The clinical features and treatment of fishhook injuries in freshwater turtles: 126 cases from 1997-2022.

OBJECTIVE: To describe the clinical features, treatment, and outcomes of wild freshwater turtles with fishing hook injuries. ANIMALS: 126 wild turtles residing in central North Carolina that were presented to a wildlife rescue clinic. METHODS: Medical records from July 1997 to July 2022 were reviewed, and data were collected and analyzed. RESULTS: The most common species presenting for a fishhook injury was the yellow-bellied slider (Trachemys scripta scripta) (n = 69/126 [54.8%]; 95% CI, 45.7 to 63.6). The most common location identified was the oral cavity (n = 77/140 [55%]; 95% CI, 46.4 to 63.4) and the most common removal method was retrograde removal after cutting the barb off of the hook (76/120 [63.3%]; 95% CI, 54.1 to 71.9). Fishhooks embedded in the esophagus had a significantly higher chance of complications affecting recovery (OR estimate, 3.49; 95% CI, 1.07 to 11.38). There was no significant increase in mortality associated with the location of the injury; however, there was a significant increase in mortality in patients that experienced complications (P < 0.001). The time in care ranged from 1 to 150 days (median, 16 days). Of the turtles evaluated, 10.8% (n = 12/111; 95% CI, 5.7 to 18.1) were euthanized or died after treatment and 89.2% (99/111; 95% CI, 81.9 to 94.3) were released. CLINICAL RELEVANCE: These findings describe various successful techniques to remove fishhooks from turtles. While no superior treatment was identified, considerations should be taken to provide patient comfort, decrease injury-associated complications, and shorten recovery time by using minimally invasive techniques. Overall, freshwater turtles with fishhook injuries have a high release rate even when the injuries are severe.

Ex vivo analysis of ultraviolet radiation transmission through ocular media and retina in select species.

The aim of this study was to assess the transmission of the ultraviolet (UV) radiation (200-400 nm) through intact enucleated globes of different species (dogs, cats, pigs, rabbits, horses, and humans) using spectrophotometry. Globes of cats (n = 6), dogs (n = 18), pigs (n = 10), rabbits (n = 6), horses (n = 10), and humans (n = 4) were analyzed. A 5-10 mm circular area of sclera and choroid from the posterior aspect of the globe was removed under a surgical microscope, leaving the retina intact in all species except the horse. Glass coverslips were added in horses and rabbits due to retinal and globe fragility. The %T of wavelengths from 200 to 800 nm were measured through the ocular media (cornea, aqueous humor, lens, and vitreous humor) and retina, and compared between species. The globes of cats and dogs allowed the most amount of UV radiation transmission, while those of pigs and humans allowed the least amount of UV radiation transmission. A small amount of UV radiation transmission through the ocular media was detected in the rabbit and horse. Results from this study will support further vision research that may be used to train companion, working, and service animals.

Hemostatic profiles in dogs with sudden acquired retinal degeneration syndrome.

BACKGROUND: Sudden acquired retinal degeneration syndrome (SARDS) is a common cause of irreversible blindness in dogs. It bears clinical resemblance to hypercortisolism, which can be associated with hypercoagulability. The role of hypercoagulability in dogs with SARDS is unknown. OBJECTIVE: Determine hemostatic profiles in dogs with SARDS. ANIMALS: Prospective pilot study: Dogs with a history of SARDS (n = 12). Prospective case-control study: Dogs with recent onset of SARDS (n = 7) and age-, breed-, and sex-matched controls (n = 7). METHODS: Prospective pilot study: We performed thromboelastography (TEG). Prospective case-control study: Dogs had CBC, serum biochemistry, urinalysis, TEG, fibrinogen concentration, antithrombin activity, D-dimers, thrombin-antithrombin complexes, and optical platelet aggregometry performed. RESULTS: Prospective pilot study: 9/12 dogs with a history of SARDS were hypercoagulable with increased TEG G value and 2/3 had hyperfibrinogenemia. Case-control study: All dogs with SARDS and 5/7 controls were hypercoagulable based on TEG G value. Dogs with SARDS had significantly higher G values (median, 12.7 kdynes/s; range, 11.2-25.4; P = .04) and plasma fibrinogen concentration (median, 463 mg/dL; range, 391-680; P < .001) compared to controls. CONCLUSIONS AND CLINICAL IMPORTANCE: Hypercoagulability was common in both dogs with SARDS and controls, but dogs with SARDS were significantly more hypercoagulable on TEG. The role of hypercoagulability in the pathogenesis of SARDS remains to be determined.

