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Traumatic injuries in small animals are a common cause for presentation to emergency departments. Severe traumatic injury results in a multitude of systemic responses, which can exacerbate initial tissue damage. Trauma resuscitation should focus on the global goals of controlling hemorrhage, improving tissue hypoperfusion, and minimizing ongoing inflammation and morbidity through the concept of "damage-control resuscitation." This approach focuses on the balanced use of blood products, hemorrhage control, and minimizing aggressive crystalloid use. Although these tenets may not be directly applicable to every veterinary patient with trauma, they provide guidance when managing the most severely injured subpopulation of these patients., Competing Interests: Disclosure The author has nothing to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: To determine the safety, feasibility, and utility of whole body computed tomography (WBCT) in polytrauma patients. A second objective was to describe the utilization of the VetMouse Trap for sedated WBCT in polytrauma patients., Methods: A prospective, observational study in a high-volume private practice. Any cat or dog weighing <20 kg that presented to the emergency department following a polytrauma was eligible. Patients were given analgesia and sedation prior to placement in the VetMouse Trap. A WBCT was then performed., Results: A total of 16 patients (8 dogs and 8 cats) met inclusion criteria. All patients presented with blunt trauma; 3 also had evidence of penetrating wounds. Five (31.25%) patients met inclusion criteria for WBCT based on their neurological evaluation. Five (31.5%) were non-ambulatory with suspicion of orthopedic injury, and 37.5% met additional criteria for WBCT. The most common areas of injury were head (43.7%), lungs (25%), and pelvis (25%). Four patients (25%) had evidence of cavitary effusion that was not seen on focused assessment using sonography for trauma (FAST) scan. No patient had any adverse events during the CT., Conclusion: This study demonstrated successful WBCT imaging of the sedated small animal polytrauma patient with the VetMouse Trap., (© Veterinary Emergency and Critical Care Society 2019.)

The goals of the Veterinary Committee on Trauma (VetCOT) trauma registry are to (1) inform improvement of veterinary and human trauma patient care and (2) design clinical and preclinical trials that could inform go/no go decisions for interventional strategies and tools. The VetCOT registry was established in 2013, and includes all trauma cases that present to Veterinary Trauma Centers. Veterinary Trauma Centers are well-resourced veterinary hospitals that are initially identified, then subsequently verified, by the American College of Veterinary and Emergency Critical Care VetCOT (http://vetcot.org/index.php/home/identification-and-verification-process/). As of June 2019, there are > 40,000 dog and cat cases in the registry, 3 publications and 9 ongoing projects utilizing data from the registry. Application materials to utilize VetCOT registry data is available on the VetCOT website (http://vetcot.org/index.php/home/registry-use-materials/)., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Objective: To report summative data from the American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma (VetCOT) registry., Design: Multi-institutional veterinary trauma registry data report., Setting: VetCOT identified veterinary trauma centers (VTCs)., Animals: Dogs and cats with evidence of trauma presented to VTCs with data entered in the VetCOT registry September 1, 2013-March 31, 2017., Interventions: VetCOT created a standardized data collection methodology for dog and cat trauma. Data were input to a web-based data capture system (REDCap) by data entry personnel trained in data software use and operational definitions of data variables. Data on demographics, trauma type (blunt vs penetrating), preadmission care, hospitalization and intensive care requirement, trauma severity assessment at presentation (eg, modified Glasgow coma scale and animal trauma triage score), key laboratory parameters, necessity for surgical intervention, and case outcome were collected. Summary descriptive data for each species are reported., Measurements and Main Results: Twenty-nine VTCs in North America, Europe, and Australia contributed information from 17,335 dog and 3,425 cat trauma cases during the 42-month reporting period. A large majority of cases presented directly to the VTC after injury (80.4% dogs and 78.1% cats). Blunt trauma was the most common source for injury in cats (56.7%); penetrating trauma was the most common source for injury in dogs (52.3%). Note that 43.8% of dogs and 36.2% of cats were reported to have surgery performed. The proportion surviving to discharge was 92.0% (dogs) and 82.5% (cats)., Conclusions: The VetCOT registry proved to be a powerful resource for collection of a large dataset on trauma in dogs and cats seen at VTCs. While overall survival to discharge was quite high, further evaluation of data on subsets of injury types, patient assessment parameters, interventions, and associated outcome are warranted., (© Veterinary Emergency and Critical Care Society 2018.)

