Laparoscopy and thoracoscopy in small animal surgery: A 2020 survey of small animal diplomate and resident veterinary surgeons.

OBJECTIVE: To document the utilization and training of laparoscopic and thoracoscopic minimally invasive surgery (MIS) techniques within the American, European, Australian and New Zealand Colleges of Small Animal Veterinary Surgeons (ACVS, ECVS, and ANZCVS) in 2020. STUDY DESIGN: Observational study. SAMPLE POPULATION: Diplomates and residents of the ACVS, ECVS, and FANZCVS. METHODS: An electronic survey was sent using veterinary list servers. Questions were organized into categories evaluating (1) the demographics of the study population and the caseload, (2) comfort level with specific procedures, (3) motivating factors and limitations, and (4) surgical training and the role of the governing bodies. RESULTS: Respondents included 111 practicing surgeons and 28 residents. Respondents' soft-tissue MIS caseloads had increased since they first started performing MIS; however, most respondents were only comfortable performing basic laparoscopy. Over half of the respondents agreed on the patient benefits and high standard of care provided by MIS. Perceived adequate soft-tissue training in MIS during residency was strongly associated with perceived proficiency at the time of survey response. Most respondents agreed that the specialty colleges should take a more active role in developing standards for soft-tissue MIS, with residents agreeing that a required standardized course would be beneficial. CONCLUSION: Soft-tissue MIS is widely performed by diplomates and residents. Perceived adequate soft-tissue MIS training was strongly associated with perceived proficiency. CLINICAL SIGNIFICANCE: There is substantial underutilization of advanced MIS techniques in veterinary specialty surgical practice, which might be improved by a stronger focus on MIS training during residency.

Conservative nonsurgical treatment for cranial cruciate ligament disease can be an effective management strategy in cats based on validated owner-based subjective assessment in some cases.

OBJECTIVE: To describe long-term outcomes of cats managed medically for cranial cruciate ligament disease (CCLD) via a validated owner-based questionnaire. ANIMALS: 18 client-owned cats. PROCEDURES: Retrospective review of medical records at 2 tertiary referral hospitals was conducted for records of cats diagnosed with CCLD for which medical management was pursued. History, physical examination findings, and medical management strategies were recorded. Owner follow-up was obtained via phone call or an email correspondence interview using a 2-part questionnaire. Part 1 consisted of 5 multiple-choice questions evaluating short-term outcomes following initiation of medical management. Part 2 assessed long-term outcomes via the validated Feline Musculoskeletal Pain Index-short form metrology instrument. RESULTS: Mean follow-up time was 66.5 ± 46.7 months (range, 7 to 154 months). Medical management included oral analgesics, activity restriction, and joint supplements. Of the 18 cats, 13 (72%) were always able to bear weight or became weight bearing within a week following initiation of medical management, and 15 (83%) were reportedly clinically normal within 3 months of initiating medical management, with complete resolution of lameness occurring in less than 2 months in 12 of those cats. Long term, 17 of the 18 (94%) owners reported they felt that their cat had a good to excellent outcome with medical management. The mean Feline Musculoskeletal Pain Index-short form score of all cats was 0.29 ± 0.53 (range, 0 to 2.13). CLINICAL RELEVANCE: Based on owner follow-up, conservative, nonsurgical management of CCLD can be an effective and appropriate management strategy for some cats; however, some may be best treated with surgical stabilization.

Intestinal incisional dehiscence rate following enterotomy for foreign body removal in 247 dogs.

OBJECTIVE: To report the intestinal incisional dehiscence rate following enterotomy for foreign body removal in dogs. ANIMALS: 247 client-owned dogs with intestinal foreign bodies treated with enterotomy between November 2001 and September 2017. PROCEDURES: Medical records were reviewed, and data were collected regarding signalment, history, surgery, clinicopathologic findings, hospitalization, intestinal incisional dehiscence, and survival to hospital discharge. Dogs were grouped according to whether intestinal incisional dehiscence occurred (dehiscence group) or did not occur (nondehiscence group) following enterotomy, and the rate of dehiscence for the total number of enterotomies during the study period was calculated. Univariable analysis was performed to identify variables associated with intestinal incisional dehiscence. RESULTS: 8 of the 247 (3.2%) dogs had preoperative septic peritonitis, and all 8 dogs survived to hospital discharge. Incisional dehiscence occurred following 5 of the 247 (2.0%) enterotomies, and only 2 dogs in the dehiscence group did not survive to hospital discharge. Duration of hospitalization was longer for dogs in the dehiscence group than for dogs in the nondehiscence group. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that enterotomy for intestinal foreign body removal had a lower rate of dehiscence in dogs during the study period, compared with rates previously reported; however, the low rate should not be used as a reason to perform an enterotomy rather than an enterectomy when needed. Surgeons should thoroughly evaluate the bowel and perform an enterotomy only when indicated.