Residency program factors affecting ACVS board examination pass rates from 2017 to 2021: A survey of ACVS small animal surgery residency programs.

OBJECTIVE: To identify small animal surgery (SAS) residency program factors associated with board examination pass rates for the American College of Veterinary Surgeons (ACVS) board certification examinations. STUDY DESIGN: Online survey. SAMPLE POPULATION: Program directors of ACVS-registered SAS residency programs. METHODS: An online survey was distributed to eligible 2021 ACVS SAS residency program directors. Respondents provided program information and Phase I and Phase II board examination pass rate data from 2017 to 2021. Programs were grouped based on overall combined board examination pass rates as "excellent" (≥90%) versus "adequate" (<90%). Data were analyzed using recursive partitioning. RESULTS: Responses from 36 ACVS SAS residency programs (18 private practice [PP], 18 academic programs [AP]) were included. Pass rates were considered "excellent" for 17/36 programs (11/17 AP, 6/17 PP). The strongest indicator of "excellent" programs was most mentors participating in rounds >75% of the time. Of those, the second indicator of "excellent" programs was a soft tissue caseload of <7 surgeries/resident/week. If the soft tissue caseload was >7 surgeries/resident/week, a high orthopedic caseload (>9 surgeries/resident/week) was indicative of "excellent" programs. If most mentors were not participating in rounds >75% of the time, APs were more likely to be "excellent." CONCLUSION: SAS APs may have higher ACVS board examination pass rates. Mentor involvement, caseload, and residency practice type may influence board examination pass rates. CLINICAL IMPACT: ACVS SAS residency programs' board examination pass rates may improve by optimizing mentor involvement and caseload regardless of practice type.

Comparison of bupivacaine liposome injectable solution and fentanyl for postoperative analgesia in dogs undergoing limb amputation.

OBJECTIVE: The objectives of the study were to compare the clinical efficacy and adverse effects of two analgesic protocols consisting of bupivacaine liposome injectable solution (BLIS) and 0.5% bupivacaine and fentanyl for postsurgical analgesia in dogs undergoing limb amputation. STUDY DESIGN: Randomized, double-blind, prospective, controlled, intent-to-treat, clinical noninferiority trial. ANIMALS: Forty client-owned dogs. METHODS: Dogs undergoing amputation were randomly assigned to either the BLIS or control group. Postoperative pain, sedation, nausea, and amount eaten were assessed using appropriate scales at 6, 12, 18, and 24 h by trained individuals blinded to the treatment protocol. Rescue analgesia was provided for Glasgow composite measure pain scale (short form) (CMPS-SF) scores of 5 or above. Clients were requested to pain score their dogs at home using a visual analogue scale (VAS) for 48 h following discharge. RESULTS: Forty dogs completed this study (20 control dogs and 20 BLIS dogs). The BLIS and control groups were equivalent for sedation, nausea, amount eaten, and pain, at all time periods except at 6 h (p < .01), when the BLIS group pain score was lower. CONCLUSION: The BLIS provided equivalent analgesia with fewer adverse effects than fentanyl constant rate infusion (CRI) following limb amputation. Rescue analgesia was provided to five dogs in the BLIS group and four in the control group, and there was no statistical difference. Nausea scores did not differ statistically. CLINICAL SIGNIFICANCE: As BLIS provides equivalent analgesia, this may allow for decreased reliance on opioids in the immediate postoperative period.

Prospective, randomized, clinical trial on the effects of laparoscopic insufflation pressures on portal pressures in dogs.

OBJECTIVE: The adverse effects of intra-abdominal pressure from capnoperitoneum on cardiovascular and pulmonary systems have been well documented, but the effects on portal pressures in dogs with various insufflation pressures is poorly defined. The aim of the present study was to measure the effect of a range of insufflation pressures on the portal pressure, using direct pressure measurements in patients undergoing laparoscopy. STUDY DESIGN: Clinical randomized prospective study. ANIMALS: Nine client-owned dogs undergoing routine laparoscopy. METHODS: Two rounds of direct portal pressure assessments were performed, at insufflation pressures of 0, 6, 10, and 14 mmHg in a predetermined randomized sequence. The data were analyzed for effects of insufflation pressure, hemodynamic alterations, and round. A best-fit exponential model of the relationship between portal pressure and insufflation pressure was created. RESULTS: Portal pressure increased by 38% at 6 mmHg, 95% at 10 mmHg, and 175% at 14 mmHg compared to baseline. Portal pressure increased at an average rate of 7.45% per mmHg of insufflation pressure. Effects of weight, weight/insufflation pressure interaction, and round of insufflation were not statistically significant. No systemic hemodynamic adverse events were observed. CONCLUSION: Portal pressure increased as insufflation pressure increased. There was no clinically significant difference in baseline portal pressure between rounds of insufflation. CLINICAL SIGNIFICANCE: This exponential model of portal pressure supports the use of the minimum insufflation pressure to allow visualization during laparoscopy. The return of portal pressure to baseline following desufflation supports the comparison of portal pressure measurements before and after laparoscopic shunt attenuation.

