Ex vivo comparison of pin placement with patient-specific drill guides or freehand technique in canine cadaveric spines.

OBJECTIVE: To compare vertebral implant placement in the canine thoracolumbar spine between 3D-printed patient-specific drill guides (3DPG) and the conventional freehand technique (FH). STUDY DESIGN: Ex vivo study. ANIMALS: Cadaveric canine spines (n = 24). METHODS: Implant trajectories were established for the left and right sides of the T10 through L6 vertebrae based on computed tomography (CT) imaging. Customized drill guides were created for each vertebra of interest. Each cadaver was randomly assigned to one of six veterinarians with varying levels of experience placing vertebral implants. Vertebrae were randomly assigned a surgical order and technique (3DPG or FH) for both sides. Postoperative CT images were acquired. A single, blinded observer assessed pin placement using a modified Zdichavsky classification. RESULTS: A total of 480 implants were placed in 240 vertebrae. Three sites were excluded from the analysis; therefore, a total of 238 implants were evaluated using the FH technique and 239 implants using 3DPG. When evaluating implant placement, 152/239 (63.6%) of 3DPG implants were considered to have an acceptable placement in comparison with 115/248 (48.32%) with FH. Overall, pin placement using 3DPG was more likely to provide acceptable pin placement (p < .001) in comparison with the FH technique for surgeons at all levels of experience. CONCLUSION: The use of 3DPG was shown to be better than the conventional freehand technique regarding acceptable placement of implants in the thoracolumbar spine of canine cadavers. CLINICAL SIGNIFICANCE: Utilizing 3DPG can be considered better than the traditional FH technique when placing implants in the canine thoracolumbar spine.

An avian Modified Glasgow Coma Scale as a prognostic indicator in raptors with head trauma.

OBJECTIVE: To develop a Modified Glasgow Coma Scale (MGCS) for use in raptors presenting with head trauma and assess the agreement of the MGCS scores between examiners with varying backgrounds, and to assess the prognostic value of the avian MGCS in raptors with head trauma. ANIMALS: 156 native raptorial species. METHODS: All raptors received an MGCS assessment within 8 hours of their presentation, between January 1, 2018, and December 31, 2019. For the first objective, the assessment was performed by a veterinary student, a wildlife veterinarian, and a board-certified or resident veterinary neurologist. Each animal received a score in 3 categories (motor activity, level of consciousness, and brain stem reflexes) and an overall score. For the second objective, the MGCS scoring was performed by the intaking clinical team member and survival after 48 hours was documented. RESULTS: Agreement between the 3 individual scores was assessed via Cronbach α and intraclass correlation. There was excellent-good agreement in all 3 assessment categories as well as the overall score. Univariate associations between survival and demographic factors were determined using the χ2 test. Overall, raptors with a total MGCS of < 10 were less likely to survive than those with a score > 12. CLINICAL RELEVANCE: An avian-specific MGCS demonstrated good-excellent agreement among raters of various backgrounds in assessing raptors with head trauma. Additionally, this study showed that an avian-specific MGCS may be correlated with the probability of survival within the first 48 hours after presentation to rehabilitation facilities in raptors with head trauma.

A rare finding of double Barr bodies and X-monosomy/X-trisomy mosaicism in a dog with presumed idiopathic epilepsy.

A 4-year-old spayed female Border Collie dog presented to the Neurology and Neurosurgery service for an approximately five-month history of seizures. A complete neurodiagnostic workup was performed and did not reveal any significant abnormalities. The patient's seizures were well controlled with a combination of anticonvulsants. During a manual blood smear review at a follow-up appointment, double Barr bodies were identified in segmented neutrophils. Karyotyping revealed that the patient is mosaic for X-monosomy and X-trisomy, a finding that has never been reported in a dog and is rarely reported in people. This case demonstrates how the identification of abnormal neutrophil nuclear appendages may correlate with chromosomal abnormalities in dogs.

