A survey of the use of ultrasound by small animal veterinary clinicians.

This study aimed to determine the current use of ultrasound amongst small animal veterinarians. A total of 1216 small animal veterinary practitioners responded to an electronic survey that was administered through the Veterinary Information Network to all its members. Descriptive statistics were generated; limited inferential statistics were performed to examine specific relationships. Eighty-four percent of respondents had access to an ultrasound unit, and 86% of respondents reported using their unit multiple times per week. The most common uses were assistance with cystocentesis (93%) and abdominocentesis (71%), pregnancy diagnosis (69%), limited abdominal evaluation (63%), to aid in thoracocentesis (59%), and limited thoracic evaluation (52%). Eighty-nine percent of respondents received some formal training in ultrasound, most commonly from continuing education courses. Most respondents (52%) reported receiving ≤25 h of training. Additionally, 88% of respondents believed it was either extremely or very important for there to be ultrasound training for veterinary students prior to graduation. Based on this survey, most small animal practitioners commonly use ultrasound for limited examinations, being most confident in the sonographic evaluation and centesis of the bladder and for the detection and centesis of effusion in a body cavity. With most respondents having ≤25 h of training in ultrasound, typically obtained in postgraduate courses, an expansion in standardized basic ultrasound training within the veterinary curriculum may be warranted.

Anesthetic and analgesic techniques used for cats undergoing ovariohysterectomies in general practice in the United States.

OBJECTIVE: To better document anesthetic and analgesic protocols used by veterinarians in general practice within the United States (US) when performing elective ovariohysterectomy in cats. STUDY DESIGN: Cross-sectional survey. POPULATION: Veterinary practitioners in the US who are members of the Veterinary Information Network Inc. (VIN). METHODS: An online anonymous survey was distributed to VIN members. The survey included questions pertaining to preanesthetic evaluation, premedication, induction, monitoring and maintenance protocols, and postoperative analgesia and sedation protocols when performing ovariohysterectomy in cats. RESULTS: A total of 1324 veterinarians completed the survey. Respondents (number; %) reported performing preanesthetic laboratory tests [packed cell volume (256; 19.3%), complete blood cell count (893; 67.4%) and biochemistry panels (1101; 83.2%)] and preanesthetic examinations (1186; 89.6%) on the morning of surgery. The most frequently administered drugs for premedication were dexmedetomidine (353; 26.7%) and buprenorphine (424; 32.0%). The most frequently administered induction agent was propofol (451; 61.3%), and isoflurane (668; 50.4%) was the most common agent for maintenance of anesthesia. The majority of respondents reported placing intravenous catheters (885; 66.8%), administering crystalloid fluids (689; 52.0%) and providing heat support (1142; 86.3%). Participants reported using perioperative and postoperative analgesia including opioids (791; 59.7%), non-steroidal anti-inflammatory drugs (NSAIDs; 697; 52.6%) and NSAIDs dispensed for home use (665; 50.2%). Cats were commonly released home on the day of surgery (1150; 86.9%), and most participants reported contacting owners for follow-up within 1-2 days (989; 74.7%). CONCLUSIONS AND CLINICAL RELEVANCE: Anesthetic protocols and management techniques for routine feline ovariohysterectomy differ widely among US veterinarians who are VIN members, and results from this study may be of use to evaluate anesthetic practices from this population of veterinarians.

Remote Teaching of Canine Cardiac Auscultation Using Digital Phonocardiograms.

