Sustainability policies and practices at veterinary centres in the UK and Republic of Ireland.

BACKGROUND: Veterinary professionals operate at the human-animal-environment interface and are concerned about sustainability issues. This study examined the extent to which sustainability is represented in policy and enacted in veterinary practice settings, as reported by practice representatives. METHODS: An online survey was completed by 392 veterinary centre representatives in the UK and Republic of Ireland to identify existing policies and practices around the environmental impacts of veterinary services and animal husbandry, responsible medicine use, animal welfare and social wellbeing. RESULTS: A minority of respondents were aware of an environmental policy at their practice (17%, 68/392). Many others were undertaking waste reduction initiatives, but wider environmental interventions were infrequently reported. The majority were aware of medicine stewardship and animal welfare policies or guidelines, but a minority reported social wellbeing policies (40%, 117/289) and the provision of advice to clients on the environmental impacts of animal husbandry (31%, 92/300). LIMITATIONS: The bias arising from the small convenience sample of practice representatives and potential discrepancies between the claims of survey respondents and their practices' policies and activities are acknowledged. CONCLUSION: Results depict a value-action gap between the concern of veterinary professionals towards sustainability and the policies and practices at their workplaces. Building on progress in the sector, wider adoption of comprehensive policies and practices, with guidance, could enhance veterinary contributions to the sustainability agenda, in particular to mitigate the environmental externalities of veterinary services and animal care and ensure safe, fair and inclusive workplaces.

Thoracic dog bite wounds in dogs: A retrospective study of 123 cases (2003-2016).

OBJECTIVE: To report the clinical, radiographic, and surgical findings and determine prognostic factors for outcome in dogs with thoracic dog bite wounds. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n = 123). METHODS: Medical records of dogs with thoracic dog bite wounds between October 2003 to July 2016 were reviewed for presenting findings, management, and outcomes. Standard wound management included debridement and sterile probing, extending the level of exploration to the depth of the wound. Univariable and multivariable binary logistic regression were used to assess risk factors for exploratory thoracotomy, lung lobectomy, and mortality. RESULTS: Twenty-five dogs underwent exploratory thoracotomy, including lung lobectomy in 12 of these dogs. Presence of pneumothorax (odds ratio [OR] 25.4, confidence interval (CI) 5.2-123.2, P < .001), pseudo-flail chest (OR 15.8, CI 3.2-77.3, P = .001), or rib fracture (OR 11.2, CI 2.5-51.2, P = .002) was associated with increased odds of undergoing exploratory thoracotomy. Presence of pleural effusion (OR 12.1, CI 1.2-120.2, P = .033) and obtaining a positive bacterial culture (OR 23.4, CI 1.6-337.9, P = .021) were associated with increased odds of mortality. The level of wound management correlated with the length of hospitalization (Spearman rank order correlation = 0.52, P < .001) but was not associated with mortality. CONCLUSION: Dogs that sustained pseudo-flail chest, rib fracture, or pneumothorax were more likely to undergo exploratory thoracotomy. Nonsurvival was more likely in dogs with pleural effusion or positive bacterial culture. CLINICAL SIGNIFICANCE: Presence of pseudo-flail, rib fracture, or pneumothorax should raise suspicion of intrathoracic injury. Strong consideration should be given to radiography, surgical exploration, and debridement of all thoracic dog bite wounds.

Thoracic dog bite wounds in cats: a retrospective study of 22 cases (2005-2015).

