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Author: Kathryn Meurs

At NC State, we are improving the world of veterinary medicine in numerous and exciting ways. Here are four areas where we are breaking new ground.

CONQUERING PAIN. Like humans, animals experience chronic pain from a variety of conditions such as arthritis, back issues, and nerve damage. In veterinary medicine, however, chronic pain is not well understood and often underdiagnosed. The first step to a breakthrough is establishing methods to measure pain. The work of B. Duncan X. Lascelles, professor of translational pain research, has helped us learn how to reliably measure chronic pain in naturally occurring chronic

Open access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To determine whether an acceptance and commitment training (ACT) program targeting reactions to difficult client interactions would reduce burden transfer, stress, and burnout among veterinary healthcare teams.

SAMPLE

Small animal veterinary hospital employees randomly assigned to participate in an ACT program (intervention group; n = 72) or to not undergo the training program (control group; 71).

PROCEDURES

The study was designed as a randomized, controlled, parallel-arms trial. All participants completed prestudy assessments of burden transfer, stress, and burnout. The ACT program consisted of 3 small-group–format educational sessions tailored to reducing reactivity to difficult veterinary client interactions; sessions were delivered via video teleconference. At the end of the educational sessions (posttest) and 1 month later (1-month follow-up), assessments of burden transfer, stress, and burnout were repeated, and participants in the intervention group provided ratings of program helpfulness and frequency of use for techniques taught in the program.

RESULTS

Participants receiving the program rated it as helpful and reported frequent use of program techniques. Relative to the control group, the intervention group showed significantly reduced burden transfer, stress, work-related burnout, and client-related burnout after completing the educational sessions. These improvements were maintained at the 1-month follow-up.

CLINICAL RELEVANCE

Findings support the usefulness of this program in reducing occupational distress in veterinary medicine. Future work is needed to examine whether it is similarly effective in formats that could be more broadly disseminated (eg, asynchronous, self-paced, independent learning).

Open access
in Journal of the American Veterinary Medical Association

Abstract

The One Health approach asserts that the health of animals and people is closely connected. Under this approach, the CDC and AVMA work globally to attain optimal health outcomes for both animals and humans. One facet of optimal health involves access to safe and effective anesthetics and analgesics. The anesthetic and analgesic drug ketamine possesses unique properties that make it particularly important for both veterinary and human patients in low- and middle-income countries (LMICs). These properties include its portability and stability, low cost, ease of administration, and wide therapeutic margin. China advocates regularly to the United Nations for global scheduling of ketamine as a controlled substance. However, this would disproportionately restrict access to ketamine in LMICs, imposing bioethical challenges related to animal patients, human patients, and communities. In alignment with the One Health vision, opposing global scheduling of ketamine in LMICs creates a unique opportunity for collaboration between veterinarians and physicians in LMICs and high-income countries to prevent these bioethical challenges.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To retrospectively review the efficacy of combined surgery comprising dorsal laminectomy and dorsal fixation using screws and polymethylmethacrylate as treatment for dogs with degenerative lumbosacral stenosis (DLSS).

ANIMALS

21 client owned dogs diagnosed with DLSS and treated surgically.

PROCEDURES

Based on clinical records, signalments, clinical signs, findings from orthopedic and neurological examinations, imaging findings, and postoperative complications were evaluated at the following time points: preoperatively, postoperatively, and 3, 6, 12, 24, and 36 months after surgery.

RESULTS

In all 21 cases, clinical signs were alleviated, proprioceptive deficits were improved from 3 months after surgery, and no recurrence of clinical signs was observed during the observation period. Minor complications were observed in 6 cases (28.6%), including implant failure in 2 (9.5%), delayed healing of surgical wounds in 2 (9.5%), seroma in 1 (4.8%), and swelling of the affected area in 1 (4.8%). There was no case with major complications.

CLINICAL RELEVANCE

Combined surgery comprising dorsal laminectomy and dorsal fixation using screws and polymethylmethacrylate is a useful treatment that can improve long-term clinical signs in dogs with DLSS.

Restricted access
in Journal of the American Veterinary Medical Association

The new 2022 AVMA Pet Ownership and Demographics Sourcebook  examines types of pet owners, spending on veterinary care, veterinary visits, and client satisfaction.

Full access

Abstract

OBJECTIVE

To describe the clinical presentation, treatment, and treatment outcomes for companion rats (Rattus norvegicus) diagnosed with lymphoma.

ANIMALS

All rats that presented to the exotics service and underwent postmortem examination during the time period of 2008 through 2020 were evaluated.

PROCEDURES

The medical records of 35 rats were evaluated for an ante- or postmortem diagnosis of lymphoma. Cases with a diagnosis of lymphoma were further reviewed for signalment, presenting complaint, clinical signs observed on physical exam, diagnostic testing performed, and treatments administered. Postmortem gross and histologic findings were reviewed.

RESULTS

7 out of 35 rats were diagnosed with lymphoma, either ante-mortem or postmortem. The most common presenting complaint that was present in all rats with lymphoma was respiratory abnormalities. Five out of 7 rats had radiographs performed, all of which had abnormalities noted in the thoracic cavity including pulmonary nodules, cranial mediastinal widening, or alteration to the cardiac silhouette. Diagnosis via cytologic aspirates was performed in 2 cases and each was diagnostic for lymphoma; however, even with treatment, survival time following initiation of chemotherapy was short (less than or equal to 24 days). The definitive diagnosis in the remainder of the cases was via necropsy.

