Evaluation of Perceived Technical Skill Development by Students During Instruction in Dental Extractions in Different Laboratory Settings-A Pilot Study.

In veterinary general practice, dental extractions are common procedures that require a specific set of surgical skills. Veterinary medical educators are tasked with preparing students for general practice, equipping them with medical knowledge and surgical skills. Results of this pilot study demonstrate students' preference for circle-based laboratory setup, a perceived high value of immediate feedback when performing laboratory exercises, and a lack of preference for timing of the laboratory relative to the relevant material provided in lecture. The impact of lecture, supplemental information, and laboratory setup on development of these surgical skills are explored.

Mucoid Pseudomonas aeruginosa infection in a cat with severe chronic rhinosinusitis.

A 6-year-old male neutered Bengal cat was presented to the University of Wisconsin Veterinary Care Hospital with a history of severe chronic rhinitis that was unresolved from kittenhood. In weeks prior to presentation, the cat's upper respiratory signs had significantly worsened and a left-sided facial swelling overlying the left frontal sinus was noted. Skull computed tomography, rhinoscopy, bilateral nasal biopsies, bacterial and fungal cultures of fluid from the left frontal sinus, and cryptococcal fungal antigen testing were performed. The cat was diagnosed with severe chronic rhinosinusitis and determined to have an infection with a mucoid variant of Pseudomonas aeruginosa (P aeruginosa). This case highlights an atypical cytomorphologic appearance of the well-known bacterial pathogen, P aeruginosa, an appearance that could be confused cytologically with other microorganisms, such as septate fungi. Mucoid variants of P aeruginosa are often associated with progressive lung or airway disease in people with cystic fibrosis and have not been previously documented in feline respiratory tract disease. This report also presents a brief review of chronic rhinosinusitis (CRS) in cats and describes a novel interventional treatment approach to feline CRS via sinusotomy and sinus flushing for severely affected cats.

Spurious reticulocyte profiles in dogs with large form babesiosis: a retrospective study.

BACKGROUND: Erroneously high reticulocyte counts (pseudoreticulocytosis) have been reported in dogs with leukemia. Pseudoreticulocytosis and an abnormal reticulocyte profile were observed in a dog with large form babesiosis presented at our institution. OBJECTIVES: The aims of this retrospective study were to determine if dogs with babesiosis and other dogs had abnormal reticulocyte profiles, and to correlate these profiles with the primary diagnosis. METHODS: All canine CBCs obtained with the Sysmex XT-2000iV or Procyte DX were reviewed. Cases of large form babesiosis were identified and their reticulocyte dot plots were analyzed. Dogs with abnormal reticulocyte profiles but without microscopically apparent intraerythrocytic Babesia piroplasms were identified. The reticulocyte profiles and fluorescence ratios of dogs with and without babesiosis were compared. RESULTS: Twenty of 92 dogs with babesiosis had abnormal reticulocyte profiles, including 8 with a separation between the reticulocyte and mature RBC plots or a continuum of reticulocytes from the RBC plot but with a higher density of dots in the middle of the "comet tail" than in the left quarter of the dot plot. Thirteen of 6980 dogs without Babesia on the blood smear had abnormal reticulocyte profiles, including 3 with leukemia. The medium-fluorescence reticulocyte ratios tended to be higher in dogs with babesiosis and abnormal dot plots than in other dogs, whereas the high-fluorescence ratio was higher in one dog with leukemia. CONCLUSION: Abnormal reticulocyte dot plots and atypical reticulocyte fluorescence ratios may occur in dogs with babesiosis and alert clinical pathologists to consider this diagnosis.

Awareness of "Predatory" Open-Access Journals among Prospective Veterinary and Medical Authors Attending Scientific Writing Workshops.

