Influence of closed glove exchange on bacterial contamination of the hands of the surgical team.

OBJECTIVE: To determine if closed glove exchange (CGE) increases hand contamination. STUDY DESIGN: Prospective experimental study. SAMPLE POPULATION: Surgical teams participating in 65 individual surgical procedures were included, resulting in 200 individual enrollments. METHODS: At the completion of surgery, gloves were removed and hands were swabbed. The inside of the gown cuff was swabbed. Each participant regloved, using a closed gloving technique. The new gloves were removed, and hands were swabbed for culture a second time. Swabs underwent standard bacterial culture. RESULTS: Before glove exchange, or baseline, contamination was found on 17/200 dominant hands and 13/200 nondominant hands. After performing CGE, contamination was found on 14/200 and 15/200 dominant and nondominant hands, respectively. No difference was detected between the number of CFUs cultured from a surgeon's hands before CGE and the number of CFUs cultured from a surgeon's hands post-CGE (one sided sign test, p = .61). Twelve (12) different bacterial species were identified, the most common were Staphylococcus spp. (97/154; 63%). CONCLUSION: Closed glove exchange did not increase bacterial hand contamination over baseline levels. CLINICAL SIGNIFICANCE: We found no evidence to support discontinuing CGE.

In vitro elution of amikacin from four hydrogel preparations: A pilot study.

OBJECTIVE: To determine in vitro elution of amikacin from poloxamer 407 NF, 1% carboxymethylcellulose (CMC), 3% CMC, 5% CMC, and control (sterile water). STUDY DESIGN: Descriptive in vitro. SAMPLE POPULATION: Triplicate samples from each experimental group. METHODS: Amikacin solution was prepared in poloxamer 407 NF, 1% CMC, 3% CMC, 5% CMC, or sterile water. Then, 1 ml of phosphate-buffered saline (PBS) was added to each of three aliquots per base and the samples were incubated at 37°C. PBS was removed and replaced at 1, 4, 8, 12, 24, 48, 72, 96, 120, 144, 168, 192, 216, and 240 hours and amikacin concentration was measured. RESULTS: The highest median concentration of amikacin in the eluent of poloxamer 407 NF, 3% CMC, and 5% CMC was observed at 48 hours: 3300, 3030, and 2190 µg/ml, respectively. The highest median concentration of amikacin in the eluent of 1% CMC and sterile water were observed at 1 hour: 13300 and 15600 µg/ml, respectively. Median eluent concentration of amikacin exceeded 2000 µg/ml (the reported minimum inhibitory concentration [MIC] of certain biofilm-producing methicillin-resistant Staphylococcus pseudintermedius) from 24 to 96 hours for poloxamer 407 NF, 24-72 hours for 3% CMC, 48-72 hours for 5% CMC, 1-4 hours for 1% CMC, and 1-4 hours for sterile water. CONCLUSION: Amikacin elution from tested substances reached or exceeded target MIC during the 240 hours tested. CLINICAL SIGNIFICANCE: Hydrogel-amikacin solutions may be useful topical treatment options for some infected wounds. In vivo safety and efficacy should be evaluated.

Staphylectomy in nonbrachycephalic dogs: A retrospective study of 27 cases.

Objective: To report the outcomes and complications associated with staphylectomy in nonbrachycephalic dogs. Animal: Twenty-seven nonbrachycephalic dogs with elongated soft palates and undergoing staphylectomy. Procedure: Retrospective study. Results: Increased upper airway noise (70.4%) and dyspnea (44.4%) were the most common presenting clinical signs. Concurrent upper airway abnormalities found in the study population included laryngeal collapse (25.9%) and laryngeal paralysis (14.8%). The most common staphylectomy technique used in this study was sharp excision (66.7%) with sutured oral and nasal mucosal apposition. The dogs in this study had an overall minor postoperative complication rate of 33.3%, with regurgitation/vomiting (11.1%) and coughing (11.1%) occurring most commonly. No dog required supplemental oxygen therapy or temporary tracheostomy. Conclusion: Staphylectomy was well-tolerated in nonbrachycephalic dogs and was associated with a relatively low rate of complications. Concurrent airway abnormalities were common among nonbrachycephalic dogs with elongated soft palates, similar to brachycephalic dogs. Clinical relevance: Clinicians should be aware that elongated soft palate can occur in nonbrachycephalic dogs, and surgical correction can be achieved with rare major or catastrophic complications.

