Objective—To compare complication and recurrence
rates in dogs treated for intussusception that underwent
enteroplication to rates in dogs treated for intussusception
that did not undergo enteroplication.
Animals—35 dogs with intestinal intussusception.
Procedure—Information on signalment, clinical signs,
potential predisposing causes, surgical technique,
opioid administration, use of enteroplication, postoperative
complications, and whether the intussusception
recurred was obtained from the medical records.
Results—Dogs ranged from 8 weeks to 10 years old.
Opioids were administered in the perioperative period
in 34 dogs. Enteroplication was performed in 16 dogs.
Complications of enteroplication that required a second
surgery were identified in 3 dogs. None of the 16
dogs that underwent enteroplication had a recurrence
of intussusception, whereas 1 of the 19 dogs that did
not undergo enteroplication had a recurrence. Rate of
intussusception recurrence and likelihood that a second
surgical procedure would be required were not
significantly different between dogs that underwent
enteroplication and dogs that did not.
Conclusions and Clinical Relevance—Results suggest
that enteroplication may be associated with lifethreatening
complications in dogs, but the likelihood
of a dog requiring a second surgical procedure following
surgical correction of intussusception was not
different between dogs that underwent enteroplication
at the time of the initial surgery and dogs that did
not. (J Am Vet Med Assoc 2001;219:1415–1418)
Case Description—A 2.8-kg (6.1-lb) 4-month-old sexually intact female domestic shorthair cat was referred for evaluation of bilateral, subcutaneous lumbar masses that were presumed to be the kidneys.
Clinical Findings—Physical examination findings included 2 mobile, nonpainful, 3×3-cm, bilaterally symmetric masses in the dorsolateral lumbar region. Abdominal radiography, ultrasonography, and CT confirmed bilateral body wall defects with renal herniation. Serum biochemistry profile, urinalysis, and excretory urography confirmed normal renal function.
Treatment and Outcome—Exploratory laparotomy, reduction of the kidneys, repair of the body wall defects, bilateral nephropexy, and ovariohysterectomy were performed. There were no perioperative complications.
Clinical Relevance—Lumbar hernia has not been reported previously in a cat. It is important for veterinarians to be aware that although rare, lumbar hernia should be included in the list of differential diagnoses for a lumbar mass or signs of chronic lumbar pain in cats.
To investigate effects of an intensive 2-day practice-level communication skills training program (CSTP) with a 3-month follow-up communication in practice program (CIPP) on veterinary health-care team members' communication confidence, client satisfaction, and practice financial metrics.
5 US companion animal veterinary practices.
Following pilot testing at 1 veterinary practice, communication skills training was performed on-site at 4 practices. The 2-day CSTP focused on veterinary communication–specific content. The CIPP included in-practice training sessions every other week to reinforce and build upon communication skills. Team members' communication skills confidence (before and after the CSTP and after the CIPP) and client satisfaction with veterinary visits (2 months before and 3 months after the CSTP) were assessed with surveys. Practice-level financial metrics were collected for 18 months. Variables of interest were compared among time points.
Measures of team member communication skills confidence and initiation of client conversations regarding the value of goods and services were significantly greater after the CIPP than before the CSTP. Composite communication skills confidence scores 3 months after the CSTP were positively correlated with the mean practice transaction charge and percentage change in the number of heartworm tests performed in the 3 months after the CSTP, compared with results for the same 3 months in the previous year. Measurements of client satisfaction were high before and after the CSTP. There was no significant change in financial metrics in the 3 months after CSTP, compared with the same 3 months in the previous year.
CONCLUSIONS AND CLINICAL RELEVANCE
This study highlighted opportunities to increase veterinary health-care team members' communication confidence and identified future considerations for communication training in veterinary workplaces.
Objective—To evaluate long-term neurologic outcome
in dogs with atlantoaxial subluxation (AAS) that
were treated nonsurgically with a cervical splint.
Animals±19 dogs with AAS and managed with a
Procedure—Medical records from 2 university hospitals
were reviewed. Information pertaining to trauma,
duration of clinical signs prior to admission, medical
treatments prior to admission, results of neurologic
and physical examinations at the time of admission,
results of laboratory testing, results of diagnostic
imaging, neurologic status at the time of discharge,
duration of time the cervical splint was used for treatment,
and neurologic status at the time of splint
removal and at a final reexamination was extracted
from the medical records. Long-term outcome was
defined as neurologic status greater than or equal to
1 year after splint removal. Factors associated with a
good or poor long-term outcome were determined.