Effect of gentamicin on CD3+ T-lymphocyte proliferation for treatment of equine recurrent uveitis: An in vitro study.

OBJECTIVE: The objective of the study was to determine the effect of gentamicin on CD3+ T-lymphocyte proliferation and cell viability using an in vitro cell culture model as a means of investigating the mechanism of action of low-dose intravitreal gentamicin injection. ANIMALS STUDIED: Three adult horses with no evidence of ophthalmic or systemic disease. PROCEDURE: Peripheral blood lymphocytes were treated with gentamicin at concentrations 37.5 µg/mL, 112.5 µg/mL, 187 µg/mL, 375 µg/mL, or 750 µg/mL then stimulated to proliferate with concanavalin A (ConA). 4',6-diamidino-2-phenylindole (DAPI) and carboxyfluoroscein succinimidyl ester (CSFE) were used as markers of cell viability and cell proliferation, respectively. Following 5-day culture, live cell counts and CSFE fluorescent intensity data were collected via automated cell count and flow cytometry. The experimental design was duplicated using preservative-free gentamicin and a proprietary brand formulation. Statistical analysis was performed using two-way ANOVA with Tukey's multiple comparison test. RESULTS: No statistically significant comparisons in CD3+ T-lymphocyte live cell counts and geometric mean fluorescent intensity of CSFE were identified between gentamicin concentrations or formulations. CONCLUSIONS: Gentamicin had no effect on equine peripheral blood CD3+ T-lymphocyte cell viability and proliferation in concentrations ranging from "safe" to "retinotoxic" in relation to intravitreal injection volumes. Low-dose intravitreal gentamicin may not suppress the Th1- and Th17-mediated immune response.

EVALUATION OF OSCILLOMETRIC BLOOD PRESSURE MEASUREMENT USING A FINGER CUFF IN ANESTHETIZED CHIMPANZEES (PAN TROGLODYTES).

Cardiovascular disease is common among chimpanzees (Pan troglodytes), and serial blood pressure monitoring in conscious animals may improve disease surveillance and guide hypertension treatment strategies. The objective of this study was to compare the accuracy of a noninvasive, oscillometric blood pressure monitor using a finger blood pressure cuff with invasively measured blood pressure in anesthetized chimpanzees. Twelve chimpanzees were anesthetized with tiletamine-zolazepam intramuscularly, intubated, and maintained on inhaled isoflurane to effect. Blood pressure measurements, which included systolic arterial pressure (SAP), mean arterial pressure (MAP), and diastolic arterial pressure (DAP), were collected simultaneously from an oscillometric blood pressure cuff placed on a forelimb digit (FBP) and a direct arterial catheter (IBP) every 5-10 min while anesthetized. One hundred paired samples were collected, and results were compared using Bland-Altman plots and analysis. FBP showed good agreement with IBP for SAP, MAP, and DAP but consistently overestimated values compared with IBP. FBP may be useful for serial blood pressure monitoring in conscious chimpanzees.

Risk factors associated with an outbreak of equine coronavirus at a large farm in North Carolina.

Background: Equine coronavirus (ECoV) leads to outbreaks with variable morbidity and mortality. Few previous reports of risk factors for infection are available in the literature. Objectives: To describe unique clinical findings and risk factors for infection and development of clinical disease. Animals: 135 horses on a farm affected by ECoV outbreak. Methods: Retrospective cohort study. Data obtained included age, breed, gender, activity level, housing, and feed at the onset of the outbreak. Factors were evaluated for assessment of risk of infection using simple logistic regression or Fisher's exact test. Significance was set at p ≤ 0.05. Results and findings: Forty-three of 54 (79.6%) horses tested on the farm were positive on fecal PCR for ECoV, and 17 horses (12.6%) developed clinical signs consistent with ECoV. Out of 17 horses in which the presence or absence of signs of colic was noted, 6 of 17 (35.3%) showed signs of colic. Three of these horses had small colon impactions, 2 of which required surgical intervention. Significant risk factors for having positive PCR results included being primarily stalled (OR 167.1, 95% CI 26.4-1719), housing next to a positive horse (OR 7.5, 95% CI 3.1-19.0), being in work (OR 26.9, 95% CI 4.6-281.9), being fed rationed hay vs. ad libitum (OR 1,558, 95% CI 130.8-15,593), and being fed alfalfa hay (OR 1,558, 95% CI 130.8-15,593). Conclusions and clinical importance: This report describes risk factors for ECoV infection many of which were associated with intensive management of show horses. Clinicians should be aware that clinical signs vary and can include severe colic.