Staphylectomie chez des chiens non-brachycéphales : une étude rétrospective de 27 cas. Objectif: Rapporter les résultats et les complications associés à la staphylectomie chez des chiens non-brachycéphales. Animal: Vingt-sept chiens non-brachycéphales au palais mou allongé et subissant une staphylectomie. Procédure: Étude rétrospective. Résultats: L'augmentation du bruit des voies respiratoires supérieures (70,4 %) et la dyspnée (44,4 %) étaient les signes cliniques les plus fréquents. Les anomalies concomitantes des voies respiratoires supérieures trouvées dans la population étudiée comprenaient un collapsus laryngé (25,9 %) et une paralysie laryngée (14,8 %). La technique de staphylectomie la plus couramment utilisée dans cette étude était l'exérèse fine (66,7 %) avec apposition suturée des muqueuses buccale et nasale. Les chiens de cette étude présentaient un taux global de complications postopératoires mineures de 33,3 %, les régurgitations/vomissements (11,1 %) et la toux (11,1 %) étant les plus fréquents. Aucun chien n'a eu besoin d'une oxygénothérapie supplémentaire ou d'une trachéotomie temporaire. Conclusion: La staphylectomie a été bien tolérée chez les chiens non-brachycéphales et a été associée à un taux relativement faible de complications. Les anomalies concomitantes des voies respiratoires étaient courantes chez les chiens nonbrachycéphales avec des palais mous allongés, semblables aux chiens brachycéphales. Pertinence clinique: Les cliniciens doivent être conscients qu'un palais mou allongé peut survenir chez les chiens non-brachycéphales et qu'une correction chirurgicale peut être obtenue avec de rares complications majeures ou catastrophiques.(Traduit par Dr Serge Messier).

Surgical ligation of patent ductus arteriosus in dogs: Incidence and risk factors for rupture.

OBJECTIVE: To determine the rates of rupture and mortality associated with surgical ligation of patent ductus arteriosus (PDA) in dogs and to identify risk factors for rupture. STUDY DESIGN: Retrospective cohort. ANIMALS: Two-hundred and eighty-five dogs with PDA undergoing surgical ligation. METHODS: Information regarding signalment, weight, surgical findings, complications, presence of residual flow, and survival was recorded. Age, weight, and presence of residual flow were compared between cases with and without rupture. RESULTS: The initial surgical approach was extrapericardial (144), intrapericardial (46), not reported (94), or Jackson-Henderson (1). Rupture of the PDA occurred in 7.0% of dogs (20/285, 13 extrapericardial, 3 intrapericardial, 4 not reported). No difference in age or weight was found between dogs with and without rupture. Overall mortality was 0.4% (1/285). Additional major complications occurred in 1.4% of dogs, all in the nonrupture group. The overall rate of residual flow after ligation was 9.4%. Dogs with rupture were more likely to have residual flow than those without rupture (P = .012). If ligation was performed after rupture (rather than hemostasis only), no difference in residual flow rates (P = .398) was noted between dogs with rupture and those without. CONCLUSION: The rate of rupture with surgical ligation of PDAs was low. No specific risk factors for rupture were identified. CLINICAL SIGNIFICANCE: Successful treatment of PDA rupture is possible, evidenced by the low mortality rate in this population of dogs. Ligation of the PDA after rupture, either in the concurrent or a subsequent procedure, reduces the odds of residual flow.

The effect of a smoke-evacuation unit on ultrafine particle concentrations in the operating room during approach to the proximal tibia for tibial plateau-leveling osteotomy surgery in dogs.

