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Abstract

OBJECTIVE

To determine if photobiomodulation causes a premature release of liposomal bupivacaine (LB) suspensions.

ANIMALS

A 25-kg mixed breed dog cadaver euthanized for reasons unrelated to this study.

METHODS

In September 2022, a proximomedial tibial incision was made in a dog cadaver, and a tibial plateau leveling osteotomy plate was implanted. A stab incision was made one-half inch distal to the incision, and a tunnel to the plate was created prior to closure of the primary wound. A 3-cc anal sac catheter was advanced through the distal incision until the bulb rested against the face of the plate. Seven treatment groups of treatment power (watts) and total energy (joules/cm2) were defined as: A, 0.5 W, 2.0 J/cm2; B, 0.5 W, 4.0 J/cm2; C, 0.5 W, 6.0 J/cm2; D, 1.0 W, 2.0 J/cm2; E, 1.0 W, 4.0 J/cm2; F, 1.0 W, 6.0 J/cm2; and sham, 0.0 W, 0.0 J/cm2. Ten samples per group of 2 mL of LB were infused into a new catheter and treated percutaneously with a class 3b laser. All samples remained in the catheter for 12 seconds to reflect the longest treatment time. Post-treatment free bupivacaine concentrations were identified with high-performance liquid chromatography.

RESULTS

The median free bupivacaine concentration was reported as: sham, 1.89 mg/mL; A, 1.93 mg/mL; B, 2.01 mg/mL; C, 2.05 mg/mL; D, 1.92 mg/mL; E, 2.03 mg/mL; and F, 2.00 mg/mL. There were no differences in median free bupivacaine concentrations between groups (P = .988).

CLINICAL RELEVANCE

Concurrent LB and photobiomodulation are recommended during the postoperative period. The results of this proof-of-concept study suggest that concurrent use of LB and photobiomodulation may be safe, but in vivo studies at similar and stronger photobiomodulation settings are warranted.

Open access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To evaluate the feasibility of endoscopic inspection of thoracolumbar and lumbar pedicle tracts in a canine large-breed model and its accuracy for the detection of breached versus nonbreached tracts.

ANIMALS

2 greyhound cadavers.

METHODS

CT scans of 2 greyhound cadavers from the sixth thoracic vertebra to the sacrum were obtained. Fifty-six pedicles were randomized to have drill tracts with different modified Zdichavsky grades (nonbreached, partial/full medial breach, or partial/full lateral breach) using 3-D–printed guides. Endoscopy was performed on a single occasion from October 9 to 10, 2023, using a 1.9-mm 0-degree needle arthroscope in a randomized blinded fashion. The grading of drill tracts was performed on postoperative CT. Specificity, sensitivity, positive and negative predictive values, and time to assign endoscopic grade were investigated.

RESULTS

Postoperative CT confirmed 43 nonbreached tracts, 7 medial breaches (partial/full), and 5 lateral breaches (partial/full). One tract was excluded because of guide misplacement. Intraosseous endoscopy was successfully performed in the remaining 55 drill tracts. Sensitivity to detect medial and lateral breaches was 71.4% and 60.0%. Negative predictive value was 93.1%. Specificity was 94.2%. Positive predictive value for detection of medial and lateral breaches was 83.3% and 54.5%. Median (range) time to assign an endoscopic grade was 118 (30 to 486) seconds.

CLINICAL RELEVANCE

Intraosseous endoscopy of pedicle drill tracts may be a useful adjunct technique during pedicle screw/pin placement in dogs.

Open access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To determine the sensitivity and specificity of a commercial whole blood real-time PCR assay (RT-PCR) for the diagnosis of histoplasmosis when compared to direct organism identification and/or urine antigen quantification by enzyme immunoassay (UA-EIA). A secondary objective was to compare the sensitivity and specificity of RT-PCR to anti–Histoplasma immunoglobulin G antibody detection by enzyme immunoassay (IgG-EIA) and IgG-EIA to UA-EIA.

