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Climate change poses a significant and increasing threat to global health. While veterinarians play integral roles in public and environmental health, the profession has been less engaged in the topic of climate change relative to their human medical counterparts. The objective of this study was to synthesize veterinary students’ perceptions and knowledge about the relationship between veterinary medicine and climate change to identify educational gaps and opportunities. An online questionnaire was disseminated to American Veterinary Medical Association (AVMA)-accredited veterinary colleges through the Student American Veterinary Medical Association newsletter. Respondents were overwhelmingly confident that climate change is happening, is due to human activities, and is impacting both human and animal health. Veterinary students also expressed the belief that veterinarians should take a leadership role on the issue of climate change, especially through promoting environmental sustainability in clinical practice. Despite this enthusiasm, most students reported a lack of educational opportunities within their veterinary programs. The results of this survey highlight opportunities for the development of educational resources on the topic, many of which could complement existing material such as that devoted to practice management, economics, and client communication. Veterinarians have the potential to meaningfully contribute to both mitigation and adaptation efforts around climate change; however, they must be equipped with the tools to do so.

Background Regular physical activity (PA) promotes health and can prevent and treat diseases among both humans and dogs. Unfortunately, most U.S. adults do not meet PA recommendations, and many dogs are also insufficiently active. Veterinary-prescribed PA programs have shown some success in increasing activity among overweight dogs, but the impacts of such programs have not yet been tested for efficacy among otherwise-healthy dogs and owners. In addition, although wearable devices that monitor PA and provide individuals with feedback (e.g., progress toward a daily step goal) can effectively increase human PA, it is unclear what impact similar wearable devices have on human and dog PA when the PA-monitoring devices are worn by dogs. The present study assessed the impact of an 8-week veterinary-prescribed PA program on activity and health among dogs and their owners, and randomized participants (n = 59) to two groups: one in which PA was measured but not visible to participants (n = 30), and one in which PA was measured and real time feedback was visible through a wearable device (n = 29). Results Participants in both groups showed significant PA increases over the course of the 8-week program. Biomedical testing performed at the veterinary clinic facilitated early diagnosis of systemic illness in one human participant. The frequency of hypertension in human participants decreased significantly from baseline to the end of the program (week 8). Other health indices (e.g., BMI in humans, body weight and BCS in dogs) improved, albeit not to a statistically significant extent, over the course of the program. There were no significant differences on the outcomes of interest between the two experimental conditions. Conclusions Veterinary-prescribed PA programs appear promising for increasing PA among insufficiently active but otherwise healthy dogs as well as their owners. Additional testing of veterinary-prescribed PA is warranted, particularly at other types of veterinary clinics (e.g., private practices). Incorporating wearable devices permitting owners to track canine PA did not appear necessary for obtaining these benefits; however, additional studies investigating alternative devices or different time periods may be warranted.

To test the ability of a hospital-wide, bundled quality-improvement initiative to improve postpartum maternal blood pressure control and adherence to postpartum follow-up among patients with hypertensive disorders of pregnancy.This quality-improvement initiative consisted of a bundle of clinical interventions including health care professional and patient education, a dedicated nurse educator, and protocols for postpartum hypertensive disorders of pregnancy care in the inpatient, outpatient and readmission setting. We implemented this initiative in patients with hypertensive disorders of pregnancy starting in January 2019 at the University of Chicago. The study period was divided into four periods, which correspond to preintervention, distinct bundle roll outs, and postintervention. Our primary outcome was postpartum hypertension visit adherence. Secondary outcomes included blood pressure values and antihypertensive medication use in the immediate postpartum and outpatient postpartum time periods. We then stratified our outcomes by race to assess whether the effect size differed.A total of 926 patients who delivered between September 2018 and November 2019 were included. Postpartum hypertension visit adherence improved from preintervention period compared with the full implementation period (33.5% vs 59.4%, P.001). Blood pressure in the first 24 hours postpartum decreased from preintervention compared with full implementation (preintervention median [interquartile range] systolic blood pressure 149 mm Hg [138, 159] vs 137 [131, 146] in postimplementation; P.001). After implementation, fewer patients experienced a blood pressure of 140/90 mm Hg or higher at the first postpartum blood pressure check, when compared with preintervention (39.1% vs 18.5%, P=.004). The effect size did not differ by race.A bundled quality-improvement initiative for patients with hypertensive disorders of pregnancy was associated with improved postpartum visit adherence and blood pressure control in the postpartum period.