Veterinary students often struggle to correctly interpret heart sounds. This study sought to evaluate if additional online training using digital phonocardiograms (DPCGs) improves students' ability to identify normal and pathologic heart sounds in dogs. Thirty-six randomly assigned veterinary students listened to and interpreted 10 audio recordings of normal heart sounds (2), heart murmurs (4), and arrhythmias (4) at the start and the end of a 4-week period. Twenty-two students participated in training with DPCGs, including those created from these recordings during this period, via a self-study website (n = 12) or online webinar (n = 10). Their results were compared with those of a control group (n = 14) that did not undergo additional training. Although pre- and post-training test scores did not differ between groups, both training groups showed within-group improvement between the two tests (p = .024, p = .037); the control group did not (p = .49). Although neither training group showed differences in ability to differentiate normal heart sounds from arrhythmias, both showed increased ability to detect and specify heart murmurs and provide refined diagnoses of detected arrhythmias. These results suggest additional training, even without actual patients, improves students' ability to identify heart murmurs and provide specific diagnoses for arrhythmias. Further study with a larger sample size and an additional group without DPCG-based training would help evaluate the effectiveness of DPCGs regarding arrhythmias. Studying a larger sample size would also allow for a training group participating in both training methods, measuring cumulative effectiveness of both methods.

Comparison of Attempts Needed for Veterinary Students to Reach Proficiency in a Basic and Advanced Robotic Simulator Task.

Surgical training of students is one of the most difficult aspects of veterinary medical education. Competing interests of house officers, owner's wishes, and ethical concerns have led to increasing use of inanimate models for basic surgical skills training. Robotic simulators have benefits for psychomotor training but have not been previously investigated in veterinary medicine. Understanding the necessary practice time for new training devices is important when determining their potential value. The aim of this study was to compare the number of attempts needed for veterinary students to reach proficiency in both a basic and advanced robotic simulator task, and to assess the predictive nature of performance variables. Each student performed a basic and advanced tasks on the Mimic dV-Trainer™ until proficiency was reached. Students required a median of eight attempts (95% CI = 7-8, range: 6-11) to reach proficiency for the basic task versus 22 attempts (95% CI = 20-26, range: 11-62) for the advanced task. The median time required to complete training for the basic and advanced task was 13.5 minutes (range: 8-24 minutes) and 26.5 minutes (range: 11-82 minutes) respectively. The difference in task attempts supports the training protocol and confirms proficiency can be attained in a short period of time. The number of attempts to reach proficiency correlated with specific performance variables which can be used by educators to aid in training students on a robotic simulator. Continued investigations on robotic simulators should be performed to investigate their use in improving psychomotor skills in veterinary students.

What to Teach in Small Animal Veterinary Orthopedics: A Survey of Practicing Veterinarians to Inform Curriculum Development.

Competency-based veterinary education focuses on the knowledge and clinical skills required to generate a productive and confident practitioner. Accurate identification of clinically relevant core competencies enables academic institutions to prioritize which new and foundational information to cover in the limited time available. The goal of this study was to aggregate the opinions of veterinary practitioners about small animal core competencies in veterinary orthopedics. An online 20-question survey was distributed with questions regarding respondent demographics, education, practice type, caseload, involvement in orthopedic procedures, access to referral hospitals, frequency of orthopedic condition presentation and procedure performance, and proposed percent allocation of various orthopedic curriculum topics. Responses were included from 721 respondents, largely first-opinion veterinarians (81%, n = 580/721). The majority (58%; n = 418/721) of respondents performed less than 10% of the orthopedic surgeries themselves and, 37% (n = 266/721) reported never performing orthopedic surgery; of those performing surgeries, 78% (n = 354/455) performed less than six orthopedic procedures monthly. The five most common orthopedic conditions seen included: generalized osteoarthritis, patellar luxation, cranial cruciate ligament disease, hip dysplasia/arthritis, and muscle/tendon injuries. Median respondent scores for the percentage which a topic should comprise in an ideal orthopedic curriculum were 20% each for 'orthopedic exam' and for 'non-surgical orthopedic knowledge', 15% each for 'non-surgical orthopedic skills,' 'orthopedic imaging (radiographs),' and 'surgical orthopedic knowledge,' 10% for 'surgical orthopedic skills,' and 2% for 'advanced orthopedic imaging.' Based on these results, a curriculum focusing on the most clinically relevant orthopedic conditions with an emphasis on diagnosis establishment and non-surgical treatments is proposed.

