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- Author or Editor: Deborah A. Keys x
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Abstract
OBJECTIVE
To describe a modified technique for reinforced, free-form external skeletal fixation (rFF-ESF) of appendicular fractures in cats and identify factors associated with development of complications.
ANIMALS
46 cats with fractures repaired with rFF-ESF at Angell Animal Medical Center between 2010 and 2019.
PROCEDURES
Medical records were reviewed for information on signalment, affected bone, fracture location and orientation, degree of comminution, severity (open vs closed), fixator type, number of fixation pins, use of an intramedullary pin (yes vs no), surgeon experience (staff surgeon vs surgical resident), anesthesia time, surgery time, perioperative antimicrobial administration, concurrent surgical procedures, intraoperative complications, postoperative alignment, whether fixator destabilization was performed, and time to complete fixator removal. Postoperative complications were recorded.
RESULTS
43 of the 46 (93%) cats had a successful outcome, with a median time to complete fixator removal of 8 weeks (range, 3 to 61 weeks). Twelve of the 46 (26%) cats had major (n = 3) or minor (9) complications. In univariable analyses, 4 factors were significantly associated with development of postoperative complications: body weight (OR for each 1-kg increase in weight, 1.8), tibial fracture (vs fracture of any other long bone; OR, 16), use of a type 2 fixator (vs a type 1 fixator; OR, 11), and use of destabilization (vs no destabilization; 7).
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that rFF-ESF can be successfully used to stabilize a variety of appendicular fractures in cats. Further studies are required to compare rFF-ESF with other fracture fixation methods.
Abstract
OBJECTIVE
To compare single and triplicate applanation tonometry values across previous intraocular pressure (IOP) studies in dogs.
ANIMALS
116 ophthalmologically normal dogs.
PROCEDURES
Triplicate IOP readings (n = 1432) from studies evaluating effect of anesthetic protocols were analyzed to estimate a range of probable differences between averaged triplicate and first, averaged and lowest, and first and lowest IOPs. The decrease in variability with triplicate measurements and the magnitude of effects on statistical power were quantified.
RESULTS
The 2.5th to 97.5th interpercentile range for differences of averaged triplicate values minus first IOP readings was –3 to 2.7 mm Hg; for averaged minus lowest: 0 to 3.7 mm Hg; for first minus lowest: 0 to 5 mm Hg. The 95% prediction interval for differences in study group means (n = 160 groups, n = 5 to 11 eyes per group) based on averaged minus first measurements was –1.0 to 0.9 mm Hg with associated SDs reduced by 4% on average. Analysis of previous studies using averaged instead of first IOP values resulted in minimal decreases in SEs of 3–9% (0.03 to 0.09 mm Hg). Of 11 comparisons found significant with averaged data, 2 (18%) were found nonsignificant with first measurements. Of 96 comparisons found nonsignificant with averaged data, 3 (3%) were found significant with first measurements.
CLINICAL RELEVANCE
With applanation tonometry in ophthalmologically normal dogs, no clinically meaningful difference was found between the first, lowest, or averaged triplicate IOP measurements, but the first reading has a larger variance and hence will result in lower statistical power.
Abstract
OBJECTIVE
The objective of this study was to compare Doppler blood pressure (DBP) measurements between blood pressure cuffs (BPCs) with and without a secondary fastener (tape) in healthy nonanesthetized large-breed dogs.
ANIMALS
28 healthy dogs.
METHODS
Superficial palmar venous arch DBP measurements with and without tape on the BPC were performed in lateral recumbency with Doppler ultrasound. Each method was performed 6 consecutive times, with the final 5 values averaged. Bland-Altman plots were made and limits of agreement calculated.
RESULTS
The limits of agreement were –40.8 (95% CI, –55.6 to –26.0) to 45.6 (95% CI, 30.8 to 60.4), indicating that the DBP measured with tape would be expected to be between 40.8 mm Hg below and 45.6 mm Hg above that measured without tape 95% of the time. The mean bias estimate was 2.4 mm Hg (SD, 22.0; 95% CI, –6.1 to 11.0; P = .724), indicating that DBP measurements with tape averaged 2.4 mm Hg higher than without tape.
CLINICAL RELEVANCE
Doppler blood pressure measurements obtained with secondary fasteners on the BPCs differed by > 10 mm Hg compared to the BPCs’ standard hook-and-loop fasteners 54% (30 of 56) of the time. Blood pressure cuffs with dysfunctional hook-and-loop fasteners should be replaced due to poor clinical reliability of DBP measurements. However, it is unclear whether Doppler sphygmomanometry is more accurate with the use of traditional Velcro BPC fasteners or with tape BPC fasteners.
