Short-duration peripherally inserted central catheters do not alter viscoelastic parameters in healthy dogs.

Objective: To determine if short-duration peripherally inserted central catheters (PICCs) cause a hypercoagulable state in healthy dogs, based on point-of-care viscoelastic coagulation monitor (VCM). Animals: Ten beagle dogs were randomly and equally allocated into control and PICC groups. Procedure: Control dogs had VCM analysis on whole blood following direct venipuncture before sedation (T0) and 2 h after sedation (T2). In the experimental group, a PICC was placed (medial saphenous or femoral vein) under sedation and removed after 4 h, with measurements before placement (T0) and 2 and 6 h after placement (T2 and T6, respectively). Parametric data were analyzed using 1-way ANOVA with Holm-Sídák test for multiple comparisons and paired or unpaired Student's t-test. Nonparametric data were analyzed using Friedman test with Dunn multiple comparison test for Wilcoxon matched-pairs signed-rank test, and Mann-Whitney U test for PICC group, control group, and to compare PICC versus control groups, respectively. Results: Clot formation time was longer at T2 versus T6 (P = 0.0342, but not clinically relevant) in the PICC group, with no significant differences between the PICC and control groups. Conclusion and clinical relevance: Short-term placement of a PICC line did not alter viscoelastic endpoints in healthy beagles.

L'utilisation de courte durée d'un cathéter central inséré par voie périphérique n'affecte pas les paramètres viscoélastiques chez les chiens sains. Objectif: Déterminer si les cathéters centraux insérés par voie périphérique (CCIP) pour une courte durée provoque un état d'hypercoagulabilité chez des chiens en bonne santé sur la base des mesures du Viscoelastic Coagulation Monitor (VCM) au point de soins. Animaux: Dix chiens sains de race beagle ont été choisis et répartis de façon égale et aléatoire dans un groupe témoin et un groupe de CCIP. Procédure: Les chiens témoins ont eu une prise de sang et analyse par VCM avant sédation (T0) et 2 heures après la sédation (T2). Dans le groupe expérimental, un CCIP a été mis en place (veines saphènes ou fémorales médiales) sous sédation et retiré après 4 heures. Les mesures viscoélastiques sur le sang frais ont été effectuées avant la pose du CCIP (T0), 2 heures après la pose (T2) et 2 heures après le retrait/6 heures après la pose du cathéter (T6). L'analyse statistique des données paramétriques a été faite par le test ANOVA à un facteur avec un test de comparaisons multiples de Holm-Sídák pour le groupe CCIP, un test t de Student apparié pour le groupe témoin, et un test t de Student non apparié pour comparer les groupes CCIP et témoin. Les données non paramétriques ont été analysées à l'aide du test de Friedman avec un test de comparaison multiple de Dunn pour le groupe CCIP, du test de rang signé de Wilcoxon pour le groupe témoin et du test de Mann-Whitney U pour comparer les groupes CCIP et témoin. Résultats: Pour le groupe CCIP, le temps de formation du caillot à T2 était plus long mais non cliniquement pertinent. comparativement à T6 (P = 0,0342) et il n'y avait aucune différence significative entre les groupes CCIP et témoin. Conclusion et pertinence clinique: La pose d'un CCIP pour une courte durée n'a pas modifié les variables viscoélastiques chez les chiens beagle en bonne santé.(Traduit par les auteurs).

Self-care practices and depression, anxiety, and stress scores in veterinary students during a semester.

Objective: To measure associations between self-care activities and depression, anxiety, and stress of preclinical veterinary students during a semester. Procedure: Preclinical veterinary students at the University of Calgary Faculty of Veterinary Medicine were recruited voluntarily. Depression, anxiety, and stress scores (DASS-21) were measured, and a self-care questionnaire was administered at the beginning and end of the semester. Results: Depression, anxiety, and stress scores did not change during the fall semester (P = 1.000). At the beginning of the semester, students who spent 15 to 30 min (P = 0.042) or 30 to 60 min (P = 0.013) outside daily had lower anxiety scores compared to those who spent < 15 min outside daily; students who spent > 2 h daily on social media had higher stress scores than students who spent < 60 min (P = 0.024); and students who slept for 6 to 8 h daily had lower stress scores than students who slept < 6 h (P = 0.015). At the end of the semester, students who "often" felt that self-care techniques managed their stress had lower depression (P = 0.003) and anxiety (P = 0.011) scores than those who "rarely" did; students who spent 30 to 60 min outside daily had lower depression scores than those who spent < 15 min (P = 0.031); students who spent 15 to 30 min (P = 0.002) or 30 to 60 min (P = 0.009) outside daily had lower stress scores than those who spent < 15 min; and students who exercised 30 to 60 min daily had lower stress scores than those who exercised < 15 min (P = 0.047). Conclusion: Self-care activities that were associated with lower depression, anxiety, or stress scores at the beginning or end of the semester included spending at least 15 min daily outside or exercising; spending < 30 min on social media daily; and sleeping 6 to 8 h daily. These practices warrant further investigation. Clinical relevance: Encouraging certain self-care practices among preclinical veterinary students has the potential to enhance their mental health and should be considered part of a veterinary school curriculum.

