Objective—To evaluate the B-mode and Doppler ultrasonographic appearance of presumptively normal main axillary and large superficial cervical lymph nodes (MALNs and SCLNs, respectively) in adult dogs.
Animals—51 healthy adult dogs (data from 1 dog were not analyzed).
Procedures—For each dog, weight, distance from the cranial aspect of the first sternebra to the caudal aspect of the left ischiatic tuberosity, and thoracic height and width at the level of the xiphoid process were recorded. Via B-mode and Doppler ultrasonography, echogenic characteristics, size in relation to body size and weight, and vascular supply of the MALNs and the SCLNs were evaluated (1 SCLN in 1 dog was not ultrasonographically visible).
Results—Most MALNs were clearly margined, solitary, and ovoid; echopatterns were homogenous or cortical and hypo- to isoechoic, compared with surrounding soft tissues. Size measurements of MALNs correlated with dogs' body length, thoracic width and height, and body weight. Most SCLNs were clearly margined, fusiform, and hypoechoic (compared with surrounding soft tissues) with a cortical or homogenous echopattern. Size measurements of SCLNs correlated with dogs' body length, thoracic width and height, and body weight. In 50 of the 100 MALNs, an intranodal vascular supply was detected; in contrast, an intranodal vascular supply in SCLNs was detected infrequently.
Conclusions and Clinical Relevance—Results indicated that, in dogs, anatomically separate lymph nodes have different echogenic and vascular characteristics; body size (skeletal length, height, and width), along with body weight, were correlated with sizes of presumptively normal MALNs and SCLNs.
Objective—To assess the perioperative and postoperative complications associated with use of vascular access ports (VAPs) in the jugular and lateral saphenous veins of dogs requiring frequent anesthetic episodes for radiation therapy.
Animals—40 dogs referred to a veterinary teaching hospital.
Procedures—VAPs were used in 23 dogs, and intravenous catheters inserted in a peripheral vein were used in 17 dogs. The frequency of perioperative and postoperative complications associated with VAP use and the frequency of infection associated with intravenous catheter use were recorded. Results of bacterial culture of VAP tips and amount of time required for VAP placement and removal and for anesthetic induction were also recorded.
Results—VAP-associated perioperative complications included malposition of the catheter tip in 4 of 23 (17.4%) dogs. The VAP-associated postoperative complications included seroma formation in 7 (30.4%) dogs, breakage of port-anchoring sutures in 3 (13.0%) dogs, suspected fatal catheter-related septicemia in 1 (4.3%) dog, and temporary partial withdrawal occlusion in 18 of 255 (7.1%) anesthetic episodes.
Conclusions and Clinical Relevance—Placement of VAPs provided ready access in dogs receiving radiation therapy. Most complications were minor and self-limiting; however, a low risk of serious complications existed. Use of fluoroscopy to assess position of the catheter tip is recommended to decrease the risk of malposition. Immediate removal of a VAP is recommended when clinical signs of infection develop. Removal of a VAP at the completion of radiation therapy should be performed unless the benefit of continued vascular access outweighs the risks.
To describe response rate, tumor progression, patient survival times, prognostic factors associated with tumor progression and patient survival times, and radiation toxicoses (acute and latent) in dogs treated with curative-intent stereotactic body radiation therapy (SBRT) for soft tissue sarcomas (STS).
35 client-owned dogs with STS treated with curative-intent SBRT between October 2011 and May 2017.
Medical records were reviewed to identify dogs that underwent SBRT. Dogs with oral tumors, hemangiosarcoma, or histiocytic sarcoma were excluded. Data collected included patient-, STS-, and SBRT-related information, including follow-up information pertaining to tumor progression and patient survival time for ≥ 6 months, unless tumor progression or patient death occurred sooner.
Objective measurements allowing for evaluation of tumor response were available for 28 dogs, of which 13 (46%) had either a partial (10/28 [36%]) or complete (3/28 [11%]) response. Twenty-four dogs died, and the medians for progression-free survival time, time to progression of disease, overall survival time, and disease-specific survival time were 521, 705, 713, and 1,149 days, respectively. Low histologic grade and extremity locations of STSs were positive prognostic factors for patient survival times. Acute adverse effects were limited to skin, and 1 dog underwent limb amputation because of a nonhealing wound.
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that SBRT for STS was well tolerated in most dogs and provided local tumor control. Additional studies are needed to determine the best SBRT protocol for treatment of STSs in dogs.
OBJECTIVE To describe self-reported use of x-ray personal protective equipment (PPE) by veterinary workers in Saskatchewan, Canada, and to examine factors that affected their use of x-ray PPE.
DESIGN Cross-sectional survey.
SAMPLE 331 veterinary workers.
