1982
1980
1984
1985
1983
1
1
1979
Small Animal/Exotics20TH ANNIVERSARY
Compendium
July 1999
C
O
M
P
E
N
D
I
U
M
’
S
20th
ANNIVERSARY
1
97
9
-
1
9
9
9
1984
Open peritoneal drainage for septic peritonitis is first described
1987
Clinical feline renal transplantation is introduced First description of free microvascular skin transfers for wound reconstruction is published
Gary W. Ellison, DVM, MS
tomy and maxillectomy techniques with excellent cosmetic and function-al results. Axial skeletal neoplasias,such as osteosarcoma and chondro-sarcoma of the face, ribs, and pelvis, were successfully managed usingmaxillectomy, thoracoplasty, andhemipelvectomy techniques, respec-tively. Large soft tissue tumors of thethorax and trunk were resected, anddefects were successfully repaired us-ing prosthetic mesh. Dogs with ap-pendicular osteosarcoma receivedlimb-salvage procedures and oftenoutlived animals in which amputa-
Highlights and Horizons in
1981
1979
First successful portosystemic shunt ligation is performed
1980
Axial pattern flaps for reconstructive surgery are introduced
1983
First mandibulectomy and maxillectomy techniques for oral neoplasia are performed
T
he past two decades were truly agolden age in the specialty of smallanimal soft tissue surgery. Countlesstalented surgeons invented, evaluated, and mastered myriad new techniques thathave allowed practitioners to treat conditions previously considered untreatable;these techniques were often surprisingly successful, resulting in a better quality of life for patients. The advances have been so numerous that adequate individu-al recognition is not possible in a short overview of this type. In my opinion,however, the most significant advances have occurred in the areas ofpain man-agement; oncologic, reconstructive, and abdominal surgery; alternative teachingmethods; and prepubertal gonadectomy.
Pain Management
Before 1979, little thought was given to postoperative pain management insmall animals. Methods for alleviating postoperative pain were popularized dur-ing the past 20 years, including topical anesthetic nerve blocks and body cavity infusions, epidural opiate administration, injectable and oral nonsteroidal antiin-flammatory drugs, and transdermal fentanyl patch application.
1,2
In the 1990s,Hardie and Kyles helped pioneer the development of point systems for more ob- jective pain analysis in small animals and advocated pre- and intraoperative (pre-emptive) treatment for pain.
1
Preemptive treatment reduced vocalization, aggres-sion, restlessness, and/or social withdrawal in animals experiencing pain as wellas the doses of analgesic and sedative drugs needed to control pain postoperative-ly.
2
Research also showed that pain peaked within 24 hours after minor electiveprocedures, whereas more invasive surgical procedures (e.g., thoracotomies, am-putation) required pain control for 72 hours or longer.
1,2
Oncologic Surgery
The landmark work of Withrow
3
and Salisbury
4
in the early 1980s demon-strated how to remove “nonresectable” oral tumors via progressive mandibulec-
Gary W. Ellison, DVM, MS, Diplomate ACVS
Professor and Service Chief, Small Animal Surgery University of Florida Gainesville, Florida
Soft Tissue Surgery
86
87
1989
1991
1993
1994
1995
1997
1999
1998
1990
1992
Compendium
July 199920TH ANNIVERSARYSmall Animal/Exotics
tion alone was performed. The use of lasers in veterinary surgery was alsoinstituted; carbon dioxide, neodymi-um-yttrium-aluminum-garnet, andargon lasers were used for the re-moval of cutaneous tumors, treat-ment of perianal fistulas, and treat-ment of glaucoma, respectively.
5
Reconstructive Surgery
Large wound defects are now com-monly closed with innovative localtransposition flaps and free-tissuetransfers. Pavletic was able to transferlarge vascularized segments of skin insingle stages without the necessity of a secondary procedure
6
; during the1980s and 1990s, at least 11 of theseaxial pattern flaps were described.Because direct cutaneous flaps couldnot reach all areas of the body, sever-al veterinary microsurgeons trans-ferred cutaneous or myocutaneousfree flaps to distant recipient sites,usually over joint surfaces or distalextremities with shear-type injuries.