The pharmacokinetics of single oral dose extended-release topiramate and adverse effects after multi-dose administration in healthy cats.

Current treatment options for feline epilepsy are limited to medications that require administration of multiple doses per day or administration of a capsule or large tablet. Expanding the current treatment options could improve patient and owner compliance and optimize seizure control. Topiramate has been used sparingly in veterinary medicine, and limited pharmacokinetic studies have focused on immediate release formulations in dogs. If effective and safe, topiramate extended-release (XR) could broaden the current treatment options for feline epilepsy. The aims of this two-phase study were to establish single-dose pharmacokinetics for topiramate XR in cats, identify a dosing regimen that maintains steady-state plasma drug concentrations within a reference range extrapolated from human medicine (5-20 µg/mL), and evaluate the safety of topiramate XR in cats following multidose administration. Topiramate XR administered orally at 10 mg/kg once daily for 30 days was sufficient to achieve the desired concentrations in all cats. While no clinically apparent adverse effects were observed, four out of eight cats developed subclinical anemia, calling into question the safety of topiramate XR with chronic administration. Further studies are necessary to better understand the potential adverse effects and overall efficacy of topiramate XR for the treatment of feline epilepsy.

Veterinary Education's Role in the Opioid Epidemic: Integration of an Online Safe Opioid Prescribing Course into the Core Curriculum.

As the COVID-19 pandemic continues, the opioid epidemic has worsened. Opioid-related deaths continue to rise, and many of these deaths can be traced to a prescription opioid. Because veterinarians prescribe opioids, many organizations and federal agencies have called for increased veterinary education on the topic. In this teaching tip, we review the current literature surrounding the veterinary profession's link to the opioid epidemic and one potential way that educational institutions can successfully and efficiently incorporate safe opioid prescribing training into the curriculum using an online course.

Canine brucellosis in three littermates, case report.

Three adult littermates were diagnosed with Brucella canis, two of which were diagnosed with discospondylitis. The first littermate, a 2-year-old spayed-female Labrador Retriever, was evaluated for progressive episodes of cervical pain, lethargy, reported circling to the right, and a right-sided head tilt. Magnetic resonance imaging (MRI) of the cervical spine revealed changes consistent with discospondylitis at C6-C7. MRI of the brain was unremarkable and cerebrospinal fluid analysis was declined. Brucella spp. was isolated from aerobic and Brucella blood cultures. PCR performed on the isolate identified Brucella canis and indirect fluorescent antibody (IFA) testing for Brucella canis also confirmed the species. Patient #1 was treated with doxycycline and marbofloxacin for 1 year. Clinical signs returned 2-years after diagnosis. Following the diagnosis of patient #1, a known littermate (patient #2) was tested for Brucella canis. Patient #2 was 2 years old and asymptomatic at the time of diagnosis. Aerobic and Brucella spp. cultures, PCR, and IFA were obtained and were diagnostic for Brucella canis. A 6-month course of marbofloxacin and doxycycline was implemented. The patient remained PCR positive following 4 months of treatment and repeat cultures were planned following 6 months of treatment; however, the patient was lost to follow-up. A third littermate (patient #3) was identified by the family of patient #1. Patient #3 was evaluated at 18 months of age for a 6-month history of progressive lumbosacral pain. Spinal radiographs revealed discospondylitis of the C3-C4, T12-T13, and L7-S1 vertebral endplates. Computed tomography (CT) of the lumbosacral spine was also consistent with discospondylitis at L7-S1. Brucella canis serologic testing consisting of rapid slide agglutination test, 2ME-rapid slide agglutination test, and cytoplasmic agar gel immunodiffusion was positive. Enrofloxacin was administered for 7 months and was discontinued thereafter based on radiographic evidence of healing and resolution of clinical signs. Although Brucella canis is not a rare disease in dogs, the documentation of two out of three adult littermates with associated discospondylitis is an interesting feature. In addition, this report highlights available diagnostic and treatment options, as each patient was managed differently based on clinical signs and the preference of the managing clinician.