The objective of this study was to compare the effectiveness of the topical application of Aloe barbadensis Miller (juice and fresh gel) to skin wounds, in dogs and cats, with that of topically applied silver sulfadiazine cream. The sample included 16 patients with cutaneous wounds (13 dogs and three cats) that were divided into three groups. Aloe vera "juice" and "fresh gel" were applied for groups I and II, respectively, while silver sulfadiazine was applied for the control group III. In order to evaluate the healing of wounds, the following parameters were taken into consideration: the percentage of wound shrinkage, the healing time and the macroscopic appearance of the scarring process. The interpretation of the data relating to the percentage of wound shrinkage showed a faster rate for groups I and II compared to that of group III. However, the wound shrinkage rates between "juice" and "fresh gel" protocols were not significantly different. Aloe vera was more effective than silver sulfadiazine, in accelerating wound shrinkage, reducing healing time and decreasing the severity of the associated injuries., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

It is well documented that physiological electric fields provide the earliest signals necessary to initiate cell proliferation, migration, and ultimately reepithelialization of wounds. Additionally, electricity is known to exert an antimicrobial effect. An electric field-generating wound dressing designed to mimic physiological electric fields has not been described in the small animal clinic. This article retrospectively reviews the use of a microcell battery-impregnated bioelectric dressing (BED) in 5 small animal patients with complex wounds. For each patient, product application and wound healing progress was monitored and documented over several weeks. Despite the severity of the wounds and being at high risk for infection, all presenting wounds treated with BED achieved complete closure within 4 weeks without becoming infected or requiring grafting. These cases provide early evidence that the use of the BED is feasible in a small animal clinic and may support healing while providing topical, nonantibiotic activity against wound pathogens., (Copyright © 2018 Elsevier Inc. All rights reserved.)

OBJECTIVE To identify historical and necropsy findings suggestive of neglect or abuse of dogs and cats by retrospective analysis of necropsy reports from a veterinary diagnostic laboratory. DESIGN Retrospective cohort study. SAMPLE 119 necropsy reports of dogs and cats. PROCEDURES Necropsy reports from February 2001 to May 2012 were electronically searched to identify potential animal abuse or neglect cases. Cases were selected and categorized according to a previously proposed method for classification of animal abuse. Inclusion criteria included signs of neglect, nonaccidental injury (NAI; blunt-force or sharp-force trauma, gunshot, burns, drowning, asphyxiation, and suspicious intoxications), and sexual abuse. Poor preservation of cadavers, age < 6 weeks, and signs of chronic illness (eg, cachexia) or injuries consistent with history indicating natural or accidental causes resulted in exclusion. Variables of interest were compared between identified cases and a reference population. RESULTS Prevalence of potential abuse cases, determined on the basis of all necropsies performed in the study period, was 73 of 8,417 (0.87%) in dogs and 46 of 4,905 (0.94%) in cats. Neglect and NAI were commonly identified in cats; NAI was most commonly found in dogs. Gunshot and blunt-force trauma were the most common NAIs in dogs and cats, respectively. Pit bull-type dogs (29/73 [40%]) were overrepresented in several abuse categories. Most cats (29/46 [63%]) were domestic shorthair, but no breed association was found. Most (41/71 [58%]) affected animals with age data available were ≤ 2 years old. CONCLUSIONS AND CLINICAL RELEVANCE Approximately 1% of dogs and cats necropsied in the study period had signs suggestive of abuse. Medical findings alone are not necessarily indicative of abuse, but some findings can increase the index of suspicion.

Objective: To describe 3 near-full-term, young-adult felids (2 domestic shorthair cats, and 1 bobcat [Lynx rufus]) that experienced uterine rupture following trauma., Series Summary: Two of the animals had motor vehicular trauma and 1 had abdominal bite wounds. The 2 domestic cats that were treated with surgical exploration and ovariohysterectomy recovered uneventfully. The bobcat died during hospitalization prior to surgical intervention, and necropsy identified uterine rupture and associated peritonitis., Unique Information Provided: Traumatic uterine rupture should be considered in known or suspected pregnant animals that experience blunt or penetrating trauma, particularly if they are in late-term pregnancy., (© Veterinary Emergency and Critical Care Society 2016.)

