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ThesisItem Open Access COMPARATIVE EVALUATION OF STAINLESS STEEL AND TITANIUM LOCKING COMPRESSION PLATES FOR REPAIR OF RADIUS AND ULNA SHAFT FRACTURES IN DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2016-12) HANUMAN SAHEB, R; DHANA LAKSHMI, N(MAJOR); VEENA, P; RAJU, N.K.BABSTRACT: Dogs with unstable radius and ulna shaft fractures which were diagnosed by clinical signs, orthopaedic examination and survey radiography were taken as clinical material for the study. The incidence of breed, age, sex, body weight, etiology and type fracture was studied. Twelve selected cases of unstable radius and ulna shaft fractures were equally divided into two groups and the fractures were stabilized with indigenously made stainless steel Locking Compression Plates along with locking screws (group I) and titanium Locking Compression Plates along with locking screws (group II) following standard AO/ASIF procedures. Selection of appropriate size of plate and screws according to body weight and type of fracture (2.7 mm plate for dogs below 11 kg body weight and 3.5 mm plate for dogs above 11 kg body weight) provided good stability. In both the groups no technical difficulties were observed while application of stainless steel and titanium LCP for radius and ulna shaft fractures. The outcome of fracture stabilization and healing was evaluated with postoperative lameness grading, radiography and biochemical analysis. All animals diagnosed with unstable radius ulna shaft fractures were with grade 4 lameness before surgical management. Post operatively, all cases in both groups showed weight bearing with functional limb usage of grade 0 lameness and good joint mobility after four weeks. Early weight bearing of limb without complications was observed in titanium LCP stabilized cases. Postoperative complications of wound dehiscence and incisional infection were observed in two cases of stainless steel LCP stabilized cases. Postoperatively the radiographical healing time was same for both groups. The fractures showed radiographically excellent post operative healing by cortical union, absence of fracture lines with limited and also bridging callus in an average period of 7-11 weeks in both groups. Statistical analysis revealed a significant difference (P < 0.01) in increase of serum alkaline phosphatase and C-reactive protein values postoperatively in both the groups. The serum alkaline phosphotase and C-reactive protein values significantly increased from 0 day to 14th day and there after reached to normal values by 45th post operative day in both the groups. In conclusion, both stainless steel and titanium LCP were good for stabilization of unstable radius and ulna fractures in dogs for bone healing, however early limb ambulance and excellent clinical outcome without postoperative complications was observed with titanium LCP due to its biocompatibility, high corrosive resistance and lower modulus than stainless steel. Due to these advantageous properties, titanium LCP is preferred for repair of radius and ulna shaft fractures in dogs even though they are slightly expensive than stainless steel LCP.ThesisItem Open Access CLINICAL EVALUATION OF ETOMIDATE AND PROPOFOL ANAESTHESIA FOLLOWING ATROPINE, DIAZEPAM AND FENTANYL PREMEDICATION IN GERIATRIC DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2016-11) HAREESH, A.U; VEENA, P(MAJOR); DHANA LAKSHMI, N; VEERABRAMHAIAH, KABSTRACT: Twelve dogs aged between 7-14 years of either sex presented to the college clinic with surgical conditions like pyometra, urethral calculi, fractures and mammary tumours were utilized to study the effect of etomidate and propofol after premedication with atropine sulphate, diazepam and fentanyl. The animals were divided into two groups of six animals each. Etomidate @ 0.3 mg/kg b.wt was given intravenously in group I dogs. Propofol @ 6 mg/kg b.wt. intravenously was given in group II dogs. Induction quality was excellent, smooth and attained sternal recumbency rapidly without struggling in all animals in both groups.Recovery from anaesthesia is smooth and excitement free in both groups. However, slightly prolonged recovery was a consistent observation in propofol group. No significant difference was noticed in RT, RR, PR and SpO2 values between the groups. Non significant decrease in heart rate was observed in dogs subjected to etomidate anaesthesia. A significant decrease in heart rate was observed in group II dogs subjected to propofol anaesthesia. ECG studies did not reveal any abnormality except increase in amplitude of QRS complex duration in both groups. The haematological parameters like Hb, PCV were differed significantly within the group and between the groups. However, all the fluctuations were within the normal physiological