Postoperative injectable opioid use and incidence of surgical site complications after use of liposomal bupivacaine in canine gastrointestinal foreign body surgery.

OBJECTIVE: To compare postoperative analgesic use and postoperative complications between dogs that received liposomal bupivacaine (LB) during surgical gastrointestinal foreign body (GIFB) removal and those that did not. STUDY DESIGN: Retrospective study. ANIMALS: Two hundred five dogs. METHODS: Medical records for all dogs with GIFB removal at the Purdue University Veterinary Hospital between May 2017 and August 2021 were searched. Incomplete records and dogs with less than 2 weeks' veterinary follow up were excluded. Data collected included: patient information, time until surgery, intraoperative findings, surgical data (including perforation at time of surgery, linear vs. solid, enterotomy vs. enterectomy), use of LB (including time and manner of administration), time to extubation after surgery, in-hospital postoperative analgesic use and duration, and postoperative complications. Fentanyl was noted as used/not used, quantified as mean hourly rate over 12 h intervals. All analyses were performed using commercial statistical software with p < .05 as the significance level. RESULTS: Dogs that received LB were heavier (n = 65, median 28.5 kg) than those that did not (n = 140, median 24.4 kg) (p = .005). Postoperative fentanyl use (p < .05 between 13 and 72 h) and hourly rates (p < .05 between 13 and 48 h) were less, and postoperative time in the intensive care unit (ICU) (p < .001) and hospital were shorter (p < .001) in dogs receiving LB. Postoperative wound complications were seen in 7/65 dogs (10.8%, 95% CI = 4.4-21.0%) with LB and 4/140 (2.9%, 95% CI = 0.8-7.2%) without LB (p = .039). CONCLUSION: Use of LB was associated with reduced postoperative analgesic use, and shortened ICU and hospital stay but also with wound complications. CLINICAL SIGNIFICANCE: Caution should be used when using LB in (clean) contaminated surgeries.

Influence of 4 drain configurations on fluid dispersal and retrieval in an instillation model.

OBJECTIVE: To describe and compare the pattern of fluid dispersal and retrieval in a novel instillation therapy system. STUDY DESIGN: In vitro experimental study. METHODS: A 10 cm2 square model was constructed using plastic sheeting secured to plexiglass, with a wound infusion catheter and Jackson-Pratt (JP) active suction drain positioned in 4 configurations: parallel, perpendicular, diagonal, and opposite. Fluid was instilled using the wound infusion catheter, allowed to dwell for 10 min, and retrieved using the JP drain. Two surface area calculations were made using imaging software: coloration with diluted methylene blue (MB) on photos, and filling with diluted contrast on fluoroscopic images. Fluid retrieval was recorded. Statistical analysis was performed using a mixed-effects linear model (p < .05). RESULTS: Configuration influenced fluid dispersion within the model (p = .0001); the diagonal configuration had the greatest surface area coverage (mean ± SD; 94.5 ± 2.4%) and the parallel configuration had the lowest surface area coverage (60.2 ± 2.9%). A dwell period increased fluid dispersal by an average of 4.0 ± 0.8% (p < .0001). Fluid retrieval exceeded 16.7 ± 1.5 mL (83.5 ± 7.5% volume instilled) for all configurations and was 0.5 ± 0.1 mL (2.5 ± 0.5% volume instilled) greater for MB than contrast agent (p < .0001). CONCLUSION: Perpendicular or diagonal configurations and low-viscosity fluid maximized fluid dispersion and retrieval. CLINICAL SIGNIFICANCE: Wound instillation therapy involves delivering lavage fluid or medications to a closed wound space. This is feasible using a wound-infusion catheter and active suction drain. Configuration should be considered to optimize fluid dispersal and retrieval when planning instillation therapy.

Biomechanical evaluation of three adjunctive methods of orthopedic tension band-wire fixation to augment simulated patella tendon repairs in dogs.

