Abstract
OBJECTIVE
The avian beak is a complex organ containing bone, neurovascular tissue, and keratinized covering (rhamphotheca). Nerve-rich papillae extend through bone into rhamphotheca providing sensory input from the beak tip. Beak trimming is a common procedure in avian species and is used for corrective, cosmetic, and behavioral modification purposes. Yet, practitioners are not well versed in complete beak anatomy, and therefore, beak trimming often disregards neurovasculature, injuring the patient and hampering recovery. Here, using comprehensive anatomical description, we aim to provide recommendations on how to safely perform beak trimming without damaging underlying sensory papillae.
ANIMALS
Here, we evaluated beaks of 2 deceased grey parrots (Psittacus erithacus).
PROCEDURES
In one, we used a novel stain and microcomputed tomography to visualize papillae in the upper and lower beaks. In a second, we hand isolated the upper and lower beak dermal papillae and used high-resolution photography plus traditional paraffin histology.
RESULTS
Papillae and their nerves were easily identified in these 2- and 3-dimensional approaches. This allowed us to determine the approximate lengths of papillae within the upper and lower beak.
CLINICAL RELEVANCE
Based on these findings, the authors recommend lateral radiographs of the bird’s head and beak to identify the location of the underlying bone relative to the overlying rhamphotheca before performing beak trims. Specifically in grey parrots, the authors recommend the upper and lower beak should not be trimmed closer than 8 to 10 mm from the underlying bone. Further work is needed to support these recommendations and provide guidelines for other species.
Abstract
OBJECTIVES
To determine the feasibility of machine learning algorithms for the classification of appropriate collimation of the cranial and caudal borders in ventrodorsal and dorsoventral thoracic radiographs.
SAMPLES
900 ventrodorsal and dorsoventral canine and feline thoracic radiographs were retrospectively acquired from the Picture Archiving and Communication system (PACs) system of the Ontario Veterinary College.
PROCEDURES
Radiographs acquired from April 2020 to May 2021 were labeled by 1 radiologist in Summer of 2022 as either appropriately or inappropriately collimated for the cranial and caudal borders. A machine learning model was trained to identify the appropriate inclusion of the entire lung field at both the cranial and caudal borders. Both individual models and a combined overall inclusion model were assessed based on the combined results of both the cranial and caudal border assessments.
RESULTS
The combined overall inclusion model showed a precision of 91.21% (95% CI [91, 91.4]), accuracy of 83.17% (95% CI [83, 83.4]), and F1 score of 87% (95% CI [86.8, 87.2]) for classification when compared with the radiologist’s quality assessment. The model took on average 6 ± 1 second to run.
CLINICAL RELEVANCE
Deep learning-based methods can classify small animal thoracic radiographs as appropriately or inappropriately collimated. These methods could be deployed in a clinical setting to improve the diagnostic quality of thoracic radiographs in small animal practice.
Abstract
OBJECTIVE
To evaluate the effects of rocuronium and sugammadex on the patient state index (PSI) in dogs anesthetized with propofol.
ANIMALS
6 intact healthy male Beagles.
PROCEDURES
Anesthesia was induced with and maintained on a propofol infusion. The estimated plasma propofol concentration (ePC) was recorded. Baseline PSI and train-of-four ratio (TOFR) readings were collected for 2 minutes in stable general anesthesia. Neuromuscular blockade (NMB) was induced with 0.6 mg/kg, IV, rocuronium, and full NMB was confirmed with a TOFR of 0. After 5 minutes, the neuromuscular function was restored with 4 mg/kg sugammadex, IV (reversal), and monitored for 5 minutes. Throughout the data collection, ePC, PSI, and TOFR were recorded every 15 seconds and compared with mixed-effect ANOVA.
RESULTS
Baseline ePC, PSI, and TOFR were 3.63 ± 0.38, 41 ± 6, and 0.97 ± 0.08 µg/mL, respectively. There was no difference between the baseline of ePC and PSI from NMB or reversal. Compared to the baseline, the TOFR decreased to 0 with NMB (P < .001) and returned to 0.96 ± 0.08 (P = .721) on reversal. After 5 minutes, sugammadex fully reversed 5 out of 6 dogs to TOFR > 0.90 and partially reversed 1 animal to TOFR = 0.80.
CLINICAL RELEVANCE
There was no evidence that NMB with rocuronium and sugammadex-induced reversal interfered with PSI readings under steady-state total intravenous anesthesia with propofol. Further evaluation of PSI is warranted to assess its utility in a clinical population to detect changes in levels of consciousness during NMB.
