Читать книгу Veterinary Endoscopy for the Small Animal Practitioner - Группа авторов - Страница 4

1 Chapter 1Figure 1.1 The first rigid endoscope, built by Bozzini in the early 1800s. T...Figure 1.2 A major step in advancing technology or endoscope development was...Figure 1.3 Representation of a light beam being bent as it passes from one m...Figure 1.4 As the angle of incidence of the light waves “α” increases, so do...Figure 1.5 Total internal reflection of light in a fiberoptic glass fiber oc...Figure 1.6 A coherent fiber bundle used for image transmission in flexible f...Figure 1.7 An image through a coherent fiber bundle of a flexible fiberoptic...Figure 1.8 An image through a coherent fiber bundle of a flexible fiberoptic...Figure 1.9 The light transmission system for a rigid endoscopic telescope wi...Figure 1.10 A small lightweight endoscopy video camera head with a separate ...Figure 1.11 An endoscopy video camera head coupled to a 10 mm diameter lapar...Figure 1.12 A surgery team utilizing video for laparoscopic surgery where al...Figure 1.13 A video gastroscope with a video camera chip at the tip of the e...Figure 1.14 An image of the duodenum in an 8‐year‐old neutered male 10 kg mi...

2 Chapter 2Figure 2.1 A double wide video tower with room for a large amount of equipme...Figure 2.2 A smaller video tower setup for small animal rigid endoscopy with...Figure 2.3 The video endoscopy tower used by the author in a private referra...Figure 2.4 A Karl Storz Endoscopy IMAGE 1 FULL HD Three‐Chip Camera Head H3‐...Figure 2.5 An endoscopic video camera head attached securely to a 10 mm lapa...Figure 2.6 A Karl Storz Endoscopy Tele Pack Vet X LED self‐contained endosco...Figure 2.7 A Xenon Nova 300‐W light source.Figure 2.8 A Xenon 100 light source for gastrointestinal endoscopy with inte...Figure 2.9 A 300‐W LED light source.Figure 2.10 The FlexXC video cystourethroscope with an internal LED light so...Figure 2.11 A battery‐powered LED light source attached to an otoscope.Figure 2.12 A minimally invasive surgery instrument with a connection post f...Figure 2.13 A minimally invasive surgery bipolar vessel sealing and cutting ...Figure 2.14 The ForceTriad vessel sealing device with standard monopolar rad...Figure 2.15 A 10 mm diameter 37 cm long “Atlas” vessel sealing instrument fo...Figure 2.16 An open‐surgery handpiece for use with the ForceTriad that seals...Figure 2.17 An open‐surgery handpiece for use with the ForceTriad that seals...Figure 2.18 An intravenous fluid administration set with a filter in the cap...Figure 2.19 A Vet Pump 2 fluid management system with irrigation and suction...Figure 2.20 A manual Tankersley tilt table (TTT) designed for performing lap...Figure 2.21 The Tankersley table tilted 45° in the position used for laparos...Figure 2.22 A large dog fixed in place on the TTT ready for performing a lap...Figure 2.23 A DRE Panomed operating table for small animal use shown with th...Figure 2.24 The DRE Panomed powered operating table for small animal practic...Figure 2.25 The same patient as seen in the Figure 2.24 tilted to the right ...Figure 2.26 Telescopes available for use in small animal practice including ...Figure 2.27 A diagram showing the angle of view of rigid telescopes used in ...Figure 2.28 The ENDOCAMELEON telescope for laparoscopy with variable angles ...Figure 2.29 A diagram of the Hopkins rod lens system shown in the telescope ...Figure 2.30 The 2.7 mm diameter, 18 cm long, 30° multipurpose rigid telescop...Figure 2.31 A one‐piece cystoscope incorporating the telescope and sheath in...Figure 2.32 A 10 mm diameter, 0° operating laparoscope with a working length...Figure 2.33 The Veterinary Otoscope for ear examination in awake patients wi...Figure 2.34 The anatomy of a flexible fiberoptic gastrointestinal endoscope....Figure 2.35 (a) An assembled cystoscope for performing transurethral cystosc...Figure 2.36 Round and oval sheaths for the 2.7 mm MPRT. The round sheath on ...Figure 2.37 Locking mechanism designs for attaching sheaths to telescopes. F...Figure 2.38 A trocar‐cannula for laparoscopy. (a) An 11 mm diameter, 10.5 cm...Figure 2.39 A 6 mm diameter, 10.5 cm long Ternamain Endo TIP cannula, with a...Figure 2.40 A 3.9 mm diameter, 5.0 cm long lightweight trocar‐cannula with a...Figure 2.41 Flexible instruments for use with flexible endoscopes and rigid ...Figure 2.42 An example of rigid instruments used with rigid telescopes. The ...Figure 2.43 An example of a rigid 5 mm diameter, 36 cm long minimally invasi...

3 Chapter 3Figure 3.1 Silverline video‐gastroscope from Karl Storz, Tuttlingen, with 1....Figure 3.2 A veterinary‐specific feline video gastroscope (outer diameter 5....Figure 3.3 Schematic figure of four‐way tip deflection with at least one way...Figure 3.4 Schematic drawing of the handpiece of a video‐gastroscope.Figure 3.5 Distal tip of video endoscope; note the working channel (a), fibe...Figure 3.6 Commonly used accessory instruments for flexible GI endoscopy: (f...Figure 3.7 Different types of biopsy forceps (top to bottom): smooth‐edged, ...Figure 3.8 Four‐wire basket, alligator grasper, and rat tooth (top to bottom...Figure 3.9 Foreign body grasping instrument (length 60 cm) that is used alon...Figure 3.10 Cytology brush with protective tubing to obtain cytology samples...Figure 3.11 Holding the handpiece of the endoscope with the left hand. The i...Figure 3.12 The rubber cap on the instrumentation channel of a rigid endosco...Figure 3.13 Foreign body grasper that is integrated into the sheath of a rig...Figure 3.14 Histopathology of two endoscopically taken duodenal biopsies. Sa...Figure 3.15 Obstructed view of gastric mucosa in a dog that has recently ing...Figure 3.16 Drawing showing a dog in left lateral recumbency with normal ori...Figure 3.17 Self‐made model for training of flexible endoscopy. Plastic tube...Figure 3.18 Ex‐vivo stomach model of a pig. The stomach is obtained from the...Figure 3.19 Training of flexible esophago‐gastro‐duodenoscopy in a live anim...Figure 3.20 (a) Plain thoracic radiograph of an eight‐year‐old male Cairn Te...Figure 3.21 Normal appearance of upper esophageal sphincter in a dog.Figure 3.22 Pictures of normal esophagus: (a) normal esophagus of a dog with...Figure 3.23 Typical appearance of normal esophagus of a cat with “herringbon...Figure 3.24 Trachea is visible over the base of the heart at 7 o'clock posit...Figure 3.25 At the cardia, the gastric mucosa can be seen extending into the...Figure 3.26 Examples of open cardia and Z‐line in two French Bulldogs. This ...Figure 3.27 Pictures of mild‐to‐severe esophagitis. (a) Mildly irregular muc...Figure 3.28 Pictures of esophageal strictures. (a) A seven‐month‐old Doberma...Figure 3.29 Esophageal stenosis in a three‐month‐old kitten which looks endo...Figure 3.30 Pictures of esophageal foreign bodies: (a) nine‐year‐old Papillo...Figure 3.31 Pictures of esophageal tumors: (a) adenocarcinoma of the esophag...Figure 3.32 A gastric leiomyosarcoma protruding into the esophagus in a 12‐y...Figure 3.33 Two images of Spirocerca lupi with a granuloma in the esophagus ...Figure 3.34 Pictures of a vascular ring anomaly: (a) a typical band seen in ...Figure 3.35 Gastroesophageal intussusception in a 12‐year‐old 27 kg mixed br...Figure 3.36 A nine‐year‐old Border Collie with chronic vomiting and signs of...Figure 3.37 Anatomy of the stomach and cranial duodenum. It is important to ...Figure 3.38 (a) With a dog placed in left lateral recumbency, the tip of the...Figure 3.39 (a) The normal stomach with the animal in left lateral recumbenc...Figure 3.40 Various pictures of the normal, closed, or partly open pylorus: ...Figure 3.41 Examples of iatrogenic damage of duodenal mucosa after the biops...Figure 3.42 The normal stomach with the patient in left lateral recumbency a...Figure 3.43 (a) Clearly visible rugal folds seen upon entering a normal part...Figure 3.44 Various pictures of normal duodenal mucosa: (a) 2‐year‐old 22 kg...Figure 3.45 Various pictures of normal duodenal papillae: (a) 3‐year‐old Bri...Figure 3.46 Gastric erosions (a) in a nine‐year‐old Border Collie and (b) in...Figure 3.47 Gastric friability in a 12‐year‐old European Shorthair cat with ...Figure 3.48 Gastric granularity (a) in a six‐year‐old giant Schnauzer with h...Figure 3.49 Gastric ulcers (a) in a 13‐year‐old Domestic Shorthair cat with ...Figure 3.50 Gastric masses (a) in a 12‐year‐old mixed breed dog with a polyp...Figure 3.51 Duodenal mucosal friability (a) in a five‐year‐old Jack Russel T...Figure 3.52 Duodenal granularity of various severities: (a) mild granularity...Figure 3.53 Duodenal erosion in a four‐year‐old Bichon Frise with hypoadreno...Figure 3.54 Duodenal lymphatic dilation of various severities: (a) mild lymp...Figure 3.55 Pictures of various gastric foreign bodies: (a–c) crown caps in ...Figure 3.56 Endoscopic picture from the stomach of a dog with a single Physa...Figure 3.57 Normal variations of the ileocolonic sphincter: (a) 12‐year‐old ...Figure 3.58 Taking blind biopsies through the iliocolonic sphincter when the...Figure 3.59 Retroflexed view in the descending colon in a great Dane to bett...Figure 3.60 Pictures of normal colonic mucosa: (a) 9‐year‐old German Shepher...Figure 3.61 Colonic erosions (a) in a 7‐year‐old German Brake with mild coli...Figure 3.62 Two examples of colonic friability (a) in a nine‐year‐old Golden...Figure 3.63 Colonic granularity examples: (a) an 11‐year‐old mixed breed dog...Figure 3.64 An ulcerated ilieocolonic sphincter in a three‐year‐old Leonberg...Figure 3.65 Histiocytic ulcerative colitis in (a) an 8‐month‐old Boxer and (...Figure 3.66 Colonic masses in (a) a 6‐year‐old Border Collie (histologically...Figure 3.67 Whipworms (Trichuris vulpis) in a six‐year‐old German Shepherd d...Figure 3.68 A plastic “overtube” with an endoscope inside to protect the end...Figure 3.69 Esophageal fishhook removal: (a) a lateral radiograph of a nine‐...Figure 3.70 Marked esophageal irritation after removal of a deeply seated bo...Figure 3.71 Typical foam and saliva obstructing the view of an esophageal fo...Figure 3.72 Various forms of low‐profile feeding tubes, also called buttons....Figure 3.73 Components of a commercial human PEG tube set (Freka), 16 Fr siz...Figure 3.74 Placement of a commercial PEG tube: (a) generous clipping of lef...Figure 3.75 (a) Materials used for a “home‐made” PEG tube using a Pezzer ure...Figure 3.76 (a) Low‐profile feeding tube (button) in a cat; (b) pet body cov...Figure 3.77 Guide wire with a balloon placed over the guide wire in a strict...Figure 3.78 Balloon catheter (length 4 cm, inflated to width 10 mm) used for...Figure 3.79 Manometer for use during balloon dilation of esophageal strictur...Figure 3.80 Mucosal tear in an esophageal stricture after balloon dilation (...Figure 3.81 Metallic stent in the esophageal lumen of a cat in which balloon...Figure 3.82 Manometer or pressure tester to use before each cleaning procedu...Figure 3.83 Example of a plastic tub filled with cleaning detergent in which...Figure 3.84 Cleaning of all channels with a cleaning brush.Figure 3.85 Plastic tubes attached with adapters to the instrumentation chan...Figure 3.86 Washing machine with endoscope ports attached to tubes for flush...Figure 3.87 Endoscope storage options: (a) one example of a cabinet for stor...Figure 3.88 Plastic tube attached to wall for disinfection of flexible endos...

4 Chapter 4Figure 4.1 Direct visual and physical access to the nasal cavity is achieved...Figure 4.2 The working tips of the two rigid biopsy forceps most commonly us...Figure 4.3 Rigid biopsy and operating forceps for turbinectomy are larger an...Figure 4.4 Five millimeter diameter Ferris‐Smith arthroscopy rongeurs with 5...Figure 4.5 Lateral radiograph of a normal dog showing the area of the skull ...Figure 4.6 Positioning for lateral radiographic projection of the nasal cavi...Figure 4.7 Lateral radiograph of a normal dog showing the area of the skull ...Figure 4.8 Positioning for ventral 20° rostral dorsocaudal oblique open mout...Figure 4.9 Ventral 20° rostral dorsocaudal oblique open mouth projection of ...Figure 4.10 Positioning for rostrocaudal projection of the skull for frontal...Figure 4.11 Rostrocaudal projection of the skull demonstrating normal fronta...Figure 4.12 HemaBlock^® placed in the nasal cavity to arrest an otherwis...Figure 4.13 Nasal tumor biopsy using the 3.0 mm rigid biopsy forceps passed ...Figure 4.14 The 3.0 mm rigid biopsy forceps positioned for biopsy of a nasop...Figure 4.15 Five French flexible biopsy forceps passed through the working c...Figure 4.16 A 1000 μm laser fiber used to vaporize tissue and control bleedi...Figure 4.17 A small quantity of mucus in the nasal cavity that is a normal f...Figure 4.18 Nasal mucosal appearance through air with a bright red color. Hi...Figure 4.19 Nasal mucosal appearance through liquid at the same location and...Figure 4.20 Turbinates are not well developed in the rostral nasal cavity ap...Figure 4.21 Normal pigment extending into the rostral nasal passage.Figure 4.22 Gently curving smooth turbinates in the rostral nasal cavity tha...Figure 4.23 Branching of the ventral nasal conchae seen from the middle meat...Figure 4.24 Ethmoidal turbinates with the normal crumpled appearance with mi...Figure 4.25 Thick ethmoidal turbinates approaching the upper end of normal....Figure 4.26 Ethmoidal turbinates at the thin end of normal with midrange int...Figure 4.27 Minimal interturbinate space in the ethmoidal turbinates at the ...Figure 4.28 Ethmoidal turbinates with midrange interturbinate space.Figure 4.29 Wide ethmoidal interturbinate space at the upper limit of normal...Figure 4.30 The same area of the nasal cavity as in Figure 4.22 with more in...Figure 4.31 The area on the nasal septum caudally that is normally roughened...Figure 4.32 The normal curved caudal margin of the nasal septum.Figure 4.33 Normal nasolacrimal duct opening in the rostral nasal cavity.Figure 4.34 Air bubbles seen during examination of a normal nasal cavity. Th...Figure 4.35 The normal nasopharynx seen with the telescope passed from the n...Figure 4.36 In this image, the endotracheal tube is seen in the right side o...Figure 4.37 A normal nasopharynx with subtle vasculature visible in the muco...Figure 4.38 Prominent vasculature visible in the mucosa of a normal nasophar...Figure 4.39 The opening of a eustachian tube in the nasopharynx at the appro...Figure 4.40 A small hard protrusion that is a common finding on the dorsal w...Figure 4.41 A wider view of the nasopharyngeal protrusion seen in the Figure...Figure 4.42 An air–liquid interface interfering with visualization of the na...Figure 4.43 The smooth discolored, greenish‐brown appearance of the mucosa i...Figure 4.44 Roughening of the mucosal surface in the discolored area of the ...Figure 4.45 An area of disrupted mucosal discoloration due to contact with t...Figure 4.46 An area of the nasal cavity with mild roughening of the mucosal ...Figure 4.47 Small random blood vessels visible in the normal nasal mucosa.Figure 4.48 Larger visible blood vessels at the margin of the olfactory orga...Figure 4.49 A normal frontal sinus lined with a thin transparent membrane an...Figure 4.50 A bone ridge extending into a normal frontal sinus. Highlights i...Figure 4.51 An air–water interface in a normal frontal sinus interfering wit...Figure 4.52 Active bleeding encountered at the beginning of rhinoscopy in a ...Figure 4.53 Fresh blood adhered to the surface of a visible tumor in the nas...Figure 4.54 A fresh blood clot from a recent bleeding episode that has not u...Figure 4.55 Abnormal material in the nasal cavity of a 12‐year‐old Brittany ...Figure 4.56 Clotted blood from a recent bleeding episode that formed into a ...Figure 4.57 Clotted blood in the same patient as Figure 4.56 in a different ...Figure 4.58 A smooth mass of clotted blood that has changed from red to a br...Figure 4.59 This clotted blood has changed from red to purple forming a larg...Figure 4.60 A purple blood clot that has formed a lobulated structure.Figure 4.61 A small blood clot‐like structure protruding between turbinates ...Figure 4.62 An organized blood clot‐like structure that appears encapsulated...Figure 4.63 A dark blood clot‐like structure with a ragged surface and stran...Figure 4.64 Ragged vascular appearing tissue that is mostly white structure ...Figure 4.65 Blood clot‐like material with three different appearances in one...Figure 4.66 The internal appearance of a blood clot‐like structure following...Figure 4.67 The internal appearance of a blood clot‐like mass with organized...Figure 4.68 Free mucopurulent exudate obscuring visibility of tumor surface ...Figure 4.69 Free bloody exudate in the nasal cavity of a dog with a nasal ma...Figure 4.70 Mucopurulent exudate that is adherent to the surface of a neopla...Figure 4.71 Large numerous blood vessels visible on the surface of a smooth ...Figure 4.72 Numerous small irregular blood vessels on the surface of a solid...Figure 4.73 Sparse small blood vessels in a solid smooth mass in the nasal c...Figure 4.74 Red coloration of a solid smooth nasal mass indicating significa...Figure 4.75 A smooth solid avascular‐appearing neoplastic mass in the nose o...Figure 4.76 A solid smooth avascular‐appearing neoplastic nasal mass in a do...Figure 4.77 An irregular solid nasal mass with an avascular appearance.Figure 4.78 A pink irregular solid neoplastic mass in the nasal cavity of a ...Figure 4.79 A dense red solid irregular mass in the nasal cavity of a dog.Figure 4.80 An irregular neoplastic nasal mass in a dog with sparse small bl...Figure 4.81 Numerous small irregular blood vessels in a solid irregular nasa...Figure 4.82 Numerous large prominent blood vessels in an irregular solid neo...Figure 4.83 A lobulated avascular appearing neoplastic nasal mass in a 14‐ye...Figure 4.84 The roughened surface of a neoplastic nasal mass.Figure 4.85 An unusual striated surface of a neoplastic mass in the nasal ca...Figure 4.86 A ragged tumor surface of a squamous cell carcinoma immediately ...Figure 4.87 A large neoplastic nasal mass with a red polypoid surface. Also ...Figure 4.88 A small polypoid neoplastic mass in the nasal cavity of an eight...Figure 4.89 A fimbriated neoplastic nasal mass with large blood vessels in t...Figure 4.90 A fimbriated neoplastic nasal mass with small blood vessels in t...Figure 4.91 A smooth cystic avascular neoplastic nasal mass with clear appea...Figure 4.92 A smooth cystic avascular neoplastic nasal mass with blue colora...Figure 4.93 A close‐up image of an avascular cystic mass showing that there ...Figure 4.94 A small avascular clear cystic projection from a nasal neoplasti...Figure 4.95 A sheet of avascular blue cystic‐appearing neoplastic tissue in ...Figure 4.96 A turbinate‐shaped avascular blue cystic structure in a dog with...Figure 4.97 A white avascular‐appearing cystic neoplastic lesion in the nasa...Figure 4.98 A pink cystic avascular‐appearing structure in the nasal cavity ...Figure 4.99 A red neoplastic cyst filled with fresh blood in the nasal cavit...Figure 4.100 Small sparse blood vessels in the wall of a neoplastic cyst in ...Figure 4.101 Numerous larger blood vessels visible in a neoplastic nasal cys...Figure 4.102 Large prominent blood vessels in the wall of a cystic neoplasti...Figure 4.103 Nasal neoplasia with solid vascular and solid avascular portion...Figure 4.104 Cystic avascular and solid vascular neoplastic tissue adjacent ...Figure 4.105 Solid vascular and solid avascular tissue in the same neoplasti...Figure 4.106 Cystic vascular tissue, solid irregular vascular tissue, and ro...Figure 4.107 Solid smooth avascular‐appearing neoplastic nasal tissue adjace...Figure 4.108 A cystic avascular‐appearing nasal tumor with