New government must prioritise veterinary legislative reform.

Now that the General Election is over, and a new government is in place, BVA is continuing its campaigning efforts to maintain momentum towards reform of the Veterinary Surgeons Act.

'Informative and educational' policy position on feeding dogs and cats.

BVA Council members supported a new BVA policy position on diet choices for dogs and cats at their meeting on 17 July. As has become usual practice, the meeting took place in a hybrid form, both online and in person.

2024 AAFP intercat tension guidelines: recognition, prevention and management.

Social tension or conflict between household cats is common but, because it often manifests as subtle behavioral changes, it can go unnoticed; it is precisely because most signs are subtle and unrecognized that the term 'tension' is used. Where associated tension-related chronic fear-anxiety leads to more overt behavioral concerns and stress-associated disease, cats may face relinquishment by caregivers or even euthanasia if the tension is not relieved. The '2024 AAFP intercat tension guidelines: recognition, prevention and management' have been authored by a Task Force of board-certified veterinary and applied behaviorists and clinical experts in feline medicine and behavior convened by the American Association of Feline Practitioners. The aim is to support veterinary professionals in understanding social behavior between cats and, more specifically, in recognizing intercat tension, preventing or minimizing its occurrence and managing the stressors. In developing the Guidelines, the Task Force has modified the five pillars of a healthy feline environment to provide a framework to assist the prevention or management of intercat tension in households with two or more cats. Because feline social behavior is often misunderstood, the Guidelines debunk 10 common myths that have the potential to negatively impact the wellbeing of companion cats. Extensively illustrated with visual examples of intercat tension and an Appendix detailing a number of case studies, the Guidelines also include a comprehensive table of psychotherapeutic medications, and a detailed algorithm that outlines a systematic approach to preventing, recognizing and resolving intercat tension. A step-by-step approach to introducing a new cat into a household with one or more resident cats is included to further support veterinarians, and a range of management tools to promote client education accompany the Guidelines.

Residency program factors affecting ACVS board examination pass rates from 2017 to 2021: A survey of ACVS small animal surgery residency programs.

OBJECTIVE: To identify small animal surgery (SAS) residency program factors associated with board examination pass rates for the American College of Veterinary Surgeons (ACVS) board certification examinations. STUDY DESIGN: Online survey. SAMPLE POPULATION: Program directors of ACVS-registered SAS residency programs. METHODS: An online survey was distributed to eligible 2021 ACVS SAS residency program directors. Respondents provided program information and Phase I and Phase II board examination pass rate data from 2017 to 2021. Programs were grouped based on overall combined board examination pass rates as "excellent" (≥90%) versus "adequate" (<90%). Data were analyzed using recursive partitioning. RESULTS: Responses from 36 ACVS SAS residency programs (18 private practice [PP], 18 academic programs [AP]) were included. Pass rates were considered "excellent" for 17/36 programs (11/17 AP, 6/17 PP). The strongest indicator of "excellent" programs was most mentors participating in rounds >75% of the time. Of those, the second indicator of "excellent" programs was a soft tissue caseload of <7 surgeries/resident/week. If the soft tissue caseload was >7 surgeries/resident/week, a high orthopedic caseload (>9 surgeries/resident/week) was indicative of "excellent" programs. If most mentors were not participating in rounds >75% of the time, APs were more likely to be "excellent." CONCLUSION: SAS APs may have higher ACVS board examination pass rates. Mentor involvement, caseload, and residency practice type may influence board examination pass rates. CLINICAL IMPACT: ACVS SAS residency programs' board examination pass rates may improve by optimizing mentor involvement and caseload regardless of practice type.

Attitudes towards surgical safety checklists among American College of Veterinary Surgeons diplomates.