Anesthetic and analgesic techniques used for dogs undergoing ovariohysterectomies in general practice in the United States.

OBJECTIVE: To acquire information about anesthesia and analgesia protocols used by United States (US) veterinarians in primary care practices when performing routine ovariohysterectomy in dogs. STUDY DESIGN: Cross-sectional survey. POPULATION: Primary care veterinarians in the US. METHODS: An online anonymous survey, originally created in New Zealand, was modified with permission and made available to Veterinary Information Network (VIN) members. The survey asked questions about performing ovariohysterectomy in healthy adolescent dogs in the categories of preanesthetic evaluation, premedication and induction protocols, maintenance protocols and monitoring equipment, and postoperative analgesic and sedation protocols and pain assessments. RESULTS: A total of 1213 US veterinarians completed the survey. Respondents (n; %) reported performing preoperative laboratory tests [packed cell volume (135; 11%), complete blood cell count (889; 73%) and biochemistry panels (1057; 87%)] and preanesthetic examinations on the morning of surgery (1083; 90%). The most commonly administered drugs for premedication were acepromazine (512; 42%), hydromorphone (475; 39%) or butorphanol (463; 38%), with propofol (637; 67%) for induction of anesthesia and isoflurane (882; 73%) for maintenance of anesthesia. Most veterinarians reported placing intravenous catheters (945; 78%), administering electrolyte solutions (747; 67%) and providing heat support (1160; 96%). Perioperative and postoperative analgesia included local anesthetics (545; 45%), opioids (844; 70%) and non-steroidal anti-inflammatory drugs (NSAIDs) (953; 79%); NSAIDs were dispensed for home use (985; 81%). Dogs were most frequently discharged on the day of surgery (1068; 88%) and the owners were contacted (914; 75%) for follow-up within 1-2 days. CONCLUSIONS AND CLINICAL RELEVANCE: Anesthetic management for routine ovariohysterectomy in dogs varies among US veterinary VIN members. Information from this study is useful for all veterinarians for comparison with their practice management and for teachers of veterinary anesthesia to continue to emphasize options for analgesia.

A survey of primary care practitioners' referral habits and recommendations of allergen-specific immunotherapy for canine and feline patients with atopic dermatitis.

BACKGROUND: A recent pilot study of primary care veterinarians' attitudes regarding canine atopic dermatitis and initiation of allergen-specific immunotherapy (ASIT) revealed several barriers to specialist referral (in the USA) and use of ASIT as a treatment modality. HYPOTHESIS/OBJECTIVES: The primary objective was to collect data on referral habits and ASIT practices among a much larger cohort of primary care veterinarians located around the world, and to explore barriers to referral and management of atopic diseases of dogs and cats with ASIT. METHODS AND MATERIALS: An online survey, administered through the Veterinary Information Network (VIN, Davis, CA, USA), asked participants to self-report their referral habits and immunotherapy recommendations, and rate barriers and motivating factors using Likert-scale responses. RESULTS: Of 827 survey responses, 97.6% identified as primary care practitioners. A larger number of practitioners (84.5%) reported seeing atopic dogs often, compared with atopic cats (9.7%). Fewer of these veterinarians (56.6%) referred atopic cats for specialist care, compared to atopic dogs (73.5%). Timely communication, sharing long-term management of the case, and provision of local continuing education were identified as factors associated with increased willingness to refer. A higher proportion of practitioners reported recommending ASIT for dogs (44.3%) than for cats (16.0%). Only 56.0% of respondents considered success rates of ASIT to be acceptable, while 27.9% were neutral on the topic. CONCLUSIONS AND CLINICAL RELEVANCE: Dermatology specialists might build stronger relationships with referring veterinarians through timely case follow-up and provision of continuing education regarding the long-term benefits of ASIT and symptomatic management practices.

Canine pedal papilloma identification and management: a retrospective series of 44 cases.