an area of cyst w...Figure 4.109 Greenish coloration of a neuroendocrine tumor in the area of th...Figure 4.110 An area of gray tumor appearing in an area of normally pigmente...Figure 4.111 A nasal tumor with an unusual speckled surface.Figure 4.112 Internal tumor tissue following biopsy of a mass revealing a fr...Figure 4.113 Solid white internal tumor tissue exposed with biopsy of a nasa...Figure 4.114 A nasal tumor that has ruptured prior to rhinoscopy exposing in...Figure 4.115 A smooth vascular red‐appearing nasopharyngeal polyp in a one‐y...Figure 4.116 A smooth avascular white appearing nasopharyngeal polyp in a fo...Figure 4.117 An irregular vascular purple‐appearing nasopharyngeal polyp in ...Figure 4.118 A multicolored nasopharyngeal polyp visible in the nasopharynx ...Figure 4.119 A nasopharyngeal polyp attached to the stalk where it exits the...Figure 4.120 Two‐millimeter biopsy forceps passed from the nasopharynx into ...Figure 4.121 The eustachian tube after removal of the nasopharyngeal portion...Figure 4.122 The middle ear portion of a nasopharyngeal polyp seen with a 1....Figure 4.123 A small nasal tumor that is extending between turbinates with l...Figure 4.124 The site or origin of a nasal tumor, or invasion of tumor into ...Figure 4.125 A unilateral nasal tumor extending caudally into and completely...Figure 4.126 Extension of unilateral nasal neoplasia caudal to the septum as...Figure 4.127 A solid irregular avascular‐appearing unilateral mass extending...Figure 4.128 A cystic avascular bluish extension of a unilateral neoplasia c...Figure 4.129 A smooth neoplastic mass extending caudal to the nasal septum t...Figure 4.130 Adhesions of turbinates to the nasal septum in the contralatera...Figure 4.131 Displacement of the nasal septum to the contralateral side by a...Figure 4.132 A view of the contralateral nasal cavity with invasion of the n...Figure 4.133 Penetration of the nasal septum into the contralateral nasal ca...Figure 4.134 Penetration of the nasal septum into the contralateral nasal ca...Figure 4.135 Biopsy forceps placed to remove solid tumor tissue under endosc...Figure 4.136 Biopsy forceps placed to remove an area of cystic tumor tissue ...Figure 4.137 Tumor tissue is removed with biopsy forceps or rongeurs until t...Figure 4.138 Using the diode laser to control bleeding during tumor debulkin...Figure 4.139 The diode laser being used to vaporize tissue as part of the tu...Figure 4.140 Completed resection of a nasal tumor with a narrow attachment a...Figure 4.141 The diode laser has been used to provide hemostasis and vaporiz...Figure 4.142 Using biopsy forceps to remove additional tissue following diod...Figure 4.143 A large nasal septal defect created by debulking a tumor that h...Figure 4.144 An adequate airway has been re‐established by removal of tumor ...Figure 4.145 Completion of nasal tumor debulking when adequate neoplastic ti...Figure 4.146 Completion of nasal tumor debulking when a total turbinectomy h...Figure 4.147 Completion of a nasal tumor debulking procedure due to inabilit...Figure 4.148 Continued active bleeding after extensive tumor debulking and t...Figure 4.149 Application of a hemostatic powder achieved immediate hemostasi...Figure 4.150 A neoplastic clear‐walled irregular avascular‐appearing cyst wi...Figure 4.151 Rapid drainage of the cyst following laser penetration. The cys...Figure 4.152 Drainage of the cyst allows the cyst wall to shrink changing fr...Figure 4.153 A solid smooth nasal mass with varied coloration but no visible...Figure 4.154 At reoperation three weeks after the initial procedure in the c...Figure 4.155 Reoperation of a nasal tumor that at initial operation was an e...Figure 4.156 A large quantity of mucopurulent exudate in the nasal cavity of...Figure 4.157 Thick viscous mucopurulent exudate seen between nasal turbinate...Figure 4.158 Mucopurulent exudate covering and adhering to a fungal colony o...Figure 4.159 Thick viscous mucopurulent exudate extending caudal to the nasa...Figure 4.160 Decreased turbinate thickness with increased interturbinate spa...Figure 4.161 Early mild change in turbinate shape due to mycotic rhinitis in...Figure 4.162 Mild loss of turbinate height with turbinate thickening in a do...Figure 4.163 Mild loss of turbinate bulk with loss of both height and thickn...Figure 4.164 Marked turbinate distortion in a dog with mycotic rhinitis.Figure 4.165 Marked distortion of the ethmoidal turbinates in a dog with an Figure 4.166 Turbinate destruction and loss of turbinate support from remain...Figure 4.167 An end‐stage nasal cavity with a nasal fungal infection and alm...Figure 4.168 Marked hyperemia of the nasal turbinate mucosa and mild turbina...Figure 4.169 Fine roughening of the nasal turbinate mucosa in response to a ...Figure 4.170 A patient with a nasal Aspergillus infection showing coarse rou...Figure 4.171 Variable mucosal roughening on the nasal septum of the dog seen...Figure 4.172 Fine uniform roughening of the nasal septum mucosa of a dog wit...Figure 4.173 Increased vascularity of the turbinate mucosa in a dog with myc...Figure 4.174 An increased visible vascular pattern in the nasopharynx of a d...Figure 4.175 Replacement of nasal mucosa with granulation tissue in direct c...Figure 4.176 An adhesion between a nasal turbinate and the nasal septum in a...Figure 4.177 Individual small white nodules representing inflammatory polyps...Figure 4.178 Inflammatory polyps on the dorsal wall of the nasopharynx appea...Figure 4.179 White nodular inflammatory polyps coalesced into a solid layer ...Figure 4.180 Two small irregular inflammatory polyps in the nasal cavity of ...Figure 4.181 A cluster of small irregular polyps in a dog with a nasal Asper...Figure 4.182 Large inflammatory polyps coalescing into a solid irregular mas...Figure 4.183 A tumor‐like mass in the nasal cavity of a dog with a nasal fun...Figure 4.184 A larger tumor‐like mass in the nasal cavity secondary to a nas...Figure 4.185 An area of septal destruction due to a nasal fungal infection. ...Figure 4.186 The bright iridescent metallic appearance of a small fungal col...Figure 4.187 A medium‐sized fungal colony showing the bright iridescent meta...Figure 4.188 A large fungal colony with areas of the bright iridescent metal...Figure 4.189 A small spherical dull fungal colony sitting directly on the mu...Figure 4.190 A small white smooth shiny fungal colony sitting on a bed of gr...Figure 4.191 A small white fuzzy fungal colony in the frontal sinus of a dog...Figure 4.192 An upright spherical nasal fungal colony partially obscured wit...Figure 4.193 An irregular fungal colony with a smooth surface in the frontal...Figure 4.194 A fuzzy fungal colony in the nasal cavity of the dog in Figure ...Figure 4.195 A fungal colony in the nasal cavity of a dog with fuzzy white a...Figure 4.196 A large black Aspergillus niger colony in the nasal cavity of a...Figure 4.197 Mucopurulent drainage in the caudodorsal nasal cavity of a dog ...Figure 4.198 Mucopurulent drainage from the frontal sinus of a dog with a fu...Figure 4.199 Thickening of the lining membrane and increased vascular patter...Figure 4.200 Removing fungal colony material from the nasal cavity of a dog ...Figure 4.201 Using a stone basket to remove a fungal colony from the frontal...Figure 4.202 A frontal sinus after complete removal of a fungal colony with ...Figure 4.203 Correct placement of nasopharynx occlusion catheters for use wi...Figure 4.204 Foreign material in the nasal cavity of a dog with an Aspergill...Figure 4.205 Fungal material surrounding a tooth foreign body in the nasal c...Figure 4.206 Thickening of the lymphatic tissue on the dorsal wall of the na...Figure 4.207 A nasopharyngeal mass partially filling the nasopharynx in a ca...Figure 4.208 A cryptococcal mass completely filling the nasopharynx of a cat...Figure 4.209 A nasal cavity cryptococcal mass in a cat with chronic nasal di...Figure 4.210 Mucopurulent nasal discharge in the nasal cavity of a cat with ...Figure 4.211 Turbinate distortion and loss of turbinate mass in a cat with a...Figure 4.212 Mucopurulent exudate in the nasal cavity of a dog with allergic...Figure 4.213 Hyperemic turbinate mucosa in a case of allergic rhinitis. Ther...Figure 4.214 Roughening of the turbinate mucosa in a case of allergic rhinit...Figure 4.215 A case of allergic rhinitis with roughening of the septa mucosa...Figure 4.216 Roughening of the dorsal surface of the nasopharynx in a dog wi...Figure 4.217 Friable mucosa damaged by minimal endoscope contact during rhin...Figure 4.218 Turbinate swelling with loss of interturbinate air space in a d...Figure 4.219 Mild turbinate distortion in a dog with allergic rhinitis.Figure 4.220 An inflammatory nodule on a turbinate in a dog with allergic rh...Figure 4.221 Multiple small inflammatory nodules on the dorsal wall of the n...Figure 4.222 Inflammatory nodules coalesced into a solid sheet on the dorsal...Figure 4.223 A solitary irregular inflammatory polyp in the nasal cavity of ...Figure 4.224 A cluster of small irregular inflammatory polyps in the nasal c...Figure 4.225 Inflammatory polyps appearing as large contiguous masses.Figure 4.226 A grass awn foreign body in the nasal cavity of a dog.Figure 4.227 A blade of grass in the nasal cavity of a dog. There is thick i...Figure 4.228 A metallic bullet fragment in the nasal cavity of a dog.Figure 4.229 An Oregon grape leaf in the nasal cavity of a dog.Figure 4.230 Unidentified amorphous organic material in the nasal cavity of ...Figure 4.231 Unidentifiable inorganic material in the nose of a dog.Figure 4.232 Unidentifiable friable inorganic material in the nasal cavity o...Figure 4.233 Thick inspissated exudate completely hiding the foreign body in...Figure 4.234 Mucopurulent exudate containing blood surrounding a nasal forei...Figure 4.235 Removing a nasal foreign body with standard alligator forceps. ...Figure 4.236 Undisturbed exudate adjacent to an abscessed tooth root in a do...Figure 4.237 Cyst‐like structures in the ventrolateral nasal cavity over inv...Figure 4.238 A fractured upper fourth premolar tooth associated with the cys...Figure 4.239 White turbinates in a cat with turbinate infarction and complet...Figure 4.240 Pale turbinates in a cat with decreased vascular supply due to ...Figure 4.241 White distorted turbinates in a cat with chronic turbinate infa...Figure 4.242 Turbinate destruction in a case of turbinate infarction with a ...Figure 4.243 Biopsy of infarcted turbinates produces minimal or no bleeding....Figure 4.244 Mild turbinate damage to an infarcted turbinate caused by conta...Figure 4.245 No bleeding even with significant iatrogenic turbinate trauma c...Figure 4.246 Mucopurulent exudate in the nasal cavity of a cat with turbinat...Figure 4.247 White avascular turbinates on one side of the nasal cavity in a...Figure 4.248 Normally vascularized turbinate tissue in the contralateral nas...Figure 4.249 An area of completely infarcted turbinate in the foreground wit...Figure 4.250 An area of white completely infarcted tissue on the right and a...Figure 4.251 Turbinate distortion and destruction in a chronic case of turbi...Figure 4.252 Inflammatory nodule formation in a cat with chronic turbinate i...Figure 4.253 A large irregular inflammatory polyp in a cat with chronic turb...Figure 4.254 An area of turbinates with loss of cartilage support in a cat w...Figure 4.255 A nasal airway stricture immediately caudal to the nares in an ...Figure 4.256 Laser correction of the stricture seen in Figure 4.255.Figure 4.257 Turbinate inflammation and distortion visible through the corre...Figure 4.258 Recurrence of the nasal stricture in Figures 4.255–4.257 two we...Figure 4.259 Laser ablation of the recurrent stricture in Figures 4.255–4.25...Figure 4.260 Turbinate inflammation, distortion, and destruction visible cau...Figure 4.261 Fibrosis and inflammation in the nasal cavity at the level of a...Figure 4.262 Inflammatory nodules in the nasal cavity of the dog with the in...Figure 4.263 Turbinate distortion and loss of turbinate mass in a dog with a...Figure 4.264 A grass awn in the deep horizontal ear canal that has penetrate...Figure 4.265 Marked hyperemia of the ipsilateral wall of the nasopharynx in ...Figure 4.266 An eight‐month‐old DSH cat with a middle ear polyp visible thro...Figure 4.267 The normal middle ear visible through a normal translucent tymp...Figure 4.268 A typical nasopharyngeal polyp seen in an 11‐year‐old DLH cat t...Figure 4.269 An atypical nasopharyngeal polyp visible in the ear canal of a ...Figure 4.270 A carcinoma in the ear canal of an eight‐year‐old DSH cat with ...Figure 4.271 Removing the external ear canal portion of a nasopharyngeal pol...Figure 4.272 A middle ear cavity that has had a polyp debrided with biopsy f...Figure 4.273 Three parts of a nasopharyngeal polyp removed from a cat. Rhino...Figure 4.274 An unusual extension of a malignant middle ear canal tumor thro...Figure 4.275 A small inflammatory lesion protruding from the eustachian tube...Figure 4.276 A close-up endoscopic view of the dorsal view of the nasal mite...Figure 4.277 A close-up lateral endoscopic view of the nasal mite “Pneumony...Figure 4.278 A solitary nasal mite in the nasal cavity of an eight-year-old...Figure 4.279 A solitary nasal mite in the frontal sinus of a dog.Figure 4.280 A solitary nasal mite in the nasopharynx of a dog.Figure 4.281 A herd of nasal mites in the nasopharynx of a three-year-old Go...Figure 4.282 An inflammatory reaction of the lymphatic tissue on the dorsal...Figure 4.283 Reactive hyperemic lymphoid tissue on the dorsal wall of the na...Figure 4.284 Solid thickened lymphatic tissue on the dorsal wall of the naso...Figure 4.285 A large mass originating on the dorsal wall of the nasopharynx ...Figure 4.286 An area of hyperemic lymphatic tissue representing the “felenoi...Figure 4.287 Thickened lymphatic tissue on the dorsal wall of the nasopharyn...Figure 4.288 A smooth mass on the dorsal wall of the nasopharynx of a 13‐yea...Figure 4.289 An irregular mass on the dorsal wall of the nasopharynx in a 11...Figure 4.290 An irregular enlarged nasal turbinate that histopathology revea...Figure 4.291 Septal thickening in the nasal cavity of the dog in Figure 4.29...Figure 4.292 Large hamartoma ridges extending from the right nasal cavity in...Figure 4.293 A nasopharyngeal hamartoma in a cat.Figure 4.294 Vascular dysplasia in a 14‐year‐old neutered male West Highland...Figure 4.295 Vascular dysplasia in a 12‐year‐old neutered male Schipperke. T...Figure 4.296 A close‐up of the vascular appearance in a free‐floating turbin...Figure 4.297 Mucosal hyperemia in a patient with rhinitis of undetermined or...Figure 4.298 Roughened nasal mucosa in a Great Dane dog with rhinitis with a...Figure 4.299 Enlarged prominent blood vessels in the nasal turbinate mucosa ...Figure 4.300 Enlarged blood vessels in the nasopharynx of a dog with rhiniti...Figure 4.301 Swollen thickened turbinates in a dog with rhinitis of undeterm...Figure 4.302 Numerous small inflammatory nodules.Figure 4.303 Pedunculated polyps in the nasal cavity of a dog with rhinitis ...Figure 4.304 An irregular cluster of inflammatory tissue.Figure 4.305 A large inflammatory tumor‐like mass in the nasal cavity of a d...Figure 4.306 Thickened turbinates seen in a rhinitis case with no documented...Figure 4.307 An area of decreased turbinate bulk in the same case as Figure ...Figure 4.308 A white mass‐like lesion in the nasal cavity of the same case a...Figure 4.309 A red mass‐like lesion in the nasal cavity of the same case as ...Figure 4.310 An area of mucosal hyperemia in the nasal cavity of the case in...Figure 4.311 Hyperemia and thickening of the caudal portion of the nasal sep...Figure 4.312 Inflammatory nodules scattered over the area of the “catenoid” ...Figure 4.313 An increased number of enlarged blood vessels on the lateral wa...Figure 4.314 A hamartoma like mass in the nasopharynx of this same case as i...Figure 4.315 Contact between rostral turbinates in a brachiocephalic dog see...Figure 4.316 Contact between rostral turbinates in a brachiocephalic dog see...Figure 4.317 An area of turbinates in a brachiocephalic dog where there is a...Figure 4.318 The nasopharynx of a French Bulldog with extension of the ethmo...Figure 4.319 The ethmoidal turbinates are seen bending around the dorsal mar...Figure 4.320 The normal nasopharynx of the above case caudal to the abnormal...Figure 4.321 A completed partial turbinectomy in the French Bulldog seen in ...Figure 4.322 A nasopharyngeal stricture in an eight‐year‐old DSH cat present...Figure 4.323 A long tapering nasopharyngeal stenosis ending in a blind pouch...Figure 4.324 A small open communication in the center of a thin wall of tiss...Figure 4.325 A large residual lumen in a nasopharyngeal stenosis with reflec...Figure 4.326 A smaller residual lumen in a nasopharyngeal stricture obscured...Figure 4.327 Unidentified material occluding the residual lumen of a nasopha...Figure 4.328 Inflammatory nodules in the nasopharynx caudal to a nasopharyng...Figure 4.329 A cluster of inflammatory polyps in the nasopharynx rostral to ...Figure 4.330 Preparing to pass a 5 Fr biopsy forceps through a small residua...Figure 4.331 The dilated stricture from Figure 4.330 after passage of the bi...Figure 4.332 A 5 Fr red rubber catheter passed through the working channel o...Figure 4.333 Positioning of a nasopharyngeal stent using rhinoscopy with the...Figure 4.334 In this image, the stent has been retracted until it is fully w...Figure 4.335 The inflated balloon after expansion of the stent. The balloon ...Figure 4.336 A fully expanded nasopharyngeal stent sitting tightly against t...Figure 4.337 A nasopharyngeal stent in a cat two years after placement that ...Figure 4.338 Removal of the exudate in the case shown in Figure 4.337 reveal...Figure 4.339 The central portion of the stent in Figures 4.337 and 4.338 was...Figure 4.340 Multiple white raised avascular appearing masses in the nasopha...Figure 4.341 Multiple small white raised avascular appearing elongated nodul...Figure 4.342 A mass in the nasal cavity partially covered with exudate.Figure 4.343 Another mass in a different area of the same nasal cavity.Figure 4.344 An irregular deformed turbinate in this case of lymphoid hyperp...Figure 4.345 Irregular turbinates with loss of bulk and support.Figure 4.346 Thickened swollen puffy irregular turbinates.Figure 4.347 Roughened mucosa on the surface of an otherwise unchanged turbi...Figure 4.348 The fractured internal structure of one of the masses after bio...Figure 4.349 An area of white solid tissue in the nasal cavity of an eight‐y...Figure 4.350 Another area of the same case that has a cystic avascular appea...Figure 4.351 Completion of the debridement procedure with minimal residual a...Figure 4.352 Rostral turbinates with mild loss of bulk and distortion in the...Figure 4.353 Extensive mucopurulent exudate in the nasal cavity of the same ...Figure 4.354 A white lobulated avascular appearing mass in the caudolateral ...Figure 4.355 Debulking the recurrent mass from the nasal cavity of the same ...Figure 4.356 Completion of the debulking process with laser charred tissue o...Figure 4.357 Completion of the scheduled debulking two weeks after the previ...Figure 4.358 A nasal mass protruding from the right nares of an eight‐year‐o...Figure 4.359 An elongated pink solid mass in the right nasal cavity in the p...Figure 4.360 A white avascular cystic or edematous mass in another part of t...Figure 4.361 A dark cystic mass and an irregular solid mass in the same pati...Figure 4.362 Another area of the same nasal cavity with long vascular floati...Figure 4.363 The tissue displaced from the nasopharynx into the oral cavity ...