OBJECTIVE: To evaluate the effects of three adjunctive methods of tension band wire fixation (TBWF) on the biomechanical properties, gap formation, and failure mode in simulated canine patella tendon rupture (RPT). STUDY DESIGN: Randomized, ex vivo. SAMPLE POPULATION: Paired hindlimbs from 32 dog cadavers. METHODS: Patellar tendons (PTs) and associated bone-muscle-tendon units were harvested. Each PT was transected then sutured using a core locking loop and simple continuous epitendinous pattern. Each hindlimb was randomly assigned to one of three groups (n = 18 hindlimbs/group) using 18 gauge 316 L wire, anchored to the tibial crest distally, to perform transpatellar, suprapatellar, or combined tension band-wire (TBW) augmentation. Ten hindlimbs were utilized as control specimens. Yield, peak, and failure loads, stiffness, loads to 1 and 3 mm gap formation, and failure mode were evaluated. RESULTS: Combined transpatellar and suprapatellar TBW augmentation was superior to transpatellar or suprapatellar groups alone. Yield (p = .0008), peak (p = .004), and failure loads (p = .005) were greater for the combined group than for the transpatellar (p = .048) and suprapatellar groups (p = .01) respectively. There was no difference regarding the occurrence of 1 or 3 mm gap formation (1 mm, p = .05; 3 mm, p = .06); however, loads required to cause gap formation were greater in the combined group (p = .036). Mode of failure differed between techniques used for PT augmentation (p < .001). CONCLUSION: Combined transpatellar and suprapatellar adjunctive TBW augmentation for simulated PT repairs was biomechanically superior to either transpatellar or suprapatellar TBWF alone. CLINICAL SIGNIFICANCE: Combined suprapatellar and transpatellar TBWF may offer a viable surgical option for increased repair-site strength and greater loads to gap formation. Further studies investigating alternative techniques and materials for RPT repair augmentation are warranted.

Complications and owner satisfaction associated with limb amputation in cats: 59 cases (2007-2017).

BACKGROUND: Limb amputation may be recommended in domestic cats following a severe injury or disease. The purpose of the study was to report the signalment, the complications, recovery outcome, owner satisfaction and expectations of domestic cats following limb amputation. RESULTS: Medical records of 3 specialty hospitals were reviewed for cats that received a single limb amputation in a 10 year period (2007-2017). These cat owners were contacted, and 59 owners completed surveys, comprising the study population. The most common reasons for limb amputation were neoplasia (54.2%, 32/59), traumatic injury (40.7%, 24/59), bone or joint infection (3.4%, 2/59), and thromboembolism (1.7%, 1/59). Thirty-four cats (57.6%) had postoperative complications. Of the fifty-nine surveys, 52.5% reported minor complications and 5.1% reported major complications. There were no differences in postoperative complication rates for thoracic versus pelvic limb amputations. All owners reported either excellent (77.9%, 46/59), good (20.3% 12/59), or fair (1.7%, 1/59) satisfaction with the procedure. Based on their previous experiences, 84.7% (50/59) of owners would elect limb amputation if medically warranted for another pet. The remaining 15.3% of owners who would not elect limb amputation again had experienced death of their pet with a median survival time of 183 days. CONCLUSION: Owners reported a positive satisfaction when considering complications, recovery outcome, and expectations. This study can be used by veterinarians to guide cat owners in the decision making process of limb amputation.

Influence of barbed suture oversew of the transverse staple line during functional end-to-end stapled anastomosis in a canine jejunal enterectomy model.

OBJECTIVE: To evaluate the influence of barbed suture oversew of the transverse staple line during functional end-to-end stapled anastomosis (FEESA) in dogs. STUDY DESIGN: Randomized, experimental, ex vivo. ANIMALS OR SAMPLE POPULATION: Grossly normal jejunal segments from 14 adult canine cadavers. METHODS: Ninety-eight jejunal segments (n = 14/FEESA group, n = 14 controls) were harvested and randomly assigned to a control group, FEESA + monofilament suture oversew, FEESA + unidirectional barbed suture oversew or FEESA + bidirectional barbed suture oversew. Oversew techniques were performed using a Cushing suture pattern. Initial (ILP) and maximum leakage pressure (MLP), repair time (s), and location of observed leakage were recorded. RESULTS: No differences were detected in ILP (p = .439) or MLP (p = .644) respectively between experimental groups. Repairs times using barbed suture were ~ 18% faster (~25 s faster; p < .001) compared to monofilament suture. There was no difference between barbed suture types (p = .697). Mean ILP (p < .001) and MLP (p < .0001) were 6.6x and 5.1x greater respectively in the control group. Leakage location occurred predominately at the crotch of the FEESA in all groups. CONCLUSION: FEESAs closed with a transverse staple line oversew using barbed suture, regardless of barb orientation, were completed faster and resulted in similar resistance to anastomotic leakage compared to monofilament suture. CLINICAL SIGNIFICANCE: Oversewing the transverse staple line following FEESA using barbed suture offers similar resistance to anastomotic leakage, and may be associated with decreased surgical times in dogs compared to monofilament suture. Further studies are necessary to determine the benefits of barbed suture use in both open and laparoscopic gastrointestinal surgical applications following FEESA in dogs.