range. Changes in biochemical parameters like AST, ALT and AKP were significant between the groups and were within the normal physiological range in both groups. Etomidate with atropine, diazepam and fentanyl premedication provided better surgical anaesthesia with smooth induction and rapid, safe and smooth recovery in geriatric dogs.ThesisItem Open Access EVALUATION OF PROPOFOL AND KETOFOL ANAESTHESIA FOLLOWING ATROPINE, DIAZEPAM AND FENTANYL PREMEDICATION IN DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2016-10) THEJASREE, P; VEENA, P(MAJOR); DHANA LAKSHMI, N; VEERA BRAMHAIAH, KABSTRACT: Twelve dogs of either sex presented to the college clinic with surgical conditions like pyometra, urethral calculi, fractures and mammary tumours were utilized to study the effect of ketofol and propofol after premedication with atropine sulphate, diazepam and fentanyl. The animals were divided into two groups of six animals each. Ketofol (1:1) combination was given intravenously in group I dogs. Propofol @ 6 mg/kg b.wt. intravenously was given in group II dogs. Induction quality was excellent, smooth and attained sternal recumbency rapidly without struggling in all animals in both groups. Recovery from anaesthesia was smooth and excitement free in both groups. However, slightly prolonged recovery was a consistent observation in propofol group. No significant difference was noticed in RT, RR, PR and SpO2 values between the groups. Non significant increase in HR was recorded in group I dogs. A significant decrease in HR was observed in dogs subjected to propofol anaesthesia. ECG studies did not reveal any abnormality except increase in amplitude of QRS complex duration in both groups. The haematological parameters like Hb, PCV were differed significantly within the group and between the groups. However, all the fluctuations were within the normal physiological range. Changes in biochemical parameters like AST, ALT and ALP were significant between the groups and were within the normal physiological range in both groups. Ketofol with atropine, diazepam and fentanyl premedication provided better surgical anaesthesia with smooth induction and rapid, safe and smooth recovery in dogs.ThesisItem Open Access MANAGEMENT OF LONG BONE DIAPHYSEAL FRACTURES WITH MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS TECHNIQUE USING LOCKING COMPRESSION PLATES IN DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2016-08) RAVI, RAIDURG; DHANA LAKSHMI, N(MAJOR); VASANTH, M.S; SRILATHA, Ch.; RAJU, N.K.BABSTRACT: Twenty four dogs presented to the college hospital (SVVU/KVAFSU) with unstable long bone diaphyseal fractures which were diagnosed by clinical signs, orthopaedic examination and survey radiography were taken as clinical material for the study. The breed, age, sex wise incidence, etiology and type of fracture were studied. The dogs were equally divided into four groups viz; Group I (humerus), Group II (radius and ulna), Group III (femur) and Group IV (tibia and fibula) and the fractures were stabilized with minimally innasive plate osteosynthesis (MIPO) using locking compression plate following standard AO/ASIF procedures. Preoperative plan was prepared using Fracture Patient Assessment Score (FPAS) and following the AO/ASIF procedures. The minimally invasive surgical approach for long bones was successfully implemented in radial and tibial diaphyseal fractures. MIPO was not successful in humeral and femoral diaphyseal fractures and hence alternate Open reduction and internal fixation (ORIF) was used for fracture repair. The outcome of fracture stabilization and healing was evaluated with postoperative lameness grading, radiography, ultrasonography and biochemical analysis. All the animals showed grade V lameness i.e. no weight bearing on limb at rest or while walking before surgery. Animals in group II (Radius Ulna) & group IV (Tibia) which underwent MIPO exhibited early limb usage (grade II lameness by 7th day and grade I lameness by 45th day) as compared to group I (Humerus) and group III (Femur) in which MIPO was unsuccessful (grade III lameness by 28th day and grade II lameness by 60th day). Radiographic healing (grade 1) was noticed in all the cases treated by MIPO of group II (Radius Ulna) and IV (Tibia) with obliterated fracture line and homogenous bone structure (callus) within 7 weeks, where as, group I (Humerus) and group III (Femur) where MIPO was unsuccessful showed grade 2 radiographic healing with barely discernible fracture line and massive bone trabeculae crossing fracture line (callus) by 7th week indicating slower fracture repair than MIPO. Ultrasonographic healing (grade 4 – Increasingly homogeneous, hyperechoic image of the tissue at the fracture site (acoustic shadow returns) was noticed in all the cases treated by MIPO of group