5 Chapter 5Figure 5.1 Flexible endoscopes: a 3.7 mm and a 5 mm bronchoscope with three ...Figure 5.2 Bronchial mucosal folding indicating bronchospasm.Figure 5.3 An anesthesia “T” adapter attaches to the endotracheal tube and a...Figure 5.4 (a) One method used to provide oxygen supplementation during bron...Figure 5.5 Oxygen supplementation is provided during bronchoscopy by connect...Figure 5.6 Artist's representation of the canine tracheobronchial tree using...Figure 5.7 All necessary equipment is set out ahead of time in preparation f...Figure 5.8 Appearance of the normal canine glottic lumen and larynx followin...Figure 5.9 C‐shaped tracheal cartilaginous rings visible through the mucosa ...Figure 5.10 The presence of either edema as shown by the glistening appearan...Figure 5.11 Normal circular shape of the tracheal rings in a dog; note the t...Figure 5.12 Dorsoventral flattening of the trachea demonstrating a Grade 2–3...Figure 5.13 A misshapen and narrowed tracheal lumen associated with tracheal...Figure 5.14 Severe foaming of airway secretions that is commonly encountered...Figure 5.15 Appearance of the distal airway in a normal dog; note the smooth...Figure 5.16 A tracheal stricture causing altered airway caliber in a dog.Figure 5.17 An intraluminal tumor obstructing the trachea and thus altering ...Figure 5.18 External tracheal compression caused by a ventral mediastinal ma...Figure 5.19 Bronchiectasis and chronic severe bronchitis with inflammatory n...Figure 5.20 A structural or fixed collapse of the left principal bronchus ca...Figure 5.21 Decreased airway caliber in the dog due to dynamic tracheal coll...Figure 5.22 A normal dorsal tracheal membrane in a one‐year‐old German Sheph...Figure 5.23 An example of significant large airway collapse commonly seen se...Figure 5.24 The appearance of healthy tracheobronchial mucosa in a dog; note...Figure 5.25 Mucosal edema is visible in this dog with bronchiectasis as it i...Figure 5.26 Polypoid mucosal nodules, seen on the dorsal wall of the upper b...Figure 5.27 The appearance of excess secretions associated with bacterial pn...Figure 5.28 The appearance of secretions associated with allergic lung disea...Figure 5.29 The endobronchial appearance of bronchiectasis in a dog. Note th...Figure 5.30 A gross lung specimen from a dog with bronchiectasis following l...Figure 5.31 Mucosal irregularity (the granular appearance) and blood on the ...Figure 5.32 Large mucosal nodules just anterior to and nearly obstructing th...Figure 5.33 A bronchial foreign body (small rock) being retrieved with endos...Figure 5.34 Severe airway narrowing secondary to external compression due to...Figure 5.35 Mucosal involvement seen as a primary squamous cell carcinoma in...Figure 5.36 Typical appearance of primary lung tumors in dogs that start in ...Figure 5.37 Endoscopic view of the sharp “V” shaped appearance of a normal c...Figure 5.38 The endoscopic appearance of the normal carina in a cat. The muc...Figure 5.39 Hilar lymphadenopathy compressing the right mainstem bronchus in...Figure 5.40 Endoscopic appearance of normal spurs or bronchial bifurcations ...Figure 5.41 Appearance of a blunted spur in a dog. Blunting occurs when the ...Figure 5.42 Performing a BAL using 20 ml of sterile saline flushed through t...Figure 5.43 Performing a BAL using 20 ml of sterile saline and hand suction ...Figure 5.44 Photomicrograph of canine BALf; note the predominance of normal ...Figure 5.45 Photomicrograph of a squamous epithelial cell and two Simonsiell...Figure 5.46 Blood agar culture plate with TNTC (too numerous to count) colon...

6 Chapter 6Figure 6.1 A continuous flow system for use with the 4.0 cystoscope with two...Figure 6.2 A deflecting bridge or Albarran lever is used with cystoscopes to...Figure 6.3 Transurethral viscous fluid injection instrument set for use with...Figure 6.4 The resectoscope system for transurethral cystoscopy in small ani...Figure 6.5 A close‐up picture of the cutting loop working tip of the bipolar...Figure 6.6 Irrigation system for transurethral cystoscopy using a one‐liter ...Figure 6.7 Anatomy drawing of the relationship of the vulva, vaginal vestibu...Figure 6.8 The vaginal vestibule distended with saline in an eight‐year‐old ...Figure 6.9 The vaginal vestibule distended with saline in a three‐year‐old s...Figure 6.10 The urethral papilla in an eight‐month‐old intact female Vizsla ...Figure 6.11 An example of a urethral tubercle typically seen in intact femal...Figure 6.12 When the cystoscope first enters the urethra during transurethra...Figure 6.13 As the telescope is passed through the urethra, fluid flow begin...Figure 6.14 Full distention of the urethra occurs in most cases as fluid flo...Figure 6.15 Yellow urine color with otherwise clear urine has minimal interf...Figure 6.16 Suspended debris of any kind in the urine creates an opacity tha...Figure 6.17 Hematuria, unless only microscopic, prevents any examination of ...Figure 6.18 Crystalluria also interferes with the visual field and may requi...Figure 6.19 Urine retention allows accumulation of sludge like debris in the...Figure 6.20 The details of normal and abnormal tissues are clearly visible w...Figure 6.21 The bladder of a 10‐year‐old spayed female Bouvier des Flanders ...Figure 6.22 An air–water interface interfering with examination of a bladder...Figure 6.23 Smoke produced by laser ablation of a transitional cell carcinom...Figure 6.24 Bleeding from microscopic mucosal tears in the bladder of a five...Figure 6.25 A Foley catheter with the bulb inflated positioned in the trigon...Figure 6.26 Five French flexible biopsy forceps passed through the operating...Figure 6.27 The biopsy forceps are opened and positioned over the selected b...Figure 6.28 The biopsy forceps are pushed forward into the tissue and closed...Figure 6.29 The biopsy site after tissue removal in the patient from Figure ...Figure 6.30 A 5 Fr polypectomy snare positioned on a polyp for partial excis...Figure 6.31 The polypectomy snare in Figure 6.30 is closed to trap and remov...Figure 6.32 A stone basket being used for extraction of a TCC mass after tra...Figure 6.33 A large bladder polyp with the patient positioned so that the le...Figure 6.34 The same polyp as Figure 6.33 with the patient repositioned so t...Figure 6.35 A polypectomy snare placed on the base of the polyp in Figure 6....Figure 6.36 The resection site of the polyp seen in the previous figures aft...Figure 6.37 The base of a large inflammatory bladder polyp with the patient ...Figure 6.38 An activated diode laser fiber in contact with the base of the l...Figure 6.39 Cut progression is assessed by stopping the laser and backing th...Figure 6.40 Completion of the cut leaves an area of cauterized tissue flush ...Figure 6.41 A small cystic calculus trapped with a stone basket in a dog wit...Figure 6.42 A weasel wire passed into an abnormal ureteral ostium prior to p...Figure 6.43 An image of the nondistended distal penile urethral lumen seen w...Figure 6.44 The distended distal penile urethral lumen seen when passing the...Figure 6.45 The narrowest point of the male dog urethra is at the caudal end...Figure 6.46 The urethra caudal to the os penis is slightly curved and is eas...Figure 6.47 Insufficient fluid flow allows the urethra to collapse, increasi...Figure 6.48 The increasing curvature of the urethra as it approaches and pas...Figure 6.49 Once the ischial arch is passed, the passage of the endoscope be...Figure 6.50 As the endoscope is passed into the prostatic urethra, distentio...Figure 6.51 The colliculus seminalis is seen as a prominent dorsal ridge and...Figure 6.52 The small flexible endoscopes suitable for transurethral cystosc...Figure 6.53 Adequate illumination is provided by these endoscopes for focal ...Figure 6.54 During examination of the ureteral openings, time is taken to ob...Figure 6.55 The ureteral openings are also visible from the cranial directio...Figure 6.56 Placing the tip of the endoscope close to the bladder wall provi...Figure 6.57 A urachal diverticulum in a male dog seen with the Flex‐XC with ...Figure 6.58 The distal urethra of a five‐year‐old intact male Irish Wolfound...Figure 6.59 The penile urethra of a male cat seen using a 1.0 mm diameter fi...Figure 6.60 The proximal penile urethra at the level immediately proximal to...Figure 6.61 The pelvic urethra of the same patient seen in Figure 6.60. The ...Figure 6.62 The abdominal segment of the urethra in a male cat examined duri...Figure 6.63 The bladder of a 10‐year‐old neutered male Domestic Shorthair ca...Figure 6.64 The right ureteral opening in the patient seen in Figure 6.63.Figure 6.65 A large quantity of sand in the bladder of a four‐year‐old neute...Figure 6.66 The bladder in the patient seen in Figure 6.65 after removal of ...Figure 6.67 Irrigation setup for prepubic percutaneous cystoscopy with a con...Figure 6.68 Puncture locations for prepubic percutaneous cystoscopy. The pun...Figure 6.69 (a) Trocar position and angle of intersection with the bladder w...Figure 6.70 The irrigation system setup with liquid inflow through the teles...Figure 6.71 Bladder and telescope position for placement of a second or oper...Figure 6.72 A standard open surgical suction tip placed into the bladder thr...Figure 6.73 Operating room setup drawing with the patient in dorsal recumben...Figure 6.74 Portal placement for laparoscopic‐assisted cystoscopy in a femal...Figure 6.75 After placement of both portals, the apex of the bladder is gras...Figure 6.76 The apex of the bladder is elevated into the operative portal ca...Figure 6.77 The cannula is removed, and the portal enlarged if needed. In th...Figure 6.78 Normal mucosa in a moderately distended bladder seen with laparo...Figure 6.79 The normal trigone in a 15‐year‐old neutered male Miniature Pood...Figure 6.80 The normal trigone seen through air from the cranial aspect duri...Figure 6.81 The right ureteral orifice on its papilla with a pulse of clear ...Figure 6.82 The right ureteral orifice seen with the bladder distended enoug...Figure 6.83 The caudal end of the pelvic urethra at the ischial arch in a ma...Figure 6.84 Examination of the pelvic urethra in a five‐year‐old neutered ma...Figure 6.85 Laparoscopic‐assisted cystoscopy also allows examination of the ...Figure 6.86 Examination of the urethra in a 16‐year‐old spayed female cat do...Figure 6.87 The colliculus seminalis seen during examination of the prostati...Figure 6.88 The openings of multiple prostatic ducts are visible on the righ...Figure 6.89 The pelvic urethra caudal to the prostate in an eight‐year‐old n...Figure 6.90 Examination of the pelvic urethra caudal to the prostate in a fo...Figure 6.91 Irrigation used during LAC dilates the pelvic urethra to form a ...Figure 6.92 Small sharp transverse circumferential ridges are occasionally s...Figure 6.93 Laparoscopic‐assisted cystoscopy for stone removal in a seven‐ye...Figure 6.94 A laser fiber passed through the operating channel of the 2.7 mm...Figure 6.95 A 5 Fr Foley urethral catheter visible in the pelvic urethra in ...Figure 6.96 The inflated bulb of an 8 Fr Foley urethral catheter in a 12‐yea...Figure 6.97 After completion of the procedure in the bladder, the cystotomy ...Figure 6.98 Multiple residual combination urate and oxalate calculi in the p...Figure 6.99 A large number of small amorphous silicate calculi in the pelvic...Figure 6.100 Fluorescence of a transitional cell carcinoma in the bladder of...Figure 6.101 The urethral tubercle and urethral orifice in a 16‐year‐old spa...Figure 6.102 The urethral orifice is usually seen as a closed or slightly op...Figure 6.103 This vaginal vestibule is distended enough to flatten all the m...Figure 6.104 A single small insignificant crypt of McCarthy in the lateral v...Figure 6.105 Three small insignificant crypts with easily visible deep walls...Figure 6.106 The lateral vestibular fossa of a seven‐year‐old spayed female ...Figure 6.107 A larger number of lateral vestibular fossa crypts involving a ...Figure 6.108 A double row of multiple crypts distorting the shape of the lat...Figure 6.109 A small deep crypt on the top of the urethral papilla adjacent ...Figure 6.110 A large deep crypt in the lateral ventricular fossa of a five‐y...Figure 6.111 The clitoral fossa in a seven‐month‐old spayed female Labrador ...Figure 6.112 The cranial wall of the clitoral fossa in a seven‐month‐old spa...Figure 6.113 The clitoris in a 13‐year‐old spayed female Schipperke. The cli...Figure 6.114 A particularly prominent vaginovestibular junction in a nine‐mo...Figure 6.115 The vaginal body of a seven‐month‐old spayed female Labrador Re...Figure 6.116 The vaginal body of a 13‐year‐old spayed female Schipperke with...Figure 6.117 The vaginal body in a three‐year‐old intact female 5.5 kg mixed...Figure 6.118 The vaginal body of a 10‐year‐old spayed female Springer Spanie...Figure 6.119 The vaginal body of a three‐year‐old spayed female Boxer dog on...Figure 6.120 The dorsal median fold seen as a prominent fixed ridge of tissu...Figure 6.121 The dorsal median fold in a seven‐month‐old spayed female Dober...Figure 6.122 A close‐up image of the cranial end of the dorsal median fold w...Figure 6.123 When first entering the urethra, when performing transurethral ...Figure 6.124 With fluid flow through the cystoscopy, the urethra fills to op...Figure 6.125 The completely distended urethra in a six‐month‐old intact fema...Figure 6.126 A distended urethra without residual mucosal ridges in a five‐y...Figure 6.127 A distended urethra with a large prominent dorsal mucosal ridge...Figure 6.128 An example of distinct narrowing of the cranial urethra in a 16...Figure 6.129 Partial dilation of an area of cranial urethral narrowing produ...Figure 6.130 An area of cranial urethral narrowing with blanched blood vesse...Figure 6.131 A single small urethral diverticulum in an 11‐month‐old intact ...Figure 6.132 Multiple small urethral diverticula in a five‐month‐old intact ...Figure 6.133 An unusual large urethral diverticulum in a three‐year‐old spay...Figure 6.134 The trigone of a collapsed bladder in a seven‐month‐old spayed ...Figure 6.135 The trigone of a collapsed bladder in an eight‐year‐old spayed ...Figure 6.136 A partially distended bladder with smooth mucosa and visible bl...Figure 6.137 A partially distended bladder in a three‐year‐old spayed female...Figure 6.138 A fully distended bladder with easily visible blood vessels wit...Figure 6.139 Multiple smoothly branching blood vessels seen in a distended b...Figure 6.140 Looking cranially with transurethral cystoscopy, the ureteral p...Figure 6.141 The left ureteral papilla and ostia seen looking cranially with...Figure 6.142 The left ureteral ostia in an overdistended bladder with the pa...Figure 6.143 A ureteral ostium appearing as an oval opening that does not ap...Figure 6.144 Normal urine flow from the right ureteral ostia seen looking cr...Figure 6.145 Normal urine flow from the left ureteral ostia in the same pati...Figure 6.146 The left ureteral papilla and ostium with bladder overdistentio...Figure 6.147 The normal trigone of the bladder in a four‐year‐old neutered m...Figure 6.148 Normal branching mucosal blood vessels seen with the Flex‐XC du...Figure 6.149 The urethra of a four‐year‐old neutered male Domestic Shorthair...Figure 6.150 The urethra of a three‐year‐old neutered male Domestic Shorthai...Figure 6.151 The prostatic urethra with a prominent colliculus seminalis in ...Figure 6.152 Glomerulations with scattered uniform distribution and size in ...Figure 6.153 A minimum number of glomerulations seen in the bladder of a sev...Figure 6.154 Glomerulations with size variation in the bladder of a 10‐year‐...Figure 6.155 A focal cluster of uniform‐sized glomerulations in a seven‐year...Figure 6.156 A sheet of glomerulations in the bladder of a seven‐year‐old sp...Figure 6.157 A small cluster of brown glomerulations indicating chronicity i...Figure 6.158 Glomerulations in the urethra of a 14‐year‐old spayed female Do...Figure 6.159 Close‐up magnified glomerulations with the appearance of petech...Figure 6.160 Close‐up magnified glomerulations with the appearance of a clus...Figure 6.161 Multiple hyperemic nodules in the bladder of a five‐year‐old sp...Figure 6.162 A single nodule in the bladder of a 11‐year‐old spayed female E...Figure 6.163 A close‐up view of nodules that are a combination of white and ...Figure 6.164 Three nodules of inflammatory tissue in the bladder of an eight...Figure 6.165 Multiple white nodules in the urethra of a six‐year‐old spayed ...Figure 6.166 Many mucosal colored nodules are present in this urethra of the...Figure 6.167 Numerous follicles in the vaginal vestibule of a dog with a rec...Figure 6.168 Multiple nodules in the vaginal vestibule and urethral orifice ...Figure 6.169 Scattered hyperemic nodules in a one‐year‐old intact female Col...Figure 6.170 A sheet of hyperemic nodules covering the dorsal median fold an...Figure 6.171 A large inflammatory polyp in the bladder of an eight‐year‐old ...Figure 6.172 An inflammatory polyp seen through air in a six‐year‐old intact...Figure 6.173 A small polyp in the bladder of 10‐year‐old spayed female Pug w...Figure 6.174 A cluster of small polyps around the left ureteral ostium of a ...Figure 6.175 A cluster of small polyps in and around a urachal diverticulum ...Figure 6.176 Multiple polyp‐like lesions on the surface of a transitional ce...Figure 6.177 One of several multipart inflammatory polyps in the bladder of ...Figure 6.178 Multiple individual polyps of variable size and appearance in t...Figure 6.179 One of the polyps in the patient in Figure 6.178 with typical n...Figure 6.180 A small bladder polyp with an unusual blood blister appearance....Figure 6.181 A small inflammatory polyp seen during transurethral cystoscopy...Figure 6.182 Mild early cystitis in an eight‐year‐old spayed female wirehair...Figure 6.183 More pronounced blood vessel tortuosity in the bladder of a sev...Figure 6.184 An increase in blood vessel numbers in the bladder of a five‐ye...Figure 6.185 An irregular vascular pattern with a combination of tortuosity,...Figure 6.186 A focal area of bladder wall vascular pattern change with incre...Figure 6.187 An increased number of small blood vessels in the proximal uret...Figure 6.188 Increased size and number of blood vessels with increased branc...Figure 6.189 An overwhelming increase in blood supply in the urethra of an 1...Figure 6.190 An example of bladder wall edema seen in a five‐year‐old neuter...Figure 6.191 An “C” shaped area of bladder wall edema that matches the shape...Figure 6.192 A large area of hemorrhage in the bladder wall of a five‐year‐o...Figure 6.193 Ecchymosis in the bladder mucosa of a five‐year‐old neutered ma...Figure 6.194 Marked hyperemia in the pelvic urethral mucosa of a 13‐year‐old...Figure 6.195 An area of mild mucosal hyperemia in the urethra of a six‐year‐...Figure 6.196 Early cellular change in the bladder mucosa of a six‐year‐old s...Figure 6.197 When seen with the telescope angle position to view the bladder...Figure 6.198 Early cellular change in the urethral mucosa with similar irreg...Figure 6.199 Partial loss of visible blood vessels in the pelvic urethra of ...Figure 6.200 Roughening of the mucosa in the urethra of a seven‐year‐old spa...Figure 6.201 Irregular patchy areas of mucosal thickening in the proximal ur...Figure 6.202 Thickened mucosa forming a ridge of abnormal tissue rather than...Figure 6.203 With progressive chronicity and severity, mucosal involvement e...Figure 6.204 Continued inflammatory activity produces further proliferation ...Figure 6.205 An area of the bladder in a seven‐year‐old spayed female Doberm...Figure 6.206 Large mucosal ridges covered with thickened inflamed mucosa and...Figure 6.207 A chronically inflamed end‐stage bladder in a 10‐year‐old neute...Figure 6.208 Visible fibrous bands in the urethra of a five‐year‐old neutere...Figure 6.209 A mucosal ulcer in the bladder of a 15‐year‐old neutered male M...Figure 6.210 A less obvious area of ulceration in the trigone area of the pa...Figure 6.211 An ulcer in the bladder of a seven‐month‐old spayed female Dobe...Figure 6.212 Free mucoid exudate in the bladder of a five‐month‐old intact f...Figure 6.213 Free mucoid exudate coming from the urethral orifice into the v...Figure 6.214 Voluminous mucopurulent exudate coming from the vaginal body th...Figure 6.215 Inspissated mucopurulent material in the vaginal body of a one‐...Figure 6.216 Adherent exudate in the bladder of a six‐year‐old spayed female...Figure 6.217 An adherent pseudomembrane of mucopurulent exudate in the ureth...Figure 6.218 A pseudomembrane of mucopurulent exudate on the floor of the va...Figure 6.219 Mucopurulent exudate seen in the vaginal body through the vagin...Figure 6.220 A urethral stricture in a 5‐year‐old spayed female 19 kg mixed‐...Figure 6.221 A mature urethral stricture of unknown etiology in a four‐year‐...Figure 6.222 A silicate calculus deeply imbedded in the urethral mucosa at t...Figure 6.223 Mucosal damage and reaction at the stone site in Figure 6.222 a...Figure 6.224 Urethral injury examined after a stone lodged in the urethra wa...Figure 6.225 Radiographs of a seven‐year‐old intact male Pug with a history ...Figure 6.226 A mature stricture was present at the caudal end of the os peni...Figure 6.227 Urethra mucosal deformity at the caudal end of the os penis fro...Figure 6.228 A distal urethral stricture not associated with a history or fi...Figure 6.229 A urethral stricture at the level of the prostate in a male dog...Figure 6.230 A urethral calculus lodged immediately proximal to a urethrocut...Figure 6.231 The stone was removed with a stone basket.Figure 6.232 Chronic urethral changes are seen here at the site where the st...Figure 6.233 A transitional cell carcinoma mass in the cranial bladder of a ...Figure 6.234 The trigone area of the patient in Figure 6.233 with large fimb...Figure 6.235 The proximal urethra in this same patient with complete replace...Figure 6.236 The distal urethra in the same patient that is also completely ...Figure 6.237 This image is with the telescope in the vaginal vestibule looki...Figure 6.238 Tumor tissue with a uniform layer of small fimbria in the right...Figure 6.239 Tumor tissue from the same patient in the left vestibular fossa...Figure 6.240 A solid sheet of TCC covering a large area of the vaginal body ...Figure 6.241 A small transitional cell carcinoma seen as an incidental findi...Figure 6.242 Flat round TCC lesion with a central indentation in a 10‐year‐o...Figure 6.243 A small round smooth raised white TCC lesion in the bladder wit...Figure 6.244 A small smooth oval satellite lesion in the bladder of an eight...Figure 6.245 A lobulated recurrent TCC lesion in the bladder of the nine‐yea...Figure 6.246 Tumor tissue spreading out onto the bladder wall from a raised ...Figure 6.247 A cystic‐appearing area of a large diffuse transitional cell ca...Figure 6.248 A