Versatility of the Angularis Oris Axial Pattern Flap for Facial Reconstruction.

OBJECTIVE: To describe the versatility of the axial pattern flap based on the cutaneous perforating branch of the angularis oris artery for reconstruction of large facial defects in dogs, including complications and clinical outcomes. STUDY DESIGN: Retrospective clinical case series. ANIMALS: Client-owned dogs (n = 8). METHODS: Facial flaps (n = 9) based at the commissure of the lip with a caudodorsal orientation were utilized, with established anatomical borders. Flaps were elevated deep to the panniculus carnosus in a caudal to rostral direction, preserving the angularis oris artery, its cutaneous perforator, and surrounding cutaneous vasculature. Flaps were rotated dorsally or ventrally to cover the defect. Primary closure of the donor site was by direct apposition in all cases. RESULTS: Angularis oris axial pattern flaps were most commonly used to close large defects of the nasomaxillary area rostral to the eyes (6 dogs), followed by orbital (2) and intermandibular (1) defects. Defects occurred because of tumor resection (6 dogs), trauma (2), and a chronic, non-healing wounding (1). All flaps healed with acceptable functional and cosmetic outcomes without major complications. Followup ranged from 10 days to 16 months. Minor postoperative complications included flap edema (8 dogs), partial incisional dehiscence (3), distal tip necrosis (2), and oroantral fistula recurrence (1). CONCLUSION: Angularis oris axial pattern flaps provided hirsute, full-thickness skin coverage of a variety of large facial defects with minor complications, and should be considered when restructuring large defects of the rostral face or chin.

Effects of ampicillin/sulbactam and enrofloxacin on the blood pressure of isoflurane anesthetized dogs.

A blinded, prospective, randomized crossover study was performed to determine the effects of ampicillin Na/sulbactam Na and enrofloxacin on the blood pressure (BP) of healthy anesthetized dogs. Eight dogs were anesthetized three different times. They randomly received enrofloxacin, ampicillin Na/sulbactam Na, and saline. Systolic, diastolic, and mean arterial BPs (SAP, DAP, and MAP, respectively), heart rate (HR), O2 saturation of hemoglobin, end-tidal CO2 (ETCO2) concentration, inspired isoflurane concentration, end-tidal isoflurane (ETiso) concentration, respiratory rate, electrocardiogram, and body temperature were measured for 20 min prior to administration of treatment, during administration over 30 min, and for 30 min after administration. There was no significant difference in the SAP or ETiso. There was no significant change in the arterial pressure values over time in the enrofloxacin and ampicillin Na/sulbactam Na groups. The control group's MAP increased over time and was increased compared with the enrofloxacin group at times 25, 35, 45, and 55. The statistical difference between the enrofloxacin and the control groups was due to an increase in the MAP in the control group, not a decrease in the enrofloxacin group's BP. Neither enrofloxacin nor ampicillin Na/sulbactam Na caused hypotension in healthy dogs anesthetized with isoflurane and fentanyl.

Investigation into the impact of audience response devices on short- and long-term content retention.

Audience Response Systems (ARSs) may enhance short-term knowledge retention. Long-term knowledge retention is more difficult to demonstrate. According to previous studies, ARS questions requiring application of knowledge or peer interaction are more effective in maintaining student attention. The purpose of this study was to determine if peer discussion or individual-knowledge questions enhance short- and/or long-term knowledge retention. Third-year veterinary students responded to ARS questions posed in individual knowledge (n=3 questions) and peer discussion (n=3 questions) format from six different instructors. To test short-term memory, the same questions were delivered during the course examination (within 21 days). To test long-term retention, these questions were posed during a retention exercise (four months later). On the course examination, students had a higher (p<.01) probability (±SE) of correctly answering ARS individual-knowledge questions (93.8 ± 1.8%) compared to novel (previously unseen, non-ARS control) course examination questions (87.5 ± 3.1%), but the probability of correctly answering examination questions previously posed using ARS peer discussion format (89.5 ± 3.0%) did not differ from individual knowledge or novel examination questions. The positive impact of ARS-knowledge questions was not maintained through the retention exercise. Neither individual knowledge (70.5 ± 6.4%) nor peer-discussion questions (67.5 ± 6.9%) performed better on the retention exercise than the questions that appeared only on the course examination (68.6 ± 6.1%). Curricular strategies that emphasize content review may be more powerful than strategies that strengthen initial learning for long-term content retention.

Association of gender and specialty interest with video-gaming, three-dimensional spatial analysis, and entry-level laparoscopic skills in third-year veterinary students.