OBJECTIVES: The aim of this study was to describe a series of cats suffering from thoracic dog bite wounds, in order to detail the clinical, radiographic and surgical findings, and evaluate outcomes and factors associated with mortality. METHODS: The medical records of cats with thoracic dog bite wounds presenting to a single institution between 2005 and 2015 were retrospectively reviewed. Data relating to clinical presentation, wound depth and management, radiographic findings, surgical findings and mortality were collected. Wound depth was defined as no external wound, superficial, deep or penetrating, and wound management was defined as conservative, exploratory or thoracic exploration. Statistical analyses were performed using Fisher's exact test, the Mann-Whitney U-test and the χ2 test. RESULTS: Twenty-two cats were included, of which two were euthanased on presentation. In cats where wound depth could be assessed (21/22), six had no external wounds, four had superficial wounds, three had deep wounds and eight suffered penetrating wounds. Sixteen cats also suffered wounds elsewhere, most commonly to the abdomen. Neither an abdominal wound nor abdominal surgery were associated with mortality. Pneumothorax was the most common radiographic finding (11/18). Individual radiographic lesions were not significantly associated with respiratory pattern, presence of pseudo-flail, need for thoracotomy or lung lobectomy, or survival. The presence of ⩾3 radiographic lesions was associated with the presence of a penetrating wound (P = 0.025) and with having thoracic exploration (P = 0.025). Local exploration was performed in 7/20 cats, while 8/20 underwent thoracic exploration. Wound management type was not significantly associated with mortality. Overall mortality rate was 27%. CONCLUSIONS AND RELEVANCE: Presence of ⩾3 radiographic lesions should raise suspicion of a penetrating injury and may be suggestive of injury requiring a greater level of intervention. The treating veterinarian should have a high index of suspicion for penetrating injury and be prepared in case thoracic exploratory surgery is necessary, particularly in the presence of pseudo-flail chest, pneumothorax or ⩾3 radiographic lesions.

Use of vacuum-assisted closure to maintain viability of a skin flap in a dog.

CASE DESCRIPTION: A 4-year-old sexually intact male Labrador Retriever-Poodle mix was admitted to the hospital for treatment of a wound in the left thoracic region. The wound had been debrided and primary closure had been performed by the referring veterinarian 4 days previously. CLINICAL FINDINGS: The dog had a 20-cm-long wound covered by a large flap of skin that extended caudally from the scapula over the left side of the thorax. A 3-cm defect was evident at the cranioventral aspect of the wound, from which purulent material was being discharged. The skin flap was necrotic, and the skin surrounding the flap was bruised. Signs of pain were elicited when the wound and surrounding region were palpated. Other findings, including those of thoracic radiography, were unremarkable. TREATMENT AND OUTCOME: The wound was debrided, and vacuum-assisted closure (VAC) was initiated for 3 days until a healthy bed of granulation tissue developed. A reconstructive procedure was performed with a rotation flap 3 days after VAC dressing removal. The VAC process was reinitiated 2 days following reconstruction because of an apparent failing of the skin flap viability. After 5 days of VAC, the flap had markedly improved in color and consistency and VAC was discontinued. Successful healing of the flap occurred without the need for debridement or additional intervention. CLINICAL RELEVANCE: Use of VAC led to a good overall outcome for the dog, with complete healing achieved. Additional evaluation of this technique for salvaging failing skin flaps is warranted in dogs, particularly considering that no reliable method for flap salvage in veterinary species has been reported to date.

Clinical outcome following pneumonectomy for management of chronic pyothorax in four cats.

Pneumonectomy is the resection of all lung lobes from one side of the thorax. The clinical findings, treatment and outcome of four cases of feline chronic pyothorax managed with exploratory thoracotomy and pneumonectomy are reported. All cases were initially medically managed with thoracic drain placement and antibiosis. However, resolution was not achieved with medical therapy and diagnostic imaging findings consistent with an area of abscessation or marked lung lobe consolidation were identified, supporting a decision for surgical management. Surgical exploration was performed via median sternotomy and, on the basis of gross inspection, non-functional lung was removed. A left-sided pneumonectomy was performed in three cats and a right-sided pneumonectomy in one. All cases survived to discharge and an excellent quality of life was reported on long-term follow-up. Pneumonectomy appears to be well tolerated in the cat.

Vaginourethroplasty as a salvage procedure for management of traumatic urethral rupture in a cat.

This report describes a cat that suffered pelvic urethral rupture associated with multiple pelvic fractures. A vaginourethroplasty was performed as a salvage procedure, via intrapelvic anastomosis of the proximal urethra to the caudal vagina, following failure of a primary urethral anastomosis. Urinary diversion was achieved via tube cystostomy and a vagino-urethral catheter was maintained for 3 days postoperatively. Anterograde cystourethrography was performed at 7 days and 14 days postoperatively. Absence of contrast leakage from the vagino-urethral anastomosis was documented at 14 days postoperatively and the tube cystostomy was removed. An Escherichia coli urinary tract infection was treated following removal of the tube cystostomy and subsequent urine culture revealed no evidence of urinary tract infection. The cat retained normal urinary continence and elimination behaviour during the 7-month follow-up period. Vaginourethroplasty could be considered as a salvage option for management of traumatic pelvic urethral rupture in the neutered female cat.

