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Background: The objectives of this study were to: (i) Determine whether operable primary liver tumors were associated with prolongations in prothrombin time (PT) and activated partial thromboplastin time (aPTT) and (ii) determine if these secondary hemostatic abnormalities were more prevalent with specific liver tumors., Study Design: Multi-institutional retrospective study., Animal Population: Dogs (n = 359) undergoing liver lobectomy for a primary liver tumor with a preoperative coagulation panel., Methods: Data was identified via electronic medical record review at eight veterinary teaching hospitals. Baseline dog characteristics, coagulation panel values, platelet count, emergency versus non-emergency procedure, whether the dogs received transfusion(s) of a blood product, liver lobe removed, and histopathological diagnosis were extracted from the medical record. Chi-square analysis was used to compare categorical variables between groups. Continuous variables were assessed for normality using the Shapiro-Wilk test., Results: A total of 74 of 359 dogs (20.6%) had a prolongation in either PT or aPTT preoperatively. A total of 20 of 359 dogs (5.6%) were found to have prolongation of both PT and aPTT. Hemangiosarcoma was the only histopathological diagnosis associated with concurrent prolongations of both PT and aPTT (p < .001) in 6/16 (37.5%) dogs., Conclusion: Coagulation panels including PT and aPTT are unlikely to detect substantial deficiencies in secondary hemostasis in most dogs with primary liver tumors except in dogs with a histopathological diagnosis of hemangiosarcoma., Clinical Significance: PT and aPTT testing is low yield as an elective preoperative screening test in dogs with primary liver tumors except in dogs where there is a hemoabdomen or high suspicion for hepatic hemangiosarcoma., (© 2024 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.)

Objective: To determine the influence of normograde (NG) versus retrograde (RG) catheterization of the cystic duct and common bile duct (CBD) in dogs with gallbladder mucoceles (GBM) treated with open cholecystectomy., Study Design: Retrospective study., Animals: Dogs (n = 117) with GBM., Methods: Medical records were reviewed for signalment, history, clinical laboratory and diagnostic imaging findings, details of surgery including catheterization method, complications, and outcome. Long-term follow-up data were obtained by telephone or electronic communication. Relationships between catheterization method and clinical variables and outcome were evaluated., Results: Dogs catheterized RG were more likely to experience any postoperative complication (p = .0004) including persistence of gastrointestinal signs (p = .0003). Survival to discharge and long-term survival did not differ by group (p = .23 and p = .49). Total bilirubin (TB) decreased by 70.3% after NG catheterization compared to 39.1% after RG catheterization (p = .03) and increased in 14.9% dogs catheterized NG and 38.0% dogs catheterized RG (p = .004). The presence of a diplomate surgeon at surgery resulted in decreased incidences of any perioperative or postoperative complication (p = .003 and p = .05)., Conclusion: Retrograde catheterization was associated with more postoperative concerns than NG catheterization, but similar survival times. Surgery should be performed by diplomates experienced in biliary surgery to minimize complications., Clinical Significance: Although both NG and RG techniques to catheterize the cystic duct and CBD are options for treatment of GBM with low mortality, results of this study provide some evidence to recommend NG over RG catheterization., (© 2021 The American College of Veterinary Surgeons.)

Objective: To identify which classification systems have been used for tumor margin reporting and to determine whether factors (publication year, tumor type, and specialty of the contributing authors) influenced trends in margin reporting within literature describing canine soft tissue sarcoma (STS) and cutaneous mast cell tumors (MCT)., Study Design: Systematic literature review., Methods: Eligible articles were identified through electronic database searches performed for STS and MCT. Data abstracted from relevant studies included publication year, author list, specialty of contributing authors, criteria used to report the planned surgical margins, and the status of histologic margins. Categorization of papers was based on the classification systems used to report surgical and histologic tumor margins., Results: Fifty-three articles were included, 11 on STS, 37 on MCT, and five that included both tumor types. Criteria for classifying the planned surgical margins were described in only 50.9% of studies. Articles that listed a veterinary surgeon as a contributing author (P = .01) and STS articles compared to MCT papers (P = .01) were more likely to report surgical margins. Most (56.6%) studies reported the status of histologic margins dichotomously as "complete" or "incomplete." Although a previously published consensus statement recommended that quantitative criteria be used to report histologic margins, only 7.5% of articles used quantitative methods., Conclusion: Classification systems used for reporting tumor margins were highly variable among studies., Clinical Significance: The findings of this review provide evidence that a standardized classification system for reporting surgical and histologic tumor margins is required in veterinary medicine. A universal system may support more consistent reporting of neoplastic biopsy specimens and allow for more meaningful comparisons across research studies., (© 2020 American College of Veterinary Surgeons.)

