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- Author or Editor: Philip H. Kass x
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Abstract
Objective—To compare the feasibility of training veterinary medicine students to perform laparoscopic versus conventional open ovariectomy in live dogs.
Design—Randomized prospective parallel-group experiment.
Population—25 students completing the second year of their veterinary curriculum.
Procedures—Students were randomly assigned to 2 groups to receive 14 hours of specific training in either open ovariectomy (n = 13) or laparoscopic ovariectomy (12). Confidence, basic surgical skills, and basic laparoscopic skills were evaluated before and after training, prior to live surgical procedures.
Results—Scores related to basic surgical skills were high in both groups and did not improve with either training program. Before live animal surgeries, student confidence and basic laparoscopic skills improved after training in laparoscopic ovariectomy and were higher than after training in open ovariectomy. Surgery time was higher for the students who received training in laparoscopic ovariectomy (129 minutes; range, 84 to 143 minutes), compared with students who received training in open ovariectomy (80 minutes; range, 62 to 117 minutes). On a 55-point scoring system, ovariectomy scores were similar between students who received training in open ovariectomy (34.5; range, 16.5 to 45) and students who received training in laparoscopic ovariectomy (34.5; range, 25 to 44.5).
Conclusions and Clinical Relevance—The training programs were effective in improving student confidence and skills in laparoscopic ovariectomy. Results of this study suggested that veterinary medical students, with assistance from an instructor, may be taught to perform laparoscopic ovariectomies with performance equivalent to that for students performing open ovariectomies.
Abstract
Objective—To identify risk factors associated with survival in dogs with nontonsillar oral squamous cell carcinoma (OSCC) that were and were not treated with curative-intent surgery.
Design—Retrospective case series.
Animals—31 dogs with OSCC.
Procedures—Medical records for dogs with OSCC that were not treated, or were treated with curative-intent surgery only between January 1990 and December 2010 were reviewed. For each dog, data regarding signalment, clinical stage, treatment, tumor recurrence, and survival time were obtained from the medical record, and archived biopsy specimens were evaluated to identify the histologic subtype of the tumor and extent of tumor-associated inflammation (TAI), perineural invasion (PNI), and lymphovascular invasion (LVI).
Results—Risk of death for the 21 dogs with OSCC that were surgically treated was decreased 91.4% (hazard ratio, 0.086; 95% confidence interval, 0.002 to 0.150), compared with that for the 10 dogs with OSCC that were not treated. The 1-year survival rate was 93.5% and 0% for dogs that were and were not surgically treated, respectively. Risk of death increased significantly with increasing TAI and increasing risk score (combination of TAI, PNI, and LVI). Tumor location, clinical stage, and histologic subtype were not associated with survival time.
Conclusions and Clinical Relevance—Results indicated that the prognosis for dogs with OSCC was excellent following surgical excision of the tumor. Risk of death increased with increasing TAI, and combining TAI, PNI, and LVI into a single risk score may be a useful prognostic indicator for dogs with OSCC.
Abstract
OBJECTIVE To describe the prevalence, histologic characteristics, concomitant abnormalities, and outcomes for various types of mammary gland tumors in companion rats (Rattus norvegicus).
DESIGN Retrospective case series.
ANIMALS 100 client-owned rats.
PROCEDURES Medical records of companion rats that had an SC mass and were examined at a veterinary teaching hospital between 1990 and 2015 were reviewed. Information regarding the signalment, age at mass detection, reproductive sterilization status, histologic diagnosis of the SC mass, location of the initial and all subsequent SC masses, treatments administered, and clinical outcomes was extracted from each record and summarized.