Effect of calcanean bone-tunnel orientation for teno-osseous repair in a canine common calcanean tendon avulsion model.

OBJECTIVE: To determine the influence of bone-tunnel anchoring technique on teno-osseous repair of the common calcanean tendon (CCT) in dogs. STUDY DESIGN: Randomized, ex vivo, biomechanical. POPULATION: Forty-two skeletally mature canine hindlimbs. METHODS: Canine hindlimbs were dissected to produce a model simulating avulsion of the CCT and accessory tendons from the calcaneus. Hindlimbs were randomized to 1 of 3 anchoring techniques (n = 14/group): a single transverse tunnel (TT), vertical tunnels (VT), or modified bone tunnels (MT) for teno-osseous repair in a 3-loop-pulley (3LP) pattern using 0 USP polypropylene. Yield, peak and failure loads, construct stiffness, loads to produce a 3 mm teno-osseous gap, and failure modes were compared between groups. RESULTS: The only difference detected consisted of TT constructs yielding at loads 25% higher than MT constructs (P = .027). CONCLUSION: Although yield loads were lower in MT constructs than other groups, the bone-tunnel anchoring techniques tested here did not appear to influence the biomechanical properties or gapping characteristics of teno-osseous repairs in this canine CCT avulsion model. CLINICAL SIGNIFICANCE: All drilling techniques and bone-tunnel orientations tested in the study reported here offer viable options to reattach the CCT to the calcaneus. Surgeons should evaluate how bone-tunnel orientation may affect placement of adjunctive fixation methods to stabilize the talocrural joint after primary CCT repair in dogs.

Influence of crotch suture augmentation on leakage pressure and leakage location during functional end-to-end stapled anastomoses in dogs.

OBJECTIVE: To determine the influence of anastomotic crotch suture augmentation on leakage pressures and leakage location following intestinal functional end-to-end stapled anastomosis (FEESA) in dogs. STUDY DESIGN: Ex vivo, randomized, experimental. SAMPLE POPULATION: Chilled jejunal segments from 3 adult dogs. METHODS: Jejunal specimens were tested within 24 hours of collection. A FEESA was performed and randomly assigned to 1 of 4 treatment groups (n = 12/group): (1) no crotch suture (NCS); (2) simple interrupted crotch suture (SICS); (3) two simple interrupted crotch sutures (TCS) placed laterally on opposing jejunal limbs; (4) simple continuous crotch suture (SCCS) augmentation. Crotch sutures were performed using 3-0 USP polydioxanone. Initial (ILP) and maximal (MLP) leakage pressures (Mean ± SD mm Hg) and leakage location were recorded and compared between groups. RESULTS: Initial leakage pressure was greater after placement of TCS (37.8 ± 6.4, P < .039) and SCCS (47.6 ± 11.0, P < .002) than NCS (27.1 ± 2.5) and SICS (33.0 ± 6.0). Maximal leakage pressure was greater in specimens including SICS, TCS, and SCCS than those without crotch suture augmentation (P < .043). Leakage occurred at the anastomotic crotch in 8/12 NCS, 6/12 SICS, 11/12 TCS, and 12/12 SCCS constructs (P < .001). CONCLUSION: Augmentation of FEESA with TCS and SCCS increased ILP and decreased the occurrence of leakage from the anastomotic crotch, while all methods of anastomotic crotch augmentation increased MLP. CLINICAL SIGNIFICANCE: Augmenting the FEESA with crotch suture(s) improved the resistance of the jejunal anastomosis to leakage in normal cadaveric segments. Placing 2 crotch sutures or use of a simple continuous pattern for anastomotic augmentation appeared to be superior to the placement of a single suture.

Complete Blood Counts and Blood Smear Analyses in 312 Diabetic Dogs (2007-2017).

