Ultrasound-guided and 'blind' sciatic nerve injection techniques: Comparison in rat cadavers.

OBJECTIVE: To compare the success rate and extent of sciatic nerve staining with a bupivacaine-dye solution using two injection techniques: 'blind' or ultrasound-guided approach. STUDY DESIGN: Prospective, experimental, randomized, cadaveric study. ANIMALS: Adult female Wistar rat cadavers [n = 24, mass 352 g (323-374)]. METHODS: Each sciatic nerve was randomly allocated to one of two groups: 'blind' (group B) or ultrasound-guided approach (group US) to injection. Following injection of bupivacaine-dye solution (0.1 mL), gross anatomical dissection was performed to visualize nerve staining, categorizing it as either positive or negative. The length of nerve staining was then measured and visual inspection conducted to identify potential nerve damage. Fisher's exact test was used to compare positive or negative nerve staining, and the Wilcoxon signed rank test used to compare the length of nerve staining between groups. RESULTS: In group B, the bupivacaine-dye solution stained 16/24 sciatic nerves (67% success). In group US, staining was successfully observed in all 24 nerves (100% success, p < 0.004). The length of nerve staining [median (interquartile range)] was 2 (2-3) mm in group B and 5 (4-6) mm in group US (p < 0.001). One sciatic nerve in group B had injectate distributed over 16 mm, suggestive of an intraneural injection. No signs of laceration or nerve damage were visible under 6× magnification in either group. CONCLUSIONS AND CLINICAL RELEVANCE: The ultrasound-guided approach for sciatic nerve injection demonstrated a higher success rate with superior injectate distribution when compared with the 'blind' approach. Ultrasound guidance is recommended over a 'blind' approach for sciatic nerve block in rats when possible.

Comparison of atlantoaxial and lumbosacral cerebrospinal fluid centesis techniques in South American camelids.

BACKGROUND: Iatrogenic blood contamination during cerebrospinal fluid (CSF) centesis is common, which can limit the diagnostic usefulness of the sample. A novel ultrasound-guided CSF collection technique is described in horses, by which CSF is obtained from the atlantoaxial (AA) space. HYPOTHESIS/OBJECTIVES: To compare ultrasound-guided AA centesis with lumbosacral (LS) centesis in South American camelids (SAC). The hypotheses were that AA centesis would yield samples with less blood contamination although being technically more challenging than LS centesis. ANIMALS: Eight clinically healthy adult SAC from a university-owned teaching herd. METHODS: Single-blinded, randomized, 4-way, 4-period crossover study in which 2 veterinarians each performed both centesis techniques on each animal once. Cytological sample analysis was performed, and the technical difficulty of sample acquisition was assessed. RESULTS: The CSF was collected successfully and without complications by either technique during all collection attempts. Aspects of technical difficulty and concentrations of CSF analytes did not vary significantly between techniques. Median total nucleated cell and red blood cell counts were 1/µL and 0.5/µL and 167.5/µL and 155/µL for AA and LS techniques, respectively. The median total protein concentration was 32.9 mg/dL and 38 mg/dL for AA and LS centeses. A median of 1 attempt was necessary for both centesis techniques and the median number of needle repositioning events was 1 for AA and 0 for LS. CONCLUSION AND CLINICAL IMPORTANCE: Depending on clinical circumstances, ultrasound-guided AA centesis appears to be an acceptable alternative to other techniques for collection of CSF from SAC.

Effect of a single intravenous injection of branched chain amino acids on body temperature of cats undergoing general anesthesia.