Evaluation of preoperative rectus sheath block with bupivacaine for analgesia in cats undergoing ovariohysterectomy: a cadaveric and randomized clinical study.

OBJECTIVE: Phase 1: to determine the feasibility of desensitizing ventral branches of spinal nerves within the rectus sheath using an ultrasound-guided rectus sheath block (USRSB). Phase 2: to determine the effect of preoperative USRSB on intraoperative responses to surgical stimulation and postoperative pain. STUDY DESIGN: Cadaveric study and prospective, randomized, blinded, parallel-arm clinical trial. ANIMALS: A group of five cat cadavers and 37 shelter-owned cats undergoing ovariohysterectomy. METHODS: Phase 1: anatomical dissection was performed on one uninjected cadaver. Abdominal walls were dissected in four cadavers (eight hemiabdomens) following bilateral USRSB using 1:1 new methylene blue and 0.5% bupivacaine (0.8 mL kg-1 total). Phase 2: preoperative bilateral USRSB was performed with 0.8 mL kg-1 of 0.25% bupivacaine (RSB) or equivalent volume of 0.9% saline (CONTROL). Intraoperative systolic arterial blood pressure (SAP), heart rate (HR), respiratory rate (fR) and vaporizer setting (vap%) were recorded before skin incision, during celiotomy and abdominal wall closure. In recovery, cats were administered robenacoxib (2 mg kg-1; CONTROL) or 0.9% saline (0.1 mL kg-1; RSB) subcutaneously. Postoperative pain was evaluated for 6 hours using the Glasgow Composite Measure Pain Scale. RESULTS: Phase 1: spinal nerves T9-L3 were identified within the rectus sheath, and stained in 0%, 40%, 63%, 75%, 100%, 88%, 50% and 13% of hemiabdomens, respectively. Phase 2: 37 cats were included (RSB, n = 17; CONTROL, n = 20). Intraoperatively, SAP, HR and fR were not significantly different between groups. Vap% was significantly lower in RSB during celiotomy (p = 0.036) and closure (p = 0.044). Postoperatively, RSB cats were 5.3 times (95% CI 1.8-8.3) more likely to require rescue analgesia than CONTROL cats. CONCLUSIONS AND CLINICAL RELEVANCE: During surgery, USRSB with bupivacaine offered minor benefits and provided markedly less postoperative analgesia than robenacoxib, indicating that relying on USRSB provides insufficient postoperative analgesia for ovariohysterectomy in cats.

Systematic review of the treatment options for pericardial effusions in dogs.

OBJECTIVE: To evaluate the evidence for the conservative and surgical management of pericardial effusions for neoplastic and idiopathic etiologies in dogs. STUDY DESIGN: Systematic review. SAMPLE POPULATION: Peer-reviewed English-language articles describing the treatment and outcome of naturally occurring pericardial effusion in domestic dogs. METHODS: A literature search was performed with PubMed, Cab Abstracts, Scopus, and Agricola in August 2019 for articles describing pericardial effusion treatment in dogs. Inclusion criteria were applied, and articles were evaluated for reported outcome and level of evidence by using The Oxford 2011 Levels of Evidence, a previously described hierarchical system, and GRADE (Grading of Recommendations, Assessment, Development and Evaluation). RESULTS: One hundred eight of the 641 unique articles that were identified and evaluated met inclusion criteria. Most articles included were case studies (68.2%) or retrospective case series (25.2%), with all articles providing a low level of evidence. The articles had inconsistent inclusion criteria, outcome measures, and follow-up, making comparison of outcomes difficult. CONCLUSION: Because of the low quality of evidence of the studies included in this systematic review and the variability of the outcomes, there is not sufficient evidence to recommend one treatment option rather than another. CLINICAL SIGNIFICANCE: There is a requirement for higher quality evidence such as randomized controlled trials and prospective comparative cohort studies. Standardization of outcome measures reported for each treatment option and disease process studied will allow for better comparison of outcomes between studies.