Abstract
OBJECTIVE
To compare the acute strength (failure load and work to failure) of standard incisional gastropexy (SIG) and modified incisional gastropexy (MIG).
ANIMALS
37 pig cadavers.
PROCEDURES
Stomachs and right abdominal walls were harvested from pigs euthanized for reasons unrelated to this study. The tissues were stored in lactated Ringer’s solution overnight in a 5 °C cooler. Matching body wall and stomach tissue pairs were randomized and divided into 2 groups, on which either SIG or MIG was performed the following day. The MIG technique was identical to SIG except 2 additional simple interrupted sutures, 1 cranial and 1 caudal to the continuous suture line, were placed full thickness into the stomach to ensure engagement of the submucosa. After gastropexy, the samples underwent biomechanical testing. Information regarding change in position and load was generated by the MTESTQuattro software. Mode of failure was examined after the procedure was complete.
RESULTS
The MIG had higher failure load and work to failure compared to SIG. All failures were caused by gastric tissue tearing.
CLINICAL RELEVANCE
The MIG is biomechanically superior to SIG and may provide more security than SIG during healing. However, clinical study is needed to ascertain if there is a difference in gastropexy failure and complications between these 2 techniques.
Abstract
OBJECTIVE
To compare complications between a modified incisional gastropexy (MIG) technique and standard incisional gastropexy (SIG).
ANIMALS
347 client-owned dogs.
PROCEDURES
Dogs that had undergone SIG or MIG from March 2005 through April 2019 were identified through a medical record search of the University of Missouri Veterinary Health Center. The MIG technique is identical to SIG except 2 additional simple interrupted sutures are added, 1 cranial and 1 caudal to the continuous suture line, going full thickness into the stomach to ensure engagement of submucosa. Medical record information was used to identify intraoperative, postoperative, and short-term complications, and telephone or email communication to pet owners and/or referring veterinarians was used to identify complications (short-term and long-term) after discontinuance of care at the University of Missouri Veterinary Health Center. Intraoperative, postoperative, short-term, and long-term complications were analyzed in aggregate within 6 matched groupings: (1) gastropexy for gastric dilatation-volvulus, (2) prophylactic gastropexy without other procedures, (3) gastropexy with ovariohysterectomy, (4) gastropexy with castration, (5) gastropexy with splenectomy, and (6) gastropexy with celiotomy other than splenectomy. Overall rates of complications potentially attributed to gastropexy were compared between SIG and MIG using the Fisher exact test. Overall rates of complications not attributed to gastropexy were compared between SIG and MIG using the χ2 test.
RESULTS
There were no significant differences in overall complication rates between SIG and MIG.
CLINICAL RELEVANCE
Surgeons who feel that engagement of gastric submucosa is important for gastropexy success may use the MIG technique with minimal fear of complications. However, superiority of one technique over the other cannot be determined on the basis of this study.
Abstract
OBJECTIVE
To prospectively assess the efficacy of emesis induction for the recovery of gastric foreign objects in cats and to determine if any factors influenced recovery.
ANIMALS
22 client-owned cats.
PROCEDURES
Cats for which emesis induction was deemed appropriate were administered an emetic agent by the attending clinician between October 2018 and April 2021. Data collected included whether emesis was successful in recovery in some or all of the foreign object, time from administration to emesis, number of emetic events, and type, length, width, and surface area of the material ingested.
RESULTS
Of the 22 cats that had emesis attempted, 11 (50%) vomited some or all of the foreign object. The time from ingestion to presentation, time from the last meal, presence of food in the vomitus, type of the object, and length, width, and surface area of the object did not influence the likelihood of successful recovery with emesis induction. The most common object cats ingested were rubber bands.
CLINICAL RELEVANCE
Recovery of gastric foreign objects in cats with emesis induction alone may be successful 50% of the time. The type and size of the object is unlikely to influence whether or not emesis will be successful. This information can help prepare cat-owners for expectations and outcomes following attempts at emesis induction.
Abstract
OBJECTIVE
To determine the incidence of histologic grade shift (alteration of grade relative to the original tumor) in recurrent canine soft tissue sarcoma (STS) and mast cell tumor (MCT), and to determine the level of agreement between blinded pathologist review and original histology interpretation of STS and MCT grades.
ANIMALS
15 dogs with recurrent cutaneous/subcutaneous STS and 5 dogs with recurrent cutaneous MCT. All included dogs underwent excision of both the primary and recurrent tumors and had tumor samples available for review.
