Student performance and course evaluations before and after use of the Classroom Performance System ™ in a third-year veterinary radiology course.

Effective teaching of veterinary radiology can be challenging in a traditional classroom environment. Audience response systems, colloquially known as "clickers," provide a means of encouraging student interaction. The purpose of this study was to compare student performance and course evaluations before and after using the Classroom Performance System™ in the third-year (fifth semester) didactic radiology course at the University of Tennessee College of Veterinary Medicine. Overall student performance was assessed by comparing median numeric final course grades (%) between years without and with use of the Classroom Performance System™. Grades of students were determined for individual instructors' sections. Student evaluations of the radiology course were compared for the years available (2007-2010). Student interactions were also evaluated subjectively by instructors who used the Classroom Performance System™. There was a significant difference (p = 0.009) between the median student grade before (2005 - 2008, median 82.2%; interquartile range 77.6-85.7%; range 61.9-95.5%) and after use of the classroom performance system (2009-2010, median 83.6%; interquartile range 79.9-87.9%; range 68.2-93.2%). There was no statistically significant difference in median student grades for individual instructors over the study period. The radiology course student evaluation scores were significantly higher in years where the Classroom Performance System™ was used in comparison to previous years (P = 0.019). Subjectively, students appeared more involved when using clickers. Findings indicated that the Classroom Performance System™ may be a useful tool for enhancing veterinary radiology education.

Radiotherapy-induced myelosuppression in dogs: 103 cases (2002-2006).

Definitive radiotherapy refers to delivery of large doses, typically 48-62 Gray, of ionizing radiation over several weeks using a daily or alternate-day fractionation schedule. The impact of definitive radiotherapy alone on haematopoiesis in tumour-bearing dogs is unknown. Medical records from 103 dogs receiving definitive (60) Cobalt teletherapy for cancer over a 5-year period were reviewed for signalment, tumour type and location, total radiotherapy dose and fractionation scheme. Complete blood count data were collected before, halfway through, and at the end of radiation treatment, and analysed for changes associated with patient variables. The results demonstrate significant reductions in haematocrit, total white blood cell count, neutrophils, eosinophils, monocytes, lymphocytes and platelets occurred during definitive radiotherapy but remained within laboratory reference intervals. These data are important for anticipation of toxicity associated with combinations of radiotherapy and chemotherapy in dogs but do not support the routine monitoring of haematology parameters during definitive radiotherapy.

Carcinoma ex pleomorphic adenoma with sebaceous differentiation in the mandibular salivary gland of a dog.

A carcinoma ex pleomorphic adenoma was diagnosed in the left mandibular salivary gland of an 8-year-old female spayed dog. The animal presented with a large nonpainful swelling in the left submandibular region. A computed tomography scan detected an irregularly enhancing soft tissue mass that was closely associated with the left external ear canal and extended to the left wing of the atlas. On surgical exploration, the mass was intimately associated with the left mandibular salivary gland. Both the mass and the adjacent gland were removed, and the diagnosis was determined by histopathology. The tumor was comprised of basaloid and low columnar epithelial cells, many glandular units formed by well-differentiated sebocytes, and multifocal regions of necrosis, mineralization, and hemorrhage. Salivary gland tumors with sebaceous differentiation are very rare in animals, with one previously reported case in a cat.

Association of airway obstruction, sleep, and phasic abdominal muscle activity after upper abdominal surgery.

We recorded nasal gas flow, sleep stage, and abdominal muscle EMG pattern in 11 patients throughout the night after abdominal surgery, to examine the association between phasic activity of the abdominal muscles, sleep stage, and flow disturbance. We used a miniaturized data logging system, and obtained satisfactory records in eight patients. The data were divided into 30-s epochs. Each epoch was classified as either awake or asleep. The epochs were also classified for the presence of phasic activity in the external oblique abdominal muscle, and for evidence of airway obstruction. Association between these features was tested by a quasi likelihood log linear model. Values given are median (quartiles) for the eight subjects. Sleep occurred for 62 (46-69)% of the study time. During sleep, inspiratory flow was normal for 69 (48-81)% of the time, whereas during wakefulness, the flow pattern was normal for 51 (28-77)% of the time. Phasic activity was present 16 (12-25)% of the time during sleep and 24 (19-37)% of the time during wakefulness (P<0.001). In the awake state, when breathing was normal, phasic activity was present 16 (11-30)% of the time. When breathing was obstructed, phasic activity was present 38 (25-44)% of the time (P<0.001). These surprising findings suggest that sleep may be seriously disturbed by airway obstruction, so that a stable sleep state is not reached. We could not confirm previous findings that disturbed breathing in post-operative patients only occurs during sleep.

The spine.