Comparison of diameter and length of subclavian arteries to external jugular veins in variably sized dogs: A cadaveric study.

OBJECTIVE: To evaluate the length and diameter of a left external jugular vein graft as a substitute for the left subclavian artery in the modified Blalock-Thomas-Taussig shunt (mBTTS) in differently sized dogs. STUDY DESIGN: Cadaveric study. ANIMALS: Dog cadavers of three weight categories (10/group): <9.5 kg, 9.5 to 27 kg, and > 27 kg. METHODS: The length and infused external diameters of harvested vessels were measured with vernier calipers and recorded. A matched-pairs t test was used to test the difference in vessel lengths. The agreement in vessel diameters was assessed by using Lin's concordance correlation coefficient (CCC). Pearson's correlation coefficients (CC) were determined for vessel diameter to weight category and vessel length to weight category. RESULTS: The external jugular vein measured longer than the subclavian artery in all dogs (52.0 ± 20.8 mm and 23.0 ± 8.9 mm, respectively), with a mean difference of 28 ± 14.3 mm (P < .001). The mean external infused subclavian and external jugular diameters measured 7.8 ± 2.2 mm and 8.0 ± 2.5 mm, respectively (P = .32). Lin's CCC was 0.87. Pearson's CC were 0.74 in both vessel diameters (P < .001); they were 0.36 and 0.43, respectively, for subclavian artery and external juglar vein length (P < .001). CONCLUSION: Autologous external jugular vein grafts had an external diameter similar to subclavian artery and a significantly longer length in variably sized dogs. CLINICAL SIGNIFICANCE: External jugular vein grafts may be an acceptable graft choice for mBTTS.

Zygomatic sialocele secondary to infarction treated with sialoadenectomy in a dog.

Zygomatic salivary gland disease is not commonly reported in dogs and there is a paucity of literature reporting salivary gland disease secondary to infarction in dogs. A 9-year-old German wirehaired pointer presented with left eye exophthalmos, 3rd eyelid elevation, negative retropulsion, and pain upon opening of the mouth. Computed tomography revealed a mass extending from the left zygomatic salivary gland, consistent with a sialocele. A left-sided zygomatic sialoadenectomy was performed successfully. Histopathologic diagnosis concluded zygomatic salivary gland infarction. The dog had no signs of recurrence 20 mo after surgery. Key clinical message: To the authors' knowledge, this is the first case report with long-term outcome of a zygomatic sialocele secondary to salivary gland infarction in a dog treated by zygomatic sialoadenectomy via zygomatic osteotomy.

Sialocèle zygomatique secondaire à un infarctus traité par sialoadénectomie chez un chien. Une atteinte des glandes salivaires zygomatiques n'est pas fréquemment rapportée chez le chien et il existe peu de littérature rapportant une maladie des glandes salivaires secondaire à un infarctus chez le chien. Un pointeur allemand à poil dur de 9 ans présentait une exophtalmie de l'oeil gauche, une élévation de la troisième paupière, une rétropulsion négative et une douleur à l'ouverture de la bouche. La tomodensitométrie a révélé une masse s'étendant à partir de la glande salivaire zygomatique gauche, compatible avec une sialocèle. Une sialoadénectomie zygomatique gauche a été réalisée avec succès. Le diagnostic histopathologique a permis de conclure à un infarctus des glandes salivaires zygomatiques. Le chien n'avait aucun signe de récidive 20 mois après la chirurgie.Message clinique clé :À la connaissance des auteurs, il s'agit du premier rapport de cas avec évolution à long terme d'une sialocèle zygomatique secondaire à un infarctus des glandes salivaires chez un chien traité par sialoadénectomie zygomatique via une ostéotomie zygomatique.(Traduit par Dr Serge Messier).

The effect of body condition on postoperative recovery of dachshunds with intervertebral disc disease treated with postoperative physical rehabilitation.

