A survey of attributes of surgical resident applicants deemed important to American College of Veterinary Surgeons board-certified surgeons involved in resident selection and methods used to evaluate these attributes.

OBJECTIVE: To determine which attributes of residency applicants were most commonly assessed by large and small animal American College of Veterinary Surgeons diplomates and to determine which evaluation methods were perceived to assess those attributes. STUDY DESIGN: Online survey. SAMPLE POPULATION: American College of Veterinary Surgeons board-certified surgeons as of March 2019. METHODS: An online survey was sent to eligible individuals. Respondents rated the importance of 23 attributes assessed by the Veterinary Internship and Residency Matching Program (VIRMP) application as well the usefulness of interviews, conversations with people knowledgeable with the applicants, and review of the VIRMP packet for evaluating each of these attributes. Responses were compared between large and small animal practitioners and between individuals involved in residency selection (supervisors) and individuals not involved in residency selection (nonsupervisors). RESULTS: Surveys were completed by 221 individuals (14.6% response rate). Seventeen of the 23 attributes were considered important by most respondents. Grade point average (GPA) and class rank were used as screening tools by 73% and 65% of supervisors, respectively. Letters of reference (LOR) were ranked as the most important part of the VIRMP packet. Conversations with people knowledgeable with the applicant was the only method judged by most respondents to be appropriate to evaluate all 23 attributes. Responses were similar between large and small animal supervisors and nonsupervisors. CONCLUSION: Respondents considered conversations with people knowledgeable with the applicant to be the most useful methods for assessing a resident applicant, but LOR, GPA, and class rank were also important. IMPACT: Resident applicants and mentors can use this information to strengthen applications.

Flexed radiographic angles for determination of atlantoaxial instability in dogs.

OBJECTIVE: To determine a flexed position for radiographic diagnosis of atlantoaxial instability (AAI) and to identify radiographic measurement cutoffs to differentiate affected dogs from neurologically healthy toy breeds. STUDY DESIGN: Retrospective case series and prospective case controls. ANIMALS: Thirty-nine client-owned toy breed dogs in which AAI had been diagnosed and 20 neurologically healthy client-owned toy breed dogs. METHODS: Medical records from three institutions were retrospectively reviewed to identify dogs affected with AAI. Flexed lateral images were reviewed, and measurements were obtained by using anatomic landmarks. Radiography was performed with control dogs to obtain the same measurements. RESULTS: Flexed lateral radiographs of thirty dogs affected with AAI were found to be positioned at a mean of 51° flexion. When flexed lateral radiographs were evaluated with a cutoff value for atlas to axis angle (AAA) >10°, evaluation of all breeds represented revealed a 90% sensitivity and 90% specificity. When this cutoff was evaluated in Yorkshire terriers, Chihuahuas, and mixes of these breeds, the sensitivity was 92%, and the specificity was 92%. When the control sample was positioned at 51° ± 10°, only two of the dogs were within the AAA cutoff value of >10°. There was no difference between the measurements obtained by using the flexed lateral view (mean = 50.9°) and the exaggerated flexed lateral view (mean = 38.9°) in the control sample. CONCLUSION: This study established objective measurements for the positioning and diagnosis of AAI on flexed lateral radiographs in toy breed dogs. CLINICAL SIGNIFICANCE: Atlantoaxial instability can be objectively diagnosed in sedated or anesthetized toy breed dogs when applying 51° flexion to cervical radiographs.

Survey of factors influencing faculty decisions on international veterinary work.

Faculty members at US colleges of veterinary medicine can encounter opportunities to work as a veterinarian in a foreign country. Institutions, governments, and other organizations can more effectively recruit faculty for these positions if they understand the characteristics of the individuals who are most likely to participate in these programs. The purpose of this study was to determine what characteristics influence veterinary faculty's desire to participate in foreign programs. Results illustrated that position type (tenure, clinical), rank (assistant professor, associate professor, full professor), gender, and the presence of pre-elementary aged children were significantly associated with willingness to work in a foreign country. In addition, survey respondents who indicated that the duration of the assignment was of high importance were less willing to travel than respondents who indicated that the duration of the assignment was of moderate importance or lower. The results from this survey provide important information about the characteristics of individuals more willing to participate in foreign programs. This information allows targeted recruiting by organizations, facilitating veterinary work in foreign countries.