BACKGROUND: Papillomavirus infections in dogs have a variety of manifestations and involve multiple viral genera. Canine pedal papillomas have been infrequently studied and reported in the literature. OBJECTIVE: To report the signalment, history, treatment and outcome of biopsy-confirmed cases of canine pedal papillomatosis, collected from veterinarians across the United States and Canada ANIMALS: Medical records from 44 dogs were submitted by North American veterinarians. METHODS AND MATERIALS: Surveys were submitted through the Veterinary Information Network for biopsy-confirmed cases of canine pedal papillomatosis. Submissions included information on patient signalment, history, biopsy report, treatment and outcome. RESULTS: Forty-four cases were reviewed. The median age of presentation was four years old. Dogs most commonly presented with lameness and/or paw licking/chewing. Only one paw was affected in 35 cases, and front paws were more often affected than back paws. Twenty-eight dogs presented with one mass. Histopathological evaluation documented 33 cases of noninverted papillomas and 11 cases of inverted papillomas. Thirty-four papillomas resolved in total; 25 resolved within three weeks after biopsy collection. Twenty-one dogs received no additional treatment and 15 of those cases resolved. Azithromycin was the most commonly reported treatment initiated after biopsy was collected. CONCLUSIONS AND CLINICAL IMPORTANCE: The biological behaviour of canine pedal papillomas in this case series was similar to oral papillomas, and most lesions resolved with or without additional treatment. Further research is needed to better characterise the causative papillomavirus types and genera involved in the development of canine pedal papillomas.

American and Canadian veterinarians' perceptions on dog and cat core vaccination rates and the impact of the human medicine anti-vaxx movement on veterinary medicine.

An electronic survey was distributed to assess American and Canadian veterinarians' perceptions on dog and cat vaccination rates. The top veterinarian concerns for vaccinating a healthy adult dog were anaphylaxis, soreness at the injection site, and lethargy; for cats, these concerns included vaccine-associated sarcoma, lethargy, and soreness at injection site. Veterinarians reported that the most common concerns mentioned by reluctant or resistant clients to vaccinating their dogs or cats were beliefs that vaccinations are costly and unnecessary or may lead to chronic or severe illness. There was a positive correlation between an organized anti-vaxx movement against mandatory vaccination for children in their community and the number of vaccine resistant or concerned clients. That the number of resistant clients was associated with the presence of an organized anti-vaxx movement implies that the human anti-vaxx movement is impacting pet owners' views on companion animal vaccinations.

Perceptions des vétérinaires américains et canadiens sur les taux de vaccination de base des chiens et des chats et impact du mouvement anti-vaxx en médecine humaine sur la médecine vétérinaire. Un sondage électronique a été distribué pour évaluer les perceptions des vétérinaires américains et canadiens sur les taux de vaccination des chiens et des chats. Les principales préoccupations des vétérinaires pour la vaccination d'un chien adulte en bonne santé étaient l'anaphylaxie, la douleur au site d'injection et la léthargie; pour les chats, ces préoccupations comprenaient le sarcome associé au vaccin, la léthargie et la douleur au site d'injection. Les vétérinaires ont signalé que les préoccupations les plus courantes mentionnées par les clients réticents ou résistants à la vaccination de leurs chiens ou chats étaient la croyance que les vaccinations sont coûteuses et inutiles ou peuvent entraîner une maladie chronique ou grave. Il y avait une corrélation positive entre un mouvement anti-vaxx organisé contre la vaccination obligatoire des enfants de leur communauté et le nombre de clients inquiets ou résistants à la vaccination. Le fait que le nombre de clients résistants soit corrélé à la présence d'un mouvement anti-vaxx organisé suggère que le mouvement anti-vaxx en médicine humaine a un impact sur l'opinion des propriétaires d'animaux de compagnie sur la vaccination des animaux de compagnie.(Traduit par Dr Serge Messier).

Veterinary Behavior: Assessment of Veterinarians' Training, Experience, and Comfort Level with Cases.