OBJECTIVE: To determine the impact of obesity on postoperative recovery from thoracolumbar hemilaminectomy in dachshunds treated with rehabilitation. STUDY DESIGN: Prospective observational trial. ANIMALS: Thirty-two dachshunds with thoracolumbar intervertebral disk disease and pain perception. METHODS: Dachshunds were entered into the study after unilateral thoracolumbar hemilaminectomy. Lean muscle and fat contents were measured with dual-energy x-ray absorptiometry (DEXA) at the beginning and at week 12 of the study. Aggressive rehabilitation was performed 1, 2, 4, and 6 weeks after surgery. Logistic regressions were used to determine the odds ratios between potential risk factors (age, duration of clinical signs, weight, body condition score, percentage body fat, percentage lean muscle mass, and disability index [DI] score at presentation) and return benchmarks of recovery. RESULTS: Body condition score, percentage body fat, percentage lean muscle mass, weight, and age did not influence the odds ratio for recovery. An increase in preoperative DI score was associated with increased risk of a slow postoperative recovery (P < .05). The odds ratios were 2.5, 4.8, and 1.8 for >7 days until standing, > 30 days until strong ambulation, and failure to return to normal within the study period, respectively. On average, dogs lost weight (2.2 kg) and body fat (2.4%) but gained muscle mass (3.0%) over the study period (P < .05). CONCLUSION: Preoperative disability but not body condition was a risk factor for a slow recovery after thoracolumbar hemilaminectomy in dachshunds with rehabilitation. CLINICAL SIGNIFICANCE: A slower recovery is likely with increased preoperative disability, but body condition does not seem to affect the postoperative prognosis of dachshunds treated with rehabilitation.

Evaluation of a scoring system based on conformation factors to predict cranial cruciate ligament disease in Labrador Retrievers.

OBJECTIVE: To determine the association of a radiographic score derived from tibial plateau angle (TPA) and femoral anteversion (FAA) with an outcome of cranial cruciate ligament deficiency (CCLD) in large dogs. STUDY DESIGN: Cross-sectional study. ANIMALS: 167 Labrador Retrievers. METHODS: Hind limbs of sound Labrador Retrievers over 6 years of age were considered at low risk for CCLD. Limbs were considered high risk for CCLD if they were affected or predisposed (sound contralateral limb in dogs with unilateral CCLD). The radiographic CCLD score was calculated for each limb. The TPA, FAA, and CCLD scores were compared between limbs of the same dog and between risk categories. A contingency table was used to evaluate the association of the CCLD score with the CCLD status of limbs. RESULTS: TPA, FAA, and CCLD scores were greater in limbs categorized as high risk for CCLD than in normal limbs. The sensitivity and specificity of the CCLD score was 87% and 79%, respectively. The positive predictive value was 69% and the negative predictive value was 92%. Scores were similar between paired right and left limbs, but did not agree for predicted status in 14/106 dogs. DISCUSSION: Our study supports an association between TPA, FAA, and CCLD in Labrador Retrievers. The negative predictive value of the CCLD score supports its application for screening dogs considered at low risk for CCLD. Positive CCLD scores should be interpreted with caution and the status of a dog may be undetermined if scores obtained on each limb disagree.

Risk factors and diagnostic accuracy of clinical findings for meniscal disease in dogs with cranial cruciate ligament disease.

OBJECTIVE: To determine the risk factors for meniscal disease and diagnostic accuracy of physical examination in dogs with cranial cruciate ligament (CCL) deficiency. STUDY DESIGN: Prospective cohort study. ANIMALS: Stifles (n = 80) of dogs with CCL deficiency. METHODS: Each dog was evaluated preoperatively for factors that may increase the risk of, or aid in the diagnosis of meniscal disease including presence of pain on extension and flexion of the affected stifle, range of motion during flexion and extension, thigh circumference, positive cranial-drawer test, positive tibial compression test, tibial plateau angle, complete tear of the CCL, presence of a meniscal click, and gait analysis. Odds ratios were calculated for each of the factors and a multivariate approach was used to create an ROC curve. Subsequent sensitivity, specificity, and area under the curve was used to determine the diagnostic value of clinical tests. RESULTS: Dogs with pain upon flexion of the stifle were 4.3 times more likely to have medial meniscal disease than those without flexion pain and dogs with a complete CCL tear were 9.6 times more likely to have medial meniscal disease than those with partial tears. A meniscal click increased the likelihood of medial meniscal disease by a factor of 11.3. The diagnostic accuracy using a meniscal click and pain upon stifle flexion was 76%. CONCLUSION: Combining the presence of a meniscal click and pain during flexion of the stifle provide a more accurate diagnosis of medial meniscal disease in dogs with CCL disease over individual examination variables.