Successful surgical management of spontaneous gastric perforations in three cats.

BACKGROUND: In the veterinary literature, feline gastroduodenal ulcer disease has been described only in individual case reports or retrospective studies reporting small numbers of cats. Although its canine counterpart is commonly encountered, less is known about factors predisposing cats to gastroduodenal ulceration and potentially perforation. Similarly the outcome following treatment is not well reported in this species. REPORTED RISK FACTORS: In dogs, hepatic disease and administration of non-steroidal anti-inflammatory drugs (NSAIDs) have been reported as the two most common causes of gastroduodenal ulceration. In cats, only one clinical report so far has implicated an NSAID as a risk factor for spontaneous gastroduodenal perforation. FINDINGS AND PRACTICAL RELEVANCE: This report describes the historical and physical findings, as well as the treatment and outcome, in three cats with spontaneous gastric perforation that were receiving anti-inflammatory medication immediately prior to presentation. It highlights the importance of thorough patient evaluation in any cat presenting with non-specific clinical signs and a history of anti-inflammatory drug administration.

Evaluation of in vitro performance of suction drains.

OBJECTIVE: To assess the in vitro performance of suction drains. SAMPLE POPULATION: 11 drainage systems (3 rigid drains and 8 compressible drains [2 grenade type, 5 concertina type, and 1 pancake type]). PROCEDURES: A pressure transducer was connected to the patient end of each drainage system. Serial pressure measurements were obtained during incremental addition and removal of air into the reservoir of each system, followed by incremental addition of water. The volume of air removed to restore the initial suction was recorded. Maximum filling volume was compared with the stated reservoir volume. For compressible drains, the suction generated following 3 compression methods was compared. RESULTS: The initial suction generated by the drainage systems ranged from -633.4 +/- 14.7 mm Hg to -90.1 +/- 19.5 mm Hg. Rigid drains had greater initial suction than compressible drains. For all compressible drains, compression with 2 hands, rather than 1, produced greater suction, apart from the pancake-type (200-mL reservoir) drains for which the reverse occurred. For grenade-type drains, rolling the reservoir from apex to base generated greater suction than 1-hand compression. Maximum filling volume was lower than stated for the concertina-type drains with 50-mL, 25-mL, and 400-mL reservoirs and the rigid-type drain with a 200-mL reservoir. As increments of air or water were added, compressible drains lost suction rapidly up to a fill of 20% to 30% and then more gradually. Rigid drains lost suction more slowly. CONCLUSIONS AND CLINICAL RELEVANCE: Drainage systems varied widely in their initial suction and rate of loss of suction during filling.

Use of a latissimus dorsi myocutaneous flap for one-stage reconstruction of the thoracic wall after en bloc resection of primary rib chondrosarcoma in five dogs.

OBJECTIVE: To describe a thoracic wall reconstructive technique using a latissimus dorsi myocutaneous flap after en bloc resection of primary rib chondrosarcoma and report outcome in 5 dogs. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=5) with primary rib chondrosarcoma. METHODS: Medical records (2003-2005) were reviewed for signalment, staging investigations, surgical findings, complications, and outcomes. Owners and veterinary surgeons were contacted for outcome information. RESULTS: A latissimus dorsi myocutaneous flap provided an air-tight thoracic wall closure after chondrosarcoma resection. Paradoxical respiratory movement of the flap occurred; however, from physical examination and blood gas analysis (2 dogs), ventilation was adequate. All flaps survived, 1 had superficial skin necrosis distally and 2 had minor wound dehiscence. One dog without tumor-free margins died of tumor-related disease 56 days after surgery. Tumor recurrence did not occur in 4 dogs with tumor-free margins. One dog was euthanatized 10 months after surgery for unrelated disease; 3 dogs were alive at writing (median follow-up: 20 months; range, 18-27 months) and all had a satisfactory functional and cosmetic outcome. CONCLUSIONS: Reconstruction of ventral thoracic wall defects using a latissimus dorsi myocutaneous flap yields a functional, cosmetic outcome. CLINICAL RELEVANCE: A latissimus dorsi myocutaneous flap can be used as a successful 1-stage reconstructive technique for ventral thoracic wall defects.