A transition toward environmentally conscious business practices is underway in many sectors. For healthcare, the topic is both concerning and tragically ironic as hospitals have substantial environmental footprints, which are now known to contribute to significant health problems that the system itself was designed to treat. The human medical field has been proactive in taking steps to reduce waste and carbon emissions by identifying best practices to minimize such impacts. Characterization of needs and gaps has been addressed through reviews of the literature regarding environmental sustainability in the context of human hospitals. Our objective was to replicate methods used in a recent review of environmental sustainability in human hospitals to summarize information available to clinical veterinarians. Two search algorithms were used across 8 databases, however only 3 peer-reviewed opinion articles specific to veterinary medicine were identified. These papers included 1 on anesthesia and 2 on production animals. Interestingly, all articles were written by United Kingdom-based authors and none were specific to companion animal practice, the largest sector in the veterinary industry in the United States. Results of this review highlight need for research and communication that supports veterinary clinics in adopting more environmentally sustainable practices. Proposed starting points informed from research in other sectors, including 5 physical themes of energy efficiency, water, waste, sustainable procurement, and transportation, and human behavior changes on the individual, group, and organizational levels, are discussed. Additional work is needed to support veterinarians and other animal health professionals to practice medicine in a way that upholds the veterinary profession's oath to promote the health of animals, the public, and the environment we all share.

Physical inactivity remains a global epidemic leading to an estimated 5 million preventable deaths per year. Although there exist numerous public-health campaigns aimed at increasing physical activity (PA), a potentially fruitful but underexplored avenue to promote both human and animal health is veterinary-prescribed PA programs. The aim of this study was to determine the feasibility and acceptability of incorporating veterinary-prescribed PA programming into a diverse array of clinic settings. Participants (n = 722 veterinary-clinic staff (VS), n = 1028 dog owners (DOs)) completed an online survey assessing: (a) the perceived importance of PA for promoting health and preventing disease, (b) willingness to participate in a veterinary-prescribed PA program, and (c) potential benefits and barriers of such a program. Both groups of participants indicated that PA is important for both human and animal health (97% and 98% of VS and 92% and 93% of DOs said PA is very or extremely important for animal and human health, respectively). Additionally, most participants in both groups expressed an interest in participating in a veterinary-prescribed PA program in the future, with only 11% of DOs and 10% of VS saying they were not interested. Benefits and barriers of this type of intervention for both practitioners and patients were also identified. Incorporating veterinary-prescribed PA programming into veterinary clinics seems to be acceptable to both DOs and VS. Additionally, many VS believe such programming would be feasible at their clinics, thus, pursuing such programs appears to be a promising avenue for promoting human and animal health.

Objective: To assess how pet owners perceive the role of veterinary medicine in addressing climate change and animal health and determine if there is a client-driven economic incentive to establish sustainable veterinary business practices.Sample: 1,044 dog and/or cat owners residing in the United States who had used veterinary services within the last 3 years.Procedures: An online Amazon mTurk survey about climate change and the perceived effects on client-owned dogs and cats was distributed to pet owners.Results: Most respondents believe climate change is occurring, and two-thirds of pet owners would value knowing their veterinarian received training on the animal health impacts of climate change. Over half of the respondents would pay more for veterinary services at a clinic with a reduced environmental impact. Additionally, clients would value some form of sustainability certification to aid in identification of such practices. Demographic influences found to be statistically significant included age, political ideology and where one resides (i.e., urban, suburban, or rural) whereas gender and income level, were not found to be significant.Conclusions and Clinical Relevance: Our data suggest there is an economic incentive for veterinary professionals to be knowledgeable about the health impacts of climate change and to implement and market sustainable practice initiatives. Prioritizing sustainable practice initiatives and climate change education in veterinary practices has the potential to mutually benefit both practitioner and client through shared patient health and financial incentives.

OBJECTIVE To quantitatively measure the amount of pressure induced at the calcaneus and cranial tibial surface of dogs by use of 2 cast configurations. ANIMALS 13 client- or student-owned dogs. PROCEDURES Pressure sensors were placed over the calcaneus and cranial tibial surface. Dogs then were fitted with a fiberglass cast on a pelvic limb extending from the digits to the stifle joint (tall cast). Pressure induced over the calcaneus and proximal edge of the cast at the level of the cranial tibial surface was simultaneously recorded during ambulation. Subsequently, the cast was shortened to end immediately proximal to the calcaneus (short cast), and data acquisition was repeated. Pressure at the level of the calcaneus and cranial tibial surface for both cast configurations was compared by use of paired t tests. RESULTS The short cast created significantly greater peak pressure at the level of the calcaneus (mean ± SD, 0.2 ± 0.07 MPa), compared with peak pressure created by the tall cast (0.1 ± 0.06 MPa). Mean pressure at the proximal cranial edge of the cast was significantly greater for the short cast (0.2 ± 0.06 MPa) than for the tall cast (0.04 ± 0.03 MPa). CONCLUSIONS AND CLINICAL RELEVANCE A cast extended to the level of the proximal portion of the tibia caused less pressure at the level of the calcaneus and the proximal cranial edge of the cast. Reducing the amount of pressure at these locations may minimize the potential for pressure sores and other soft tissue injuries.