OBJECTIVE: To evaluate the effectiveness of a smoke-evacuation unit on reducing ultrafine particle concentration in the operating room (OR) during the approach to the proximal tibia for tibial plateau-leveling osteotomy (TPLO). STUDY DESIGN: Prospective, randomized, controlled clinical trial. SAMPLE POPULATION: Twenty-nine client-owned dogs undergoing unilateral TPLO at a single institution were assigned to either smoke-evacuator groups (SE; n = 15) or non-smoke-evacuator groups (NSE; n = 14). METHODS: Dogs were randomly assigned to the SE group or the NSE group. An airborne particle measuring device measured and recorded baseline and intraoperative particles per cm3 (ppc) during the approach to the proximal tibia during which electrosurgery was used to provide hemostasis, dissect subcutis, transect and elevate fascia. The mean ppc, maximum ppc, and baseline ppc were compared between groups. Mean ppc was also compared to the baseline ppc within each group. RESULTS: During surgery, mean ppc (1352) and maximum ppc (62 450) for the NSE group were higher in than mean ppc (763) and maximum ppc (10 100) for the SE group (P < .0001, P < .0001, respectively). Mean ppc was higher in both SE (mean ppc = 763; P < .0001) and NSE (mean ppc = 1352; P = .0001) than their respective baseline ppc (213 and 240). CONCLUSION: The use of a smoke evacuator decreased particle concentrations 56.4% during the approach to the proximal tibia. Performing the approach to the proximal tibia resulted in higher particle concentrations than the baseline, regardless of smoke-evacuator use. CLINICAL SIGNIFICANCE: Surgeons should be aware of smoke produced by electrosurgery, potential health consequences, and methods of smoke mitigation (smoke evacuation).

Short- and long-term survival after adrenalectomy in 53 dogs with pheochromocytomas with or without alpha-blocker therapy.

OBJECTIVE: To report data related to the short- and long-term survival of dogs undergoing adrenalectomy for pheochromocytoma, and to determine the influence of preoperative alpha-blocker therapy. STUDY DESIGN: Retrospective. ANIMALS: Fifty-three dogs. METHODS: Medical records were reviewed for dogs diagnosed with pheochromocytoma and treated with adrenalectomy between 2010 and 2020. Preoperative management, imaging studies, intraoperative cardiovascular instability, complications, and procedural information were recorded. When applicable, duration of survival and cause of death, time to recurrence or metastasis, and postoperative complications were recorded. RESULTS: During anesthesia, a hypertensive episode was documented in 46/53 dogs and arrhythmias were recorded in 16/53 dogs. Of these, 37/46 hypertensive dogs and 11/16 dogs with arrhythmias were treated with an alpha-blocker before surgery. Intraoperative systolic blood pressures reached higher levels by a magnitude of nearly 20% in dogs that were treated preoperatively with an alpha-blocker (P = .01). All dogs survived surgery and 44 survived to discharge. Follow up ranged from 6 to 1653 days (median 450 days). Median survival time for dogs discharged from the hospital was 1169 days (3.2 years). Recurrence and metastasis were suspected in 3 and 8 dogs, respectively. CONCLUSION: Most dogs survived the immediate postoperative period and achieved long-term survival with a low reported incidence of tumor recurrence or metastasis. Preoperative alpha-blocker therapy was not associated with increased survival. CLINICAL SIGNIFICANCE: The favorable outcomes reported in this study should be taken into consideration when discussing treatment options for dogs with pheochromocytomas. This study provides no evidence to support preoperative alpha-blocker therapy.

The impact of a surgical checklist on surgical outcomes in an academic institution.

OBJECTIVE: To determine the influence of a surgical checklist (SC) on morbidities and compliance with safety measures. STUDY DESIGN: Before-and-after-intervention study. SAMPLE POPULATION: Three thousand two hundred eighty-six dogs: 1375 dogs pre-SC and 1911 post-SC. METHODS: Completion of safety measures and occurrence of morbidity and/or mortality during hospitalization and up to death or 30-days postoperatively were recorded. RESULTS: Safety measures were more frequently completed post-SC, including oral confirmation of patient identity (467/1177 [40%] vs. 1911/1911 [100%]) and oral confirmation of surgical site (568/1175 [48%] vs. 1911/1911 [100%]). In addition, duration of anesthesia decreased from 241 to 232 min (t = 2.824; p = .005); a greater proportion of animals that were intended to receive antibiotics did so prior to incision (1142/1316 [86.8%] vs. 1656/1845 [89.8%] [χ2 = 6.70, p = .01]); and fewer dogs had unplanned return to the OR (32/1065 [3.0%], vs. 21/1472 [1.4%]) (χ2 = 7.52, p = .006). No difference in surgical site infection (adjusted odds ratio 1.02 [95%CI: 0.63-1.66]); morbidity, (adjusted odds ratio 1.00 [95%CI: 0.77-1.29]); or death within 30 days (adjusted odds ratio 1.15 [95%CI: 0.72-1.83]) was detected on multivariable logistic regression analysis. The checklist prevented one wrong-site surgery. CONCLUSION: Implementation of the checklist at our institution led to a decrease in anesthesia duration, increased administration of planned perioperative antibiotics before incision, increased completion of safety measures, and decreased unexpected return to the OR. IMPACT: Despite the lack of effect on morbidities, the use of SC is recommended to improve compliance with safety measures and potentially prevent rare catastrophic events.