Objective: To determine the indications, frequency of complications and long term outcome associated with axial pattern flaps used to repair wound defects in dogs and cats., Methods: Medical records from two independent referral centres for dogs and cats undergoing wound repair with an axial pattern flap were reviewed., Results: Seventy-three animals were included, 49 dogs: 24 cats. Indications for axial pattern flaps were chronic wounds (43/73; 59%) and closure following tumour resection (30/73; 41%). Axial pattern flaps used were: thoracodorsal, caudal superficial epigastric, reverse saphenous conduit, superficial brachial, deep circumflex iliac, superficial cervical, caudal auricular, lateral thoracic, cranial superficial epigastric, genicular and superficial temporal. Postoperative complications occurred in 64 patients (89%) and 8 patients (11%) had no complications. Complications were: dehiscence, swelling of the flap, necrosis, infection, discharge and seroma. Flap outcome was excellent in 16 patients (23%), good in 29 (41%), fair in 21 (30%) and poor in 5 (7%)., Clinical Significance: There is a high complication rate associated with axial pattern flaps but these are usually easily managed and long term outcome is excellent, in either species., (© 2015 British Small Animal Veterinary Association.)

Objectives: To report indications for use and complications associated with commonly used closed active suction wound drains in a large number of clinical cases., Methods: Retrospective review of medical case records (from 2004 to 2010) for dogs and cats that had a closed active suction drain placed into a wound. Only the four most common drain types were included: Mini Redovac®, Redovac®, Jackson Pratt® and Wound Evac®., Results: Two hundred and fifty-three drains were placed in 33 cats and 195 dogs. Mini Redovac drains were used most frequently in cats (76 · 5%) and Redovac drains in dogs (54 · 3%). The infection rate for clean surgeries in dogs was 15 · 6% (unattainable in cats). Major complications occurred in four dogs; minor complications occurred in 12 drains in cats (35 · 3%), and in 74 drains in dogs (33 · 8%). There was no statistically significant association between the type of drain and complication rate for either species., Clinical Significance: Although closed active suction drains can be used with low risk of major complications, they lead to a high rate of infection in clean surgeries in dogs. It is recommended that such drains are kept in place for the shortest time possible and that strict asepsis is adhered to both during placement and management., (© 2015 British Small Animal Veterinary Association.)

Objective: To review the relevant human and veterinary literature regarding the timing of surgical intervention for trauma patients and the impact on outcome., Data Sources: Original research, clinical studies, and review articles with no date restrictions from both human and veterinary literature., Human Data Synthesis: Despite extensive research into the ideal timing of surgical intervention for human trauma victims, debate is ongoing and views are still evolving. Prior to the 1970s, the standard of care consisted of delayed surgical treatment, as these patients were considered too ill to undergo surgery. Beginning in the 1970s, and continuing for nearly 2 decades, early definitive surgical treatment was recommended. The most recent evolution of human trauma management incorporates the concept of damage control surgery, which acknowledges the importance of early skeletal stabilization or laparotomy for reducing morbidity while attempting to avoid complications such as acute respiratory distress syndrome or multiple organ dysfunction syndrome., Veterinary Data Synthesis: Despite a relatively large amount of literature available regarding veterinary trauma, no evidence exists to provide the clinician guidance as to the ideal timing of surgery for trauma patients. With the exception of diaphragmatic hernia, no studies were identified that attempted to evaluate this variable., Conclusions: Veterinary-specific studies are needed to evaluate the impact of surgical timing on outcome following trauma. The information that can be obtained from studies in this area can improve veterinary trauma care and may be used as models for human trauma care through translational applications., (© Veterinary Emergency and Critical Care Society 2015.)

Laser therapy, or photobiostimulation, is becoming a popular modality in the animal rehabilitation setting. It is used widely for the treatment of pain reduction, reduction of inflammation, and wound care and healing. Applications in the rehabilitation setting include postoperative cases, osteoarthritis, treatment of pain of a known origin, soft tissue injuries, and wounds., (Copyright © 2014 Elsevier Inc. All rights reserved.)