Pratiques d'autosoins et scores de dépression, d'anxiété et de stress chez les étudiants vétérinaires au cours d'un semestre. Objectif: Mesurer les associations entre les activités d'autosoins et la dépression, l'anxiété et le stress des étudiants vétérinaires au cours d'un semestre. Procédure: Les étudiants vétérinaires de la faculté de médecine vétérinaire de l'University of Calgary ont été recrutés sur une base volontaire. Des scores de dépression, d'anxiété et de stress (DASS-21) ont été mesurés et un questionnaire d'autosoins a été administré au début et à la fin du semestre. Résultats: Les scores de dépression, d'anxiété et de stress n'ont pas changé au cours du semestre d'automne (P = 1,000). Au début du semestre, les étudiants qui passaient 15 à 30 min (P = 0,042) ou 30 à 60 min (P = 0,013) à l'extérieur par jour présentaient des scores d'anxiété inférieurs à ceux qui passaient < 15 min à l'extérieur par jour; les étudiants qui passaient > 2 h par jour sur les réseaux sociaux avaient des scores de stress plus élevés que les étudiants qui passaient < 60 min (P = 0,024); et les étudiants qui dormaient de 6 à 8 h par jour avaient des scores de stress inférieurs à ceux qui dormaient < 6 h (P = 0,015). À la fin du semestre, les étudiants qui estimaient « souvent ¼ que les techniques d'autosoins géraient leur stress avaient des scores de dépression (P = 0,003) et d'anxiété (P = 0,011) inférieurs à ceux qui l'étaient « rarement ¼; les étudiants qui passaient 30 à 60 min à l'extérieur quotidiennement avaient des scores de dépression inférieurs à ceux qui passaient moins de 15 min (P = 0,031); les étudiants qui passaient 15 à 30 min (P = 0,002) ou 30 à 60 min (P = 0,009) à l'extérieur quotidiennement avaient des scores de stress inférieurs à ceux qui passaient < 15 min; et les étudiants qui faisaient de l'exercice de 30 à 60 min par jour avaient des scores de stress inférieurs à ceux qui faisaient de l'exercice < 15 min (P = 0,047). Conclusion: Les activités d'autosoins associées à des scores de dépression, d'anxiété ou de stress plus faibles au début ou à la fin du semestre comprenaient le fait de passer au moins 15 minutes par jour à l'extérieur ou de faire de l'exercice; passer < 30 minutes sur les réseaux sociaux quotidiennement; et dormir 6 à 8 h par jour. Ces pratiques méritent une enquête plus approfondie. Pertinence clinique: Encourager certaines pratiques d'autosoins chez les étudiants vétérinaires a le potentiel d'améliorer leur santé mentale et devrait être considéré comme faisant partie du programme d'études d'une école vétérinaire.(Traduit par Dr Serge Messier).

Rapport de cas Surgical retrieval of a migrated vascular access port catheter in a dog.

A 4-year-old spayed female Boston terrier was diagnosed with a suspected meningioma involving the optic chiasm and resulting in vision loss. A vascular access port (VAP) was placed in the left medial saphenous vein to facilitate frequent anesthetic episodes for radiation therapy. Five days after placement, the VAP was nonfunctional with the silicone catheter still intact. During VAP removal surgery, it was discovered that the silicone catheter had migrated. Intraoperative focal ultrasound could not identify the migrated catheter within the pelvic limb. Thoracic computed tomography identified the migrated catheter retroflexed onto itself in the cranial vena cava and extending into the right pulmonary artery as it passed through the right side of the heart. The dog underwent a hybrid surgical approach consisting of an endovascular retrieval forceps technique with median sternotomy for intravenous non-radiopaque foreign body removal. Postoperative complications, including regurgitation and left atrial thrombus, were managed. The left atrial thrombus persisted for 10 mo after the hybrid surgery. Key clinical message: A hybrid approach consisting of an endovascular retrieval forceps technique with median sternotomy was effective in removing an intravenous non-radiopaque foreign body in a dog.