Adaptation of a hands-on veterinary surgical training course from a traditionally taught laboratory to a remotely taught laboratory during a global pandemic.

OBJECTIVE: The goal of this study was to evaluate and report details of a remotely taught surgical laboratory. STUDY DESIGN: Observational. SAMPLE POPULATION: Second-year veterinary students (n = 143) enrolled in a surgical laboratory; 9 weeks were taught traditionally, and 6 weeks were taught remotely. METHODS: Because of the global pandemic, remote laboratories were developed and delivered. Students performed surgical procedures in model organs remotely while being observed by and receiving feedback from instructors on an internet-based video platform. Methods for remote surgical teaching were explored, and successes and challenges were detailed. Surveys were administered to the students and faculty to gather perspectives on their experience and subsequent confidence. RESULTS: Surveys were completed by 81 of 143 (57%) students and seven of seven (100%) instructors. The mean overall student satisfaction score (1 not at all satisfied, 10 very satisfied) for in-person instruction was 8.2, and the mean score for remote instruction was 6.2 (P < .001). Overall, the instructors had a mean satisfaction score of 8 for in-person laboratories and a mean satisfaction score of 6 for remotely taught laboratories. Most students had a perception of greater one-on-one instructor attention in remote laboratories. Students reported similar confidence levels for three surgical procedures. CONCLUSION: The described remote teaching method resulted in the perception of greater instructor attention given to students. Student and instructor satisfaction was lower with remote teaching than with in-person teaching. IMPACT: The described method of remote teaching may be applied to teaching surgical students in settings when face-to-face instruction cannot be achieved and may be developed further to create an experience equivalent to face-to-face instruction.

Influence of a cell salvage washing system and leukocyte reduction filtration on bacterial contamination of canine whole blood ex vivo.

OBJECTIVE: To determine the ability of cell salvage washing and leukoreduction filtration to remove bacterial contamination from canine whole blood. STUDY DESIGN: Ex vivo nested cohort study. SAMPLE POPULATION: Commercially purchased fresh canine whole blood (n = 33 units). METHODS: Commercially obtained canine whole blood was inoculated with known concentrations of one of three species of bacteria, Escherichia coli (ATCC 25922), Staphylococcus pseudintermedius (quality control strain; Texas A&M University), or Pseudomonas aeruginosa (ATCC 27853). Negative controls were inoculated with sterile saline. The inoculated blood was processed through a cell salvage system and filtered through a series of two leukocyte reduction filters. Samples were aseptically collected at five points during processing (inoculum, prewash, postwash, post-first filtration, and post-second filtration) for bacterial enumeration. RESULTS: Bacterial concentrations were reduced by 85.2%, 91.5%, and 93.9% for E coli, S pseudintermedius, and P aeruginosa, respectively, after washing (P < .0001), and bacterial concentrations were reduced by 99.9%, 100%, and 100%, respectively, after the first filtration (P < .0001). After the second filtration, none of the three species of bacteria could be isolated (100% reduction). No bacterial growth was obtained from negative controls throughout the study. The type of bacteria (P = .29) did not allow prediction of bacterial reduction. CONCLUSION: Cell salvage washing combined with leukoreduction filtration eliminated bacterial contamination of whole dog blood (P < .0001). CLINICAL SIGNIFICANCE: Cell salvage washing and leukoreduction filtration could be applied to intraoperative autotransfusion in clinical animals, especially those treated for trauma or hemorrhage with concurrent bacterial contamination.

Prognostic factors for short-term survival of dogs that experience postattenuation seizures after surgical correction of single congenital extrahepatic portosystemic shunts: 93 cases (2005-2018).