Evaluation of the effects of dietary supplementation with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis.

OBJECTIVE: To evaluate the effects of a food supplemented with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis. DESIGN: Randomized, double-blinded, controlled clinical trial. ANIMALS: 38 client-owned dogs with osteoarthritis examined at 2 university veterinary clinics. PROCEDURES: Dogs were randomly assigned to receive a typical commercial food (n = 16) or a test food (22) containing 3.5% fish oil omega-3 fatty acids. On day 0 (before the trial began) and days 45 and 90 after the trial began, investigators conducted orthopedic evaluations and force-plate analyses of the most severely affected limb of each dog, and owners completed questionnaires to characterize their dogs' arthritis signs. RESULTS: The change in mean peak vertical force between days 90 and 0 was significant for the test-food group (5.6%) but not for the control-food group (0.4%). Improvement in peak vertical force values was evident in 82% of the dogs in the test-food group, compared with 38% of the dogs in the control-food group. In addition, according to investigators' subjective evaluations, dogs fed the test food had significant improvements in lameness and weight bearing on day 90, compared with measurements obtained on day 0. CONCLUSIONS AND CLINICAL RELEVANCE: At least in the short term, dietary supplementation with fish oil omega-3 fatty acids resulted in an improvement in weight bearing in dogs with osteoarthritis.

Developing an international program in a North American veterinary college.

Developing an international program in a North American veterinary college can be challenging. A unique set of constraints are encountered in implementing such a program. In this article, the author discusses the process of setting up an international program and provides information on taking advantage of an individual college's strengths while working around the obstacles encountered.

Fortetropin inhibits disuse muscle atrophy in dogs after tibial plateau leveling osteotomy.

OBJECTIVE: To determine if a commercial myostatin reducer (Fortetropin®) would inhibit disuse muscle atrophy in dogs after a tibial plateau leveling osteotomy. DESIGN: A prospective randomized, double-blinded, placebo-controlled clinical trial. ANIMALS: One hundred client-owned dogs presenting for surgical correction of cranial cruciate ligament rupture by tibial plateau leveling osteotomy. PROCEDURES: Patients were randomly assigned into the Fortetropin® or placebo group and clients were instructed to add the assigned supplement to the dog's normal diet once daily for twelve weeks. Enrolled patients had ultrasound measurements of muscle thickness, tape measure measurements of thigh circumference, serum myostatin level assays, and static stance analysis evaluated at weeks 0, 8, and 12. RESULTS: From week 0 to week 8, there was no change for thigh circumference in the Fortetropin® group for the affected limb (-0.54cm, P = 0.31), but a significant decrease in thigh circumference for the placebo group (-1.21cm, P = 0.03). There was no significant change in serum myostatin levels of dogs in the Fortetropin® group at any time point (P>0.05), while there was a significant rise of serum myostatin levels of dogs in placebo group during the period of forced exercise restriction (week 0 to week 8; +2,892 pg/ml, P = 0.02). The percent of body weight supported by the affected limb increased in dogs treated with Fortetropin® (+7.0%, P<0.01) and the placebo group (+4.9%, P<0.01) at the end of the period of forced exercise restriction. The difference in weight bearing between the Fortetropin® and placebo groups was not statistically significant (P = 0.10). CONCLUSION: Dogs receiving Fortetropin® had a similar increase in stance force on the affected limb, no significant increase in serum myostatin levels, and no significant reduction in thigh circumference at the end of the period of forced exercise restriction compared to the placebo. These findings support the feeding of Fortetropin® to prevent disuse muscle atrophy in canine patients undergoing a tibial plateau leveling osteotomy.