Diabetes mellitus is a common endocrinopathy in dogs that has been associated with various biochemical changes and comorbid diseases, but hematologic abnormalities have been rarely reported. The aim of this retrospective study was to evaluate complete blood count and blood smear alterations and to describe their relationship with, and incidence of comorbid diseases in, diabetic dogs. Three-hundred twelve diabetic dogs, 286 dogs diagnosed with systemic, nondiabetic illnesses, and 506 healthy dogs were identified during the study period. Groups were compared using contingency tables and logistic regression. Associations between statistically significant complete blood count and blood smear alterations and comorbidities were evaluated using multivariable analysis. High-grade codocytosis and anisocytosis were identified more frequently in diabetic dogs, whereas high-grade reactive lymphocytosis and keratocytosis were identified less frequently (P < .001). Diabetic dogs with high-grade codocytosis had lower red blood cell, hemoglobin, hematocrit and higher white blood cell counts (P < .001). Diabetic ketoacidosis was diagnosed more frequently in diabetic dogs with high-grade codocytosis when compared with those with low-grade codocytosis (P < .001) or when compared with any other cell morphologic alterations. This study suggests that blood smear analysis should be a routine part of the evaluation of diabetic dogs.

2022 AAHA Canine Vaccination Guidelines.

These guidelines are an update and extension of previous AAHA peer-reviewed canine vaccination guidelines published in 2017. Vaccination is a cornerstone of canine preventive healthcare and one of the most cost-effective ways of maintaining a dog's health, longevity, and quality of life. Canine vaccination also serves a public health function by forming a barrier against several zoonotic diseases affecting dogs and humans. Canine vaccines are broadly categorized as containing core and noncore immunizing antigens, with administration recommendations based on assessment of individual patient risk factors. The guidelines include a comprehensive table listing canine core and noncore vaccines and a recommended vaccination and revaccination schedule for each vaccine. The guidelines explain the relevance of different vaccine formulations, including those containing modified-live virus, inactivated, and recombinant immunizing agents. Factors that potentially affect vaccine efficacy are addressed, including the patient's prevaccination immune status and vaccine duration of immunity. Because animal shelters are one of the most challenging environments for prevention and control of infectious diseases, the guidelines also provide recommendations for vaccination of dogs presented at or housed in animal shelters, including the appropriate response to an infectious disease outbreak in the shelter setting. The guidelines explain how practitioners can interpret a patient's serological status, including maternally derived antibody titers, as indicators of immune status and suitability for vaccination. Other topics covered include factors associated with postvaccination adverse events, vaccine storage and handling to preserve product efficacy, interpreting product labeling to ensure proper vaccine use, and using client education and healthcare team training to raise awareness of the importance of vaccinations.

Evidence of acrolein in synovial fluid of dogs with osteoarthritis as a potential inflammatory biomarker.

BACKGROUND: Acrolein is a known pro-inflammatory toxic aldehyde, propagating cellular damage and tissue inflammation in humans and animal models of various diseases. Osteoarthritis (OA) has a significant inflammatory component; however, presence of acrolein in synovial fluid of joints with OA has not been previously reported. The first aim of this study was to evaluate evidence of acrolein in the synovial fluid of dogs with OA as well as in Control joints. The second aim was to determine if evidence of acrolein can be detected in synovial fluid samples that have been in a frozen state for long periods of time. METHODS: In this pilot clinical study, synovial fluid samples were prospectively collected (i.e., New samples) from a single joint of both clinically healthy (New Control, n = 5) and dogs with OA (New OA, n = 16) and frozen until the time of analysis. Additionally, frozen synovial fluid samples from a biobank (i.e., Old samples) were used to evaluate ability to detect evidence of acrolein in long-term stored samples (median of 4.89 years) in Old Control (n = 5) and Old OA (n = 5) samples. Measurements of acrolein in all synovial fluid samples was based on detection of its major protein adduct, N ε - (3-formyl-3, 4-dehydropiperidino)lysine (FDP-lysine), using the western blot method. Synovial fluid matrix metalloproteinase 2 (MMP2) was measured in all samples using the western blot method as a positive control of OA inflammation. RESULTS: Acrolein-lysine adduct was detected in both Control (n = 10) and OA (n = 21) groups in both Old and New samples. Acrolein-lysine adduct and MMP2 were detectable at a lower level in the Old compared to New synovial fluid samples; however, the differences were not statistically significant (p > 0.1). The measured MMP2 levels were significantly higher in the OA compared to Control group samples (p = 0.033), but not for acrolein-lysine adduct (p = 0.30). CONCLUSIONS: This study confirmed evidence of acrolein in canine synovial fluid of both OA and Control groups. Freezing of synovial fluid for up to 5 years does not appear to significantly affect the ability to detect acrolein-lysine adduct and MMP2 in these samples.

