Preoperative parameters (signalment, digital radiography, urinalysis, urine microbiological culture) and novel algorithm improve prediction of canine urocystolith composition.

OBJECTIVE: To determine the accuracy of 4 preoperative parameters (signalment, urinalysis, urine microbiological culture, and digital radiography) in predicting urocystolith composition, compare accuracy between evaluators of varying clinical experience and a mobile application, and propose a novel algorithm to improve accuracy. ANIMALS: 175 client-owned dogs with quantitative analyses of urocystoliths between January 1, 2012, and July 31, 2020. METHODS: Prospective experimental study. Canine urocystolith cases were randomly presented to 6 blinded "stone evaluators" (rotating interns, radiologists, internists) in 3 rounds, each separated by 2 weeks: case data alone, case data with a urolith teaching lecture, and case data with a novel algorithm. Case data were also entered into the Minnesota Urolith Center mobile application. Prediction accuracy was determined by comparison to quantitative laboratory stone analysis results. RESULTS: Prediction accuracy of evaluators varied with experience when shown case data alone (accuracy, 57% to 82%) but improved with a teaching lecture (accuracy, 76% to 89%) and further improved with a novel algorithm (accuracy, 93% to 96%). Mixed stone compositions were the most incorrectly predicted type. Mobile application accuracy was 74%. CLINICAL RELEVANCE: Use of the 4 preoperative parameters resulted in variable accuracy of urocystolith composition predictions among evaluators. The proposed novel algorithm improves accuracy for all clinicians, surpassing accuracy of the mobile application, and may help guide patient management.

Comparison of autograft and allograft fixation in Pemberton osteotomy.

UNLABELLED: This retrospective study compared the results of autograft and allograft fixation in 29 children (36 hips) who underwent Pemberton osteotomy. Autograft fixation was used in 21 hips and allograft fixation was used in 15 hips. In the autograft group, 76% of patients had a successful result; 4 of 8 of patients with a neuromuscular disorder in this group had a successful result. In the allograft group, 93% of patients had a successful result; 6 of 7 of patients with a neuromuscular disorder in this group had a successful result. Pemberton osteotomy performed with allograft fixation provided similar or better results than autograft, especially in children with neuromuscular disorders. LEVEL OF EVIDENCE: diagnostic study, Level III-2 (retrospective cohort study).

Preliminary evaluation of the utility of comparing SpO2 /FiO2 and PaO2 /FiO2 ratios in dogs.

OBJECTIVE: To determine whether the ratio of pulse oximetry saturation/fraction of inspired oxygen (SpO2 /FiO2 , [SF]) correlates with the ratio of partial pressure of oxygen in arterial blood/FiO2 (PaO2 /FiO2 , [PF]) in dogs. DESIGN: Prospective, observational pilot study. SETTING: Urban tertiary veterinary referral center. ANIMALS: Thirty-eight client-owned dogs requiring assessment of oxygenation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Arterial blood gas analysis with co-oximetry was performed on samples obtained from the dorsal pedal artery. Median SpO2 was 91.5% (range 80-97%) and median PaO2 was 70.1 mmHg (range 44.5-103.8 mmHg). Hypoventilation was uncommon and venous admixture was the predominant cause of hypoxemia in this population. Median SF was 435.7 (range 381.0-461.9) and median PF was 334.0 (range 211.9-494.3). Nine dogs (23.6%) had PF <300; no dogs had PF below 200. SF and PF were correlated (ρ = 0.618, P < 0.01). CONCLUSIONS: SF and PF in dogs spontaneously breathing room air have good correlation, suggesting that SF may be a useful, noninvasive surrogate for PF when assessing oxygenation in canine patients. Further studies are warranted to confirm and validate this relationship in spontaneously breathing and mechanically ventilated dogs on varying levels of FiO2 and to assess the ability of SF to predict outcome.