OBJECTIVE: To examine attitudes towards surgical safety checklists (SSCs) among American College of Veterinary Surgeons (ACVS) diplomates and to identify barriers to implementation. STUDY DESIGN: Qualitative online research survey. SAMPLE POPULATION: A total of 1282 current ACVS diplomates. METHODS: An anonymous online survey was distributed to current ACVS diplomates via email. ACVS diplomates were identified using publicly available data through the ACVS website. A total of 1282 surveys were electronically distributed, and respondents were given 4 weeks to respond. The survey consisted of 34 questions examining (1) demographic information, (2) current use of SSCs, (3) knowledge and attitudes towards SSCs, (4) perceived advantages and disadvantages to use of SSCs, (5) implementation strategies, and (6) potential reasons for noncompletion of SSCs. RESULTS: Survey response rate was 20% (257/1282). A total of 169 of 249 (67.9%) respondents indicated using SSCs. Respondents generally agreed that SSCs were proven to reduce surgical complications (196/249 [78.7%]) and did not perceive any disadvantages to use (100/138 [75.2%]). Respondents not using SSCs were more likely to perceive them as a waste of time (p < .001). The most common reasons for noncompletion of SSCs were forgetfulness (21/52 [39.6%]) and time constraints (19/52 [36.5%]). Improved training (72/138 [52.2%]) and modifying the SSC based on staff feedback (69/138 [50%]) were suggested as methods to improve SSC uptake. CONCLUSION: Respondents currently using SSCs were generally satisfied. Time constraints and memory related issues were common causes for noncompletion of SSCs. CLINICAL SIGNIFICANCE: Efforts to expand the implementation of SSCs in veterinary surgery should focus on improved engagement of relevant stakeholders and modification of the SSC to suit local conditions.

Thromboelastographic results and hypercoagulability in dogs with surgically treated hepatocellular adenoma and carcinoma: A Veterinary Society of Surgical Oncology prospective study.

BACKGROUND: The most common haemostatic abnormality in dogs with cancer is hypercoagulability. A transient hypercoagulability has been documented in people with hepatocellular carcinoma (HCC) that resolves within weeks following hepatic tumour resection. OBJECTIVE: The objective was to compare the haemostatic status of dogs with liver tumours and healthy control dogs, by comparing coagulation and thromboelastography (TEG) measurements at three time points. METHODS: Liver tumour and healthy control dogs receiving surgery for liver lobectomy and ovariohysterectomy, respectively, were prospectively enrolled. All dogs had blood collected at three time points: pre-operative, 24 h post-operative and ~2 weeks post-operative. Haematological and haemostatic values were compared across time points in each group using repeated measures ANOVA tests. RESULTS: Ten and eight dogs were enrolled for the liver and control groups, respectively. Platelet count was significantly higher in the liver group than the control group at all time points, but within the normal range (pre-operative: 438.7 vs. 300.9 × 109 /L, p = .0078; 24 h post-operative: 416.2 vs. 283.9 × 109 /L, p = .0123; 10-14 days post-operative: 524.6 vs. 317.3 × 109 /L, p = .0072). The measure of the overall coagulant state (G-value) was significantly increased for the liver group compared to the control group at all time points (pre-operative: 15.6 vs. 8.6 d/sc, p = .0003; 24 h post-operative: 18.3 vs. 11.2 d/sc, p = .039; 10-14 days post-operative: 15.1 vs. 9.6 d/sc, p = .015). CONCLUSION: The liver group was hypercoagulable based on elevated G-values at all time points compared to the control group. This hypercoagulability was attributed to the effect of hepatic tumours alone, and not secondary to surgery and anaesthesia.

Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi-institutional, retrospective, Veterinary Society of Surgical Oncology study.

OBJECTIVE: The objective of this study was to describe the clinical features, prognostic factors, and outcomes in dogs with surgically treated salivary gland carcinoma. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Seventy-two client-owned dogs from 16 institutions with surgically excised salivary gland carcinoma. METHODS: Medical records of dogs undergoing sialoadenectomy from January 1, 2000 to January 1, 2020 were reviewed for signalment, clinical signs, preoperative staging results, preoperative mass evaluation, complications, histopathologic diagnosis, local recurrence, metastatic disease, and survival times. Survival functions were estimated using the Kaplan-Meier estimator. Factors related to survival were individually tested using the log-rank test. RESULTS: The overall median survival time (MST) associated with salivary carcinoma was 1886 days. Local recurrence occurred in 29/69 (42%) dogs with an overall disease-free interval (DFI) of 191 days. Metastatic disease occurred in 22/69 (31.9%) dogs, with an overall DFI of 299 days. Lymph node metastasis was present at the time of surgery in 11/38 (28.9%) dogs in which lymphadenectomy was performed at the time of surgery; these dogs had a shorter DFI at 98 days (P = .03) and MST at 248 days (P < .001). CONCLUSION: The prognosis for dogs with salivary gland carcinoma treated surgically was more favorable than previously reported. Nodal metastasis was a negative prognostic factor for canine salivary gland carcinoma. CLINICAL SIGNIFICANCE: Surgical intervention should be considered for dogs with salivary carcinoma.

Risk factors and outcome in dogs with recurrent massive hepatocellular carcinoma: A Veterinary Society of Surgical Oncology case-control study.