cystic‐appearing area of a large TCC at the trigone in a 13‐y...Figure 6.249 A large transitional cell carcinoma with necrotic fimbria in th...Figure 6.250 Necrosis of the top of a smooth round transitional carcinoma of...Figure 6.251 A large mineralized TCC in the bladder of a 15‐year‐old neutere...Figure 6.252 A large transitional cell carcinoma in the trigone of a nine‐ye...Figure 6.253 A small smooth raised mucosal lesion on the bladder mucosa that...Figure 6.254 A small satellite TCC lesion having the dark purple blood‐fille...Figure 6.255 One of many extensions with the dark purple appearance of infla...Figure 6.256 A blood‐covered TCC mass in the bladder of an eight‐year‐old sp...Figure 6.257 A large free blood clot in the bladder of a dog with a large tr...Figure 6.258 A well‐organized blood clot protruding from the urethral orific...Figure 6.259 A trigonal and proximal urethral TCC in the bladder of a 15‐yea...Figure 6.260 Local extension of a large transitional cell carcinoma in the b...Figure 6.261 Local extension of a large TCC in the bladder of an 11‐year‐old...Figure 6.262 Extensive fimbriation of a urethral TCC in a 10‐year‐old spayed...Figure 6.263 A smooth raised white TCC lesion in the urethra of an 11‐year‐o...Figure 6.264 A transitional cell carcinoma with a lobulated appearance in th...Figure 6.265 Necrotic TCC tissue in the urethra of a six‐year‐old spayed fem...Figure 6.266 Small areas of mineralized TCC tissue at the proximal end of th...Figure 6.267 TCC in a 12‐year‐old Norfolk Terrier with diffuse involvement o...Figure 6.268 A large transitional cell carcinoma in the caudal bladder of a ...Figure 6.269 A large multipart lobulated TCC in an 11‐year‐old spayed female...Figure 6.270 A mass in the pelvic urethra of an 11‐year‐old neutered male Ge...Figure 6.271 TCC in the bladder of a 14‐year‐old neutered male Labrador Retr...Figure 6.272 Another area of the bladder mass in the dog in Figure 6.271 sho...Figure 6.273 Transurethral examination of the bladder in an eight‐year‐old n...Figure 6.274 A transitional cell carcinoma in the trigone of a 12‐year‐old n...Figure 6.275 A large transitional cell carcinoma at the trigone of an eight‐...Figure 6.276 Assessment of the prostatic urethral mucosa caudal to the main ...Figure 6.277 The trigonal TCC in the Golden Retriever seen in the previous i...Figure 6.278 Transitional carcinoma lesions in the pelvic urethra of a 12‐ye...Figure 6.279 A prostatic mass in a 10‐year‐old neutered male Pug. Histopatho...Figure 6.280 A solitary smooth well‐defined transitional cell carcinoma of t...Figure 6.281 A diffuse smooth slightly lobulated and indistinctly defined TC...Figure 6.282 A lobulated transitional cell carcinoma involving the trigone o...Figure 6.283 Proximal urethral involvement with TCC in a five‐year‐old spaye...Figure 6.284 Unusual fimbriation of a bladder wall TCC in a 10‐year‐old spay...Figure 6.285 A diffuse irregular transitional cell carcinoma involving a lar...Figure 6.286 Another portion of the tumor seen in Figure 6.285 with a smooth...Figure 6.287 A nine‐year‐old intact female Labrador Retriever with a large b...Figure 6.288 The appearance of the bladder wall in the patient in Figure 6.2...Figure 6.289 A small cell lymphoma of the bladder seen in a 16‐year‐old spay...Figure 6.290 A close‐up of a single nodule of the small cell lymphoma seen i...Figure 6.291 A vascular irregular transmissible venereal tumor (TVT) in the ...Figure 6.292 A vascular irregular TVT in the vaginal body of the same patien...Figure 6.293 A round transmissible venereal tumor seen in vaginal body throu...Figure 6.294 The TVT in Figure 6.293 following distention of the vaginal bod...Figure 6.295 Further distention of the vagina allowed it to be determined th...Figure 6.296 A polypectomy snare was placed at the base of this TVT lesion, ...Figure 6.297 The resection site following transection of the TVT stalk with ...Figure 6.298 A leiomyoma in the vaginal body in an eight‐year‐old intact fem...Figure 6.299 Sample collection for histopathology is done by excision of the...Figure 6.300 The base of the lesion transected flush with the surrounding mu...Figure 6.301 Vaginoscopy of a 12‐year‐old intact female Pomeranian with a ma...Figure 6.302 A polypectomy snare was placed over the mass and positioned usi...Figure 6.303 Examination of the resection site after transection using the s...Figure 6.304 Multiple small masses were also found in the vaginal body as in...Figure 6.305 Another area of the vaginal body had a cluster of individual ma...Figure 6.306 Multiple samples were collected with a polypectomy snare for hi...Figure 6.307 A large round intraluminal vaginal mass seen in a 12‐year‐old i...Figure 6.308 This mass appeared very similar to a vaginal hyperplasia lesion...Figure 6.309 Multiple individual sharp calcium oxalate monohydrate crystals ...Figure 6.310 A cluster of adherent sharp calcium oxalate crystals forming a ...Figure 6.311 A cluster of adherent rounded calcium oxalate crystals forming ...Figure 6.312 Multiple irregular calcium oxalate calculi in the bladder of a ...Figure 6.313 Multiple smooth round calculi seen in the bladder of a 10‐year‐...Figure 6.314 A large irregular calcium oxalate calculus that appears to be f...Figure 6.315 A single large calcium oxalate calculus formed as an aggregate ...Figure 6.316 A tubular calcium oxalate calculus formed from an aggregate of ...Figure 6.317 Fine calcium oxalate sand in the bladder of a 10‐year‐old spaye...Figure 6.318 A white calcium oxalate calculus formed as a cluster of adheren...Figure 6.319 A smooth round struvite calculus in a seven‐year‐old spayed fem...Figure 6.320 A large oval struvite calculus in a six‐year‐old neutered male ...Figure 6.321 A large oval struvite stone in a four‐year‐old spayed female Mi...Figure 6.322 Struvite sludge in a six‐year‐old neutered male Domestic Shorth...Figure 6.323 Multiple urate calculi seen in the caudal pelvic urethra of an ...Figure 6.324 A small smooth urate calculus in the pelvic urethra of a one‐ye...Figure 6.325 Two round urate stones with a roughened surface seen in the sam...Figure 6.326 A large single urate calculus in the bladder of a 13‐year‐old n...Figure 6.327 A classic “jackstone” silica calculus in the bladder of a six‐y...Figure 6.328 Multiple silica calculi seen in the urethra of a nine‐year‐old ...Figure 6.329 A cluster of individual white irregular silica calculi in the p...Figure 6.330 A small oxalate calculus protruding from the ureteral ostium in...Figure 6.331 Multiple small struvite calculi imbedded in the mucosa of an 11...Figure 6.332 An unusual finding of a single small silica calculus lodged in ...Figure 6.333 A small struvite calculus trapped in mucosal folds of the vagin...Figure 6.334 A silica calculus lodged in the urethra at the level of the cau...Figure 6.335 A silica calculus deeply imbedded in the urethral mucosa at the...Figure 6.336 A linear calculus covering a strand of suture material still at...Figure 6.337 Multiple free linear calculi in an eight‐year‐old spayed female...Figure 6.338 Residual clearly visible suture tracts at a cystotomy incision ...Figure 6.339 A different view of the suture tracts in the previous case show...Figure 6.340 A strand of suture material seen in the bladder lumen where it ...Figure 6.341 A very thin vaginal web seen as a very thin hairlike strand of ...Figure 6.342 A simple vaginal web seen as a band of tissue extending dorsove...Figure 6.343 A thick vaginal septum in a seven‐month‐old spayed female Labra...Figure 6.344 The vaginal septum from Figure 6.343 seen at an oblique angle a...Figure 6.345 The vaginovestibular junction of an eight‐month‐old spayed fema...Figure 6.346 The same patient as Figure 6.345 with a weasel wire passed thro...Figure 6.347 The same patient as Figures 6.345 and 6.346 with the endoscope ...Figure 6.348 A bizarre vaginovestibular junction in a seven‐month‐old intact...Figure 6.349 Ectopic ureteral ostia with normal appearance but are minimally...Figure 6.350 A left ectopic ureteral ostium that is minimally displaced but ...Figure 6.351 Bilateral minimally displaced ectopic ureters with prominent mu...Figure 6.352 An enlarged deformed ectopic ureteral ostium in the proximal en...Figure 6.353 An enlarged deformed ectopic ureter opening at the midpoint of ...Figure 6.354 A moderately enlarged ectopic ureter opening at the very distal...Figure 6.355 A full‐length urethral septum separating an intramural ureteral...Figure 6.356 A large fenestration in an ectopic ureter with the ostium at th...Figure 6.357 A small fenestration in the septum between the ectopic ureter a...Figure 6.358 A large cranial ectopic ureter opening in the proximal urethra ...Figure 6.359 The cranial end of the caudal segment of the ectopic ureter see...Figure 6.360 The caudal end of an intramural urethral ectopic ureter opening...Figure 6.361 The caudal opening of an ectopic ureter in an 18‐month‐old spay...Figure 6.362 Endoscopy of the dilated ectopic ureter that was large enough t...Figure 6.363 Further passage of the rigid cystoscope into the dilated ureter...Figure 6.364 A depression in the mucosa in a dog with bilateral ectopic uret...Figure 6.365 The site where a ureteral opening would normally occur with a d...Figure 6.366 Urine flow through an opening at a normal ureteral ostium site ...Figure 6.367 The normal right ureteral ostium in an 18‐month‐old spayed fema...Figure 6.368 Bilateral ectopic ureteral ostia with mild asymmetry in a four‐...Figure 6.369 Urethral diverticula at the caudal end of a bifurcating ridge o...Figure 6.370 A multipart transverse band of mucosa in an 11‐week‐old intact ...Figure 6.371 A small urethral wall indentation appearing to be a diverticulu...Figure 6.372 The urethral indentation seen in Figure 6.372 was explored, and...Figure 6.373 A right‐side ureterocele in a six‐month‐old intact female Chino...Figure 6.374 The ectopic right ureteral ostium in the patient in Figure 6.37...Figure 6.375 The inside of a ureterocele with a weasel wire passed through w...Figure 6.376 The lumen of a ureterocele seen at its exit point through the o...Figure 6.377 The ostium of an ectopic ureter seen using the Flex‐XC flexible...Figure 6.378 The normal contralateral right ureteral ostium in the same pati...Figure 6.379 The same normal contralateral right ureteral ostium seen in Fig...Figure 6.380 With the retroflexed endoscope looking caudally at the normal l...Figure 6.381 With enlarged ectopic ureteral openings and hydroureter, both p...Figure 6.382 In this image, the flexible endoscope has been passed cranially...Figure 6.383 The ectopic ureter opening in the pelvic urethra seen from the ...Figure 6.384 An 8 Fr red rubber catheter seen passing from the urethra into ...Figure 6.385 Examination of the ureteral ostia from the cranial aspect using...Figure 6.386 With further bladder distention, the abnormalities become more ...Figure 6.387 Observation of pulsatile urine flow revealed that there was uri...Figure 6.388 Further investigation of the dorsal mucosal ridge extending cau...Figure 6.389 A small ureterocele seen in a six‐month‐old neutered male Labra...Figure 6.390 The opening of the left ectopic ureter from Figure 6.389 is see...Figure 6.391 A small distinct urachal diverticulum in a five‐month‐old spaye...Figure 6.392 A small distinct urachal diverticulum in a six‐month‐old neuter...Figure 6.393 A urachal diverticulum seen on the outside of the bladder as an...Figure 6.394 A very small urachal diverticulum surrounded with hyperemic tis...Figure 6.395 Inflammatory nodules surrounding a urachal diverticulum in a fo...Figure 6.396 A urachal diverticulum surrounded by thickened bladder wall for...Figure 6.397 A urachal diverticulum in a five‐month‐old intact female Bouvie...Figure 6.398 A large urachal diverticulum with a visible lumen in a four‐mon...Figure 6.399 Inflammatory polyps at the site of a urachal diverticulum in a ...Figure 6.400 Multiple small calculi trapped in the urachal diverticulum of a...Figure 6.401 An enlarged dysplastic blood vessel in the bladder of a 15‐year...Figure 6.402 An additional image of the same area of vascular dysplasia seen...Figure 6.403 Hyperemia of the urethra in a 13‐year‐old spayed female Dachshu...Figure 6.404 Petechia in the urethra of a three‐year‐old spayed female Jack ...Figure 6.405 Ecchymoses in the trigone of the Dachshund with pelvic fracture...Figure 6.406 An area of bladder wall contusion with swelling, hyperemia, and...Figure 6.407 Multiple linear mucosal tears in the bladder of the 13‐year‐old...Figure 6.408 A mucosal laceration in a two‐year‐old spayed female Lhasa Apso...Figure 6.409 A bladder mucosal laceration secondary to trauma with necrosis ...Figure 6.410 A necrotic flap of urethral mucosa in the two‐year‐old spayed f...Figure 6.411 A small bladder wall penetration with an attached blood clot. D...Figure 6.412 A small bladder penetration with necrosis of tissue margins and...Figure 6.413 A small bladder penetration obscured with sand‐sized calculi in...Figure 6.414 A pulse of clear urine coming from the right ureter in the dog ...Figure 6.415 A pulse of hematuria from the left ureter in the dog in the Fig...Figure 6.416 Blood coming from the right ureter of a one‐year‐old intact fem...Figure 6.417 Clear urine coming from the left ureter of the patient in Figur...Figure 6.418 Blood coming from the left ureteral ostia of a one‐year‐old int...Figure 6.419 The diode laser is used for correction of urachal diverticula b...Figure 6.420 Application of the diode laser fiber in noncontact mode for cor...Figure 6.421 Completion of urachal diverticulum ablation with the diode lase...Figure 6.422 An inflammatory polyp in the bladder of a six‐year‐old intact f...Figure 6.423 A polypectomy snare placed and ready for transection at the bas...Figure 6.424 The resection site after removal of the polyp seen in Figures 6...Figure 6.425 A diode laser fiber positioned over a small inflammatory polyp ...Figure 6.426 The ablation sites of two small polyps in the patient in Figure...Figure 6.427 A urethral stricture of unknown etiology after balloon dilation...Figure 6.428 After balloon dilation and stent placement for stricture manage...Figure 6.429 Biopsy of the small TCC lesion in the bladder of a nine‐year‐ol...Figure 6.430 The tumor site after collecting a biopsy sample with the 5 Fr b...Figure 6.431 The tumor site after ablation of the base and surrounding tissu...Figure 6.432 TUC was performed at three months to evaluate tumor recurrence....Figure 6.433 Examination at 11 months revealed early tumor regrowth, and the...Figure 6.434 Eighteen‐month evaluation with TUC determined that there was no...Figure 6.435 Early tumor growth was found at 27 months.Figure 6.436 Laser ablation was repeated at this time.Figure 6.437 Examination was not repeated for 15 months, 30 months after ini...Figure 6.438 The mass was transected at its base with the diode laser and re...Figure 6.439 Cloudy liquid interfering with continued laser ablation of a la...Figure 6.440 Smoke in an air‐filled bladder obscuring visibility during lase...Figure 6.441 A small satellite TCC lesion in the bladder with multiple satel...Figure 6.442 A laser fiber positioned for ablation of the TCC lesion in Figu...Figure 6.443 Completion of ablation of a small TCC mass seen through saline....Figure 6.444 Laser ablation of TCC lesions in the pelvic urethra of a 12‐yea...Figure 6.445 Completed ablation of the TCC lesions in the pelvic urethra of ...Figure 6.446 A large TCC mass in the bladder of a 10‐year‐old spayed female ...Figure 6.447 A pedunculated TCC mass with a narrow stalk that is accessible ...Figure 6.448 A transitional carcinoma in an 11‐year‐old neutered male Austra...Figure 6.449 Transection of the tumor base seen in Figure 6.448 with the dio...Figure 6.450 The resection site of the tumor seen in Figures 6.448 and 6.449...Figure 6.451 A large trigonal transitional cell carcinoma mass in a nine‐yea...Figure 6.452 The right ureteral ostium in the patient in Figure 6.451. The m...Figure 6.453 The left ureteral ostium in the patient in Figures 6.451 and 6....Figure 6.454 The polypectomy snare positioned on the base of the tumor. The ...Figure 6.455 The resection site after the contraction of the snare loop with...Figure 6.456 A free tumor mass that has been resected by transection of the ...Figure 6.457 The free tumor mass seen in Figure 6.456 is being grasped with ...Figure 6.458 Removal of a freed TCC mass from the bladder of an 11‐year‐old ...Figure 6.459 A urinary stone basket was used to remove a tumor mass that has...Figure 6.460 Transection of a tumor mass into pieces small enough to pass th...Figure 6.461 A large solitary transitional cell carcinoma in the cranial ure...Figure 6.462 The mass in Figure 6.461 was transected at its base with a diod...Figure 6.463 Necrotic tissue left in the urethra following laser ablation of...Figure 6.464 A urethral stricture interfering with urination seen two weeks ...Figure 6.465 The stricture in Figure 6.464 after balloon dilation for tempor...Figure 6.466 Balloon dilation in the previous case produced temporary improv...Figure 6.467 Narrowing of the urine stream developed 20 weeks after stent pl...Figure 6.468 The intrastent stricture was successfully treated with balloon ...Figure 6.469 Ingrowth of TCC tissue typically progresses with all stents eve...Figure 6.470 Reduced functional urethral lumen due to tissue ingrowth in a p...Figure 6.471 A large number of oxalate cystic uroliths in this 13‐year‐old s...Figure 6.472 A large number of small calculi in the bladder of a six‐year‐ol...Figure 6.473 Examination of the bladder with TUC after the first hydropropul...Figure 6.474 Reexamination of the bladder after the second hydropropulsion s...Figure 6.475 Mucoid sludge in the bladder of a three‐year‐old spayed female ...Figure 6.476 Removal of a small cystic calculus using a small grasping force...Figure 6.477 Removal of a single small cystic calculus from the bladder of a...Figure 6.478 Multiple small cystic calculi mixed with blood and held togethe...Figure 6.479 A lateral abdominal radiograph of a seven‐year‐old neutered mal...Figure 6.480 Laparoscopic‐assisted cystoscopy was performed to remove the cy...Figure 6.481 The large calculi were removed with grasping forceps.Figure 6.482 All large stones and small fragments were removed.Figure 6.483 Removal of a pelvic urethral calculus with 2 mm‐diameter rigid ...Figure 6.484 Removal of a pelvic urethral calculus using a 5 Fr stone basket...Figure 6.485 An oxalate calculus in the distal urethra of an eight‐year‐old ...Figure 6.486 Transurethral correction of ectopic ureters was first attempted...Figure 6.487 The opening of the right ectopic intramural ureter at the cauda...Figure 6.488 The ostium of the left ureter in the patient in Figure 6.487 in...Figure 6.489 The free wall of the ectopic ureter separating the ectopic uret...Figure 6.490 A 600 μm laser fiber was passed through the operating channel o...Figure 6.491 The free wall of the ectopic ureter was cut cranially into the ...Figure 6.492 The ectopic ureter was dilated throughout its length, thereby m...Figure 6.493 The vaginal vestibule of a seven‐month‐old intact female Chocol...Figure 6.494 The vaginal vestibule of an 11‐week‐old intact female Yellow La...Figure 6.495 An asymmetrical vaginal vestibule with the patient, a one‐year‐...Figure 6.496 The vaginal vestibule of a three‐year‐old spayed female Siberia...Figure 6.497 The small opening of a right‐side intramural ectopic ureter in ...Figure 6.498 A weasel wire was placed into the ectopic ureter to help identi...Figure 6.499 Transection of the thick septum between the vaginal ostium of a...Figure 6.500 An 8 Fr red rubber urinary catheter passed from the vaginal ope...Figure 6.501 An intramural ectopic ureter in the urethra of a dog with a lar...Figure 6.502 Transection of the ureteral free wall caudal to the defect furt...Figure 6.503 Progression of the free wall cut cranially reveals the size of ...Figure 6.504 The ureterocele free wall is cut to the level where the ureter ...Figure 6.505 The exit point of the ureter through the bladder wall is freque...Figure 6.506 The small opening of an intramural ectopic ureter in the caudal...Figure 6.507 Continuation of the very small intramural ectopic ureter lumen ...Figure 6.508 Thickening of the axial free wall of the ectopic ureter in the ...Figure 6.509 The weasel wire in this image has been passed cranially in the ...Figure 6.510 Extension of the ectopic ureter free wall cut beyond the crania...Figure 6.511 The ureteral free walls were cut with the laser in a five‐month...Figure 6.512 The location of the right ureter with no opening. The ureteral ...Figure 6.513 The healed left ureteral ostium 18 months after transurethral l...Figure 6.514 Transurethral examination of ectopic ureters corrected with tra...Figure 6.515 The left ureteral neostoma with a small visible lumen that was ...Figure 6.516 Urine flow was seen from the right ureteral neostoma, but there...Figure 6.517 An example of a healed ureteral ostium after transurethral ecto...Figure 6.518 Once the abnormal anatomy has been defined and the openings of ...Figure 6.519 The electrode is inserted into the ectopic ureteral opening, an...Figure 6.520 The electrode is activated to apply the radio‐frequency cutting...Figure 6.521 With radio‐frequency being active, the electrode is retracted c...Figure 6.522 The free wall of the ectopic ureter is cut to the normal level ...Figure 6.523 A modified narrow loop electrode was used in this patient with ...Figure 6.524 Small vaginal webs are transected easily with small flexible bi...Figure 6.525 Small flexible scissors passed through the operating channel of...Figure 6.526 The diode laser is used for transecting small vaginal webs when...Figure 6.527 Small thin vaginal webs can be broken with pressure from the ti...Figure 6.528 Prior to the availability of the diode laser, large thick vagin...Figure 6.529 Mild bleeding was seen following the transection of large thick...Figure 6.530 Examination of the cut vaginal septum seen in Figures 6.528 and...Figure 6.531 A diode laser fiber that has been passed through the operating ...Figure 6.532 The thick vaginal septum seen in Figure 6.531 while being cut w...Figure 6.533 Completed transection of the vaginal septum seen in Figures 6.5...Figure 6.534 Preparation for bulking agent injection with the cystoscope pos...Figure 6.535 Placement of the needle is critical. It is inserted parallel to...Figure 6.536 Injection is initiated and observed for the creation of a visib...Figure 6.537 Injection is continued slowly while observing the increase in t...Figure 6.538 Injection is discontinued when the desired quantity of material...Figure 6.539 The same steps are repeated twice to produce three injection si...Figure 6.540 The desired end result is three equal‐sized projections of coll...Figure 6.541 A patient initially treated for ectopic ureters with transureth...