Lifetime cost of surgical treatment for canine hip osteoarthritis is less than conservative management in dogs under eight years of age.

OBJECTIVE: To determine the lifetime cost of 3 treatments for canine hip osteoarthritis: (1) conservative management, (2) femoral head and neck excision (FHNE), or (3) total hip replacement. We hypothesized that FHNE would be the least expensive treatment at all ages. SAMPLE: Cost estimates from 11 private and academic referral centers from 8 randomly chosen cities across the US. METHODS: Costs of surgeries were collected from practices in 8 US cities. The literature was used to determine expected postoperative costs. For conservative management, costs of pain medications and diet were obtained by use of online pharmacies. A 4.5% inflation adjustment was used for costs in subsequent years. RESULTS: For a dog aged 1 to 7 years, FHNE had the lowest lifetime cost. Total hip replacement had the second lowest cost until age 4, after which conservative management was lower. For dogs > 8 years, conservative management was the most cost-effective. CLINICAL RELEVANCE: For dogs presenting with clinical signs at or under 1 year of age, the perceived benefits of total hip replacement may not be financially prohibitive if lifetime cost of care is considered. Femoral head and neck excision was also less expensive than long-term conservative management. This can help veterinarians inform owners on costs of treatments over the lifetime of their pet. This type of analysis is limited to financial costs alone and does not account for differences in outcomes, as these are not well established. It should be expanded in the future as better data on outcomes and impacts of care become available.

Evaluation of topical epidural analgesia delivered in gelfoam for postoperative hemilaminectomy pain control.

OBJECTIVE: To evaluate efficacy of a topical epidural analgesia used alone, or in combination with hydromorphone, against a standard pain protocol for the 48 hours immediately after hemilaminectomy. STUDY DESIGN: Randomized, blinded, controlled, clinical trial. ANIMALS: Dogs (n = 30) with thoracolumbar intervertebral disc disease treated with hemilaminectomy. METHODS: Dogs were randomly divided into 3 groups: group 1 received intermittent hydromorphone postoperatively, group 2 received a topical epidural of preservative-free morphine and dexmedetomidine administered via gel foam, group 3 received both forms of analgesia. All dogs were monitored and assessed for pain for 48 hours immediately postoperatively. Data were analyzed using MANOVA and Wilcoxon Rank Sum Tests. RESULTS: There was a significant temporal difference in treatment groups 1 and 3 when using a 0-10 pain scale (MANOVA, P = .02). There was also a significant difference at the 48th hour postoperatively between groups 1 and 3 (Wilcoxon Rank Sum Test). CONCLUSION: Topical epidural of preservative-free morphine and dexmedetomidine administered via gelfoam is not sufficient analgesia alone post hemilaminectomy but in conjunction with other opioid administration may lead to superior pain relief.

Randomized, controlled clinical trial evaluating the efficacy of pulsed signal therapy in dogs with osteoarthritis.

OBJECTIVES: To evaluate the efficacy of pulsed signal therapy (PST) in reducing pain and increasing function in dogs with osteoarthritis (OA) using a randomized, blinded, controlled clinical trial. STUDY DESIGN: Randomized, controlled, blinded clinical trial. ANIMALS: Adult dogs (n = 60) with moderate-to-severe clinical signs of OA. METHODS: Dogs were randomized by age into 2 groups: dogs ≥ 9 years and dogs < 9-years old. The control group received 1 hour of rest in hospital for 9 consecutive days and dogs in the treatment group received PST for 1 hour on 9 consecutive days. Goniometry and gait analysis were performed, and the Canine Brief Pain Inventory (CBPI) questionnaire was given to the owners to fill out without supervision. Outcome measures were repeated at the end of treatment (Day 11) and 6 weeks after beginning treatment (Day 42). RESULTS: The PST group performed significantly better than the control group as measured by the CBPI Severity and Interference scores (P < .01). Extension (P = .04) and peak vertical force (PVF) (P = .03) were not statistically significant after adjusting for multiple comparisons. CONCLUSIONS: The group receiving PST performed better than the treatment group according to owner assessment.