OBJECTIVE: To identify prognostic factors for short-term survival of dogs that experience seizures within 7 days after surgical correction of single congenital extrahepatic portosystemic shunts (cEHPSS). STUDY DESIGN: Multi-institutional retrospective study. SAMPLE POPULATION: Ninety-three client-owned dogs. METHODS: Medical records at 14 veterinary institutions were reviewed to identify dogs that underwent surgical attenuation of a single cEHPSS from January 1, 2005 through February 28, 2018 and experienced postattenuation seizures (PAS) within 7 days postoperatively. Logistic regression analysis was performed to identify factors associated with 1-month survival. Factors investigated included participating institution, signalment, shunt morphology, concurrent/historical conditions, presence of preoperative neurologic signs, presence of preoperative seizures, aspects of preoperative medical management, surgical details including method and degree of shunt attenuation, type of PAS (focal only or generalized ± focal), drugs administered as part of the treatment of PAS, and development of complications during treatment of PAS. RESULTS: Thirty (32.3%) dogs survived to 30 days. Seventy-six (81.7%) dogs experienced generalized PAS. Factors positively associated with short-term survival included having a history of preoperative seizures (P = .004) and development of focal PAS only (P = .0003). Most nonsurvivors were humanely euthanized because of uncontrolled or recurrent seizures. CONCLUSION: Dogs that experienced PAS that had a history of preoperative seizures and those that experienced focal PAS only had significantly improved short-term survival. CLINICAL SIGNIFICANCE: The results of this study provide information that will help in the counseling of owners who seek treatment for PAS after surgical correction of cEHPSS. © 2020 The American College of Veterinary Surgeons.

Norwich terriers possess a greater vertebral heart scale than the canine reference value.

Previous studies have demonstrated evidence that normal reference ranges for radiographic vertebral heart scale values can vary among dog breeds. The purpose of this retrospective, observational study was to determine whether the normal vertebral heart scale values published by Buchanan and Bücheler for lateral radiographs are applicable to the Norwich terrier. Secondary objectives were to determine if clinical signs of respiratory disease, age, sex, weight, body condition score, recumbency, or thoracic depth-to-width ratio had any influence on vertebral heart scale measurements in this breed. The electronic medical record systems of two universities were reviewed and Norwich terriers were included in the study if they had orthogonal thoracic radiographs performed and no historical or radiographic evidence of cardiopulmonary disease. A vertebral heart scale was calculated for each patient. Sixty-one client-owned, Norwich terrier dogs with no clinical signs of cardiovascular disease were evaluated. The vertebral heart scale for Norwich terriers without evidence of cardiac disease (10.6 ± 0.6) was found to be significantly greater than the canine reference value of 9.7 ± 0.5 initially established by Buchanan and Bücheler. No significant correlation was found between clinical signs of respiratory disease, sex, age, thoracic depth-to-width ratio or lateral recumbency, and vertebral heart scale. Norwich terriers with a body condition score ≥6 had a significantly higher vertebral heart scale than those with a body condition score ≤5. Breed-specific ranges and body condition scores need to be considered when interpreting vertebral heart scale values for Norwich terriers.

Effect of prophylactic treatment with levetiracetam on the incidence of postattenuation seizures in dogs undergoing surgical management of single congenital extrahepatic portosystemic shunts.

OBJECTIVE: To report the incidence of postattenuation seizures (PAS) in dogs that underwent single congenital extrahepatic portosystemic shunt (cEHPSS) attenuation and to compare incidence of PAS in dogs that either did or did not receive prophylactic treatment with levetiracetam (LEV). STUDY DESIGN: Multi-institutional retrospective study. POPULATION: Nine hundred forty dogs. METHODS: Medical records were reviewed to identify dogs that underwent surgical attenuation of a single cEHPSS from January 2005 through July 2017 and developed PAS within 7 days postoperatively. Dogs were divided into 3 groups: no LEV (LEV-); LEV at ≥15 mg/kg every 8 hours for ≥24 hours preoperatively or a 60 mg/kg intravenous loading dose perioperatively, followed by ≥15 mg/kg every 8 hours postoperatively (LEV1); and LEV at <15 mg/kg every 8 hours, for <24 hours preoperatively, or continued at <15 mg/kg every 8 hours postoperatively (LEV2). RESULTS: Seventy-five (8.0%) dogs developed PAS. Incidence of PAS was 35 of 523 (6.7%), 21 of 188 (11.2%), and 19 of 228 (8.3%) in groups LEV-, LEV1, and LEV2, respectively. This difference was not statistically significant (P = .14). No differences between groups of dogs that seized with respect to investigated variables were identified. CONCLUSION: The overall incidence of PAS was low (8%). Prophylactic treatment with LEV according to the protocols that were investigated in our study was not associated with a reduced incidence of PAS. CLINICAL SIGNIFICANCE: Prophylactic treatment with LEV does not afford protection against development of PAS. Surgically treated dogs should continue to be monitored closely during the first 7 days postoperatively for seizures.