Influence of musical preferences and intraoperative questions on suturing speed.

OBJECTIVE: To determine the effect of music and surgeon-directed questions on suturing speed. STUDY DESIGN: Randomized observational study. SAMPLE POPULATION: Fifty-five faculty veterinarians, residents, interns, and fourth-year veterinary students. METHODS: Experience, gender, and favorable and unfavorable music choices were self-declared by participants. Each person performed four timed suture trials, which required them to complete a simple 10 cm continuous suture pattern on a model. The initial trial served as practice and did not include music or questions. The order of the three remaining trials was randomized, and consisted of one trial each with favorable music, unfavorable music, and required the participant to answer 2 questions. Trial duration was compared using a mixed effects linear model. Influence of gender and experience on participants' categorical responses to 2 different questions was evaluated using a Pearson χ2 test and Fisher's exact test, respectively. Stratified analysis was used to evaluate further the effect of experience and gender. RESULTS: Question trials were on average 8.1 s longer than favorable music trials (P = .008), with no notable difference found between unfavorable and favorable music or unfavorable music and question trials. Experience (P = .021) and gender (P = .033) influenced participants' response to question 1 but not question 2 (P = .267 and P = .839, respectively). CONCLUSION: Listening to favorable music, rather than answering questions, may result in decreased closure times. This influence was greater for less experienced individuals and less experienced male veterinarians and veterinary students. CLINICAL SIGNIFICANCE: The absence of questions may increase suturing speed, particularly for minimally experienced surgeons or when instruction is taking place in a surgical laboratory setting.

Evaluation of staple line reinforcement after partial gastrectomy closure in an ex vivo canine model.

OBJECTIVE: To determine the influence of stapling on leakage pressures after canine partial gastrectomy. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Gastric specimens from 24 adult canine cadavers. METHODS: Partial gastrectomy constructs were assigned to one of three closure techniques (n = 8 per group): group 1, stapled closure with a 90-mm thoracoabdominal stapling device and a 4.8-mm staple cartridge; group 2, hand-sewn double-layer inverting suture closure with 3-0 glycomer 631; and group 3, staple line reinforcement with an inverting Cushing suture pattern. Leakage and pressure testing were performed. Initial leakage pressure (ILP), maximal leakage pressure (MLP), and leakage location were recorded. Significance was set at P < .05. RESULTS: Placement of a Cushing suture (group 3) increased ILP and MLP by 3.2-fold and 2.8-fold, respectively, compared with stapled closures alone (P < .001). Constructs closed with double-layer suture closure reached ILP and MLP 4.5-fold and threefold greater, respectively, compared with those with stapled closures alone (P < .001). Maximal leakage pressure did not differ between groups 2 and 3 (P = .14). Leakage occurred from the inverting suture line in all constructs of groups 2 and 3 and from staple holes in six of eight group 1 constructs. CONCLUSION: Double-layer suture closure of canine partial gastrectomies achieved superior biomechanical properties compared with stapled closure techniques. Reinforcing staple closures with an inverting suture line improved resistance to leakage. CLINICAL SIGNIFICANCE: Reinforcing single-layer closure of partial gastrectomies with an inverting Cushing pattern is recommended to improve resistance to leakage. In vivo investigation is warranted to evaluate influence of closure technique on gastric healing, postoperative stasis, ischemic injury, and postoperative dehiscence.

Influence of preconstructed effector loop location using a barbed unidirectional suture on leakage pressures following canine enterotomy closure.

OBJECTIVE: To evaluate the influence of preconstructed effector loop location using a barbed unidirectional suture on leakage pressures following canine enterotomy closure. STUDY DESIGN: Randomized, experimental, cadaveric. ANIMALS OR SAMPLE POPULATION: Grossly normal jejunal segments from three canine cadavers. METHODS: Jejunal segments were harvested and randomly assigned based upon effector loop location from the beginning of the incisional line. Groups (n = 12/group) included 0 mm, 5 mm, 10 mm, 15 mm, and intact controls (n = 6/group), repaired using a 3-0 unidirectional barbed suture in a simple continuous pattern. Initial leakage pressure (ILP), maximum intraluminal pressure (MIP), repair time, and leakage location were recorded. RESULTS: Mean ILP for 0 mm group (24.42 ± 8.43 mmHg) was lower (p ≤ .001) compared to all experimental groups with ILP ~40% lower. There was no difference in MIP among experimental groups (p = .239). Repair time increased (p < .0001) as the distance of the effector loop increased ≥5 mm from the beginning of the incisional line. Leakage location differed among groups (p < .001) with leakage in the 0 mm group from the incisional line (75%), compared to leakage from predominantly from the suture holes in other groups, respectively. CONCLUSION: Effector loop location influenced ILP and leakage location. Effector loops placed at the beginning of the incisional line (0 mm) decreased ILP compared to loops placed at 5, 10, and 15 mm. CLINICAL SIGNIFICANCE: Effector loop location using a unidirectional barbed suture should be placed ≥5 mm from beginning of the incisional line for enterotomy closure. Further in vivo studies are necessary to determine the clinical significance of these findings.