ANIMALS

Cats presented to the Kansas State University Veterinary Health Center from February through September of 2023 in which histoplasmosis was diagnosed or suspected.

METHODS

From February through September of 2023, cats were tested by RT-PCR, IgG-EIA, and UA-EIA if histoplasmosis was diagnosed cytologically or was a differential diagnosis for the presenting clinical signs. Cats were excluded if all 3 tests were not submitted or if the diagnosis of histoplasmosis could not be excluded despite a negative UA-EIA result. Cats with cytologically or histologically confirmed histoplasmosis were designated as proven histoplasmosis cases, and cats with a positive UA-EIA result without cytological or histological confirmation were designated as probable histoplasmosis cases.

RESULTS

10 cats were diagnosed with either proven (n = 6) or probable (4) histoplasmosis, and 10 cats were considered true negatives. Whole blood RT-PCR results were negative in all 20 cats (sensitivity, 0%; 95% CI, 0% to 30.85%). The IgG-EIA was 90% sensitive (95% CI, 55.50% to 99.75%) and 70% specific (95% CI, 34.75% to 93.33%). The UA-EIA results were positive in all cats with proven histoplasmosis.

CLINICAL RELEVANCE

This commercial RT-PCR is insensitive when used on whole blood collected in EDTA and should not be used to diagnose feline histoplasmosis. Further studies are required to determine whether alternate RT-PCR protocols for EDTA-collected whole blood could be useful for diagnosing histoplasmosis in cats.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To evaluate the long-term efficacy, prognostic factors, and complications of intravitreal cidofovir injection in dogs with end-stage glaucoma.

ANIMALS

130 client-owned dogs.

METHODS

Medical records of dogs that underwent intravitreal cidofovir injections were reviewed. A minimum follow-up period of 6 months was required as the inclusion criterion. Signalment, type of glaucoma, preinjection intraocular pressure (IOP), types of applied glaucoma eye drop, coexisting ocular diseases, outcomes, and complications were recorded. Success was defined as IOP of ≤ 25 mm Hg at the 2-week recheck that remained to the 6-month recheck.

RESULTS

The overall success rate of intravitreal cidofovir injection was 91.5% (140/153). The success rate of a single injection was 69.3% (106/153), of a second injection was 59.5% (25/42), of a third injection was 42.9% (6/14), of a fourth injection was 33.3% (2/6), and of a fifth injection was 50.0% (1/2). Intraocular pressures at 6 months after injection were relatively higher when the injection was repeated, fewer types of glaucoma eye drop were applied prior to the injection, and cataract stages were advanced at the time of injection (P < .05). The most common complications were phthisis bulbi (42.5%), cataract progression (30.1%), and intraocular hemorrhage (16.3%). Six eyes were enucleated, and 3 were enucleated due to corneal perforation.

CLINICAL RELEVANCE

Intravitreal cidofovir injection had a high long-term success rate in lowering IOP in dogs with end-stage glaucoma.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To assess the fatigue and load-to-failure mechanical characteristics of an intramedullary nail with a threaded interference design (TID) in comparison to a commercially available veterinary angle-stable nail with a Morse taper bolt design (I-Loc) of an equivalent size.

METHODS

10 single interlocking screw/bolt constructs of TID and I-Loc implants were assembled using steel pipe segments and placed through 50,000 cycles of simulated, physiologic axial or torsional loading. Entry torque, postfatigue extraction torque, and 10th, 25,000th, and 50,000th cycle torsional toggle were assessed. Each construct was then loaded to failure in the same respective direction as fatigue testing. Four complete constructs of each design were then assessed using a synthetic bone analog with a 50-mm central defect via nondestructive torsional and axial loading followed by axial load to failure.