CLINICAL RELEVANCE

Results suggest that lymphoma is a common neoplastic disease in rats and a thorough diagnostic work-up is indicated in any rat that presents for general malaise or respiratory signs.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To document clinicopathologic findings in domestic rabbits with liver lobe torsion and identify prognostic factors.

ANIMALS

82 rabbits.

PROCEDURE

Medical records of 4 institutions were reviewed to identify rabbits with an antemortem diagnosis of liver lobe torsion that were examined between 2010 and 2020.

RESULTS

The prevalence of liver lobe torsion was 0.7% (82/11,402). In all 82 rabbits, the diagnosis was made by means of abdominal ultrasonography. Fifty (60.1%) rabbits underwent liver lobectomy, 23 (28%) received medical treatment alone, and 9 (10.9%) were euthanized or died on presentation. Overall, 32 (39%) rabbits died within 7 days of initial presentation and 50 (61%) survived. Seven-day survival rate did not differ significantly between medical treatment alone and surgical treatment. However, median survival time following medical treatment (530 days) was shorter than that following surgical treatment (1,452 days). Six of 14 rabbits had evidence of systemic inflammatory disease on necropsy. Rabbits with right liver lobe torsion were less likely to survive for 7 days than were those with caudate torsions (P = 0.046; OR, 3.27; 95% CI, 1.04 to 11.3). Rabbits with moderate to severe anemia were less likely to survive for 7 days than were rabbits that were not anemic or had mild anemia (P = 0.006; OR, 4.41; 95% CI, 1.55 to 12.51). Other factors associated with a decreased 7-day survival rate were high heart rate at admission (P = 0.013) and additional days without defecation after admission (P < 0.001). Use of tramadol was associated with an increased survival rate (P = 0.018).

CLINICAL RELEVANCE

The prognosis for rabbits with liver lobe torsions was more guarded than previously described. Rabbits that underwent liver lobectomy had a longer median survival time than did rabbits that only received medical treatment.

Restricted access
in Journal of the American Veterinary Medical Association
History and Physical Examination Findings

A 6-month-old 3.7-kg male Chihuahua presented for neuter, removal of persistent deciduous maxillary canines, and dental imaging of unerupted teeth. The owner reported no discomfort or atypical teething/chewing. Aside from bilaterally absent mandibular first premolars and third molars, his preoperative exam was unremarkable. Intraoral dental radiographs were taken of the right and left first premolar and third molar regions (Figure 1). The owner was advised to schedule for reevaluation in 2 months (allowing time for natural dentition eruption) with imaging and removal of any unerupted teeth.

Selected intraoral radiographic

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To describe oncologic outcomes following administration of a uniform stereotactic radiotherapy protocol (SRT; 10 Gy X 3) for canine intranasal tumors and to identify whether any clinical or dosimetric factors were predictive of event-free or overall survival time (EFST or OST).

ANIMALS

129 dogs.

PROCEDURES

In this single-institution retrospective study, the medical records database was searched for canine nonlymphomatous intranasal tumors treated with 10 Gy X 3 SRT between August 2013 and November 2020. Findings regarding adverse effects and outcomes were analyzed overall, for dogs grouped on the basis of life stage (mature adult, senior, or end of life), and for treatment-related or tumor-related variables to identify potential predictors of outcome.

RESULTS

After SRT, most dogs clinically improved with minimal acute radiotoxicity. The median EFST was 237 days; median OST was 542 days. Receipt of other tumor-directed therapies before or after SRT was associated with improved EFST in senior dogs (hazard ratio [HR], 0.416) and improved OST in mature adult (HR, 0.241) and senior dogs (HR, 0.348). In senior dogs, administration of higher near-minimum radiation doses was associated with improved EFST (HR, 0.686) and OST (HR, 0.743). In senior dogs, chondrosarcoma was associated with shorter OST (HR, 7.232), and in dogs at end of life, having a squamous cell or transitional carcinoma was associated with worse EFST (HR, 6.462).

CLINICAL RELEVANCE

This SRT protocol results in improved quality of life and prolonged OST for dogs of all life stages. Radiation protocol optimization or use of multimodal therapy may further improve outcomes.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To evaluate the diagnostic capabilities of a novel helical fan beam CT system used for imaging of horses with a range of clinical distal limb problems.

ANIMALS

167 horses.

PROCEDURES

Medical records were reviewed of horses presented for CT of the distal limb at 2 university-based veterinary hospitals. The following data were recorded: age, sex, breed, presenting complaint, sedation used for imaging, scanning time, procedure time, other diagnostic imaging methods performed, imaging diagnosis, clinical diagnosis, and complications during imaging.

RESULTS

Most horses were Thoroughbreds and Quarter Horses. Procedure times ranged from 15 to 40 minutes, with scanning completed in 15 to 45 seconds for each region of interest. The foot or pastern region was commonly scanned (88/167 [53%] horses), with navicular bone disease diagnosed in 42 of 88 (48%) horses. The fetlock region was also commonly scanned (42/167 [40%] horses), with palmar or plantar osteochondral disease diagnosed in 17 of 42 (40%) horses. Horses were compliant during scanning, and no complications with sedation or damage to the scanner occurred. A specific imaging diagnosis for the lameness was achieved more frequently with CT imaging (166/167 [99%]) than with planar digital radiography (26/58 [45%]).

CLINICAL RELEVANCE

The helical fan beam CT system could be used safely to scan sedated standing horses from the carpal or tarsal region distally. Subjectively, the machine was easy to operate, allowing CT to be incorporated into lameness investigations. CT imaging was very likely to result in a clinical diagnosis in horses with distal limb lameness.

Restricted access
in Journal of the American Veterinary Medical Association