Studies of US animal shelters consistently indicate that behavior is often a major reason for relinquishment and, thereby, euthanasia of millions of dogs and cats annually. Even though this is an area in which veterinarians can intervene to support the human-animal bond, prior research has documented that they frequently do not bring the topic up during appointments. This study explored veterinarians' training in animal behavior and behavioral medicine, along with their level of comfort in treating common behavioral problems. An online survey of practicing veterinarians (N = 1,085) found that only 42.8% felt they'd received a significant amount of training in this field during veterinary school, but the majority reported participating in continuing education sessions about behavior. Almost all respondents reported seeing patients with behavioral issues (99.6%), even when the initial appointment was made for other reasons. Participants felt most comfortable discussing inappropriate elimination and begging for food but were least comfortable treating issues involving aggression. Most veterinarians treat their own behavior cases, using a combination of behavior modification techniques and medication. Only 22.1% refer cases needing behavioral therapy to a specialist. Given the prevalence of behavioral problems in companion animals and the potential for early veterinary intervention to play a significant role in animal health, it is important for veterinary schools to include this topic in their curricula. At present, 73% of schools require a course in animal behavior. The release of the new Competency-Based Veterinary Education framework is anticipated to support a greater teaching emphasis in this area.

Hair and saliva analysis fails to accurately identify atopic dogs or differentiate real and fake samples.

BACKGROUND: The availability of direct-to-consumer medical testing for human and veterinary health conditions has increased in recent years. For allergies, several companies market proprietary hair and saliva tests directly to pet owners. These tests have not been validated and there is limited regulatory oversight for such tests in veterinary medicine. HYPOTHESIS/OBJECTIVES: To examine the accuracy and reproducibility of a commercial direct-to-consumer hair and saliva allergen test. ANIMALS: Seven healthy animals (six dogs, one cat); six animals (five dogs, one cat) with atopic dermatitis; 11 samples of synthetic fur and sterile saline. METHODS AND MATERIALS: Duplicate animal hair and saliva, and 11 synthetic fur and saline samples were collected (total samples 35) and submitted to the company for analysis, yielding 12,075 outcomes for statistical analysis. RESULTS: Positive test results were provided by the direct-to-consumer pet allergy for all submitted samples, including synthetic fur and saline. The test results for healthy and atopic animal samples were no different from each other or from synthetic fur and saline samples. Reproducibility for paired samples was not different from random chance. The results for real animals correlated strongly with results for synthetic fur and saline samples (r = 0.71, P < 0.05). CONCLUSIONS AND CLINICAL IMPORTANCE: The direct-to-consumer hair and saliva test for pet allergies examined in this study performed no better than chance and the results were not reproducible.

MRI has limited agreement with CT in the evaluation of vertebral fractures of the canine trauma patient.

Complete assessment of vertebral trauma in dogs currently requires CT and MRI for evaluation of the osseous and soft tissue structures that contribute to vertebral stability. Some studies in people have suggested that MRI may be sensitive and specific at detecting vertebral fractures making this potentially a single modality that could be used in spinal trauma evaluation. This study aimed to assess the ability for observers to evaluate vertebral fractures using MRI when compared to CT, which was used as the reference standard. Twenty-nine dogs with previously diagnosed acute vertebral fractures and four dogs with no vertebral fracture that had undergone sequential CT and MRI were included into the study. One hundred twenty-eight vertebrae were evaluated for the presence of fractures. Imaging studies were read by two observers blinded to the history. While both observers had similarly high sensitivity and specificity for simple detection of any fractured vertebrae, interobserver agreement was only moderate (κ = 0.584). When evaluations were specifically limited to detection of structurally unstable fractured vertebrae both observers showed improved specificity and interobserver agreement became substantial (κ = 0.650). Complete agreement for exact fracture location between MRI and CT results was only achieved in 14.3-32.6% of fractured vertebra with up to 79% of fractures being missed in some vertebral structures. This suggests that although MRI may be able to detect the presence of fractured vertebrae, it is not able to replace CT for the complete evaluation of the traumatized spine and documentation of fracture morphology.