RESULTS

All constructs were angle stable at all time points and withstood fatigue loading. Median insertional torque, extraction torque-to-insertion torque ratio, and torsional yield load were 33%, 33%, and 72.5% lower, respectively, for the TID interlocking screws. No differences in torsional peak load, torsional stiffness, axial yield load, axial stiffness, or axial peak load were identified. No differences in complete construct angle stability, torsional stiffness, axial peak load, axial stiffness, or axial yield load were identified.

CLINICAL RELEVANCE

The TID had an inferior torsional yield load when compared to I-Loc implants but generated angle stability and sustained simulated physiologic fatigue loading. The TID may be a suitable mechanism for generating angle stability in interlocking nails.

Open access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

Sinus osteotomy is currently performed in equine surgery with conventional surgical methods, such as trephines and oscillating bone saw, leading to subsequent trauma to the bone during cutting. Piezoelectric devices are now used in maxillofacial surgery in humans as a standard tool as it is less traumatic than the oscillating bone saw and shortens the healing period. The aim of this study was to show that the piezoelectric device can be used for equine sinus surgery, compare its use with the oscillating bone saw, and describe the outcome of cases involving osteotomy performed with a piezoelectric surgical device.

ANIMALS

10 horse specimens for cadaveric study and 11 client-owned equines for clinical evaluation.

METHODS

Each cadaveric head underwent a frontonasal bone flap on a randomly assigned side with the piezotome and the oscillating bone saw on the opposite side. Surgical time was recorded for every procedure, and gross examination was performed. A Welch t test was used to compare the surgical time between piezoelectric and oscillating saw use. For the clinical study, animals presented for sinonasal surgery at the hospital from March through October 2023 were included.

RESULTS

Osteotomy was possible with the piezotome in all animals. Surgical time was significantly increased when using the piezotome in comparison with the oscillating saw (P < .05). All clinical patients were treated adequately for the sinonasal disorder they were presented for using the piezotome instead of the oscillating saw. No adverse effects nor long-term complications related to its use have been noted, and preservation of the surrounding soft tissues was evident.

CLINICAL RELEVANCE

The use of a piezoelectric device in equine surgery is feasible. However, the cadaveric study showed an increased surgical time to perform a frontonasal bone flap.

Open access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To determine the predictive value of corneal ultrasound biomicroscopy (UBM) findings for the outcome of equine corneal disease.

ANIMALS

46 horses with a clinical diagnosis of either infectious ulcerative keratitis or stromal abscess.

METHODS

Corneal UBM (VevoMD; UHF70; VisualSonics) of horses with infectious corneal disease presenting to the North Carolina State University Equine Ophthalmology Service from 2019 to 2023 were evaluated. Size and depth of lesion, presence of Descemet membrane disruption (DMD), corneal thickness, and aqueous humor cell counts (AHCC) were assessed. Comparisons of UBM and clinical exam findings, presence of infectious organisms, and outcome (healed or enucleated) were performed.

RESULTS

The UBMs from 46 horses were evaluated. Increased AHCC was significantly associated with increased size and depth of corneal lesions on UBM but not with DMD. Deep lesions and DMD were significantly associated with an enucleation outcome. Horses treated with systemic antibiotics had significantly lower AHCC on UBM, but there were no differences in AHCC with the use of other systemic or topical medications. There was no significant correlation between infectious disease results, clinical findings (aqueous flare or cells), outcome, and UBM AHCC.

CLINICAL RELEVANCE

Parameters on UBM, such as depth of lesion, DMD, and AHCC, may be useful diagnostic and prognostic tools to augment the ophthalmic exam of horses with corneal disease. The UBM findings of deep corneal lesions and DMD suggest a poor prognosis and warrant aggressive surgical intervention.

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

Clinical research is a growing part of the academic clinician’s job, and documenting areas of low self-efficacy can inform training initiatives.

SAMPLE

182 US academic veterinary clinicians.

METHODS

A survey of academic veterinary clinicians was distributed to 31 US institutions. Self-efficacy was assessed with a modified Clinical Research Appraisal Instrument–12. The relationship between research self-efficacy and completion of formal research training and years of experience was evaluated.

