Anatomical classification of feline congenital extrahepatic portosystemic shunts based on CT angiography: A SVSTS and VIRIES multi-institutional study in 231 cats.

The prevalence of anatomical-based subtypes of feline congenital extrahepatic portosystemic shunts (EHPSS) has not been completely elucidated. The goal of this study was to use CT angiography to create an anatomical-based nomenclature system for feline congenital EHPSS. Additionally, subjective portal perfusion scores were generated to determine if intrinsic portal vein development was associated with different shunt conformations or patient age at the time of CT. The SVSTS and VIRIES list services were used to recruit cases. Data collected included patient DOB, gender, breed, weight, CT date, and reported diagnosis. Shunts were classified based upon (1) the shunt portal vessel(s) of origin, (2) the shunt systemic vessel(s) of insertion, and (3) any substantial portal vessels contributing to the shunt. Additionally, hepatic portal perfusion was subjectively scored between 1 (poor/none) and 5 (good/normal) based on the caliber of the intrahepatic PVs. A total of 264 CT scans were submitted from 29 institutions. Due to exclusion criteria, 33 (13%) were removed, leaving 231 CT scans to be included. Twenty-five different EHPSS anatomies were identified with five classifications accounting for 78% of all shunts (LGP [53%], LGC-post [11%], LCG [7%], LGC-pre [4%], and PC [4%]). Shunt origin involved the left gastric vein in 75% of the described classifications. Significant differences were identified among the five most common shunt types with respect to age at the time of CT scan (P = .002), breed (P < .001), and subjective portal perfusion score (P < .001). This refined anatomical classification system for feline EHPSS may enable improved understanding, treatment comparisons, and outcome prediction for cats with these anomalies.

A systematic review of complications related to laparoscopic and laparoscopic-assisted procedures in dogs.

OBJECTIVE: To evaluate and report the quality of the scientific literature reporting complications associated with laparoscopic and laparoscopic-assisted procedures in client-owned or healthy research dogs and to report and illustrate laparoscopic complications related to individual organ systems. STUDY DESIGN: Systematic review. ANIMALS: Client-owned or healthy research dogs. METHODS: A literature review was performed by using PubMed and CAB abstracts for English-language studies providing descriptions of complications related to laparoscopic and laparoscopic-assisted procedures in dogs. Study selection used PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment was performed by using a MINORS (Methodological Items for Non-Randomized Studies) scoring system and a grading scale of level of evidence. Descriptive statistics were used. RESULTS: In total, 741 manuscripts were identified, with 64 manuscripts eligible for data extraction and quality assessment. The most represented organ system was the female genital tract, represented by 22 (34.4%) studies. The most commonly reported intraoperative and postoperative complications were related to abdominal entry and portal incisions, respectively. In 53 of 54 non-randomized studies, high risk of bias was found. Forty-eight (75%) studies provided level III or IV evidence. CONCLUSION: This report provides an updated review of complications related to laparoscopic and laparoscopic-assisted procedures in dogs, classified by organ system. The overall quality of evidence was low, limiting direct comparison of complication rates between studies. CLINICAL SIGNIFICANCE: There is a need for implementation of standardized criteria for defining complications, study time frames and greater numbers of high quality prospective randomized trials in veterinary laparoscopy to permit comparison of complication and conversion rates between published studies and across organ systems.

Non-functional thyroid cystadenoma in three boxer dogs.

BACKGROUND: Thyroid neoplasia is a common endocrine neoplasm in dogs. The boxer is one of the reported breeds predisposed to malignant thyroid neoplasia. However, the association between thyroid neoplasia, malignancy and breed should be considered with caution. CASES PRESENTATION: This article describes the presentation, clinical pathological findings, computed tomographic (CT) imaging findings and histopathological features of benign cystic thyroid tumour (cystadenoma) diagnosed in three boxers. These three dogs were presented for investigation of unilateral (n = 2) or bilateral (n = 1) cervical masses with no associated clinical signs of thyroid dysfunction. In each case, post-contrast CT scan identified a large, lateralised, non-invasive, well-defined homogeneous cystic structure with a hyperattenuating contrast-enhancing capsule of suspected thyroid origin displacing the surrounding cervical tissues. Ultrasound-guided fine needle aspiration of the cysts yielded fluid with a high thyroxine concentration in each case. Histopathology was consistent with thyroid cystadenoma in all cases. One dog was concurrently diagnosed with oral melanoma and euthanased. Two dogs underwent surgical excision with one lost to follow-up after 36 months and the other euthanased after 16 months following diagnosis of mast cell tumour. CONCLUSIONS: To the authors' knowledge, this is the first detailed report of non-functional benign thyroid cystadenoma in dogs and provides relevant information about case management for this type of tumour. The presence of a large cystic structure associated with benign non-functional thyroid neoplasia may be a condition to which boxer dogs are predisposed.

Teaching and proficiency assessment for arthroscopy in veterinary surgery: A 2017 survey of diplomates and residents of the American and European College of Veterinary Surgeons.

OBJECTIVE: To determine current methods of arthroscopic skills training and proficiency assessment, identify skills considered fundamental to arthroscopy, and evaluate desire for a formal training and assessment program. STUDY DESIGN: Anonymized electronic survey. SAMPLE POPULATION: Diplomates and residents of the American College of Veterinary Surgeons (ACVS) and European College of Veterinary Surgeons (ECVS). METHODS: An electronic survey was distributed in commercial software (Qualtrics, Provo, Utah). Questions were divided into 4 categories: (1) demographics, (2) arthroscopy experience, (3) teaching, and (4) proficiency assessment. Descriptive statistical analysis was performed. Comparisons between groups were performed by using χ2 , t tests, and 1-way ANOVA (P ≤ .05). RESULTS: In total, 429 diplomates and 149 residents responded (response rate 28%). Overall, 80% of respondents trained using clinical cases. Barriers to simulator training included cadaver/simulator availability and time. Skills deemed most fundamental included anatomic knowledge, precise portal placement, triangulation, and image orientation. Overall, 90% of respondents supported a formal training program with requirement to demonstrate proficiency; 80% believed this should be part of standard ACVS/ECVS residency training. CONCLUSION: Arthroscopic skills are taught by using clinical cases, with subjective proficiency assessment. Fundamental skills are those that may be taught using simulators. There is enthusiasm for formal arthroscopic skills training and assessment. CLINICAL SIGNIFICANCE: Improved acquisition and assessment of fundamental arthroscopic skills is indicated. A validated methodology for formal training using simulators, minimizing morbidity, and facilitating objective evaluation is warranted. This is the first phase of a project to develop and validate a simulator program.