Indications, complications, and mortality rate following craniotomy or craniectomy in dogs and cats: 165 cases (1995-2016).

OBJECTIVE: To determine the most common indications for cranial surgery and identify risk factors associated with the occurrence of complications and death in the perioperative period following cranial surgery. ANIMALS: 150 dogs and 15 cats. PROCEDURES: For this multi-institutional retrospective case series, medical records of dogs and cats that underwent cranial surgery at any of the 4 participating institutions between 1995 and 2016 were reviewed. Variables were evaluated included species, sex, age, neurolocalization, history of preoperative seizures, surgical approach, histological results, perioperative complications, and outcome. Logistic regression analysis was performed to assess for risk factors for complications. RESULTS: The most common neurolocalization was the forebrain (110/165 [66.7%]), with 94 (57.0%) animals having had seizures preoperatively. The rostrotentorial (116/165 [70.3%]) and caudotentorial (32/165 [19.4%]) surgical approaches were most commonly reported. The most common indication was the treatment of meningioma (75/142 [52.8%]). Complications arose in 58 of the 165 (35.2%) cases within 24 hours and in 86 (52.1%) cases 1 to 10 days postoperatively. Perioperative complications included hypotension (38/165 [23.0%]) and anemia (27/165 [16.4%]). During the postoperative period, the most common complications were neurologic deficits, seizures, postoperative anemia, and aspiration pneumonia. The mortality rate with death or euthanasia perioperatively or ≤ 10 days postoperatively was 14.5% (24/165). Long-term complications occurred in 65 of the 165 (39.4%) animals, with seizures and neurologic deficits being the most common. CLINICAL RELEVANCE: Cranial surgery was performed most commonly for the removal of neoplastic lesions in dogs and cats, and most complications were not life-threatening.

Effectiveness of Supplementary Materials in Teaching the Veterinary Neurologic Examination.

Clinical neurology can be difficult for veterinary students to comprehend, and part of understanding the clinical aspect is performing a proper neurologic examination. In this study, first-year veterinary students in a Small Animal Physical Exam and Anatomy rotation were given supplemental learning activities to determine their effect on student procedural knowledge and motivation in performing a neurologic examination. Students were randomly assigned to one of three groups: the first watched a video of a clinician performing the neurologic examination, the second read a handout about the neurologic exam, and the third was the control group, where students were not provided any supplemental activities. At the start and end of the rotation, students participated in a survey assessing their overall procedural knowledge and motivation to learn about the neurologic exam. No notable improvement occurred in overall student knowledge from the beginning to end of the rotation, nor when using supplemental material (p > .05). However, there was a significant difference in quiz scores between the three condition groups (p < .01), suggesting the type of learning activity did influence student learning. Additionally, students in the video and reading groups showed a significant increase in motivational scores compared with those in the control group (p < .05), demonstrating supplemental learning activities do improve student motivation in learning about the neurologic examination. This study provides evidence that while supplemental materials may not immediately help veterinary students learn to perform the neurologic examination, they do have a positive impact on students' learning motivation.

Pharmacokinetics of a cytosine arabinoside subcutaneous protocol in dogs with meningoencephalomyelitis of unknown aetiology.

