Abstract
To address the limitations of traditional IACUC review of clinical research studies involving client-owned animals, the AVMA issued a policy describing the use of a veterinary clinical studies committee (VCSC), analogous to an institutional review board, as a way to ensure the adequate review and oversight of such studies. While IACUC composition, review, approval processes, and responsibilities are well established, uniform guidance for VCSCs is not readily available and not included in the guidance for IACUCs. In this manuscript we describe suggested best practices for scientific and ethical review of veterinary clinical research studies, regardless of the specific research setting. This resource complements the AVMA policy mentioned above by providing additional thoughts on aspects of VCSCs, including considerations necessary for the adequate review and oversight of clinical research studies using client-owned animals by VCSCs or IACUCs.
Abstract
OBJECTIVE
To report the complication rate of dogs undergoing oral oncological surgery when using a bone-cutting piezoelectric unit for osteotomies.
CLINICAL PRESENTATION AND PROCEDURES
Retrospective cohort evaluation of medical records from 2012 through 2022 for canine patients that underwent mandibulectomy or maxillectomy for the treatment of oral neoplasia at the Companion Animal Hospital at Cornell University. Cases were included if osteotomy was performed using a piezoelectric unit. Medical records were then reviewed for documentation of intraoperative hemorrhage and administration of blood products.
RESULTS
41 maxillectomies and 57 mandibulectomies met the inclusion criteria (98 in total). Only 1 (1.02%) case was associated with excessive surgical bleeding requiring administration of blood products.
CLINICAL RELEVANCE
Results of this study show that intraoperative hemorrhage requiring the use of blood products during or immediately after a mandibulectomy or maxillectomy is rare when using a piezoelectric unit to perform osteotomies, and is substantially lower than that previously reported when using oscillating saws or other bone-cutting devices for maxillectomies.
Abstract
OBJECTIVE
To evaluate analgesic efficacy of 3 different preoperative protocols in cows undergoing right flank laparotomy for displaced abomasum.
ANIMALS
40 cows diagnosed with displaced abomasum.
PROCEDURES
The cows were assigned by block randomization to 1 of 3 preoperative protocols: inverted L-block using 50 mL of 2% lidocaine (ILB; n = 13), ILB plus preoperative flunixin meglumine (2 mg/kg, IV; ILB-F; 13), and dorsolumbar epidural anesthesia using 2% xylazine (0.8 mL) and 2% lidocaine (4 mL; EPI; 14). Venous blood samples were collected for CBC, serum biochemistry, and cortisol preoperatively and at 0 (immediately after), 3, 17, and 48 hours postoperatively.
RESULTS
The mean (95% CI) of the serum cortisol in ILB, ILB-F, and EPI were 108.7 (66.7 to 150.7), 150.7 (116.4 to 185.0), and 139.8 (93.4 to 186.3), respectively. The serum cortisol concentrations decreased over time in all groups (ILB, P = .001; ILB-F and EPI, P < .001). In the ILB group, the cortisol concentration at 17 and 48 hours postoperatively decreased (P = .026 and P = .009, respectively), compared with that preoperatively. In the ILB-F and EPI groups, the preoperative cortisol concentration was the highest and then decreased at 0, 3, 17, and 48 hours postoperatively (ILB-F, 0 hours [P = .001] and 3, 17, and 48 hours [P < .001]; EPI, all [P < .001]).
CLINICAL RELEVANCE
ILB-F and EPI improved intraoperative and immediate postoperative indicators of pain-related stress when compared to standard ILB. EPI requires less anesthetic, which may be beneficial when in short supply.
Abstract
OBJECTIVE
To evaluate the risk and timing of right heart failure (RHF) in feedlot cattle.
ANIMALS
Study population consisted of 1,717,356 cattle (5,527 cohorts) in 13 US and Canadian feedlots. There were 1,336 RHF diagnosed at necropsy.
PROCEDURES
Multivariable models were utilized to evaluate risk and timing of RHF death.