Determination of the center of mass in a heterogeneous population of dogs.

The center of mass (CoM) is the location in a body where mass distribution is balanced. It has a fundamental role in balance and motion which has been poorly described in the dog. The objective of this study was to estimate the variance of the center of mass (CoM) in a heterogeneous population of client-owned dogs and to describe the relationship between CoM, subject morphometrics and an inertial measurement unit (IMU) box positioned ventrally on a neck collar. A single force platform and a reaction board were used to determine CoM in the transverse, sagittal and dorsal planes in thirty-one healthy adult dogs. A series of morphometric measurements were acquired with each dog standing, including distances relative to an IMU box positioned ventrally on a neck collar. Mean transverse plane CoM was 48% the distance from ischium to the IMU box, near the xiphoid process. Mean sagittal place CoM was 59% the width of the chest on the left side. Mean dorsal plane CoM was 41% the distance from the most dorsal to the most ventral aspect of the body. Dog length was the primary variable required to maximize the relationship between three-dimensional CoM and identifiable variables measured. A CoM based normalization procedure should be considered to normalize mass or motion based outcome measure output (e.g., ground reaction forces, vector acceleration) in a heterogeneous population of dogs. Future research will be needed to determine if CoM-based normalization procedures reduce variance in outcome measures affected by subject morphometrics.

Canine mitral valve size as measured by computed tomography.

OBJECTIVE: To measure the mitral annulus in dogs. Our hypothesis was that mitral measurement would be possible and consistent among observers using CT. SAMPLE: Thoracic CT scans of dogs without known heart disease. PROCEDURES: Five trained investigators measured 4 aspects of the mitral valve and the fourth thoracic vertebrae (T4) length using multiplanar reformatting tools. Ten randomly chosen animals were measured by all investigators to determine interobserver reliability. RESULTS: There were 233 CT scans eligible for inclusion. Dogs weighed 2 to 96 kg (mean, 28.1 kg), with a variety of breeds represented. Golden Retrievers (n = 28) and Labrador Retrievers (n = 37) were overrepresented. The intraclass correlations were all greater than 0.9, showing excellent agreement between observers. The means and SDs of each measurement were as follows: trigone-to-trigone distance, 17.2 ± 4.7 mm; the remaining circumference, 79.0 ± 17.5 mm; commissure-to-commissure distance, 30.8 ± 6.5 mm; septal leaflet-to-lateral leaflet distance, 26.3 ± 6.0 mm; T4 length, 16.9 ± 3.1 mm; and the total circumference normalized by T4, 5.7 ± 0.7 mm. CLINICAL RELEVANCE: This study provides information that may help in the development of future treatment for mitral valve dysfunction and subsequent annular enlargement.

Evaluation of S-adenosyl l-methionine in a double-blinded, randomized, placebo-controlled, clinical trial for treatment of presumptive osteoarthritis in the dog.

OBJECTIVE: To evaluate the efficacy of S-adenosyl l-methionine (SAMe) in the treatment of clinically inferred canine osteoarthritis (OA). STUDY DESIGN: Six weeks, double-blinded, placebo-controlled, clinical trial. ANIMALS: Dogs (n=33) with clinical signs, history, and orthopedic exams consistent with OA. METHODS: Dogs were block randomized by body condition score (<6/9, or ≥6/9) into either the placebo or SAMe group. Outcome was assessed using pressure platform gait analysis, examination score, goniometry, and the Canine Brief Pain Inventory (CBPI) at the time of study entrance and at 3 and 6 weeks after entry. Groups were compared using parametric and nonparametric paired tests as appropriate, and numbers needed to treat (NNT) were calculated for the CBPI and peak vertical force (PVF). RESULTS: Both groups (n=15 placebo, n=18 SAMe) had a reduction in mean PVF (P=.02) and vertical impulse (VI; P=.06) from the 1st to 3rd visit. There was no significant difference between the placebo group and SAMe group for PVF, VI, or either part of the CBPI (Severity or Impact). The NNT at 6 weeks for the Severity score was 3, Impact score was 25, and PVF was 45. CONCLUSIONS: These data do not support the use of SAMe as an effective stand alone treatment for reducing clinical signs of OA, as measured by PVF, VI, goniometry, CBPI (both Severity and Impact), and examination score within 6 weeks of treatment.