The impact of postdischarge surveillance on surgical site infection diagnosis.

OBJECTIVE: To evaluate the impact of postdischarge surveillance on surgical site infection (SSI) diagnosis. STUDY DESIGN: Prospective enrollment with retrospective case review SAMPLE POPULATION: Dogs and cats (n = 1271) undergoing surgery April 2012-November 2013. METHODS: The medical record of each animal was reviewed and a 30-day follow-up questionnaire was sent to each pet owner. A standardized definition of SSI was used to identify all animals with SSI. The method of SSI detection was recorded as: re-presentation to the hospital, scheduled recheck, questionnaire, communication with the referring veterinarian, or a combination of the above. RESULTS: SSI was identified in 36 (2.83%) of the 1271 animals included. All SSIs were diagnosed after discharge from the hospital. Seven of the 36 animals with SSI were diagnosed at re-presentation to the hospital, 5/36 at scheduled recheck, 10/36 on questionnaire, 10/36 at re-presentation to the hospital AND on questionnaire, and 4/36 on communication with referring veterinarian. Of the diagnosed SSIs, 72.2% were documented in the medical record. Therefore, without active postdischarge surveillance, 10/36 SSIs (27.8%) would have gone unknown to surgeons at our institution. CONCLUSION: Understanding the incidence of SSI with feedback to surgeons is an important aspect of an infection control program and has been shown to reduce SSI risks. Without active postoperative surveillance, 27.8% of SSIs would have gone unknown to surgeons. Implementing active surveillance will allow accurate reporting of incidence of SSIs in veterinary hospitals.

Long-term postoperative effects of administration of allogeneic blood products in 104 dogs with hemangiosarcoma.

OBJECTIVE: To determine the influence of administering allogeneic blood products (ABP) on the progression of hemangiosarcoma in dogs. STUDY DESIGN: Multi-institutional, retrospective study. SAMPLE POPULATION: One hundred four dogs with hemangiosarcoma that survived until postoperative discharge from the hospital. METHODS: Medical records of dogs that had been operated on for hemoangiosarcoma were reviewed for signalment, presence of a hemoabdomen, presence of metastatic disease, and whether the dog had received chemotherapy or Yunnan Baiyao. Data that were collected were compared between dogs that received perioperative ABP and those that did not. Disease-free interval was compared between groups. The Kaplan-Meier method was used to obtain univariate descriptive statistics for time to clinical decline. A multivariable Cox regression model was used to analyze association or effect of potential predictor variables. RESULTS: The median disease-free interval (DFI) was shorter in the 67 dogs that received a blood transfusion (76 days; range, 1-836) than in the 37 dogs that did not receive a blood transfusion (120 days; range, 38-916). According to the multivariable Cox regression model, administration of blood products (P = .04) and the presence of gross metastatic disease at the time of surgery (P < .01) shortened the DFI, whereas administration of Yunnan Baiyao (P = .01) prolonged the DFI. CONCLUSION: Allogeneic blood product administration was associated with a shorter disease-free interval in this population. However, we could not demonstrate the association between blood products and shorter DFI because of confounding factors. CLINICAL SIGNIFICANCE: Dogs that receive ABP at the time of surgical therapy for hemangiosarcoma may have accelerated disease progression compared with dogs that do not receive ABP.

Removal of hemangiosarcoma cells from canine blood with a cell salvage system and leukocyte reduction filter.