To ensure a successful outcome when performing emergency surgery, the clinician must have the knowledge to be able to assess the patient to determine that surgical intervention is necessary, and to determine the urgency of the procedure. The clinician must have the skills to manage common surgical emergency procedures and the equipment necessary to perform the surgery. This article discusses surgical considerations for the emergent patient, including preoperative patient assessment, readiness, surgical instrumentation, and patient preparation. An overview of the trauma triad of death, options for providing effective hemostasis, damage control surgery, peritoneal lavage and drainage, and wound management are reviewed., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Objective: Examine prognostic factors that may indicate when surgical lens removal is indicated to prevent vision-threatening complications in patients presented following traumatic perforating corneal laceration with associated lens capsule disruption., Procedures: Seventy-seven patients (10 cats and 67 dogs) were evaluated with this injury; of these, 47 were presented acutely and treated surgically and/or medically. Successful outcome was defined as functional vision in the treated eye., Results: The 47 patients with acute injuries were divided into 3 treatment groups A-C for comparison; A - corneal repair/lens removal (n = 15), B - corneal repair/no lens removal (n = 9), C - medical management (n = 23). Groups A and B showed a significantly greater rate of vision loss compared to Group C that was most obvious greater than 18 months post-injury (P = 0.029 and 0.0097, respectively). Cox proportional hazards regression analysis found a significantly higher increased rate of vision loss in Group A (HR = 4.5; P = 0.023) and a higher but nonsignificant increased rate of vision loss in Group B (HR = 3.0; P = 0.23) compared to Group C after controlling for age and cause of injury. The length of the corneal laceration and time interval from injury to referral were also relevant prognostic factors., Conclusions: Medical management is an appropriate therapy for patients of all ages suffering perforating corneal injuries with associated lens capsule disruption. Patients with corneal injuries requiring surgical repair or managed by lens removal following corneal repair suffered vision-threatening complications approximately 3 to 4.5 times the rate of patients treated by medical management, respectively. Favorable prognostic signs for treatment by medical management include good corneal wound apposition and a formed anterior chamber without uveal prolapse or continued aqueous leakage., (© 2012 American College of Veterinary Ophthalmologists.)

This report describes the diagnosis and treatment of a traumatic avulsion of the lateral head of the gastrocnemius muscle in a three-and-a-half-year-old male neutered Domestic Shorthaired cat. Surgical repair was achieved using a modified three-loop pulley suture pattern passed through a suture anchor inserted at the point of origin of the tendon and around the fabella. A stifle flexion device was utilised during the postoperative period to protect the repair. Follow-up at five months showed a return to normal function. This is the first report of avulsion of the lateral head of the gastrocnemius in a cat.

Two clinical cases of accidental entrapment of cats in front-loading washing machines are described. One cat died the day after presentation as a result of aspiration pneumonia and head trauma, despite supportive care. The second cat survived with supportive treatment, but developed dermatologic complications 10 d later.

Practical Relevance: Cats often present with distal limb shearing injuries as a result of road traffic accidents (RTAs). Many apparently unsalvageable limbs can be saved through intensive and appropriate early treatment if the basic principles of good wound management are followed., Clinical Challenges: When a limb is crushed under the wheel of a car, the skin, soft tissues and bone can be injured in a variety of ways, and the wounds are invariably heavily contaminated. Management of such cases is intensive, extensive and expensive. As well as the client's financial constraints, the ethics of prolonged treatment versus the alternative of amputation should be carefully considered. This article reviews the priorities for managing these cases, and presents a logical approach for achieving optimal outcomes., Patient Group: Any cat allowed access to the outdoors is potentially at risk of sustaining RTA injuries, young cats particularly so., Evidence Base: Many textbooks and original articles have been published on aspects of managing soft tissue injuries and skin grafting. To the author's knowledge, only two peer-reviewed papers have dealt specifically with shearing injuries, both presenting a retrospective analysis of cases in dogs.

Using univariate analysis, the correlation between signalment, history, outcome and radiographic diagnosis made on whole-body radiographs was investigated in 100 consecutive feline trauma patients of an urban clinic. The radiographic findings included: 53 thoracic injuries, 39 abdominal injuries, 34 pelvic injuries, 28 soft tissue injuries, 26 spinal injuries, and 19 cases with signs of hypovolemia. Only four radiographs were considered normal. Surgical intervention was carried out in 51 cases. Of the 100 cases, 73 survived, 23 were euthanatized, and four died. A significant positive correlation with euthanasia was found when compared to patient age (p=0.0059), abdominal trauma (P=0.0500), spinal fractures (P=0.0468), and soft tissue injuries (P=0.0175). A significant negative correlation with survival was found when compared to patient age (P=0.0358), abdominal trauma (P=0.0439), intraperitoneal free air (P=0.0041), and soft tissue injury (P=0.0288). The results of this study indicate that whole-body radiographs are useful in detecting injury in the thorax, abdomen, spine, pelvis and soft tissues, and are valuable in the diagnostic work-up of feline trauma patients.

Tail and perineal wounds arise from various causes. Reconstructive techniques are beneficial to the resolution of congenital, traumatic, and neoplastic conditions that involve the tail and perineum. This article reviews some common and not so common conditions and the techniques to treat them effectively.