OBJECTIVE To determine whether gender or interest in pursuing specialty certification in internal medicine or surgery was associated with video-gaming, 3-D spatial analysis, or entry-level laparoscopic skills in third-year veterinary students. DESIGN Cross-sectional study. SAMPLE A convenience sample of 68 (42 female and 26 male) third-year veterinary students. PROCEDURES Participants completed a survey asking about their interest in pursuing specialty certification in internal medicine or surgery. Subsequently, participants' entry-level laparoscopic skills were assessed with 3 procedures performed in box trainers, their video-gaming skills were tested with 3 video games, and their 3-D spatial analysis skills were evaluated with the Purdue University Visualization of Rotations Spatial Test. Scores were assigned for laparoscopic, video-gaming, and 3-D spatial analysis skills. RESULTS Significantly more female than male students were interested in pursuing specialty certification in internal medicine (23/42 vs 7/26), and significantly more male than female students were interested in pursuing specialty certification in surgery (19/26 vs 19/42). Males had significantly higher video-gaming skills scores than did females, but spatial analysis and laparoscopic skills scores did not differ between males and females. Students interested in pursuing specialty certification in surgery had higher video-gaming and spatial analysis skills scores than did students interested in pursuing specialty certification in internal medicine, but laparoscopic skills scores did not differ between these 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE For this group of students, neither gender nor interest in specialty certification in internal medicine versus surgery was associated with entry-level laparoscopy skills.

Occurrence and Clinicopathologic Features of Splenic Neoplasia Based on Body Weight: 325 Dogs (2003-2013).

Medical records of 396 dogs undergoing splenectomy for treatment of a splenic mass or nodular disease were reviewed retrospectively. Overall distribution of histopathologic diagnosis and clinicopathologic features were evaluated for 325 dogs that met inclusion criteria. Dogs were dichotomized into two groups based on weight, with the statistically derived cutoff identified as 27.8 kg. Malignancy was diagnosed in 58% of dogs, with no difference between small (55%) and large (61%) dogs (P = .291). Overall, 32% of splenic masses were hemangiosarcoma (HSA), which comprised 25 and 39% of all masses in small and large dogs, respectively. The diagnosis of HSA, non-HSA malignancy, or benign splenic disease was significantly different between the groups (P = .019). Of malignant diagnoses, HSA comprised 46 and 65% of small and large dog splenic neoplasms, respectively (P = .009). In both groups, dogs with HSA were significantly more likely to have preoperative anemia, hemoabdomen, thrombocytopenia, and a blood transfusion, as compared to dogs with non-HSA malignancy or benign lesions. Overall, dogs had similar odds of having a malignant splenic lesion regardless of weight, but dogs ≤27.8 kg were significantly less likely to be diagnosed with HSA.

In vitro effect of multiple hydrogen peroxide gas plasma sterilizations on the rate of closure of ameroid constrictors.

OBJECTIVE: To evaluate the effect of multiple hydrogen peroxide gas plasma (HPGP) sterilizations on the rate of closure of ameroid constrictors. SAMPLE: Thirty-six 5.0-mm ameroid constrictors. PROCEDURES: Ameroid constrictors were randomly allocated to 6 groups. Each group underwent 1, 2, 3, 4, 5, or 6 HPGP sterilizations. Ameroid constrictors were then incubated for 35 days in canine plasma and digitally imaged at predetermined times during incubation. One individual, who was unaware of the group to which each ameroid constrictor was assigned, measured the lumen area of the constrictor on each digital image. Mean lumen area was compared among groups. RESULTS: No ameroid constrictors were completely closed after 35 days of incubation in canine plasma. Mean lumen area after incubation did not differ among constrictors that underwent 1, 2, and 3 sterilizations. Constrictors that underwent 4 sterilizations were closed significantly more than were those that underwent 1, 2, or 3 sterilizations. Mean lumen area after incubation did not differ significantly between constrictors that underwent 5 and 6 sterilizations, although the final lumen areas for those constrictors were significantly smaller than those for constrictors that underwent 1, 2, 3, and 4 sterilizations. CONCLUSIONS AND CLINICAL RELEVANCE: Ameroid constrictors that underwent 5 and 6 HPGP sterilizations had a 9% to 12% decrease in lumen area, compared with that of constrictors that underwent ≤ 4 plasma sterilizations, and the use of such constrictors could increase the risk of portal hypertension and secondary acquired shunting or decrease the risk of persistent shunting.

In vitro evaluation of three intravenous fluid line warmers.