OBJECTIVE: To evaluate the effect of a single intravenous injection of branched chain amino acids (BCAAs) on body temperature in cats undergoing general anesthesia. STUDY DESIGN: Prospective, blinded, randomized, crossover, experimental study. ANIMALS: A total of 10 healthy adult cats (five female and five male). METHODS: Cats were anesthetized three times with three different treatments in a random order: 3 mL kg-1 lactated Ringer's solution (LRS), 100 mg kg-1 BCAAs (B100) or 200 mg kg-1 BCAAs (B200) solution immediately before induction of anesthesia. After induction, rectal temperature was measured every 5 minutes. Blood samples were collected for the measurement of blood glucose (BG) just before induction, at the end of the 90 minute period of anesthesia, and 24 hours after anesthesia induction. The differences between baseline and each subsequent rectal temperature, and BG measurements were analyzed. Areas under the curve (AUCs) for temperature differences were calculated for each animal for the anesthetic period (AUCT0-90). Parametric or nonparametric data were analyzed by one-way repeated measures anova or Friedman test. A value of p < 0.05 was considered significant. RESULTS: There were no significant differences in AUCT0-90 between groups: 41.6 ± 7.7 for LRS, 43.4 ± 6.9 for B100 and 42.9 ± 7.5 for B200 (p = 0.368). No significant differences were observed in BG between groups at 90 minutes and 24 hours after anesthesia induction (p = 0.283 and p = 0.089, respectively). The incidence of hypoglycemia [BG ≤ 3.17 mmol L-1 (57 mg dL-1)] after anesthesia tended to be higher in both B100 (4/10 cats) and B200 groups (3/10 cats) than in LRS group (1/10 cats). CONCLUSIONS AND CLINICAL RELEVANCE: A single, preanesthetic intravenous injection of BCAAs did not attenuate heat loss during anesthesia. More cats were hypoglycemic in the BCAA groups than in the LRS group.

Patient safety culture is needed in veterinary medicine.

Studies in human medicine indicate that between 22,000 and 400,000 people die every year as a direct result of medical errors. In veterinary medicine, 42% of human-caused incidents caused harm to the patient, including 5% resulting in death. In a university veterinary teaching hospital, there were 5.3 errors/1,000 patient visits, and 4 of these resulted in death. Veterinary medicine falls far behind other safety-critical industries in adopting a culture of patient safety. Organizations should respond in a just and effective way when errors occur. Psychological safety for team members to identify and speak up about areas of concern must be created and the results of improvements made based on these concerns shared within the professional group. If veterinary medicine is going to embrace patient safety culture, it needs to be included in the curriculum. Accrediting and licensing bodies need to require the teaching and application of principles of patient safety culture. Faculty must be trained to deliver patient safety-oriented care. Experts in human systems engineering should be brought in to educate veterinarians on how the systems we work in impact patient outcomes. If we are going to fulfill the promise of the Veterinarian's Oath, we must embrace patient safety culture and all the difficult changes it requires of our professional culture.

The effect of age on the induction dose of propofol for general anesthesia in dogs.

OBJECTIVE: In people, the dose of propofol (DOP) required for procedural sedation and anesthesia decreases significantly with age. The objective of this study was to determine if the DOP required to perform endotracheal intubation decreases with age in dogs. STUDY DESIGN: Retrospective case series. ANIMALS: 1397 dogs. METHODS: Data from dogs anesthetized at referral center (2017-2020) were analyzed with three multivariate linear regression models with backward elimination using a combination of either absolute age, physiologic age, or life expectancy (ratio between age at the time of anesthetic event and expected age of death for each breed obtained from previous literature) as well as other factors as independent variables, and DOP as the dependent variable. The DOP for each quartile of life expectancy (<25%, 25-50%, 50-75%, 75-100%, >100%) was compared using one-way ANOVA. Significance was set at alpha = 0.025. RESULTS: Mean age was 7.2 ± 4.1 years, life expectancy 59.8 ± 33%, weight 19 ± 14 kg, and DOP 3.76 ± 1.8 mg kg-1. Among age models, only life expectancy was a predictor of DOP (-0.37 mg kg-1; P = 0.013) but of minimal clinical importance. The DOP by life age expectancy quartile was 3.9 ± 2.3, 3.8 ± 1.8, 3.6 ± 1.8, 3.7 ± 1.7, and 3.4 ± 1.6 mg kg-1, respectively (P = 0.20). Yorkshire Terrier, Chihuahua, Maltese, mixed breed dogs under 10 kg, and Shih Tzu required higher DOP. Status of neutered male, ASA E, and Boxer, Labrador and Golden Retriever breeds decreased DOP, along with certain premedication drugs. CONCLUSIONS AND CLINICAL RELEVANCE: In contrast to what is observed in people, an age cut-off predictive of DOP does not exist. Percentage of elapsed life expectancy along with other factors such as breed, premedication drug, emergency procedure, and reproductive status significantly alter DOP. In older dogs, the dose of propofol can be adjusted based on their elapsed life expectancy.