7 Chapter 7Figure 7.1 Schematic of the reproductive tract of the bitch.Figure 7.2 Anatomy of the cervical tubercle and vaginal fornix in the bitch ...Figure 7.3 Canine rigid endoscope (TCI scope)‐Karl Storz SE & Co. KG.Figure 7.4 TELE PACK™‐Karl Storz SE & Co. KG.Figure 7.5 Catheters (Rusch‐Teleflex) for endoscopic transcervical procedure...Figure 7.6 Introduction of the TCI scope in an angled direction.Figure 7.7 Endoscopic view of the urethral papilla (A) and vaginal opening (...Figure 7.8 Endoscopic view of vaginal folds.Figure 7.9 Endoscopic view of the dorsal median fold (DMF) and paracervical ...Figure 7.10 Endoscopic view of the dorsal median fold (DMF), paracervical ar...Figure 7.11 Endoscopic view of the cervical tubercle and os (arrow) in the b...Figure 7.12 Catheterization of the cervix under endoscopic view to perform e...Figure 7.13 Endoscopic view of fluid in the cervical area in the bitch.Figure 7.14 Endoscopic view of cervix catheterization (a) and semen back flo...Figure 7.15 Endoscopic view of the vagina during proestrus in the bitch.Figure 7.16 Endoscopic view of the vagina during estrus in the bitch.Figure 7.17 Endoscopic view of the vagina during diestrus in the bitch.Figure 7.18 Endoscopic view of the vagina during anestrus in the bitch.Figure 7.19 Endoscopic view of a vaginal septum (dorso‐ventral septum) that ...Figure 7.20 Endoscopic view of a vaginal band that is easily ruptured by dig...Figure 7.21 Endoscopic view of the resection of a vaginal septum in the bitc...Figure 7.22 Endoscopic view of vaginitis in the bitch.Figure 7.23 Endoscopic view of lymphoid follicles in the bitch.Figure 7.24 Endoscopic view of vaginal mass in the bitch.Figure 7.25 Endoscopic view of vaginal polypus in the bitch.Figure 7.26 Endoscopic view of uterine bifurcation in the bitch.Figure 7.27 Endoscopic view of cervical tubercle during normal postpartum (f...Figure 7.28 Endoscopic view of a single paw in a dystocia case in the bitch....Figure 7.29 Endoscopic view of the urethra in the bitch.Figure 7.30 Endoscopic view of paracervical region during estrus in the bitc...

8 Chapter 8Figure 8.1 Using a 10 mm diameter operating laparoscope in a single‐port for...Figure 8.2 An S‐PORTAL for single laparoscopic surgery (SILS). The S‐Portal ...Figure 8.3 Performing a laparoscopic ovariectomy in a dog using a two‐port t...Figure 8.4 Performing a laparoscopic ovariectomy and laparoscopic‐assisted g...Figure 8.5 An intact female Golden Retriever positioned on a tilt table in p...Figure 8.6 A right‐side ovarian pedicle site seen with laparoscopy following...Figure 8.7 A large blood clot in the right lumbar gutter of the patient seen...Figure 8.8 A right‐side ovarian pedicle site seen with laparoscopy in an 11‐...Figure 8.9 An insufflator used for laparoscopy in small animals. This unit, ...Figure 8.10 A Veress needle used for initial insufflation of the abdomen wit...Figure 8.11 Disposable low‐pressure insufflation tubing with a filter for co...Figure 8.12 Five millimeter diameter CLICKline instruments with 36 cm length...Figure 8.13 Three types of 5 mm biopsy forceps for small animal laparoscopy ...Figure 8.14 Close‐up images of the tips of the working inserts of 5 mm opera...Figure 8.15 Ten millimeter diameter operative instruments with 36 cm length ...Figure 8.16 Two options for stabilizing the ovary against abdominal wall whe...Figure 8.17 A three‐blade gall bladder extractor used for removal of large o...Figure 8.18 Examples of needle holders and assistants used for intracorporea...Figure 8.19 Curved CLICKline instruments for use with SILS ports. This desig...Figure 8.20 Lateral drawing of an undistended abdomen with a Veress needle i...Figure 8.21 Lateral drawing of distended abdomen with a Veress needle in pla...Figure 8.22 The Veress needle is inserted until the tip of the needle is in ...Figure 8.23 The “hanging drop” test for proper Veress needle position in the...Figure 8.24 When the Veress needle is properly placed in the peritoneal spac...Figure 8.25 If the Veress needle is NOT properly placed, either in the abdom...Figure 8.26 A transverse view of the abdominal wall at the linea alba with a...Figure 8.27 The appearance of flow and pressure readings of an insufflator a...Figure 8.28 The appearance of flow and pressure readings of an insufflator a...Figure 8.29 The ideal arrangement for laparoscopy with the telescope pointed...Figure 8.30 Initial right paramedian operating portal site determination usi...Figure 8.31 Abdominal wall displacement produced by external digital palpati...Figure 8.32 A number 10 scalpel blade penetrating the abdominal wall with a ...Figure 8.33 Proper hand position for holding a laparoscopy trocar‐cannula fo...Figure 8.34 The tip of the trocar of a laparoscopy trocar‐cannula properly p...Figure 8.35 Proper insertion of a smooth laparoscopy trocar‐cannula with the...Figure 8.36 When the cannula is properly inserted, the trocar is removed and...Figure 8.37 The leading edge of the screw tip of an EndoTIP laparoscopy cann...Figure 8.38 A 6 mm EndoTIP cannula threaded adequately into the abdomen.Figure 8.39 The normal‐appearing lateral abdominal wall looking transversely...Figure 8.40 As the telescope is angled from the transverse position craniall...Figure 8.41 Continued rotation of the telescope from the cranial direction a...Figure 8.42 Progression to a transverse position of the telescope to the rig...Figure 8.43 With the telescope pointed caudally into the right side of the p...Figure 8.44 A thick well‐defined internal rectus abdominis muscle sheath lay...Figure 8.45 A thin but easily seen and well‐defined internal sheath of the r...Figure 8.46 A subtle poorly defined internal rectus abdominus sheath at the ...Figure 8.47 There is no visible internal rectus abdominis muscle sheath in t...Figure 8.48 The left caudal portion of the lateral abdominal wall is visible...Figure 8.49 The translucent central tendon of the diaphragm. A portion of br...Figure 8.50 The muscular portion of the diaphragm in this image demonstrates...Figure 8.51 A single island of muscle tissue in the central tendon of the di...Figure 8.52 Multiple islands of muscle tissue in the central tendon of the d...Figure 8.53 Irregular contour of the central tendon with more dense tissue a...Figure 8.54 Irregular contour of the central tendon seen with a large transl...Figure 8.55 The central tendon of the diaphragm in a very small dog that is ...Figure 8.56 The internal end of the inguinal canal or vaginal ring in a norm...Figure 8.57 The same structures as in Figure 8.56 in an intact male dog with...Figure 8.58 In a 12‐year‐old male dog that was neutered as a young dog, the ...Figure 8.59 A 13‐year‐old neutered male cat showing atrophied deferent duct ...Figure 8.60 The vaginal process in a female dog passing through the vaginal ...Figure 8.61 Continuation of the falciform ligament to meet with the median l...Figure 8.62 A thin falciform ligament with minimal fat and multiple transluc...Figure 8.63 A thickened fat‐filled falciform ligament in an older dog seen f...Figure 8.64 The left side of the fat‐filled falciform ligament seen in Figur...Figure 8.65 The falciform ligament of the liver, a variable remnant of the v...Figure 8.66 A normal fat‐filled falciform ligament extending cranially to co...Figure 8.67 Atypical‐appearing fat on the abdominal wall in the caudal abdom...Figure 8.68 Normal appearance of the liver with rounded smooth surfaces and ...Figure 8.69 A normal‐appearing liver demonstrating sharp margins of the lobe...Figure 8.70 A normal‐appearing liver with a dappled bright red coloration pr...Figure 8.71 Dark muddy purple coloration of a normal‐appearing liver. A norm...Figure 8.72 Brown coloration of a normal‐appearing liver. A normal‐appearing...Figure 8.73 A normal‐appearing liver with dappled coloration and prominent s...Figure 8.74 A normal‐appearing common bile duct in a cat seen as the dark pu...Figure 8.75 The left kidney is seen with the patient in a right oblique posi...Figure 8.76 The right kidney is visible with the patient in a left oblique p...Figure 8.77 A blunt probe is positioned under the hepatorenal ligament to de...Figure 8.78 The cranial extent of the pancreas is visible as an off‐white sm...Figure 8.79 The caudal portion of the right lobe of the pancreas seen from t...Figure 8.80 A normal‐appearing spleen with the typical dark purple coloratio...Figure 8.81 A normal spleen in an 11‐year‐old dog with accentuated roughenin...Figure 8.82 A normal spleen with a linear area of pink on the caudal margin....Figure 8.83 A normal spleen with a circular area of pink on the ventral surf...Figure 8.84 Siderosis on the surface of the spleen in a 7‐year‐old spayed fe...Figure 8.85 A normal distended bladder with prominent blood vessels. This bl...Figure 8.86 A normal partially distended bladder with small subtle blood ves...Figure 8.87 A grossly overdistended bladder filling the caudal abdomen and i...Figure 8.88 A segment of the left ureter seen on the surface of the lumbar f...Figure 8.89 The same ureter in Figure 8.88 seen further caudally where it di...Figure 8.90 The normal left ureter seen crossing ventral to the colon and en...Figure 8.91 The ventral surface of the gastric body seen on the left side of...Figure 8.92 The ventral surface of a moderately distended gastric body seen ...Figure 8.93 The ventral surface of the gastric body is visible on the right ...Figure 8.94 A moderately distended stomach showing the greater curvature on ...Figure 8.95 The ventral surface of the pyloric antrum, pylorus, and proximal...Figure 8.96 Angulation of the pylorus for better visualization using graspin...Figure 8.97 Exposing the pylorus for better visualization by pushing the pyl...Figure 8.98 Loops of jejunum seen against the left abdominal wall without ov...Figure 8.99 The mesenteric border of the jejunum seen without omental coveri...Figure 8.100 The ileum is identified by visualizing the antimesenteric ileal...Figure 8.101 A gas‐distended cecum covered with omentum is visible ventral t...Figure 8.102 The descending colon visible in the left lumbar gutter free of ...Figure 8.103 The descending colon seen in the caudal abdomen dorsal to the b...Figure 8.104 The descending colon seen in the right caudal abdomen dorsal to...Figure 8.105 The left ovary in a juvenile dog is seen caudal to the left kid...Figure 8.106 The right ovary in a juvenile dog seen in the right lumbar gutt...Figure 8.107 The area of the left ovary in a young dog in estrus demonstrati...Figure 8.108 The left ovary in an older female dog surrounded by fat. The ov...Figure 8.109 The opening of the right ovarian bursa in a dog during anestrus...Figure 8.110 The appearance of the proliferated fimbria of the infundibulum ...Figure 8.111 The uterine tube is seen in this image as a pink raised ridge o...Figure 8.112 The uterus of a young dog undergoing estrus with numerous promi...Figure 8.113 An older intact female dog that had been through multiple heat ...Figure 8.114 The left uterine horn in a 12‐year‐old multiparous large breed ...Figure 8.115 The uterine body, bifurcation, and caudal portion of the uterin...Figure 8.116 The uterine body, bifurcation, and caudal portion of the uterin...Figure 8.117 The left adrenal gland in a 10‐year‐old spayed female Saint Ber...Figure 8.118 A mildly hypertrophied right adrenal gland in an 11‐year‐old ne...Figure 8.119 A left adrenal gland in a one‐year‐old overweight female Rottwe...Figure 8.120 Vascular supply to the left ovary in an overweight juvenile dog...Figure 8.121 The caudal vena cava in an icteric cat seen at the level of the...Figure 8.122 The caudal vena cava in a young dog seen in the central abdomen...Figure 8.123 Blood vessels and nerves visible laparoscopically with the pati...Figure 8.124 Bruising of the abdominal wall secondary to a traumatic inciden...Figure 8.125 Scarring of the abdominal wall seen as an incidental finding du...Figure 8.126 Defects in the abdominal wall muscles from an old injury. The p...Figure 8.127 Adhesions to the abdominal wall due to an old injury unrelated ...Figure 8.128 Abdominal wall bruising following ultrasound‐guided fine needle...Figure 8.129 Omental adhesions to the ventral abdominal wall secondary to an...Figure 8.130 Abdominal wall scar tissue at the site of previous laparoscopy ...Figure 8.131 Acute adhesions of the liver to the abdominal wall in a patient...Figure 8.132 The abdominal wall lesion after blunt division of the adhesions...Figure 8.133 Adhesions of omentum to the abdominal wall in another area of t...Figure 8.134 Using sharp dissection to divide adhesions of omentum to the ab...Figure 8.135 A vessel sealing device used for dividing omental adhesions to ...Figure 8.136 An inguinal hernia ring in a male dog seen as an incidental fin...Figure 8.137 The left internal inguinal ring in a dog with a left side retai...Figure 8.138 Omentum herniated through an umbilical hernia ring viewed from ...Figure 8.139 Nodules of neoplastic tissue on the abdominal wall of a 14‐year...Figure 8.140 A thin sheet of cancer cells on the abdominal wall of the patie...Figure 8.141 A thick hard mass of neoplastic tissue in a different area of t...Figure 8.142 Nodules of adenocarcinoma on the surface of the spleen in the p...Figure 8.143 A single nodule of neoplastic tissue on the surface of the blad...Figure 8.144 A small mass of neoplastic tissue in the omentum in the above p...Figure 8.145 Inflammatory nodules on the abdominal wall of a six‐year‐old sp...Figure 8.146 Hyperemia of the abdominal wall in a 7‐year‐old 30 kg mixed bre...Figure 8.147 Petechia on another area of small intestine in the patients see...Figure 8.148 Hyperemia and petechia on the diaphragm in same patient with pe...Figure 8.149 A large neoplastic mass originating from the central diaphragm ...Figure 8.150 Steatitis associated with active pancreatitis in a cat.Figure 8.151 Changed fat shape visible on the mesenteric border of the small...Figure 8.152 A small nodule of tissue attached by a narrow stalk to the omen...Figure 8.153 Marked yellow discoloration of fat in a cat with bile duct obst...Figure 8.154 Caudal abdominal fat discolored with blood in a patient with he...Figure 8.155 Altered fat appearance on the mesenteric side of the jejunum in...Figure 8.156 A linear metallic foreign body visible in the omentum of the ce...Figure 8.157 The foreign body grasped with 5 mm dissector/grasping forceps....Figure 8.158 The foreign body partially freed of tissue and held with the gr...Figure 8.159 The foreign body after removal from the omental tissue.Figure 8.160 The foreign body was transferred to a second grasping forceps w...Figure 8.161 The foreign body site after removal of the foreign body examine...Figure 8.162 Increased reticulation of the liver surface with no other chang...Figure 8.163 The distant liver lobe has an increased reticulation pattern, a...Figure 8.164 Loss of liver reticulation in a case with grade 3–4 (on a scale...Figure 8.165 A close‐up view of the liver in Figure 8.164 showing almost com...Figure 8.166 A liver surface with partial loss of reticulation in an 11‐year...Figure 8.167 Widened swollen pale interlobar tissue obscuring the reticulate...Figure 8.168 Surface irregularity of the liver in an 11‐year‐old spayed fema...Figure 8.169 Surface irregularity of the liver with moderate accumulations o...Figure 8.170 Blunting of liver margins and loss of reticulation in the left ...Figure 8.171 Blunting of the liver margins with uniform surface irregularity...Figure 8.172 Distortion of the liver in a seven‐year‐old spayed female Golde...Figure 8.173 Fibrosis on the surface of the liver in a two‐year‐old spayed f...Figure 8.174 Focal areas of fibrosis in the liver of a 13‐year‐old American ...Figure 8.175 Focal areas of fibrosis in the liver of an 11‐year‐old spayed f...Figure 8.176 Extensive fibrosis of the liver without significant distortion ...Figure 8.177 Extensive fibrosis of the liver with mild distortion, moderate ...Figure 8.178 Severe distortion of the liver shape and contour with extensive...Figure 8.179 The left liver lobes in a 13‐year‐old neutered male Golden Retr...Figure 8.180 The right liver lobes in the same dog as in Figure 8.179 showin...Figure 8.181 A tumor‐like mass in the liver of a dog with severe cirrhosis s...Figure 8.182 A tumor like mass in the liver of a dog with severe cirrhosis r...Figure 8.183 Lipidosis of the liver in a seven‐year‐old Domestic Shorthair c...Figure 8.184 A small but otherwise normal‐appearing liver in a six‐month‐old...Figure 8.185 An eight‐month‐old female Vizsla with a small liver based on ul...Figure 8.186 The appearance of a liver with marked diffuse lobular dissectin...Figure 8.187 An area of the liver in an 11‐year‐old neutered male Shetland S...Figure 8.188 Another area of the liver in Figure 8.187 with two defined area...Figure 8.189 An unusual‐appearing liver with marked fibrosis appearing on th...Figure 8.190 Another area of the liver from Figure 8.189 with less visible f...Figure 8.191 A hepatocellular adenoma in an eight‐year‐old neutered male Cho...Figure 8.192 Another area of the hepatocellular adenoma that does not have t...Figure 8.193 A well‐differentiated hepatocellular carcinoma that appears lik...Figure 8.194 A hepatocellular carcinoma that has variable appearance with ar...Figure 8.195 A hepatocellular carcinoma composed entirely of tissue that doe...Figure 8.196 A hepatocellular tumor in a 12‐year‐old neutered male Golden Re...Figure 8.197 A tumor mass in another area of the liver in the case of hepato...Figure 8.198 A bile duct carcinoma with the classic doughnut shape.Figure 8.199 The bile duct carcinoma in the same patient as Figure 8.198 wit...Figure 8.200 An anaplastic sarcoma of the liver in a 10‐year‐old spayed fema...Figure 8.201 A small purple hemangiosarcoma lesion that appears cystic or bl...Figure 8.202 Small flat solid‐appearing hemangiosarcoma lesions in the same ...Figure 8.203 Multiple solid‐appearing masses of various sizes and shapes in ...Figure 8.204 A large blood‐filled cystic‐appearing hemangiosarcoma lesion ad...Figure 8.205 A large cystic‐appearing blood‐filled mass adjacent to a smalle...Figure 8.206 A small solitary metastatic islet cell tumor lesion in a dog wi...Figure 8.207 Multiple liver metastatic islet cell tumor masses.Figure 8.208 A small solitary metastatic islet cell lesion on the underside ...Figure 8.209 The liver of a 12‐year‐old neutered male Domestic Shorthair cat...Figure 8.210 A large metastatic adenocarcinoma of undetermined origin in the...Figure 8.211 A small pink lesion representing a metastatic adenocarcinoma le...Figure 8.212 Another metastatic adenocarcinoma lesion appearing as a small w...Figure 8.213 A mass of non‐neoplastic hyperplastic liver tissue in the liver...Figure 8.214 A small pale nodule of nodular hyperplasia in the liver of an 1...Figure 8.215 A normal‐appearing gall bladder and liver. The gall bladder was...Figure 8.216 The gall bladder in a 10‐year‐old neutered male Shih Tzu with g...Figure 8.217 Variation in gall bladder color in an uncompromised dog without...Figure 8.218 An incidental finding of a focal area of gall bladder wall thic...Figure 8.219 Apparent gall bladder wall thickening due to an empty gall blad...Figure 8.220 Apparent gall bladder wall thickening due to the gall bladder b...Figure 8.221 Gall bladder distension in a 14‐year‐old spayed female Domestic...Figure 8.222 A large distended gall bladder with no indication of bile duct ...Figure 8.223 Mild dilation of the common bile duct in a cat with no cause of...Figure 8.224 Marked dilation of the common bile duct in a dog without convol...Figure 8.225 Marked dilation of the extra‐hepatic bile ducts with severe con...Figure 8.226 A mass is visible in the case in Figure 8.225 with bile duct di...Figure 8.227 A normal‐appearing kidney in a six‐month‐old Goldendoodle with ...Figure 8.228 An indentation