RESULTS 105 SC masses were initially detected in 100 rats. The most prevalent SC mass identified was mammary gland fibroadenoma (56/105 [53%]), followed by mammary gland carcinoma (13/105 [12%]). Overall, 26 of 105 (25%) masses were malignant. Sexually intact males were more likely to have nonmammary SC tumors than sexually intact females. In rats receiving no adjunctive treatment after excision of a mammary gland fibroadenoma (n = 16), a second fibroadenoma was detected 1 to 8 months after initial excision, at a median of 4.5 months after surgery. A concomitant pituitary gland tumor was identified in most rats with mammary gland fibroadenoma (21/28 [75%]) and other types of mammary gland tumors (10/17 [59%]). Fourteen of 35 (40%) rats with mammary gland fibroadenoma had concomitant reproductive tract abnormalities.
CONCLUSION AND CLINICAL RELEVANCE Results suggested that, like other species, companion rats with SC masses should undergo a thorough diagnostic workup that includes histologic examination of the excised mass.
Abstract
OBJECTIVE To compare efficacy between cyclosporine and prednisone for treatment of primary immune-mediated polyarthritis (IMPA) in dogs.
DESIGN Randomized controlled clinical trial.
ANIMALS 20 client-owned dogs with primary IMPA.
PROCEDURES Dogs were randomly assigned to receive prednisone (starting at 1 mg/kg [0.45 mg/lb], PO, q 12 h; n = 10) or cyclosporine (5 mg/kg [2.3 mg/lb], PO, q 12 h; 10) for 90 days. Cyclosporine-treated dogs also received carprofen, tramadol, or both for the first 7 days for analgesia. Data collection, physical examination, and cytologic analysis of synovial fluid samples were performed on days 0, 14, 45, and 90. Trough whole blood cyclosporine concentrations were determined on days 7 to 17 for cyclosporine-treated dogs. Treatment failure was defined as lack of clinical improvement by day 14, lack of cytologic improvement by day 45, or need to change treatment because of adverse effects.
RESULTS Treatment was successful for 7 prednisone-treated dogs and 7 cyclosporine-treated dogs. Absence of synovial fluid cytologic abnormalities on day 45 was identified for 5 prednisone-treated dogs and 8 cyclosporine-treated dogs. Prednisone-treated dogs were more likely to develop polyuria, polydipsia, and polyphagia than were cyclosporine-treated dogs. Opportunistic infections (ie, demodicosis or Erysipelothrix bacteremia) were identified in 2 cyclosporine-treated dogs and 0 prednisone-treated dogs, and diarrhea developed in 1 cyclosporine-treated dog, requiring treatment discontinuation.
CONCLUSIONS AND CLINICAL RELEVANCE Although the number of dogs evaluated was small, limiting generalizability, results of this study suggested that cyclosporine offers promise as a suitable alternative to prednisone for treatment of IMPA in dogs.
Abstract
Objective—To evaluate the exposure obtained for minimally invasive abdominal organ biopsy (MIOB) from 3 access incisions in cats.
Design—Prospective experimental study and clinical case series.
Animals—6 purpose-bred research cats and 6 feline clinical patients with indications for abdominal organ biopsy.
Procedures—Three 3-cm incisions into the peritoneal cavity were created at different locations along the linea alba in research cats in randomized order. A wound retraction device was inserted in each incision. Ability to exteriorize various abdominal organs to the extent required to reasonably perform a surgical biopsy was recorded, and results were compared among incision sites. On the basis of results obtained, the access incision that provided exposure of the most frequently biopsied abdominal organs was used to perform MIOB in 6 feline clinical patients with various underlying pathological conditions.
Results—On the basis of experiments with research cats, a 3-cm access incision centered midway between the caudal margin of the xiphoid cartilage and the umbilicus was found to provide access for MIOB for most organs. In 5 of 6 clinical patients, all of the organs of interest were biopsied successfully via this incision location, although access to all hepatic lobes and all parts of the pancreas was inconsistent. In 1 cat, conversion to an open approach was performed because a palpable mass was detected in the area of the duodenocolic ligament.
