Abstract
OBJECTIVE
To document the long-term outcome of surgically treated primary and dental-related sinusitis in horses and to describe a simple protocol for postoperative management.
METHODS
All surgically treated sinusitis cases referred between January 2016 and June 2022 were reviewed. Cases diagnosed with primary and dental-related sinusitis and with a follow-up of at least 6 months after hospital discharge were included. Cases with other sinus pathology were excluded.
RESULTS
130 cases met the inclusion criteria. 104 out of 130 were treated with sinoscopy and 26/130 with sinusotomy. 86 out of 130 cases (66.2%) were diagnosed with a dental pathology as a cause of sinusitis that required tooth extraction. Diagnostics were refined with the help of CT in 55/130 (42%) cases. Short-term complications were encountered in 8/130 (6.2%), and full response after initial treatment was successful for 107/130 cases (82.3%). The mean number of postoperative daily flushes was 3.15, and horses were discharged after a mean hospitalization period of 6.4 days.
CLINICAL RELEVANCE
Thorough debridement of sinuses affected by primary or dental-related sinusitis followed by a simple aftercare protocol can lead to a positive long-term outcome.
Abstract
OBJECTIVE
To report the prevalence and document the treatment and outcome of odontogenic abscesses and associated jaw osteomyelitis in pet rabbits.
ANIMALS
200 client-owned rabbits.
METHODS
Pet rabbits surgically treated using extraoral teeth extraction with marsupialization for abscesses of dental origin and jaw osteomyelitis were included in the study (February 2018 to February 2023). A case must have had pre- and postoperative computed tomographic study and a follow-up period of at least 4 months.
RESULTS
In total, 113 male and 87 female rabbits were treated surgically. The mean age at the time of the diagnosis at the authors' clinic was 3 years and 11 months. Male rabbits suffered from odontogenic abscesses significantly more often than females. The mean surgical time varied from 25 to 95 minutes, based on the severity of the pathology and location. The wound healed completely in an average of 39.7 days (range, 14 to 145 days; 95% CI, 36.9 to 42.5 days). Major complications detected in 18.5% (37/200) cases were associated with prolonged healing time mostly due to the formation of a bone sequestrum and gingival suture failure. The disease-free time following abscess resolution was on average 29 months (range, 4 to 60 months). The recurrence of the odontogenic infection was 8% (16/200 cases).
CLINICAL RELEVANCE
The radical surgical technique with the extraction of all the infected teeth with the removal of all affected tissue and osteomyelitic bone and regular follow-up wound management is an effective method for the treatment of odontogenic abscesses with jaw osteomyelitis.
Abstract
OBJECTIVE
To develop a formal definition of veterinary care deserts as guidance for veterinary and animal welfare professionals to easily identify areas with limited access to veterinary care that can be targeted with expansion or implementation of programs and services.
SAMPLE
52 sources relating to veterinary care and 55 sources relating to human resource deserts were reviewed for themes and parameters relating to resource desert definitions and barriers to care. Of these, 37 veterinary and 42 human sources were included to inform the themes and parameters for our definition.
METHODS
We performed a scoping literature review with a focus on veterinary care barriers and definitions of human resource deserts.
RESULTS
The review identified 3 common themes of accessibility (transportation; distance to resource), affordability (owner income or poverty level; cost of care), and availability (density of professionals) that were incorporated into the definition of a veterinary care desert and parameterized at the level of census tracts. A working definition for veterinary care deserts was established as a geographic area where accessible, affordable, and available veterinary care is limited.
CLINICAL RELEVANCE
By consulting publicly available census tract data on accessibility, affordability, and availability, veterinary care providers and organizations can use this definition to identify areas most likely to be experiencing reduced access to veterinary care and target interventions accordingly.
Abstract
OBJECTIVE
To collect voided urine from dogs with clinical signs of lower UTI and determine the diagnostic performance of a commercially available rapid immunoassay (RIA) immediately after urine collection and after refrigeration at 4 and 24 hours.
ANIMALS
40 client-owned dogs.
METHODS
Aerobic urine culture was performed on urine collected by cystocentesis. Urine samples were collected by voiding, and the RIA performed in triplicate within 30 minutes (time 0) and again in triplicate after 4 and 24 hours of refrigeration. Test precision and agreement between culture results and RIA results at each time point were determined, and factors possibly associated with false results investigated.
RESULTS
14 of 40 dogs (35%) had UTI verified by aerobic urine culture, and all had positive RIA. Three dogs had false positive RIA results. Sensitivity, specificity, positive predictive value, and negative predictive value of the RIA were 100, 88%, 82%, and 100%, respectively, and results were not different after 4 and 24 hours of refrigeration. Precision was excellent.
CLINICAL RELEVANCE
This point-of-care RIA, performed on voided urine refrigerated up to 24 hours, rapidly and accurately identifies bacteriuria in dogs with lower urinary tract clinical signs, inexpensively.
Abstract
OBJECTIVE
To determine if equine cadavers modified with joint distension would yield higher fluid volumes, require fewer needle redirects, and improve student self-efficacy.
SAMPLE
19 third-year veterinary students.
METHODS
Voluntary participation was sought during 4 sessions of an equine arthrocentesis and diagnostic analgesia laboratory. Half of the sessions were provided with unmodified cadavers and half were provided with cadavers modified with joint distention. Prior to and after the laboratory, participating students completed surveys regarding their self-efficacy with arthrocentesis of the metacarpophalangeal and distal interphalangeal joints. During the study, the number of needle redirects and the volume of fluid obtained was recorded.
RESULTS
Increased fluid volumes were obtained from the modified metacarpophalangeal and distal interphalangeal joints. No difference was identified in number of needle redirects between cadaver types for either joint. Self-efficacy scores increased at the end of the laboratory for arthrocentesis of the metacarpophalangeal joint in both modified and unmodified groups. Self-efficacy scores increased at the end of the laboratory for arthrocentesis of the distal interphalangeal joint for the modified but not unmodified groups.
CLINICAL RELEVANCE
Modified equine cadavers provided a higher fluid yield following arthrocentesis compared to unmodified cadavers, but despite this, multiple attempts were required for proper needle placement. Performing equine arthrocentesis improved student self-efficacy with the task. Given our results, the model used for introduction to performing equine arthrocentesis may be less important than practice with the skill. In order to improve proficiency and self-efficacy, equine arthrocentesis should be provided multiple times throughout the veterinary curriculum.