Computed tomography (CT) and magnetic resonance imaging (MRI) are becoming increasingly accessible in veterinary medicine. Because of their ability to image the bony spine and spinal cord noninvasively and with exceptional detail, these techniques have revolutionized the way spinal disorders are diagnosed in both people and animals. Although the veterinary literature on this topic is limited, interpretation of CT and MR images of the spine are facilitated by the similarity of human and animal disease processes. This article provides an overview of imaging strategies, normal anatomy, and the CT and MRI features of degenerative, infectious, neoplastic, and vascular diseases of the spine.

Magnetic resonance imaging appearance of intracranial hemorrhage secondary to cerebral vascular malformation in a dog.

A 14-year-old dog developed an acute onset of depression, disorientation, left hemiparesis,left hemianopia, left facial hypoesthesia, and a tendency to turn to the right. Based on these findings, a lesion affecting the right forebrain was suspected. Magnetic resonance imaging showed a mass within the right cerebral hemisphere resulting in compression of the right lateral ventricle and shifting the longitudinal fissure to the left. The lesion was hyperintense on T1-weighted images and hyperintense with focal regions of hypointensity on proton density-, and T2-weighted images, consistent with a subacute hemorrhage. At necropsy, there was a hematoma in the parietal portion of the right cerebral hemisphere. The hemorrhage was surrounded by numerous thin-walled veins, most likely a venous malformation. Magnetic resonance imaging of intracranial hemorrhage is reviewed.

Bilateral renal metastases of nasal chondrosarcoma in a dog.

Chondrosarcoma is the most common nonepithelial sinonasal neoplasm in the dog, and metastasis is considered rare. A 7-year-old Irish Setter had bilateral renal enlargement 17 months following surgery and radiotherapy for a primary nasal chondrosarcoma. Histologic evaluation revealed chondrosarcoma metastases in both kidneys. A diagnosis of nasal chondrosarcoma with bilateral renal metastasis was made. The clinical importance of this report is that routine recommendations for the evaluation of regional and/or distant metatasis in a dog with a dignosis of nasal chondrosarcoma, namely routine whole body physical examination and thoracic radiography, failed to demonstrate the presence of abdominal metatases, which ultimately led to the demise of this dog. The biologically aggressive nature of this chondrosarcoma of the nasal cavity indicates that additional information is needed before a prognosis can be reliably established for dogs with this tumor type.

Quantitative 99mTc-pertechnetate thyroid scintigraphy in normal beagles.

This study was done to investigate the validity of published canine thyroid/salivary (T/S) ratios of approximately 1 in normal dogs and to determine thyroid uptake of 99mTc-pertechnetate (pertechnetate) measured as percent uptake of injected dose. These parameters were evaluated in 13 Beagle dogs over a 4 hour period. Mean +/- standard deviation (SD) and median T/S ratios of 1.2 +/- 0.3 and 1.1 were essentially the same at twenty minutes and 1 hour. T/S values ranged from 0.9 to 2.2 at 20 minutes and from 0.8 to 2.4 at 1 hour. T/S ratio values progressively declined over the subsequent time intervals with mean +/- SD and median values of 0.6 +/- 0.2 and 0.6, respectively, measured at 4 hours. The mean +/- SD maximum percent dose uptake of pertechnetate within the thyroid gland was 0.55% +/- 0.15% with a range of 0.28% to 0.90%. The mean +/- SD time interval from injection of pertechnetate to maximum uptake within the thyroid gland was 160 +/- 55 minutes with a range 31-240 minutes. The data derived from this study of normal dogs may be useful in the evaluation of dogs with thyroidal diseases including hypothyroidism.

Changes in renal function in cats following treatment of hyperthyroidism using 131I.

Changes in renal function of twenty-two cats treated for hyperthyroidism using radioiodine were evaluated. Serum thyroxine (T4), serum creatinine, blood urea nitrogen (BUN) and urine specific gravity were measured before treatment and 6 and 30 days after treatment. Twenty-two cats had pretreatment and 21 cats had 6 day posttreatment measurement of glomerular filtration rate (GFR) using nuclear medicine imaging techniques. There were significant declines in serum T4 at 6 days following treatment, but the changes in GFR, serum creatinine and BUN were not significant. At 30 days following treatment, there were significant increases in BUN and serum creatinine and further significant declines in serum T4. Nine cats were in renal failure prior to treatment and 13 cats were in renal failure 30 days following treatment. Renal failure was defined as BUN greater than 30 mg/dl and/or serum creatinine greater than 1.8 mg/dl with concurrent urine specific gravity less than 1.035. These 13 cats included eight of 9 cats in renal failure prior to treatment and 5 cats not previously in renal failure. Follow up information beyond 30 days following treatment on 9 of these 13 cats indicated that all remained in renal failure. Based on receiver operating curve analysis of pretreatment glomerular filtration rate (GFR) in predicting posttreatment renal failure, a value of 2.25 ml/kg/min as a point of maximum sensitivity (100%) and specificity (78%) was derived. Fifteen of 22 cats had pretreatment GFR measurements of less than 2.25 ml/kg/min. These 15 cats included all 9 cats in renal failure and 5 cats with normal renal clinicopathologic values prior to treatment. At 30 days following treatment, 13 of these 15 cats were in renal failure. The 2 cats not in renal failure had persistently increased serum T4 values. Seven of 22 cats had pretreatment GFR measurements greater than 2.25 ml/kg/min. None of these 7 cats was in renal failure at 30 days following treatment, all cats having normal BUN, serum creatinine, and urine specific gravity values. It was concluded that significant declines in renal function occur after treatment of hyperthyroidism and this decline is clinically important in cats with renal disease. Pretreatment measurement of GFR is valuable in detecting subclinical renal disease and in predicting which cats may have clinically important declines in renal function following treatment.