Results—A good final outcome was reported in 10 of
16 dogs. Median duration of clinical signs prior to referral
was 30 days; dogs that were affected ≤ 30 days
were significantly more likely to have a good long-term
outcome, compared with dogs affected > 30 days. The
neurologic grade at admission, radiographic appearance
of the dens, age at onset of clinical signs, and
history were not associated with outcome.
Conclusions and Clinical Relevance—Nonsurgical
management of AAS by use of a cervical splint is a
viable treatment modality for young dogs with a first
episode of acute-onset clinical signs, regardless
of the severity of neurologic deficits at admission.
(J Am Vet Med Assoc 2005;227:257–262)
Objective—To identify risk factors for failure to survive and development of septic peritonitis following full-thickness gastrointestinal incision in dogs.
Design—Retrospective cohort study.
Animals—Dogs that underwent gastrointestinal surgery from 1998 through 2007 at the University of Georgia Veterinary Teaching Hospital.
Procedures—Medical records of dogs undergoing a full-thickness gastrointestinal incision were reviewed, and information regarding dog history, clinicopathologic findings, surgery characteristics, and outcome was collected.
Results—Records for 197 dogs (225 surgeries) were evaluated. In 35 (16%) surgeries, the dogs died prior to hospital discharge. After 28 (12%) surgeries, dogs developed septic peritonitis. For 45 (20%) surgeries, dogs had preoperative septic peritonitis; of those, approximately a third resulted in continued septic peritonitis (17/45; 38%) or death (15/45; 33%). Of the 180 surgeries performed in dogs lacking preoperative septic peritonitis, 11 (6%) resulted in development of septic peritonitis and 20 (11 %) resulted in death. When all surgeries were considered, common risk factors for development of septic peritonitis included preoperative septic peritonitis, low preoperative serum albumin and plasma protein concentrations, and intraoperative hypotension. Presence of a foreign body was a protective factor.
Conclusions and Clinical Relevance—Multiple factors were associated with failure to survive and development of septic peritonitis after gastrointestinal surgery in dogs. Aggressive perioperative attempts to increase protein concentrations and intraoperative surgical strategies to decrease the chance of a poor outcome may be indicated in dogs with risk factors identified in this study.
To evaluate outcomes associated with an experiential leadership program (the Veterinary Leadership Experience [VLE]) among participants 1 year after program completion.
157 veterinary students and 61 veterinary professionals who participated in the 2015 or 2016 VLE.
Participants completed various instruments to assess emotional intelligence, psychological flexibility, resilience, and client-communication skills prior to (pretest) and 1 year after (posttest) attending the VLE; pretest and posttest findings were compared for all but client-communication skills, for which only posttest responses were analyzed. An additional posttest instrument assessed the impact that the VLE had on key knowledge areas (ie, self-awareness, self-management, social awareness, relational competence, communication skills, and conflict management skills) and overall impact.
1 year after completing the VLE, participants reported that the program had a high impact on all key knowledge areas; the impact on social awareness and overall impact was significantly higher for veterinary students than for veterinary professionals. Veterinary professionals reported a greater increase in emotional intelligence after program completion than did veterinary students. For each assessed client-communication skill, the percentage of veterinary professionals who reported increased confidence in that skill after program completion was lower than the corresponding percentage of veterinary students. Resilience and psychological flexibility scores did not increase after program completion.
CONCLUSIONS AND CLINICAL RELEVANCE
Assessment of the effectiveness and long-term outcomes of experiential leadership programs is important to understanding whether such programs are having the intended effect. Veterinary students and veterinary professionals who were assessed 1 year after completing the VLE reported improvements in leadership skills foundational to the program.
Case Description—A 1.5-year-old mixed-breed dog was examined because of a 1-month history of anorexia, vomiting, diarrhea, and weight loss.