II (Radius Ulna) and IV (Tibia) ,where as, group I (Humerus) and group III (Femur) where MIPO was unsuccessful showed (grade 3 - Evidence of bridging of the fracture gap with inhomogeneous tissue (mix of hypoechoic and hyperechoic areas) by 5th week. Vascularization was not detectable by use of power Doppler ultrasonography by 9th week in all the group. No major intraoperative complications like implant instability or loosening of screws were seen in MIPO group (Radius Ulna and Tibia), however, Dog no 1(Radius Ulna) and Dog no 3 (Tibia) showed lateral angulation of distal limb. Statistical analysis revealed increase (P<0.05) in the serum alkaline phosphatase values significantly from 0 day to 7th day in all the groups and there after the levels decreased reaching normal at 45th day. Serum Calcium values were also increased significantly from 0 day to 14th day in all the groups. Serum phosphorus level showed significant difference on the day 0, 7, 14 and 28 days in all the groups. Based on present study, it was concluded that successful MIPO technique for long bone fracture repair can be done clinically for faster healing in radial and tibial fractures, whereas for Femoral and Humeral long bone fractures, it was difficult due to more instability and unsuccessful alignment due to strong musculature and bone configuration. As the MIPO technique has a “learning curve”, it can be successful once the surgeon gains dexterity in MIPO and can be attempted for complex fracture where alignment may be possible due to loss of bone.ThesisItem Open Access EVALUATION OF COMPLICATIONS FOLLOWING OVARIOHYSTERECTOMY IN BITCHES(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2015-04) SIVA PRASAD, K; DEVI PRASAD, V(MAJOR); DHANA LAKSHMI, N; VEERA BRAMHAIAH, KABSTRACT: In the present study, the complications following ovariohysterectomy in twenty four adult post pubertal bitches belonging to different breeds for a period of one year were recorded and analyzed. The estrous, pregnant and animals with genital pathologies were excluded. By adopting standard operative procedure and meticulous postoperative care, usual complications like fatal haemorrhage, wound dehiscence etc were not at all observed. Change in body weight, behaviour, hormonal and biochemical parameters; specific complications in a period of one year were recorded. Increased food intake and obesity were observed in 20 out of 24 animals (83.33%). Up to 9 months following ovariohysterectomy, no change was recorded in the aggression of any of the dogs. After nine months the overall reactivity and aggression of the ovariohysterectomized bitches was found to be increased. The preoperative mean value of oestradiol 17 was found progressively and significantly (P<0.05) decreased from 3rd month to 12th month postoperatively. There were no changes in the concentrations of progesterone values. The preoperative mean values of serum cholesterol and alkaline phosphatase were found progressively and significantly (P<0.05) elevated from 3rd to 12th month postoperatively. These values were well within the physiological ranges. The preoperative mean values of serum calcium and phosphorus were progressively and significantly (P<0.05) elevated 3rd to 12th month postoperatively. Incidence of specific complications like ovarian remnant syndrome, stump granuloma, osteopenia and venereal granuloma was very low (i.e. @ 4.17 percent each; n= 24). The remnants of the ovarian bursa were resected surgically. The sections revealed ovarian follicles to a minor extent, fibrous tissue interspersed between the altered connective tissue elements. A stump granuloma was diagnosed by a palpable swelling in the caudal abdomen by Tran abdominal B mode ultrasonography and plain radiography. Exploratory surgery was performed and the stump granuloma was resected. Histopathology revealed severe inflammatory cell infiltration with glandular proliferation. Radiographs obtained randomly revealed osteopenia in only one animal, in which cortical thinning with decreased radio-opacity of the pelvic bones was observed. Urinary incontinence in two cases was successfully treated by following routine treatment for cystitis. A single case of vaginal granuloma was diagnosed three months after ovariohysterectomy. Microscopically, there were several oval or spherical cells with high rate of mitosis. Based on the above observations it can be recommended that, the owners must be advised to restrict the feeding to their pets and give them proper exercise in order to avoid weight gain. They must be informed that, their pet may become more reactive and aggressive and hence, appropriate measures should be taken to control them through training. Occasional blood profiles and routine abdominal ultrasonography may be indicated to avoid dangerous consequences. Further