on the surface of an otherwise normal‐appearing ...Figure 8.229 Hydronephrosis of the left kidney in a three‐year‐old spayed fe...Figure 8.230 Hemangiosarcoma in the left kidney of a 12‐year‐old neutered ma...Figure 8.231 A kidney in a 14‐year‐old spayed female Domestic Shorthair cat ...Figure 8.232 The left kidney in a 16‐year‐old spayed female Domestic Shortha...Figure 8.233 The right kidney in a 12‐year‐old neutered male Domestic Shorth...Figure 8.234 Severe pancreatitis in a 17‐year‐old spayed female Domestic Sho...Figure 8.235 Inflamed fat surrounding a poorly defined abscess cavity in the...Figure 8.236 Pancreatic swelling without changes in the appearance of pancre...Figure 8.237 Pancreatic swelling with early changes in the appearance of the...Figure 8.238 An insulinoma in the distal right lobe of the pancreas visible ...Figure 8.239 A malignant islet cell tumor hidden in peripancreatic fat and o...Figure 8.240 A pancreatic pseudocyst in an eight‐year‐old neutered male Dome...Figure 8.241 Needle aspiration of the pancreatic pseudocyst has removed its ...Figure 8.242 A small nodule on the spleen determined by histopathology to be...Figure 8.243 A splenic hematoma appearing as a discrete round mass on the sp...Figure 8.244 An elongated mass on the spleen that was a hematoma.Figure 8.245 A large irregular hematoma in the spleen of a 10‐year‐old spaye...Figure 8.246 A high‐grade anaplastic sarcoma in the spleen with metastasis t...Figure 8.247 Metastatic melanoma in the spleen of a 12‐year‐old neutered mal...Figure 8.248 A spleen with color variation from purple to red with no other ...Figure 8.249 A red rather than purple spleen. Is this color a normal spleen ...Figure 8.250 An abnormally shaped spleen with a projection or normal‐appeari...Figure 8.251 A spleen that appears folded sharply at mid‐body.Figure 8.252 A variation in surface texture of a spleen in a 12‐year‐old spa...Figure 8.253 Marked roughening of the surface of a spleen in a 12‐year‐old s...Figure 8.254 Normal‐appearing splenic tissue projecting from the margin of t...Figure 8.255 A pale raised area of splenic tissue. Without biopsy there is n...Figure 8.256 A raised area of tissue with mottled coloration. Without biopsy...Figure 8.257 Surface fibrosis of a spleen suspected to be secondary to previ...Figure 8.258 Extensive alteration of splenic shape with surface fibrosis tho...Figure 8.259 Adhesions of omentum to the spleen and abdominal wall with scar...Figure 8.260 A small nodule (<1.0 cm diameter) of ectopic splenic tissue in ...Figure 8.261 A larger mass of ectopic splenic tissue in the cranial abdomen ...Figure 8.262 Nodular hyperplasia of the left adrenal gland in an 8‐year‐old ...Figure 8.263 A hyperplastic right adrenal gland in a Domestic Shorthair cat....Figure 8.264 A pheochromocytoma in the right adrenal gland of an 11‐year‐old...Figure 8.265 A pheochromocytoma in the left adrenal gland of an 11‐year‐old ...Figure 8.266 A larger noninvasive adrenal mass in a 14‐year‐old neutered mal...Figure 8.267 An increased number of prominent blood vessels visible on the e...Figure 8.268 Dramatically increased dilated tortuous blood vessels on the ex...Figure 8.269 A bladder with a normal‐appearing external surface and with sig...Figure 8.270 A urachal diverticulum visible on the external surface of the b...Figure 8.271 A urachal diverticulum seen as a deformity at the apex of the b...Figure 8.272 A urachal diverticulum at the apex of the bladder in a six‐mont...Figure 8.273 A non‐patent urachal remnant visible as a solid band of tissue ...Figure 8.274 A patent persistent urachus extending as an open tube to the um...Figure 8.275 The bladder in a 10‐year‐old spayed female Domestic Shorthair c...Figure 8.276 Change in the external appearance of the bladder wall in a 13‐y...Figure 8.277 Distortion of the apex of the bladder due to a large apical tra...Figure 8.278 A pseudomass or pseudocalculus seen as a small mass in the cent...Figure 8.279 Adhesions to the ventral bladder wall seen at the time of lapar...Figure 8.280 Abnormal blood vessels seen with laparoscopy in a 12‐year‐old s...Figure 8.281 A traumatized bladder visible in a nine‐year‐old intact male Be...Figure 8.282 A large dilated distal ureter at its insertion into the bladder...Figure 8.283 A mildly dilated distal left ureter at its insertion into the b...Figure 8.284 A pedunculated leiomyoma on the external surface of the stomach...Figure 8.285 Abnormal‐appearing blood vessels and lymphatic vessels seen on ...Figure 8.286 A small intestinal small cell lymphoma in a 13‐year‐old spayed ...Figure 8.287 An adenocarcinoma in the small intestine of an 11‐year‐old spay...Figure 8.288 Another segment of the small intestine in the same patient as i...Figure 8.289 A cecal tumor seen in a 13‐year‐old large spayed female mixed b...Figure 8.290 An adenocarcinoma in the colon of a 16‐year‐old spayed female D...Figure 8.291 Prominent lymphatic vessels containing white lymph as an incide...Figure 8.292 Tortuous blood vessels and dilated indistinct lymphatic vessels...Figure 8.293 A focal accumulation of ectopic mineralized tissue of undetermi...Figure 8.294 A very small right ovarian remnant in a 5‐year‐old 27 kg spayed...Figure 8.295 A normal well‐healed right‐side ovarian pedicle site without an...Figure 8.296 A normal well‐healed left‐side ovarian pedicle site without any...Figure 8.297 A small discreet remnant of ovarian tissue on the right side in...Figure 8.298 A large right‐side ovarian remnant in an 18‐month‐old 25 kg spa...Figure 8.299 A left‐side ovarian remnant in a 6‐month‐old 22 kg spayed femal...Figure 8.300 An unusual right‐side ovarian remnant with part of the right ut...Figure 8.301 A dilated fluid‐filled uterine horn in an intact female dog wit...Figure 8.302 A fluid‐filled uterine horn in an intact female dog with pyomet...Figure 8.303 A normal‐appearing cryptorchid testicle seen in the caudal abdo...Figure 8.304 An extrahepatic portosystemic shunt in a neutered male Domestic...Figure 8.305 Enlarged blood vessels at the site of right ovarian pedicle adh...Figure 8.306 An enlarged blood vessel seen in lumbar fat and extending throu...Figure 8.307 Dilated lymphatic vessels on the portal veins of a six‐year‐old...Figure 8.308 Dilated lymphatic vessels on the caudal pole of the left kidney...Figure 8.309 Dilated lymphatic vessels on the gastric wall in the same patie...Figure 8.310 Dilated lymphatic vessels on the colon wall of a three‐year‐old...Figure 8.311 Fat‐filled small intestinal lymphatic vessels in the same patie...Figure 8.312 Fat‐filled lymphatic vessels in the small bowel wall of a six‐y...Figure 8.313 Clear abdominal fluid that is a pure transudate due to a protei...Figure 8.314 Yellow‐colored fluid that is otherwise a clear pure transudate ...Figure 8.315 A modified transudate seen as cloudy abdominal fluid in a patie...Figure 8.316 Serosanguineous fluid in the abdomen of a cat with metastatic n...Figure 8.317 Serosanguineous peritoneal fluid in the patient in Figure 8.314...Figure 8.318 Purulent fluid in the abdomen of a cat with a pancreatic absces...Figure 8.319 Free unclotted blood in the abdomen of a one‐year‐old female Be...Figure 8.320 Blood clots in the lumbar gutter of the patient in Figure 8.319...Figure 8.321 Bleeding from a splenic biopsy site in a 9‐year‐old 37 kg neute...Figure 8.322 Blood clots and free unclotted blood in the abdomen of a dog un...Figure 8.323 Spontaneous hemostasis with clotted blood covering an injury to...Figure 8.324 Gelfoam applied to the site of an injury to the spleen at the t...Figure 8.325 A hepatocellular tumor biopsy site with moderate active bleedin...Figure 8.326 The biopsy site in Figure 8.325 with no active bleeding after l...Figure 8.327 A laparoscopic liver biopsy site performed with a 5 mm diameter...Figure 8.328 Two adjacent liver biopsy sites taken from a 10‐year‐old spayed...Figure 8.329 A moderate but still insignificant amount of bleeding from a li...Figure 8.330 The liver biopsy site from Figure 8.329 a short time after the ...Figure 8.331 Operating room setup and portals for laparoscopic liver biopsy ...Figure 8.332 Two styles of 5 mm apposing cup or clam shell biopsy forceps us...Figure 8.333 Obtaining a liver biopsy from the margin of a liver lobe with t...Figure 8.334 Biopsy forceps positioned for taking a biopsy from the center o...Figure 8.335 Biopsy of a liver mass using the 5 mm apposing cup forceps with...Figure 8.336 The biopsy forceps are closed with moderate pressure and the fo...Figure 8.337 The appearance of the liver biopsy site after removal of the fo...Figure 8.338 Performing cholecystocentesis using a 3.5″ long 20 gauge spinal...Figure 8.339 Cholecystocentesis where the gall bladder was emptied for decom...Figure 8.340 Operating room setup and patient positioning for pancreatic bio...Figure 8.341 Operating room setup and patient positioning for pancreatic bio...Figure 8.342 Pancreatic biopsy in a cat using apposing cup biopsy forceps ap...Figure 8.343 An Endoclip applied to a blood vessel at the biopsy site of Fig...Figure 8.344 Operating room setup and patient positioning for kidney biopsy ...Figure 8.345 When the kidney to be biopsied is known prior to the procedure ...Figure 8.346 Biopsy of the right kidney with the patient in lateral recumben...Figure 8.347 Biopsy of the right kidney with the patient obliqued from dorsa...Figure 8.348 A pledget of Gelfoam placed on a kidney biopsy site with contin...Figure 8.349 The appearance of the kidney biopsy site and Gelfoam several mi...Figure 8.350 Active bleeding from a kidney biopsy site after sample collecti...Figure 8.351 Application of HemaBlock powder to the actively bleeding biopsy...Figure 8.352 Immediately following application of the HemaBlock powder to th...Figure 8.353 Operating room setup and patient position for laparoscopic‐assi...Figure 8.354 Operating room setup and patient position for laparoscopic‐assi...Figure 8.355 Grasping the antimesenteric border of the jejunum adjacent to a...Figure 8.356 Running the bowel using two 5 mm atraumatic forceps to select a...Figure 8.357 A loop of jejunum selected for biopsy that has been elevated to...Figure 8.358 To enlarge an operative portal for exteriorization of a loop of...Figure 8.359 An intestinal biopsy site that has been returned to the abdomen...Figure 8.360 Biopsy of the margin of the spleen using opposing cup biopsy fo...Figure 8.361 Minimal bleeding from the splenic biopsy site of the case in Fi...Figure 8.362 More significant bleeding from a splenic biopsy site in the cen...Figure 8.363 Spontaneous hemostasis of the biopsy site shown in Figure 8.362...Figure 8.364 A Gelfoam pledget placed in a splenic biopsy site to aid hemost...Figure 8.365 Operating room setup for laparoscopic ovariectomy and ovariohys...Figure 8.366 An alternative operating room setup for laparoscopic ovariectom...Figure 8.367 Telescope portal placement for single‐port ovariectomy using an...Figure 8.368 The left ovary visible between the spleen at the lower left of ...Figure 8.369 The left ovary grasped with 5 mm diameter Babcock forceps passe...Figure 8.370 The ovary is elevated away from the surrounding tissue to provi...Figure 8.371 A TT ovariectomy hook is passed through the abdominal wall at t...Figure 8.372 The telescope portal site on the ventral midline at or caudal t...Figure 8.373 The telescope portal site on the ventral midline at or caudal t...Figure 8.374 The ovary positioned against the abdominal wall with the Mouret...Figure 8.375 Babcock forceps are removed leaving the ovary in place fixed to...Figure 8.376 Initial placement of a 5 mm LigaSure vessel sealing device on t...Figure 8.377 The ovarian pedicle in Figure 8.376 after sealing and cutting t...Figure 8.378 Placement of the vessel sealing device on the uterine horn to c...Figure 8.379 The vessel sealing device placed in the center of the pedicle o...Figure 8.380 The ovarian pedicle site after completion of the transection us...Figure 8.381 The ovary and periovarian tissue after transection of the ovari...Figure 8.382 The ovarian package held in place with the Mouret needle after ...Figure 8.383 Grasping the utero‐ovarian ligament with reinserted Babcock for...Figure 8.384 The ovarian package is pulled up to or into the telescope cannu...Figure 8.385 Portal and needle placement for the two‐port ovariectomy techni...Figure 8.386 The left ovary seen from an umbilical telescope portal with the...Figure 8.387 The left suspensory ligament is grasped with Babcock forceps ad...Figure 8.388 The ovary is elevated away from the surrounding tissue with the...Figure 8.389 The right ovary placed against the abdominal wall in preparatio...Figure 8.390 The right ovary held against the abdominal wall with Babcock fo...Figure 8.391 After placement of the Mouret needle retractor, the Babcock for...Figure 8.392 The Babcock forceps is replaced with a vessel sealing device pa...Figure 8.393 Nearing completion of transection of the ovarian pedicle with t...Figure 8.394 Completed transection of the ovarian pedicle with the vessel se...Figure 8.395 A small ovary with limited periovarian tissue retracted up to a...Figure 8.396 A small ovarian package in a 1‐year‐old female Irish Setter aft...Figure 8.397 A medium‐sized ovary with surrounding fat in a nine‐month‐old f...Figure 8.398 A large ovarian package in a grossly overweight one‐year‐old fe...Figure 8.399 The large ovarian and periovarian tissue mass pulled tightly ag...Figure 8.400 The portal dilating device (Gall bladder extractor) placed arou...Figure 8.401 The ovarian tissue package partially extracted through the abdo...Figure 8.402 After portal placement for the three‐port technique and patient...Figure 8.403 Babcock forceps are passed through the caudal portal and the su...Figure 8.404 The ovary is elevated away from the surrounding tissue with the...Figure 8.405 If the handle of the Babcock forceps is released, the weight of...Figure 8.406 The ovarian pedicle elevated with the weight of the 5 mm Babcoc...Figure 8.407 The ovary held with Babcock forceps in preparation of ovarian p...Figure 8.408 The same ovary as in Figure 8.407 with the Babcock rotated 90° ...Figure 8.409 Transection of the ovarian pedicle using a 5 mm LigaSure vessel...Figure 8.410 Transecting the mesometrium in a thin juvenile dog using scisso...Figure 8.411 Transecting the mesometrium in an older multiparous female Labr...Figure 8.412 Cranial traction is placed on the uterine horn to elevate it aw...Figure 8.413 Tension and elevation of the caudal portion of the right uterin...Figure 8.414 Transection of the uterine horn at the uterine body bifurcation...Figure 8.415 Transection of the uterine body in a juvenile dog using a bipol...Figure 8.416 Transection of the uterine artery and vein as a separate step i...Figure 8.417 Transection through the cervix of the patient seen in Figure 8....Figure 8.418 The Babcock forceps are positioned to grasp the caudal cut end ...Figure 8.419 The ovarian remnant shown in Figure 8.298 grasped with Babcock ...Figure 8.420 Transection of the ovarian remnant pedicle using the LigaSure v...Figure 8.421 After completion of transection, the sealed incision line is ch...Figure 8.422 The resected ovarian remnant is maintained in the grasp of the ...Figure 8.423 The ovarian remnant tissue package is retracted to the end of t...Figure 8.424 Increased blood vessels in the area of left ovarian pedicle sca...Figure 8.425 Resection of the left ovarian pedicle scar with the enlarged bl...Figure 8.426 Operating room set up for laparoscopic cryptorchid castration w...Figure 8.427 Portal placement for cryptorchid castration using laparoscopic ...Figure 8.428 An intra‐abdominal cryptorchid testicle seen without any organ ...Figure 8.429 Further head down tilting of the patient in Figure 8.428 allows...Figure 8.430 A close‐up view of the gubernaculum testis indistinctly seen in...Figure 8.431 Babcock forceps grasping the head of the epididymis rather than...Figure 8.432 Babcock forceps grasping the tail of the epididymis rather than...Figure 8.433 Babcock forceps positioned to grasp the ductus deferens as anot...Figure 8.434 Transection of the pampiniform plexus and ductus deferens using...Figure 8.435 The transected patient end of the pampiniform plexus and ductus...Figure 8.436 Placement of a pretied loop ligature on the pampiniform plexus ...Figure 8.437 The ligature loop is closed and tightened around the structures...Figure 8.438 The suture and tissue are cut freeing the testicle for removal....Figure 8.439 The abdominal testicle in a unilateral cryptorchid patient that...Figure 8.440 The ligated and transected structures returned to the abdomen a...Figure 8.441 Operating room setup for laparoscopic assisted gastropexy place...Figure 8.442 Portal positions for laparoscopic‐assisted gastropexy with the ...Figure 8.443 The pyloric antrum and pylorus are identified. The pyloric antr...Figure 8.444 A dilated pyloric antrum obscuring visibility of the pylorus.Figure 8.445 A poorly visible pylorus due to position of the tissues and ang...Figure 8.446 Applying pressure to the dilated pyloric antrum seen in Figure ...Figure 8.447 Grasping the pyloric antrum and retracting it caudally allowing...Figure 8.448 The 10 mm Babcock/Duval forceps placed on the ventral surface o...Figure 8.449 The gastropexy site on the ventral wall of the pyloric antrum a...Figure 8.450 The gastropexy site on the ventral wall of the pyloric antrum a...Figure 8.451 The pyloric antrum is manipulated with the grasping forceps to ...Figure 8.452 The pyloric antrum in Figure 8.451 is manipulated with the gras...Figure 8.453 The grasped ventral wall of the pyloric antrum has been elevate...Figure 8.454 In this image, an 11 mm EndoTIP cannula is being used. This is ...Figure 8.455 Enlarging the gastropexy portal by passing a #10 scalpel blade ...Figure 8.456 The enlarged gastropexy portal from the outside with a small po...Figure 8.457 The gastropexy seromuscular incision in the pyloric antrum with...Figure 8.458 A continuous suture line is started at the center of the crania...Figure 8.459 The completed gastropexy site seen from the inside with the abd...Figure 8.460 A healed laparoscopic‐assisted gastropexy site seen during lapa...Figure 8.461 Identification of a ping pong ball gastric foreign body during ...Figure 8.462 Grasping the ping pong ball with Vulsellum forceps for removal....Figure 8.463 A small residual gastric foreign body seen with re‐examination ...Figure 8.464 A gastric foreign body seen with laparoscopic‐assisted gastroto...Figure 8.465 Re‐examination of the stomach in Figure 8.464 revealing an addi...Figure 8.466 Examination of the gastric lumen was repeated to remove all eig...Figure 8.467 The small bowel grasped in normal tissue adjacent to a focal sm...Figure 8.468 The small bowel mass resected using laparoscopic‐assisted techn...Figure 8.469 The cecum with the mass elevated for evaluation to determine re...Figure 8.470 The cecum is grasped in normal tissue adjacent to the mass usin...Figure 8.471 The exteriorized cecum and mass with a stay suture placed ready...Figure 8.472 Resection of the cecal mass with an open surgical stapling devi...Figure 8.473 Operating room setup for laparoscopic cholecystectomy with the ...Figure 8.474 Four‐portals are used for performing laparoscopic cholecystecto...Figure 8.475 Three operative portals are placed using the telescope in the i...Figure 8.476 Grasping a flaccid gall bladder wall for stabilization to allow...Figure 8.477 Following cystocentesis of the gall bladder in Figure 8.476 wit...Figure 8.478 For the top down dissection technique, the gall bladder is gras...Figure 8.479 A blunt probe gently applied as a retractor to move the adjacen...Figure 8.480 Curved 5 mm diameter Metzenbaum scissors are used to cut the ti...Figure 8.481 A free gall bladder prior to extraction from the abdomen with m...Figure 8.482 