Resident Selection Criteria in Veterinary Medicine.

With the continued rise of interest and need for veterinary specialists, information regarding optimal selection criteria for successful residency candidates has been lacking in veterinary medicine. A 28-question online survey was developed to determine prioritized resident selection criteria, the importance of formal interviews, and residency supervisor satisfaction with the current selection process. This survey was sent to all programs listed by the Veterinary Internship and Residency Matching Program (VIRMP) for the 2019-2020 program year. Overall, the most important aspects of the residency application process were (1) letters of recommendation, (2) performance during the interview, (3) personal contact/recommendation from a colleague, (4) personal statement, and (5) demonstrated interest in the residency specialty. While measures of academic performance including GPA and veterinary class rank may play a role in sorting of candidates in more competitive specialties, this does not necessarily exclude them from the ranking process. This information should be helpful to candidates and program directors alike in understanding the success of the current residency candidate selection process.

Effects of tiletamine-zolazepam vs. propofol on peri-induction intraocular pressure in dogs: A randomized, masked crossover study.

Introduction: Anesthesia induction agents have the potential to cause severe ocular side effects, resulting in lasting damage to the eye. Objectives: The purpose of this study is to determine the effects of tiletamine-zolazepam on IOP compared to propofol when they are used as an induction agent in normal healthy dogs. Methods: Twenty healthy adult client owned dogs weighing 22.2 ± 7.6 kg were selected for the study. In a randomized order, all dogs received tiletamine-zolazepam 5 mg/kg IV or propofol 8 mg/kg IV titrated to effect without premedication. Washout between each treatment was at least seven days. IOP measurements were obtained at four time points: baseline, post-induction, post-intubation, and after recovery using applanation tonometry. No additional procedures were performed. After normality of the data was determined, a linear mixed model was built with time, eye, treatment and all interactions of those variables as fixed effects and subject as a random effect. Results: There was no significant difference for age, body weight, drug dose, baseline IOP, and recovery IOP between treatments. Average IOP measurements remained within the normal range of 15-25 mmHg at these time points. However, IOP was significantly less elevated by the tiletamine-zolazepam treatment vs. propofol at the post-induction (mean difference: -4.7 ± 4.6 [95%CI -6.8 to -2.5]) and the post-intubation (mean difference: -4.4 ± 4.6 [95%CI -6.5 to -2.2]) time points. Clinical significance: Dogs receiving tiletamine-zolazepam for anesthetic induction had a significantly less elevated IOP at induction and intubation compared to dogs receiving propofol.

Post-operative Pain Assessment Following Tooth Extraction Using Liposomal Encapsulated Bupivacaine as a Local Anesthetic in Dogs.

The objective of this study was to evaluate owner assessment of appetite, demeanor, and mouth soreness following dental extractions in dogs receiving either bupivacaine hydrochloride (BH) or liposomal encapsulated bupivacaine (LEB) for dental blocks. Thirty healthy, adult dogs requiring dental extractions were enrolled in the study. All procedures were completed with dogs under general anesthesia. A non-steroidal anti-inflammatory drug was administered subcutaneously in the preoperative period. Dogs were randomly assigned to receive BH or LEB. An owner assessment to evaluate appetite, demeanor, and soreness of mouth was completed at the end of both the first and second day after discharge from the hospital. The total of the owner assessments for day 1 and both days combined was significantly lower for dogs receiving LEB (P = .007). There were no differences in the number of extractions (P = .21), time from block to evaluations (P = .07), in-hospital pain assessments (P = .99), or number of dogs requiring rescue analgesia (P = .99). This study concluded, dogs that received LEB for dental blocks had improved appetite and demeanor, and reduced soreness of mouth, as evaluated by the owner two days postoperatively, when compared to dogs who received BH.