studies with longer experimental time and more animal materials were required in order to make firm conclusions in order to associate these findings with ovariohysterectomy.ThesisItem Open Access A COMPARATIVE STUDY ON THE USE OF KETAMINE AND THIOPENTAL AS INDUCTION AGENTS FOR ISOFLURANE INHALATION ANAESTHESIA IN DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2012-07) SRAVANTI, MADDIMADUGU; GIREESH KUMAR, V(MAJOR); RAGHAVENDER, K.B.P; PURUSHOTHAM, GABSTRACT : The present clinical study was carried out on 12 dogs between 1 year to 10 years of age presented for ovariohysterectomy and castration. These dogs were randomly divided into two groups comprising of six animals in each group. All the dogs were uniformly premedicated. In the six dogs of group-I, anaesthesia was induced by intravenous administration of Ketamine at the rate of 5 mg/kg body weight. In dogs of group II, Thiopental sodium was used as an intravenous anaesthetic induction agent at the dose of 10 mg/kg body weight as a 2.5 per cent solution. Immediately after induction, the dogs of two groups were intubated and anaesthesia was maintained with 1.5% to 2% inhalation of Isoflurane during the entire surgical procedure. The anaesthetic effects like induction of anaesthesia, duration of anaesthesia, recovery time and physiological parameters like temperature, heart rate, respiratory rate and Electrocardiograph (ECG) were studied before induction, during anaesthesia and after recovery from anaesthesia. Haematological parameters like TEC, TLC, Hb, PCV, DLC and biochemical parameters like AST, ALT, BUN and Serum Creatinine were recorded before induction, during anaesthesia and after recovery. The results of the present study indicated that there was a significant difference between the induction time of Ketamine and thiopentone. Thiopentone differed significantly when compared to the use of ketamne as the induction agent where the induction time ranged from 50 to 128 seconds (mean 89.66 ± 6.74). It was also observed that while Ketamine at 5 mg/kg body weight induced anaesthesia deep enough to allow intubation in only four out of the six dogs. In the other two dogs, an additional dose of 1 mg/kg body weight was necessitated. Thiopentone uniformly induced anaesthesia deep enough to allow intubation in all the six dogs at the dose of 10 mg/kg of body weight as a 2.5 per cent solution, The anaesthetic protocols studied produced satisfactory and safe deep surgical anaesthesia in both the groups of dogs. However, in the dogs of groups I, maintenance of anaesthesia necessitated a concentration of 2% isoflurane in oxygen. The concentration of isoflurane was increased from 1.5% to 2 % as soon as the dogs showed some sluggish response to pedal and tail clamp reflexes, while in the dogs of group II of the six dogs necessitated only 1.5% isoflurane. In all the dogs of the two groups, recovery from anaesthesia was found to be smooth and uneventful. The dogs of group II recovered earliest from anaesthesia when compared to the group I. As far as the physiological parameters were concerned, the results showed that in all the dogs of groups I and II, anaesthesia resulted in a significant drop in the rectal temperature during and after anaesthesia as compared to the before induction. Although the heart rates between the groups were found to be differ from each other, they were still well within the normal range and hence were considered in consequential. The results showed that Ketamine induction caused a significant reduction of the respiratory rate in the dogs of group I during the maintenance of anaesthesia. The respiratory rate returned to normal as the dogs recovered from anaesthesia. Since these parameters caused no complications and since they returned to normalcy soon, the changes were considered to be clinically acceptable. The recovery from anaesthesia in all the six dogs of group II was considered good. In the dogs of group I, good recovery in four dogs and fair recovery in two dogs was recorded. Haematological examination revealed that there were no significant differences in the various parameters like TEC, TLC, Hb, PCV, DLC in any of the two groups and the three intervals. This underscored the fact that all the anaesthetic protocols studied were safe and uneventful as far as these observations were concerned. The results of the present clinical study clearly revealed in all the dogs of the two groups that the various biochemical parameters studied, i.e., AST, ALT, BUN and Serum Creatinine remained within normal limits. Hence, this also conclusively proved that the two anaesthetic protocols studied were safe and did not result in any damage to the heart, liver and kidneys during the anaesthetic period. Electrocardiographic studies in the dogs of both the groups revealed no abnormalities