Hurdles of Cataract Surgery: Veterinary Ophthalmology Resident's Perspective (Part B).

The purpose of this study was to describe veterinary ophthalmology residents' perceived preparedness for performing cataract surgery who are currently enrolled in, or recently graduated from, veterinary academic or private practice institutions. A descriptive survey was distributed online to 127 residents at academic and private practice training programs in the United States. The survey included items about educational resources available for residents and techniques commonly taught during cataract surgery. Residents were asked to describe their perceived preparedness in performing various surgical steps or techniques, difficulty of each surgical step, and the available educational resources. Thirty-five (27.5%) residents completed the survey and were included in this study. Residents who had access to wet labs gained surgical competency in creating a clear corneal incision, capsulorhexis, and wound closure. They reported sculpting with the phacoemulsification handpiece, quadrant or cortical removal, and capsulorhexis as most difficult and were not as prepared or a little prepared in performing capsulorhexis and sculpting during active phacoemulsification. When comparing residents' perceived competency before and after their first surgical experience, there was a significant change in their ability to perform all surgical steps except hydrodissection (p < .05). Cataract surgery is one of the more advanced surgical skills obtained during residency training. Supervised wet lab time improves a resident's preparedness for executing certain surgical steps. However, further research is needed to determine whether educational resources such as structured curriculum or virtual simulation may improve residents' preparedness for executing surgical steps not easily replicated in a wet lab.

Equine pectinate ligament descemetization is associated with age.

PURPOSE: To evaluate the correlation between equine pectinate ligament descemetization and ocular disease. METHODS: The pathology database of the North Carolina State University Veterinary Medical Center was searched from 2010-2021 for all equine globes. Disease status was then assigned as affected by glaucoma, uveitis, or "other" based upon clinical records. The iridocorneal angles (ICA) of each globe were evaluated for the presence of pectinate ligament descemetization, the length of descemetization, as well as for the degree of angle collapse and the extent of cellular infiltrate or proteinaceous debris. One slide from each eye was evaluated by two separate, blinded investigators (HW & TS). RESULTS: A total of 66 eyes from 61 horses were identified, with a total of 124 sections of ICA of sufficient quality to review. 16 horses were affected by uveitis, 8 by glaucoma, 7 by both glaucoma and uveitis, and 30 horses by other ocular disease, most commonly ocular surface disease or neoplasia, which served as controls. Pectinate ligament descemetization was most prevalent in the control group compared to the glaucoma and uveitis groups. Pectinate ligament descemetization length was positively correlated with age, with an increase of 13.5 µm per year of age (p = .016). Infiltrate scores and angle closure scores were higher in both the glaucoma and uveitis group compared to the control group (p < .001). CONCLUSIONS: Equine pectinate ligament descemetization appears to be correlated with increased age and should not be used as a histologic marker for the presence of glaucoma.

Morphometry and Morphology of the Articular Surfaces of the Medial Region of the Temporomandibular Joint in the Felis Catus (Domestic cat) - A Cone Beam Computed Tomography Study.