Cytosine arabinoside (CA) is a commonly used treatment for dogs with meningoencephalomyelitis of unknown aetiology (MUE) with various proposed protocols, many requiring 24 hours (h) of hospitalization or two visits within 24 h. This is a unidirectional study evaluating the pharmacokinetics of a CA subcutaneous (SC) protocol and a standard constant rate infusion (CRI) protocol in 8 dogs with MUE. Dogs received the CRI (200 mg/m2 IV over 24 h), followed by a SC protocol (50 mg/m2 every 2 h for 4 treatments) four weeks later. Plasma CA concentrations were measured by high-pressure liquid chromatography-tandem mass spectrometry (HPLC-MS). Median peak CA concentration for the SC protocol (3.40 µg/ml, range 1.60-9.70 µg/ml) was significantly higher than the CRI (1.09 µg/ml, range 0.77-1.67 µg/ml; p = .02). Median concentration at 1h and 8h following initiation of treatment was significantly higher for the SC protocol (CA1 2.28 µg/ml, range 0.97-2.67; CA8 1.83 µg/ml, range 0.77-2.84) compared to the CRI (CA1 0.01 µg/ml, range 0-0.45; CA8 0.74 µg/ml, range 0.67-1.11; p = .01). While the PK properties of CA when administered as a CRI has been previously investigated, this study demonstrated that CA when administered via repeated 50 mg/m2 injections every 2 h over an 8-h period, provided sustained plasma levels above its therapeutic target and for a significantly longer duration of time than did a standard CRI protocol.

Assessment of the cutaneous trunci reflex in neurologically healthy cats.

OBJECTIVES: The aim of this study was to perform the cutaneous trunci reflex (CTR) in neurologically normal cats using two different instruments and determine how body condition score (BCS), body circumference, age, sex and instrument type may affect this reflex. METHODS: Sixty-five cats without evidence of neurologic disease were prospectively enrolled. Cats were randomly assigned to have the reflex tested first using a pair of hemostatic forceps or the integrated Babinski tip of an MDF Babinski Buck Reflex Hammer. After 30 mins, the reflex was retested using the other instrument. Data collected included the reflex presence, reflex caudal border, reflex intensity (weak, moderate, strong) and reflex symmetry (unilateral or bilateral). The influence of BCS, body circumference, age and sex on these variables was statistically evaluated along with effect of the instrument used. RESULTS: The CTR was elicited bilaterally in 52 (80%) cats and unilaterally in 64 (98%) cats. In two cats, the CTR was only able to be elicited using the Buck Reflex Hammer, while in four cats, the CTR was only able to be elicited using hemostatic forceps. Body circumference, BCS, age and sex had no effect on the presence, caudal border, intensity or symmetry of the CTR, regardless of the instrument used. No difference in the bilateral presence of the CTR was noted based on the instrument used first (P = 0.53). When assessing the influence of the instrument on reflex presence, caudal border, intensity and symmetry, the hemostatic forceps elicited the reflex further caudally (P = 0.02) and usually bilaterally (P = 0.02). CONCLUSIONS AND RELEVANCE: The CTR could be elicited in the majority of cats with both instruments. However, hemostatic forceps elicited a reflex more caudally and bilaterally symmetrical than the Buck Reflex Hammer.

Comparison of creatine kinase in cerebrospinal fluid collected from the cerebellomedullary and lumbar cisterna in 10 dogs with neurologic disease.

BACKGROUND: Analysis of cerebrospinal fluid CK (CSF-CK) might be useful as a prognostic indicator in dogs with neurologic disease. Previous studies have mostly analyzed CSF-CK collected from the cerebellomedullary (CM) cisterna, but CSF collection sites could affect its levels. OBJECTIVES: This is a pilot study aimed to evaluate differences in CSF-CK concentrations when collected from the CM or lumbar cisterna in dogs presenting with neurologic disease. METHODS: Ten dogs presenting for neurologic disease underwent magnetic resonance imaging and CSF collection from both the CM and lumbar cisterna. Cerebrospinal fluid CK was analyzed within 30 minutes. RESULTS: Ten dogs were prospectively recruited. Overall, there was no statistically significant difference between CSF-CK collected from the CM or lumbar cisterna (P = .31). When evaluated by neurolocalization, CSF-CK was different between sites in dogs with thoracolumbar myelopathy (P = .024), but not in dogs with intracranial or cervical neurolocalization (P = .93). All dogs with thoracolumbar myelopathy had equivocal or higher CK levels at the lumbar collection site compared with levels at the CM collection site. CONCLUSIONS: Cerebrospinal fluid CK values differed depending on the CSF site collection, especially in dogs with thoracolumbar myelopathy. In dogs with thoracolumbar myelopathy, CSF-CK was likely to be higher when CSF was taken from the lumbar cisterna compared with the CM cisterna. Collecting CSF from the thoracolumbar site could provide better prognostic information than if collected at the CM collection site.