Local recurrence after surgical excision of canine massive hepatocellular carcinoma (HCC) has been poorly studied in veterinary medicine with scant information published regarding risk factors for and outcome following recurrence. The aim of this case-control study was to describe the time to recurrence, evaluate potential risk factors for recurrence, and report the outcome in dogs with massive HCC. Medical records for 75 dogs who developed recurrence and 113 dogs who did not develop recurrence were reviewed. Statistical analyses were performed to determine risk factors for recurrence as well as the median time to develop recurrence and overall survival time (OS). None of the risk factors evaluated were significant for the development of recurrence. The median time to develop recurrence was 367 days (range 32-2096 days). There was no significant difference in median OS for dogs who developed recurrence vs. those who did not (851 vs. 970 days). For dogs with recurrent HCC, treatment at recurrence trended toward prolonged OS but was not significantly different from dogs not undergoing treatment at recurrence. There was no significant difference in median OS for dogs with histologically complete vs. incomplete tumour excision (990 vs. 903 days). Although specific risk factors for recurrence were not identified, elevations in liver values were noted in patients with recurrent disease and could act as a noninvasive surveillance tool. Recurrence was noted earlier in dogs who had routine post-operative surveillance (228 vs. 367 days). Routine surveillance for recurrence is recommended especially in dogs where further intervention is possible and should extend beyond 1 year. Patients with massive HCC have a good long-term prognosis regardless of incomplete excision, pulmonary metastasis, or recurrent local disease.

Outcome with surgical treatment of canine soft tissue sarcoma in the region of the ischiatic tuberosity: A veterinary society of surgical oncology retrospective study.

The aim of this study was to determine the outcome of dogs with soft tissue sarcoma (STS) within the region of the ischiatic tuberosity (ITSTS) treated surgically. This was a multi-institutional retrospective study. Fifty-two dogs met the inclusion criteria, which were: histologically confirmed STS in the region of the IT treated with surgical resection between March 1st, 2009 and March 1st, 2021 with a minimum follow-up time of 6 months. Data collected included patient signalment, preoperative diagnostics, surgical intent/method, surgical complications, histopathology, margins, outcome and cause of death. Statistical analyses were performed to determine significant factors in the treatment and prognosis of ITSTS. Overall survival time (OST) and disease progression were negatively associated with tumour grade, while recurrence was positively associated with grade and incomplete margins. Of the 52 included dogs, there were 24 grade I, 20 grade II and 7 grade III tumours. Forty dogs had reported histopathologic margins of which 26 were reported to be complete and 14 were incomplete. OST and progression-free survival was not reached for tumours graded as I or II and was 255 and 268 days respectively, for grade III. Median time to recurrence was not reached for tumours excised with complete margins and was 398 days for those with incomplete margins. The surgical complication rate was 25%. ITSTS was not found to be a unique clinical entity in dogs as tumour behavior, treatment recommendations, and prognosis were similar to STS in other locations, with overall outcome and prognosis influenced by histologic grade and margins. While surgical complications were common, none resulted in significant morbidity or mortality.

Outcomes of cats treated with maxillectomy: 60 cases. A Veterinary Society of Surgical Oncology retrospective study.

Maxillectomy is poorly described for the management of oral tumours in cats and is occasionally not recommended because of the high complication rate and sub-optimal outcome reported in cats treated with mandibulectomy. The purpose of this study was to retrospectively evaluate the complications and oncologic outcome in cats treated with maxillectomy. Sixty cats were included in the study. Maxillectomy procedures included unilateral rostral (20.0%), bilateral rostral (23.3%), segmental (10.0%), caudal (20.0%) and total unilateral maxillectomy (26.7%). Intra-operative and post-operative complications were reported in 10 (16.7%) and 34 (56.7%) cats, respectively. The most common post-operative complications were hyporexia (20.0%) and incisional dehiscence (20.0%). The median duration of hyporexia was 7 days. Benign tumours were diagnosed in 19 cats (31.7%) and malignant tumours in 41 cats (68.3%). Local recurrence and metastatic rates were 18.3% and 4.9%, respectively; the median progression-free interval (PFI) was not reached. The disease-related median survival time was not reached overall or for either benign or malignant tumours. The 1- and 2-year survival rates were, respectively, 100% and 79% for cats with benign tumours, 89% and 89% for cats with malignant tumours, 94% and 94% for cats with fibrosarcomas, 83% and 83% for cats with squamous cell carcinomas, and 80% and 80% for cats with osteosarcomas. Poor prognostic factors included mitotic index for PFI, adjuvant chemotherapy for both PFI and survival time, and local recurrence for survival time. Maxillectomy is a viable treatment option for cats resulting in good local tumour control and long survival times.