Effect of Duration and Onset of Clinical Signs on Short-Term Outcome of Dogs with Hansen Type I Thoracolumbar Intervertebral Disc Extrusion.

OBJECTIVE: The aim of this study was to determine if either the rate of onset of clinical signs or duration from initial clinical signs to surgical decompression affected the overall quality or duration of recovery in dogs with intervertebral disc extrusion. STUDY DESIGN: This was a retrospective case series of 131 client owned dogs. Medical records of dogs surgically treated with hemilaminectomy for intervertebral disc extrusion between January 2016 and December 2017 were reviewed for signalment, neurological grade at presentation, rate of onset and duration of clinical signs and surgical variables. These variables were analysed to determine their effect on return of pain sensation, urinary continence and ambulation. RESULTS: Duration of clinical signs prior to surgery and rate of onset of signs did not correlate with return of pain sensation, urinary continence or ambulation. Preoperative neurological grade was the main variable that was found to be associated with outcome. CONCLUSIONS: Delay from initial clinical signs of intervertebral disc extrusion to surgery is unlikely to affect the ultimate outcome or the length of time for a dog to regain pain sensation, urinary continence or ambulation. The rate of onset of signs likewise does not influence these outcomes.

Efficacy of immobilization of the tarsal joint to alleviate strain on the common calcaneal tendon in dogs.

OBJECTIVE: To measure strain in the common calcaneal tendon during trotting in dogs and to compare strain before and after immobilization of the tarsal joint. ANIMALS: 6 dogs. PROCEDURES: A microminiature strain gauge was surgically implanted on the tendinous portion of the gastrocnemius muscle. Surface electromyography (EMG) values, percentage strain, and ground reaction forces were measured before and after immobilization. Peak vertical force; vertical impulse; initial, maximum, and final strain; and peak-to-peak EMG amplitude were recorded. Data were analyzed by use of a repeated-measures ANOVA and paired t tests. RESULTS: Timing of strain data correlated closely with foot strike of the hind limb and EMG activity in all dogs. Maximum tendon strain was simultaneous with peak vertical force. Continued muscle contraction was evident after immobilization. There was no significant difference in maximum strain after immobilization, compared with maximum strain during normal motion. Minimum strain, both at the beginning and end of the strain curve, was significantly decreased for the immobilized state, compared with results for nonimmobilized joints. CONCLUSIONS AND CLINICAL RELEVANCE: Immobilization of the tarsal joint did not eliminate calcaneal tendon strain during weight bearing in dogs. Decreased isometric muscle contraction during the swing phase of the gait could account for smaller minimum strain in immobilized joints. Immobilization is frequently applied after Achilles tendon rupture to alleviate strain and force on the sutured repair, with possible complications because of the immobilization method. Consideration of these findings could be important in adjusting current treatment recommendations.

Single-day and multiday repeatability of stance analysis results for dogs with hind limb lameness.

OBJECTIVE: To assess single-day and multiday repeatability of weight distribution (stance) data obtained with a commercial analyzer for dogs with naturally occurring hind limb lameness. ANIMALS: 46 dogs (15 and 31 for single-day and multiday trials, respectively). PROCEDURES: For single-day trials, 5 to 10 measurements/trial were collected to determine body weight (BW), weight distribution on each limb, and forelimb and hind limb symmetry indices (SIs). The dog was removed from the room and returned immediately; 5 trials were performed. For multiday trials, measurements were performed in the same manner on 2 sequential days. Data were compared among trials (single-day measurements) and between days (multiday measurements). Repeatability (correlation coefficients and Lin concordance correlation coefficients [LCCCs]) and variability (coefficients of variation [CVs]) were assessed. RESULTS: In single-day trials, BW (r = 0.999), weight distribution on the lame hind limb (r = 0.915) and contralateral hind limb (r = 0.948), and hind limb SI (r = 0.964) were each significantly correlated among trials. In multiday trials, BW results were similar; weight distribution on the lame hind limb and contralateral hind limb and hind limb SI were each less closely but still significantly correlated between days. The LCCCs were highest for BW, weight distribution on the contralateral hind limb, and hind limb SI in single-day trials and for BW and weight bearing on the contralateral and lame hind limbs in multiday trials. The CVs were lowest for BW and highest for forelimb SI in both trial types. CONCLUSIONS AND CLINICAL RELEVANCE: The analyzer used allowed repeatable measurement of BW and weight distribution on the hind limbs of dogs with hind limb lameness. Measurement of forelimb stance variables was not repeatable in this group of dogs.