RESULTS
Arrival year was associated with RHF and was influenced by arrival quarter on the magnitude of risk of RHF (P < .01), but no linear increase over years was identified. The impact of feedlot elevation on RHF was modified by breed (beef, dairy, or dairy-cross; P < .01) with beef cattle in the highest elevation category having 0.54 times the risk of RHF as dairy cattle in the same elevation category (LCL = 0.31; UCL = 0.962). Cattle that died due to RHF and were treated for bovine respiratory disease died 11 days (LCL = 1.33, UCL = 20.2 days) sooner than cattle never treated for bovine respiratory disease (P = .03). Cattle breed was associated with RHF timing (P = .01), and dairy-cross cattle RHF cases died approximately 37 days earlier (SE = 13.0 days; P = .01) compared to beef cattle.
CLINICAL RELEVANCE
This research showed demographic factors associated with RHF and their respective influence on risk and timing of RHF. Risk rates of RHF were similar to previous research. This could allow for comparisons across different feedlot populations, using different diagnoses at necropsy and RHF risk/rates do not appear to be increasing.
Abstract
OBJECTIVE
To retrospectively evaluate the prevalence and clinical progression of wobbly hedgehog syndrome (WHS) and concurrent incidence of neoplasia in a cohort of African pygmy hedgehogs (Atelerix albiventris).
ANIMALS
49 hedgehogs.
CLINICAL PRESENTATION AND PROCEDURES
Medical records of hedgehogs from 7 institutions across the US over a 20-year period (2000 to 2020) were retrospectively reviewed. Inclusion criteria were hedgehogs of any sex or age with postmortem CNS histopathology consistent with WHS. Collected data included sex, age at onset and euthanasia, major histopathologic findings, reported neurologic clinical signs, and treatments administered.
RESULTS
24 males and 25 females were included. Fifteen of 49 (31%) individuals had subclinical WHS with no reported antemortem neurologic clinical signs. In neurologically affected (clinical) hedgehogs (n = 34), the mean ± SD age at onset was 3.3 ± 1.5 years with a median (range) time from onset to euthanasia of 51 days (1 to 319 days). In neurologically affected hedgehogs, the most commonly reported clinical signs were ataxia (n = 21) and pelvic limb paresis (16) and the most commonly administered treatment was meloxicam (13). Overall, 31 of 49 (63%) hedgehogs had a concurrent histopathologic diagnosis of neoplasia outside of the CNS.
CLINICAL RELEVANCE
The prognosis for hedgehogs with WHS is poor. No treatment had a significant effect on survival time, and neoplasia was a common comorbidity in the current cohort. A small but clinically relevant subset of neurologically normal hedgehogs had a histopathologic diagnosis of WHS.
Abstract
OBJECTIVE
To describe the etiologies, clinicopathologic findings, diagnostic modalities employed, treatments, and outcome associated with cases of septic bicipital bursitis.
ANIMALS
9 horses.
CLINICAL PRESENTATION AND PROCEDURES
Medical records of horses diagnosed with septic bicipital bursitis between 2000 and 2021 were reviewed. Horses were included if synoviocentesis of the bicipital bursa revealed a total nucleated cell count of ≥ 20,000 cells/µL with a neutrophil proportion of ≥ 80%, a total protein concentration of ≥ 4.0 g/dL, and/or the presence of bacteria on cytology, or positive culture of the synovial fluid. Information retrieved from medical records included signalment, history, clinicopathologic variables, diagnostic imaging findings, treatment, and outcome.
RESULTS
Trauma was the most common inciting cause (n = 6). Synoviocentesis using ultrasonographic guidance was performed in all cases and showed alterations consistent with septic synovitis. Radiography identified pathology in 5 horses, whereas ultrasonography identified pathology in all horses. Treatment consisted of bursoscopy (n = 6) of the bicipital bursa of which 1 was performed under standing sedation, through-and-through needle lavage (3), bursotomy (2), or medical management alone (2). Five (55.6%) horses survived to discharge. Long-term follow-up was available for 3 horses and all were serviceably sound, with 2 in training as pleasure horses and 1 case continuing retirement.