in the sizes of P, QRS or T- waves, no changes in the cardiac axes and no arrhythmias of any kind in any dog of any of the groups. From the results of the present study, it was concluded that both the anaesthetic protocols produced satisfactory deep surgical anaesthesia in dogs. While 2.5% thiopentone was found to have produced sufficiently deep anaesthetic induction to allow intubation at the uniform dose of 10 mg/kg, Ketamine was found to be effective at 5 mg/kg in 4 dogs and two dogs required 6 mg/kg i/v. When anaesthesia was induced with thiopentone sodium @ 10 mg/kg body weight, the dogs could be maintained at 1.5% isoflurane inhalation in oxygen. When anaesthesia was induced with Ketamine (5 to 6mg/kg, i/v), maintenance of anaesthesia was best done with 2% Isofluorane. Both the anaesthetic protocols studied in the present study resulted in minimal, clinically insignificant changes in the various physiological, biochemical and electrocardiographic parameters.ThesisItem Open Access A CLINICAL STUDY OF LONG BONE FRACTURES IN SHEEP AND GOATS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2012-05) VIJAY KUMAR, MORA; RAGHAVENDER, K.B.P(MAJOR); BHARATHI, S; SANTHI LAKSHMI, MABSTRACT: The present study was carried out on 45 clinical cases of long bone fractures in sheep (7) and goats (38) of either sex aged between 2 months to 7 years, referred for treatment to the Teaching Veterinary Clinical Complex, Campus Veterinary Hospital, College of Veterinary Science, Rajendranagar, Hyderabad. Routine clinical examination followed by radiography was used for diagnosis. Out of the 45 cases that were taken up for study, 15 animals (9 metacarpal, 4 metatarsals and one each of radius-ulna and tibia fractures) were treated by application of Plaster of Paris cast. Post-operative radiographic examination showed good alignment and apposition of the fracture fragments in all the cases treated with application of POP cast. Minimal complications were encountered, i.e., transient disuse atrophy in one case. 13 cases (8 were metacarpal fractures followed by 2 metatarsals, 2 cases of radius-ulna and 1 tibia), were treated by application of, Polyvinyl Chloride (PVC) splints and bandage was used to externally immobilize fractures in 13 cases (8 metacarpal, 2 metatarsals, 2 radius-ulna and 1 tibial fracture). PVC splints and bandage application resulted in satisfactory alignment and fracture healing in 9 cases while in 4 cases the alignment was not exact but satisfactory fracture healing occurred with callus formation and mild periosteal reaction in most of the cases, inspite of inexact alignment. Mild pressure sores and muscle contracture occurred in one goat, but these symptoms resolved once the goat started using the limb, following removal of the PVC splints. Modified Thomas splints were constructed with aluminum rods of 8 mm diameter to suit individual animals. These splints were used to treat 5 animals (4 tibial fractures and 1 femur fracture). Good alignment with satisfactory fracture healing followed in 4 animals, while in one case, mal union was noticed by the second week of application. However, even this animal could use the limb satisfactorily. Free-form External Skeletal Fixation (ESF) was used in 10 cases (2 sheep and 8 goats) with open fractures. ESF was applied to immobilize 4 metatarsal, 3 tibial, 2 metacarpal and one radius-ulna fractures. The ESF assembly was constructed using an aluminum rod and epoxy compound (M-seal) to act as a connecting bar, to economize. Results showed that the ESF was easy to use, economic in cost and served the purpose of immobilizing open fractures well. Post operative clinical and radiographic evaluation showed good fracture healing with good endosteal and minimal periosteal callus formation. ESF allowed early weight bearing and prevented associated muscle atrophy. In one animal with open fracture of tibia, slight outward deviation was observed. However, this animal had satisfactory weight bearing and pain free locomotion during the post-operative period. No evidence of infection, discharge or swelling was seen in any animal. At the time of removal of the ESF, the proximal pin was found to be loose in all the animals. However, this did not cause any hindrance to fracture healing. The two cases with fracture of the femur, healed well and recovered uneventfully following internal fixation with intramedullary pinning in one case and intramedullary pinning combined with full Cerclage wiring in the other. The Steinman pins were removed on the 45th and 48th post-operative day following good fracture healing and pain free limb usage by the animals. The complications encountered in the animals of the present study were considered minimal and transient to be of any significance.ThesisItem Open Access A CLINICAL STUDY ON