OBJECTIVE: To determine in vitro output temperature differences of 3 IV fluid warmers. DESIGN: Prospective, randomized study. SAMPLE: 3 IV fluid warmers. PROCEDURES: Warming capabilities of a distance-dependent blood and fluid warmer marketed for human and veterinary use (product A) and a veterinary-specific distance-dependent fluid warmer (product B) were compared at 0, 4, 8, and 12 cm from the device to the test vein and at flow rates of 20, 60, 100, 140, 180, 220, 260, and 300 mL/h with room temperature (approx 22°C) fluids (phase 1). The superior warming device was compared against a distance-independent IV fluid warmer (product C) with room temperature fluids at the same flow rates (phase 2). The effect of prewarmed fluids (38°C) versus room temperature fluids was evaluated with the superior warming device from phase 2 (phase 3). RESULTS: In phase 1, product B produced significantly warmer fluids than product A for all flow rates and distances. Both distance-dependent devices produced warmer fluid at 0 cm, compared with 4, 8, and 12 cm. In phase 2, product B produced warmer fluid than product C at 60, 100, 140, and 180 mL/h. In phase 3, there was no significant benefit to use of prewarmed fluids versus room temperature fluids. Output temperatures ≥ 36.4°C were achieved for all rates ≥ 60 mL/h. CONCLUSIONS AND CLINICAL RELEVANCE: Product B had superior warming capabilities. Placing the fluid warmer close to the patient is recommended. Use of prewarmed fluids had no benefit. Lower IV fluid flow rates resulted in lower output fluid temperatures.

Effect of cold compress application on tissue temperature in healthy dogs.

OBJECTIVE: To measure the effect of cold compress application on tissue temperature in healthy dogs. ANIMALS: 10 healthy mixed-breed dogs. PROCEDURES: Dogs were sedated with hydromorphone (0.1 mg/kg, IV) and diazepam (0.25 mg/kg, IV). Three 24-gauge thermocouple needles were inserted to a depth of 0.5 (superficial), 1.0 (middle), and 1.5 (deep) cm into a shaved, lumbar, epaxial region to measure tissue temperature. Cold (-16.8°C) compresses were applied with gravity dependence for periods of 5, 10, and 20 minutes. Tissue temperature was recorded before compress application and at intervals for up to 80 minutes after application. Control data were collected while dogs received identical sedation but with no cold compress. RESULTS: Mean temperature associated with 5 minutes of application at the superficial depth was significantly decreased, compared with control temperatures. Application for 10 and 20 minutes significantly reduced the temperature at all depths, compared with controls and 5 minutes of application. Twenty minutes of application significantly decreased temperature at only the middle depth, compared with 10 minutes of application. CONCLUSIONS AND CLINICAL RELEVANCE: With this method of cold treatment, increasing application time from 10 to 20 minutes caused a further significant temperature change at only the middle tissue depth; however, for maximal cooling, the minimum time of application should be 20 minutes. Possible changes in tissue temperature and adverse effects of application > 20 minutes require further evaluation.

Effect of warm compress application on tissue temperature in healthy dogs.

OBJECTIVE: To measure the effect of warm compress application on tissue temperature in healthy dogs. ANIMALS: 10 healthy mixed-breed dogs. PROCEDURES: Dogs were sedated with hydromorphone (0.1 mg/kg, IV) and diazepam (0.25 mg/kg, IV). Three 24-gauge thermocouple needles were inserted to a depth of 0.5 cm (superficial), 1.0 cm (middle), and 1.5 cm (deep) into a shaved, lumbar, epaxial region to measure tissue temperature. Warm (47°C) compresses were applied with gravity dependence for periods of 5, 10, and 20 minutes. Tissue temperature was recorded before compress application and at intervals for up to 80 minutes after application. Control data were collected while dogs received identical sedation but with no warm compress. RESULTS: Mean temperature associated with 5 minutes of heat application at the superficial, middle, and deep depths was significantly increased, compared with the control temperature. Application for 10 minutes significantly increased the temperature at all depths, compared with 5 minutes of application. Mean temperature associated with 20 minutes of application was not different at the superficial or middle depths, compared with 10 minutes of application. Temperature at the deep depth associated with 10 minutes of application was significantly higher, compared with 20 minutes of application, but all temperature increases at this depth were minimal. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that application of a warm compress should be performed for 10 minutes. Changes in temperature at a tissue depth of 1.5 cm were minimal or not detected. The optimal compress temperature to achieve therapeutic benefits was not determined.