New materials have allowed the role of the bandage to expand from passive protector to active participant in the wound healing process. By building a bandage that maintains a moist wound environment,the veterinarian uses the patient's own wound healing mechanisms to provide selective autolytic debridement, speed granulation and epithelialization, decrease infection, and increase patient comfort. A large variety of primary dressings are available to custom-make a bandage appropriate to each stage of wound healing. This article discusses the principles of moist wound healing, selection and application of primary dressings, special considerations for applying and changing bandages and splints, and prevention of bandage complications.

Management of large trunk wounds begins with good wound management and bandaging. When a healthy wound bed exists and adequate tissue is present, the wound is closed. Fortunately, there is an abundance of loose trunk skin in most animals, and wound closure can be accomplished by simple reconstructive techniques, such as undermining and tension or "walking sutures." Nevertheless, some wounds and areas of the torso may require more advanced tension-relieving techniques, skin stretching, and tissue implants or flaps to achieve tension-free closure and successful wound healing. Use of these techniques allows wound closure and good cosmetic results for even those wounds that initially may seem foreboding.

Anesthesia, sedation, and pain management should be taken seriously in the emergency patient. Proper knowledge of the drugs available and their pharmacokinetics and pharmacodynamics are necessary to administer anesthesia safely to critical patients. A proactive approach regarding monitoring, titration of anesthetic drugs, and anticipation of life-threatening complications helps in achieving successful anesthetic outcomes.

High-rise syndrome was diagnosed in 119 cats over a 4-year period. 59.6% of cats were younger than one year, and the average height of the fall was four stories. High-rise syndrome was more frequent during the warmer period of the year. 96.5% of the presented cats, survived after the fall. 46.2% of cats had fractured limbs; 38.5% of fractures were of the forelimb, 61.5% of the hindlimb. The tibia was fractured most often (36.4%), followed by the femur (23.6%). 78.6% of femoral fractures were distal. The mean age of patients with femoral fractures was 9.1 months, and with tibial fractures 29.2 months. Thoracic trauma was diagnosed in 33.6% of cats. Pneumothorax was diagnosed in 20% of cats, and pulmonary contusions in 13.4%. Falls from the seventh or higher stories, are associated with more severe injuries and with a higher incidence of thoracic trauma.

Data were collected on the injuries, treatment and outcome of 128 cats involved in road accidents and seen as first-opinion cases in veterinary practices in Cambridgeshire. Sixteen cats were dead on arrival; the mortality rate for the remaining cats was 16 per cent. Half of the cats were aged between seven months and two years, with more males than females affected. Most cats had moderate injuries; strays had more severe injuries than owned cats. Areas of the body most often injured were the extremities, head and neck, pelvis and thorax. Skeletal injuries were present in 67 cats and neurological signs in 29. Diagnostic procedures and medical treatment were necessary for the majority of cats; surgery was required in 51 cases. Most cats were hospitalised for between two and seven days and some required up to one month of treatment. The cost of treatment was less than 400 pounds sterling for 84 per cent of cats.

Five cats with large, distal extremity abrasion wounds were treated with an autogenous, full-thickness, mesh skin graft. Survival of the mesh grafts in all five cats was considered between 90 and 100%. Successful grafting requires asepsis, an adequately prepared recipient bed consisting of healthy granulation tissue, proper harvesting and preparation of the graft, meticulous surgical technique and strict postoperative care. Factors that are essential for the survival of skin grafts include good contact between the graft and the recipient bed, normal tension on the sutured graft, strict immobilization after grafting and prevention of accumulation of blood or serum under the graft. Meshing the graft provides more graft flexibility over uneven surfaces and allows adequate drainage. In contrast to previous proposals, the authors recommend no bandage change before the fourth day after grafting. Full-thickness mesh skin grafting can be used to successfully treat large distal skin wounds in cats.

Between March 2000 and February 2001, six veterinary practices in Cambridgeshire collected data on 117 owned cats which they had examined after a road traffic accident (RTA). The owners of 66 of these cats completed questionnaires and the information in them was compared with the information in questionnaires from a control population of 796 cats that had never been in a road accident. The RTA cats were, on average, younger than the controls; when adjusted for age the two populations did not differ with respect to the time they spent outdoors or the time they had lived at their current address. Proportionately more of the RTA cats wore reflective collars and/or lived in areas with higher levels of traffic than the controls. The accidents were evenly distributed throughout the year, and there was a trend for more accidents to happen during the night than the day. Forty-eight per cent of the accidents whose location was known occurred just outside or very near the cat's home.

