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- Author or Editor: Galina M. Hayes x
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Abstract
OBJECTIVE
To determine whether conservative lateral surgical margins (equal to tumor diameter for tumors < 2 cm in diameter or 2 cm for larger tumors) were noninferior to wide (3-cm) lateral surgical margins for achieving tumor-free histologic margins following excision of grade I and II cutaneous mast cell tumors (MCTs) in dogs.
ANIMALS
83 grade I and II MCTs excised with a deep surgical fascial margin and requisite lateral surgical margins from 68 dogs from 2007 to 2017. Tumors representing scar revision or local recurrence were excluded.
PROCEDURES
A pathology department database was searched to identify qualifying MCTs, and medical records were cross-referenced to obtain data regarding patients and tumors. Outcome (complete vs incomplete excision as histologically determined) was compared between conservative- and wide-margin groups. A noninferiority margin of ≥ 0.9 was used for the risk ratio (probability of complete excision for the conservative- vs wide-margin group), implying that noninferiority would be established if the data indicated that the true risk of complete excision with the conservative-margin approach was at worst 90% of that for the wide-margin approach.
RESULTS
The proportion of excised MCTs with tumor-free histologic margins was similar between the conservative- (43/46 [93%]) and wide- (34/37 [92%]) margin groups. There were no differences in tumor diameter or location between treatment groups. The risk ratio (1.02; 95% confidence interval, 0.89 to 1.19) met the criterion for noninferiority.
CONCLUSIONS AND CLINICAL RELEVANCE
The conservative-margin approach appeared to be noninferior to the wide-margin approach for achieving tumor-free histologic margins in the dogs of this study, and its use could potentially reduce the risk of postoperative complications. (J Am Vet Med Assoc 2020;256:567-572
Abstract
OBJECTIVE To identify risk factors associated with surgical site infection (SSI) in dogs following tibial plateau leveling osteotomy (TPLO).
DESIGN Retrospective cohort study.
ANIMALS 320 dogs that underwent unilateral or bilateral TPLO (n = 405 procedures) between 2007 and 2015 and were reexamined by a veterinarian at least once ≥ 8 weeks after the procedure.
PROCEDURES Data were extracted from medical records regarding signalment, TPLO procedure details, medical history of dermatitis, and SSI status. Logistic regression was performed to identify factors associated with SSI development.
RESULTS An SSI developed following 34 (8.4%; 95% confidence interval [CI], 6.1% to 11.5%) procedures. Prophylactic antimicrobial administration was provided following 36.8% (n = 149) of procedures. For 71 (17.5%) procedures, the dog had dermatitis at the time of surgery; 12 of these procedures involved dermatitis at the surgical site. The incidence of SSI following the 12 procedures for dogs with dermatitis at the surgical site was 16.7% (2/12 [95% CI, 3.3% to 54.3%]) and was 10.2% (6/59 [95% CI, 4.5% to 21.3%]) for dogs with dermatitis elsewhere; however, these differences in incidence were not significant. On multivariable analysis, German Shepherd Dogs (vs other breeds), meniscectomy (vs no meniscectomy), and attending surgeon having performed ≤ 20 (vs > 20) procedures during the study period were associated with increased odds of SSI.
CONCLUSIONS AND CLINICAL RELEVANCE SSI following TPLO was associated with the German Shepherd breed, meniscectomy, and surgeon. Prospective studies are needed to investigate the mechanisms underlying these associations.
Abstract
OBJECTIVE To describe outcomes for dogs after treatment of craniodorsal hip luxation with closed reduction and Ehmer sling placement and investigate potential risk factors for sling-associated tissue injury or reluxation of the affected hip at or near the time of sling removal.
DESIGN Retrospective multicenter cohort study.
ANIMALS 92 dogs.
PROCEDURES Case information was solicited from 10 veterinary medical facilities through electronic communications. Data on patient demographic information, cause of injury, presence of concurrent injuries, details of Ehmer sling placement and management, and outcome at sling removal were collected. Data were analyzed for associations with outcomes.
RESULTS 40 of 92 (43.5%) dogs had reluxation of the affected hip joint at or near the time of sling removal. Odds of reluxation occurring for dogs that had the initial injury attributed to trauma were 5 times those for dogs without known trauma (OR, 5.0; 95% confidence interval, 1.3 to 18.7). Forty-six (50%) dogs had soft tissue injuries secondary to sling use; 17 of these dogs had injuries classified as severe, including 1 dog that required limb amputation. Odds of severe sling injury for dogs that had poor owner compliance with home care instructions noted in the record, those that had the sling placed by an intern rather than a board-certified surgeon or resident, and those that were noted to have a soiled or wet bandage on ≥ 1 occasion were 12.5, 4.0, and 5.7 times those for dogs without these findings, respectively.
CONCLUSIONS AND CLINICAL RELEVANCE Placement of an Ehmer sling following closed reduction of a craniodorsal hip luxation had a low success rate and high complication rate.