7
Severe distal degloving injuries weretreated by using segments of existingdigital pads to reconstruct weight-bearing metatarsal and metacarpalpads, allowing salvage of limbs thatpreviously would have been ampu-tated.
8
Abdominal Surgery
Major advances have been madeduring the past 20 years in under-standing gastric dilatation-volvulus(GDV). Free-radical scavengers wereused to reduce gastric ischemia.
9
Epi-demiologic work by Glickman dem-onstrated a genetic predispositiontoward GDV in Great Danes andIrish setters with a high thoracic orabdominal height:width ratio.
10
Dogsfed once daily were reportedly twiceas likely to develop GDV compared with those fed twice daily.
10
Many successful surgical techniques weredeveloped for the prevention of GDV, including circumcostal (Fal-lah), incisional (McCoy), belt-loop(Whitney), and ventral midline(Meyer-Lindenburg) gastropexy.
11
The first descriptions of subtotalcolectomy for surgical managementof idiopathic megacolon (IM) in cats were provided by Bright and Rosenin the early 1980s. This procedureremains popular for cats with medi-cally refractory cases of IM. Openperitoneal drainage was studied by several surgeons in the mid-1980sand is now commonly used to treatsevere septic peritonitis in small ani-mals. White and Williams describedan efficacious prostatic omentaliza-tion technique for managing recur-rent prostatic abscesses and cysts thatgave better results than did previous-ly described techniques.
12
In 1979, portosystemic shunts indogs and cats were introduced by Breznock, who later described theanatomic categories of shunts, ex-plained the pathophysiology andmedical management of the disease,and established the guidelines forportal pressures during ligation.
13
A slow occlusion device was subse-quently used by Vogt and Krawinkelin 1993 that lowered the morbidity associated with partial portosystemicshunt occlusion.The first successful feline renaltransplants were reported by Gregory and Gourley in 1987. Since theseinitial transplants, morbidity andmortality associated with renal trans-plantation in cats has been greatly re-duced. There are currently at least sixcenters in the United States that per-
s
Anything for Love.
The increasingvalue owners are placing on theirpets
’
companionship is evidentby the amount of money they are willing to spend on veterinary careto keep them healthy. In just 5years
—
from 1991 to 1996
—
annual spending on veterinary care for cats and dogs rose from$7 to $11 billion.
a
s
The Wave of the Future?
Asowners demand more advancedand specialized care for their pets,the veterinary profession hasneeded to adjust accordingly.In 1985, there were only 2261veterinary specialists in the UnitedStates; today, 6293 veterinariansspecialize in an ever-growingnumber of fields.
aa
According to the American Veterinary Medical Association.
1994–Present
Comprehensive pain control is developed in small animals
OWNERS
’
OUTLOOK
1990
Surgical lasers are first used in veterinary medicine
form this sophisticated procedure, with many patients having good toexcellent results.In 1995, Matthews and Sukhianimade a significant contributioninthe management of perianal fistulas with the disclosure that cyclosporine was effective in improving lesions inalmost 100% of dogs treated, elimi-nating the need for surgery in half of the patients.
Alternative Teaching Methods
In the early 1990s, in response toincreased attention to the ethical useof animals in veterinary curricula,psychomotor skills laboratories wereimplemented to develop students
’
technical skills in the laboratory be-fore working on live animals andcadavers were substituted for live an-imals when possible. Several educa-
1991
Prepubertal gonadectomy in dogs is first described
1993
First use of gradual occlusion ring for portosystemic shunts Synthetic models for instruction of psychomotor skills are developed
1997
Risk factors for gastric dilatation-volvulus are first described
Search History:
Result 00 of 00
00 results for result for
p.
More From This User
Notes
Load more