Between March 2000 and February 2001, six veterinary practices in Cambridgeshire collected data on 117 owned cats which they had examined after a road accident. For one week every month during the same year, the practices distributed questionnaires to the owners of cats which had been examined for reasons other than a road accident, and the data from these cats were checked to ensure that they were representative of the practice records, which were compared with a survey of the owned cat population for age and sex. From this population, the cats that were allowed outdoors and had never been in a road accident were chosen as controls, and compared with the cats that had been in a road accident for age, sex, pedigree status and coat colour. The cats that had been in a road accident differed from the control population with respect to age, sex and pedigree status; for every one-year increase in age, the odds of a road accident decreased by 16 per cent; the odds for males (entire and neutered) being in a road accident were 1.9 times the odds for females (entire and neutered), and the odds for pedigree cats were 0.29 those for non-pedigree cats.

Objective: To describe the use of skin-fold advancement flaps for covering large skin defects in dogs and cats., Study Design: Clinical study., Animals: Eight client-owned animals: 6 dogs and 2 cats., Methods: Six dogs and 2 cats underwent reconstruction of soft-tissue wounds resulting from traumatic, neoplastic, or infectious lesions. Skin-fold flaps were created by division of the medial and lateral attachment to the proximal limb or the dorsal and ventral attachment to the trunk, enabling closure of adjacent defects on the trunk or proximal limb, respectively., Results: Skin-fold flaps proved effective for closing defects in all animals. Necrosis of a portion of the flap occurred in 2 dogs due to technical errors, but the resultant defects remained amenable to primary closure. All wounds ultimately healed primarily, without major complications., Conclusion and Clinical Relevance: The skin-fold advancement flap is a versatile technique that lends itself to use in a variety of locations, depending on which attachments are divided. The clinical results are comparable with those reported for axial pattern and subdermal plexus flaps., (Copyright 2001 by The American College of Veterinary Surgeons)

A study of non-accidental injury in small animals in the UK, based on responses from a random sample of small animal practitioners, identified 6 per cent of the 448 reported cases as being sexual in nature. Twenty-one cases occurred in dogs, five in cats and two in unspecified species. Reasons for suspecting sexual abuse were: the type of injury; behaviour of the owner; statements from witnesses; and admission by the perpetrator. Types of injury included vaginal and anorectal penetrative (penile and non-penile) injury, perianal damage, and trauma to the genitals. Some injuries (such as castration) were extreme, and some were fatal. In contrast, other cases revealed no obvious damage. The type and severity of injuries were similar to those described in texts on child abuse and human forensic pathology.

Objective: To assess the results of an omental pedicle graft in combination with a thoracodorsal axial pattern flap for the reconstruction of chronic nonhealing axillary wounds in 10 cats caused by forelimb entrapment within a collar., Study Design: A prospective, clinical trial. ANIMALS USED: Ten client-owned domestic shorthair cats., Methods: Routine biochemical and hematologic evaluation was performed on each cat, and all were tested for feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV). Microbial culture was performed on samples from the wounds. After surgical debridement, omentalization using a vascular pedicle of greater omentum, and closure of the chronic axillary wounds, using a thoracodorsal axial pattern flap, was performed. All excised tissue was examined histologically., Results: The sex distribution was 7 males and 3 females, with a mean age of 3.5 years. The cats had undergone a median number of 3 previous repair attempts over a 1.5- to 25-month period before referral (mean, 10.2 months). No hematologic or biochemical abnormalities were noted apart from moderately elevated creatine kinase and aspartate transaminase concentrations in some cats. All cats were negative for FIV and FeLV. Histologic examination of resected tissue revealed hair (foreign body) in 2 cats and an unidentified foreign-body reaction in 3 other cats. Complete healing occurred in all cats (mean follow-up period of 21.7 months), with 2 cats requiring further surgery: 1 for flap dehiscence at 4 days after surgery, and 1 for donor-site dehiscence at 4 days after surgery. One other cat developed a large seroma in the axilla that resolved by 10 days following surgery., Conclusion: The use of an omental pedicle graft in combination with a thoracodorsal axial pattern flap is the first consistently successful 1-step technique for the management of chronic nonhealing axillary wounds in cats., (Copyright 2001 by The American College of Veterinary Surgeons)

Records of 243 cases of non-accidental injury (NAI) in dogs, and 182 cases in cats, submitted by a sample of small animal practitioners in the UK, revealed a wide range of injuries. These included bruises, fractures, repetitive injuries, burns and scalds, stab and incised wounds, poisoning, asphyxiation and drowning (which showed remarkable similarities to NAI in children), as well as sexual abuse and injuries specifically caused by firearms. Traumatic skeletal injuries in the dogs were more commonly found in the anterior part of the skeleton, in comparison with those resulting from road traffic accidents. Young male dogs and young cats were particularly at risk of NAI. A moderately increased risk was identified in the Staffordshire bull terrier, cross-breed dogs and the domestic shorthaired cat, whereas the Labrador retriever showed a decreased risk. No single injury or group of injuries, when divorced from the circumstances surrounding a suspect case, could be considered to indicate, conclusively, NAI. Repetitive injuries, however, were highly suggestive of NAI.

