Pre-surgical hand preparation in veterinary practice.

The objective of this paper is to review the evidence for different methods of surgical hand preparation applicable to veterinary practice. Surgical hand preparation is an essential step in performing surgery as a veterinarian. Recommended protocols and products for surgical hand preparation have varied since its inception in the late 1800s. Many factors must be considered when assessing the efficacy, safety, and users' compliance with any available product. Traditional scrub methods employing chlorhexidine gluconate or povidone-iodine have been compared to alcohol-based rub protocols with respect to immediate and prolonged efficacy, safety, compliance, requirements for theatre furniture, cost and water usage. Although much of the comparative data has been generated in human medical facilities, extrapolation of the data to veterinary surgery is appropriate. Considerations for veterinary practice are specifically discussed. Overall, the benefits of alcohol-based rubs indicate that this should be the preferred method of pre-surgical hand preparation for veterinarians in all types of practice.

Canine Brachycephaly: Anatomy, Pathology, Genetics and Welfare.

Brachycephalic dog breeds have experienced a marked rise in popularity in recent years. While numerous people clearly desire this phenotype in their pets, many of these dogs unfortunately experience several concomitant sequelae, including major problems with respiration and thermoregulation, as well as gastrointestinal, ophthalmological, dermatological, reproductive and even dental problems. This mini review focuses on the anatomical and pathological changes associated with brachycephalic skull shape, including brachycephalic obstructive airway syndrome and other co-existent disorders. It then details the known genetic contributors to brachycephaly, and concludes with a brief discourse on the welfare of these animals.

Outcome of secondary intention healing of full thickness lower eyelid defects in dogs.

OBJECTIVES: To assess healing of the canine lower eyelid without anatomical reconstruction. MATERIALS AND METHODS: Retrospective case series of three client-owned dogs with lower eyelid defects. These dogs that underwent debridement of lower eyelid wounds that were left to heal by secondary intention were assessed for anatomical, functional and aesthetic outcomes. RESULTS: Two of the cases had previously undergone tumour resection with a lip-to-lid reconstruction and, following flap failure, developed a full thickness defect. The third dog presented with a traumatic laceration. Each dog lost approximately 70 to 90% of the lower eyelid margin. Two received topical antimicrobial eye drops after debridement, while the third dog required no further treatment. Follow-up periods of 3 years, 15 months and 4 months were available. All owners were satisfied with the cosmetic outcome and provided pictures. One owner reported epiphora but no other ophthalmic complications occurred. CLINICAL SIGNIFICANCE: The result of this small case series supports the notion that not all lower eyelid injuries or tumour resections require anatomical reconstruction. Selected cases can be left to heal by secondary intention with minimal post-operative complications.

Kinetics of Plasma Cell-Free DNA and Creatine Kinase in a Canine Model of Tissue Injury.

BACKGROUND: Cell-free DNA (cfDNA) comprises short, double-stranded circulating DNA sequences released from damaged cells. In people, cfDNA concentrations correlate well with disease severity and tissue damage. No reports are available regarding cfDNA kinetics in dogs. OBJECTIVES/HYPOTHESIS: Cell-free DNA will have a short biological half-life and would be able to stratify mild, moderate, and severe tissue injury. Our study aims were to determine the kinetics and biological half-life of cfDNA and to contrast them with those of creatine kinase (CK). ANIMALS: Three groups of 10 dogs undergoing open ovariohysterectomy, surgery for cranial cruciate ligament rupture (CCLR), or hemilaminectomy. METHODS: Plasma for cfDNA and CK analysis was collected at admission, at induction of anesthesia, postsurgery (time 0) and at 6, 12, 24, 36, 48, 60, and 72 hours after surgery. RESULTS: The biological half-life of plasma cfDNA and CK were 5.64 hours (95% confidence interval [CI 95], 4.36-7.98 hours) and 28.7 hours (CI95, 25.3-33.3 hours), respectively. In the hemilaminectomy group, cfDNA concentrations differed significantly from admission at 6-12 hours after surgery. Creatine kinase activity differed among the surgical groups and reached a peak 6 hours after surgery. In the ovariohysterectomy and CCLR groups, plasma CK activity 72 hours after surgery did not differ from admission activity of the ovariohysterectomy group. In contrast, in the hemilaminectomy group, plasma CK activity after 72 hours did not return to the ovariohysterectomy group admission activity. CONCLUSIONS AND CLINICAL IMPORTANCE: Plasma CK activity has a longer biological half-life than previously thought. In contrast to plasma CK activity, cfDNA has a short half-life and could be a useful marker for peracute severe tissue injury.