CLINICAL RELEVANCE
Ultrasonography was the most informative imaging modality and paramount in obtaining synovial fluid samples for definitive diagnosis of septic bicipital bursitis. Bursoscopy performed under standing sedation is a feasible treatment option. Horses treated for bicipital septic bursitis have a fair prognosis for survival and may return to some level of athletic performance.
Abstract
OBJECTIVE
To evaluate intraoperative and postoperative complications and outcomes following subconjunctival enucleations with and without third eyelid removal in domestic rabbits.
ANIMALS
18 client-owned rabbits with ocular disease confined to the globe that underwent 20 subconjunctival enucleation procedures at a veterinary teaching hospital.
METHODS
Records were retrospectively reviewed for all enucleations performed at a veterinary teaching hospital from 2014 to 2022. A standard subconjunctival enucleation procedure was performed in all cases, with third eyelid removal in 2 surgeries and without third eyelid removal in the remaining 18 surgeries. Outcomes were assessed on the basis of observations in medical records and owner follow-up.
RESULTS
20 total enucleations were included. Reported reasons for enucleation included suspected or confirmed ocular Encephalitozoon cuniculi infection in 9 rabbits, refractory glaucoma in 4 rabbits, and various intraocular diseases in 5 rabbits. The only intraoperative complication reported was hemorrhage during the third eyelid removal in 1 surgery. Postoperative complications included serous to mucoid discharge from the surgical site in 8 of 20 surgeries and swelling at the surgery site in 2 of the 8 cases that had discharge. Postoperative swelling spontaneously resolved within 3 months of surgery; postoperative discharge spontaneously resolved within 10 months of surgery.
CLINICAL RELEVANCE
Subconjunctival enucleation with or without third eyelid removal in rabbits may be a viable enucleation technique to reduce the risk for intraoperative hemorrhage, but it can result in postoperative complications, including transient discharge and swelling at the surgical site.
Abstract
OBJECTIVE
Describe surgical guidelines for a new technique to correct stenotic nares in brachycephalic cats.
ANIMALS
8 client-owned brachycephalic cats with stenotic nares between April 2017 and July 2022.
PROCEDURES
8 brachycephalic cats with severe stenotic nares presented to the Angell Animal Medical Center with the patient age ranging from 2 years to 9 years of age. Surgical correction was performed on each cat with the combined use of the “Alar Fold Lift-Up” and “Sulcus Pull-Down” techniques.
RESULTS
Successful correction of the stenotic nares was achieved, enabling each cat to breathe normally.
CLINICAL RELEVANCE
The combined use of the “Alar Fold Lift-Up” and “Sulcus Pull-Down” techniques is simple to perform on an outpatient basis. Surgery is restricted to the adjacent skin and does not require the surgical alteration of the external nose or nares. Long-term follow-up indicates the procedure is effective in improving nasal breathing in each cat.
Abstract
OBJECTIVE
To report preliminary findings of hypofractionated superficial radiotherapy for treatment of cutaneous mast cell tumors (MCTs) and report the acute and late toxicity associated with its use.
ANIMALS
3 dogs and 1 cat.
PROCEDURES
In this retrospective study, medical records from January 2021 through July 2022 were searched for animals that received superficial radiation therapy for MCTs of the head.
RESULTS
4 patients with 5 MCTs were included. Three of the masses were periocular and required protection of the globe with a tungsten eye shield. One patient did not complete the intended protocol due to diffuse metastatic spread noted after the second fraction. Of the 3 patients that completed their protocol, 100% had a complete response. Two canine patients were treated adjunctively with toceranib. Two of the 4 patients experienced grade 1 acute veterinary radiation therapy oncology group (VRTOG) toxicity, and the 3 patients that completed their protocol experienced grade 1 late VRTOG toxicity. No radiation effects were documented to the cornea or lens in any patient.
CLINICAL RELEVANCE
Superficial radiation therapy was effective in our limited study population, and patients experienced minimal side effects for treatment of cutaneous MCTs.