The articular surfaces of the temporomandibular joint (TMJ) in the cat consist of the articular head of the condylar process of the ramus of the mandible and the mandibular fossa of the petrous part of the temporal bone. Anatomic conformation of the TMJ articular surfaces can vary; however, this has not been studied in the cat. Thus, the aim of this study was to characterize the conformation of the medial region of the TMJ in mesocephalic adult cats as well as to determine the articular relationship by measurement of the degree of coverage of the mandibular fossa over the articular head. This was accomplished by assessing 60 TMJs from 30 mesocephalic adult cats by means of cone-beam computed tomography (CBCT). The width and depth of the mandibular fossa, and the degree of coverage of the mandibular fossa were evaluated using parasagittal reconstructions of the medial aspect of the TMJ by two observers. No statistically significant difference was observed during the intra and interobserver evaluation of the mandibular fossa width and depth and the degree of coverage of the mandibular fossa over the articular head. P-values for the studied variables were greater than 0.05. The resulting measurements demonstrated a concave mandibular fossa with a prominent retroarticular process and a poorly developed articular eminence; a well-defined rounded articular surface, and a high degree of coverage (171°) of the mandibular fossa over the articular head. In conclusion, the articular surfaces at the medial aspect of the TMJ displayed elevated geometric similarity, with an articular head of the condylar process deeply seated in the mandibular fossa.

Outcomes of 434 dogs with non-steroidal anti-inflammatory drug toxicosis treated with fluid therapy, lipid emulsion, or therapeutic plasma exchange.

BACKGROUND: Traditional management of non-steroidal anti-inflammatory drug (NSAID) intoxication includes gastrointestinal decontamination, intravenous administration of fluids (IVF), and gastroprotection. Intravenous administration of lipid emulsion (ILE) and therapeutic plasma exchange (TPE) are popular novel therapeutic strategies. HYPOTHESIS: Compare outcomes of dogs treated with IVF, ILE, and TPE for NSAID intoxications and evaluate outcome predictors for drug subgroups. ANIMALS: Four hundred thirty-four dogs with NSAID intoxications (2015-2020). METHODS: Multicenter retrospective study of ibuprofen, carprofen, and naproxen intoxication. An ordinal outcome was defined as mild gastrointestinal, moderate kidney, or signs of severe central nervous system disease. RESULTS: Signs of neurological disease were overrepresented and acute kidney injury underrepresented in the TPE group among dogs exposed to kidney- or CNS-toxic doses (P = .05), though all TPE dogs with signs of neurological disease had evidence of neurotoxicity at presentation. Dogs treated with IVF had a higher maximal creatinine concentration (median, 1.1 mg/dL; range, 0.4-8.44 mg/dL) compared with IVF + ILE (median, 0.9 mg/dL; range, 0.4-6.2 mg/dL; P = .01). Increased maximum time to presentation (P < .001), higher baseline creatinine (P < .001) and PCV (P = .007), and absence of induced emesis (P < .001) were associated with greater clinical severity. Ibuprofen toxicosis was associated with more severe clinical signs compared with carprofen (P = .03). Overall survival rate was 99%. CONCLUSIONS AND CLINICAL IMPORTANCE: NSAID toxicosis generally carries an excellent prognosis in dogs. Despite similar outcomes of lower incidence of AKI in the TPE group, and slightly lower maximal creatinine concentration in dogs treated with ILE vs IVF alone, ILE and TPE should be considered in the management of severe NSAID toxicosis.

Alterations to the synovial invaginations of the navicular bone are associated with pathology of both the navicular apparatus and distal interphalangeal joint when evaluated using high field MRI.

Limited information exists regarding associations between distal interphalangeal joint (DIPJ) abnormalities and synovial invagination changes in the distal sesamoid (navicular) bone. This retrospective, analytical study aimed to measure specific characteristics of the synovial invaginations of the navicular bone to determine whether any single characteristic was associated with abnormalities in the DIPJ or navicular apparatus (NA) using high field MRI and a sample of 200 horses' feet. The DIPJ and NA were graded independently by three scorers. The grades were averaged, creating a global pathology score for the DIPJ, NA, and synovial invaginations. Higher global scores represented more severe pathology. The number of invaginations, depth of penetration, invagination shape, and cross-sectional area (CSA) of the largest invagination were recorded. Interobserver agreement was measured using Cohen's Kappa. Associations of global scores of the DIPJ and NA with individual invagination characteristics were assessed using linear mixed modeling. A significant relationship was found between the number of invaginations and global DIPJ score, with higher invagination numbers associated with higher DIPJ scores. For invagination depth and CSA, a significant relationship was noted with global scores of both the DIPJ and NA. Reliable relationships between the shape of synovial invaginations and global scores of DIPJ and NA were not found, likely due to poor interobserver scoring (0.305). These findings suggest that primary DIPJ disease and NA pathology should be considered when noticing alterations to navicular synovial invaginations on MRI. This contrasts traditional views that synovial invagination abnormalities are indicative solely of NA pathology.