Récupération chirurgicale d'un cathéter de port d'accès vasculaire migré chez un chien. Une femelle terrier de Boston stérilisée âgée de 4 ans a reçu un diagnostic de méningiome présumé impliquant le chiasma optique et entraînant une perte de vision. Un port d'accès vasculaire (VAP) a été placé dans la veine saphène médiale gauche pour faciliter les épisodes fréquents d'anesthésie pour la radiothérapie. Cinq jours après la mise en place, le VAP était non fonctionnel avec le cathéter en silicone toujours intact. Au cours de la chirurgie de retrait du VAP, il a été découvert que le cathéter en silicone avait migré. L'échographie focale peropératoire n'a pas pu identifier le cathéter migré dans le membre pelvien. La tomodensitométrie thoracique a identifié le cathéter migré rétroflexé sur lui-même dans la veine cave crânienne et s'étendant dans l'artère pulmonaire droite lorsqu'il traversait le côté droit du coeur. Le chien a subi une approche chirurgicale hybride consistant en une technique de forceps de récupération endovasculaire avec sternotomie médiane pour l'extraction intraveineuse de corps étrangers nonradio-opaques. Les complications postopératoires, y compris la régurgitation et le thrombus auriculaire gauche, ont été prises en charge. Le thrombus auriculaire gauche a persisté pendant 10 mois après la chirurgie hybride.Message clinique clé :Une approche hybride consistant en une technique de forceps de récupération endovasculaire avec sternotomie médiane a été efficace pour retirer un corps étranger intraveineux non-radio-opaque chez un chien.(Traduit par Dr Serge Messier).

Bilateral lung lobe torsions in a cat.

A 13-year-old spayed female domestic longhair cat was presented for tachypnea and was identified to have reduced lung sounds over the left hemithorax. Thoracic ultrasound examination and computed tomography identified changes consistent with bilateral lung lobe torsion. A median sternotomy confirmed torsion of both the cranial portion of the left cranial lung lobe and the right middle lung lobe. The affected lobes were resected. Pleural fluid analysis was indicative of a modified transudate and histopathology was consistent with a subacute to chronic torsion with no evidence of neoplasia or infection. The patient recovered without complication. Lung lobe torsion is an uncommon presentation across all species and is especially rare in cats. To the authors' knowledge, bilateral lung lobe torsion has not been previously reported in small animals.

Torsions bilatérales de lobes pulmonaires chez un chat. Une chatte domestique à poils longs âgées de 13 ans fut présentée pour tachypnée et on identifia une diminution des bruits respiratoires du côté de l'hémithorax gauche. Une échographie thoracique et un examen par tomodensitométrie (CT) identifièrent des changements compatibles avec une torsion bilatérale de lobes pulmonaires. Une sternotomie médiane confirma la torsion des portions crâniales du lobe pulmonaire crânial gauche et du lobe pulmonaire moyen droit. Les lobes affectés furent excisés. L'analyse du liquide pleural était indicatrice d'un transsudat modifié et l'histopathologie était compatible avec une torsion subaigüe à chronique sans évidence de néoplasie ou d'infection. La chatte récupéra sans complication. La torsion des lobes pulmonaires est une présentation peu commune chez toutes les espèces et est spécialement rare chez les chats. Selon les auteurs, une torsion bilatérale des lobes pulmonaires n'a pas encore été rapportée chez les petits animaux.(Traduit par Dr Serge Messier).

Suspected congenital urethral diverticulum in a dog.

A 2-year-old neutered male dog with a history of urinary incontinence, recurrent urinary tract infections, and unilateral cryptorchidism was presented with an acute onset of perineal swelling. Urinary contrast studies revealed a urothelial lined structure in the perineum. Surgical resection of 80% to 90% of this structure, suspected to be a congenital urethral diverticulum, was successful.

Diverticule urétral congénital soupçonné chez un chien. Un chien mâle stérilisé âgé de 2 ans ayant une anamnèse d'incontinence urinaire, d'infections des voies urinaires récurrentes et de cryptorchidie unilatérale a été présenté suite à l'apparition aiguë d'enflure périnéale. Des épreuves de contraste urinaire ont révélé une structure urothéliale recouverte dans le périnée. Une résection chirurgicale de 80 % à 90 % de cette structure, soupçonnée d'être un diverticule urétral congénital, a été réalisée avec succès.(Traduit par Isabelle Vallières).

Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats.