A study of veterinarians' perceptions, and experience, of non-accidental injury (NAI) to pets was undertaken using an anonymous questionnaire distributed to a random sample of 1000 small animal practitioners in the UK. NAI was acknowledged by 91.3 per cent (95 per cent confidence interval, 88.2 to 93.9 per cent) of the 404 respondents who returned questionnaires, of whom 48.3 per cent (95 per cent confidence interval, 43.4 to 53.1 per cent) had either suspected or seen NAI. Four hundred and forty-eight cases were documented, predominantly in dogs (243) and cats (182). Factors either raising suspicion, or facilitating recognition, of NAI included: implication of a particular person, features of the history, referral agency involvement, behaviour of the owner and/or the animal, nature of the injuries, and socioeconomic class of owners. Additionally, sexual abuse and suspected cases of Munchausen syndrome by proxy were recorded.

This article describes the differential diagnosis of hind limb lameness in adult dogs with common clinical presentations and diagnostic methods outlined.

Hind limb lameness is seen frequently in young dogs and may result from congenital abnormalities, traumatic injuries, or developmental diseases. An understanding of the patient's history, a good physical and radiographic evaluation, and sound knowledge of the common diseases affecting immature dogs permit early diagnosis and successful treatment in most cases.

Feline lameness is an increasingly recognized clinical problem. Today's veterinary practitioner must be comfortable with his/her ability to diagnose the various conditions responsible for lameness in the cat and be able to discuss the significance of their findings with the client. Disease of the feline musculoskeletal system can be grouped into broad categories, including: trauma, arthritis, infectious causes, developmental disorders, neoplasia, and muscular problems. Specific diseases from each of these categories will be discussed, particularly those that differ in their presentation or clinical behavior from that same disease in the canine patient.

Lameness of the forelimb may be one of the more frustrating problems in small animal orthopedics. It is likely that numerous causes of forelimb lameness are not yet defined or well understood. The common and some less common causes of forelimb lameness are discussed as well as their means of diagnosis. The application of new diagnostic tools including arthroscopy and ultrasound are also discussed.

Competence in evaluating lameness is vital for the veterinary practitioner. This skill is becoming even more important with the increasing popularity of large-breed dogs and the corresponding increase in the number of developmental orthopedic problems seen on a day-to-day basis. A proper physical examination of the lame patient is essential to the management of the case. This article reviews the initial evaluation of the lame veterinary patient without dwelling on the specific differential diagnoses and corresponding treatments.

The demand for advanced diagnostic imaging procedures such as nuclear scintigraphy, ultrasonography, computed tomography, and magnetic resonance imaging has increased dramatically over the past 10 years. Veterinarians, seeking to improve their diagnostic capabilities and clients willing to pursue "best medicine" have driven this demand, resulting in installation of advanced imaging facilities at most academic and private referral practices. Knowledge of potential benefits of various modalities will allow the veterinarian to optimize his or her use of diagnostic imaging in his or her own practice or in a referral practice.

Forelimb lameness is a common problem in young dogs and can be caused by a wide variety of problems. Accurate and comprehensive diagnosis and treatment must be provided for these patients. Differential diagnoses for forelimb lameness in the young patient fall into the categories of congenital abnormalities; developmental disorders; trauma; and infectious, nutritional, metabolic, and neoplastic causes. The etiopathogeneses of many of these disorders are still unknown, and treatment options and prognoses vary tremendously. Until definitive causes are determined, it is the responsibility of veterinarians to address the factors that contribute to the development and progression of these disorders. These areas primarily involve weight and nutritional management as well as breeding programs.

Use of an externally applied, noninvasive skin-stretching device in 24 dogs and cats is described. The device uses adhesive-coated pads that are applied to the skin of an animal; pads are positioned on opposite sides of a surgical site and are connected by means of adjustable elastic cables. The cables maintain continuous tension, and cable tension is adjusted and progressively increased at intervals of 6 to 8 hours to promote skin recruitment (stretching), using the cutaneous viscoelastic properties of mechanical creep and stress relaxation. Consequently, skin adjacent and distant to the surgical site can be recruited to facilitate wound closure, typically within 72 to 96 hours after application of the device. The skin-stretching device has been used effectively in dogs and cats to stretch skin prior to elective surgical procedures, stretch skin during management of open wounds prior to suturing, and alleviate incisional tension after surgery.