TREATMENT OF LONG BONE FRACTURES USING EXTERNAL SKELETAL FIXATION IN DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2012-02) VARGHESE SAMUEL MATHAI; RAGHAVENDER, K.B.P(MAJOR); GIREESH KUMAR, V; PURUSHOTHAM, GABSTRACT : The present clinical study was undertaken in 12 dogs presented with long bone fractures for treatment at Campus Veterinary Hospital, College of Veterinary Science, Rajendranagar, Hyderabad and Teaching Veterinary Clinical Complex, Bhoiguda, Secunderabad during the year 2010-2011. Routine clinical examination followed by radiography was used for diagnosis. Out of the 12 dogs studied, 3 dogs had open fractures and the remaining 9 dogs had closed fractures. Two of the 3 open fractures were seen in radius-ulna and the third case involved tibia. Out of the 9 cases of closed fractures, 8 were simple transverse fractures and one comminuted fracture. These 12 dogs were randomly assigned to groups I and II, irrespective of the age, sex or breed. The first group was treated with Type 1a linear external skeletal fixator and the second group with free-form external skeletal fixator. Only fractures of femur, tibia-fibula, humerus and radius-ulna were included in the present study. Group I dogs were treated with Type 1a stainless steel linear external skeletal fixator. Dogs in group II were treated with Free-form external skeletal fixator using epoxy compound as the connecting bar. Inj. Ceftriaxone sodium was administered at a rate of 20mg/kg body weight as intravenous injection for the first ten days postoperatively. Inj. Meloxicam was administered preoperatively for pain relief at the dose rate of 0.2 mg per kg intramuscularly and continued postoperatively for 4 days once a day. The limb was bandaged with modified Robert Jones bandage with an inner layer of bandage between the fixator and the skin in both the group of dogs. The inner layer was replaced every alternate day until the pin tracts had stopped discharging. The suture lines as well as the pin entry points were cleaned with normal saline and Povidone-iodine was infused through the pin tracts during the entire post operative period. Clinical evaluation was routinely carried out at periodical intervals for swelling, exudation, weight bearing and stability of the implant in all the dogs of the two groups. Post-operative radiographs were obtained immediately after surgery and at the end of 2nd, 4th, 6th and 8th week for evaluation of the fracture healing. From the results of the present clinical study it was concluded that both the types of external skeletal fixation were useful in treatment of long bone fractures in dogs. However, the linear external skeletal fixator was considered more versatile since it allowed post-operative adjustment. The free-form external skeletal fixator did not allow any adjustment following its application. However, free-form external skeletal fixator facilitated its application even in those cases where the half pins could not be placed in a linear fashion. In addition, it was felt that the use of free-form external skeletal fixator in young, rapidly growing puppies needed further evaluation. Free-form external skeletal fixator was found to be relatively inexpensive and required lesser instrumentation.ThesisItem Open Access A CLINICAL STUDY ON THE DISEASES OF ESOPHAGUS AND STOMACH WITH SPECIAL REFERENCE TO ENDOSCOPY IN DOGS(SRI VENKATESWARA VETERINARY UNIVERSITY TIRUPATI - 517 502. (A.P.) INDIA, 2010-07) RAVIRAJ VINAYAK, SURYAWANSHI; RAGHAVENDER, K.B.P(MAJOR); GIREESH KUMAR, V; PURUSHOTHAM, G; SHANTHI LAKSHMI, MABSTRACT: The present study was undertaken in 42 cases out of the 120 clinical cases of dogs presented with diseases of esophagus and stomach with the history of persistent vomiting or regurgitation. A total of 120 dogs were presented with the chief complaint of recurrent vomiting or regurgitation. Out of the total of 120 cases selected for closer examination, 78 dogs (65%) responded to routine medical treatment with antiemetics, antibiotics and fluid therapy and hence, they were excluded from the purview of the present clinical study. The remaining 42 dogs (35%), which continued to vomit or regurgitate for more than one week and showed signs consistent with the primary diseases of the esophagus and stomach formed the patient material for the present clinical study. All the 42 clinical cases of dogs underwent routine physical, clinical, haematological and biochemical examinations as well as plain and contrast radiographic, Ultrasonographic and endoscopic assessment to rule out the concurrent diseases prior to the consideration in the present study. The results of the present study revealed that out of the total 42 cases selected for the present study, 31dogs (73.81%) had diseases of the esophagus while the rest (11dogs; 26.19%) had diseases of