Investigation of the effects of hyperthyroidism on renal function in the cat.

This study evaluated the effects of thyroxine on renal function in the cat. Baseline serum thyroxine (T4) concentrations, clinicopathologic data (complete blood count [CBC], serum chemistry panel, urinalysis), and nuclear medicine determinations of glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and effective renal blood flow (ERBF) were measured in 10 normal adult cats. Cats were then injected with thyroxine (T4) (50 micrograms/kg SQ) daily for 30 d to induce hyperthyroidism. Clinicopathologic and nuclear medicine studies were repeated at 30 d. Cats injected with thyroxine had significant increases in T4, GFR, and ERBF and significant declines in serum creatinine and blood urea nitrogen (BUN) values. Administration of high doses of exogenous thyroxine to cats results in significant stimulation of renal function.

Incidence of persistent symptoms after laparoscopic cholecystectomy: a prospective study.

BACKGROUND AND AIMS: Laparoscopic cholecystectomy is the standard treatment for symptomatic gall stone disease. This study aimed to assess the effect of the operation on patients' symptoms. METHODS: One hundred consecutive patients undergoing laparoscopic cholecystectomy between June 1994 and June 1995 were evaluated using standard questionnaires examining demographic details, indication for laparoscopic cholecystectomy, characteristics of pain, and other associated dyspeptic and colonic symptoms. A history of psychiatric disturbances and of hysterectomy were also recorded. The same questionnaires were administered again six months after the operation. Operation notes and histological reports were reviewed. RESULTS: Three patients were converted to open surgery and were excluded from analysis. The median age of the remaining 97 patients was 50.9 (19-85) years; 19 were men. There was one complication each of bleeding and biliary leak. Indications for laparoscopic cholecystectomy were biliary type pain (66 patients) and complicated gall stone disease (acute cholecystitis 21, cholestatic jaundice six, and pancreatitis four). Thirteen patients (13%) had persistent pain and two (3%) developed diarrhoea at follow up. Only one patient with persistent pain after laparoscopic cholecystectomy originated from the complicated gall stone disease group. Logistic discriminant analysis showed that bloating (p < 0.001), constipation (p < 0.05), and previous and current use of psychotrophic drugs (p < 0.001) were significantly more common among those with a poor outcome after laparoscopic cholecystectomy. Heartburn was unaffected. Of patients with persistent symptoms after cholecystectomy 77% had no or mild histological changes of cholecystitis as compared with 30% in the pain free group. CONCLUSIONS: The incidence of persistent pain after laparoscopic cholecystectomy was 13%. Abdominal bloating and psychiatric medications were predictive for persistence of pain after laparoscopic cholecystectomy.

Increasing incidence of tuberculosis in the young and the elderly in Scotland.

BACKGROUND: Since 1987 there has been an arrest in the previously established decline of tuberculosis notifications in Scotland. A study was undertaken to determine whether age contributed to this phenomenon. METHODS: Notifications of tuberculosis in Scotland were quantified by year and age group for the years 1981-92 from national statistics supplied by the Information and Statistics Division. Population data were obtained from the 1981 and 1991 national censuses. RESULTS: Age group analysis of pulmonary tuberculosis notifications showed that, in the 0-14 age group, incidence (per 10(5) population) decreased from 7.4 in 1981 to 2.6 in 1987, rising by an estimated 12.6% per annum to 3.7 in 1992. In the 65+ age group incidence declined from 30.1 in 1981 to 17.3 in 1988, and rose by an estimated 4.1% per annum to 22.2 in 1992. In the age groups 15-44 and 45-64 a continuous decrease in notification rate was seen over the period of the study. CONCLUSIONS: The plateauing of the incidence of tuberculosis in Scotland is associated with significant increases since 1987 of tuberculosis in the young and elderly. Contributions from ethnic minorities and those infected with HIV are negligible. An ageing population over the decade, with the highest tuberculosis rates seen in the older age group, may explain these findings.