Climate change is one of the greatest public health threats of the twenty-first century. Recent surveys of veterinary students and practicing veterinarians have highlighted their concerns about the impacts of climate change on animal health and a strong desire to be knowledgeable about the practice and promotion of environmental sustainability within clinical practice. Most American Veterinary Medical Association (AVMA)–accredited veterinary schools have a veterinary teaching hospital (VTH) where veterinary students receive their core clinical education. Given this, VTHs may provide opportunities for students to learn how veterinary clinics can decrease their environmental footprint and actions they could incorporate into their future clinical work. To assess the feasibility of and support for introducing environmentally sustainable practices into VTHs, we distributed an anonymous online survey to all AVMA-accredited veterinary schools with an associated VTH. Responses were received from 843 individuals representing 23 VTHs in 7 countries. While the overwhelming majority of responding personnel believe this is an important topic, there is little evidence that sustainable behaviors are being practiced or showcased within VTHs. Respondents were most interested in working to increase recycling and reduce general waste and energy consumption within their hospitals. In addition to a lack of educational resources, funding was a commonly identified barrier to incorporating more environmentally sustainable practices. These results add to the growing evidence that enhanced incorporation of sustainability into veterinary medical education at all stages is needed and that VTHs provide a unique opportunity to lead by example.

Early warning systems for climate change adaptation, preparedness and response will need to take into consideration the range of factors that can drive risk and vulnerability. There are no data from which to nominate the most effective, efficient and reliable wildlife health signals for public health planning, but there is growing opinion that wildlife health could signal public health vulnerability related to climate change. The objective of this commentary is to explore the potential for wildlife to contribute to climate change early warning for public health protection in Canada. Wildlife impact many determinants of human health through both direct and indirect mechanisms; several of which are strongly interconnected. There is a long history of wildlife serving as bio-sentinels for environmental pollutants and pathogens. Wildlife health could support public health threat detection, risk assessment and risk communication by detecting and tracking infectious and non-infectious hazards, being bio-sentinels of effects of new or changed hazards, providing biologically understandable information to motivate changes in personal risk behaviours and providing insights into new and unanticipated threats. Public health risk communication and strategic planning priorities for climate change could benefit from a wildlife health intelligence system that collects data on incidents of disease and hazard discovery as well as information on social and environmental conditions that affect risk perception and likelihoods of human exposure or harms.

Little is currently known about the pacing gait in dogs and it has been speculated that pacing may be utilized by dogs with musculoskeletal pathology. The goals of the present study were to determine if pacing in dogs is associated with musculoskeletal disease and to establish if controlled speed impacts pacing. Dogs underwent orthopedic and lameness assessments. Musculoskeletal pathology, when identified, was further defined with radiography of the affected area. Dogs were considered musculoskeletally normal (MSN) if no pathology was detected and they had no history of musculoskeletal disease. All others were considered musculoskeletally abnormal (MSA). Animals were then evaluated for pacing using digital-video-imaging under three conditions: Off-lead, lead-controlled, and on a treadmill. Thirty-nine dogs were enrolled (MSN: n = 20; MSA: n = 19). Overall, pacing was observed more frequently in dogs under lead-controlled than off-lead conditions (P < 0.001). Lead-controlled MSN dogs were observed to pace significantly more frequently (n = 17/20) than lead-controlled MSA dogs (n = 10/19; P = 0.029). There was no significant difference within each group for the frequency of pacing under treadmill or off-lead conditions. Pacing always occurred at speeds between a walk and a trot, speeds ranged from 0.98 to 2.84 m/s, (mean 1.8 m/s). Pacing was demonstrated in MSN and MSA dogs under all study conditions. Pacing should be considered a gait variation that can be observed in clinically normal dogs. Relative speed and leash walking was determined to be a factor in the use of the pacing gait. Key words: Pacing, gait analysis, lameness, canine locomotion, symmetrical gait, lateral gait, amble.

OBJECTIVE To determine the influence of a novel surgical guide on the accuracy and technical difficulty of closing wedge osteotomies (CWO). STUDY DESIGN Ex vivo experimental study. SAMPLE POPULATION Canine tibia models (n = 40). METHODS A 20° cranial CWO (CCWO) was created without (standard procedure; STCCWO) or with the aid of a novel wedge osteotomy guide (WOCCWO). Procedures were performed by diplomate (n = 4) and resident (n = 6) surgeons, with each performing 2 STCCWO followed by 2 WOCCWO. To prevent bias, surgeons were unaware of the study purpose until after completing the STCCWO. The wedges were evaluated by comparing the deviation from the 20° target angle, divergence of the 2 osteotomies (osteotomy divergence angle [ODA]), and measurements of the wedge height at the caudomedial cortex (CMC) and caudolateral cortex (CLC). Technique difficulty was explored through a surgeon questionnaire. RESULTS The WOCCWO resulted in smaller mean ODA (WOCCWO = 0.86°, SD ± 0.38°, P < .001), and smaller mean difference between CMC and CLC (WOCCWO = 0.29 mm, SD ± 0.19, P < .001) than for the STCCWO (4.22°, SD ± 2.16° and 1.39 mm, SD ± 0.65 respectively). Deviation from the target 20° wedge angle was greater after STCCWO (1.46°, SD ± 1.27°) than after WOCCWO (0.53°, SD ± 0.33°, P = .004). No difference was reported regarding the difficulty of the procedures, but resident surgeons stated that they were more likely to use the guide in a clinical setting compared with diplomates. CONCLUSION The wedge osteotomy guide improved the accuracy of CCWO compared with standard technique. CLINICAL SIGNIFICANCE The clinical significance of the differences detected in this study is unclear and warrants in vivo investigation.