Clinical Findings—The dog was very thin on physical examination (body condition score, 3/9). Results of all diagnostic tests were within reference limits except intestinal thickening and lymphadenopathy were identified on abdominal ultrasound examination. During exploratory laparotomy, thickening at the ileocecal-colic junction and within the transverse colon and mesenteric lymphadenopathy were identified, and the ileocecal-colic junction was resected. Histopathologic evaluation of the ileocecal-colic junction and full-thickness biopsy specimens from other sites as well as results of a serum ELISA were diagnostic for gastrointestinal Pythium insidiosum infection.
Treatment and Outcome—Pythiosis was initially treated medically with administration of itraconazole and terbinafine by mouth, but the colonic lesion was progressive with this regimen. Two months after diagnosis, a subtotal colectomy was performed; marginal excision (0.6 cm) was obtained at the aboral margin. The dog was treated with 3 doses of a pythiosis vaccine beginning approximately 2 weeks after surgery and was continued on itraconazole and terbinafine for 5 months. Parenteral and enteral nutrition as well as considerable general supportive care were required postoperatively. Six months after treatment, the dog had a normal serum ELISA titer. Two years after treatment, the dog had returned to preoperative weight and was clinically normal.
Clinical Relevance—This patient had an unusually positive therapeutic response to chronic, extensive, marginally excised gastrointestinal pythiosis.
Objective—To evaluate outcomes of dogs and owner satisfaction and perception of their dogs’ adaptation following amputation of a thoracic or pelvic limb.
Design—Retrospective case series.
Animals—64 client-owned dogs.
Procedures—Medical records of dogs that underwent limb amputation at a veterinary teaching hospital between 2005 and 2012 were reviewed. Signalment, body weight, and body condition scores at the time of amputation, dates of amputation and discharge from the hospital, whether a thoracic or pelvic limb was amputated, and reason for amputation were recorded. Histologic diagnosis and date of death were recorded if applicable. Owners were interviewed by telephone about their experience and interpretation of the dog's adaptation after surgery. Associations between perioperative variables and postoperative quality of life scores were investigated.
Results—58 of 64 (91%) owners perceived no change in their dog's attitude after amputation; 56 (88%) reported complete or nearly complete return to preamputation quality of life, 50 (78%) indicated the dog's recovery and adaptation were better than expected, and 47 (73%) reported no change in the dog's recreational activities. Body condition scores and body weight at the time of amputation were negatively correlated with quality of life scores after surgery. Taking all factors into account, most (55/64 [86%]) respondents reported they would make the same decision regarding amputation again, and 4 (6%) indicated they would not; 5 (8%) were unsure.
Conclusions and Clinical Relevance—This information may aid veterinarians in educating clients about adaptation potential of dogs following limb amputation and the need for postoperative weight control in such patients. (J Am Vet Med Assoc 2015;247:786–792)
To evaluate long-term outcomes and identify factors associated with death or the need for revision surgery in dogs with permanent tracheostomies (PTs).
Retrospective cohort study.
69 client-owned dogs that received a PT between January 2002 and June 2016 at 1 of 4 veterinary teaching hospitals.
Medical records were reviewed, and data extracted included signalment, history, clinical signs, radiographic and laryngeal examination findings, presence of esophageal abnormalities, date and reason for receiving a PT, postoperative complications, cause of death, and survival time. Dogs surviving < 2 weeks after receiving a PT were excluded.
Major complications occurred in 42 of 69 (61%) dogs, with aspiration pneumonia (13 [19%]), skinfold occlusion (13 [19%]), and stoma stenosis (12 [17%]) being most common. Revision surgery was performed in 24 of 69 (35%) dogs, most commonly because of stoma stenosis or skinfold occlusion (9/24 [38%] each). Brachycephalic dogs were more likely (OR, 3.5; 95% confidence interval, 1.2 to 10.2) to require revision surgery than were nonbrachycephalic dogs. The overall median survival time was 1,825 days, and dogs that received corticosteroids before receiving a PT, had tracheal collapse, or were older had shorter survival times.
CONCLUSIONS AND CLINICAL RELEVANCE
Results of the present study indicated that creation of a PT was a viable treatment option for obstructive upper airway diseases in dogs and that long-term survival after receiving a PT was possible; however, a PT may not reduce the risk of aspiration pneumonia in dogs.