Objective: To determine the diagnostic accuracy of optical coherence tomography (OCT) to assess surgical margins of canine soft tissue sarcoma (STS) and determine the influence of observer specialty and training., Study Design: Blinded clinical prospective study., Animals: Twenty-five dogs undergoing surgical excision of STS., Methods: In vivo and ex vivo surgical margins were imaged with OCT after tumor resection. Representative images and videos were used to generate a training presentation and data sets. These were completed by 16 observers of four specialties (surgery, radiology, pathology, and OCT researchers). Images and videos from data sets were classified as cancerous or noncancerous., Results: The overall sensitivity and specificity were 88.2% and 92.8%, respectively, for in vivo tissues and 82.5% and 93.3%, respectively, for ex vivo specimens. The overall accurate classification for all specimens was 91.4% in vivo and 89.5% ex vivo. There was no difference in accuracy of interpretation of OCT imaging by observers of different specialties or experience levels., Conclusion: Use of OCT to accurately assess surgical margins after STS excision was associated with a high sensitivity and specificity among various specialties. Personnel of all specialties and experience levels could effectively be trained to interpret OCT imaging., Clinical Significance: Optical coherence tomography can be used by personnel of different specialty experience levels and from various specialties to accurately identify canine STS in vivo and ex vivo after a short training session. These encouraging results provide evidence to justify further research to assess the ability of OCT to provide real-time assessments of surgical margins and its applicability to other neoplasms., (© 2020 American College of Veterinary Surgeons.)

Objective: To evaluate the feasibility and safety of microwave ablation (MWA) as a modality to induce tumor necrosis within distal radial osteosarcoma (OSA)., Study Design: Pilot study., Animals: Six client-owned dogs with distal radius OSA confirmed by cytological examination., Methods: Dogs underwent computed tomography for surgical planning before general anesthesia for fluoroscopy-guided ablation. Computed tomography was repeated 48 hours after MWA, before amputation. The ablated tumor was evaluated with histopathology., Results: Six dogs underwent MWA of distal radius OSA. A lower power setting (30 W) was selected for the first two dogs to avoid collateral soft tissue damage. The power was increased to 75 W for the last four dogs. The temperature was maintained between 45°C and 55°C (113 °F-131 °F) at the bone/soft tissue interface. Tumor necrosis varied between 30% and 90% (median, 55%) according to histopathology. No intraoperative or periprocedural complications were observed., Conclusion: Microwave ablation induced variable tumor necrosis and did not induce immediate postablation complications in these six dogs with distal radius OSA., Clinical Significance: These results justify further evaluation of MWA as a potential modality to treat primary bone lesions in dogs., (© 2020 The American College of Veterinary Surgeons.)

Objective: To determine outcome and prognostic factors in small breed dogs in which hemangiosarcoma was diagnosed and whether outcomes differed between small and large breed dogs with splenic hemangiosarcoma., Study Design: Bi-institutional retrospective study., Animals: Forty-three small breed (<20 kg) and 94 large breed client-owned dogs., Methods: Medical records were reviewed to identify dogs treated with splenectomy for splenic hemangiosarcoma. Data acquired included signalment, preoperative staging, bloodwork results, surgical findings, histopathologic findings, administration of chemotherapy, presence/absence of metastatic disease, and survival time (ST). Cox proportional hazards regression analysis was performed to assess prognostic factors associated with survival., Results: The overall median ST was 116 days and 97 days for small and large breed dogs, respectively. The ST for dogs treated with surgery and chemotherapy was 207 and 139 days for small and large breed dogs, respectively. The disease-free interval (DFI) was 446 and 80 days for small and large breed dogs, respectively. Dog size was associated with DFI (P = .02) but not with ST (P = .09). The presence of metastasis at diagnosis was associated with decreased ST in small (P = .03) and large (P = .0009) breed dogs. Administration of chemotherapy (P = .02) was associated with increased ST (P = .02) in small breed dogs., Conclusion: The ST was not different in small and large breed dogs with splenic hemangiosarcoma treated with splenectomy and chemotherapy., Clinical Significance: Prognosis remains poor despite aggressive therapies in small and large breed dogs., (© 2020 The American College of Veterinary Surgeons.)