Authors face many choices when selecting a journal for publication. Prospective authors, especially trainees, may be unaware of "predatory" online journals or how to differentiate them from legitimate journals. In this study, we assessed awareness of open-access and predatory journals among prospective authors attending scientific writing workshops; our long-term goal was to inform educational goals for the workshops. We surveyed participants of writing workshops at veterinary and medical schools and an international conference over a 1-year period. The survey included 14 statements for respondents to indicate agreement level on a Likert-like scale and four questions on awareness of resources about predatory journals; respondents also defined "predatory journal." A total of 145 participants completed the survey: 106 (73.1%) from veterinary schools and 86 (59.3%) graduate students or residents. Fewer faculty (vs trainees) agreed that open access was an important factor in deciding where to publish; faculty and postdoctoral researchers were more likely to expect to pay more to publish in an open-access journal. Most respondents (120/145, 82.7%) agreed/strongly agreed that the decision to accept a manuscript should not be influenced by publication charges, but 50% (56/112) indicated that they "didn't know" how publishing costs were supported. Of the 142 respondents who answered, 33 (23.0%) indicated awareness of the term "predatory journal"; 34 (23.9%) were aware of the Directory of Open Access Journals; 24 (16.9%) were aware of the Science "sting" article about predatory journals; and 7 (4.8%) were aware of Beall's list. Most (93/144, 64.5%) definitions of predatory journals described poor but not predatory journal practices, and some respondents misunderstood the term completely. Mentors should help novice authors to be aware of predatory journals and to distinguish between legitimate and illegitimate open-access journals, thus selecting the best journal for their work.

Developing Confidence in Uncertainty: Conflicting Roles of Trainees as They Become Educators in Veterinary and Human Medicine.

The important role of medical trainees (interns and residents) as teachers is increasingly recognized in veterinary and human medicine, but often is not supported through adult learning programs or other preparatory training methods. To develop appropriate teaching programs focused on effective clinical teaching, more understanding is needed about the support required for the trainee's teaching role. Following discussion among faculty members from education and veterinary and pediatric medicine, an experienced external observer and expert in higher education observed 28 incoming and outgoing veterinary and pediatric trainees in multiple clinical teaching settings over 10 weeks. Using an interpretative approach to analyze the data, we identified five dynamics that could serve as the foundation for a new program to support clinical teaching: (1) Novice-Expert, recognizing transitions between roles; (2) Collaboration-Individuality, recognizing the power of peer learning; (3) Confidence-Uncertainty, regarding the confidence to act; (4) Role-Interdisciplinarity, recognizing the ability to maintain a discrete role and yet synthesize knowledge and cope with complexity; and (5) Socialization-Identity, taking on different selves. Trainees in veterinary and human medicine appeared to have similar needs for support in teaching and would benefit from a variety of strategies: faculty should provide written guidelines and practical teaching tips; set clear expectations; establish sustained support strategies, including contact with an impartial educator; identify physical spaces in which to discuss teaching; provide continuous feedback; and facilitate peer observation across medical and veterinary clinical environments.

Relationship between automated total nucleated cell count and enumeration of cells on direct smears of canine synovial fluid.

Canine osteoarthritis is a common disorder seen in veterinary clinical practice and causes considerable morbidity in dogs as they age. Synovial fluid analysis is an important tool for diagnosis and treatment of canine joint disease and obtaining a total nucleated cell count (TNCC) is particularly important. However, the low sample volumes obtained during arthrocentesis are often insufficient for performing an automated TNCC, thereby limiting diagnostic interpretation. The aim of the present study was to investigate whether estimation of TNCC in canine synovial fluid could be achieved by performing manual cell counts on direct smears of fluid. Fifty-eight synovial fluid samples, taken by arthrocentesis from 48 dogs, were included in the study. Direct smears of synovial fluid were prepared, and hyaluronidase added before cell counts were obtained using a commercial laser-based instrument. A protocol was established to count nucleated cells in a specific region of the smear, using a serpentine counting pattern; the mean number of nucleated cells per 400 × field was then calculated. There was a positive correlation between the automated TNCC and mean manual cell count, with more variability at higher TNCC. Regression analysis was performed to estimate TNCC from manual counts. By this method, 78% of the samples were correctly predicted to fall into one of three categories (within the reference interval, mildly to moderately increased, or markedly increased) relative to the automated TNCC. Intra-observer and inter-observer agreement was good to excellent. The results of the study suggest that interpretation of canine synovial fluid samples of low volume can be aided by methodical manual counting of cells on direct smears.

Impact of disinfectant-filled foot mats on mechanical transmission of bacteria in a veterinary teaching hospital.