Mastectomy in 25 small ruminants (2002-2019).

OBJECTIVE: To describe the outcome of small ruminants treated with unilateral and bilateral mastectomy by using three surgical techniques. STUDY DESIGN: Retrospective study. ANIMALS: Twenty-five small ruminants (24 goats and one sheep). METHODS: Medical records of animals that underwent mastectomy between November 1, 2002, and May 1, 2019, were reviewed. Follow-up information was obtained by telephone questionnaire with owners. Signalment, surgical data, intraoperative and postoperative complications, bacterial culture results, histopathologic diagnoses, short- and long-term outcomes, and other procedures performed were recorded. RESULT: Procedures consisted of six unilateral (with an elliptical incision) and 19 total (with inverted cloverleaf or elliptical skin incisions) mastectomies. All animals survived to hospital discharge. Intraoperative complications included contamination of the surgical site with mammary-gland fluid, hemorrhage, and difficulty dissecting skin from the mammary gland. Postoperative complications included seroma formation (7/25), surgical-site infection (5/25), and dehiscence of the skin incision (3/25). Mammary neoplasia was diagnosed in seven of 15 animals with histopathologic examination. No association was detected between surgical technique, diagnosis of neoplasia, and long-term outcome. Overall, client satisfaction was high. CONCLUSION: Mastectomy was effective at removing abnormally enlarged udders secondary to chronic mastitis, inappropriate lactation, idiopathic causes, or neoplasia and was associated with a low rate of complications in small ruminants. CLINICAL SIGNIFICANCE: Unilateral mastectomy with an elliptical skin incision or total mastectomy, preferably with inverted cloverleaf skin incision, may be indicated to remove diseased mammary tissue in small ruminants and can result in long-term survival with low morbidity and cosmetically pleasing results.

Biomechanical evaluation of a novel barbed suture pattern with epitendinous suture augmentation in a canine flexor tendon model.

OBJECTIVE: To determine the effect of a novel barbed suture pattern (NBSP) compared to a three-loop-pulley (3LP) with and without epitendinous suture (ES) augmentation on the biomechanical strength and gap formation of repaired canine tendons. STUDY DESIGN: Ex vivo, cadaveric, randomized, experimental study. SAMPLE POPULATION: Forty, adult superficial digital flexor tendons (SDFT). METHODS: SDFT were randomly assigned to one of four groups (n = 10/group). Sharp tenotomy was performed and repaired with 3LP, NBSP, 3LP + ES, and NBSP + ES. Constructs were tested to failure while evaluating yield, peak, and failure loads, loads at 1 and 3 mm gap formation, and failure mode. RESULTS: Constructs augmented with ES sustained 80% greater yield (p < .001), peak (p < .001), and failure (p < .001) loads, with no difference between 3LP + ES and NBSP + ES constructs regarding peak (p = .614), and failure forces (p = .865). Loads resulting in 1 and 3 mm gap formation were greater when constructs were augmented with an ES (p ≤ .003). Failure mode differed between groups (p < .001), occurring predominantly due to suture pull-through in 3LP and NBSP groups compared to tissue failure distant to the repair site in ES augmented constructs. CONCLUSION: Tendons repaired with the NBSP used in this study resisted similar forces as those repaired with 3LP. Augmentation with an ES improved the biomechanical properties of repaired constructs, including resistance to gap formation. CLINICAL RELEVANCE: The NBSP repair tested here may be advantageous over monofilament suture repair as it uses a similar-sized barbed core suture but eliminates the requirement for knot tying.

Biomechanical analysis of accessory tendon graft augmentation for primary gastrocnemius tendon reconstruction in dogs.