Objective: To report the outcomes of dogs with lesions of the genitourinary tract treated by vaginectomy or vulvovaginectomy., Study Design: Multi-institutional retrospective study., Animals: Female dogs that underwent vulvovaginectomy, complete vaginectomy, or subtotal vaginectomy from 2003 to 2018 with complete medical records and a minimum of 60 days follow-up., Methods: Data collected from medical records included preoperative, intraoperative, and postoperative data, such as the occurrence of urinary incontinence (UIC), disease recurrence, and death/euthanasia., Results: This study included 21 dogs. Four dogs had vulvovaginectomy, six had complete vaginectomy, and 11 had a subtotal vaginectomy performed. The mean age at surgery was 9.2 years (SD, 3.3). Thirteen dogs were intact at presentation. Smooth muscle tumors were diagnosed most commonly (10 leiomyomata, three leiomyosarcomas, two leiomyofibromas). The median duration of follow-up was 520 days (range, 71-1955). Major complications requiring revision surgery were recorded in two dogs. Postoperative UIC occurred in six of 21 dogs, resolving spontaneously within 60 days in three dogs. Dogs with malignant tumors (n = 6) survived at least 71 days (median, 626; 95% CI, 71-1245), and recurrence of disease occurred in two dogs. In dogs with benign tumors (n = 15), the median survival time was not reached. These dogs survived at least 104 days and had no recurrence of the disease., Conclusion: Vaginectomy and vulvovaginectomy resulted in prolonged survival and low rates of major complications and UIC., Clinical Significance: This study provides evidence to recommend that the risks of this procedure and expectations should be discussed with clients., (© 2020 The American College of Veterinary Surgeons.)

Objective: To describe percutaneous microwave ablation (MWA) of presumptive pulmonary metastases and the outcome of two dogs., Animals: Two dogs with pulmonary lesions after treatment of spontaneously occurring appendicular osteosarcoma., Study Design: Preliminary prospective clinical study., Methods: Two large-breed dogs were referred from tertiary veterinary hospitals 146 and 217 days after limb amputation to pursue MWA as an alternative therapy to metastasectomy. Both dogs had been receiving chemotherapy protocols at their respective referral centers., Results: A novel percutaneous approach for MWA with ultrasonographic or computed tomographic (CT) guidance was successfully performed. The only complications consisted of pneumothoraxes, requiring treatment in one dog. In the weeks after their procedures, both dogs were reported to do well at home. Dog 1 died and dog 2 was euthanized 82 and 19 days, respectively, after their MWA of confirmed (dog 1) or presumed (dog 2) metastatic disease., Conclusion: Percutaneous MWA of pulmonary nodules was technically feasible in two dogs without major complications., Clinical Significance: Percutaneous MWA may provide a minimally invasive option for treatment of osteosarcoma pulmonary metastases. Additional studies are required to evaluate the benefits of MWA on survival and confirm histologic cell death within pulmonary neoplastic lesions., (© 2020 The American College of Veterinary Surgeons.)