Comparison of Four Arteries for Invasive Blood Pressure Measurements and Dixtal 2010 Oscillometric Values in Horses Anesthetized With Isoflurane: Does the Artery Matter?

This study evaluated the agreement between invasive blood pressure (IBP) values measured in three different arteries and by an oscillometric device (NIBP) with the ones from the transverse facial artery (FA). Six horses (424.2 ± 40.7 kg) were sedated with xylazine (0.6 mg/kg IV), induced with ketamine (2 mg/kg IV) and midazolam (0.1 mg/kg IV), and maintained with isoflurane (1.2 MAC) for 90 minutes in lateral recumbency. FA, auricular artery (AA), lateral digital artery (LDA), and metatarsal artery (MA) were catheterized, and a standard adult cuff was placed on the tail. IBP and NIBP values were recorded at 30, 45, 60, 75, and 90 minutes of anesthesia. Data were analyzed with Shapiro-Wilk and Repeated-Measures Bland-Altman. Values for FA (mm Hg) were 85.4 ± 10.3 for SAP, 70.6 ± 9.3 for MAP, and 58.5 ± 9.5 for DAP. Mean bias and 95% Limit of agreement (LOA) for AA were -1.7 (-29.0 to 25.6), 2.2 (-18.4 to 22.9), 1.9 (-18.2 to 22.0), for LDA: 1.4 (-25.1 to 27.8), 2.9 (-19.3 to 25.0), 2.3 (-18.4 to 22.9), for MA: -3.2 (-28.3 to 22.0), 2.7 (-16.6 to 22.1), 4.9 (-13.8 to 22.2), and for NIBP: -5.7 (-28.3 to 16.9), 7.9 (-9.5 to 25.3), 17.2 (-2.4 to 36.8), for SAP, MAP and DAP respectively. There is a reasonable bias for IBP values among the arteries evaluated, however a wide LOA, demonstrating the arteries are not interchangeable. NIBP method from Dixtal 2010 results in inaccurate blood pressure values in horses.

Effect of Romanowsky-Stained Concentrated Preparations versus Direct Smears on Veterinary Students' Ability to Identify Bacterial Sepsis in Fluid Cytology Samples from Dogs, Cats, and Horses.

Veterinary students' accuracy, confidence, and time required to diagnose bacterial sepsis in fluid cytology samples was evaluated using two different slide preparation methods: direct smears and cytocentrifuged concentrated preparations. We hypothesized veterinary students would diagnose fluids as septic on concentrated preparations more accurately and quickly than on direct smears. Thirty third- and fourth-year students who had previously participated in a clinical pathology course completed a survey regarding general cytology experience and reviewed 40 randomized Romanowsky-stained slides via microscopy. Slides consisted of 10 septic and 10 non-septic samples with matched direct and concentrated slides, prepared from fluids from dogs, cats, and a horse. Participants' slide evaluation time, diagnosis, confidence, and slide photographs of areas considered septic were recorded. No difference in diagnostic accuracy between direct and concentrated samples was identified (area under the curve: 57% for both preparations, p = 0.77), although students agreed with pathologist-determined diagnoses more often when viewing concentrated samples (M = 63%, SD = 11% for concentrated; M = 56%, SD = 21% for direct, p = .012). A positive relationship existed between accuracy of diagnosis (R2 = .59) and senior status (p = .002), comfort interpreting cytology slides (p < .03), and if the student had taken the senior pathology rotation (p = .02). Only 38% (121/319) of participant photographs correctly identified sepsis. Under experimental conditions, concentrated preparations did not increase the accuracy of veterinary students' bacterial sepsis diagnosis; however, since accuracy did increase with cytology experience and comfort level, additional pre-clinical and clinical cytology training may benefit students before entering practice.

Specifications Grading for Veterinary Medicine.