A 6-year-old, male castrated, mixed-breed dog was referred to the James L. Voss Veterinary Teaching Hospital at Colorado State University for bicavitary effusion. On examination, the dog was tachycardic and tachypneic with bilaterally decreased lung sounds. Thoracic and abdominal ultrasonic examination revealed pleural and peritoneal effusions, which were aspirated and submitted for fluid analysis and cytology. Both cavity fluids were classified as exudates with a large population of vacuolated mononuclear cells. Multiplex immunocytochemistry (ICC) for cytokeratin and vimentin demonstrated exclusively cytokeratin expression, indicating these cells were of epithelial origin. A full diagnostic evaluation was performed, including CBC, clinical chemistry, a pet-side test for heartworm disease, ehrlichiosis, Lyme disease, and anaplasmosis, imaging modalities of thorax, abdomen, and heart, urinalysis, and fine-needle aspirations of spleen, liver, and popliteal lymph nodes. The dog was diagnosed with pleural and peritoneal carcinoma with presumed carcinomatosis. A single dose of intracavitary carboplatin was administered before discharge, and over a period of 2 weeks, 5 thoracocenteses were performed. A subcutaneous mass was noted at a thoracocentesis site one week after initial presentation. Cytology of the mass was consistent with carcinoma, and neoplastic seeding of the tumor cells from the thoracocentesis was suspected. The dog was euthanized 15 days after the first visit, and a necropsy was performed. Findings were consistent with carcinomatosis secondary to anaplastic pulmonary carcinoma with transient subcutaneous seeding of neoplastic cells during routine thoracocentesis. This case demonstrates the utility of multiplex ICC in the clinical setting.

Gonadectomies are the most commonly performed surgical procedures in dogs. The benefits and risks associated with gonadectomy in dogs have been broadly investigated. Due to concerns associated with ovariectomy, some pet-owners and veterinarians are considering surgical alternatives which terminate the capacity for reproduction without removal of the gonads to preserve functions of the gonadal hormones. The objective of this study was to determine the feasibility of complete resection of the glandular portion of the uterus with hysterectomy (HE). Using a prospective cadaveric and an ex-vivo design, uterine resection was performed cranially and caudally to the cervix, and at the proper ligament to simulate routine ovariohysterectomy and HE. Using microscopic evaluation procedures, there was identification of glandular tissue at the surgical margin of all samples resected cranially to the cervix and no glandular tissue in the samples resected caudally to the cervix. Half of the samples from the uterine horns contained glandular tissue. The results of the present study indicate ligation and transection of the uterus caudally to the cervix (as recommended for HE) allows for complete resection of glandular tissues, however, transection at the proper ligament may not. The clinical relevance of retention of para-ovarian uterine glandular tissue is unknown. Additional research is needed where there is investigation of the consequences and surgical technique for HE before there is widespread clinical use of this procedure.

Regular physical activity (PA) is a health promoting behavior that transcends species. The collective evidence of a positive relationship between PA and health in both people and animals suggests that implementation of outdoor, dog-associated activities to increase PA may synergistically enhance both human and dog health. A systematic literature review was performed to identify research investigating objective, quantitative health outcomes in both dogs and people exercising together. Within the confines of the search, only 2 studies fulfilled the criteria for complete review. One study was administered through a veterinary clinic and another through a human health care provider. Both studies focused on obesity treatment, either for the dog or for both the dog and the owner. Collectively this work demonstrates the feasibility of simultaneously promoting health in both groups through PA; however there are limitations to the generalizability of the findings. Additional research is needed to further investigate the feasibility and effectiveness of PA promotion in primary care veterinary clinics as well as the use of animal-assisted PA promotion as a preventative, not just therapeutic, tool. As diseases that can be prevented, at least in part, by regular PA are now the leading causes of morbidity and mortality in developed countries, veterinarians have the potential to significantly impact not only the health of their patients, but also that of the public.

Objectives To report our experience with thoracoscopic lung lobectomy in dogs with primary lung tumors and compare the long-term outcome between dogs with primary lung tumors treated with lobectomy via thoracoscopy or thoracotomy. Study Design Retrospective case series; case–control study. Animals Thirteen dogs with primary lung tumors treated with thoracoscopic lung lobectomy; case-matched cohort of 9 dogs with primary lung tumors treated with lobectomy via thoracotomy. Methods Medical records from dogs that underwent thoracoscopic lung lobectomy at a single institution were reviewed. Only cases with primary lung tumors were included. Surgical complications and conversion rate were reported. Cases without conversion and with clean margins on histologic examination were matched on prognostic criteria to cases with primary lung tumors treated with lobectomy via thoracotomy. Survival was compared between thoracoscopy and thoracotomy. Results Thirteen dogs with primary lung tumors that measured 2.2–7 cm underwent thoracoscopic lung lobectomy. Nine dogs were diagnosed with carcinoma and 4 with histiocytic sarcoma. There were 3 conversions to open thoracotomy because of poor visualization. There were no differences in short-term outcome between dogs that had their procedures completed via thoracoscopy and those that were converted to thoracotomy. Nine dogs with clean margins were matched with 9 dogs treated via thoracotomy. Mean (standard deviation) followup was 367 (327) days for dogs undergoing thoracoscopy and 603 (612) days for dogs undergoing thoracotomy. The 2-year survival rate was 44% for thoracoscopy and 56% for thoracotomy (P = .942). Conclusion Selected primary lung tumors in dogs can be safely resected with thoracoscopy and not affect long-term outcome.

