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Introduction

Second-guessing refers to the all-too-human tendency to question or criticize someone's—or one's own—actions or decisions after the results of those actions or decisions are already known. In the sports world, second-guessing is frequently known as Monday morning quarterbacking and is a generally harmless pastime. In the health-care field, however, second-guessing can be detrimental, shaking the confidence of clinicians, particularly those early in their careers.

Of course, there are times when retrospective analysis of case-management decisions is appropriate. Structured morbidity and mortality rounds and even informal conversations with mentors and colleagues can help in identifying and correcting deficiencies in clinical

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in Journal of the American Veterinary Medical Association
Introduction

Medical error is widespread in both human 1 and veterinary medicine, 24 although the latter is much less studied. Much of this error is attributable to poor communication, either between the veterinarian-physician and client-patient or within the medical team. This commentary focuses on the issues of within-team communication.

Handoffs

Within-team communication failures often occur during shift changes or transfers of case responsibility. In fact, an Institute of Medicine 2001 report indicates that inadequate handoffs are “where safety often fails first.” 5 As a result, there has been great interest within the human medical field

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To evaluate use of an ultrasonographically and radiographically determined value, the vertebral epaxial muscle score (VEMS), for assessing muscle mass in cats.

ANIMALS 30 healthy neutered cats of various body weights and between 1 and 6 years of age.

PROCEDURES Mean epaxial muscle height was calculated from 3 transverse ultrasonographic images obtained at the level of T13. Length of T4 was measured on thoracic radiographs, and the VEMS (ratio of epaxial muscle height to T4 length) was calculated and compared with body weight. Ratios of epaxial muscle height to various anatomic measurements also were compared with body weight as potential alternatives to use of T4 length.

RESULTS 1 cat was excluded because of a heart murmur. For the remaining 29 cats, mean ± SD body weight was 5.05 ± 1.40 kg. Mean epaxial muscle height was 1.27 ± 0.13 cm, which was significantly correlated (r = 0.65) with body weight. The VEMS and value for epaxial muscle height/(0.1 × forelimb circumference) were not significantly correlated (r = −0.18 and −0.06, respectively) with body weight, which is important for measures used for animals of various sizes.

CONCLUSIONS AND CLINICAL RELEVANCE The VEMS and value for epaxial muscle height/(0.1 × forelimb circumference) can both be used to normalize muscle size among cats of various body weights. Studies are warranted to determine whether these values can be used to accurately assess muscle mass in cats with various adiposity and in those with muscle loss.

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in American Journal of Veterinary Research
History

A 3-year-old 0.46-kg sexually intact male African pygmy hedgehog (Atelerix albiventris) was evaluated at the Veterinary Teaching Hospital at the Louisiana State University School of Veterinary Medicine because of a 4-day history of lethargy, anorexia, and decrease in water intake. The owners reported that the hedgehog was less active, they had not seen it defecate recently, and they thought it had possibly urinated on itself.

Clinical and Gross Findings

At the first clinical evaluation, the hedgehog was responsive, stable, and apparently clinically normal. The hedgehog was admitted to the hospital for a full diagnostic workup. During the

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in Journal of the American Veterinary Medical Association