Assigning grades in a traditional manner is often problematic: grades may or may not reflect actual student achievement, and students may base their self-worth on grades. Specifications (spec) grading claims to remedy these through a novel grading scheme. The scheme also purports to uphold high academic standards, reflect student learning, motivate students to focus on learning (rather than a grade), discourage cheating, reduce student stress, give students control over their grade, minimize conflict between students and faculty, save faculty time, make expectations clear, and facilitate higher-order learning. In spec grading, students must achieve 80% or higher to pass selected assignments, which include exams and quizzes, with the number and nature of assignments dictating the student's final letter grade for the course. Students may resubmit assignments until they pass. Implementing spec grading requires creating assignments, determining assignment bundles, and communicating the new scheme to students to set clear expectations. The purpose of this tip is to describe how to develop a course using spec grading for didactic and clinical applications.

Specifications Grading in a Cardiovascular Systems Course: Student and Course Coordinator Perspectives on the Impacts on Student Achievement.

This study investigated students' and a course coordinator's perceptions about specifications (spec) grading in a cardiovascular systems course and assessed its effects on student performance. Spec grading was hypothesized to result in lower perceived student stress about the course, improved student performance, and less work for the course coordinator. The study used a mixed methods approach consisting of student pre-, peri-, and post-course surveys; student focus group interviews; analysis of student course evaluations; and course coordinator reflection. Participants were from a cross-section of one course in the veterinary professional curriculum. Results demonstrated significantly more A grades assigned to students than in the previous year's course, where traditional grading was used (p = .024). The focus group produced two primary themes: pros and cons. Pros included flexibility, student control over grades, generally lower perceived stress, opportunities to resubmit assignments, and more motivation to learn. Cons included confusion about the process, some disorganization, perceived higher workload for the professor, and communication concerns. The course coordinator's positive perceptions included students being less combative about grades than with the traditional system, students appreciating opportunities to resubmit assignments, and students demonstrating improved learning outcomes. Negative course coordinator perceptions were that reduced student stress was inconsistently achieved and that there was increased time commitment compared with traditional grading. Course evaluation themes included skepticism about spec grading in the beginning, varying stress experiences, improved learning, and increased workload. In conclusion, spec grading variably reduced student stress and did not result in less work for the course coordinator.

Echocardiographic and radiographic aortic remodeling in cats with confirmed systemic hypertension.

Systemic hypertension (SH) in cats may occur secondary to renal disease, hyperthyroidism, or idiopathic causes. Asymmetric dilation of the sinuses of Valsalva has been recognized in people with systemic hypertension as target organ damage (TOD). Aortic knob formation (lateral bowing of the aortic arch to proximal descending aorta on the posteroanterior/anteroposterior radiographic projection) is recognized as TOD in people due to SH. None of these changes have been reported in feline patients. The first objective of this retrospective case-controlled study was to compare echocardiographic changes in the aorta of 76 cats with systemic hypertension (SH) to those seen in 76 cats with normal blood pressure (NBP). Our second objective was to have blinded reviewers assess heart size and aortic shape and size from available thoracic radiographs of 49/76 cats with SH and 46/76 cats with NBP. A two-way unpaired t-test with significance set at alpha = 0.01 was used to evaluate aortic echocardiographic parameters. The mean of the aortic diameter and length of each aortic cusp was significantly larger in cats with SH than in cats with NBP. The aortic cusps were considered altered in size in 62 of 76 cats with SH, 12/62 ≥ with 0.5 mm, and 50/62 ≥ 1.0 mm. No significant difference in the vertebral heart score (VHS) was noted between groups. The aortic knob to lateral margin of the trachea in cats with SH had an area under the curve (AUC) of 0.74 (95% CI:0.61-0.87) with best cutoff of 1.12 cm with sensitivity of 81% and specificity of 69%.

Examination of Motivational Influences on Clinical-Year Veterinary Students' Career Decisions.

The purpose of this study was to identify motivations for fourth-year veterinary students to choose future career paths based on post-graduation employment or post-graduation education. Approximately 500 students from four institutions were invited to participate in an online survey. Surveys were based on the cognitive evaluation theory, a minitheory within the self-determination macrotheory framework developed by Deci and Ryan. Intrinsic motivational factors were categorized by autonomy, competence, and relatedness, and extrinsic motivators were categorized by environmental and interpersonal factors. Students pursuing post-graduation education have intrinsic motivators that aligned with competence and were extrinsically motivated by a mentor, while students interested in post-graduation employment had intrinsic motivators that were more focused on autonomy with extrinsic motivational influences of debt/finances and geographic location.