Golden retriever pigmentary uveitis: Challenges of diagnosis and treatment.

Pigmentary uveitis (PU), also known as Golden Retriever Pigmentary Uveitis (GRPU), is a common ocular condition of Golden Retrievers that has severe, vision-threatening ocular complications and can require surgical intervention. In order to ensure consistency in the diagnosis of GRPU between examiners, a specified set of diagnostic criteria must be applied. This is critical to ensure owners, breeders, and veterinary ophthalmologists maintain confidence in the ocular certification process. Therefore, current and former members of the American College of Veterinary Ophthalmologists' Genetics Committee came together to draft this Viewpoint Article on the challenges of diagnosis and treatment of Golden Retriever Pigmentary Uveitis for veterinary ophthalmologists, Golden Retriever owners, and Golden Retriever breeders.

Outcome comparison between radiation therapy and surgery as primary treatment for dogs with periarticular histiocytic sarcoma: An Italian Society of Veterinary Oncology study.

Localized histiocytic sarcoma may occur as a primary lesion in periarticular tissues of large appendicular joints. Treatment options for the primary lesion include radical surgical excision, radiation therapy (RT), or both, in combination with chemotherapy for potential systemic metastases. In an effort to better characterize the time to progression (TTP) following surgical vs non-surgical approaches for periarticular histiocytic sarcoma (PAHS), a contemporary European population of affected dogs was retrospectively surveyed. Medical records were queried for newly-diagnosed PAHS cases undergoing surgery (predominantly limb amputation) or RT followed by systemic chemotherapy. Of 49 dogs, 34 underwent RT and 15 underwent surgery. All dogs received adjuvant chemotherapy. There was no statistically significant difference in TTP or overall survival between groups. The median TTP was 336 days for the operated dogs and 217 days for the irradiated dogs (P = .117). The median overall survival time was 398 days for the operated dogs and 240 days for the irradiated dogs (P = .142). On multi-variable analysis, the variables significantly associated with an increased risk of both tumour progression and tumour-related death were regional lymph node and distant metastasis at admission. Survival and local control rates following RT may be comparable to radical resection. These data may better inform shared decision-making processes between multi-disciplinary care providers and owners.

Perioperative complications and outcome after surgery for treatment of gastric carcinoma in dogs: A Veterinary Society of Surgical Oncology retrospective study of 40 cases (2004-2018).

OBJECTIVE: To describe the clinical characteristics, perioperative complications, and outcomes in dogs surgically treated for gastric carcinoma. STUDY DESIGN: Multi-institutional retrospective case series. ANIMALS: Forty client-owned dogs with histologically confirmed gastric carcinoma. METHODS: Medical records were reviewed for preoperative diagnostics, surgery, histopathology, postoperative complications, adjuvant chemotherapy, disease progression, and survival. Variables were assessed for associations with outcome by using Cox proportional hazards regression analysis. RESULTS: Surgical treatment included partial gastrectomy (28 dogs), Billroth I (9 dogs), subtotal gastrectomy (2 dogs), and submucosal resection (1 dog). Major postoperative complications occurred in 8 of 40 dogs, including septic peritonitis secondary to dehiscence in 4 dogs. The median progression free interval was 54 days, and the median survival time (MST) was 178 days (range, 1-1902). According to multivariable analysis results, experiencing an intraoperative complication was associated with an increased risk of death (hazard ratio [HR] 3.5, 95% CI 1.1-9.8, P = .005), and administration of adjuvant chemotherapy correlated with an improved survival (HR 0.4, 95% CI 0.2-0.9, P = .03). CONCLUSION: In this population of dogs, MST exceeded historically reported data, major postoperative complication rates were comparable to established literature, and administration of adjuvant chemotherapy was associated with improved survival. CLINICAL SIGNIFICANCE: Results from this study may be used to counsel owners more accurately regarding prognosis for dogs undergoing surgical excision for gastric carcinoma.

ACVIM consensus statement on the diagnosis of immune-mediated hemolytic anemia in dogs and cats.