Dynamic MRI is reliable for evaluation of the lumbosacral spine in healthy dogs.

Magnetic resonance imaging (MRI) is commonly used to diagnose degenerative lumbosacral stenosis; however, studies show limited correlation between imaging and clinical signs. The purpose of this prospective observer agreement study was to use dynamic MRI of the lumbosacral (LS) spine of healthy dogs to determine reliable reference ranges. Twenty-two healthy large breed dogs were prospectively enrolled. MRI of the LS spine was performed in T2-weighted, T1-weighted, and T2-weighted SPACE sequences in neutral, flexed, and extended positions. Four observers performed image analyses. Measurements included LS angle, vertebral canal height and area, and LS foraminal areas. Ordinal categorical assessment of loss of fat signal in the foramina, LS compression, intervertebral disc (IVD) degeneration, spondylosis, and IVD protrusion was also performed. The majority of values were significantly larger in flexion versus neutral position, and significantly smaller in extension versus neutral position (P < .05). Subclinical compression and IVD protrusion was noted in a neutral position in 45% and 55% of dogs and in an extended position in 85% and 73% of dogs, respectively. Interobserver agreement was strong (intracluster correlation coefficient [ICC] > .5) except for the L7:LS vertebral canal area ratio (ICC ≤ .03). Intraobserver agreement was high (rho > .5) for all measurements except for the mid-L6:LS vertebral canal height ratio (rho = .38). There was poor interobserver agreement for loss of fat signal in the foramina and evidence of compression. This study provides the groundwork for future studies using dynamic MRI to evaluate dogs with signs of clinical LS disease.

Assessment of the cutaneous trunci muscle reflex in neurologically abnormal cats.

OBJECTIVES: The aim of this study was to evaluate the presence of the cutaneous trunci reflex (CTR) in a population of neurologically abnormal cats in regard to age, body condition score (BCS), sex, breed, evidence of traumatic injury, pain, known metabolic disease, mentation, neurolocalization and diagnostic classification. METHODS: A retrospective medical record review was performed to identify cats with a history of neurologic disease undergoing a complete neurologic assessment between 24 September 2012 and 20 March 2019. CTR outcome (present, absent), signalment, evidence of traumatic injury, pain, known metabolic disease, mentation, neurolocalization and diagnostic classification were recorded. RESULTS: A total of 182 cats were identified. The CTR was present in 118 cats (64.8%) and absent in 64 cats (35.2%). Statistical analysis revealed no association between CTR outcome and age, BCS, sex, breed, evidence of traumatic injury, non-spinal pain, known metabolic disease, mentation, neurolocalization or diagnostic classification. A significant association was found between spinal pain and CTR outcome (P = 0.037). CONCLUSIONS AND RELEVANCE: These findings suggest that elicitation of the CTR in the cat can be unreliable. Further prospective controlled studies are warranted to determine whether continued inclusion of the CTR in feline neurologic examinations is justified. Consideration of the reliability of the CTR is indicated, particularly in the context of fractious or anxious patients for which only a limited window for examination may be present.

Comparison of cerebellomedullary and lumbar cerebrospinal fluid analysis in dogs with neurological disease.

