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Abstract

OBJECTIVE

To determine the knowledge and use of safe surgical checklists (SSCs) and surgical safety practices (SSPs) in different sectors of veterinary medicine.

SAMPLE

1,235 small animal veterinarians who perform surgery in the United States and Canada.

PROCEDURES

An online survey was distributed to veterinarians through social media platforms, specialty listservs, and the Veterinary Information Network. Respondents provided information regarding their role, practice type, as well as knowledge, attitudes, and use of SSCs. Respondents also provided information about performance of SSPs including team introductions; confirmation of antibiotic prophylaxis, patient identity, procedure to be performed; and confirmation of completion of all procedures.

RESULTS

A greater proportion of Diplomates of the American College of Veterinary Surgeons (49/77 [64%]) reported using an SSC than other veterinarians (257/1157 [22%]; P < .0001). A greater proportion of veterinarians working in university and multispecialty hospitals reported using a SSC (71/142 [50%]) than in other practice settings (235/1092 [22%]; P < .0001). Use of a SSC correlated with consistent performance of surgical safety practices listed above (P < .0001). Primary care veterinarians commonly reported not using a SSC because they did not know about them (359/590 [61%]). Of the 507 respondents who had ever used a SSC, 333 (66%) believed the checklist had prevented an error or complication.

CLINICAL RELEVANCE

Despite widespread knowledge and adoption of SSC use in human medicine, knowledge and use of SSCs is lacking in primary care veterinary practice. Checklist use has previously been shown to decrease post operative complications and in this study was correlated with increased use of SSPs that decreased complications.

Full access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To calculate the necessary pseudophakic intraocular lens (IOL) power to approximate emmetropia in adult tigers.

ANIMALS

17 clinically normal adult tigers.

PROCEDURES

33 eyes of 17 clinically normal adult tigers underwent routine ophthalmic examination and B-scan ultrasonography while anesthetized for unrelated procedures. Specific ultrasound data (globe measurements and corneal curvature) and estimated postoperative IOL positions were utilized to calculate predicted IOL power by use of Retzlaff and Binkhorst theoretical formulas. Applanation tonometry and refraction were also performed.

RESULTS

Mean ± SD axial globe length was 29.36 ± 0.82 mm, preoperative anterior chamber depth was 7.00 ± 0.74 mm, and crystalline lens thickness was 8.72 ± 0.56 mm. Mean net refractive error (n = 33 eyes) was +0.27 ± 0.30 diopters (D). By use of the Retzlaff formula, mean predicted IOL power for the postoperative anterior chamber depth (PACD), PACD – 2 mm, and PACD + 2 mm was 43.72 ± 4.84 D, 37.62 ± 4.19 D, and 51.57 ± 5.72 D, respectively. By use of the Binkhorst equation, these values were 45.11 ± 4.91 D, 38.84 ± 4.25 D, and 53.18 ± 5.81 D, respectively. Mean intraocular pressure for all eyes was 14.7 ± 2.69 mm Hg.

CLINICAL RELEVANCE

The calculated tiger IOL was lower than reported values for adult domestic felids. Further studies evaluating actual PACD and pseudophakic refraction would help determine the appropriate IOL power to achieve emmetropia in this species.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine the impact of a free-choice diet on nutritional intake and body condition of feral horses.

Animals—Cadavers of 41 feral horses from 5 Australian locations.

Procedures—Body condition score (BCS) was determined (scale of 1 to 9), and the stomach was removed from horses during postmortem examination. Stomach contents were analyzed for nutritional variables and macroelement and microelement concentrations. Data were compared among the locations and also compared with recommended daily intakes for horses.

Results—Mean BCS varied by location; all horses were judged to be moderately thin. The BCS for males was 1 to 3 points higher than that of females. Amount of protein in the stomach contents varied from 4.3% to 14.9% and was significantly associated with BCS. Amounts of water-soluble carbohydrate and ethanol-soluble carbohydrate in stomach contents of feral horses from all 5 locations were higher than those expected for horses eating high-quality forage. Some macroelement and microelement concentrations were grossly excessive, whereas others were grossly deficient. There was no evidence of ill health among the horses.

Conclusions and Clinical Relevance—Results suggested that the diet for several populations of feral horses in Australia appeared less than optimal. However, neither low BCS nor trace mineral deficiency appeared to affect survival of the horses. Additional studies on food sources in these regions, including analysis of water-soluble carbohydrate, ethanol-soluble carbohydrate, and mineral concentrations, are warranted to determine the provenance of such rich sources of nutrients. Determination of the optimal diet for horses may need revision.