Background Accelerometer-based activity monitoring is a promising new tool in veterinary medicine used to objectively assess activity levels in dogs. To date, it is unknown how device orientation, attachment method, and attachment of a leash to the collar holding an accelerometer affect canine activity data. It was our goal to evaluate whether attachment methods of accelerometers affect activity counts. Eight healthy, client-owned dogs were fitted with two identical neck collars to which two identical activity monitors were attached using six different methods of attachment. These methods of attachment evaluated the use of a protective case, positioning of the activity monitor and the tightness of attachment of the accelerometer. Lastly, the effect of leash attachment to the collar was evaluated. For trials where the effect of leash attachment to the collar was not being studied, the leash was attached to a harness. Activity data obtained from separate monitors within a given experiment were compared using Pearson correlation coefficients and across all experiments using the Kruskal-Wallis Test. Results There was excellent correlation and low variability between activity monitors on separate collars when the leash was attached to a harness, regardless of their relative positions. There was good correlation when activity monitors were placed on the same collar regardless of orientation. There were poor correlations between activity monitors in three experiments: when the leash was fastened to the collar that held an activity monitor, when one activity monitor was housed in the protective casing, and when one activity monitor was loosely zip-tied to the collar rather than threaded on using the provided metal loop. Follow-up, pair-wise comparisons identified the correlation associated with these three methods of attachment to be statistically different from the level of correlation when monitors were placed on separate collars. Conclusions While accelerometer-based activity monitors are useful tools to objectively assess physical activity in dogs, care must be taken when choosing a method to attach the device. The attachment of the activity monitor to the collar should utilize a second, dedicated collar that is not used for leash attachment and the attachment method should remain consistent throughout a study period.

Objective To determine the incidence of fibular penetration during placement of the Synthes® locking TPLO plate with and without the use of a jig. Study Design Cadaveric, experimental study. Sample Population Cadaveric paired pelvic limbs (n = 8) from skeletally mature dogs. Methods Limbs were assigned to 1 of 2 groups (jig-less-TPLO = no jig used; jig-TPLO = jig used). Synthes® locking TPLO plates were applied using proximal screws of excessive length to facilitate identification of fibular penetration. Screw tip locations were identified by dissection and frequency of fibular penetration was compared between groups. Results None of the jig-TPLO limbs and 6 (75%) of jig-less-TPLO limbs had fibular penetration, a difference that was statistically significant. Fibular penetration was most frequently associated with the most proximal screw. Conclusions A significantly higher incidence of fibular penetration occurs when Synthes® locking TPLO is performed without use of a jig.

Objective To report clinical and histopathologic features of long digital extensor (LDE) tendon mineralization with concurrent cranial cruciate ligament (CCL) rupture in a dog. Study Design Case report. Animal 1.5-year-old, male castrated, English bulldog mix weighing 31.5 kg. Methods Pre- and postoperative orthogonal radiographs, arthroscopic evaluation, arthrotomy with en bloc surgical excision, and histopathologic analysis of the excised LDE tendon. Results There was radiographic evidence of mineralization in the region of the proximal LDE and stifle instability suggestive of CCL rupture. Arthroscopy, and subsequent arthrotomy, showed complete tearing of the CCL and an intact but grossly thickened LDE. No evidence of avulsion or bony proliferation associated with the LDE was appreciated. Tibial plateau leveling osteotomy (TPLO) and tenectomy of the LDE returned the dog to normal weight-bearing. No evidence of ectopic mineralization in the affected limb or similar clinical signs in the contralateral limb have been observed in 12 months follow-up. Conclusions LDE tenectomy followed by stabilization of the stifle by TPLO resulted in a functional outcome. Mineralization without concurrent avulsion of the LDE has not been reported in dogs; however, posterolateral tendon injury in people has been linked to knee instability and cruciate ligament rupture.