OBJECTIVE: To evaluate the efficacy of disinfectant-filled foot mats at reducing tracking of Salmonella enterica and overall bacterial contamination on floors in a veterinary teaching hospital. DESIGN: Prospective study. Samples-Bacteria collected from floors before and after placement of disinfectant-filled foot mats. PROCEDURES: Foot mats filled with a phenolic-based disinfectant were placed at key transition areas in common-use corridors between the large animal hospital (LAH) and small animal hospital in a veterinary medical teaching hospital. Microbiological samples were collected for total bacterial counts and for the presence of S enterica at 14 designated sample sites in the veterinary medical teaching hospital. Samples were collected at regular intervals for 7 months before mat placement and for 13 months after mat placement. RESULTS: Median numbers of aerobic bacteria isolated before and after disinfectant mat placement were not significantly different for most sites sampled. For 3 of the 4 transition areas between the LAH and connecting common-use corridor, there was a significant difference in median bacterial counts on either side of the threshold. This difference was significant regardless of whether a disinfectant mat was present or not. Salmonella enterica isolates were cultured from several sites in the LAH and sites outside the LAH, irrespective of the presence of a disinfectant mat. CONCLUSIONS AND CLINICAL RELEVANCE: -Disinfectant-filled mats may not be uniformly effective in reducing the bacterial load on floors or in reducing mechanical tracking of S enterica from contaminated areas in a veterinary teaching hospital. Further studies are needed to determine effective measures to reduce mechanical transmission of bacteria on footwear in veterinary hospitals.

Each to their own: skeletal muscles of different function use different biochemical strategies during aestivation at high temperature.

Preservation of muscle morphology depends on a continuing regulatory balance between molecules that protect and molecules that damage muscle structural integrity. Excessive disruption of the biochemical balance that favours reactive oxygen species (ROS) in disused muscles may lead to oxidative stress, which in turn is associated with increased atrophic or apoptotic signalling and/or oxidative damage to the muscle and thus muscle disuse atrophy. Increases in the rate of oxygen consumption likely increase the overall generation of ROS in vivo. Temperature-induced increases in oxygen consumption rate occur in some muscles of ectotherms undergoing prolonged muscular disuse during aestivation. In the green-striped burrowing frog, Cyclorana alboguttata, both large jumping and small non-jumping muscles undergo atrophy seemingly commensurate with their rate of oxygen consumption during aestivation. However, because the extent of atrophy in these muscles is not enhanced at higher temperatures, despite a temperature-sensitive rate of oxygen consumption in the jumping muscle, we proposed that muscles are protected by biochemical means that, when mobilised at higher temperatures, inhibit atrophy. We proposed that the biochemical response to temperature would be muscle-specific. We examined the effect of temperature on the antioxidant and heat shock protein systems and determined the extent of oxidative damage to lipids and proteins in two functionally different skeletal muscles, the gastrocnemius (jumping muscle) and the iliofibularis (non-jumping muscle), by aestivating frogs at 24 and 30°C for 6 months. We assayed small molecule antioxidant capacity, mitochondrial and cytosolic superoxide dismutase activities and Hsp70 concentrations to show that protective mechanisms in disused muscles are differentially regulated with respect to both temperature and aestivation. High aestivation temperature results in an antioxidant response in the metabolically temperature-sensitive jumping muscle. We assayed lipid peroxidation and protein oxidation to show that oxidative damage is apparent during aestivation and its pattern is muscle-specific, but unaffected by temperature. Consideration is given to how the complex responses of muscle biochemistry inform the different strategies muscles may use in regulating their oxidative environment during extended disuse and disuse at high temperature.

Influence of elevated temperature on metabolism during aestivation: implications for muscle disuse atrophy.

Reactive oxygen species (ROS), produced commensurate with aerobic metabolic rate, contribute to muscle disuse atrophy (MDA) in immobilised animals by damaging myoskeletal protein and lipids. Aestivating frogs appear to avoid MDA in part by substantially suppressing metabolic rate. However, as ectotherms, metabolic rate is sensitive to environmental temperature, and the high ambient temperatures that may be experienced by frogs during aestivation could in fact promote MDA. In this study, we investigated the effect of temperature on the metabolic rate of the aestivating frog Cyclorana alboguttata and its skeletal muscles in order to determine their likely susceptibility to MDA. Compared with non-aestivating frogs, a significant decrease in metabolic rate was recorded for aestivating frogs at 20, 24 and 30°C. At 30°C, however, the metabolic rate of aestivating frogs was significantly higher, approximately double that of frogs aestivating at 20 or 24°C, and the magnitude of the metabolic depression was significantly reduced at 30°C compared with that at 20°C. Temperature effects were also observed at the tissue level. At 24 and 30°C the metabolic rate of all muscles from aestivating frogs was significantly depressed compared with that of muscles from non-aestivating frogs. However, during aestivation at 30°C the metabolic rates of gastrocnemius, sartorius and cruralis were significantly elevated compared with those from frogs aestivating at 24°C. Our data show that the metabolism of C. alboguttata and its skeletal muscles is elevated at higher temperatures during aestivation and that the capacity of the whole animal to actively depress metabolism is impaired at 30°C.