PROCEDURES
The medical records and histology database from a single institution were reviewed, and data were recorded and analyzed. A single board-certified veterinary pathologist performed blinded evaluation of all excisional tumor samples, including both primary and recurrent disease, and these were evaluated independently and in conjunction with initial pathologic diagnoses.
RESULTS
Based on single pathologist review, 7 of 15 (46.7%) dogs with recurrent STS had grade shift characterized by a higher or lower recurrent tumor grade in 4 of 7 and 3 of 7 cases, respectively, and 1 of 5 dogs with recurrent MCT had grade shift characterized by an increased grade of the recurrent tumor. Variability in reported grade between original histology report and pathologist review occurred for 13 of 30 (43.3%) STS excisional biopsy samples and 0 of 10 MCT excisional biopsy samples.
CLINICAL RELEVANCE
Grade shift has been reported in multiple tumor types in people and has the potential to alter prognosis and treatment recommendations. This is the first study to document this phenomenon in dogs. Additional large-scale studies are needed to determine factors associated with grade shift as well as prognostic significance of grade shift for recurrent canine STS and MCT.
Abstract
OBJECTIVE
To evaluate technical efficiency of US companion animal practices.
SAMPLE
60 independently owned companion animal practices selected from the 2022 AVMA Veterinary Practice Owners Survey.
PROCEDURES
A ratio of the weighted sum of outputs to weighted sum of inputs was computed for each practice (ie, decision-making unit [DMU]). Inputs included labor (hours worked) and capital (fixed costs and number of exam rooms). Outputs (or production) included annual gross revenue, number of patients seen per year, and number of appointment slots per full-time–equivalent (FTE) veterinarian per year. Data envelopment analysis was used to optimize the ratio and estimate relative efficiency (RE) scores.
RESULTS
25 (42%) practices were classified as having high efficiency (RE = 1 or 100% efficient), 26 (43%) as having moderate efficiency (RE > 0.7 but < 1.0), and 9 (15%) as having low efficiency (RE ≤ 0.7). Mean RE scores for moderate- and low-efficiency practices were 0.83 and 0.66, meaning they could have reached their current production levels with 17% or 34% less resources. Per the model, if all 60 practices were 100% efficient on the RE scale, 22 fewer FTE veterinarians, 47 fewer FTE veterinary technicians and assistants, and 43 fewer FTE nonmedical staff would be needed overall.
CLINICAL RELEVANCE
These preliminary findings suggested that efforts to optimize efficiency could allow companion animal practices to meet demands for their services without necessarily needing to hire more staff. Such efforts might include engaging support staff to their full potential and implementing automated processes. Additional research is needed to identify routines or workflows that distinguish high-efficiency practices from others.
Abstract
OBJECTIVE
To describe the clinical characteristics, procedural techniques, complications, and outcomes of dogs and cats undergoing any of the following modified hemipelvectomy techniques: concurrent partial sacrectomy and/or partial vertebrectomy, osseous excision crossing midline, and reconstruction without the use of local musculature.
ANIMALS
23 client-owned animals (20 dogs and 3 cats) that underwent modified hemipelvectomy techniques. Animals that underwent traditional (nonmodified) hemipelvectomy techniques were excluded.
PROCEDURES
The medical records of 3 academic institutions were reviewed, and data were recorded and analyzed.
RESULTS
Modified hemipelvectomy was performed with partial sacrectomy and/or vertebrectomy in 11 dogs, excision crossing pelvic midline with concurrent limb amputation in 5 dogs and 2 cats, and closure without use of native muscle or mesh in 4 dogs and 1 cat. Surgery was performed for tumor excision in all cases. Excision was reported as complete in 16 of 23, incomplete in 6 of 23, and not recorded in 1 of 23 animals. All animals survived to discharge. Only animals undergoing partial sacrectomy/vertebrectomy (4/11) experienced postoperative mobility concerns. Major intra- or post-operative complications (grades 3 and 4) occurred in 2 dogs that underwent partial sacrectomy/vertebrectomy, and 1 of these animals experienced a complication that resulted in death. The median time to death or last follow-up was 251 days (range, 3 to 1,642).
CLINICAL RELEVANCE
The modified hemipelvectomy techniques reported in this cohort were overall well tolerated with good functional outcomes. These findings support the use of these modified hemipelvectomy techniques in dogs and cats, and previous notions regarding tolerable hemipelvectomy procedures should be reconsidered. However, additional studies with larger numbers of patients undergoing modified hemipelvectomy techniques are needed to gain more information.