Bilateral lysis of aortic saddle thrombus with early tissue plasminogen activator (BLASTT): a prospective, randomized, placebo-controlled study in feline acute aortic thromboembolism.

OBJECTIVES: The aim of this study was to investigate the impact of tissue plasminogen activator (TPA) on the treatment of feline aortic thromboembolism (FATE). METHODS: Cats diagnosed with FATE involving ⩾2 limbs were enrolled in a prospective, multicenter, double-blinded, randomized, placebo-controlled study within 6 h of an event. Diagnosis was made by clinical findings and one confirmatory criterion. Cats received placebo or TPA (1 mg/kg/h with the first 10% by bolus). All cats received pain control and thromboprophylaxis. The primary outcome was a change from baseline in a published limb score at 48 h. Secondary outcomes included 48 h survival, survival to discharge and complication proportions. Statistical analyses included pattern-mixture models, logistic regression and Fisher's exact, Student's t- and Mann-Whitney-Wilcoxon tests. RESULTS: Based on a power analysis, 40 cats were enrolled; however, only 20 survived to 48 h (TPA, n = 12; placebo, n = 8 [P = 0.34]). There was a statistically significant improvement in limb scores compared with baseline for both groups (P <0.001). Limb score at 48 h was 1 point lower (better) in the TPA group (P = 0.19). Thrombolysis had no statistically significant effect on 48 h survival (P = 0.22). Lower affected limb lactate was associated with better 48 h survival (odds ratio 1.53, 95% confidence interval 1.08-2.17; P = 0.02). The survival to discharge rates were 45% (TPA) and 30% (placebo; P = 0.51). Complications in the TPA and placebo groups included acute kidney injury (22% and 19%, respectively; P = 1.00) and/or reperfusion injuries (33% and 19%, respectively; P = 0.45). CONCLUSIONS AND RELEVANCE: Survival and complication rates of acute FATE were not different with or without thrombolysis. High in-hospital mortality decreased the statistical power to detect a statistically significant difference between treatments with regard to our primary outcome.

Point-of-care viscoelastic coagulation assessment in healthy dogs during the perianesthetic period.

BACKGROUND: The viscoelastic coagulation monitor (VCM Vet) is a novel, portable device that provides a global assessment of hemostasis. The study aims were to evaluate serial viscoelastic analysis during the perianesthetic period in healthy dogs and to compare the agreement between two VCM Vet devices. Twenty healthy dogs undergoing orthopedic surgery were enrolled. Whole blood samples were collected from an intravenous catheter at four time points: baseline, 15 min after premedication, 60 min after inhalant initiation, and 60 min after inhalant termination. Viscoelastic tests were performed in duplicate on different devices, providing: clot time (CT; seconds), clot formation time (CFT; seconds), alpha angle (α; degrees), amplitude (units) at 10 (A10) and 20 (A20) minutes post clot time, maximum clot firmness (MCF; units), and lysis index (%) at 30 (Li30) and 45 (Li45) minutes post maximum clot formation. RESULTS: One hundred sixty samples were analyzed. The speed of CT and CFT significantly decreased an average of 25.5 s (95% confidence interval [CI]15.9-35.0) and 6.9 s (95% CI 3.1-10.7) per time point, respectively. There were no significant changes in clot strength or lysis variables. The Bland-Altman style plot shows an acceptable rate of agreement for all variables with intra-class correlation ranging from 0.64-0.94. CONCLUSION: The rate of clot formation (CT and CFT) decreased over the perianesthetic period in healthy dogs undergoing surgery. These changes were small and occurred without changes in clot strength or fibrinolysis rate, thus were not clinically relevant. There was clinically acceptable consistency between devices.

Clinicopathological findings in and prognostic factors for domestic rabbits with liver lobe torsion: 82 cases (2010-2020).