Clinical presentation of 26 anaplasma phagocytophilum-seropositive dogs residing in an endemic area.

Anaplasma (A.) phagocytophilum, the etiological agent of canine granulocytic anaplasmosis, is capable of inciting moderate to severe clinical disease in a variety of mammals and is endemic in the upper midwest. The purpose of this study was fourfold: to describe the range of clinical signs in dogs seropositive to A. phagocytophilum; to examine the prevalence of immune-mediated hemolytic anemia (IMHA) in this population; to evaluate whether specific clinical signs were associated with coexposure to Borrelia (B.) burgdorferi in actively infected dogs; and to determine whether clinical response to doxycycline was complete in treated dogs. Medical records of dogs seropositive for A. phagocytophilum were reviewed retrospectively. Peripheral blood smears were also reviewed retrospectively for granulocytic Anaplasma morulae. Lethargy (81%), inappetence (58%), and lameness (50%) were the most common clinical signs, followed by fever (46%). Thrombocytopenia was the most common laboratory abnormality, and IMHA was diagnosed in three dogs. Dogs that were thrombocytopenic and had antibodies to both A. phagocytophilum and B. burgdorferi had a median platelet count of 51,000/µL (range 20,000 to 171,000/µL), which was significantly lower than the count in dogs with antibodies only to A. phagocytophilum (P=0.04). Some dogs had an apparent relapse of clinical signs after an appropriate course of doxycycline. Testing for A. phagocytophilum by polymerase chain reaction, serum antibody assays, and/or blood smear evaluation should be considered in dogs with IMHA, cough, or epistaxis and that reside in A. phagocytophilum-endemic areas. If moderate to severe thrombocytopenia is present, testing for concurrent B. burgdorferi infection may be warranted.

Neoplastic pleocytosis in a dog with metastatic mammary carcinoma and meningeal carcinomatosis.

A 12-year-old female spayed Labrador Retriever was presented with a history of seizures and abnormal vocalization. Approximately 1 year before presentation, multiple mammary cysts had been surgically excised. A mammary mass was noted on physical examination, and 2 separate parenchymal brain lesions were found on imaging studies. Cerebrospinal fluid (CSF) collected from the cisterna magna was analyzed, and abnormalities included moderate pleocytosis with atypical discrete round cells that occasionally formed loose clusters. The dog was euthanized, and on necropsy a primary solid mammary carcinoma was identified as well as multiple metastatic foci in the brain with diffuse meningeal involvement. The cells in the CSF had a morphologic appearance similar to the cells in the primary mammary tumor and in the metastatic tumors in the brain. On immunostaining, cells from the primary mammary tumor, the brain tumors, and the CSF expressed cytokeratin. The CSF cells did not express CD18, CD3, or CD79a. A final diagnosis of mammary carcinoma with brain metastasis and meningeal carcinomatosis was made.

Histiocytic sarcoma of macrophage origin in a cat: case report with a literature review of feline histiocytic malignancies and comparison with canine hemophagocytic histiocytic sarcoma.

Mild nonregenerative anemia was detected in a 9-year-old neutered male domestic shorthair cat during a routine examination. Bone marrow core biopsy revealed erythroid hyperplasia; however, a specific cause was not identified. Over the next 8 months the anemia progressed, eventually becoming mildly regenerative, and moderate thrombocytopenia developed. On ultrasonographic examination, marked splenomegaly, mild hepatomegaly, and abdominal lymphadenopathy were found. Cytologic evaluation of splenic aspirates revealed increased numbers of mildly to moderately pleomorphic histiocytes that frequently had phagocytosed RBCs, leukocytes, and occasionally platelets. Histopathologic examination of the spleen and liver revealed effacement of splenic architecture by a histiocytic sarcoma (HS), and neoplastic histiocytes in hepatic sinusoids. A second bone marrow aspirate revealed neoplastic infiltration by similar cells. The histiocytes in all tissues were mildly to moderately pleomorphic and markedly erythrophagocytic. The immunophenotype of histiocytes in the spleen was CD1c(-)/CD11b(+)/CD18(+)/MHC-II(+), supporting a macrophage cell lineage. The clinical, pathologic, and immunophenotypic findings in this cat were similar to those in hemophagocytic HSs in dogs. To our knowledge, this is the first report of a HS of purported macrophage phenotype in a cat.