Development of the Auburn Induction Scale for evaluating induction quality in dogs.

OBJECTIVE: To develop and begin establishing evidence for validity of an instrument to assess the quality of induction in dogs. STUDY DESIGN: Cross-sectional survey and video scoring. ANIMALS AND POPULATION: A total of 51 veterinary anesthesia personnel, four board-certified anesthesiologists and videos of induction of anesthesia in 18 dogs. METHODS: In Part 1, an online survey was sent to veterinary anesthesia personnel to solicit expressions and words that they associate with induction of anesthesia. These expressions were evaluated by four anesthesiologists to create a composite scale (Auburn Induction Scale). In Part 2, 18 videos were reviewed by the same four anesthesiologists on two separate occasions. The videos were scored using the Auburn Induction Scale, a simple descriptive scale (SDS) and a visual analog scale (VAS). Intra-rater and inter-rater reliability was measured using an intraclass correlation coefficient (ICC). Significance was set at p < 0.05. RESULTS: The survey yielded 51 responses that were condensed into 133 expressions. The four anesthesiologists created 18 items incorporating the 133 expressions. The mean ± standard deviation intra-rater reliability ICC was 0.81 ± 0.08 for the Auburn Induction Scale, 0.71 ± 0.02 for the SDS and 0.71 ± 0.08 for the VAS for all raters. The mean ± standard deviation inter-rater reliability ICC was 0.69 ± 0.04 for the Auburn Induction Scale, 0.61 ± 0.05 for the SDS and 0.60 ± 0.06 for the VAS. CONCLUSIONS AND CLINICAL RELEVANCE: In a research setting, widespread use of this scale may be helpful in increasing the accuracy of data and improving agreement between studies assessing induction of anesthesia in dogs. The results of this study have yielded a composite scale that is more reliable between and among raters than a unidimensional scale.

Comparison of 2 blind approaches to the paravertebral brachial plexus regional block in canine cadavers.

The paravertebral brachial plexus block (PVB) provides thoracic limb analgesia. The objective was to describe a blind craniocaudal (CC) approach to the PVB and compare its accuracy, time, and difficulty of performance with a blind dorsoventral (DV) approach. The operator was initially trained by experienced clinicians to perform both approaches on 5 cadavers. Next, a CC or DV approach to the PVB was performed on both thoracic limbs of 20 cadavers (20 for each approach). Methylene blue dye was equally divided into 4 aliquots to stain the ventral branches of the sixth to eighth cervical and first thoracic spinal nerves. Successfully stained (stain ≥ 1 cm) spinal nerves were counted. The time to perform each approach was recorded and ease of performance was scored using a numerical scale (1 "easy" to 4 "difficult"). The phrenic nerve was checked for stain. A Wilcoxon signed-rank test was used to compare approaches. The data are presented as median (interquartile range; minimum to maximum range). The number of stained nerves with the CC approach 3 (1; 2 to 4), was higher than the DV approach 2 (2; 0 to 4) (P = 0.002). The time (in seconds) to perform the CC approach 125 (79; 70 to 194), was not different from the DV approach 142 (54; 101 to 232) (P = 0.084). The CC approach 2 (2; 1 to 4) was easier to perform than the DV approach 3 (1; 2 to 4) (P = 0.024). No phrenic nerve staining was observed with either approach. The CC approach is an alternative to the DV approach for performing the PVB in dogs.