Veterinary Student Stress, the Benefit of Canine Pets, and Potential Institutional Support of Dog Ownership.

The stress of veterinary school and the high prevalence of psychological distress among veterinary students have been well documented. Pet ownership is known to improve overall health and reduce stress among the public. Yet, for veterinary students, owning a pet (especially a dog) can offer both rewards and challenges. The academic schedule for veterinary students often comprises long hours that can make caring for a dog challenging. This study explores the area of veterinary students' dog care options and perspectives by examining two aspects of this issue: (a) currently available options, as reported by academic administrators, and (b) perceived need for these options, as reported by veterinary students. A survey of associate deans for academic affairs (n = 30) found that routine on-site kenneling options for student-owned dogs are available at eight (26.6%) veterinary schools. Simultaneously, results of a student survey (n = 768) revealed a great desire for on-campus services. Among students who did not have access to on-campus kenneling facilities, 71.5% (453 of 634) felt that creating these options would be important or very important. Across all students surveyed, 76% (581 of 764) felt it would be important to have on-site dog housing/care available. Students experience considerable stress over having to find accommodations or care for their dogs while engaged in academic activities. Thus, providing on-site boarding and care options for student-owned dogs can play an important role in both recruiting prospective veterinary students and enhancing the well-being of those currently in the program.

Contrast-enhanced ultrasound complements two-dimensional ultrasonography in diagnosing gallbladder diseases in dogs.

Gall-bladder diseases are common in dogs and two-dimensional ultrasonography is a current standard method for diagnosis and treatment planning. However, findings from this modality can be nonspecific. The aim of this retrospective, case series study was to describe conventional and contrast-enhanced ultrasound (using SonoVue® ) findings in a group of dogs with histologically confirmed gall bladder disease. A total of 65 dogs were included. Branchlike, heterogeneous, and homogeneous contrast enhancement of echogenic intraluminal mass-forming lesions was a contrast-enhanced ultrasound characteristic of polypoid lesions due to cystic mucosal hyperplasia of the gallbladder and/or tumor, which had different wash-in and washout characteristics. In dogs with mobile or immobile biliary sludge or mucocele, the echogenic intraluminal masses remained unenhanced. A double rim mark or enhancement defect in the gallbladder wall was a characteristic of edema or necrosis/rupture of the wall, respectively. Conventional ultrasonography correctly identified biliary sludge or mucocele in 36/37 dogs, cholecystitis/edema in 44/47 dogs, necrosis/rupture in 19/25 dogs, and gallbladder neoplasia in three of three dogs with these pathologies. It falsely identified biliary sludge or mucocele in eight of 28 dogs, cholecystitis/edema in three of 15 dogs, necrosis/rupture in 13/37 dogs, and gall-bladder neoplasia in 20/59 dogs that did not have these pathologies. Contrast-enhanced ultrasound correctly identified cholecystitis/edema in 42/47 dogs, but falsely identified cholecystitis/edema in three of 18 dogs. It correctly identified necrosis/rupture, benign polypoid lesions, and gallbladder neoplasia in all dogs with no false-positive results. Findings supported contrast-enhanced ultrasound as a complement to conventional ultrasonography for dogs with suspected gallbladder pathologies such as edema, necrosis, and rupture.

A digitális fonokardiográfia szerepe a kutyák szívhangjainak hallgatózásos vizsgálatának oktatásában.