Conclusions and Clinical Relevance—Optimization of access incision location for MIOB allowed biopsy specimen collection from organs of interest to be performed in a minimally invasive manner in cats.
Abstract
OBJECTIVE To evaluate signalment, clinical signs, treatment, and factors affecting visual prognosis in dogs with uveodermatologic syndrome (UDS).
DESIGN Retrospective case series and nested cohort study.
ANIMALS 50 dogs (37 Akitas and 13 non-Akitas) with UDS evaluated at 4 ophthalmology practices.
PROCEDURES Data were collected from the medical records regarding signalment, clinical signs, biopsy results, medications, adverse effects, vision and glaucoma status at initial and subsequent examinations, and duration of follow-up. Various factors were examined for associations with development of blindness or glaucoma following initial examination.
RESULTS The most common ophthalmic signs included aqueous flare (n = 35 [70%]), iris abnormalities (29 [58%]), retinal detachment (23 [46%]), and choroidal depigmentation or chorioretinal infiltrates (10 [20%]). At initial examination, 36% (18/50) of dogs had glaucoma and 57% (26/46) were blind in both eyes. Twenty-five (50%) dogs had vision at their final visit, representing 78% of the 32 dogs that had vision at initial examination or regained vision during the follow-up period. In dogs that lost vision, median time to permanent blindness in both eyes was 13.5 months (range, 0.4 to 59 months) after initial examination. No significant associations with time to glaucoma or vision loss were identified for signalment variables, specific medications, or duration of clinical signs prior to initial examination.
CONCLUSIONS AND CLINICAL RELEVANCE UDS commonly resulted in glaucoma, vision loss, or both in affected dogs. No evaluated factor was associated with visual prognosis; however, a subset of patients maintained vision through to the final recheck examination.
Abstract
OBJECTIVE To describe diagnosis, treatment, and outcome of and risk factors for ophthalmic disease in leopard geckos (Eublepharis macularius) evaluated at a veterinary teaching hospital.
DESIGN Retrospective case series.
ANIMALS 112 of 144 (78%) leopard geckos that were evaluated at a veterinary teaching hospital in January 1985 through October 2013 and for which sufficient medical record information was available.
PROCEDURES Information from medical records was used to identify leopard geckos with ophthalmic disease, characterize cases, and determine risk factors for the presence of ophthalmic disease.
RESULTS Of the 112 leopard geckos, 52 (46%) had ophthalmic disease (mainly corneal or conjunctival disease). Female geckos were less likely to have ophthalmic disease, and there was a positive association between increasing age and ophthalmic disease. Use of a paper towel substrate, absence of any heat source, and lack of vitamin A supplementation were positively associated with a diagnosis of ophthalmic disease. Head dysecdysis was the only concurrent disorder significantly associated with ophthalmic disease. At necropsy, 5 affected leopard geckos had squamous metaplasia of the conjunctivae.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that ophthalmic disease is a common finding in leopard geckos. The cause of ocular surface disease in leopard geckos may be multifactorial, and hypovitaminosis A may be an important risk factor. Although animals receiving supplemental vitamin A were less likely to have ophthalmic disease, further understanding is required regarding the metabolism of and nutritional requirements for vitamin A in leopard geckos.
Abstract
Objective—To determine the effect of sliding and wedge osteotomies of the humerus on the joint surface contact areas in anatomically normal elbow joints of dogs.
Sample Population—Left thoracic limbs from 5 skeletally mature mixed-breed canine cadavers.
Procedure—Joint casting was performed by placement of colored polymethylmethacrylate in the elbow joint cavity followed by loading in a materials testing system at physiologic angle and load. Joint casting was performed in unaltered specimens, after 10° medial opening wedge osteotomy, and after lateral sliding osteotomy of the proximal portion of the humerus. Computer-aided analysis of photographs of proximal radial and ulnar articular surfaces after each casting procedure was performed.