Le bloc du plexus brachial paravertébral (PVB) fournit une analgésie du membre thoracique. L'objectif était de décrire une approche craniocaudale (CC) aveugle du PVB et de comparer sa précision, son temps et sa difficulté de performance avec une approche dorso-ventrale (DV) aveugle. L'opérateur a été initialement formé par des cliniciens expérimentés pour effectuer les deux approches sur cinq cadavres. Ensuite, une approche CC ou DV du PVB a été réalisée sur les deux membres thoraciques de 20 cadavres (20 pour chaque approche). Le colorant bleu de méthylène a été divisé de manière égale en quatre aliquotes pour colorer les branches ventrales des sixième à huitième nerfs cervicaux et rachidiens thoraciques. Les nerfs spinaux colorés avec succès (coloration ≥ 1 cm) ont été comptés. Le temps d'exécution de chaque approche a été enregistré et la facilité d'exécution a été notée à l'aide d'une échelle numérique (1 « facile ¼ à 4 « difficile ¼). Le nerf phrénique a été vérifié pour la coloration. Un test des rangs signés de Wilcoxon a été utilisé pour comparer les approches. Les données sont présentées sous forme de médiane (intervalle interquartile; intervalle minimum à maximum). Le nombre de nerfs colorés avec l'approche CC 3 (1; 2 à 4) était plus élevé que l'approche DV 2 (2; 0 à 4) (P = 0,002). Le temps (en secondes) pour effectuer l'approche CC 125 (79; 70 à 194) n'était pas différent de l'approche DV 142 (54; 101 à 232) (P = 0,084). L'approche CC 2 (2; 1 à 4) était plus facile à réaliser que l'approche DV 3 (1; 2 à 4) (P = 0,024). Aucune coloration du nerf phrénique n'a été observée avec l'une ou l'autre approche. L'approche CC est une alternative à l'approche DV pour réaliser le PVB chez le chien.(Traduit par Docteur Serge Messier).

Single instead of triplicate intraocular pressure measurements in dogs do not substantially lower accuracy and precision but do slightly reduce statistical power.

OBJECTIVE: To compare single and triplicate applanation tonometry values across previous intraocular pressure (IOP) studies in dogs. ANIMALS: 116 ophthalmologically normal dogs. PROCEDURES: Triplicate IOP readings (n = 1432) from studies evaluating effect of anesthetic protocols were analyzed to estimate a range of probable differences between averaged triplicate and first, averaged and lowest, and first and lowest IOPs. The decrease in variability with triplicate measurements and the magnitude of effects on statistical power were quantified. RESULTS: The 2.5th to 97.5th interpercentile range for differences of averaged triplicate values minus first IOP readings was -3 to 2.7 mm Hg; for averaged minus lowest: 0 to 3.7 mm Hg; for first minus lowest: 0 to 5 mm Hg. The 95% prediction interval for differences in study group means (n = 160 groups, n = 5 to 11 eyes per group) based on averaged minus first measurements was -1.0 to 0.9 mm Hg with associated SDs reduced by 4% on average. Analysis of previous studies using averaged instead of first IOP values resulted in minimal decreases in SEs of 3-9% (0.03 to 0.09 mm Hg). Of 11 comparisons found significant with averaged data, 2 (18%) were found nonsignificant with first measurements. Of 96 comparisons found nonsignificant with averaged data, 3 (3%) were found significant with first measurements. CLINICAL RELEVANCE: With applanation tonometry in ophthalmologically normal dogs, no clinically meaningful difference was found between the first, lowest, or averaged triplicate IOP measurements, but the first reading has a larger variance and hence will result in lower statistical power.

Scoping review of quality of anesthetic induction and recovery scales used for dogs.

OBJECTIVE: To compare, describe and assess the level of validation of all instruments measuring quality of induction and recovery from anesthesia in dogs. DATABASES USED: A search was performed using the electronic database PubMed to find articles containing an induction quality scale, a recovery quality scale or both in dogs. Articles not directly accessible through PubMed were obtained through the Auburn University Library website and Google Scholar. The phrases 'induction scoring systems dogs', 'recovery scoring systems dogs', 'anesthetic induction score dogs', and 'anesthetic recovery score dogs' were used for searches using the 'best match search' function. The time frame searched was from 1980 to May 2020. The search was conducted from March 2020 to May 2020. CONCLUSIONS: A thoroughly tested and validated scale for measuring the quality of induction and recovery does not exist in the current veterinary literature. A large disagreement exists between studies on the use of induction and recovery scales, and many have reported inconsistent results with current instruments. It is recommended that an induction and recovery scale intended for wide-scale use be constructed and tested extensively for psychometric validation and reliability.