the stomach. During the present study, megaesophagus was diagnosed in 18 (42.86%) dogs, reflux esophagitis in 2 dogs (4.76%), vascular ring anomalies in 2 dogs (4.76%), esophageal diverticula and esophageal nodule in one dog each (2.38% each), esophageal foreign bodies in 5 dogs (11.90%), esophageal erosion or ulcers in 2 dogs (4.76%), chronic gastritis in 3 dogs (7.14%), gastric foreign bodies in 4 dogs (9.52% ), gastric erosion/ ulcer in 2 dogs (4.76%) and gastric dilatation and Volvulus in 2 dogs (4.76%). The results also showed that the occurrences of these diseases were seen in dogs ranging from two and a half months to thirteen years of age. No sex wise occurrence of the esophageal or stomach diseases was reported. All the dogs afflicted with the various diseases exhibited similar symptoms like emaciation, shrunken abdomen, chronic weight loss, prominent rib cage, regurgitation, vomiting or both. In the present clinical study, 18 clinical cases of megaesophagus were recorded. The disease was encountered in Labrador (2 dogs), Golden Retriever (2 Dogs), German Shepherd (5 Dogs), Doberman (2 Dogs), Mongrel (3 Dogs), Pomeranian (2 Dogs), Cocker Spaniel (1 Dog) and Boxer (1 Dog) breeds of dogs. The mean age of occurrence was found to be 6.25 ± 0.88 years. Out of these 18 dogs, 11were found to be males (61.12 %) and the rest were females (7 dogs; 38.88%). All these 18 dogs showed the signs of regurgitation of the food soon after food consumption. The haematological and biochemical studies showed that all the parameters studied were with in the normal range, except for haemoglobin. Ultrasonography did not reveal any sort of esophageal pathology. Radiographic features of megaesophagus in the seven dogs were air filled dilated esophagus and tracheoesophageal stripe sign. Esophagography clearly revealed generalized distention of esophagus in all the 18 dogs. While endoscopy revealed markedly dilated, flaccid esophagus and pooling of retained fluid, in the most dependent segment of the esophagus. The results of the present study indicated that among the three treatment regimens tested, Metoclopramide combined with feeding the dogs in an upright position from an elevated platform improved the esophageal function to the maximum extent. Post mortem examination of the seven dogs died or euthanized showed severe dilatation and thinning of the esophageal wall, while histopathological examination showed scanty muscle bundles, infiltration of polymorphonuclear cells with submucosal congestion and enlargement of submucosal glandular pattern with epithelial irregularity. Scanning electron microscopy revealed destruction of blood vessels, loss of normal architecture and direction of inner circular as well as outer longitudinal muscle fibers while, transmission electron microscopic examination showed complete loss of cellular architecture, mitochondrial destruction and complete loss of architecture of myoneuronal plate at the neuromuscular junction suggestive of neuromuscular disorder. Two clinical cases of dogs were tentatively diagnosed to be suffering from reflux esophagitis. Endoscopic examination characterized by mucosal erythema, haemorrhage, mucosal irregularity, erosion with thickened mucosal folds especially at the lower esophageal area confirmed reflux esophagitis. Endoscopic examination showed the evidence of reflux esophagitis in these two dogs. Both the dogs recovered uneventfully following the treatment adopted. Esophagoscopy of a nine year old male Pomeranian dog with sings of recurrent cough and retching revealed a lemon sized nodular growth appearing as broad based protuberance with nipple like orifice located just caudal to the base of the heart suggestive of Spirocerca lupi infestation. No surgical exploration was conducted as the dog was not available for further investigation. Plain radiography of five cases out of 42 cases (11.90%) revealed osseous foreign bodies in the esophagus of four dogs and radiolucent foreign bodies (socks) in an other dog. In three dogs, osseous foreign bodies located in the thoracic esophagus were pushed in to the stomach successfully by endoscope itself. In dog, osseous foreign bodies located in the post pharyngeal was retrieved by cheatle forceps under the endoscopic illumination. The dog with socks in the cervical esophagus vomited the socks out due to emetic effects of xylazine prior to endoscopic manoeuvre. All dogs recovered uneventfully. Barium swallow of the dogs revealed stricture of esophagus over the base of heart and cranial distention of esophagus suggestive of vascular ring anomalies. Despite of giving supportive therapy, both the dogs died. Necropsy revealed distention of esophagus cranial to the constructive vascular band confirmed vascular ring anomalies. Histopathological examination further