Naturally occurring tumors in dogs as comparative models for cancer therapy research.

The United States pet population has been a vastly underutilized resource for cancer therapy studies. Naturally occurring tumors in dogs develop twice as frequently as in man, have histopathologic features and a biologic behavior similar to tumors in man, and progress at a more rapid rate than in man. Cancer is one of the leading causes of death in man and dogs. The canine malignancies that are of practical use for comparative therapeutic studies include lymphoma, mammary tumors, oral melanoma, lung tumors, nasal tumors, soft tissue sarcomas, and osteosarcoma. This report will discuss the comparative nature of these malignancies and the current trends in clinical cancer research, namely dose intensification and biomodulation, using naturally occurring tumors in client-owned dogs.

Saucerisation (recession) of neuro-retinal rim is characteristic of glaucoma.

Colour stereophotographs of the optic disc and surrounding retina were assessed by a Humphrey analyser system in a series of Japanese individuals. When compared with 9 age- and sex-matched control eyes (9 controls), the 10 eyes of 10 patients with early open-angle glaucoma showed a significantly lower level of the mid-point of the neuroretinal rim relative to the level of the surface of the retina about 1/4 of a disc diameter beyond the disc edge. When the mid-point of the rim was related to the surface of tissue at the disc edge, the level of the former was significantly lower at the three measurement points on the nasal side and at 6 o'clock. In the 9 normal controls, the lower half of the neuro-retinal rim was at a significantly lower level than the upper half, relative to the surface of tissue at the disc edge. We conclude that saucerisation and/or recession of the neuro-retinal rim frequently accompanies glaucoma and we suspect it is an early sign of it.

Ultrasonographic findings in dogs and cats with oxalate nephrosis attributed to ethylene glycol intoxication: 15 cases (1984-1988).

Renal ultrasonographic findings in 12 dogs and 3 cats determined to have oxalate nephrosis presumed to be secondary to ethylene glycol intoxication were examined. Ultrasonographic changes varied from mild to marked increases in renal cortical echogenicity. A pattern of greater than normal cortical and medullary echogenicity with persistence of areas of lesser echo intensity at the corticomedullary junction and central medullary regions was observed. This pattern, termed the halo sign, was recognized in 7 dogs and 1 cat concurrent with the development of clinical anuria. Ultrasonographic patterns in these clinical cases were similar to those observed in a previous study of dogs with experimentally induced ethylene glycol nephrosis. Ultrasonographic findings were not considered pathognomonic of ethylene glycol nephrosis. Due to the high death rate reported in the cases surveyed, detection of ultrasonographic changes was considered to warrant a guarded to poor prognosis. Because of the association of the halo sign with anuria, its detection was considered to warrant a grave prognosis.

Ascorbic acid as suspected cause of oxalate nephrotoxicosis in a goat.

Oxalate nephrotoxicosis was determined, by renal biopsy, to be the cause of azotemia in a goat. The origin of the oxalate was determined to be a high concentration of ascorbic acid that had been administered parenterally to the goat. Ascorbic acid has been documented as a cause of oxalate nephrotoxicosis in human beings.

Bacterial epididymitis in two stallions.

Two stallions had unilateral bacterial epididymitis attributable to S zooepidemicus infection. Diagnosis was based on bacterial isolation, WBC in the semen, higher than normal blood fibrinogen concentration, and leukocytosis with regenerative left shift. One horse had high seminal pH. Ultrasonography of the involved epididymides revealed changes consistent with the appearance of abnormal accumulation of exudate in the tail of the epididymis. Treatment included unilateral orchiectomy and antibiotic administration. In stallion 1, the infection persisted despite treatment. Treatment result was not available for stallion 2.

Medical and surgical management of benign prostatic hyperplasia, diskospondylitis, and penile paresis in an ocelot.

Benign prostatic hyperplasia, diskospondylitis at the T13-L1 intervertebral disk space, and penile paresis were diagnosed in a 16-year-old male ocelot. Treatment consisted of castration for the benign prostatic hyperplasia and long-term administration of antibiotics for the diskospondylitis. On physical examination 8 weeks after initial referral, the prostate gland was no longer palpable and could not be visualized radiographically or ultrasonographically. The diskospondylitis lesion was found to be healing, on the basis of radiographic results.

Primary jejunal osteosarcoma associated with a surgical sponge in a dog.

Primary jejunal osteosarcoma was diagnosed in association with a surgical sponge in a dog. The tumor was biologically aggressive, resulting in widespread metastasis throughout the abdomen within 2 months of surgical resection. Microscopic examination of the resected osteosarcoma revealed strands of gauze material throughout the tumor mass. It was theorized that the presence of a sponge foreign body may have resulted in malignant transformation of adjacent tissues similar to what has been reported to occur after internal fixation of some long-bone fractures.