no success. The skin of the cat was extremely extensible and very fragile. It was very easy for the skin to be torn but with no bleeding at all. The cat had to be handle with gentle touch and care.
The diagnostic work-up included a complete blood count, blood serum biochemistry panel and urinalysis to rule out any internal disease associated with these skin lesions. CBC showed mild leucocytosis (white blood cell count: 19.5 x 10^9, reference range: 5.0 x 10^9 –18.9 x 10^9). In biochemistry analisys the changes were CK – 225 U/L (reference range: 17.00 – 150.20 U/L) and LDH – 427 U/L (reference range: 35.10 – 224.90 U/L).
The dog doesn’t have any important data in medical history.
At the presentation in our clinic:
During the walk dog showed grade one lameness.
At the clinical examination the dog showed normal proprioception but reduced withdraw re ex on right hind limb. During palpation region of gastrocnemius muscle was markedly painful. The rest of neurology and orthopedic examination was in within normal limits.
CT Study
There is a focal dilation of a vascular structure, presumably a vein, caudal to the medial aspect of the right sti e. The vascular dilation/aneurism has a maximal diameter of 7.7 mm and extends over a distance of approximately 4 cm. Contrast  lling of the dilated area is heterogeneous with some areas lacking contrast  lling. The affected vessel is an anastomosis/branch between the caudal branches of the saphenous vein and the caudal proximal femoral vein.
MRI study:
On the right limb at the level of tibial nerve there is a lesion with heterogeneous contrast intake in long contact with blood vessel. The lesion is 3 cm long in diameter.
Lesion at the level of tibial nerve in close contact with saphenous vein and the caudal proximal femoral vein. Heterogeneous contrast intake.
The surgical approach was made from medial side at the level of proximal part of gastrocnemius muscle. The careful identi cation of blood supplies and nerve structure was needed. The healthy proximal and distal part of the nerve was identi ed and the excision with 3 cm margins has been done.
The dog was treated post operatively with antibiotics for 7 days (cephalexin 15mg/kg BID), fentanyl patch for 3 days, carprofen 2 mg/kg BID for 7 days, gabapentin since 3th day 20 days 10mg/kg TID.
Neurological exam has been done after 1,3,6 and 12 months. The only abnormal  nding 6 and 12 months post op was longer ground phase during walk and reduced withdraw re ex.
Punch biopsy of the skin was performed together with dr Rares Capitan and sent for histological investigation in Romania. The histopathologic  ndings were compatible with Feline Cutaneous Asthenia.
A 10 kg BW, 8,5 years old miniature schnauzer was presented at the clinic with owners complain of lameness on right hind limb for last  ve months.
At previous vet the dog was submitted to complete orthopedic, radiography and CT study with no diagnosis after the diagnostic workout. The dog was treated with 20 days of NSAID therapy (carprofen 2mg/kg BID 10 days and the dosage was reduced by half for the next 10 days). There was no improvement so the dog was treated with prednisolone for 20 days SID with again very little improvement.

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