Histological evaluation of the soft palate in dogs affected by brachycephalic obstructive airway syndrome.

AIMS: To histologically examine tissue obtained from the thick rostral portion of the soft palate in severely affected brachycephalic dogs, and to quantitatively compare the histological findings with a similar region in control dogs. METHODS: Nine dogs examined for treatment of brachycephalic obstructive airway syndrome (BOAS) were prospectively recruited into the study. Four mesaticephalic dogs were also recruited following euthanasia for reasons unrelated to respiratory or gastrointestinal disease. Palatine tissue was harvested using an elliptical incision extending from the junction with the hard palate to the free caudal edge, and passing axial to the tonsilar crypts. The resected portion was fixed in formalin and stained using H&E. Tissues were examined in transverse section and assessments of the palatinus muscles, interstitium, lamina propria and salivary tissue were recorded. Quantitative analysis of the proportions of palatinus muscle, salivary tissue and stroma was performed using ImageJ image analysis software. RESULTS: When compared to the control dogs, the histological findings of the clinically affected dogs showed a marked increase in acute and chronic muscle degeneration and necrosis. This was typified by swollen, hypereosinophilic fibres with centralised nuclei, myofibre atrophy, loss of cross striations and fragmented sarcoplasm. There was reduced proportions of palatinus muscle (p<0.001) and increased proportions of collagenous stroma (p=0.004) and salivary gland tissue (p=0.046) in the clinical samples, compared to control dogs. CONCLUSIONS: Increased thickness of the palate in dogs with BOAS was not due to muscle hypertrophy but was due to increased stroma within the lamina propria, and increased proportions of salivary tissue. There was also a reduction of muscle mass, especially within the paired palatinus muscles, that may have consequences for palate function. CLINCAL RELEVANCE: The results of this study enable us to start investigating the aetiology of the changes seen in brachycephalic compared to mesaticephalic dogs, which will impact timing and extent of treatment of clinical cases.

Computer-assisted surgical correction of an antebrachial deformity in a dog.

OBJECTIVE: To report the use of three dimensional (3D) computed tomographic (CT) imaging, computer simulation and rapid prototype modelling to aid surgical correction of a complex antebrachial deformity in a dog. METHODS: A six-year-old, 13 kg spayed female Chihuahua crossbreed dog was presented for worsening forelimb gait and exercise intolerance. Both forelimbs had gross angular limb deformity with carpal hyper-flexion, valgus and radial procurvatum. Surgical planning from radiographs was problematic therefore CT data were used to generate 3D reconstructions of the antebrachium. Using imaging software we then quantified the nature of the deformity using a previously unreported method based on the centre of rotation of angulation as a 3D model. Computer simulated closing of the virtual wedge osteotomy was then performed as proof of concept. A stereolithographic model complete with osteotomy axes, was then created in plastic using a rapid prototyping machine. Oscillating saw guides were fabricated in polymethylmethacrylate and cold sterilised. A closing wedge osteotomy with de-rotation was performed and stabilised with a pre-contoured dynamic compression plate. At the three- and six-month follow-up examinations there was improved weight-bearing and cosmetic appearance. CONCLUSIONS: Computer assistance was valuable for locating and quantifying this antebrachial deformity and conceptualising the corrective surgery. The results of our study suggest that rapid prototyping can be used to create models and saw guides to simplify one-stage corrective osteotomies and more accurately treat angular limb deformity.