Full access
in American Journal of Veterinary Research

Abstract

Case Description—An 8-month-old spayed female domestic ferret (Mustela putorius furo) was referred for examination to determine the cause of lethargy and severe anemia.

Clinical Findings—Initial examination revealed that the ferret was lethargic but with appropriate mentation. The only other abnormal findings were severe pallor of the mucous membranes, nasal planum, and skin and a PCV of 8%. Pure red cell aplasia (PRCA) was diagnosed on the basis of cytologic evaluation of a bone marrow biopsy specimen.

Treatment and Outcome—Medical treatment included blood transfusions, IM administration of iron dextran, oral administration of antimicrobials and gastrointestinal tract protectants, and SC administration of erythropoietin. Once PRCA was diagnosed, the ferret was orally administered prednisone, cyclosporine, and azathioprine. Nine months after onset of treatment, the PRCA was in remission and the ferret was doing well. Immunosuppressive treatment was discontinued at 14 months after onset of treatment, and 36 months after initial examination, the ferret appeared to be healthy.

Clinical Relevance—It is important that PRCA be considered as a differential diagnosis for a ferret with severe anemia. Prolonged immunosuppressive treatment was successful in the ferret described here. (J Am Vet Med Assoc 2010;237:695-700)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To optimize the isolation and culture of mesenchymal stem cells (MSCs) from umbilical-cord blood (UCB), identify variables that predicted successful MSC isolation, and determine whether shipping, processing, and cryopreservation altered MSC viability, recovery rates, and expansion kinetics.

Sample Population—UCB samples from 79 Thoroughbred and Quarter Horse mares.

Procedures—UCB samples were processed to reduce volume and remove RBCs. Nucleated cells (NCs) were cryopreserved or grown in various culture conditions to optimize MSC monolayer expansion and proliferation. Donor and UCB-sample factors were analyzed to determine their influence on the success of MSC isolation and monolayer expansion.

Results—MSCs capable of multilineage in vitro differentiation were expanded from > 80% of UCB samples. Automated UCB processing and temperature-controlled shipping facilitated sterile and standardized RBC reduction and NC enrichment from UCB samples. The number of NCs after UCB samples were processed was the sole variable that predicted successful MSC expansion. The UCB-derived MSCs and NCs were successfully cryopreserved and thawed with no decrease in cell recovery, viability, or MSC proliferation. The use of fibronectin-coated culture plates and reduction of incubator oxygen tension from 20% to 5% improved the MSC isolation rate. Some UCB-derived MSC clones proliferated for > 20 passages before senescence. Onset of senescence was associated with specific immunocytochemical changes.

Conclusions and Clinical Relevance—Equine UCB samples appeared to be a rich source of readily obtainable, highly proliferative MSCs that could be banked for therapeutic use.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To conduct a retrospective multi-institutional study reporting short- and long-term outcomes of adrenalectomy in patients presenting with acute hemorrhage secondary to spontaneous adrenal rupture.

ANIMALS

59 dogs and 3 cats.

METHODS

Medical records of dogs and cats undergoing adrenalectomy between 2000 and 2021 for ruptured adrenal masses were reviewed. Data collected included clinical presentation, preoperative diagnostics, surgical report, anesthesia and hospitalization findings, histopathology, adjuvant treatments, and long-term outcome (recurrence, metastasis, and survival).

RESULTS

Median time from hospital admission to surgery was 3 days, with 34% of surgeries being performed emergently (within 1 day of presentation). Need for intraoperative blood transfusion was significantly associated with emergent surgery and presence of active intraoperative hemorrhage. The short-term (≤ 14 days) complication and mortality rates were 42% and 21%, respectively. Negative prognostic factors for short-term survival included emergent surgery, intraoperative hypotension, and performing additional surgical procedures. Diagnoses included adrenocortical neoplasia (malignant [41%], benign [12%], and undetermined [5%]), pheochromocytoma (38%), a single case of adrenal fibrosis and hemorrhage (2%), and a single case of hemangiosarcoma (2%). Local recurrence and metastasis of adrenocortical carcinoma were confirmed in 1 and 3 cases, respectively. Overall median survival time was 574 days and 900 days when short-term mortality was censored. No significant relationship was found between histopathological diagnosis and survival.

CLINICAL RELEVANCE

Adrenalectomy for ruptured adrenal gland masses was associated with similar short- and long-term outcomes as compared with previously reported nonruptured cases. If hemodynamic stability can be achieved, delaying surgery and limiting additional procedures appear indicated to optimize short-term survival.

Full access
in Journal of the American Veterinary Medical Association