Objective: To identify prognostic factors for short-term survival of dogs that experience seizures within 7 days after surgical correction of single congenital extrahepatic portosystemic shunts (cEHPSS)., Study Design: Multi-institutional retrospective study., Sample Population: Ninety-three client-owned dogs., Methods: Medical records at 14 veterinary institutions were reviewed to identify dogs that underwent surgical attenuation of a single cEHPSS from January 1, 2005 through February 28, 2018 and experienced postattenuation seizures (PAS) within 7 days postoperatively. Logistic regression analysis was performed to identify factors associated with 1-month survival. Factors investigated included participating institution, signalment, shunt morphology, concurrent/historical conditions, presence of preoperative neurologic signs, presence of preoperative seizures, aspects of preoperative medical management, surgical details including method and degree of shunt attenuation, type of PAS (focal only or generalized ± focal), drugs administered as part of the treatment of PAS, and development of complications during treatment of PAS., Results: Thirty (32.3%) dogs survived to 30 days. Seventy-six (81.7%) dogs experienced generalized PAS. Factors positively associated with short-term survival included having a history of preoperative seizures (P = .004) and development of focal PAS only (P = .0003). Most nonsurvivors were humanely euthanized because of uncontrolled or recurrent seizures., Conclusion: Dogs that experienced PAS that had a history of preoperative seizures and those that experienced focal PAS only had significantly improved short-term survival., Clinical Significance: The results of this study provide information that will help in the counseling of owners who seek treatment for PAS after surgical correction of cEHPSS. © 2020 The American College of Veterinary Surgeons., (© 2020 The American College of Veterinary Surgeons.)

Objective: To evaluate the pharmacokinetics (PK) of platinum (Pt) and safety of carboplatin-impregnated calcium sulfate hemihydrate (C-I CSH) beads after implantation in healthy cats., Study Design: In vivo experimental study., Animals: Six healthy adult cats., Methods: Three C-I CSH beads were implanted in muscle pockets over the right and left hemithoraces of each cat (~3.9 mg/kg of Pt; 60.4 mg/m 2 of calculated carboplatin). Hematology and blood chemistry were tested at baseline and 3, 7, 14, and 21 days postimplantation. Serum was analyzed for Pt at specific times from 1 hour to 21 days. Tissue was obtained for histopathology and analysis of Pt at 3, 7, 14, and 21 days at standardized distances from implantation sites., Results: Platinum was detected in tissues at all times and distances (range, 0.1-4.19 μg/g). Serum Pt increased up to 2.6 hours (3.25 μg/mL) then decreased sharply. Samples containing muscle had higher Pt compared with samples without muscle (P = .004). Mild hypercalcemia was noted in four cats, and mild inflammatory reaction was noted on histopathology of all samples., Conclusion: Platinum was released from C-I CSH beads differentially into surrounding tissues over 21 days. Systemic absorption of Pt was minimal, but mild hypercalcemia occurred., Clinical Significance: Implantation was well tolerated by healthy adult cats. Securing beads within muscle may limit Pt diffusion to targeted tissue. Although Pt concentrations did not achieve levels reported to be cytotoxic for feline sarcoma cells in culture, results provide evidence to support evaluation of efficacy in the tumor microenvironment of cats with locally invasive cancers., (Published 2020. This article is a U.S. Government work and is in the public domain in the USA.)

Objective: To compare demographics and disease characteristics in dogs in which peritoneopericardial diaphragmatic hernia (PPDH) had been diagnosed and report outcomes after surgical treatment (ST) or conservative treatment (CT)., Study Design: Retrospective study., Sample Population: One hundred twenty-eight dogs (91 ST, 37 CT) in which PPDH had been diagnosed., Methods: Medical records were reviewed for demographics, perioperative findings, and outcomes. Follow-up was obtained via telephone interview and email correspondence with owners and referring veterinarians. Baseline variables were compared between treatment groups., Results: Dogs treated surgically were younger (P < .001), more likely to be sexually intact (P = .002), more likely to have clinical signs from PPDH vs an incidental diagnosis (P < .001), and more likely to have other congenital abnormalities (P = .003) compared with dogs treated conservatively. Ninety-seven percent of ST dogs were discharged from hospitals. Intraoperative and postoperative complications were reported in 22% and 41% of dogs, respectively, although most complications were classified as low grade (75% and 83%, respectively). Follow-up was available in 87 dogs, at a median of 1062 days. Hernia recurrence was not reported in any surgically treated dog. The deaths of nine dogs (five ST, four CT) could be attributed to PPDH, and long median survival times were observed in both the ST and CT groups (8.2 and 5 years, respectively)., Conclusion: Preoperative characteristics differed between dogs treated conservatively vs surgically. Surgical treatment was associated with low operative mortality, and both ST and CT dogs had good long-term survival., Clinical Significance: A diagnosis of PPDH can confer a good long-term prognosis for both ST and CT dogs., (© 2019 The American College of Veterinary Surgeons.)