PROCEDURES A questionnaire was distributed to Saskatchewan veterinary workers electronically and by conventional mail. Recipients were encouraged to share the questionnaire with colleagues. The questionnaire consisted of questions regarding radiation safety practices used during small animal radiographic procedures, including frequency of use of dosimeters and lead aprons, thyroid shields, eyeglasses, and gloves. Respondents were also requested to provide suggestions for increasing use of PPE.
RESULTS 460 questionnaires were completed, of which 331 were returned by workers involved with performing radiographic procedures. Two hundred eighty-five of 331 (86%) respondents reported that at least 1 worker was always in the room during x-ray exposure, and 325 (98%), 291 (88%), and 9 (3%) respondents reported always wearing a lead apron, thyroid shield, and protective eyeglasses, respectively, during radiographic imaging. Two hundred seventeen of 327 (66%) respondents used lead gloves correctly less than half the time. Mean percentage of time that gloves were worn correctly was higher for workers who were required to do so by their employers than for those who were not.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested use of PPE during radiographic procedures can be increased by employers making PPE use mandatory. Other respondent-identified factors that would increase PPE use included the availability of properly fitting and functional PPE and education of workers about health risks associated with ionizing radiation exposure.
To describe self-reported radiation safety practices by equine veterinary technicians in North America and identify factors associated with these practices.
154 equine technicians.
An electronic questionnaire regarding radiation safety practices during the use of portable x-ray equipment was sent to 884 members of the American Association of Equine Veterinary Technicians and Assistants. Data were summarized, and various factors were evaluated for associations with reported safety practices.
221 of 884 (25.0%) questionnaires were completed, including 154 by equine technicians who had been involved in equine radiography as x-ray tube operators, cassette holders, or both in the previous year. Lead apron use was suboptimal, reported as “always” for 80.0% (104/130) of tube operators and 83.1% (123/148) of cassette holders. Approximately 20% of participants never wore thyroid shields, and approximately 90% never wore lead eyeglasses. Almost 50% of participants did not have lead eyeglasses available. Although > 55% of participants always held the x-ray equipment by hand, 58.4% (73/125) of tube operators and 25.0% (35/140) of cassette holders never wore gloves. Cassette holders wore lead gloves and personal radiation dose–monitoring devices significantly more frequently than did tube operators.
CONCLUSIONS AND CLINICAL RELEVANCE
Compliance of North American equine technicians with radiation safety recommendations by the National Council on Radiation Protection and Measurements was suboptimal. Improvements in radiation safety training and education, strengthening the connection between academic institutions and private practices, and greater availability and requirement of personal protective equipment use by senior clinicians and employers might aid in improving safety practices.
Objective—To measure respiratory motion of the thoracic wall region in dogs using a real-time motion tracking system and compare the amount of respiratory motion between dogs positioned with and without a vacuum-formable cushion.
Procedures—Dogs were anesthetized and positioned in sternal and dorsal recumbency with and without a vacuum-formable cushion. Three-dimensional movement of anatomic landmarks was measured with a real-time motion capture system that tracked the locations of infrared light–emitting diodes attached externally to the dorsal or ventral and lateral aspects of the thoracic wall.
Results—Dogs positioned in sternal recumbency had significantly less cranial-to-caudal and left-to-right respiratory motion at the lateral aspect of the thoracic wall, compared with dogs positioned in dorsal recumbency, whether or not a cushion was used. For dogs treated in sternal recumbency, use of a cushion significantly increased the peak displacement vector (overall movement in 3-D space) for 3 of 4 marker locations on the dorsal thoracic wall. As respiratory rate increased, respiratory motion at the lateral and ventral aspects of the thoracic wall decreased when data for all dogs in dorsal recumbency were evaluated together.
Conclusions and Clinical Relevance—Associations between respiratory rate and respiratory motion suggested that the use of rapid, shallow ventilation may be beneficial for dogs undergoing highly conformal radiation treatment. These results provide a basis for further research on respiratory motion in anesthetized dogs.
OBJECTIVE To assess outcomes, factors associated with survival time, and radiation-induced toxicoses in dogs treated for nasal tumors with curative-intent stereotactic body radiation therapy (SBRT).
DESIGN Retrospective case series.
ANIMALS 28 client-owned dogs.
PROCEDURES By use of a 6-MV linear accelerator, dogs were treated with SBRT (3 consecutive-day fractions of 9 or 10 Gy or once with 1 fraction of 20 Gy). Data regarding adverse effects, outcomes, and survival times were obtained from the medical records.
RESULTS The median survival time to death due to any cause was 388 days. Of the 24 dogs known to be dead, 14 (58%) died or were euthanized because of local disease progression. Acute radiation-induced adverse effects developed in the skin (excluding alopecia) in 26% (6/23) of dogs and in the oral cavity in 30% (7/23) of dogs. Acute ocular adverse effects included discharge in 26% (6/23) of dogs and keratoconjunctivitis sicca in 4% (1/23) of dogs. Among the 22 dogs alive at > 6 months after SBRT, 4 (18%) developed a unilateral cataract; 4 (18%) developed other complications that may have been late-onset radiation toxicoses (excluding leukotrichia and skin hyperpigmentation).
