Ch. 93: Colon

Question 1

Czajkowski JVECC 2020

Colonic torsion in 4 Great Danes

outcome?
recurrence?

Answer 1

3 cases had favorable outcomes with emergency surgical intervention and returned to normal activity levels with resolution of clinical signs

Two cases of colonic torsion recurred - 1 euthanized

Question 2

Latimer JAVMA 2019

Evaluation of short-term outcomes and potential risk factors for death and intestinal dehiscence following full-thickness LI incisions in dogs

• dehiscence rate?
• mortality rate?
• factors assoc. w/ dehiscence?

Answer 2

7 d post-op dehiscence rate 10% (9/90) and mortality rate 17% (15/90)

Factors associated w/ dehiscence:
- Pre-existing colon trauma or dehiscence
- peritonitis
- administration of blood products
- >2 classes abx
- + microbial culture from sx sample
- open abdominal mgmt.
- peritonitis post-op

Colon cleansing procedures NOT S.A. w/ postop dehiscence

Question 3

Cinti Vet Sx 2019
CASE REPORT

Temporary end-on colostomy as a treatment for anastomotic dehiscence after a transanal rectal pull-through procedure in a dog

Answer 3

After 90d perineal/perianal sinus tract healed, colostomy was eliminated & end-to-end anastomosis of colon done

1 yr post op few episodes fecal incontinence & good QOL w/o other complications

Question 4

Duffy Vet Sx 2020

Influence of closure technique on leakage pressures in an ex vivo canine typhlectomy model

• 3 closure techniques?
• which leaked at highest pressure?
• conclusion?

Answer 4

(1) Parker-Kerr pattern, (2) stapled, (3) Stapled with oversew (Cushing)

Group 3 leaking at higher ILP compared to others

Conclusion: Placement of a Cushing suture pattern to augment stapled incisions improved the ability of typhlectomies to sustain pressure compared with sutured or stapled cadaveric specimens alone.

Question 5

Sapora Vet Sx 2021

Ex vivo comparison of hand-sutured versus circular stapled anastomosis in canine large intestine

• which construct leaked at lowest pressure?
• conclusion?

Answer 5

Anastomoses leaked at lower pressures when stapled rather than hand-sewn

End-to-end colonic anastomoses closed with circular stapler leaked at lower pressures than hand-sutured anastomoses. Use of the EEA stapler with a staple height of 3.5 mm did not result in safe colonic anastomoses

Question 6

Matz Vet Sx 2022

Ex vivo comparison of different thoracoabdominal stapler sizes for typhlectomy in canine cadavers

• staplers used?
• difference in staplers and mean pressure?

Answer 6

Staplers: TA 30 V3, TA 60 3.5mm, TA 60 4.8mm

Each stapler size that was evaluated resulted in a mean ILP in excess of typical intraluminal pressures under normal circumstances. There were no differences among groups

Question 7

Lux JAVMA 2021

Evaluation of short-term risk factors associated with dehiscence and death following full-thickness incisions of the large intestine in cats: 84 cases (1993-2015)

• % survival to discharge?
• dehiscence rate?
• factors assoc. with dehiscence?

Answer 7

94% (79 of 84 cats) survived to discharge

overall dehiscence rates at a minimum of 7 days after surgery was 8.3% (7/84 cats)

Factors associated w/ dehiscence included hypoalbuminemia, renal dysfunction, administration of blood products or > 2 classes of antimicrobials, & intra-abdominal fecal contamination

Question 8

Grossman JAVMA 2021

Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats

• male vs. female more common?
• % major complications?
• % recurrence of constipation?
• factors assoc. with shorter survival?

Answer 8

Male cats 2.5 times as likely to have subtotal colectomy compared with females

Major complications 9.9%

32% had recurrence of constipation at median of 344 days

Shorter survival:
- body condition score <4/9 (6x)
- Heart disease (3x)
- Major complications (28x)
- Long-term postop liquid feces (10x)

Question 9

McKenna JSAP 2021
CASE REPORT

Diagnosis and treatment of a cecal mucocele in a dog

Answer 9

5 cm x 2 cm intraluminal cecal mass-like structure

Exploratory and typhlectomy performed

Consistent with cecal mucocele (cystic dilation of the cecal lumen with stasis of mucus)

Question 10

Moores JVECC 2021

Nonsurgical reduction of prolapse colocolic intussusception in 2 puppies

Answer 10

Rectal manipulation and saline enema performed in both dogs and reduction of the intussusception confirmed endoscopically or ultrasonographically

Bupivacaine and prednisolone foam enemas were administered to reduce tenesmus

Intussusception had not recurred 4 months and 1 year following manual reduction

Question 11

Longley JVECC 2022

Colonic perforation in 4 dogs following treatment with meloxicam

outcomes for each dog?

Answer 11

3 cases treated with meloxicam for variable nonspecific signs
- confirmed perf, went to surgery, did well

1 case prescribed meloxicam after perineal herniorrhaphy
- collapsed and died 7 days postsurgery
- necropsy ulceration and perforation of ascending colon

Question 12

Stecyk JAVMA 2022

Gastrointestinal signs and a need for nutritional management may persist long term in dogs and cats undergoing resection of the ileocolic junction: 35 cases (2008–2020)

• % O reported good outcome dogs vs. cats?
• common long term findings/results?

Answer 12

10/20 dogs (50%) and 11/15 cats (73%) were reported by their owners to have a good long-term outcome based on the lack of long-term gastrointestinal signs or the ability to control gastrointestinal signs with diet and supplements alone

Despite owner-reported good outcomes, long-term diarrhea, weight loss, and muscle loss were common

Question 13

PQ Removal of what structure is assoc with bad poops based on paper?

Answer 13

Not sure what paper - but in general, cats where ileocolic junction is removed likely to have poorly formed stools up to 3 months and some may be incontinent