Surgical excision is the foundation of treatment for early-stage solid tumors in man and companion animals. Complete excision with appropriate margins of surrounding tumor-free tissue is crucial to survival. Intraoperative imaging allows real-time visualization of tumors, assessment of surgical margins, and, potentially, lymph nodes and satellite metastatic lesions, allowing surgeons to perform complete tumor resections while sparing surrounding vital anatomic structures. This Review will focus on the use of near-infrared imaging and optical coherence tomography for intraoperative tumor visualization., (© 2019 The American College of Veterinary Surgeons.)

Objective: To document the appearance of artifacts created by commonly encountered surgical conditions and instrumentation on optical coherence tomography (OCT) and to compare these findings with histopathology., Study Design: Ex vivo study., Animals: Five canine cadavers., Methods: Skin, subcutaneous fat, skeletal muscle, and fascia samples were obtained from fresh canine cadavers. Blood pooling, hemostatic crushing, scalpel blade cut, monopolar electrosurgery, bipolar vessel sealing device, and ultrasonic energy surgical artifacts were induced on each tissue type. Each specimen was imaged with OCT and subsequently histologically processed., Results: Most surgical instrumentation used for tumor excision created a high-scattering region with local architectural disruption. Blood pooling was visible as a high-scattering layer overlying tissue with normal architecture. Only the scalpel blade created a focal, low-scattering area representing a sharply demarcated cut within the tissue distinct from the appearance of other instrumentation., Conclusion: Common surgical instruments and conditions encountered during tumor excision produced high-scattering OCT artifacts in tissues commonly seen at surgical margins., Clinical Significance: The clinical value of OCT hinges on the ability of personnel to interpret this novel imaging and recognize artifacts. Defining and describing the appearance of common surgical artifacts provides a foundation to create image libraries with known histological and OCT interpretation, ultimately improving the diagnostic accuracy of OCT for assessment of surgical margins., (© 2019 The American College of Veterinary Surgeons.)

Objective: To describe the clinical characteristics, perioperative complications, and outcomes in dogs surgically treated for gastric carcinoma., Study Design: Multi-institutional retrospective case series., Animals: Forty client-owned dogs with histologically confirmed gastric carcinoma., Methods: Medical records were reviewed for preoperative diagnostics, surgery, histopathology, postoperative complications, adjuvant chemotherapy, disease progression, and survival. Variables were assessed for associations with outcome by using Cox proportional hazards regression analysis., Results: Surgical treatment included partial gastrectomy (28 dogs), Billroth I (9 dogs), subtotal gastrectomy (2 dogs), and submucosal resection (1 dog). Major postoperative complications occurred in 8 of 40 dogs, including septic peritonitis secondary to dehiscence in 4 dogs. The median progression free interval was 54 days, and the median survival time (MST) was 178 days (range, 1-1902). According to multivariable analysis results, experiencing an intraoperative complication was associated with an increased risk of death (hazard ratio [HR] 3.5, 95% CI 1.1-9.8, P = .005), and administration of adjuvant chemotherapy correlated with an improved survival (HR 0.4, 95% CI 0.2-0.9, P = .03)., Conclusion: In this population of dogs, MST exceeded historically reported data, major postoperative complication rates were comparable to established literature, and administration of adjuvant chemotherapy was associated with improved survival., Clinical Significance: Results from this study may be used to counsel owners more accurately regarding prognosis for dogs undergoing surgical excision for gastric carcinoma., (© 2019 The American College of Veterinary Surgeons.)