OBJECTIVE: To evaluate outcomes in cats undergoing subtotal colectomy for the treatment of idiopathic megacolon and to determine whether removal versus nonremoval of the ileocecocolic junction (ICJ) was associated with differences in outcome. ANIMALS: 166 client-owned cats. PROCEDURES: For this retrospective cohort study, medical records databases of 18 participating veterinary hospitals were searched to identify records of cats with idiopathic megacolon treated by subtotal colectomy from January 2000 to December 2018. Data collection included perioperative and surgical variables, complications, outcome, and owner perception of the procedure. Data were analyzed for associations with outcomes of interest, and Kaplan-Meier survival time analysis was performed. RESULTS: Major perioperative complications occurred in 9.9% (15/151) of cats, and 14% (12/87) of cats died as a direct result of treatment or complications of megacolon. The median survival time was not reached. Cats with (vs without) a body condition score < 4/9 (hazard ratio [HR], 5.97), preexisting heart disease (HR, 3.21), major perioperative complications (HR, 27.8), or long-term postoperative liquid feces (HR, 10.4) had greater hazard of shorter survival time. Constipation recurrence occurred in 32% (24/74) of cats at a median time of 344 days and was not associated with retention versus removal of the ICJ; however, ICJ removal was associated with long-term liquid feces (OR, 3.45), and a fair or poor outcome on owner assessment (OR, 3.6). CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that subtotal colectomy was associated with long survival times and a high rate of owner satisfaction. Removal of the ICJ was associated with less favorable outcomes in cats of the present study.

In vitro elution of amikacin and vancomycin from impregnated plaster of Paris beads.

OBJECTIVE: To describe in vitro elution characteristics of amikacin and vancomycin from calcium sulfate hemihydrate 98% (plaster of Paris, POP) beads and characterize eluent inhibition of Staphylococcus spp. STUDY DESIGN: Experimental study. METHODS: POP beads were impregnated with amikacin or vancomycin alone or in combination and then incubated alone or in combination for 84 days at 37 degrees C in plastic tubes containing sterile phosphate-buffered saline (PBS). Beads containing no antimicrobial served as negative control. Beads were intermittently moved to a new tube containing drug-free PBS. Antimicrobial was measured in the eluent using a polarized fluorescent immunoassay. Eluent inhibition of Staphylococcus spp. was determined at each time point. RESULTS: Antimicrobial release from beads was characterized by an initial rapid phase then a slower phase. Although antimicrobial release from beads occurred throughout the 84 days, most was in the first 24 hours, except for vancomycin alone. Duration of eluent inhibition of Staphylococcus spp. growth ranged from 0.5 (amikacin alone) to 56 days (vancomycin alone). Control eluent did not inhibit bacterial growth. CONCLUSIONS: Amikacin elution from POP beads was rapid, inhibiting growth for <24 hours with or without vancomycin. Vancomycin elution was slower and inhibited growth for 56 days alone or for 5 days with amikacin. CLINICAL RELEVANCE: Vancomycin-impregnated beads appear to be reasonable as a therapeutic option whereas amikacin-impregnated POP beads and amikacin and vancomycin combinations may require further study before considering as a therapeutic option.

Intraosseous Catheter Flow Rates and Ease of Placement at Various Sites in Canine Cadavers.

Objective: To compare intraosseous catheter placement difficulty, success rates, and flow rates at four different locations in canine cadavers. Design: Prospective study. Setting: Private referral center. Animals: Eleven fresh canine cadavers. Interventions: With owner consent, animals presenting for euthanasia were recruited. Animals received heparin (1,000 IU/kg IV) at least 5 min prior to euthanasia. After euthanasia, EZIO intraosseous catheters were placed into the ilial wing, proximal medial tibia, proximal lateral humerus, and distal lateral femur on one side of the animal. Time to catheter placement and catheter difficulty were scored for each placement site. Sterile saline was infused into each location simultaneously over 5 min, first via gravity then using 300 mmHg pressure. Animals were repositioned onto the contra-lateral side and the experiment repeated. Measurements and Main Results: Placement was successful in 16/22 ilial, 18/22 tibial, and 22/22 femoral and humoral attempts. A post-hoc analysis revealed the ileum had a significantly greater difficulty score when compared to the femur and humerus (p ≤ 0.0001). The femur had a statistically significant faster placement time when compared to the ileum (p ≤ 0.05). Gravity infusion rates were statistically lower in the tibia when compared to humerus (p ≤ 0.01) and between the tibia when compared to the femur (p ≤0.001). Additionally, pressurized infusion rates were statistically lower in the tibia compared to the humerus (p ≤ 0.0001), the femur (p ≤ 0.0001), and the ileum (p ≤ 0.01). Conclusions: The femur and humerus had high success rate for IO catheter placement and low placement time and difficulty scores. Pressurized intraosseous flow rates were highest in the humerus and femur. Contrary to human literature, success rates for catheter placement in the humerus and femur were higher than at other sites, suggesting the humerus and femur may be preferred sites for intraosseous catheter placement in the dog. Further investigation through a larger sample size is required to confirm these findings.