Immune-mediated hemolytic anemia (IMHA) is an important cause of morbidity and mortality in dogs. IMHA also occurs in cats, although less commonly. IMHA is considered secondary when it can be attributed to an underlying disease, and as primary (idiopathic) if no cause is found. Eliminating diseases that cause IMHA may attenuate or stop immune-mediated erythrocyte destruction, and adverse consequences of long-term immunosuppressive treatment can be avoided. Infections, cancer, drugs, vaccines, and inflammatory processes may be underlying causes of IMHA. Evidence for these comorbidities has not been systematically evaluated, rendering evidence-based decisions difficult. We identified and extracted data from studies published in the veterinary literature and developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria for IMHA, comorbidities, and causality. Succinct evidence summary statements were written, along with screening recommendations. Statements were refined by conducting 3 iterations of Delphi review with panel and task force members. Commentary was solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted. The resulting document is intended to provide clinical guidelines for diagnosis of, and underlying disease screening for, IMHA in dogs and cats. These should be implemented with consideration of animal, owner, and geographical factors.

Effect of surgical site infection on survival after limb amputation in the curative-intent treatment of canine appendicular osteosarcoma: a Veterinary Society of Surgical Oncology retrospective study.

OBJECTIVE: To determine the influence of surgical site infection (SSI) on the median disease-free interval (DFI) and median survival time (MST) in dogs after amputation in the curative-intent treatment of appendicular osteosarcoma (OSA). STUDY DESIGN: Multi-institutional retrospective cohort study. ANIMALS: Fifteen dogs with OSA and SSI, and 134 dogs with OSA and no SSI. METHODS: Medical records were reviewed, and dogs were included if the following criteria were met: histologic confirmation of OSA, no evidence of metastasis, ≥1 chemotherapy treatment, and available follow-up data. We used the definition of SSI from the Centers for Disease Control and Prevention. Kaplan-Meier estimates of median DFI and MST for the SSI and non-SSI groups were compared by log-rank test. Univariate and multivariate Cox proportional hazard regression analysis was evaluated for associations with DFI and survival. RESULTS: The median DFI and MST of all OSA dogs were 236 days (95% CI, 181-283) and 283 days (95% CI 237-355), respectively. The median DFI of dogs with SSI (292 days) did not differ from that of dogs without SSI (224 days, P = .156). The MST of dogs with SSI (292 days) did not differ from that of dogs without SSI (280 days, P = .417). Failure to complete chemotherapy was associated with decreased DFI and survival (P < .001). Adjustments for chemotherapy completion found no effect of SSI on survival. CONCLUSION: SSI did not influence the survival of dogs with appendicular OSA treated with amputation and curative-intent treatment. CLINICAL SIGNIFICANCE: The extended survival associated with SSI after limb-spare surgery for OSA does not appear to be present after amputation. Interactions between the canine immune system and OSA warrant additional study.

Teaching and proficiency assessment for arthroscopy in veterinary surgery: A 2017 survey of diplomates and residents of the American and European College of Veterinary Surgeons.

OBJECTIVE: To determine current methods of arthroscopic skills training and proficiency assessment, identify skills considered fundamental to arthroscopy, and evaluate desire for a formal training and assessment program. STUDY DESIGN: Anonymized electronic survey. SAMPLE POPULATION: Diplomates and residents of the American College of Veterinary Surgeons (ACVS) and European College of Veterinary Surgeons (ECVS). METHODS: An electronic survey was distributed in commercial software (Qualtrics, Provo, Utah). Questions were divided into 4 categories: (1) demographics, (2) arthroscopy experience, (3) teaching, and (4) proficiency assessment. Descriptive statistical analysis was performed. Comparisons between groups were performed by using χ2 , t tests, and 1-way ANOVA (P ≤ .05). RESULTS: In total, 429 diplomates and 149 residents responded (response rate 28%). Overall, 80% of respondents trained using clinical cases. Barriers to simulator training included cadaver/simulator availability and time. Skills deemed most fundamental included anatomic knowledge, precise portal placement, triangulation, and image orientation. Overall, 90% of respondents supported a formal training program with requirement to demonstrate proficiency; 80% believed this should be part of standard ACVS/ECVS residency training. CONCLUSION: Arthroscopic skills are taught by using clinical cases, with subjective proficiency assessment. Fundamental skills are those that may be taught using simulators. There is enthusiasm for formal arthroscopic skills training and assessment. CLINICAL SIGNIFICANCE: Improved acquisition and assessment of fundamental arthroscopic skills is indicated. A validated methodology for formal training using simulators, minimizing morbidity, and facilitating objective evaluation is warranted. This is the first phase of a project to develop and validate a simulator program.