confirmed presence of concurrent gastritis. Plain radiography of three year old female German shepherd dog with post prandial regurgitation, revealed saclike out pouching of cranial thoracic esophageal wall that rested on floor of sternum which was further confirmed by endoscopy. No treatment was initiated in this case on the owner was reluctant for surgery. The two dogs with vomiting of about three weeks duration that did not respond to routine medication were diagnosed to be suffering from esophageal erosions/ulcers, both by endoscopy and by positive contrast radiography. The dogs responded well to the treatment adopted. Gastroscopy of all three dogs revealed generalized congestion as well as petechial hemorrhagic spots on gastric mucosa with minor areas of mucosal erosions suggestive of chronic gastritis. Cytological examination of stomach fluid collected during endoscopy further confirmed chronic gastritis. No Helicobacter Like Organisms (HLO) was encountered. These three dogs responded well to the treatment protocol adopted i.e. combination of amoxicillin, clarithromycin, Metronidazole and ranitidine. In the present study, gastroscopy of two dogs revealed gastric ulcerative patches with marked thickening and irregular edges confirmed gastric erosion or ulcers. Both the dogs treated with sucralfate and omperazole responded well to complete recovery. In present clinical study, four dogs were diagnosed to be affected with gastric foreign bodies. Out of four cases, two dogs that underwent plain radiographic examination revealed presence of sewing needle in the stomach of one dog and a pair of metal caps of cool drink bottle and a safety pin in another dog. The metallic foreign bodies whose removal was considered to be too risky by endoscope were removed by standard gastrotomy. In the remaining two dogs that swallowed dog nylon belt, plain radiograph did not confirm their presence. Endoscopic examination revealed presence of dog collar made up of nylon in the stomach. Endoscopic retrieval of the nylon belt in the stomach of one dog was successfully done while, in the second case, the radiolucent foreign body (another nylon belt), which turned out later on to be a linear foreign body, was removed successfully by standard gastrotomy and enterotomy operation. All the dogs recovered uneventfully. In the two dogs with gastric dilatation and volvulus (GD-V) in the present study, the clinical and radiographic signs helped in confirmation of the disease and the clinical out come of their treatment with surgical derotation and gastropexy was uneventful. From the results of the present clinical study, it was concluded that about 35% of dogs (42 out of 120 dogs) that were refractory to general medical treatment for vomiting or regurgitation were appeared to be affected with primary diseases of esophagus and stomach. The most common malady affecting the esophagus in dogs was found to be megaesophagus (18), and this can be reasonably well managed by using metoclopramide and feeding the dogs in an upright position from an elevated platform. The disease is considered to be a neuromuscular disease as seen during scanning and transmission electron microscopy. The neuromuscular junctions as seen by transmission electron microscopy appeared to be destroyed in cases of megaesophagus. Esophagography was found to be more useful procedure in confirming the cases of megaesophagus than endoscopy. This is because it is sometimes difficult in mild cases to be sure whether the esophagus was really dilated or it appeared so due to insufflation during endoscopy. On endoscopy examination, a large cavernous lumen extending the length of the esophagus is vividly suggestive of megaesophagus. But a normal esophagus can also appear flaccid and distended under anaesthesia. The other diseases encountered in the present study in their order frequency of occurrence are esophageal foreign bodies (5), gastric foreign bodies (4), chronic gastritis (3), reflux esophagitis (2), esophageal erosion/ulcer (2), gastric erosion/ ulcer (2), vascular ring anomalies (2), gastric dilatation and volvulus (2), esophageal nodule (1) and esophageal diverticulum (1). Endoscopy is not always useful in treatment of esophageal or gastric foreign bodies in dogs for the shape and size of foreign body, duration of obstruction and nature and location of foreign body in the esophagus and stomach determine the use and success of endoscopy for therapeutic purpose. Endoscopy proved to be a valuable and useful aid in the diagnosis of esophageal and gastric ulcers/ erosions, esophageal nodule and esophageal diverticulum. Albeit veterinarians are still in the early phase of adoption of minimally invasive procedures, endoscopy proves to be vital diagnostic and therapeutic tool of the future veterinarians armamentarium.