OBJECTIVE: To determine the ability of an intraoperative cell salvage (IOCS) system and a leukocyte reduction filter (LRF) to remove hemangiosarcoma (HSA) cells from canine blood. STUDY DESIGN: Cultured HSA cells were added to canine blood to simulate intraoperative hemorrhage and address hemoabdomen from ruptured splenic HSA. The blood/HSA cell mixture was processed through an IOCS, followed by LRF processing. SAMPLE POPULATION: Whole blood from 3 healthy dogs combined with cultured HSA cells. METHODS: The ability of quantitative reverse transcriptase polymerase chain reaction (qRT-PCR), multiparameter flow cytometry, and cytologic examination to detect 50 HSA cells per milliliter of culture media was confirmed. RT-PCR, multiparameter flow cytometry, and cytologic examination were used to determine the presence of cultured HSA cells at 4 points during processing. RESULTS: HSA cells were found in all control samples and in all samples after IOCS but prior to LRF processing with all 3 cell detection methods. HSA cells were not found after IOCS/LRF processing with all 3 cell detection methods. CONCLUSION: IOCS combined with LRF processing is able to remove cultured HSA cells from canine blood. The addition of LRF to IOCS may allow application of IOCS in dogs with HSA. CLINICAL SIGNIFICANCE: A combination of IOCS and LRF processing may provide an alternative to allogeneic blood transfusion in dogs with hemoabdomen due to HSA.

Lung lobe torsion in dogs: 52 cases (2005-2017).

OBJECTIVE: To report outcomes and risk factors for mortality in dogs that underwent surgical management of lung lobe torsion. STUDY DESIGN: Retrospective case series from 5 veterinary teaching hospitals (2005-2017). ANIMALS: Fifty dogs with 52 instances of lung lobe torsion. METHODS: Data collected from medical records included signalment, clinical findings, results of clinicopathologic testing and diagnostic imaging, surgical treatment, lung lobe affected, intraoperative and postoperative complications, histopathologic and microbiologic findings, and outcome. Follow-up was obtained from medical records and telephone contact with primary care veterinarians. RESULTS: Fifty-two instances of lung lobe torsion were identified in 50 dogs, with a median follow-up of 453 days (range, 0-3075). Forty-six (92%) dogs survived to discharge. Dogs with concurrent torsion of the right cranial and middle lung lobes were less likely to survive (2/4) than those with torsion of the left cranial lung lobe (22/22). No other risk factors for mortality prior to hospital discharge were identified. Overall median survival time after hospital discharge was 1369 days. Four dogs had >1 episode of lung lobe torsion. CONCLUSION: The percentage of dogs surviving to discharge after surgical treatment of lung lobe torsion was higher than previously reported. The short- and long-term prognosis was excellent with surgical treatment of lung lobe torsion. CLINICAL SIGNIFICANCE: Surgery should be recommended when lung lobe torsion is suspected because of the high survival to discharge rate and excellent long-term prognosis.

Frequency of Dehiscence in Hand-Sutured and Stapled Intestinal Anastomoses in Dogs.

OBJECTIVE: To determine the frequency of dehiscence of hand-sutured and stapled intestinal anastomoses in the dog and compare the surgery duration for the methods of anastomosis. STUDY DESIGN: Historical cohort study. SAMPLE POPULATION: Two hundred fourteen client-owned dogs undergoing hand-sutured (n = 142) or stapled (n = 72) intestinal anastomoses. METHODS: Medical records from 5 referral institutions were searched for dogs undergoing intestinal resection and anastomosis between March 2006 and February 2014. Demographic data, presence of septic peritonitis before surgery, surgical technique (hand-sutured or stapled), surgery duration, surgeon (resident versus faculty member), indication for surgical intervention, anatomic location of resection and anastomosis, and if dehiscence was noted postoperatively were retrieved. Estimated frequencies were summarized and presented as proportions and 95% confidence intervals (CI) and continuous outcomes as mean (95% CI). Comparisons were made across methods of anastomosis. RESULTS: Overall, 29/205 dogs (0.14, 95% CI 0.10-00.19) had dehiscence, including 21/134 dogs (0.16, 0.11-0.23) undergoing hand-sutured anastomosis and 8/71 dogs (0.11, 0.06-0.21) undergoing stapled anastomosis. There was no significant difference in the frequency of dehiscence across anastomosis methods (χ(2), P = .389). The mean (95% CI) surgery duration of 140 minutes (132-147) for hand- sutured anastomoses and 108 minutes (99-119) for stapled anastomoses was significantly different (t-test, P < .001). CONCLUSION: No significant difference in frequency of dehiscence was noted between hand- sutured and stapled anastomoses in dogs but surgery duration is significantly reduced by the use of staples for intestinal closure.

Comparison of Outcome After Use of Extra-Luminal Rings and Intra-Luminal Stents for Treatment of Tracheal Collapse in Dogs.