Objective To determine if use of various commonly practiced tibial tuberosity advancement (TTA) preoperative planning methods leads to variable TTA cage size recommendations. Study Design Radiographic study. Animals Dogs (n = 14) with naturally occurring cranial cruciate ligament disease. Methods TTA was planned by a single observer on mediolateral stifle radiographs of each dog using 2 sets of tibial plateau landmarks (anatomic [A] vs. femorotibial common tangent [T]) and 2 advancement measurement techniques (transparent overlay [O] vs. simulated TTA using imaging software [S]) for 4 different planning methods (AO, AS, TO, TS). Cage size recommendations for each stifle were tabulated for each of the 4 planning methods. Mean advancement (mm) required to obtain patellar tendon angle (PTA) = 90° for each of the 4 planning methods were statistically compared. Results In the 14 stifles studied, the 4 planning methods evaluated led to 4 different cage size recommendations in 1 stifle, 3 different recommendations in 8 stifles, 2 different recommendations in 3 stifles, and 1 recommendation in only 2 stifles. There was a significant difference in the mean advancement measurement between the 4 planning methods (P

Objective—To identify epidemiological trends in cutaneous neoplasms affecting equids in central North America and compare them with previously reported trends. Design—Retrospective case series. Sample—3,351 cutaneous biopsy specimens from 3,272 equids with a neoplastic diagnosis. Procedures—Diagnostic reports from 2 diagnostic laboratories (Colorado State University and Prairie Diagnostic Services Inc) were reviewed for frequency of specific lesions and epidemiological trends. Variables included in analyses (if known) were age, sex, breed, geographic location, date of diagnosis, location of neoplasm on the body, and presence or absence of ulceration. Results—Sarcoid, squamous cell carcinoma (SCC), and melanoma were the 3 most common tumors diagnosed. Tumors associated with UV radiation (SCC, SCC in situ, hemangioma, hemangiosarcoma) were 2.3 (95% confidence interval [CI], 1.8 to 3.0) times as common in biopsy specimens received by Colorado State University than in specimens received by Prairie Diagnostic Services Inc. Appaloosa horses and American Paint horses, respectively, were 7.2 (95% CI, 5.6 to 9.2) and 4.4 (95% CI, 3.6 to 5.4) times as likely as other breeds to have tumors associated with UV radiation. Thoroughbreds were predisposed to cutaneous lymphoma, whereas Arabians were more likely to have melanomas. Draft and pony breeds were 3.1 (95% CI, 1.9 to 5.1) times as likely as other breeds to have benign soft tissue tumors. Morgans and pony breeds more commonly had basal cell tumors. Tumors in the perianal region were significantly more likely to be SCC or melanoma while tumors on the limbs were more likely to be giant cell tumor of soft parts. Conclusions and Clinical Relevance—Signalment, anatomic location of the mass, and geographic location of the horse can be used to help equine practitioners formulate differential diagnoses for cutaneous masses. Further research is necessary to identify the biological basis for the development of many equine cutaneous neoplasms.

Objective—To compare calibration methods for digital radiography in terms of measurement accuracy and interobserver variability. Design—Prospective study. Sample—Digital radiographic images of a 155-mm-long Steinmann pin. Procedures—Measurement of pin length on digital radiographs was determined with a 25.4-mm-diameter calibration ball and commercially available software program via 3 calibration methods (ie, no calibration, autocalibration, and manual calibration). Digital radiographs of the calibration ball and pin were obtained with each placed at various vertical heights from the table (7 heights) and horizontal distances from the center of the beam (4 distances). Measurements of pin length on digital radiographs were made by 4 observers who were blinded to the orientation of the calibration ball and pin. Results—Pin lengths obtained by each calibration method were significantly different from each other and from the true value. Manual calibration was the most accurate. There was no significant interobserver variability in measurements. There was no significant change in measurements when the calibration ball was moved horizontally, but pin length measurements changed significantly when the ball was moved vertically (away from the table) with an approximate magnification error of 1% per centimeter of distance between the calibration ball and pin. Conclusions and Clinical Relevance—For digital radiography, manual calibration is recommended to achieve the most accurate measurements. Ideally, the calibration ball should be placed at the same vertical height as the object to be measured; however, if this cannot be achieved, the magnification error can be expected to be approximately 1% per centimeter of distance.

Objective: To determine the effect of proximal ulnar osteotomy (PUO), distal ulnar osteotomy (DUO), and DUO with release of the interosseous ligament (DOLR) on displacement of the proximal ulna at the radioulnar joint. Study Design: Experimental mechanical study. Sample Population: Cadaveric, skeletally mature canine thoracic limb pairs (n=11). Methods: Thoracic limbs disarticulated at the elbow were randomly assigned to 1 of 2 groups: (A) limbs were tested with no treatment (NOTX), then with PUO; (B) limbs were tested with DUO followed by DOLR. A distraction force was applied to the proximal ulna with the distal limb secured in a frame, and displacement of the proximal ulnar segment at the radioulnar joint was recorded. Results: Mean displacement was 0.36 mm (95% confidence interval [CI]: 0−1.12 mm) in the NOTX group, 4.68 mm (95% CI: 3.82–5.55 mm) for PUO limbs, 0.95 mm (95% CI: 0.52–1.39 mm) for the DUO group, and 4.36 mm (95% CI: 3.71–5.02 mm) for the DOLR group. Mean ulnar displacement of the DOLR group was significantly different compared with the DUO group, but there was no significant difference between the PUO and DOLR groups. Conclusions: No significant difference was observed in displacement of the proximal ulnar segment after DOLR compared with PUO.