OBJECTIVE: To evaluate the effect of accessory tendon graft (ATG) augmentation as an adjunct to a core locking-loop (LL) and epitendinous suture (ES) repair in a gastrocnemius tendon (GT) model. STUDY DESIGN: Randomized, ex vivo, biomechanical. POPULATION: Twenty-two canine GT musculotendinous constructs. METHODS: GT repair constructs were randomly divided into two groups (n = 10/group). After transection, paired GT were repaired with LL + ES alone or with concurrent ATG augmentation. Yield, peak and failure loads, tensile loads required to create 1 and 3 mm gapping, and failure modes were evaluated. Four GT were used as intact controls for validation of testing methodology. ATG constructs were compared to LL + ES and control specimens. RESULTS: Yield (p < .0001), peak (p = .0001) and failure loads (p = .0003) were greater when ATG was used for repair. Greater force was required to cause 1 mm (p = .0001) and 3 mm (p = .0002) gap formation in the ATG group, however, the frequency of gap formation did not differ between groups. All repaired constructs failed exclusively by suture pull-through. CONCLUSION: Autologous ATG augmentation as an adjunct to primary GT repair increased yield, peak and failure forces by approximately 1.6×, 1.9×, 1.8× respectively and required 2.1× greater force to cause 1 and 3 mm formation respectively compared to LL + ES repairs alone. CLINICAL SIGNIFICANCE: ATG augmentation should be considered as an autologous method to support and strengthen the primary GT repair. These results justify studies to determine the effect of ATG on clinical function following graft harvest in dogs.

Caudal paramedian approach to cryptorchidectomy in 29 small ruminants (2011-2019).

OBJECTIVE: To describe a caudal paramedian approach to cryptorchidectomy in small ruminants. STUDY DESIGN: Retrospective case series. ANIMALS: Sheep (n = 20) and goats (n = 9) with cryptorchidism. METHODS: Medical records from January 2011 to July 2019 of small ruminants that underwent caudal paramedian cryptorchidectomy at our institution were retrospectively reviewed. Data from animal signalment, operative and postoperative complications, and client satisfaction were evaluated. RESULTS: Twenty sheep and nine goats underwent caudal paramedian cryptorchidectomy during the study period. The median age of rams was 2 months, and the median age of bucks was 3 months; median weights for rams and bucks were 20.5 kg (range, 14.5-41.3) and 28.1 kg (range, 12.9-82), respectively. Cryptorchidism was bilateral in 27.6% (8/29) of cases and unilateral in 72.4% (21/29). Among unilateral cases, 85.7% (18/21) were right sided and 14.3% (3/21) were left sided. Twenty-four of 29 (82.8%) cases were performed under sedation. One operative complication occurred in a 4-year-old 82 kg buck (rate, 3.4% [95% CI: 0.1%-17.2%]). Postoperatively, there were two minor and one major complications (rates, 6.9% [95% CI: 0.8%-22.1%] and 3.4% [95% CI: 0.1%-17.2%], respectively). Long-term follow-up (range, 8-117 months) reports described owner satisfaction and all animals doing well at the time of follow-up telephone call. CONCLUSION: Caudal paramedian approach to cryptorchidectomy was safely performed in small ruminants less than 4 months old. CLINICAL SIGNIFICANCE: Ease of surgical technique, minimal operative and postoperative complications, and owner satisfaction make this a suitable method for cryptorchidectomy.

Golden retriever pigmentary uveitis: Vision loss, risk factors for glaucoma, and effect of treatment on disease progression.

OBJECTIVE: In previous reports, almost half of Golden Retrievers with Pigmentary Uveitis (GRPU) have lost vision in an eye within a year of diagnosis. The purpose of this study was to determine the proportion of GRPU affected dogs with vision loss, risk factors for the development of glaucoma, and effect of treatment on disease progression. ANIMALS STUDIED: Client owned Golden Retrievers. PROCEDURES: Two complete ophthalmic examinations were performed at least 6 months apart. Visual status, presence of glaucoma, GRPU score, and treatment were recorded. A proportional odds (ordinal logistic) model was fitted to determine whether the use of topical steroidal or non-steroidal (NSAID) ophthalmic preparations was associated with a change in GRPU scores. RESULTS: Twenty-nine Golden Retrievers, 58 eyes, were included. One eye was enucleated after the first examination. On first examination, 57/58 (98.3%) eyes and 29/29 (100%) dogs were visual. At the second examination, 48/57 (84.2%) eyes and 25/29 (86.2%) dogs were visual. Vision loss in 7/9 (77.8%) eyes was secondary to glaucoma. Posterior synechia and fibrinous material in the anterior chamber were significant risk factors for the development of glaucoma (P < .001). There was no significant difference in the change in GRPU score between eyes receiving topical steroids and topical NSAIDs (P = .14). Time between examinations was a significant factor in disease progression (increased GRPU score; P = .016). CONCLUSION: The number of eyes and dogs that retained vision was higher than previous reports. No topical treatment was superior in slowing disease progression. Golden Retriever Pigmentary Uveitis is a slowly progressive disease.