Absztrakt Sok állatorvostanhallgatónak esik nehezére a szívhangok helyes értelmezése. Kutatásunk célja a digitális fonokardiogramokat felhasználó online, tanterven kívüli oktatás hatásának felmérése volt a hallgatók szívhangok felismerésével kapcsolatos diagnosztikai képességeire. Harminchat véletlenszeruen elosztott állatorvostanhallgató hallgatott meg és értelmezett 10 hangfelvételt élettani szívhangokról (2), szívzörejekrol (4) és szívritmuszavarokról (4) egy négyhetes periódus elején és Végén. Huszonkét hallgató vett részt DPCG-ket felhasználó képzésben, egy önképzo oldal (n = 12) és egy online webinar (n = 10) keretein belül. A két teszten elért eredményeiket egy kontrollcsoportéval vetettük össze (n = 14), akik nem vettek részt tanterven kívüli képzésben. Bár az elo- és utótesztek pontszámai nem különböztek szignifikánsan a csoportok között, mindkét oktatásban résztvevo csoport szignifikáns csoporton belüli javulást mutatott a két teszt között (p = 0,023, p = 0,037), míg a kontrollcsoport nem (p = 0,49). Bár egyik csoport sem ért el javulást az élettani szívhangok felismerésében és szívritmuszavaroktól való elkülönítésében, mindkét csoportban javulást láttunk a szívzörejek felismerésében és azonosításában, valamint az észlelt szívritmuszavarok azonosításában. Eredményeink alapján a hallgatók hallgatózásos vizsgálattal kapcsolatos diagnosztikai képességei javíthatóak tanterven kívüli oktatással, akár élo álatok igénybevétele nélkül is. További, nagyobb elemszámmal végzett, valamint DPCG-t nem használó oktatómódszereket alkalmazó kutatás szükséges a DPCG-k szerepének pontos meghatározásához. Egy emelt elemszámmal végzett kutatás lehetové tenné továbbá egy kombinált oktatott csoport létrehozását, mérhetové téve a két módszer kumulatív hatását. This translation was provided by the authors. To view the original article visit: https://doi.org/10.3138/jvme-2021-0097.

EVALUATION OF QUANTITATIVE THYROID SCINTIGRAPHY FOR DIAGNOSIS AND STAGING OF DISEASE SEVERITY IN CATS WITH HYPERTHYROIDISM: COMPARISON OF THE PERCENT THYROIDAL UPTAKE OF PERTECHNETATE TO THYROID-TO-SALIVARY RATIO AND THYROID-TO-BACKGROUND RATIOS.

Thyroid scintigraphy is commonly used for evaluation of cats with hyperthyroidism, with the thyroid-to-salivary ratio (T/S) being the most common method to quantify the degree of thyroid activity and disease. Calculation of thyroid-to-background ratios (T/B) or percent thyroidal uptake of (99m) TcO(-) 4 (TcTU) has only been reported in a few studies. The purpose of this prospective, cross-sectional study was to evaluate a number of quantitative scintigraphic indices as diagnostic tests for hyperthyroidism, including the T/S, three different T/B, TcTU, and estimated thyroid volume. Of 524 cats referred to our clinic for evaluation of suspected hyperthyroidism, the diagnosis was confirmed (n = 504) or excluded (n = 20) based on results of a serum thyroid panel consisting of thyroxine (T4 ), triiodothyronine (T3 ), free T4 (fT4 ), and thyroid-stimulating hormone (TSH) concentrations. In the hyperthyroid cats, median values for TcTU, T/S, and three T/B ratios were all significantly higher (P < 0.001) than values in euthyroid suspect cats or clinically normal cats. All scintigraphic parameters were relatively sensitive and specific as diagnostic tests for hyperthyroidism, but the T/S ratio had the highest test accuracy. The T/S ratio correlated strongly with the TcTU (r = 0.85). However, the TcTU had a higher and more significant correlation (P < 0.01) with serum T4 (r = 0.76 vs. 0.64), T3 (r = 0.77 vs. 0.64), and estimated thyroid volume (r = 0.62 vs. 0.38). Overall, calculation of TcTU is an accurate diagnostic test, but also appears to be the best parameter to predict the functional volume and metabolic activity of the feline adenomatous thyroid gland.

EVALUATION OF CONTRAST-ENHANCED ULTRASONOGRAPHY AS A METHOD FOR DETECTING GALLBLADDER NECROSIS OR RUPTURE IN DOGS.