Objective— To identify surgical techniques performed by veterinary surgeons for the treatment of cranial cruciate ligament disease in large-breed dogs with excessive tibial plateau angle (eTPA), compare their outcomes, identify risk factors for postoperative complications, and compare outcome and complication rate with tibial plateau leveling osteotomy (TPLO) in dogs without eTPA. Study Design— Multicenter, case–control study. Animals— eTPA group (TPA≥35°)=58 dogs (78 stifles); control group (TPA≤30°)=58 dogs (72 stifles). Methods— Control and eTPA group dogs were identified. Medical records, radiographic reviews, and pet-owner interviews were used to identify surgical treatments performed, their complications, and outcome. Odds ratios with 95% confidence intervals, χ2 tests, and t-tests were calculated to discern differences between eTPA and control-group dogs. Results— TPLO was the most common treatment for eTPA. Owner-perceived outcome was superior for eTPA group dogs when TPLO resulted in TPA≤14° compared with those with postoperative TPA>14°. Loss of tibial plateau leveling during convalescence was the most commonly observed major complication; addition of ancillary implants to TPLO significantly reduced its incidence. Postoperative complications were more common in dogs with eTPA than in dogs without eTPA; however, no difference in owner-perceived outcome was identified. Conclusions— Surgical treatment of dogs with eTPA has a higher complication rate, but comparable outcome to that of dogs without eTPA. Clinical Relevance— Postoperative TPA≤14° and addition of ancillary implants are recommended when using TPLO to treat dogs with eTPA.

Being able to conduct an equine field necropsy in a safe and proficient manner is a helpful skill for the equine practitioner. Use of a systematic process enables the practitioner to develop a familiarity with normal anatomic positioning and tissue appearance such that abnormalities are quickly identified. This article outlines a systematic necropsy protocol that can be used to investigate mortality events and clinical questions.

The meaning of health for wildlife and perspectives on how to assess and measure health, are not well characterized. For wildlife at risk, such as some polar bear (Ursus maritimus) subpopulations, establishing comprehensive monitoring programs that include health status is an emerging need. Environmental changes, especially loss of sea ice habitat, have raised concern about polar bear health. Effective and consistent monitoring of polar bear health requires an unambiguous definition of health. We used the Delphi method of soliciting and interpreting expert knowledge to propose a working definition of polar bear health and to identify current concerns regarding health, challenges in measuring health, and important metrics for monitoring health. The expert opinion elicited through the exercise agreed that polar bear health is defined by characteristics and knowledge at the individual, population, and ecosystem level. The most important threats identified were in decreasing order: climate change, increased nutritional stress, chronic physiological stress, harvest management, increased exposure to contaminants, increased frequency of human interaction, diseases and parasites, and increased exposure to competitors. Fifteen metrics were identified to monitor polar bear health. Of these, indicators of body condition, disease and parasite exposure, contaminant exposure, and reproductive success were ranked as most important. We suggest that a cumulative effects approach to research and monitoring will improve the ability to assess the biological, ecological, and social determinants of polar bear health and provide measurable objectives for conservation goals and priorities and to evaluate progress.

Mast cell tumors are uncommon in horses and typically have a benign clinical course, but there are occasional reports of more aggressive behavior. The objective of this study was to review histologic features and KIT expression patterns of 72 previously diagnosed equine cutaneous mast cell tumors to determine if either is associated with clinical outcomes. Biopsy specimens were reviewed using histologic criteria derived from grading schemes, and KIT antibody expression patterns used in canine tumors and surveys were sent to referring veterinarians for follow-up clinical data. Arabians were overrepresented relative to the reference population. Most tumors were well differentiated with low mitotic rates (96%), and aberrant KIT staining patterns, as described in dogs, were uncommonly identified (12%). Associated clinical disease was uncommon and no tumors exhibited malignant behavior. Overall, KIT staining pattern and histologic features were not associated with poor clinical outcome or abnormal tumor behavior.

An 18-year-old, male, castrated, captive-born leopard (Panthera pardus) presented to Colorado State University’s Veterinary Teaching Hospital with a two-week history of regurgitation. Thoracic radiographs and ultrasound revealed a well-differentiated cranioventral mediastinal mass measuring 7.5 × 10 × 5.5 cm, impinging the esophagus. A sternotomy followed by mass excision was performed. The mass was diagnosed as an ectopic thyroid carcinoma. The leopard recovered from surgery with minimal complications and returned to near-normal activity levels for just under 6 months before rapidly declining. He had an acute onset of severe dyspnea and lethargy and was euthanized. On postmortem examination the tumor was found to involve the lung, liver, thyroid, parietal pleura, bronchial lymph nodes, and the internal intercostal muscles. This case report describes the history, diagnosis, surgical treatment, postoperative care, and recovery as well as the eventual decline, euthanasia, and necropsy of a leopard with thyroid carcinoma. When compared to thyroid carcinomas of domestic animals, the leopard’s disease process more closely resembles the disease process seen in domestic canines compared to domestic cats.