Comparison of the Effect of Dog, Surgeon and Surgical Procedure Variables on Improvement in Eight-Week Static Weight-Bearing following Tibial Plateau Levelling Osteotomy.

OBJECTIVE: The purpose of this article was to compare the effect of surgeon and tibial plateau levelling osteotomy (TPLO) procedure variations on the outcome of TPLO in naturally occurring cranial cruciate ligament disease. MATERIALS AND METHODS: Records from 142 dogs that had a TPLO procedure were reviewed for information regarding surgical procedure, status of meniscus at the time of surgery, surgeon identity, ACVS diplomate or resident, meniscal release, progression of healing at the progress evaluation based on radiographic interpretation and complications encountered. The primary outcome measure was static force on the affected limb at re-evaluation (42-84 days postoperatively) on a PetSafe Stance Analyzer. RESULTS: Re-evaluation tibial plateau angle (TPA) was negatively and significantly correlated with improvement (r = -0.2132, p = 0.013). Postoperative and re-evaluation TPA were all significantly correlated with one another. The amount of TPA change from initial to immediate postoperative values was significantly correlated with the preoperative TPA (r = 0.628, p < 0.001). Surgeon, surgical experience, arthrotomy, meniscal damage, meniscal intervention, complications, postoperative TPA and preoperative TPA had no significant effect on weight-bearing at recheck. CLINICAL SIGNIFICANCE: TPLO show improvement of 4.58% body weight on the affected limb at 6 to 12 weeks rechecks on a Stance Analyzer. Surgeon, surgical experience, arthrotomy, meniscal damage, meniscal intervention, complications, postoperative TPA and initial TPA have no effect on this measurement of surgical outcome.

Evaluation of local and systemic effects after intramuscular implantation of lead shot alternatives in rats.

OBJECTIVE: To evaluate the local and systemic effects of IM implantation of lead shot alternatives in rats. ANIMALS: 22 laboratory rats. PROCEDURES: Sterile IM implantation of shot metals was performed, with euthanasia and necropsy at 2, 8, 16, and 26 weeks after implantation. Skeletal muscle specimens were examined histologically and kidney specimens were tested for heavy metals. In vivo and in vitro evaluation of corrosion of metals was performed. RESULTS: Corrosion of susceptible metals was greatest at 2 weeks in vivo and in vitro. Inflammation associated with all pellet types was greatest 2 weeks after implantation. Nickel-plated steel incited significantly greater inflammation at 2 weeks, compared with bismuth alloy. Kidney iron concentration was significantly greater at 26 weeks, compared with other test periods. Local tissue deposition of iron was verified by use of Prussian blue staining for all iron-containing metals. Concentration of arsenic in kidneys was significantly greater at 8, 16, and 26 weeks after implantation, compared with 2 weeks. CLINICAL RELEVANCE AND IMPACT FOR HUMAN MEDICINE: Humans or dogs wounded with nickel-plated steel may require more aggressive initial monitoring than those wounded with other shot types. Monitoring of systemic arsenic concentrations may be indicated in patients wounded with shotgun pellets.

Dr. Buzby's ToeGrips® Application Results in Minimal Changes in Kinetic Gait Parameters in Normal Dogs.