Objective: To describe a novel surgical technique for ventral orbital reconstruction after ventral orbitectomy by using a temporalis fascia transposition flap., Study Design: Case report., Methods: A 7-year-old, spayed female Boston terrier was treated for multilobular osteochondrosarcoma arising from the cranial aspect of the left zygomatic arch, causing asymmetry of the face and mild exophthalmos of the left eye. A ventral orbitectomy with a wide surgical excision (including the cranial aspect of the zygomatic bone, the medial aspect of the lacrimal bone, and the dorsal aspect of the maxilla) was performed with preservation of the left eye. To support and maintain the left eye in a normal position, a temporalis fascia transposition flap was elevated and used. No complications occurred during the procedure., Results: Thirteen days after surgery, the referring veterinarian reported no complications. Complete excision was confirmed on histopathology. Eighty-three days after surgery, the dog remained asymptomatic with only mild epiphora of the left eye. Follow-up information from the owner 11 months after surgery indicated that the dog was asymptomatic with minimal ventral globe deviation., Conclusion: Additional ventral support of the globe after ventral orbitectomy via a temporalis fascia transposition flap resulted in an excellent functional and cosmetic outcome., Clinical Significance: A temporalis fascia transposition flap can be used to reconstruct the ventral aspect of the orbit in dogs., (© 2019 The American College of Veterinary Surgeons.)

Objective: To describe and report outcomes after lateral translation of the manus for limb-sparing management of distal radial osteosarcoma in dogs., Study Design: Retrospective case series., Study Population: Eighteen client-owned dogs., Methods: The distal aspect of the affected radius and associated neoplastic tissues were excised. The distal aspect of the ulna was preserved except for its medial cortex, which was removed en bloc with the radial segment. The manus was translated laterally to place the radial carpal bone in contact with the distal aspect of the ulna. A limb-sparing or locking compression plate was placed on the remaining proximal radius and the 3rd metacarpal bone. A 3.5-mm SOP (string of pearls) plate was placed on the lateral aspect of the proximal ulna and the 4th metacarpal bone. Dogs were administered chemotherapy. Data were collected to assess surgical and oncologic outcomes. Limb function was subjectively assessed., Results: The percentage of radius removed ranged from 43% to 94% (median 54%). Complications developed in 12 limbs, with infection in 10, biomechanical complications in 6, and local recurrence in 4. Limb function was subjectively assessed as acceptable. Median disease-free interval was 219 days, and median survival time was 370 days., Conclusion: Outcomes after lateral translation of the manus compared favorably to other limb-sparing techniques for dogs with distal radial osteosarcoma, particularly in dogs requiring excision of a large segment of the radius., Clinical Significance: The lateral manus translation provides an alternative limb-sparing technique that does not require an allograft, endoprosthesis, or autograft., (© 2018 The American College of Veterinary Surgeons.)

Objective: To report the incidence of postattenuation seizures (PAS) in dogs that underwent single congenital extrahepatic portosystemic shunt (cEHPSS) attenuation and to compare incidence of PAS in dogs that either did or did not receive prophylactic treatment with levetiracetam (LEV)., Study Design: Multi-institutional retrospective study., Population: Nine hundred forty dogs., Methods: Medical records were reviewed to identify dogs that underwent surgical attenuation of a single cEHPSS from January 2005 through July 2017 and developed PAS within 7 days postoperatively. Dogs were divided into 3 groups: no LEV (LEV-); LEV at ≥15 mg/kg every 8 hours for ≥24 hours preoperatively or a 60 mg/kg intravenous loading dose perioperatively, followed by ≥15 mg/kg every 8 hours postoperatively (LEV1); and LEV at <15 mg/kg every 8 hours, for <24 hours preoperatively, or continued at <15 mg/kg every 8 hours postoperatively (LEV2)., Results: Seventy-five (8.0%) dogs developed PAS. Incidence of PAS was 35 of 523 (6.7%), 21 of 188 (11.2%), and 19 of 228 (8.3%) in groups LEV-, LEV1, and LEV2, respectively. This difference was not statistically significant (P = .14). No differences between groups of dogs that seized with respect to investigated variables were identified., Conclusion: The overall incidence of PAS was low (8%). Prophylactic treatment with LEV according to the protocols that were investigated in our study was not associated with a reduced incidence of PAS., Clinical Significance: Prophylactic treatment with LEV does not afford protection against development of PAS. Surgically treated dogs should continue to be monitored closely during the first 7 days postoperatively for seizures., (© 2018 The American College of Veterinary Surgeons.)