Gall bladder necrosis and rupture are life-threatening conditions in dogs requiring surgical intervention and early diagnosis is essential. Human patients with suspected gall bladder necrosis/rupture are commonly evaluated with contrast-enhanced ultrasonography (CEUS), however this procedure has not been described in dogs with suspected gall bladder necrosis/rupture. In a prospective diagnostic cohort study, CEUS (using SonoVue contrast medium) was performed in 93 dogs with gallbladder lesions identified by abdominal conventional ultrasonography. Necrosis/rupture was identified by CEUS as a focal lack of enhancement of the gallbladder wall. Dogs with positive CEUS finding for necrosis/rupture (complete lack of regional wall enhancement) underwent immediate surgery as did dogs with other biliary disorders requiring surgery. Dogs with negative CEUS findings or those not requiring surgery were managed medically. In cases undergoing surgery, necrosis/rupture was confirmed intraoperatively (and via histopathology). Absence of necrosis/rupture was confirmed either intraoperatively (via histopathology) or was assumed to be absent by complete recovery with medical management. Forty-nine dogs underwent surgery and cholecystectomy: 24 had necrosis/rupture. CEUS was more accurate (100% sensitive and specific) in diagnosing gallbladder wall necrosis/rupture than conventional ultrasonography (75% sensitive and 81% specific) (P < 0.03). In conclusion, CEUS provides accurate characterization of gallbladder wall integrity that can impact decisions regarding clinical management, either surgical or medical.

Frequency of delusional infestation by proxy and double delusional infestation in veterinary practice: observational study.

BACKGROUND: Nothing is known about the prevalence of delusional infestation in veterinary practice and the consequences for psychiatrists. AIMS: We attempted to examine the frequency of delusional infestation among pet owners presenting their animals to veterinary clinics. METHOD: We conducted a survey among 32 663 veterinary clinicians who were members of the Veterinary Information Network. RESULTS: The respondents had seen 724 suspected cases of delusional infestation by proxy in a pet. The clients were mainly White, female and 30-60 years old. They presented mainly dogs and cats, and the alleged infestation was mainly with arthropods or worms. Also, 252 clients claimed to be affected themselves; we termed this 'double delusional infestation'. CONCLUSIONS: Delusional infestation is seen frequently in veterinary practice. Psychiatrists need to be aware that patients may have pets they believe are infested.

Characteristics and Survival of 121 Cats Undergoing Excision of Intracranial Meningiomas (1994-2011).

OBJECTIVE: To report clinical features and outcomes of cats undergoing excision of intracranial meningiomas. STUDY DESIGN: Retrospective, multicenter case series. SAMPLE POPULATION: One hundred and twenty-one cats. METHODS: Signalment, clinical signs, duration of clinical signs, preoperative drug therapy, diagnostic imaging reports, surgery, histopathology, and outcome were collected from records of cats undergoing excision of intracranial meningiomas. Survival estimates were made using Kaplan-Meier analysis. RESULTS: There were 76/121 neutered males and 83/121 domestic short-hairs. Body weight ranged from 1.5-8.7 kg (median 5.0 kg). Age at diagnosis ranged from 3-18 years (median 12 years). Clinical signs included changes in behavior, ataxia, seizures, visual deficits, circling, and paresis. Duration of neurologic signs ranged from <1-23 months (median 1.25 months). At the time of writing, 13 cats were alive, 54 were dead or euthanatized, and 54 were lost to followup. Seven cats (13% of cats that died; 6% of all cats) died or were euthanatized in the immediate postoperative period (<1 month post-surgery) and 9 cats (17% of all cats that died; 7% of all cats) died from causes related to the meningioma but outside the immediate perioperative period. The median survival time for all cats was 37 months (95% confidence interval 28-54 months). CONCLUSION: Cats undergoing excision of intracranial meningiomas had a low perioperative mortality and a long-term prognosis of more than 3 years.