Comparison of short- and long-term function and radiographic osteoarthrosis in dogs after postoperative physical rehabilitation and tibial plateau leveling osteotomy or lateral fabellar suture stabilization.

OBJECTIVES: To compare short- and long-term functional and radiographic outcome of cranial cruciate ligament (CrCL) injury in dogs treated with postoperative physical rehabilitation and either tibial plateau leveling osteotomy (TPLO) or lateral fabellar suture stabilization (LFS). STUDY DESIGN: Prospective observational clinical study. ANIMALS: Medium to large breed dogs with naturally occurring CrCL injury (n=65). METHODS: Dogs with CrCL injury were treated with either TPLO or LFS and with identical physical rehabilitation regimes postoperatively. Limb peak vertical force (PVF) was measured preoperatively and at 3, 5, and 7 weeks, and 6 months and 24 months postoperatively. Stifles were radiographically assessed for osteoarthrosis (OA) preoperatively and 24 months postoperatively. RESULTS: Thirty-five dogs had LFS and 30 dogs had TPLO. Radiographic OA scores were significantly increased at 24 months compared with preoperative scores in all dogs. Radiographic OA scores preoperatively and at 24 months were not significantly different between treatment groups. PVF was significantly increased from preoperative to 24 months among both treatment groups but not significantly different between treatment groups preoperatively or at 3, 5, 7 weeks, 6, or 24 months. CONCLUSION: No significant difference in outcome as determined by ground reaction forces or radiographic OA scores were found between dogs with CrCL injury treated with LFS or TPLO. CLINICAL RELEVANCE: LFS and TPLO remain good options for stabilizing stifles with CrCL injury with all dogs showing significant functional improvement. This study does not support the superiority of either surgical technique.

Controlled, non-inferiority trial of bupivacaine liposome injectable suspension.

OBJECTIVES: Recently, a bupivacaine liposome injectable suspension (BLIS) became commercially available in the veterinary market that may provide local analgesia for 72 h. The purpose of this study was to compare a BLIS incisional block with a control protocol in cats after ovariohysterectomy (OHE). The hypothesis was that a BLIS block would provide equivalent pain relief. METHODS: This study was designed as a randomized, double-blind, non-inferiority trial. Students performed an OHE followed by a two-layer incisional and body wall block with either standard bupivacaine (control) or BLIS. Postoperatively, cats in the control group received robenacoxib, whereas the BLIS cats received saline. All cats were evaluated using the feline Glasgow Composite Measure Pain Scale (GCMPS) at multiple time points postoperatively. RESULTS: There were 24 control cats and 23 BLIS cats. One cat from each group required rescue medication. The mean GCMPS scores were low and the groups were equivalent at all time points (P <0.05). This study showed that BLIS was equivalent to the control group up to 42 h and pain scores remained low up to 68 h after surgery. CONCLUSIONS AND RELEVANCE: BLIS incisional block is equivalent to a control pain protocol and reduces the need for continued postoperative drug administration.

Incidence of Normal versus Support Trot in the Healthy Adult German Shepherd Dog.

INTRODUCTION: Current sports medicine textbooks suggest German Shepherd dogs leave a forelimb on the ground longer than other breeds for support because of angulated joints eliminating a true suspension phase (support trot). The objective of this study was to characterize the trot of healthy, adult German Shepherd dogs and describe morphometric relationships. The hypothesis was that all German Shepherd dogs have a standard trot that does not correlate with morphometric measurements. MATERIALS AND METHODS: Forty healthy, adult German Shepherd dogs with no history of musculoskeletal disease or visible lameness were enrolled in this study. Height, weight, body length, standing limb distance and standing joint angles were measured. Dogs were trotted over a pressure walkway collecting five valid trials. Each trial was categorized by the presence or absence of the suspension phase and the percent of standard trot trials was calculated. Mean and standard deviations were calculated for all data. A Spearman's rank sum test was performed for each of the morphometric measurements to assess correlation with the percent of standard trot trials. RESULTS: Of the dogs analysed, 37.5% demonstrated a standard trot in all five trials, 60% of dogs utilized a support trot intermittently, and one dog (2.5%) solely utilized a support trot in all trials. There was no correlation between combinations of morphometric measurements and percentage of standard trot statistically or visually. DISCUSSION/CONCLUSION: This prospective clinical study showed that the use of the support trot was not correlated with morphometric measurements.