Optimal Suture Bite Size for Closure of Feline Linea Alba-A Cadaveric Study.

Objective: This study aimed to determine the most appropriate suture bite and stitch interval (SBSI) size for closing feline linea alba. Study design: Randomized ex vivo mechanical testing. Sample population: Ventral abdominal walls from 35 male feline cadavers were harvested and separated into 125 segments. Methods: Segments were incised along midline then sutured back together using 3-0 polydioxanone using one of the following SBSI: 3, 5, 7.5, or 10 mm whereby the distance represents the distance both between the suture bites, and from the bite to incision line. The location of segments as well as the weight of the cadaver were recorded. A single linear distraction mechanical breaking test was performed. Statistical analyses (logistic and linear regression) were performed to determine which factors were associated with visual and mechanical failure, as well as load at failure or maximum displacement. Results: SBSI was significantly associated with load at failure or maximum displacement (p < 0.001). In particular, 5 mm SBSI had the highest load at failure amongst all the bite sizes (LSmeans = 27.55N, 95% Confidence Interval (CI): 23.65-31.44); this was significantly higher than 7.5 mm (LSmeans = 19.15N, 95% CI: 15.26-23.05, p = 0.016) and 10 mm (LSmeans = 16.55N, 95%CI:12.39-20.70, p = 0.0012) but not significantly higher than 3 mm (LSmeans = 23.78N, 95% CI: 19.69-27.86, p = 0.2). Increased SBSI increased the odds of visual failure (p < 0.001) whereas increased weight of the cadaver reduced the odds of visual failure (OR = 0.52, 95%CI: 0.30-0.88, p = 0.016). Conclusion: The 5 mm SBSI had the highest load at failure and was not significantly different from the 3 mm SBSI when apposing feline linea alba using 3-0 polydioxanone. Clinical significance: Using 5 mm SBSI is the preferred bite size compared to 7.5 or 10 mm SBSI when apposing feline linea alba with 3-0 polydioxanone.

Blood concentration of bupivacaine and duration of sensory and motor block following ultrasound-guided femoral and sciatic nerve blocks in dogs.

Peripheral nerve blocks are becoming increasingly popular for perioperative use as anesthetics and analgesics in small animals. This prospective study was performed to investigate the duration of motor and sensory blockade following use of bupivacaine for ultrasound-guided femoral and sciatic nerve blocks in dogs and to measure the plasma concentrations of bupivacaine that result from these procedures. Six dogs were anesthetized twice using a randomized cross-over design. At the first anesthetic, dogs were assigned to receive either an ultrasound-guided femoral nerve block or sciatic nerve block with 0.15 mL kg-1 of bupivacaine 0.5%. Two months later, the other nerve block was performed during a second anesthetic. At 5, 10, 15, 20, 30 and 60 minutes after injection, arterial blood samples were collected for laboratory measurement of bupivacaine. After 60 minutes, dogs were recovered from anesthesia. Starting at two hours post-injection, video-recordings of the dogs were made every two hours for 24 hours. The videos were randomized and the degree of motor and sensory blockade was evaluated using a three-point scoring system (0 = no effect, 1 = mild effect, 2 = complete blockade) by two blinded assessors. The median (range) times to full recovery from motor blockade were 11 (6-14) hours (femoral) and 12 (4-18) hours (sciatic), and 15 (10-18) hours (femoral) and 10 (4-12) hours (sciatic) for sensory blockade. There were no differences in the median times to functional recovery for the two techniques. Plasma concentrations of bupivacaine were no different following the blocks and were less than 0.78 µg mL-1 at all times. These results suggest that these ultrasound-guided nerve blocks do not result in potentially toxic systemic levels of local anesthetic and that their duration of action is useful for providing anesthesia and analgesia for pelvic limb procedures.

Prognostic factors for successful outcome following urethral rupture in dogs and cats.

Twenty dogs and 29 cats were identified with urethral rupture. Males predominated in both groups. The most common cause of urethral rupture in dogs was vehicular trauma, and in cats it was trauma associated with urethral obstruction and catheterization. Clinicopathological findings, type of surgical correction, time to surgery, type of urinary diversion, and duration of urinary diversion were not statistically associated with the outcome. In this study, the presence of multiple traumatic injuries was associated with a poor outcome.