Irregular rough liver surface after dissection of the gall blad...Figure 8.483 Applying an Endoclip with a 10 mm clip applier to the isolated ...Figure 8.484 Three Endoclips applied to the isolated cystic bile duct after ...Figure 8.485 Two Endoclips applied to the isolated cystic duct that are too ...Figure 8.486 A pretied loop ligature being placed on the common bile duct in...Figure 8.487 The tightened loop ligature after removal of the knot pusher pr...Figure 8.488 Irrigation being applied to the dissection surface of the liver...Figure 8.489 Operating room setup and patient position for performing a part...Figure 8.490 Portal placement for performing a partial pancreatectomy of the...Figure 8.491 Portal placement for performing a partial pancreatectomy of the...Figure 8.492 Portal placement for performing a partial pancreatectomy of the...Figure 8.493 An insulinoma in the caudal portion of the right lobe of the pa...Figure 8.494 The right lobe of the pancreas is isolated by incising the meso...Figure 8.495 A pretied loop ligature was used in this patient and is seen be...Figure 8.496 The pretied loop has been positioned and tightened on the pancr...Figure 8.497 After suture placement, the pancreas is cut with Metzenbaum sci...Figure 8.498 The freed pancreas segment prior to preparation for extraction....Figure 8.499 The resected pancreas segment is placed into a tissue retrieval...Figure 8.500 The tissue retrieval bag is removed through the operative cannu...Figure 8.501 A cyst in the center of the left lobe of the pancreas with an e...Figure 8.502 Aspiration of the lesion in Figure 8.501 with a 20 gauge spinal...Figure 8.503 Completion of aspiration leaving a collapsed cyst. Aspiration c...Figure 8.504 The omental grasping forceps are replaced with forceps to grasp...Figure 8.505 The cyst is opened with Metzenbaum scissors initially with an o...Figure 8.506 Resection of the cyst‐free wall is continued with Metzenbaum sc...Figure 8.507 The cyst‐free wall is completely excised leaving only the porti...Figure 8.508 Thorough lavage of the surgery site is done after excision of t...Figure 8.509 Portal placement for nephrectomy with the patient in lateral re...Figure 8.510 Operating room setup for laparoscopic adrenalectomy with the pa...Figure 8.511 Portal placement for laparoscopic adrenalectomy with the patien...Figure 8.512 Portal placement for laparoscopic adrenalectomy with the patien...Figure 8.513 Cutting the translucent avascular hepatorenal ligament with sha...Figure 8.514 Dissection of tissue off of the caudolateral portion of the rig...Figure 8.515 Application of two Endoclips on the isolated phrenicoabdominal ...Figure 8.516 Transection of the phrenicoabdominal vein between the Endoclips...Figure 8.517 The adrenal gland and mass are separated from the vena cava usi...Figure 8.518 The phrenicoabdominal arterial trunk crosses the dorsal aspect ...Figure 8.519 Dissection of the caudal pole of the adrenal gland is done with...Figure 8.520 Completion of dissection of the adrenal gland leaves the origin...Figure 8.521 Multiple Endoclips are applied to the phrenicoabdominal vein fo...Figure 8.522 The vessel is transected peripheral to the Endoclips with Metze...Figure 8.523 All Endoclips are left on the patient side of the cut to ensure...Figure 8.524 Operating room setup and patient positioning for laparoscopic e...Figure 8.525 Portal placement for laparoscopic exploration of patients with ...Figure 8.526 After exploration and definition of the shunt vessel, additiona...Figure 8.527 If indicated, the telescope is moved to the initial operative p...Figure 8.528 Operating room and patient position for laparoscopic splenectom...Figure 8.529 Portal placement for urethral occluder implantation with an umb...Figure 8.530 The apex of the bladder is grasped with Babcock forceps and the...Figure 8.531 The medial ligament of the bladder and its extension caudally v...Figure 8.532 The translucent avascular lateral ligaments of the bladder wher...Figure 8.533 This is a mockup of the first step for the method of laparoscop...Figure 8.534 A Babcock grasping forceps is passed into one of the caudal ope...Figure 8.535 The long monofilament nonabsorbable suture loop is pulled throu...Figure 8.536 Babcock forceps are reinserted into the 6 mm cannula and passed...Figure 8.537 The Babcock forceps and the loop of suture through the occluder...Figure 8.538 The occluder in position in a patient after completion of the s...Figure 8.539 A mockup picture with the suture passed through the second eyel...Figure 8.540 The occluder in a patient after the end of the monofilament non...Figure 8.541 A mockup of placing an extracorporeal knot to secure the occlud...Figure 8.542 In a patient, the suture ends have been tightened to pull the o...Figure 8.543 Occluder position is checked after the suture is tied and the a...Figure 8.544 The actuating tube in the abdomen seen with the telescope in an...Figure 8.545 Short areas of tissue were present surrounding the actuating tu...Figure 8.546 Multiple significant adhesions were present with omentum attach...Figure 8.547 Adhesions of the bladder to the abdominal wall.Figure 8.548 Division of the omental adhesions to the abdominal wall with sh...Figure 8.549 Division of adhesions of the bladder to the abdominal wall with...Figure 8.550 Tissue attachment points of the actuating tube were divided wit...Figure 8.551 The actuating tube was exposed as far caudally as was reasonabl...Figure 8.552 Endoclips were applied to the actuating tube for occlusion to m...Figure 8.553 Portal placement for laparoscopic‐assisted cystoscopy with the ...Figure 8.554 The exact site for operative portal placement is determined by ...Figure 8.555 Once the site is selected for portal placement and an appropria...Figure 8.556 The operative portal cannula is placed using a blunt obturator ...Figure 8.557 The apex of the bladder is grasped with 5 mm Babcock or other a...Figure 8.558 The grasped bladder is elevated to the cannula. In some patient...Figure 8.559 The bladder is pulled through the abdominal wall portal to perf...Figure 8.560 A closed cystotomy incision after return of the bladder to the ...Figure 8.561 Portals for laparoscopic‐assisted cystopexy. An umbilical teles...Figure 8.562 Cranial traction is applied to the apex of the bladder from the...Figure 8.563 The bladder wall site for cystopexy is grasped with Babcock or ...Figure 8.564 The completed cystopexy with a continuous suture pattern attach...Figure 8.565 The healed cystopexy site in the previous patient seen nine mon...

9 Chapter 9Figure 9.1 Reusable trocar–cannulas used for thoracoscopy in small animals: ...Figure 9.2 Disposable plastic cannulas used for thoracoscopy in small animal...Figure 9.3 Adequate lung collapse for thoracoscopy in a patient using the se...Figure 9.4 Noncompliant lungs in a dog with pericardial effusion that did no...Figure 9.5 Pleural insufflation used in a dog for a right caudal lung lobect...Figure 9.6 Paraxiphoid telescope portal with the patient in dorsal recumbenc...Figure 9.7 The ventral mediastinum is visible as a complete or incomplete cu...Figure 9.8 When there is a complete mediastinum the pneumothorax produced is...Figure 9.9 A patient with a complete mediastinum that is shifted to the left...Figure 9.10 A natural fenestration visible in the ventral mediastinum that a...Figure 9.11 Cutting a hole in a complete mediastinum to provide access to th...Figure 9.12 Cutting a hole in an incomplete mediastinum without a visible fe...Figure 9.13 A thickened ventral mediastinum covered with reactive pleural ti...Figure 9.14 Cutting a normal mediastinum off of the sternum using sharp diss...Figure 9.15 Cutting through a normal ventral mediastinum where there is a bl...Figure 9.16 A ventral mediastinum with increased number and size of blood ve...Figure 9.17 Cutting the mediastinum off of the sternum in the patient in Fig...Figure 9.18 The mediastinum is cut away from the sternum as far cranially as...Figure 9.19 When indicated the mediastinum is cut off the sternum caudally t...Figure 9.20 Completion of taking the mediastinum down from the sternum provi...Figure 9.21 Placing a lateral chest wall operative portal using a sharp troc...Figure 9.22 Establishing a lateral chest wall portal using blunt dissection ...Figure 9.23 Establishing a lateral chest wall portal by passing a scalpel bl...Figure 9.24 Placing a plastic disposable laparoscopy cannula through the che...Figure 9.25 Placing an EndoTIP cannula through a sharp chest wall incision w...Figure 9.26 Final position of a threaded EndoTIP cannula placed as a lateral...Figure 9.27 A chest tube is placed through the paraxiphoid telescope portal ...Figure 9.28 Adequate chest tube position is confirmed visually with the tele...Figure 9.29 After chest tube placement with this technique the paraxiphoid t...Figure 9.30 Chest tube placement is done with standard open surgical techniq...Figure 9.31 The normal appearance of the right chest wall seen using thoraco...Figure 9.32 The sympathetic trunk is seen running from cranial to caudal acr...Figure 9.33 The thoracic duct is seen as a single clear linear vessel in the...Figure 9.34 A branching thoracic duct is seen as a clear linear vessel in th...Figure 9.35 Smaller lymphatic ducts seen in a 3‐year‐old male English Spring...Figure 9.36 The diaphragm is visible as a convex muscular dome‐shaped struct...Figure 9.37 The dome‐shaped central tendon portion of the diaphragm is a tra...Figure 9.38 The peripheral attachment of the diaphragm meets the chest wall ...Figure 9.39 In the ventral thorax the enlarged costochondral junctions are v...Figure 9.40 The azygos vein is seen in the right dorsal thorax running from ...Figure 9.41 The left pulmonary ligament is seen as the translucent sheet of ...Figure 9.42 The cranial vena cava is visible in the cranial mediastinum with...Figure 9.43 The caudal vena cava seen entering the thorax through the caval ...Figure 9.44 Another view of the caudal vena cava seen in Figure 9.43 showing...Figure 9.45 The caudal vena cava seen from a paraxiphoid telescope portal wi...Figure 9.46 The phrenic nerve is seen as it angles dorsally from the cranial...Figure 9.47 Continuation of the phrenic nerve is seen on the lateral surface...Figure 9.48 The cranial surface of the pericardium is visualized well with t...Figure 9.49 An obese patient with the pericardium mostly covered with fat an...Figure 9.50 Normal lung visible with the patient in dorsal recumbency from a...Figure 9.51 Close‐up examination of lung tissue allows individual alveoli to...Figure 9.52 Normal cranial mediastinal anatomy seen with the patient in dors...Figure 9.53 The sternal lymph node is visible in this picture as the pink ov...Figure 9.54 Removing residual pleural space fluid, in this case, bloody flui...Figure 9.55 Removing residual pericardial fluid that was not removed with pr...Figure 9.56 Subpleural bleeding in the chest wall of a ten‐year‐old neutered...Figure 9.57 A lung lesion with a puncture injury and surrounding contusion s...Figure 9.58 A pericardial puncture lesion seen from the inside of the perica...Figure 9.59 A large chest wall mass originating from a rib in the left crani...Figure 9.60 A primary chondrosarcoma originating in the costal cartilage in ...Figure 9.61 A porcupine quill penetrating the left chest wall from the outsi...Figure 9.62 Secondary chest wall reaction due to a migrating plant material ...Figure 9.63 Pyogranulomatous pleuritis involving the parietal pleura on the ...Figure 9.64 An extensive adhesion from an area of abnormal lung to the chest...Figure 9.65 Thickened pleura obscuring visualization of thoracic wall anatom...Figure 9.66 Pleural thickening due to chylothorax in the left caudal and dor...Figure 9.67 A small number of submacroscopic pleural nodules in the parietal...Figure 9.68 Extensive white mesothelioma nodules on the chest wall pleura an...Figure 9.69 One of several large red irregular pleural masses on the chest w...Figure 9.70 A pleural mass attached to the chest wall of a 12‐year‐old neute...Figure 9.71 Additional smaller discrete nodules on another area of the chest...Figure 9.72 Widely spread submacroscopic nodules on the diaphragm and chest ...Figure 9.73 In this same patient a lesion comprised of a collection of nodul...Figure 9.74 The pulmonary mass in the same patient shown in the Figures 9.70...Figure 9.75 Pyogranulomatous pleuritis and pneumonia with adhesion to and in...Figure 9.76 Adhesion of the right caudal lung lobe to the diaphragm due to c...Figure 9.77 A deformed liver lobe in the chest of a large 12‐year‐old spayed...Figure 9.78 Pyogranulomatous pleuritis secondary to recurrent pyothorax due ...Figure 9.79 Prominent mediastinal blood vessels in a dog with vascular conge...Figure 9.80 A small thymic carcinoma in the cranial mediastinum of a 13‐year...Figure 9.81 A medium‐sized lymphocyte rich thymoma in a 12‐year‐old neutered...Figure 9.82 A large lymphocyte rich thymoma with limited vascularity filling...Figure 9.83 A large lymphocyte rich vascular thymoma in the cranial thorax o...Figure 9.84 A non‐thymic lymphoma mass in the cranial mediastinum of an 8‐ye...Figure 9.85 An ectopic thyroid carcinoma in the cranial mediastinum of a 12‐...Figure 9.86 A poorly differentiated carcinoma of undetermined origin in the ...Figure 9.87 A large neuroendocrine tumor in the cranial mediastinum of a 7‐y...Figure 9.88 A large thin walled cranial mediastinal cyst in a 16‐year‐old sp...Figure 9.89 A cranial mediastinal accumulation of chyle is visible in a 9‐ye...Figure 9.90 A large inflammatory caudal mediastinal mass in a three‐year‐old...Figure 9.91 A partially decomposed grass awn found free in the pleural space...Figure 9.92 A group of porcupine quills in the cranial thorax of a 5‐year‐ol...Figure 9.93 A large primary bronchogenic adenocarcinoma in the right cranial...Figure 9.94 The dorsomedial surface of the same mass as seen in Figure 9.93 ...Figure 9.95 A large adenocarcinoma in the cranial end of the left caudal lun...Figure 9.96 Malignant histiocytosis lesions in the left cranial lung lobe of...Figure 9.97 A massive right caudal lung lobe primary lung tumor in a 10‐year...Figure 9.98 A small primary lung tumor visible on the surface of the right c...Figure 9.99 Superficial changes in the surface of the caudal part of the lef...Figure 9.100 Two small flat red dots representing metastatic lesions on the ...Figure 9.101 Multiple small flat red metastatic hemangiosarcoma lesions were...Figure 9.102 Small raised red hemangiosarcoma metastases in a 10‐year‐old sp...Figure 9.103 A small raised purple metastatic lesion on the ventral margin o...Figure 9.104 A small purple polypoid metastatic lesion on the medial surface...Figure 9.105 A metastatic adenocarcinoma of undetermined, suspected mammary,...Figure 9.106 Massive infiltration of all lung lobes with an uncountable numb...Figure 9.107 An enlarged hilar lymph node in a 6‐year‐old spayed female Mini...Figure 9.108 An air‐filled bulla in the foreground and an empty collapsed bu...Figure 9.109 An air‐filled bulla on the caudal margin of the right cranial l...Figure 9.110 An air‐filled bulla on the dorsal surface of the left cranial l...Figure 9.111 A large air‐filled bulla in the right cranial lung lobe on the ...Figure 9.112 Multiple air‐filled bullae on the caudoventral corner of the ri...Figure 9.113 The bulla seen in Figure 9.109 that is collapsed during the exh...Figure 9.114 An obvious hole in a distended bulla with visible air flow seen...Figure 9.115 The bullae on the dorsal surface of the left cranial lung lobe ...Figure 9.116 Chronic pulmonary fibrosis in a 10‐year‐old spayed female Domes...Figure 9.117 Atelectatic non‐aerated lung in a 13‐year‐old spayed female Ger...Figure 9.118 Diffuse pulmonary hemorrhage and atelectasis seen in the crania...Figure 9.119 Chronic fibrosing pneumonia in the right caudal lung lobe in a ...Figure 9.120 Underdeveloped right cranial and middle lung lobes in an 8‐mont...Figure 9.121 Histiocytic pneumonia in the right cranial lung lobe of an eigh...Figure 9.122 Lung lobe torsion in a 4‐year‐old spayed female Whippet seen af...Figure 9.123 Small white mesothelioma nodules in the cranial mediastinum of ...Figure 9.124 Small white mesothelioma nodules on the caudal vena cava and on...Figure 9.125 Moderate pleural thickening in a 9‐year‐old neutered male Domes...Figure 9.126 Cranial mediastinal subpleural chyle accumulation in the same p...Figure 9.127 In the same patient as seen in Figure 9.125 and 9.126 the thora...Figure 9.128 The same patient after dissection to expose the thoracic duct a...Figure 9.129 The cautery blade from a standard monopolar radiofrequency elec...Figure 9.130 Completion of the cautery process with a dry field and oblitera...Figure 9.131 Marked pleural thickening in a cat with chylothorax of short du...Figure 9.132 Constrictive pleuritis causing collapse of the lungs in the sam...Figure 9.133 Minimal pleural reaction and thickening in an 8‐year‐old neuter...Figure 9.134 In the same patient as Figure 9.133 streaks of fibrin accumulat...Figure 9.135 Marked pleural thickening due to chylothorax in a 9‐year‐old sp...Figure 9.136 Constrictive pleuritis compressing the lung lobes on the right ...Figure 9.137 A large fluid filled pericardium in an 8‐year‐old neutered male...Figure 9.138 A heart base mass visible through the pericardium prior to crea...Figure 9.139 A large heart base tumor visible as a mass distending the peric...Figure 9.140 A normal appearing pericardium in a dog with pericardial effusi...Figure 9.141 Mild pericardial thickening in an 11‐year‐old neutered male lar...Figure 9.142 Moderate pericardial thickening secondary to a heart base tumor...Figure 9.143 Marked pericardial thickening in a 12‐year‐old spayed female La...Figure 9.144 A pericardium with mesothelial reaction suspicious of mesotheli...Figure 9.145 A metastatic thyroid carcinoma lesion on the base of the aorta ...Figure 9.146 Inflammatory pericarditis in a spayed female Whippet of unknown...Figure 9.147 Mesothelioma nodules on the internal surface of the pericardium...Figure 9.148 A solid sheet of mesothelioma lining the pericardium in a neute...Figure 9.149 A completed pericardial window in a patient with a heart base t...Figure 9.150 Elevation of the pericardium looking cranially from the paraxip...Figure 9.151 Using a 30° telescope with the angle directed down in the same ...Figure 9.152 Additional elevation with two instruments and the 30° telescope...Figure 9.153 A large dark purple heart base tumor in a ten‐year‐old neutered...Figure 9.154 A heart base tumor with areas of multiple different appearances...Figure 9.155 A heart base tumor with the appearance of blood clots of differ...Figure 9.156 Biopsy of a pleural mesothelioma nodule using 5 mm diameter opp...Figure 9.157 Biopsy of a large mesothelioma mass on the parietal pleura in a...Figure 9.158 Biopsy of a pleural lesion in a dog with chylothorax. The lesio...Figure 9.159 A metastatic mass on the parietal pleura of a 12‐year‐old neute...Figure 9.160 An inoperable cranial mediastinal mass biopsied with the patien...Figure 9.161 A primary osteosarcoma in the chest wall of a 16‐month‐old neut...Figure 9.162 Biopsy of an enlarged hilar lymph node in a 6‐year‐old spayed f...Figure 9.163 Placement of 5 mm diameter opposing cup or clam shell biopsy fo...Figure 9.164 Placement of 5 mm biopsy forceps at the margin of a focal lung ...Figure 9.165 A defect in the margin of normal appearing lung tissue after a ...Figure 9.166 The biopsy site at the side of the focal lung lesion seen in Fi...Figure 9.167 Abnormal lung tissue in the cranial portion of the left cranial...Figure 9.168 The cut end of the resected left cranial lung lobe after applic...Figure 9.169 Abnormal lung tissue involving the right cranial and middle lun...Figure 9.170 An articulated EndoGIA linear stapler