Recall Bias in Client-Reported Outcomes in Canine Orthopaedic Patients Using Clinical Metrology Instruments.

OBJECTIVE: The aim of this study was to determine the accuracy of client recollection of their dogs' preconsultation status using clinical metrology instruments such as the Liverpool Osteoarthritis in Dogs (LOAD) and Canine Brief Pain Inventory (CBPI) questionnaires in dogs presenting to a referral orthopaedic clinic. STUDY DESIGN: This is a longitudinal prospective cohort study of client-owned dogs presenting for investigations of lameness (n = 217). LOAD and CBPI questionnaires were completed by the owners at the first consultation (T0). Owners were contacted at 2 (T1), 6 (T2), and 12 (T3) months and asked to recall their dogs' T0 status by completing another LOAD and CBPI questionnaire. The agreement between the T0 and recalled LOAD and CBPI scores was determined using the two-way mixed effects intraclass correlation coefficient (ICC). The Wilcoxon signed-rank test was used to determine the difference between scores. RESULTS: For the LOAD scores, there was moderate agreement between T0 and T1 (ICC: 0.64) and T0 and T2 (ICC: 0.53) scores and poor agreement between T0 and T3 (ICC: 0.496). For the CBPI Pain Severity Scores, there was poor agreement between T0 and all three subsequent time points (ICC < 0.5). For the CBPI Pain Interference Scores, there was moderate agreement between T0 and T1 (ICC: 0.57) and T2 (ICC: 0.56) scores and poor agreement between T0 and T3 (ICC: 0.43). CONCLUSION: The LOAD and CBPI questionnaires are subject to recall bias. Studies reporting retrospectively acquired CMI data should be interpreted with caution.

Well leg compartment syndrome due to the lithotomy position in orthopedic surgery: a report of two cases and a review of the literature.

The well leg compartment syndrome (WLCS) is a complication that can occur because of the lithotomy surgical position. Although it is a very rare entity, it can lead to a permanent disability if not properly treated. Very few cases have been described in the literature as a result of orthopedic surgery. We present two cases of WLCS that developed because of the lithotomy position. The first case concerns a patient who sustained a left floating knee and developed a compartment syndrome of the right uninjured calf during surgery. A good outcome has been achieved after early fasciotomies. The second case is about a patient who developed a compartment syndrome of the right buttock after a left unicompartmental knee replacement. This patient was treated conservatively because of delayed diagnosis. A brief literature review regarding the WLCS in orthopedic surgery is also conducted.

The effect of butorphanol on the incidence of dexmedetomidine-induced emesis in cats.

OBJECTIVE: Τo evaluate the antiemetic effect of butorphanol (BUT) when co-administered with dexmedetomidine (DEX) in cats. STUDY DESIGN: Double-blind, randomized controlled cross-over experimental study. ANIMALS: Fourteen purpose-bred healthy Domestic Short Hair cats, seven females and seven males, aged median (range) 14-84 (78) months and weighing 1.7-5.5 (4.0) kg. METHODS: Each cat received five different treatment protocols intramuscularly (IM): (A) 25 µg kg(-1) DEX; (B) 20 µg kg(-1) DEX and 0.2 mg kg(-1) BUT; (C) 20 µg kg(-1) DEX and 0.1 mg kg(-1) BUT; (D) 25 µg kg(-1) DEX and 0.2 mg kg(-1) BUT; and (E) 20 µg kg(-1) DEX. Episodes of emesis, incidence and severity of nausea, and time to lateral recumbency were recorded for a period of 8 minutes after treatment administration, and the sedation was scored at the end of this period. The Friedman test and the Cochran's Q-test were used to analyse the data. Significance was evaluated at the 5% level. RESULTS: The proportion of cats that vomited was significantly lower with the treatment protocols that included BUT (B, C and D) compared with the protocols that included only DEX (A and E). The proportion of cats that had nausea was significantly higher with the protocols that included only DEX (A and E) compared with protocols B and D. Time to lateral recumbency (p=0.09) and sedation score (p=0.07) was not statistically different between the treatment protocols. CONCLUSIONS AND CLINICAL RELEVANCE: Butorphanol can be used to prevent emesis and reduce the incidence and the severity of nausea caused by DEX in cats. It seems that the combination of BUT and DEX is very useful not only when emesis could result in serious complications, but also to provide comfort and well-being in cats sedated for minor procedures.