BACKGROUND: Cerebrospinal fluid (CSF) analysis aids in categorizing underlying disease processes in patients with neurologic disease. Convention suggests that CSF should be collected caudal to the lesion. However, little evidence exists to justify this assertion. HYPOTHESIS/OBJECTIVES: Evaluate the clinicopathologic differences between CSF collected from the cerebellomedullary (CM) and lumbar cisterns in dogs presented for evaluation of neurologic disease. ANIMALS: Fifty-one client-owned dogs undergoing magnetic resonance imaging (MRI) and CSF collection for investigation of neurologic disease. METHODS: Cerebrospinal fluid was prospectively collected from the CM and lumbar cisterns in all patients. The total protein (TP) concentration, red blood cell (RBC) count, and total nucleated cell count (TNCC) were analyzed within 30 minutes of collection. Results and cytology findings were interpreted by a single pathologist. RESULTS: Fifty-one paired samples were collected. The TNCC (P < .001), RBC (P < .001), and TP (P < .001) were different between collection sites. When grouped by neurolocalization, TP (intracranial, P < .001; cervical, P < .001; thoracolumbar, P < .001) and RBC (intracranial, P < .001; cervical, P ≤ .002; thoracolumbar, P = .006) counts were significantly different. The TNCC was significantly different in the cervical (P = .04) and thoracolumbar localizations (P = .004) but not for intracranial (P = .30) localizations. The pathologist's interpretation differed between sites in 66.7% of the cases (34/51). CONCLUSIONS: In dogs with lesions that neurolocalized to the brain or cervical spinal cord, there may be clinical benefit in collecting fluid from both the CM and lumbar cisterns. In dogs with thoracolumbar myelopathy, CSF collected from the CM cistern may not be representative of the underlying disease process.

Noise-Induced Hearing Loss in 3 Working Dogs.

Three working dogs were diagnosed with noise-induced hearing loss following exposure to loud noise. Physical and neurologic examinations in each case revealed no significant findings. Brainstem auditory evoked response (BAER) demonstrated bilateral sensorineural deafness. One dog did not regain hearing but continued working with adjusted protocols utilizing hand signals. One dog was lost to follow-up. The last dog was treated with oral Vitamin B complex (daily), Vitamin E (400 IU daily), and N-acetyl-cystine (600 mg daily) and regained hearing 2 months later, based on repeat BAER testing.

Glioma Mimics: Magnetic Resonance Imaging Characteristics of Granulomas in Dogs.

Granulomas can "mimic" gliomas on magnetic resonance imaging (MRI) in human patients. The goal of this retrospective study was to report canine brain granulomas that were consistent with glioma based upon MRI, report their histologic diagnosis, and identify MRI criteria that might be useful to distinguish granuloma from glioma. Ten granulomas, initially suspected to be glioma based on MRI, were ultimately diagnosed as granulomatous meningoencephalomyelitis (n = 5), infectious granulomas (n = 3) or other meningoencephalitis (n = 2). Age was 1.6-15.0 years and two dogs were brachycephalic breeds. MRI characteristics overlapping with glioma included intra-axial, heterogeneous, T2-weighted hyperintense, T1-weighted hypointense to isointense mass lesions with contrast-enhancement. Signals on fluid attenuation inversion recovery, gradient echo and diffusion weighted imaging also matched glioma. Peri-lesional edema and mass effect were toward the high end of findings reported for glioma. MRI characteristics that would be considered unusual for glioma included dural contact (n = 4), T2-hypointensity (n = 2), concomitant meningeal-enhancement (n = 9), and minor changes in the contralateral brain (n = 2). Cerebrospinal fluid analysis revealed albuminocytological dissociation or mild pleocytosis. These cases show that granulomas can "mimic" glioma on canine brain MRI. In individual cases, certain MRI findings may help increase the index of suspicion for granuloma. Lack of pronounced cerebrospinal fluid pleocytosis does not exclude granuloma. Signalment is very useful in the suspicion of glioma, and many of these dogs with granuloma were of ages and breeds in which glioma is less commonly seen.

The utility of intraoperative impression smear cytology of intracranial granular cell tumors: Three cases.