OBJECTIVE: To document clinicopathologic findings in domestic rabbits with liver lobe torsion and identify prognostic factors. ANIMALS: 82 rabbits. PROCEDURE: Medical records of 4 institutions were reviewed to identify rabbits with an antemortem diagnosis of liver lobe torsion that were examined between 2010 and 2020. RESULTS: The prevalence of liver lobe torsion was 0.7% (82/11,402). In all 82 rabbits, the diagnosis was made by means of abdominal ultrasonography. Fifty (60.1%) rabbits underwent liver lobectomy, 23 (28%) received medical treatment alone, and 9 (10.9%) were euthanized or died on presentation. Overall, 32 (39%) rabbits died within 7 days of initial presentation and 50 (61%) survived. Seven-day survival rate did not differ significantly between medical treatment alone and surgical treatment. However, median survival time following medical treatment (530 days) was shorter than that following surgical treatment (1,452 days). Six of 14 rabbits had evidence of systemic inflammatory disease on necropsy. Rabbits with right liver lobe torsion were less likely to survive for 7 days than were those with caudate torsions (P = 0.046; OR, 3.27; 95% CI, 1.04 to 11.3). Rabbits with moderate to severe anemia were less likely to survive for 7 days than were rabbits that were not anemic or had mild anemia (P = 0.006; OR, 4.41; 95% CI, 1.55 to 12.51). Other factors associated with a decreased 7-day survival rate were high heart rate at admission (P = 0.013) and additional days without defecation after admission (P < 0.001). Use of tramadol was associated with an increased survival rate (P = 0.018). CLINICAL RELEVANCE: The prognosis for rabbits with liver lobe torsions was more guarded than previously described. Rabbits that underwent liver lobectomy had a longer median survival time than did rabbits that only received medical treatment.

Outcomes of nonsteroidal anti-inflammatory drug toxicosis treated with therapeutic plasma exchange in 62 dogs.

BACKGROUND: Therapeutic plasma exchange (TPE) is gaining popularity for the management of nonsteroidal anti-inflammatory drug (NSAID) overdose in dogs. HYPOTHESIS/OBJECTIVES: Describe a population of dogs treated with TPE for NSAID overdose. ANIMALS: Sixty-two dogs with NSAID overdose treated with TPE. METHODS: Multicenter retrospective study of dogs treated with TPE for ibuprofen, carprofen, or naproxen overdose. RESULTS: The median dose of ibuprofen, carprofen or naproxen ingested was 533 mg/kg (range, 36-4857 mg/kg), 217 mg/kg (range, 88-625 mg/kg) and 138 mg/kg (range, 26-3000 mg/kg), respectively. Based on previously established toxic ranges for each NSAID, 2 (3.2%), 14 (22.6%), and 46 (74.2%) dogs ingested a gastrointestinal, renal, and neurological toxic dose, respectively. The median time between ingestion and presentation was 4 hours (range, 1-20 hours). The median number of plasma volumes processed was 1.6 (range, 0.4-2.2). The median TPE session duration was 2 hours (range, 1-4.5 hours). Circuit clotting developed during 8 (12.9%) sessions. Patient adverse events reported during 21 (33.8%) sessions consisted of urticaria (12.9%), asymptomatic hypocalcemia (9.6%), and hypotension (9.6%). The median duration of hospitalization was 2.25 days (range, 1-11 days). Sixty-one (98.4%) dogs survived to discharge, and none were rehospitalized. Thirty-one (91.1%) of the 34 dogs with at least 1 follow-up visit were not azotemic at the time of reevaluation. CONCLUSIONS AND CLINICAL IMPORTANCE: This population of dogs managed with TPE had excellent outcomes, even in cases of high NSAID dose ingestion. When TPE is available and the time frame is appropriate, this extracorporeal modality should be considered for the management of NSAID overdose.

Perianesthetic mortality in English Bulldogs: a retrospective analysis in 2010 - 2017.