Objective: To describe modifications to the lateral orbitotomy for surgical excision of tumors affecting the frontal, parietal, palatine, or temporal bones., Study Design: Case report., Animal: A 5-year-old female spayed American pit bull terrier., Methods: The dog presented for excision of a bone tumor affecting the right frontal and parietal bones. A modified lateral orbitotomy was performed with combined partial zygomatic arch and vertical ramus ostectomies to increase working space and allow drilling of the calvarium ventral to the mass., Results: The dog tolerated the procedure well, and there were no complications from either the ostectomies or the craniectomy. Histopathological examination was consistent with complete excision of an osteoma. The dog survived 2 years with no recurrence and was euthanized due to an intestinal mass., Conclusion: The lateral orbitotomy approach can be modified with combined partial zygomatic arch and vertical ramus ostectomies to increase exposure and working space for resection of tumors affecting the frontal, parietal, palatine, or temporal bones., (© 2018 The American College of Veterinary Surgeons.)

Objective: To evaluate the efficacy of a surgical safety checklist (SSC) in reducing perioperative and postoperative complications., Study Design: Before-and-after intervention study., Animals: Client-owned dogs (n = 633) and cats (n = 44)., Methods: Consecutive surgeries were enrolled in the study. The "before" phase consisted of 267 surgeries performed without an SSC (SSC - ) followed by 75 SSC - surgeries in which a trained observer was in the operating room to detect possible complications. An SSC was then implemented in the operating rooms during 1 week. The "after" phase consisted of 58 surgeries in which a safety checklist (SSC + ) and an observer were used and 277 SSC + surgeries without an observer. Complications were prospectively recorded when witnessed by the observer, and all other perioperative complications were retrospectively recorded from veterinary records and client telephone communication., Results: There were more perioperative and postoperative complications when surgeries were performed without an SSC (140/342 [40.9%; 95% CI, 35.7%-46.4%]) than there were when surgeries were performed with an SSC (98/335 [29.3%; 95% CI, 24.4%-34.4%]; P = .002). Surgical checklist use, presence of an observer, American Society of Anesthesiologists score, and anesthesia time were all independently associated with the odds of complications., Conclusion: Implementation of an SSC in an academic teaching hospital decreased the odds of perioperative and postoperative surgical complications., Clinical Significance: This study supports the use of an SSC to prevent surgical complications in veterinary teaching hospitals., (© 2018 The American College of Veterinary Surgeons.)

Objective: To define and compare clinical characteristics of canine primary appendicular hemangiosarcoma (HSA) and telangiectatic osteosarcoma (tOSA), including signalment, presentation, response to treatment, and prognosis., Study Design: Multi-institutional retrospective study., Animals: Seventy dogs with primary appendicular HSA or tOSA., Methods: Patient data were obtained from institutions' medical records. Immunohistochemistry was applied to archived tissues to establish tumor type. Patient characteristics, treatment responses, and outcomes were described and compared by tumor type., Results: Forty-one HSA and 29 tOSA were identified. Dogs with HSA were more likely than dogs with tOSA to be male and have hind limb tumors; 78% of HSA occurred in hind limbs, particularly the tibia. Dogs with tOSA weighed a median of 9.9 kg (95% CI 4.6-15.3) more than dogs with HSA. Most dogs received antineoplastic treatment, predominantly amputation with or without adjuvant chemotherapy. Overall survival with local treatment and chemotherapy was 299 days (95% CI 123-750) for HSA and 213 days (95% CI 77-310) for tOSA. Younger age and more aggressive treatment were associated with longer survival in dogs with HSA but not tOSA. One-year survival rates did not differ between dogs with HSA (28%) and those with tOSA (7%)., Conclusion: Distinct clinical features were identified between HSA and tOSA in this population. Both tumors were aggressive, with a high incidence of pulmonary metastases. However, local treatment combined with chemotherapy led to an average survival 7 months for tOSA and 10 months for HSA., Clinical Significance: HSA should be considered as a differential in dogs with aggressive lytic bone lesions, particularly medium-sized dogs with tibial lesions. HSA has a unique clinical presentation but similar therapeutic response and outcome to OSA. Amputation and chemotherapy appear to prolong survival in some dogs with HSA and tOSA., (© 2018 The American College of Veterinary Surgeons.)