Poor traction on slick surfaces is difficult for dogs with neurologic deficits, osteoarthritis, or recovering from injury or surgery. Many dogs respond inappropriately to slick surfaces by decreasing digital pad-floor contact and extending their toenails. A device marketed to increase paw-floor friction in dogs was evaluated. Fifteen normal dogs underwent kinetic gait analysis before and after application of Dr. Buzby's ToeGrips®. Ground reaction forces, including vertical peak force (VPF) and impulse for each limb, were measured and compared between pre- and post-application values. Stance time was significantly increased in all limbs after toe grip application. Stride velocity was slower in all limbs but significantly slower only in the left forelimb. VPF was significantly deceased in both hindlimbs after toe grip application, but the decrease was within the group SDs. Vertical impulse was significantly increased in both forelimbs and in the right hindlimb. Dr. Buzby's ToeGrips® result in a slower gait, with slightly decreased VPF in the hindlimbs and increased effort for propulsion kinetic changes were of minor magnitude and unlikely to be clinically relevant.

Prospective Evaluation of Intra-Articular Dextrose Prolotherapy for Treatment of Osteoarthritis in Dogs.

The objective of this study was to evaluate intra-articular dextrose prolotherapy for osteoarthritis of the elbow or stifle in dogs in a randomized, double-blind, placebo-controlled, prospective pilot study. Seventeen dogs were evaluated with 10 meeting inclusion criteria for this study. Evaluations included orthopedic exam, visual lameness scoring, Canine Brief Pain Inventory (CBPI), goniometry, kinetic gait analysis, and radiography. Initial lameness score, age, body weight, duration of lameness, and CBPI scores did not differ between groups. Change in CBPI pain severity score in the prolotherapy group from wk 6-12 was significantly less improved than in the placebo group, with no other significant differences in pain severity or pain interference scores between groups. Range of motion and radiographic scores did not differ between groups at any time. Mean kinetic forces improved in prolotherapy dogs but were not significantly different between treatment groups at any time. Although easily performed and well-tolerated, there were no statistically significant benefits of dextrose prolotherapy for treatment of osteoarthritis of the elbow and stifle in dogs. Post hoc power analysis of these sample means and standard deviations found that 29-106 animals per group would be necessary to demonstrate significant differences in kinetic forces, providing useful guidance for future studies.

Pharmacokinetics of cefazolin for prophylactic administration to dogs.

OBJECTIVE To evaluate pharmacokinetics of cefazolin after IV injection of cefazolin (22 mg/kg) and after simultaneous IV and IM injections of cefazolin (total dose, 44 mg/kg) to dogs. ANIMALS 12 adult Beagles. PROCEDURES Dogs (6/group) were assigned to receive a single injection of cefazolin (IV group; 22 mg/kg, IV) or simultaneous injections (IV + IM group; 22 mg/kg, IV, and 22 mg/kg, IM). Interstitial fluid was collected over a 5-hour period by use of ultrafiltration probes for pharmacokinetic analysis. RESULTS Mean cefazolin concentration in the interstitial fluid at 1, 1.5, 2, 3, 4, and 5 hours after injection was 39.6, 29.1, 21.2, 10.3, 6.4, and 2.7 µg/mL, respectively, for the IV group and 38.3, 53.3, 46.4, 31.7, 19.1, and 8.9 µg/mL, respectively, for the IV + IM group. Mean area under the concentration-time curve extrapolated to infinity, maximum concentration, half-life, and time to maximum concentration was 74.99 and 154.16 h·µg/mL, 37.3 and 51.5 µg/mL, 0.96 and 1.11 hours, and 1.28 and 1.65 hours, respectively, for the IV and IV + IM groups. CONCLUSIONS AND CLINICAL RELEVANCE Cefazolin concentrations in interstitial fluid of dogs were maintained at > 4 µg/mL for 4 hours after a single IV injection and for 5 hours after simultaneous IV and IM injections. Therefore, simultaneous IV and IM administration of cefazolin 30 to 60 minutes before surgery should provide interstitial fluid concentrations effective against the most common commensal organisms (Staphylococcus spp and Streptococcus spp) on the skin of dogs for surgical procedures lasting ≤ 4 hours.