BACKGROUND: Many veterinarians consider English Bulldogs to have a greater perianesthetic mortality risk. The aims of this study were to 1) determine total and anesthesia-related, perianesthetic mortality (PAM) rates in English Bulldogs (EB), 2) identify potential risk factors associated with mortality in EB, and 3) determine the difference in the perianesthetic mortality rates between EB, other-brachycephalic breeds (OB), and non-brachycephalic breeds (NB). Records from EB that were anesthetized between 2010 and 2017, were investigated. OB and NB were enrolled to match with each EB based on a procedure and age from the study period. Data collected in EB included: age, ASA status, weight, procedure types, anesthetic and analgesic management, anesthetic duration, anesthetic recovery location, and cause of death. Age and cause of death were determined from OB and NB. Fisher's exact test was used to compare PAM rate and age in EB, OB, and NB. Mann-Whitney U test was used to compare EB survivor and EB non-survivor. Logistic regression models were used to identify factors and odds ratio (OR) associated with PAM in EB. RESULT: Two hundred twenty nine EB, 218 OB, and 229 NB were identified. The total and anesthesia-related PAM rates in EB were 6.6 and 3.9%, respectively. EB had a greater total PAM rate compared with OB (p = 0.007). ASA status was different between survivors and non-survivors in EB (p < 0.01). Risk factors identified regardless of the cause of death were premedication with full µ opioids (OR = 0.333, p = 0.114), continuous infusion of ketamine post-operatively (OR = 13.775, p = 0.013), and acepromazine administration post-operatively (OR = 7.274, p = 0.004). The most common cause of death in EB was postoperative respiratory dysfunction (87.5%). CONCLUSION: Total and anesthesia-related mortality in EB is considerable. Most deaths in EB occurred during the postoperative period secondary to respiratory complications.

Refinement of the Feline Musculoskeletal Pain Index (FMPI) and development of the short-form FMPI.

OBJECTIVES: The aim of this study was to investigate the reliability and responsiveness of the Feline Musculoskeletal Pain Index (FMPI) using the collective results of multiple clinical studies and iteratively refine the FMPI for future use. METHODS: Data were compiled from previously conducted studies involving client-owned cats with degenerative joint disease (DJD) and which used the FMPI. The reliability of the FMPI was assessed using the data from the initial visits of those studies. For the assessment of responsiveness of the FMPI, only placebo-controlled studies that used analgesic treatments were included. Treatment groups from each study were combined and categorized as 'placebo' group and 'analgesic' group. Then, the mean change from baseline in score of each FMPI item and across all items within and between these groups were assessed. Based on the results of the reliability and responsiveness of the FMPI, stepwise elimination was used to remove the items that were least able to distinguish between the placebo and analgesic groups. Finally, after the stepwise elimination, a proposed new FMPI-short form (FMPI-sf) was constructed and its reliability was reassessed using the data sets described above. Individual and combined data sets of the studies were also used to compare the responsiveness of the original FMPI and the FMPI-sf. RESULTS: The data from 180 cats from four studies were included. The original FMPI had a reasonable reliability, but low/no responsiveness. The elimination process of FMPI items refined the responsiveness of the instrument while maintaining its reliability. When the responsiveness was compared between the original FMPI (17 items) and the FMPI-sf (nine items), the treatment effect between groups was always greater when the FMPI-sf was used. CONCLUSIONS AND RELEVANCE: The proposed FMPI-sf may be able to better distinguish between placebo and analgesic effects in cats with DJD.

Development and Formative Evaluation of a Low-Fidelity Equine Castration Model for Veterinary Education.

Entrustable Professional Activities (EPAs) are units of activity that early-stage professionals perform in the workplace that necessitate simultaneous integration of multiple competencies. EPA #6 requires students to perform a common surgical procedure on a stable patient, including pre-operative and post-operative management. Castration is one of the most common surgeries performed by equine primary care practitioners and is considered an "entry-level competency" for veterinary graduates entering equine private practice, however, to our knowledge there are no equine castration models available for veterinary student education. Therefore, we developed an inexpensive, low-fidelity model of equine field castration and evaluated it using a mixed-methods approach. Two different groups of students, with or without model experience, completed surveys before and after live horse castration. Students who used the model also completed model specific surveys. Videos of the students completing the model were evaluated by at least two different equine veterinary faculty using a 15-point rubric, and inter-rater reliability of the rubric was determined. After completing the model, students reflected on strengths and weaknesses of their performance. From our student survey results, we determined that student attitudes toward the model were mostly positive. Interestingly, there were several student attitudes toward the model that became significantly more favorable after live horse castration. Prior to live horse castration, there was no significant difference in confidence in model vs. no-model groups. Following live horse castration, students who used the model had higher confidence in procedure preparation and hand-ties than students who did not use the model, but they had lower scores for confidence during patient recovery. When reflecting on model castration, students most commonly cited preparation and surgical description as strengths, and ligature placement and hand-ties as weaknesses. Experts provided several suggestions to improve the model, including incorporation of emasculators and the need for better model stabilization. Our findings suggest that both students and veterinary educators feel that this low-fidelity model has educational value. Rubric performance metrics were favorable, but additional steps are needed to improve grading consistency among educators. Future research will determine whether student performance on the model is predictive of competence score during live-horse castration.