is positioned across the ...Figure 9.171 The lobectomy resection site after removal of the stapler and r...Figure 9.172 This is the authors preference for operating room setup and pat...Figure 9.173 An alternative operating room setup, patient positioning, and p...Figure 9.174 The authors preferred portal placement for pericardial window s...Figure 9.175 An alternative for portal placement for pericardial window surg...Figure 9.176 A pericardial window can also be created with the patient in le...Figure 9.177 Pericardial window surgery portal placement when the patient is...Figure 9.178 Grasping the pericardium with 5 mm diameter aggressive rat toot...Figure 9.179 Excessive fat covering the pericardium and preventing access to...Figure 9.180 Reactive loose pleura on the pericardium interfering with visua...Figure 9.181 Grasping forceps elevating tissue in a patient where it cannot ...Figure 9.182 Grasping forceps with a grip that has clearly elevated the peri...Figure 9.183 Dissecting pleura and fat off of the pericardium to provide acc...Figure 9.184 Metzenbaum scissors positioned to cut into the pericardium in F...Figure 9.185 Cutting pericardium with scissors after initial penetration and...Figure 9.186 Elevation of the pericardium is maintained with the grasping fo...Figure 9.187 The procedure is continued until a patch of pericardium approxi...Figure 9.188 In this picture there is loss of pericardial elevation during c...Figure 9.189 The same patient as in Figure 9.188 with the grasping forceps r...Figure 9.190 This image demonstrates grasping forceps with a position that d...Figure 9.191 Thickened pericardial tissue may require more robust scissors t...Figure 9.192 Using a 5 mm vessel sealing device to create a pericardial wind...Figure 9.193 A thickened highly vascular pericardium in an 8‐year‐old neuter...Figure 9.194 Removing pericardial window tissue through a 6 mm EndoTIP cannu...Figure 9.195 Extracting pericardial window tissue with a significant adipose...Figure 9.196 Performing a subtotal pericardiectomy for treatment of chylotho...Figure 9.197 Subtotal pericardiectomy being performed in a 3‐year‐old neuter...Figure 9.198 Completed subtotal pericardiectomy in a dog with no visible per...Figure 9.199 Completed subtotal pericardiectomy in a cat with no visible per...Figure 9.200 Abnormal lung tissue in the ventral margin of the caudal portio...Figure 9.201 Positioning an articulating EndoGIA stapling device across the ...Figure 9.202 The stapling cartridge in Figure 9.201 was too short leaving a ...Figure 9.203 Completion of transection of lung tissue for this partial lung ...Figure 9.204 The resection line of a partial lobectomy of the right cranial ...Figure 9.205 Positioning of an EndoGIA stapling device on the ventral margin...Figure 9.206 The sealed staple line following partial lung lobectomy in the ...Figure 9.207 Running saline over a partial lung lobectomy site done with an ...Figure 9.208 Operating room arrangement for total lobectomy of a left crania...Figure 9.209 Operating room arrangement for total lobectomy of a left caudal...Figure 9.210 Portal placement for total lobectomy of the right caudal lung l...Figure 9.211 Portal placement for total lobectomy of the right cranial lung ...Figure 9.212 A 5 mm diameter vessel sealing device in position demonstrating...Figure 9.213 Cutting an avascular dorsal pulmonary ligament of the left caud...Figure 9.214 The activated vessel sealing device on the dorsal pulmonary lig...Figure 9.215 An EndoGIA stapler placed across the hilus of the left caudal l...Figure 9.216 A second EndoGIA stapler placed across the untransected portion...Figure 9.217 A tissue retrieval bag being used to remove a resected lung lob...Figure 9.218 The right cranial lung lobe elevated to expose the hilus in a p...Figure 9.219 The hilar resection site in the right cranial lung lobe seen in...Figure 9.220 A stapling device on the hilus of the cranial portion of the le...Figure 9.221 The hilar resection site in the left cranial portion of the lef...Figure 9.222 Operating room setup for combined thoracic duct occlusion and s...Figure 9.223 Portal placement for thoracic duct occlusion and subtotal peric...Figure 9.224 Pleural reaction with thickening in a 9‐year‐old spayed female ...Figure 9.225 Pleural reaction with thickening in a three‐year‐old neutered m...Figure 9.226 Incising the thickened pleura in the dog in Figure 9.224 expose...Figure 9.227 Incised thickened pleura in the cat in Figure 9.226 with expose...Figure 9.228 Clips applied after dissection of multiple thoracic duct branch...Figure 9.229 Dissected periaortic tissue in the cat seen in Figures 9.225 an...Figure 9.230 Portal placement for correction of persistent right aortic arch...Figure 9.231 Exposure and identification of the ligamentum arteriosum by sha...Figure 9.232 The ligamentum arteriosum is isolated from the esophagus and su...Figure 9.233 Patency of the ligamentum arteriosum in many patients requires ...Figure 9.234 Dissection over the constricted area of the esophagus is contin...Figure 9.235 Dissection of the cranial mediastinal mass shown in Figure 9.83...Figure 9.236 Completed dissection of the mass in Figure 9.235 with removal t...Figure 9.237 Dissection of a cranial mediastinal ectopic thyroid carcinoma i...Figure 9.238 The tumor site after complete resection of the ectopic thyroid ...Figure 9.239 Resecting a large vascular lymphocyte rich thymoma from the cra...Figure 9.240 Completed resection of the cranial mediastinal mass in Figure 9...Figure 9.241 The reactive ventral mediastinum in a five‐year‐old intact male...Figure 9.242 Transection of reactive caudal mediastinal tissue in the same p...Figure 9.243 Completed resection of the caudal mediastinal mass seen in Figu...Figure 9.244 Removing one of 45 porcupine quills seen in Figure 9.92 from th...Figure 9.245 Removing the quill from the patient seen in Figure 9.61 using 5...Figure 9.246 The quill in Figure 9.245 after it was withdrawn from its posit...Figure 9.247 The lung lesion caused by the porcupine quill shown being remov...Figure 9.248 A porcupine quill protruding from the heart of a dog with multi...Figure 9.249 A lung penetration with air leakage caused during portal placem...

10 Chapter 10Figure 10.1 Normal canine ear model.Figure 10.2 Video otoscope in the intertragic incisure (notch). This is the ...Figure 10.3 Luminal fold at the entrance to the horizontal ear canal. This p...Figure 10.4 Normal stenosis (lateral compression) of horizontal canal just i...Figure 10.5 Normal vasculature – canine ear canal (indicated by the arrows);...Figure 10.6 Hairs growing on the floor of the horizontal canal, just in fron...Figure 10.7 Normal canine tympanic membrane.Figure 10.8 Normal canine tympanic membrane with “normal” dilated pars flacc...Figure 10.9 Another example of a normal canine tympanic membrane.Figure 10.10 Normal tympanic membrane of the cat.Figure 10.11 Canine middle ear. Cadaver scull preparation.Figure 10.12 Canine middle ear. Cadaver preparation with soft tissues in pla...Figure 10.13 Feline middle ear. Cadaver skull.Figure 10.14 Normal feline middle ear with tympanum removed; other soft tiss...Figure 10.15 Canine ear. Dilated, fluid‐filled ceruminous glands associated ...Figure 10.16 Canine chronic, proliferative otitis externa with fibroprolifer...Figure 10.17 Feline concurrent otitis media and externa. Tympanum is thicken...Figure 10.18 Feline otitis media from Figure 10.15. Ear cleaned and dried. M...Figure 10.19 Chronic canine otitis media and externa. The canal was cleaned ...Figure 10.20 Video otoscope cone with working channel attached to a single‐c...Figure 10.21 Otoscope cone with adapter that allows for simultaneous fluid a...Figure 10.22 Video tower with a three‐chip camera connected to an otoscopy c...Figure 10.23 Storz C‐Mac Video system. Handheld, battery‐operated light sour...Figure 10.24 Telescope cone and handheld, battery‐operated light source adap...Figure 10.25 Multipurpose Rigid Telescope (30°) with arthroscope sheath that...Figure 10.26 Instrumentation available for use through a video otoscope work...Figure 10.27 Flushing and suctioning device (Storz Vetpump 2); allows contro...Figure 10.28 One individual is “driving” the video telescope cone while a se...Figure 10.29 Chronic canine allergic otitis externa with secondary Malassezi...Figure 10.30 The canine ear from Figure 10.29 after cleaning with flushing a...Figure 10.31 The canine ear from Figures 10.29 and 10.30 after debris was re...Figure 10.32 Canine otitis media. An extremely dilated pars flaccida is seen...Figure 10.33 Canine otitis media from Figure 10.32. A large hole has been cr...Figure 10.34 The ear from Figure 10.33 after middle ear cleaning. Large amou...Figure 10.35 Canine ceruminous adenoma. Biopsy forceps are used to remove (p...Figure 10.36 Canine ceruminous adenocarcinoma. The ear canal was first clean...Figure 10.37 Canine ceruminous adenocarcinoma from Figure 10.36. Narrow‐base...Figure 10.38 Feline aural polyp. Horizontal canal of the ear has been cleane...Figure 10.39 Feline inflammatory polyp seen in Figure 10.38. Polyp had grown...Figure 10.40 Image of exudate and epithelial debris within the tympanic bull...

11 Chapter 11Figure 11.1 A large smooth single calcium oxalate renal calculus in a six‐ye...Figure 11.2 A large smooth renal calculus in a nine‐year‐old severely overwe...Figure 11.3 A single small irregular calcium oxalate renal calculus in a 12‐...Figure 11.4 A single small calcium oxalate calculus composed of multiple sha...Figure 11.5 One of many solidified blood renal calculi in a 13‐year‐old neut...Figure 11.6 A lateral abdominal radiograph of the five‐year‐old spayed femal...Figure 11.7 Several of the many renal calculi in the left kidney of the cat ...Figure 11.8 A single large smooth calcium oxalate calculus in the right uret...Figure 11.9 Rigid 2.0 mm diameter double spoon arthroscopy forceps grasping ...Figure 11.10 Flexible 3.0 Fr diameter grasping forceps being used to remove ...Figure 11.11 Floating a small calculus out through a 2.0 mm diameter arthros...Figure 11.12 The renal pelvis after removal of all calculi.Figure 11.13 One of the renal recesses in the same kidney as Figure 11.12 wi...Figure 11.14 A small calculus wedged in the peripheral extent of a pelvic re...Figure 11.15 The peripheral end of the pelvic recess from Figure 11.14 after...Figure 11.16 A ureteral calculus composed of an aggregate of calcium oxalate...Figure 11.17 Debris from a fractured solidified blood calculus in the ureter...Figure 11.18 A normal undistended ureter in a dog with renal calculi but no ...Figure 11.19 A normal distended ureter in a cat with renal calculi and no ur...Figure 11.20 A dilated ureter proximal to a ureteral calculus in a nine‐year...Figure 11.21 Mucosal irritation at the site of a ureteral stone seen followi...Figure 11.22 Severe inflammation of the ureteral mucosa seen after removal o...Figure 11.23 A ureteral structure seen following removal of a ureteral calcu...Figure 11.24 A ureteral stricture distal to the site of a ureteral calculus ...Figure 11.25 A double pigtail ureteral stent placed after ureteral surgery f...Figure 11.26 Debris in a renal cyst examined using TANU by making a small st...Figure 11.27 The renal cyst wall following removal of the debris seen in Fig...Figure 11.28 A normal gall bladder in a 10‐year‐old neutered male Domestic L...Figure 11.29 The normal cystic bile duct in the same patient as seen in Figu...Figure 11.30 A ventrodorsal abdominal radiograph of a 12‐year‐old spayed fem...Figure 11.31 Calculi in the gall bladder of the 12‐year‐old spayed female Ca...Figure 11.32 Similar small gall stones and mucosal polyps in the cystic bile...Figure 11.33 A calculus in the common bile duct of the same patient as in Fi...Figure 11.34 An inflammatory polyp in a hepatic bile duct of the patient in ...Figure 11.35 Small calculi fragments remaining in the common bile duct after...Figure 11.36 The proximal common bile duct after completed removal of all ca...Figure 11.37 The proximal surface of the sphincter of Oddi seen by insertion...Figure 11.38 A temporary stent placed in the common bile duct through the sp...Figure 11.39 Appearance of gastric mucosal detail seen with a small rigid te...Figure 11.40 Appearance of duodenal mucosal villi with a rigid telescope pla...Figure 11.41 Transition of gastric mucosa in the background to duodenal muco...Figure 11.42 The major duodenal papilla seen with a small rigid telescope pl...Figure 11.43 A temporary stent that was placed in the bile duct using endosc...Figure 11.44 The normal tip and distal shaft of the penis in the prepuce see...Figure 11.45 The normal proximal shaft of the penis to its base seen with sa...Figure 11.46 A close‐up image of the reflection of mucosa at the base of the...Figure 11.47 Ruptured frenulum remnants in the prepuce of a four‐year‐old ne...Figure 11.48 A typical persistent penile frenulum in a three‐year‐old neuter...Figure 11.49 An atypical persistent penile frenulum appearing as a partial s...Figure 11.50 Cutting a persistent penile frenulum in the three‐year‐old neut...Figure 11.51 Exudate in the caudal portion of the prepuce in a nine‐year‐old...Figure 11.52 The underlying inflammatory reaction on the base of the penis a...Figure 11.53 Inflammatory nodules on the preputial mucosa after removal of t...Figure 11.54 A mass in the caudal recess of the prepuce. Prepucoscopy was us...Figure 11.55 A laceroscopy view of a fresh chest wall bite wound following a...Figure 11.56 An area of viable tissue in a deep wound in a dog with multiple...Figure 11.57 An area of devitalized tissue in the same patient as Figure 11....Figure 11.58 A caudal pharyngeal wall laceration in a four‐year‐old spayed f...Figure 11.59 A laceration in the soft palate of an eight‐year‐old German Sho...Figure 11.60 A laceration in the dorsal wall of the nasopharynx of the patie...Figure 11.61 The deep extent of the laceration at the thoracic inlet of the ...Figure 11.62 Foreign material debris in the traumatic penetration of a stick...Figure 11.63 Removing the foreign material seen in Figure 11.62 with rigid g...Figure 11.64 A Penrose drain was placed with endoscopic guidance in an eight...Figure 11.65 Closing the dorsal nasopharyngeal laceration seen in Figure 11....Figure 11.66 A Penrose drain fragment in a surgical wound from removal of an...Figure 11.67 Foreign material in a chronic draining fistula in the oral cavi...Figure 11.68 The foreign material removed from the dog in Figure 11.68 deter...Figure 11.69 An interdigital draining fistula in an eight‐year‐old spayed fe...Figure 11.70 A large stick foreign body in an eight‐year‐old neutered male L...Figure 11.71 The fistula cavity in the dog in Figure 11.71 after removal of ...Figure 11.72 Examination of the eye through the swollen eyelids revealed a c...Figure 11.73 A tangential view of the cornea showing normal uniform thicknes...Figure 11.74 The normal limbus of the eye.Figure 11.75 Staining of the entire corneal surface with fluorescein in the ...Figure 11.76 The inside of a cystic tumor that was accessed for biopsy by pl...Figure 11.77 Mild dental calculus on the medial aspect of the fourth premola...Figure 11.78 Mild dental calculus on the lateral aspect of the upper left ca...Figure 11.79 Severely infected incisors with severe gingivitis and purulent ...Figure 11.80 Severely infected upper right canine tooth and first molar in t...Figure 11.81 A craniolateral slab fracture of the left upper carnassial toot...Figure 11.82 An apical fracture exposing the root of an upper carnassial too...Figure 11.83 An endoscopic view of abnormal tissue in the apex of the alveol...Figure 11.84 Using a 2.0 mm arthroscopy forceps to biopsy the abnormal‐appea...Figure 11.85 The alveolus seen in Figure 11.84 after debriding.Figure 11.86 A normal tonsil in a nine‐year‐old neutered male Domestic Short...Figure 11.87 A normal tonsil in a 11‐year‐old spayed female Brittany Spaniel...Figure 11.88 Tonsillitis in a seven‐year‐old spayed female Vizsla.Figure 11.89 A small primary tonsillar squamous cell carcinoma in a 12‐year‐...Figure 11.90 The tip of the back end of a grass awn foreign body protruding ...Figure 11.91 Taking a biopsy of the tonsil in a seven‐year‐old spayed female...Figure 11.92 When indicated with tonsillar neoplastic lesions, completeness ...Figure 11.93 A normal relaxed soft palate with normal overlap with the epigl...Figure 11.94 A normal contracted soft palate in the patient in Figure 11.93....Figure 11.95 A typical elongated soft palate in a six‐year‐old spayed female...Figure 11.96 An atypical elongated soft palate with a narrowed extension of ...Figure 11.97 The immediate postoperative appearance following soft palate sh...Figure 11.98 A healed soft palate resection in a patient put under anesthesi...Figure 11.99 An increased vascular pattern and white inflammatory nodules in...Figure 11.100 A lymphoma mass in the soft palate in a 12‐year‐old neutered m...Figure 11.101 A solid mass of solidified exudate visible in the soft tissues...Figure 11.102 The tissue space medial to the tympanic bulla after removal of...Figure 11.103 The endotracheal tube traversing the pharynx as seen by advanc...Figure 11.104 Appearance of the pharyngeal end of the oro‐otic fistula prior...Figure 11.105 Appearance of the oro‐otic fistula by passage of the telescope...Figure 11.106 A red rubber catheter placed as an irrigation and drain tube e...Figure 11.107 A normal canine larynx with dorsal up on the image during the ...Figure 11.108 A close‐up of the normal canine vocal folds appearing with the...Figure 11.109 The most normal‐appearing feline larynx image available for th...Figure 11.110 The larynx of a seven‐year‐old spayed female Domestic Shorthai...Figure 11.111 The larynx of a 13‐year‐old neutered male Burmese cat anesthet...Figure 11.112 The appearance of laryngospasm in a 10‐year‐old spayed female ...Figure 11.113 Classic‐appearing laryngoceles in a three‐year‐old neutered ma...Figure 11.114 Large solid‐appearing everted lateral saccules in a one‐year‐o...Figure 11.115 Large fluid‐filled or cystic‐appearing everted lateral saccule...Figure 11.116 Small flaccid everted lateral saccules in an eight‐year‐old sp...Figure 11.117 Large irregular everted lateral saccules in a six‐year‐old neu...Figure 11.118 Small irregular everted lateral saccules in a six‐month‐old in...Figure 11.119 Using a diode laser to ablate everted lateral saccules in an 1...Figure 11.120 Completion of laser ablation of the left side of the patient i...Figure 11.121 Bilateral laryngeal collapse in a two‐year‐old spayed female P...Figure 11.122 Unilateral laryngeal collapse on the left side in a five‐year‐...Figure 11.123 Inspiratory adduction of the flaccid vocal folds producing a d...Figure 11.124 Expiratory abduction of the flaccid vocal folds to the resting...Figure 11.125 The larynx of a 13‐year‐old neutered male Labrador Retriever w...Figure 11.126 Small inflammatory nodules on the aryepiglottic fold of a two‐...Figure 11.127 Small indistinct inflammatory nodules on the vocal folds of a ...Figure 11.128 A laryngeal inflammatory polyp causing obstruction of the lary...Figure 11.129 The resection site of the polyp in Figure 11.128 was at the ve...Figure 11.130 A second inflammatory lesion in the same patient as Figures 11...Figure 11.131 A laryngeal stricture secondary to oral bark attenuation in a ...Figure 11.132 The larynx of a four‐year‐old intact male Shetland Sheepdog pr...Figure 11.133 Cutting the laryngeal stricture in the patient in Figure 11.13...Figure 11.134 Completed transection of the laryngeal stricture tissue in the...Figure 11.135 The larynx in a 12‐year‐old spayed female Norfolk Terrier with...Figure 11.136 A skin lesion image captured with a rigid endoscope providing ...Figure 11.137 The anal sac lumen of a three‐year‐old intact male Great Dane ...