Results—The lateral sliding humeral osteotomy and 10° medial opening wedge osteotomy significantly altered joint surface contact regions of the canine elbow joint. Osteotomies resulted in a reduction in the size of the radial, ulnar, and combined radioulnar contact areas. Both osteotomies also resulted in craniolateral migration of the radial contact area and craniomedial recession of the ulnar contact area. Although the reduction in ulnar contact area with these treatments is consistent with our hypotheses, the reduction in radial contact area was not anticipated.
Conclusions and Clinical Relevance—Humeral osteotomies alter joint surface contact areas of the canine elbow joint in vitro. Humeral osteotomies may decrease contact areas on the diseased region of the joint in dogs with elbow dysplasia; however, the overall decrease in joint surface contact area suggests that these procedures may induce focal increases in pressure that may cause iatrogenic cartilage damage when applied in vivo. (Am J Vet Res 2003;64:506–511)
Abstract
Objective—To determine induction doses, anesthetic constant rate infusions (CRI), and cardiopulmonary effects of propofol in red-tailed hawks and great horned owls and propofol pharmacokinetics in the owls during CRI.
Animals—6 red-tailed hawks and 6 great horned owls.
Procedure—The CRI dose necessary for a loss of withdrawal reflex was determined via specific stimuli. Anesthesia was induced by IV administration of propofol (1 mg/kg/min) and maintained by CRI at the predetermined dose for 30 minutes. Heart and respiratory rates, arterial blood pressures, and blood gas tensions were obtained in awake birds and at various times after induction. End-tidal CO2 (ETCO2) concentration and esophageal temperature were obtained after induction. Propofol plasma concentrations were obtained after induction and after completion of the CRI in the owls. Recovery times were recorded.
Results—Mean ± SD doses for induction and CRI were 4.48 ± 1.09 mg/kg and 0.48 ± 0.06 mg/kg/min, respectively, for hawks and 3.36 ± 0.71 mg/kg and 0.56 ± 0.15 mg/kg/min, respectively, for owls. Significant increases in PaCO2, HCO3, and ETCO2 in hawks and owls and significant decreases in arterial pH in hawks were detected. A 2-compartment model best described the owl pharmacodynamic data. Recovery times after infusion were prolonged and varied widely. Central nervous system excitatory signs were observed during recovery.
Conclusions and Clinical Relevance—Effects on blood pressure were minimal, but effective ventilation was reduced, suggesting the need for careful monitoring during anesthesia. Prolonged recovery periods with moderate-to-severe excitatory CNS signs may occur in these species at these doses. (Am J Vet Res 2003;64:677–683)
Abstract
Objective—To assess the use of a caudal external thoracic artery axial pattern flap to treat sternal cutaneous wounds in birds.
Animals—16 adult Japanese quail.
Procedure—A cutaneous defect in the region of the mid-sternum was surgically created in all quail. In 6 quail (group I), an axial pattern flap was created from the skin of the lateral aspect of the thorax and advanced over the sternal defect. In 8 quail (group II), a flap was similarly created and advanced but the flap vasculature was ligated. All quail were euthanatized at 14 days after surgery and had necropsies performed. Sections of the flap and the surrounding tissue were examined histologically to assess flap viability.
Results—All axial pattern flaps in group-I quail had 100% survival. In group II, mean percentage area of flap survival was 62.5%; mean area of necrosis and dermal fibrosis of flaps were significantly greater than that detected in group I. In flaps of group-II quail, neovascularization in the deep dermis and profound necrosis of the vascular plexus in the superficial dermis were observed.
Conclusions and Clinical Relevance—Results indicated that the caudal external thoracic artery axial pattern flap could be used successfully in the treatment of surgically created sternal cutaneous defects in quail with no signs of tissue necrosis or adverse effects overall. Use of this technique to treat selfmutilation syndromes or application after surgical debulking of tumors or other masses might be beneficial in many avian species. (Am J Vet Res 2004;65:497–502)