Two adult male dogs (a 7-year-old shorthaired Chihuahua and 14-year-old Shih Tzu) and one adult female dog (a 9-year-old Maltese) presented for evaluation of new-onset seizure activity. Magnetic resonance imaging of the brain demonstrated a large, poorly marginated T2-weighted hyperintense, and strong contrast enhancing extra-axial mass in each case. A surgical biopsy for histopathologic evaluation was elected in all cases, and intraoperative impression smears were successfully obtained. Intraoperative cytology identified a homogenous population of round to polygonal cells with central to eccentric nuclei, coarse chromatin, and variably amphophilic to eosinophilic granular cytoplasm. Cytologic findings led to a suspected diagnosis of granular cell tumor (GCT) in all cases. Histopathologic review identified a densely cellular, unencapsulated neoplastic mass comprised of sheets of large round to polygonal cells with abundant eosinophilic cytoplasm containing numerous eosinophilic intracytoplasmic granules, confirming the diagnosis of GCT in all cases. The cases reported here are unique in that they reveal an accurate intraoperative cytologic diagnosis of a rare canine central nervous system neoplasm. Intraoperative cytology of the intracranial masses could provide clinicians with important and quick diagnostic and prognostic information; therefore, expediting decisions made intraoperatively. Further research is warranted to determine the diagnostic accuracy of intraoperative cytology for neoplasia in veterinary patients.

Effect of implementation of a surgical safety checklist on perioperative and postoperative complications at an academic institution in North America.

OBJECTIVE: To evaluate the efficacy of a surgical safety checklist (SSC) in reducing perioperative and postoperative complications. STUDY DESIGN: Before-and-after intervention study. ANIMALS: Client-owned dogs (n = 633) and cats (n = 44). METHODS: Consecutive surgeries were enrolled in the study. The "before" phase consisted of 267 surgeries performed without an SSC (SSC- ) followed by 75 SSC- surgeries in which a trained observer was in the operating room to detect possible complications. An SSC was then implemented in the operating rooms during 1 week. The "after" phase consisted of 58 surgeries in which a safety checklist (SSC+ ) and an observer were used and 277 SSC+ surgeries without an observer. Complications were prospectively recorded when witnessed by the observer, and all other perioperative complications were retrospectively recorded from veterinary records and client telephone communication. RESULTS: There were more perioperative and postoperative complications when surgeries were performed without an SSC (140/342 [40.9%; 95% CI, 35.7%-46.4%]) than there were when surgeries were performed with an SSC (98/335 [29.3%; 95% CI, 24.4%-34.4%]; P = .002). Surgical checklist use, presence of an observer, American Society of Anesthesiologists score, and anesthesia time were all independently associated with the odds of complications. CONCLUSION: Implementation of an SSC in an academic teaching hospital decreased the odds of perioperative and postoperative surgical complications. CLINICAL SIGNIFICANCE: This study supports the use of an SSC to prevent surgical complications in veterinary teaching hospitals.

Computed tomographic study of safe implantation corridors in rabbit lumbar vertebrae.

OBJECTIVES: A study was performed to evaluate the lumbar vertebrae of domestic rabbits using computed tomography (CT) in order to identify safe corridors for implant insertion. METHODS: Computed tomography imaging of 20 adult New Zealand white rabbits was evaluated using three-dimensional multiplanar reconstruction, and safe corridors were determined. Following corridor determination, implant placement was performed, and imaging was repeated. RESULTS: The cranial and caudal endplates contained the majority of the vertebral bone stock, and were an average of 3.14 and 3.30 mm in length, respectively. The mean safe corridor angle was 62.9 degrees (range: 58.8-66.7), and the mean width of the corridor was 2.03 mm (range: 1.60- 2.07). Post-placement imaging revealed that 35% of the pins demonstrated errors of placement, most commonly canal impingement. CONCLUSIONS: The results of the corridor evaluation indicate that an insertion angle of approximately 60 degrees relative to the sagittal midline is appropriate for implant insertion in the lumbar vertebrae of New Zealand white rabbits. Additionally, due to the hourglass shape of rabbit vertebrae, the endplates provide maximal bone stock for implant purchase, so insertion should be attempted in these regions. However, the high percentage of errors in placement indicate the need to more clearly define entry points to access the canal, and highlight the challenges of appropriate placement in the small bones of rabbits.