RESULTS

Respondents were predominantly junior to midcareer faculty. The lowest reported confidence was in performing advanced statistical analyses (3; 0 to 10). Other low-confidence tasks included designing a qualitative methods study (4; 0 to 10), terminating a collaboration that isn’t working (5; 0 to 10), describing a funding agency’s review/award process (5; 0 to 10), establishing a timeline for a grant application (5; 0 to 10), establishing collaborator and consultant agreements (5; 0 to 10), and asking staff to leave the project team (5; 0 to 10). Completion of a formal research training program was significantly associated with improved self-efficacy in many tasks. Years of experience was also associated, especially in project management and interpersonal interactions.

CLINICAL RELEVANCE

These results highlight the need for targeted training opportunities for academic veterinary clinicians in biostatistical support, qualitative study design methods, and aspects of communication and interpersonal skills that are important for developing and leading effective research teams. Range of confidence suggests that development opportunities in all domains will improve self-efficacy for some clinicians. Future studies should focus on the impact of formal training sessions on various domains of self-efficacy and on targeted mentoring in supporting confidence in more experiential learning domains.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

Episodic mandibular tremor (EMT), manifested as teeth chattering, is not well described in dogs. The aim of this study was to describe clinical signs, MRI findings, and outcome of dogs with EMT.

ANIMALS

11 dogs retrospectively and 31 dogs in an online survey.

METHODS

A retrospective multicenter study of dogs with EMT between 2018 and 2023 and prospective online questionnaire open to owners of pets with teeth chattering.

RESULTS

All dogs had rapid and short-lasting (< 1 minute) episodes of EMT in the absence of other neurological signs. Lip smacking occasionally accompanied the tremor in 5 of 11 (45.5%) hospital dog cases. Excitement was a common trigger in 14 of 31 (45.2%) dogs from the survey. Cavalier King Charles Spaniel was the most common breed in both clinical and survey populations. Median age at presentation was 3 years for both hospital cases and the survey dogs. A concurrent medical condition was present in 8 of 11 (72.7%) hospital cases and 20 of 31 (64.5%) survey dogs. In 3 hospital dogs that underwent further investigations, no brain disease was present.

CLINICAL RELEVANCE

EMT and its clinical features are presented for the first time, shedding light on a clinical sign that might resemble an idiopathic movement disorder or a manifestation of pain in dogs.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

Acute-onset pancreatitis (AP) is common in dogs and presents diagnostic as well as management challenges. Until recently, the management of AP in dogs was based mainly on supportive and symptomatic care. Identification and management of a possible cause of the disease is important, but the majority of cases are considered to be idiopathic. Fluid therapy that is tailored to the patient’s needs is crucial to provide adequate hydration while preventing overhydration. Antiemetics are required to control vomiting and fluid loss and aid in early nutritional support. Recognition and management of complications is also crucial. Furthermore, analgesics for abdominal pain are very important. More recently, pharmaceutical modification of the inflammatory cascade has gained interest and the first specific therapeutic agent for the treatment of AP, fuzapladib sodium, has been shown to have a reasonable expectation of effectiveness in a pilot study. This drug has been licensed for the treatment of clinical signs of AP in dogs in Japan and also has achieved FDA conditional approval in the US. Antibiotics should not be used indiscriminately but are indicated for patients with aspiration pneumonia, gastrointestinal bacterial translocation, or evidence of another bacterial infection. Proton pump inhibitors and plasma are not routinely prescribed in pancreatitis unless specifically indicated. Nonsteroidal anti-inflammatory drugs should be avoided. Corticosteroid therapy, once thought to be contraindicated, may have some beneficial effects, as shown in a single retrospective study. However, further studies are required before their routine use can be recommended. Finally, a surgical approach is rarely indicated.

Open access
in Journal of the American Veterinary Medical Association