HOPX+ injury-resistant intestinal stem cells drive epithelial recovery after severe intestinal ischemia.

Intestinal ischemia is a life-threatening emergency with mortality rates of 50%-80% due to epithelial cell death and resultant barrier loss. Loss of the epithelial barrier occurs in conditions including intestinal volvulus and neonatal necrotizing enterocolitis. Survival depends on effective epithelial repair; crypt-based intestinal epithelial stem cells (ISCs) are the source of epithelial renewal in homeostasis and after injury. Two ISC populations have been described: 1) active ISC [aISC; highly proliferative; leucine-rich-repeat-containing G protein-coupled receptor 5 (LGR5+)-positive or sex-determining region Y-box 9 -antigen Ki67-positive (SOX9+Ki67+)] and 2) reserve ISC [rISC; less proliferative; homeodomain-only protein X positive (HOPX+)]. The contributions of these ISCs have been evaluated both in vivo and in vitro using a porcine model of mesenteric vascular occlusion to understand mechanisms that modulate ISC recovery responses following ischemic injury. In our previously published work, we observed that rISC conversion to an activated state was associated with decreased HOPX expression during in vitro recovery. In the present study, we wanted to evaluate the direct role of HOPX on cellular proliferation during recovery after injury. Our data demonstrated that during early in vivo recovery, injury-resistant HOPX+ cells maintain quiescence. Subsequent early regeneration within the intestinal crypt occurs around 2 days after injury, a period in which HOPX expression decreased. When HOPX was silenced in vitro, cellular proliferation of injured cells was promoted during recovery. This suggests that HOPX may serve a functional role in ISC-mediated regeneration after injury and could be a target to control ISC proliferation.NEW & NOTEWORTHY This paper supports that rISCs are resistant to ischemic injury and likely an important source of cellular renewal following near-complete epithelial loss. Furthermore, we have evidence that HOPX controls ISC activity state and may be a critical signaling pathway during ISC-mediated repair. Finally, we use multiple novel methods to evaluate ISCs in a translationally relevant large animal model of severe intestinal injury and provide evidence for the potential role of rISCs as therapeutic targets.

Irradiation of the Normal Murine Tongue Causes Upregulation and Activation of Transient Receptor Potential (TRP) Ion Channels.

Signal transduction at sensory neurons occurs via transmembrane flux of cations, which is largely governed by the transient receptor potential (TRP) family of ion channels. It is unknown whether TRP channel activation contributes to the pain that accompanies radiation-induced oral mucositis. This study sought to characterize changes in TRP channel expression and function that occur in the locally irradiated tissues and afferent neurons of mice. Female CD-1 mice received single high-dose (27 Gy) tongue irradiation, or sham irradiation. Animals were euthanized either before overt glossitis developed (days 1 and 5 postirradiation), when glossitis was severe (day 11), or after mice had recovered (days 21 and 45). Tongue irradiation caused upregulation of the Trpv1 gene in trigeminal ganglia (TG) neurons. Other TRP genes (Trpv2, Trpv4, Trpa1, Trpm8) and Gfrα3 (which acts upstream of several TRP channels) were also upregulated in TGs and/or tongue tissue, in response to radiation. Ex vivo calcium imaging experiments demonstrated that the proportions of TG neurons responding to histamine (an activator of TRPV1, TRPV4 and TRPA1), TNF-α (an activator of TRPV1, TRPV2 and TRPV4), and capsaicin (a TRPV1 agonist), were increased as early as one day after tongue irradiation; these changes persisted for at least 21 days. In a subsequent experiment, we found that genetic deletion of TRPV1 mitigated weight loss (a surrogate marker of pain severity) in mice with severe glossitis. The results intimate that various TRP channels, and TRPV1 in particular, should be explored as analgesic targets for patients experiencing pain after oral irradiation.