Effects of administration of adipose-derived stromal vascular fraction and platelet-rich plasma to dogs with osteoarthritis of the hip joints.

OBJECTIVE To evaluate effects of simultaneous intra-articular and IV injection of autologous adipose-derived stromal vascular fraction (SVF) and platelet-rich plasma (PRP) to dogs with osteoarthritis of the hip joints. ANIMALS 22 client-owned dogs (12 placebo-treated [control] dogs and 10 treated dogs). PROCEDURES Dogs with osteoarthritis of the hip joints that caused signs of lameness or discomfort were characterized on the basis of results of orthopedic examination, goniometry, lameness score, the Canine Brief Pain Inventory (CBPI), a visual analogue scale, and results obtained by use of a pressure-sensing walkway at week 0 (baseline). Dogs received a simultaneous intraarticular and IV injection of SVF and PRP or a placebo. Dogs were examined again 4, 8, 12, and 24 weeks after injection. RESULTS CBPI scores were significantly lower for the treatment group at week 24, compared with scores for the control group. Mean visual analogue scale score for the treatment group was significantly higher at week 0 than at weeks 4, 8, or 24. Dogs with baseline peak vertical force (PVF) in the lowest 25th percentile were compared, and the treatment group had a significantly higher PVF than did the control group. After the SVF-PRP injection, fewer dogs in the treated group than in the control group had lameness confirmed during examination. CONCLUSIONS AND CLINICAL RELEVANCE For dogs with osteoarthritis of the hip joints treated with SVF and PRP, improvements in CBPI and PVF were evident at some time points, compared with results for the control group.

Pathophysiology and management of arthritis.

This article primarily reviews the pathophysiology, diagnosis, and therapy of osteoarthritis but also briefly discusses immune-mediated arthritides. Given the frequency of occurrence of arthritis in veterinary patients, it is crucial that clinicians be aware of the mechanisms of the disease and be comfortable with diagnosis and treatment. Unfortunately,there is a great deal of information still to be learned in regards to management of these cases. Because of the rapid and continuing research gains, it behooves clinicians to maintain a current awareness of the related literature.

In vitro evaluation of biomechanical effects of multiple hemilaminectomies on the canine lumbar vertebral column.

OBJECTIVE: To conduct an in vitro investigation of the biomechanical characteristics of the canine lumbar spinal column in flexion and extension and measure the destabilizing effects of multiple consecutive unilateral and bilateral hemilaminectomies. SAMPLE POPULATION: 30 isolated multisegmental spinal units (L1-L4) from nonhypochondroplastic dogs weighing 15 to 30 kg. PROCEDURES: Physically normal and surgically altered spinal specimens were subjected to 4-point bending in flexion and extension to determine effects of multiple consecutive hemilaminectomies on the basis of analysis of test system load-displacement data. Six groups with 5 spinal columns in each were defined on the basis of the following procedures: hemilaminectomy at L2-L3, 2 adjacent hemilaminectomies at L1-L3, 3 adjacent hemilaminectomies at L1-L4, bilateral hemilaminectomies at L2-L3, 2 bilateral hemilaminectomies at L1-L3, and no hemilaminectomy (intact). Spinal stability before and after surgery was determined in all groups. Each group served as its own control for nondestructive testing. Spinal strength was evaluated through destructive testing to determine deformation at failure, strength to failure, and mode of catastrophic failure. The intact group served as the control for destructive testing. RESULTS: Stability in extreme flexion and extreme extension did not change significantly following any hemilaminectomy procedure. Postoperative stability within the neutral zone was significantly decreased in all groups. Range of motion within the neutral zone was not significantly different from the intact condition in any group. CONCLUSIONS AND CLINICAL RELEVANCE: Multiple hemilaminectomies did not decrease stiffness of the lumbar spinal column during flexion and extension. These results support clinical recommendations regarding multiple consecutive hemilaminectomies in dogs.