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that dogs treated with SBRT had outcomes comparable to those reported for dogs with nasal carcinomas and sarcomas that undergo conventionally fractionated radiation therapy. Administration of SBRT was associated with a comparatively lower frequency of acute radiation-induced adverse effects. For SBRT and conventionally fractionated radiation therapy, the frequencies of serious late-onset adverse effects appear similar.
OBJECTIVE To describe animal owners' experiences with palliative radiation therapy (PRT) of pets and identify factors influencing satisfaction with their pets' treatment.
DESIGN Retrospective, cross-sectional study.
SAMPLE 118 owners of dogs, cats, or rabbits.
PROCEDURES Medical records were searched to identify animals that underwent PRT between 2004 and 2013. Signalment, tumor-related data, and outcome information were recorded. Owners completed an electronic survey assessing satisfaction with treatment (ie, satisfaction with the decision for their pet to undergo PRT and indication that they would choose PRT for their pet again), expectations regarding PRT, and perceptions of their pets' quality of life (QOL) and signs of discomfort from acute adverse radiation effects. Additional data regarding practical aspects of treatment, pet death, communications with veterinarians, and owner demographics were collected. Variables were tested for association with measures of owner satisfaction.
RESULTS 92 of 116 (79%) owners were satisfied with the decision to have their pets undergo PRT. Most (92/118 [78%]) owners reported their pet's QOL improved after PRT; these owners were significantly more likely to be satisfied than those who did not report improved QOL. Owners who perceived their pets had discomfort from adverse radiation effects (38/116 [33%]) were significantly less likely to be satisfied than owners who did not report this observation. Measures of satisfaction were not associated with patient survival time. Twenty-one of 118 (18%) owners indicated they expected PRT would cure their pet's tumor.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that short life expectancy should not deter recommendation of PRT for pets. Protocols that minimize risk of acute adverse effects may be advantageous. Veterinarians should attempt to ensure that owners understand the goals of PRT.
To describe the radiation safety behaviors of veterinary specialists performing small animal fluoroscopic procedures and examine potential risk factors for these behaviors, including knowledge of radiation risk and training regarding machine operating parameters.
197 veterinary specialists and residents in training.
An electronic questionnaire was distributed to members of the American Colleges of Veterinary Internal Medicine (subspecialties of cardiology and small animal internal medicine), Veterinary Radiology, and Veterinary Surgery.
The overall survey response rate was 6% (240/4,274 email recipients). Of the 240 respondents, 197 (82%) had operated an x-ray unit for a small animal fluoroscopic procedure in the preceding year and fully completed the questionnaire. More than 95% of respondents believed that radiation causes cancer, yet approximately 60% of respondents never wore hand or eye protection during fluoroscopic procedures, and 28% never adjusted the fluoroscopy machine operating parameters for the purpose of reducing their radiation dose. The most common reasons for not wearing eye shielding included no requirement to wear eyeglasses, poor fit, discomfort, and interference of eyeglasses with task performance. Respondents who had received training regarding machine operating parameters adjusted those parameters to reduce their radiation dose during procedures significantly more frequently than did respondents who had not received training.
CONCLUSIONS AND CLINICAL RELEVANCE
On the basis of the self-reported suboptimal radiation safety practices among veterinary fluoroscopy users, we recommend formal incorporation of radiation safety education into residency training programs. All fluoros-copy machine operators should be trained regarding the machine operating parameters that can be adjusted to reduce occupational radiation exposure.
The objectives of this study were to investigate scattered radiation doses to the hands of equine workers holding the cassette and the x-ray tube by hand, for both limb and vertebral column studies, and to compare the scattered radiation attenuation of lead with radiation protection lead-free gloves. Radiation doses to the hands of the cassette holder in the primary beam were also investigated.
A whole-body horse cadaver.
A portable x-ray unit was used to simulate 6 radiographic study types in the horse cadaver. Doses were measured with no shielding and, for cassette holders, with the ion chamber enclosed in a lead glove and a lead-free glove. Thirty exposures were performed for each study view and condition (n = 1,920).
Mean scattered doses to x-ray unit operators were higher than doses to cassette holders for ungula (hoof), thoracic vertebrae, and lumbar vertebrae studies, whereas doses to cassette holders were higher than doses to x-ray tube operators for studies of the metacarpophalangeal joint (fetlock) and tarsus (hock). Doses did not differ for the stifle joint. Mean percentage decrease in scattered radiation dose was 99.58% with lead gloves and 98.9% with lead-free gloves.
X-ray tube operators can be exposed to equal or higher scattered radiation doses to the hand as cassette holders. Lead-free hand shielding should only be considered as an alternative to lead gloves if their lighter weight increases frequency of use by workers.