Objective: To assess the content and face validity of a model of an obstructed feline ureter as a tool for teaching ureteral microsurgery., Study Design: Prospective, experimental study., Sample Population: Seven expert and 11 novice microsurgeons., Methods: The model was created from latex rubber with an inner diameter of 0.8 mm and an outer diameter of 5 mm. The "ureter" was created with an inner compartment, a thin wall, and a soft, outer layer mimicking periureteral fat. A "ureterolith" 0.8-1.2 mm in diameter was placed inside the inner compartment by using a blunt-tipped cannula. A standardized "ureterotomy" was performed by 7 expert and 11 novice microsurgeons. Both groups completed questionnaires evaluating the content and face validity of the model using subjective measures and a 5-point Likert scale. Reliability was analysed by calculation of Cronbach's α for all questions to ensure α ≥ .7. The median responses to each question were compared between groups with a nonparametric independent samples median test. P < .05 was considered significant., Results: The Cronbach's α for the experts and the novices for content validity questions was .7 and .9, respectively, and for the face validity questions it was .7 and .8, respectively. The model was rated to have excellent content validity and very good face validity., Conclusion and Impact: The model elicited positive responses from expert and novice microsurgeons and can be recommended as a tool for teaching ureteral microsurgery. A model validated by face and content measures should next be scrutinized by determination of construct, concurrent, and predictive validity by using objective measures., (© 2018 The American College of Veterinary Surgeons.)

Objective: To describe the complications and outcome after total prostatectomy in dogs with histologically confirmed prostatic carcinoma., Study Design: Multi-institutional retrospective case series., Animals: 25 client-owned dogs., Methods: Medical records of dogs undergoing total prostatectomy were reviewed from 2004 to 2016. Data retrieved included signalment, presenting signs, preoperative clinical findings, laboratory data, diagnostic imaging, surgical technique, histologic diagnosis, postoperative complications, occurrence of postoperative metastasis, and survival., Results: Twenty-five dogs underwent total prostatectomy for prostatic carcinoma. Urinary anastomotic techniques included urethrourethral anastomosis in 14 dogs, cystourethral anastomosis in 9 dogs, ureterocolonic anastomosis in 1 dog, and anastomosis between the bladder neck and penile urethra in 1 dog. All dogs survived to discharge. Fifteen dogs were diagnosed with transitional cell carcinoma, 8 dogs with prostatic adenocarcinoma, 1 with prostatic cystadenocarcinoma, and 1 with an undifferentiated carcinoma. Permanent postoperative urinary incontinence was present in 8 of 23 dogs. The median survival time was shorter in dogs with extracapsular tumor extension compared with those with intracapsular tumors. The overall median survival time was 231 days (range, 24-1255), with 1- and 2-year survival rates equal to 32% and 12%, respectively., Conclusion and Clinical Significance: Total prostatectomy, combined with adjunct therapies, prolongs survival and lowers complication rates compared to previous reports of dogs with prostatic carcinoma. It should be noted, however, that case selection likely played a significant role in postoperative outcome., (© 2018 The American College of Veterinary Surgeons.)

Objective: To determine outcomes in dogs with distal radial osteosarcoma treated with ulnar rollover transposition (URT) limb-sparing surgery including: viability of the ulnar graft, complications, subjective limb function, disease-free interval (DFI), and survival time (ST)., Study Design: Retrospective case series., Animals: Twenty-six client-owned dogs with distal radial osteosarcoma and no involvement of the ulna., Methods: Data of dogs treated with URT were collected at the time of surgery and retrospectively from medical records and by contacting owners and referring veterinarians., Results: URT technique was performed on 27 limbs in 26 dogs. The ulnar graft was determined to be viable in 17 limbs, nonviable in 3, and unknown in 7. Complications occurred in 20 limbs. Infection was diagnosed in 12 limbs. Biomechanical complications occurred in 15 and local recurrence in 2 limbs. Limb function graded by veterinarians or owners was poor in 2 limbs, fair in 4, good in 14, excellent in 3, and unknown in 4. Median DFI was 245 days and median ST was 277 days., Conclusion: The URT technique maintained the viability of the ulnar graft. The complication rate was high but limb function appeared acceptable. Although sufficient length of the distal aspect of the ulna must be preserved to perform this technique, local recurrence was not increased compared to other limb-sparing techniques when cases were appropriately selected., (© 2017 The American College of Veterinary Surgeons.)