OBJECTIVE: To report short- and long-term complications and outcomes of dogs treated for tracheal collapse secondary to chondromalacia with extra-luminal rings (ELR) or intra-luminal stents (ILS). STUDY DESIGN: Retrospective cohort. SAMPLE POPULATION: Dogs with naturally occurring tracheal collapse (n = 103). METHODS: Medical records (2002-2012) of dogs diagnosed with tracheal collapse that had treatment with ELR (n = 73) or ILS (30) were reviewed. Demographic information, procedural information, complications, survival time, and subjective outcomes were recorded. Follow-up periods were defined as <730 days (short-term) and >730 days (long-term). RESULTS: Ninety-two percent of dogs undergoing ELR and 100% of dogs undergoing ILS survived to hospital discharge. ELR dogs were significantly younger (P = .009) and significantly fewer had main-stem bronchial collapse (P < .001). After accounting for effects of age and presence of main-stem bronchial collapse, there was no significant difference in median survival time between groups. Dogs with main-stem bronchial collapse (regardless of treatment type) had a shorter survival time than dogs without main-stem bronchial collapse. Major complications occurred in ELR (42%) and ILS dogs (43%). CONCLUSIONS: Both ELR and ILS are associated with high complication rates. Younger dogs and dogs without main-stem bronchial collapse had a longer survival time, regardless of treatment.

Electrolyte and acid/base changes in dogs undergoing autologous blood transfusion via a cell salvage device.

This study reports electrolyte and acid/base disturbances observed in clinical cases receiving autologous transfusion of blood processed by a cell salvage device. The records of 12 client-owned dogs that received an autologous transfusion via a cell salvage device with pre- and post-autologous transfusion blood work available were reviewed. Blood work from the 12 case dogs was compared to blood work from 12 control dogs with similar diseases. Control dogs received similar surgical treatment and were administered a similar volume per kg of packed red blood cells as case dogs, but did not undergo autologous transfusion. Case dogs that received autologous transfusion via a cell salvage device were significantly more likely to experience a decrease in ionized calcium and magnesium levels post-transfusion than were control dogs. Calcium and magnesium levels should be closely monitored during and after autologous transfusion. Calcium and/or magnesium supplementation may be required.

Changements électrolytiques et acido-basiques chez les chiens subissant une transfusion sanguine autologue à l'aide d'un dispositif de récupération des cellules. Cette étude signale les perturbations électrolytiques et acido-basiques observées dans des cas cliniques recevant une transfusion de sang autologue traitée à l'aide d'un dispositif de récupération des cellules. On a évalué les dossiers de 12 chiens, appartenant à des propriétaires, qui avaient reçu une transfusion autologue à l'aide d'un dispositif de récupération des cellules et avaient subi des analyses sanguines avant et après la transfusion autologue. Les analyses sanguines des 12 chiens ont été comparées aux analyses de 12 chiens témoins atteints de maladies semblables. Les chiens témoins ont reçu des traitements chirurgicaux semblables et un volume semblable par kg de concentré de globules rouges que les chiens du cas, mais n'ont pas subi la transfusion autologue. Il était significativement plus probable que les chiens du cas qui avaient reçu une transfusion autologue à l'aide d'un dispositif de récupération des cellules subissent une baisse du niveau de calcium ionisé et de magnésium après la transfusion que les chiens témoins. Le niveau de calcium et de magnésium devrait être étroitement surveillé durant et après la transfusion autologue. Des suppléments de calcium et/ou de magnésium pourront être requis.(Traduit par Isabelle Vallières).

Small animal patient preoperative preparation: a review of common antiseptics, comparison studies, and resistance.

This review aims to describe commonly used antiseptics in veterinary medicine including their mechanism of action, spectrum of activity, potential adverse effects, and application techniques. Additionally, it provides a review of the veterinary literature comparing antiseptics, a discussion of effectiveness and efficacy studies, and the potential for increased resistance to biocides and antimicrobials. This review concludes that appropriate selection and use is necessary to prevent the occurrence of surgical site infections, adverse effects, and potential for increasing resistance to antimicrobials. Continued research is needed to fill gaps in the current knowledge such as optimal preparation procedures for various surgical sites, standardization of efficacy and effectiveness testing, and the clinical impact of decreased susceptibility to chlorhexidine and other antiseptics.