Evaluation of Flap Survival Using Local Glucose Measurement in Dogs Undergoing Reconstructive Procedures: Two Case Reports

Early recognition of vascular compromise is essential for reconstructive flap survival. In human surgery, local glucose monitoring is widely used as an objective indicator of perfusion, but its application in veterinary patients is still limited. This report describes postoperative glucose measurement as a simple and minimally invasive method for evaluating flap viability in two dogs. This report describes two prospectively observed clinical cases in which local glucose measurement was applied as an adjunctive monitoring tool during postoperative flap management. Local glucose values were measured with a handheld glucometer at predefined flap and control sites. Serial readings were compared with daily assessments of flap color, temperature, turgor, and wound integrity. A previously suggested threshold of 60-62 mg/dL was used as a reference for potential perfusion compromise. In Case 1, a phalangeal fillet flap showed a brief glucose decline on postoperative days 2-3, followed by normalization and uneventful healing. In Case 2, which underwent advancement flap reconstruction after wound dehiscence, glucose values remained persistently below 60 mg/dL and preceded visible ischemia and distal necrosis. Local glucose monitoring provided rapid and clinically meaningful information about flap perfusion. Transient decreases reflected reversible postoperative congestion, whereas persistent hypoglycemia indicated progressive ischemia. These findings support the use of glucose monitoring as an adjunct in small-animal reconstructive surgery.