A survey of emergency and critical care veterinarians regarding IV fluid bolus therapy and monitoring practices in small animals.

OBJECTIVE: To determine how veterinary emergency and critical care clinicians define IV fluid bolus therapy (FBT) and what constitutes a positive response to a fluid bolus. DESIGN: Online survey of 222 emergency and critical care veterinarians between December 17, 2018, and March 1, 2019. INTERVENTIONS: An online survey was provided to diplomates of the American College of Veterinary Emergency and Critical Care (ACVECC), residents of ACVECC-approved training programs, as well as house officers and emergency clinicians of a corporate multicenter emergency and specialty care veterinary hospital. The survey investigated the administration of various crystalloid, colloid, and blood products for FBT, as well as expected physiological responses. MEASUREMENTS AND MAIN RESULTS: The majority of respondents considered balanced isotonic crystalloids appropriate for FBT (220/222 [99.1%]). Respondents showed greater variability in acceptance of 0.9% sodium chloride (105/222 [47.30%]), hypertonic (3-7%) sodium chloride (131/222 [59.01%]), and hydroxyethyl starch solutions (90/222 [40.54%]). Most respondents did not consider physiological plasma (44/222 [19.82%]) an appropriate choice. The most commonly used parameters for monitoring FBT responses were heart rate (220/222 [99.10%]), blood pressure (217/222 [97.75%]), capillary refill time (192/222 [86.49%]), lactate (181/222 [81.53%]), pulse pressure (151/222 [68.02%]), and rectal temperature (145/222 [65.32%]). The majority of respondents perceived that 0-20% (165/222 [74.32%]) of hypotensive patients are nonresponsive to FBT. CONCLUSIONS: Small animal emergency and critical care clinicians favored balanced isotonic electrolyte solutions and hypertonic sodium chloride solutions for FBT over other options. When monitoring responses to FBT, heart rate, blood pressure, capillary refill time, and plasma lactate were among the most commonly monitored parameters, and there was a lack of familiarity with others. Despite the widespread use of FBT, these findings outline the need for further prospective clinical trials regarding the ideal fluid type and rate, as well as the appropriate responses to FBT.

Influence of osteochondrosis on the longevity and racing performance of standardbred trotters and pacers.

OBJECTIVE: To determine the influence of clinical osteochondrosis (OC) on the short-term (2, 3, and 4-year-old) and long-term racing performance and longevity of standardbred racehorses. STUDY DESIGN: Retrospective case-control study. SAMPLE POPULATION: Standardbred racehorses from a single breeding farm born between 2009 and 2017 that survived to racing age (n = 2711). Three hundred eighty-two (14%) horses were OC-affected (829 lesions confirmed arthroscopically during surgical treatment), and 2329 (86%) horses were nonaffected. METHODS: Racing performance data were obtained from an online database and evaluated with multiple linear regression models. RESULTS: Trotters were more likely than pacers to be affected by OC (odds ratio [OR] = 1.4, 95% CI = 1.1-1.9, P = .006). Compared with nonaffected horses, long-term OC-affected horses had 8.8 fewer starts (95% CI = -14.4 to -3.2, P = .002), 1.0 fewer wins (95% CI = -1.9 to -0.1, P = .030), and 3.8 fewer total number of first through third place finishes (95% CI = -6.2 to -1.4, P < .0001). Nonaffected horses had longer careers compared with OC-affected horses, racing 0.32 years longer (95% CI = -0.52 to -0.12, P = .002). Osteochondrosis had no impact on short-term racing performance. Horses with lesions at the distal intermediate ridge of the tibia or lateral trochlear ridge of the talus had decreased performance compared with horses without these lesions. CONCLUSION: Pacers were less likely than trotters to be affected by OC. Affected horses had fewer starts and shorter careers, despite early surgical intervention. CLINICAL SIGNIFICANCE: Osteochondrosis decreases long-term racing performance in racing standardbreds.