Influence of oversewing the transverse staple line during functional end-to-end stapled intestinal anastomoses in dogs.

OBJECTIVE: To determine the effect of oversewing the transverse staple line after functional end-to-end stapled intestinal anastomoses (FEESA) on canine jejunal leakage pressures. STUDY DESIGN: Experimental, ex vivo, randomized study. SAMPLE POPULATION: Jejunal segments from three adult canine cadavers. METHODS: Jejunal segments were harvested within 2 hours of euthanasia and anastomosed (24 jejunal segments per group, consisting of two segments per construct with n = 12/ group). Constructs were then randomly assigned to receive FEESA alone, FEESA + Cushing oversew, or FEESA + simple-continuous oversew of the transverse staple line with 3-0 polydioxanone. Results for initial leakage pressure (ILP) and maximal leakage pressure (MLP) and initial leakage location (LL) were compared between groups. RESULTS: Mean ILP was 1.8-fold higher for FEESA + Cushing oversew (62.4 ± 7.8 mm Hg) compared with FEESA alone and FEESA + simple-continuous oversew (P < .001). Mean MLP were higher for both oversewn techniques compared with FEESA alone (P < .001). Oversewing the transverse staple line with either pattern increased mean MLP by 1.4-fold compared with FEESA alone. Leakage occurred at the level of the transverse staple line in nonoversewn constructs (P < .001). CONCLUSION: Oversewing the transverse staple line after FEESA increased MLP and decreased the occurrence of leakage at this location. Oversewing with a Cushing pattern increased ILP compared with oversew with a simple-continuous pattern. CLINICAL SIGNIFICANCE: Our results provide evidence to support oversewing the transverse staple line after FEESA. Doing so may reduce the occurrence of postoperative dehiscence. These findings warrant additional focused investigation in vivo through a prospective randomized clinical trial.

Repeatability of in vitro carboplatin elution from carboplatin-impregnated calcium sulfate hemihydrate beads made in a clinic setting.

OBJECTIVE: To evaluate the intra-lot and inter-lot consistency and total carboplatin elution over 25 days from carboplatin-impregnated calcium sulfate hemihydrate (C-I CSH) beads manufactured in a clinic setting. STUDY DESIGN: In vitro elution study. METHODS: Two volumes of carboplatin were mixed with CSH to yield 4 mg and 8 mg C-I CSH doses. Two lots of beads were made for each concentration and split into five doses (n = 10 per concentration). Beads hardened in molds and were placed in a covered six-well plate, submerged in phosphate-buffered saline, and incubated with samples collected at 12 time points (0, 6, 12, and 24 hours and 2, 3, 5, 7, 10, 14, 18, and 25 days). The amount of carboplatin in each sample was evaluated by high-performance liquid chromatography/mass spectrometry. Correction for carboplatin degradation and dilution was applied, and eluted carboplatin was calculated. Intra-lot and inter-lot coefficient of variation (CV) was calculated for each concentration. RESULTS: The intra-lot CV ranged between 7.9% and 23.1%, and the inter-lot CV ranged from 3.5% to 10.3%, with improvement noted in each successive lot of beads. Mean peak eluted carboplatin was 2.45 ± 0.43 mg (61%) and 3.68 ± 0.41 mg (45.9%) for the 4-mg and 8-mg C-I CSH beads, respectively, with both occurring at the 12-hour timepoint. CONCLUSION: Progressive improvement in variability with successive lots of beads indicated a learning curve with bead manufacturing with a low variation both within and between lots of C-I CSH beads. CLINICAL SIGNIFICANCE: On-site mixing of carboplatin with commercial CSH bead powder leads to a low variation of carboplatin per bead dose.