Correlation of ultrasonographic appearance of lesions and cytologic and histologic diagnoses in splenic aspirates from dogs and cats: 32 cases (2002-2005).

OBJECTIVE: To determine the accuracy of cytologic diagnosis, compared with histologic diagnosis, in determination of disease in ultrasound-guided fine-needle aspirates of splenic lesions. DESIGN: Retrospective study. SAMPLE POPULATION: Splenic specimens from 29 dogs and 3 cats. PROCEDURES: Records were searched for dogs and cats that had undergone ultrasound-guided splenic aspiration. Criteria for inclusion were ultrasonographic identification of splenic lesions and cytologic and histologic evaluation of tissue from the same lesion. Cytologic samples were obtained by fine-needle aspiration, and histologic specimens were obtained via surgical biopsy, ultrasound-guided biopsy, or necropsy. RESULTS: Cytologic diagnoses corresponded with histologic diagnoses in 19 of 31 (61.3%) cases and differed in 5 of 31(16.1%) cases, and 1 aspirate was inadequate for evaluation. In 7 of 31 (22.6%) cases, histologic evaluation of tissue architecture was required to distinguish between reactive and neoplastic conditions. On the basis of histologic diagnosis in 14 animals with nonneoplastic conditions, the cytologic diagnosis was correct in 11 cases, not definitive in 2 cases, and incorrect in 1 case. In 17 animals with malignant neoplastic diseases, the cytologic diagnosis was correct in 8 cases, not definitive but consistent with possible neoplasia in 5 cases, and incorrect in 4 cases. Multiple similar-appearing nodules were significantly associated with malignancy, whereas single lesions were more often benign. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasound-guided aspiration of splenic lesions is a minimally invasive tool for obtaining specimens for cytologic evaluation. Although cytologic diagnoses often reflect histologic results, if missampling or incomplete sampling occurs or tissue architecture is required to distinguish between reactive and neoplastic conditions, accurate diagnosis with fine-needle aspiration may not be possible.

Cutaneous mass aspirate from a Golden Retriever: "glandular guile".

A 3-year-old, neutered, male Golden Retriever was presented for evaluation of a 10 X 9 X 5 mm, firm, red, raised, cutaneous mass located over the left cranial thorax and noted incidentally by the owner. On cytologic evaluation of a fine-needle aspirate of the mass, the interpretation was a malignant tumor with predominantly mesenchymal features. Differentials included liposarcoma, atypical amelanotic melanoma, anaplastic sarcoma, and anaplastic carcinoma. Following complete excision of the mass, a diagnosis of sebaceous adenocarcinoma was made based on histologic features, positive immunostaining for pancytokeratin, and negative staining for vimentin, Melan-A, and S-100. There was no evidence of metastasis on physical examination or thoracic radiographs, and the prognosis was good. The unique and previously unreported cytologic features of this small, sebaceous adenocarcinoma were the extreme pleomorphism, including marked anisocytosis, anisokaryosis, and multinuclearity, and the paucity of epithelial features.

Using an independent quality control software program, EZ Runs, to monitor quality control procedures for a bench-top coagulation analyzer.

BACKGROUND: Comprehensive quality control (QC) procedures are necessary to ensure accurate analytic method performance. Highly automated systems typically have inherent QC programs that facilitate performance and maintenance of QC procedures; however, for bench-top analyzers that lack internal systems, independent QC programs must be used. OBJECTIVE: The goal of this study was to evaluate the adaptability of an independent QC program, EZ Runs (Westgard QC Inc, Madison, WI, USA), to the maintenance of QC procedures for a mechanical, bench-top coagulation unit and to compare the results with our current, manual, QC method in a qualitative way. METHODS: A QC application file for activated partial thromboplastin time (aPTT) performed on a STart4 (Diagnostica Stago, Parsippany, NJ) was created in EZ Runs. Results were recorded and interpreted using this software package as well as the current, manual, QC method. RESULTS: EZ Runs was adaptable to QC monitoring for the bench-top analyzer, and the program permitted identification of both random and systematic errors not detected by the manual QC system. CONCLUSIONS: EZ Runs improved the performance and maintenance of QC procedures for this bench-top coagulation analyzer. The results indicated the need to improve staff training in assay performance and QC interpretation. In addition, use of the software program indicated that a multirule QC design was needed to monitor assay performance.