An approximately 4-year-old castrated male, Saanen cross goat presented to the Colorado State University Veterinary Teaching Hospital for evaluation and removal of a 22 cm × 22 cm, dark red, thickened, and crusted cutaneous lesion along the left ventrolateral thorax. An initial incisional biopsy performed approximately 8 weeks earlier was suspicious for cutaneous hemangiosarcoma. Surgical excision was deemed to be the most appropriate treatment option for this goat. A complete physical exam, complete blood count, and chemistry profile were performed and results were within normal limits. Thoracic radiographs and abdominal ultrasound were performed to rule out metastatic disease and comorbid conditions; no metastatic lesions or other abnormalities were observed. En bloc surgical excision of the affected skin was performed and the entire tissue was submitted for histopathology. A final diagnosis of cutaneous hemangiolipoma was reached upon extensive sectioning and histologic examination of the larger tissue specimen. The goat recovered well from surgery and has had no further complications up to 9 months postoperatively. To our knowledge, this is the first case report of a hemangiolipoma in a goat and surgical excision for such lesions appears to be a viable treatment method.

Objective—To identify risk factors for development of excessive tibial plateau angle (TPA) in large-breed dogs with cranial cruciate ligament disease (CCLD). Design—Case-control study. Animals—58 dogs with excessive TPAs (ie, TPA ≥ 35°; case dogs) and 58 dogs with normal TPAs (ie, TPA ≤ 30°; control dogs). Procedures—Medical records and radiographs were reviewed and owners were interviewed to identify potential risk factors for excessive TPA. Results—Case dogs were 3 times (95% confidence interval, 1.2 to 8.0) as likely to have been neutered before 6 months of age as were control dogs. Case dogs with TPA ≥ 35° in both limbs were 13.6 times (95% confidence interval, 2.72 to 68.1) as likely to have been neutered before 6 months of age as were control dogs with TPA ≤ 30° in both limbs. Case dogs were significantly younger at the onset of hind limb lameness than were control dogs. Conclusions and Clinical Relevance—Results suggested that early neutering was a significant risk factor for development of excessive TPA in large-breed dogs with CCLD. Further research into the effects of early neutering on TPA and the pathophysiology of CCLD is warranted.

Objective—To categorize histologic lesions affecting the tongue, determine the frequency with which they develop, and identify risk factors associated with their development in dogs. Design—Retrospective case series. Animals—1,196 dogs. Procedures—Diagnostic reports of lingual biopsy specimens from dogs evaluated from January 1995 to October 2004 were reviewed. Results—Neoplasia comprised 54% of lingual lesions. Malignant tumors accounted for 64% of lingual neoplasms and included melanoma, squamous cell carcinoma, hemangiosarcoma, and fibrosarcoma. Largebreed dogs, especially Chow Chows and Chinese Shar-Peis, were at increased risk for melanoma. Females of all breeds and Poodles, Labrador Retrievers, and Samoyeds were more likely to have squamous cell carcinomas. Hemangiosarcomas and fibrosarcomas were commonly diagnosed in Border Collies and Golden Retrievers, respectively. Benign neoplasms included squamous papilloma, plasma cell tumor, and granular cell tumor. Small-breed dogs, especially Cocker Spaniels, were at increased risk for plasma cell tumors. Glossitis accounted for 33% of diagnoses; in most cases, the inciting cause was not apparent. Whereas large-breed dogs were more likely to have lingual neoplasia, small-breed dogs were more likely to have glossitis. Calcinosis circumscripta accounted for 4% of lingual lesions and predominately affected young large-breed dogs. The remaining submissions consisted mostly of various degenerative or wound-associated lesions. Conclusions and Clinical Relevance—The frequency of lingual lesions was not evenly distributed across breeds, sexes, or size classes of dogs. Veterinarians should be aware of the commonly reported lingual lesions in dogs so that prompt diagnosis and appropriate management can be initiated.

Objective—To determine risk factors associated with Cryptococcus gattii infection in dogs and cats residing on Vancouver Island in British Columbia, Canada. Design—Matched case-control study. Animals—20 dogs and 29 cats with C gattii infection and matched controls. Procedure—Dogs and cats with a confirmed or probable diagnosis of cryptococcosis resulting from infection with C gattii were enrolled by veterinarians, and owners completed a questionnaire designed to obtain information pertaining to potential risk factors for the disease. Owners of matched control animals were also interviewed. Odds ratios and 95% confidence intervals or paired t tests were calculated to determine significant associations. Results—Animals were enrolled during 2 noncontiguous periods in August 2001 to February 2002 (8 dogs and 9 cats enrolled) and May to December 2003 (12 dogs and 20 cats enrolled). Risk factors significantly associated with development of cryptococcosis included residing within 10 km of a logging site or other area of commercial soil disturbance, above-average level of activity of the animal, travelling of the animal on Vancouver Island, hunting by the animal, and owners hiking or visiting a botanic garden. Conclusions and Clinical Relevance—Results indicated that dogs and cats that were active or that lived near a site of commercial environmental disturbance had a significantly increased risk of developing C gattii infection. Veterinarians should communicate these risks to owners in context because cryptococcosis was an uncommon disease in this population.