Objective: To characterize rib, intrathoracic, and concurrent orthopedic injuries, and prognosis associated with traumatic rib fracture in cats., Design: Retrospective study., Animals: 75 cats., Procedure: Medical records from January 1980 to August 1998 were examined for cats with traumatic rib fracture. Signalment, cause of trauma, interval from trauma to evaluation at a veterinary teaching hospital, referral status and date, method of diagnosis, duration of hospitalization, number and location of rib fractures, presence of flail chest, costal cartilage involvement, intrathoracic and concurrent orthopedic injury, and clinical outcome were reviewed., Results: Median age was 3 years. Twenty-five (58%) cats with reported cause of trauma were injured by interaction with another animal. Forty-seven (78%) cats that were treated survived. Cats that died had a median duration of hospitalization of < 1 day. Ten (13%) cats had flail chest. Sixty-five (87%) cats had intrathoracic injury (median, 2 injuries). Nine (100%) cats without detected intrathoracic injury that were treated survived. Thirty-five (47%) cats had concurrent orthopedic injury. Cats with flail chest, pleural effusion, or diaphragmatic hernia were significantly more likely to die than cats without each injury., Conclusions and Clinical Relevance: Traumatic rib fracture in cats is associated with intrathoracic and concurrent orthopedic injury. Aggressive treatment of cats with traumatic rib fracture is warranted, because the prognosis is generally favorable. Diagnosis and treatment of intrathoracic injury associated with traumatic rib fracture in cats should precede management of concurrent orthopedic injury.

Avulsion of nerve roots of the brachial plexus can be diagnosed clinically, neurologically, radiographically and by electromyography. But like the myelography these techniques are inprecise for determination of the severity (partial or complete disruption) and the localization of the lesion. In human medicine the combination of computerized tomography with myelography shows high accuracy. Veterinary reports of experience in this field are not yet known. The aim of the present study was to demonstrate nerve root avulsions using myelography and computerized tomography. Three dogs and one cat with traumatic lesions of the brachial plexus were examined. The lesion could be seen in all patients. Thus CT-myelography results in an improved prognostic assessment of brachial plexus paralysis. Moreover, this technique could become one of the most important diagnostic methods for brachial plexus lesions involving nerve root reinsertion--neurotizations in veterinary medicine.

The greater omentum was used to aid in the reconstruction of nonhealing wounds in five cats. In each cat the cause of the nonhealing wound could not be determined. A vascular omental pedicle was created at laparotomy by dividing the dorsal leaf of the omentum at it pancreatic attachments (four cats) or by dividing the ventral leaf at its gastric attachments (one cat). The pedicle was then passed through either the ventral or lateral body wall into the nonhealing wound via a subcutaneous tunnel. The wounds were closed over the omentum after local tissue mobilization. All the wounds healed uneventfully and have remained healed with a mean follow-up period of 2.5 years. Complications included intestinal herniation through a ventral midline exit hole (one cat), presumed abdominal fat herniation through a ventral abdominal exit hole (one cat) and seroma formation (one cat). All of the complications were treated successfully. The omentum should be considered a useful adjunct in the treatment of nonhealing wounds in cats.

A comparison is made between the management of human and animal wounds. Wounds should be classified in order to aid the selection of the most appropriate form of treatment. The concept of the 'golden period' is now less accepted and effective early surgical treatment is advocated. The application of newer dressing materials is recommended together with the initial results of a pilot study based on the application of these materials to animal wounds. An enthusiasm was demonstrated in this study and the need for further research has been identified.

Excess pressure by sutures in wound closure can lead to "cutting out" of sutures or to ischemia of tissue adjacent to the sutures. Excess pressure can be avoided by use of specific suture patterns or surgical procedures. The surgeon should select the simplest procedure and should consider, in order of preference, the use of subdermal sutures, tension-relieving sutures, and then surgical procedures, including undermining, relaxing incisions, and plasty procedures.

In wound management, the first consideration is first aid, and the primary aim must be to minimize further tissue damage. Definitive care includes cleaning, debridement, and repair procedures. Saline solution is the key to cleaning; antibiotics and antiseptics are not always indicated. Debridement should be done surgically. The wound is then managed by primary closure or delayed primary closure, or it is left open to heal by contraction and epithelialization.