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Objective: To investigate effects of an intensive 2-day practice-level communication skills training program (CSTP) with a 3-month follow-up communication in practice program (CIPP) on veterinary health-care team members' communication confidence, client satisfaction, and practice financial metrics., Sample: 5 US companion animal veterinary practices., Procedures: Following pilot testing at 1 veterinary practice, communication skills training was performed on-site at 4 practices. The 2-day CSTP focused on veterinary communication-specific content. The CIPP included in-practice training sessions every other week to reinforce and build upon communication skills. Team members' communication skills confidence (before and after the CSTP and after the CIPP) and client satisfaction with veterinary visits (2 months before and 3 months after the CSTP) were assessed with surveys. Practice-level financial metrics were collected for 18 months. Variables of interest were compared among time points., Results: Measures of team member communication skills confidence and initiation of client conversations regarding the value of goods and services were significantly greater after the CIPP than before the CSTP. Composite communication skills confidence scores 3 months after the CSTP were positively correlated with the mean practice transaction charge and percentage change in the number of heartworm tests performed in the 3 months after the CSTP, compared with results for the same 3 months in the previous year. Measurements of client satisfaction were high before and after the CSTP. There was no significant change in financial metrics in the 3 months after CSTP, compared with the same 3 months in the previous year., Conclusions and Clinical Relevance: This study highlighted opportunities to increase veterinary health-care team members' communication confidence and identified future considerations for communication training in veterinary workplaces.

Objective: To evaluate outcomes associated with an experiential leadership program (the Veterinary Leadership Experience [VLE]) among participants 1 year after program completion., Sample: 157 veterinary students and 61 veterinary professionals who participated in the 2015 or 2016 VLE., Procedures: Participants completed various instruments to assess emotional intelligence, psychological flexibility, resilience, and client-communication skills prior to (pretest) and 1 year after (posttest) attending the VLE; pretest and posttest findings were compared for all but client-communication skills, for which only posttest responses were analyzed. An additional posttest instrument assessed the impact that the VLE had on key knowledge areas (ie, self-awareness, self-management, social awareness, relational competence, communication skills, and conflict management skills) and overall impact., Results: 1 year after completing the VLE, participants reported that the program had a high impact on all key knowledge areas; the impact on social awareness and overall impact was significantly higher for veterinary students than for veterinary professionals. Veterinary professionals reported a greater increase in emotional intelligence after program completion than did veterinary students. For each assessed client-communication skill, the percentage of veterinary professionals who reported increased confidence in that skill after program completion was lower than the corresponding percentage of veterinary students. Resilience and psychological flexibility scores did not increase after program completion., Conclusions and Clinical Relevance: Assessment of the effectiveness and long-term outcomes of experiential leadership programs is important to understanding whether such programs are having the intended effect. Veterinary students and veterinary professionals who were assessed 1 year after completing the VLE reported improvements in leadership skills foundational to the program.

Objective: To evaluate long-term outcomes and identify factors associated with death or the need for revision surgery in dogs with permanent tracheostomies (PTs)., Design: Retrospective cohort study., Animals: 69 client-owned dogs that received a PT between January 2002 and June 2016 at 1 of 4 veterinary teaching hospitals., Procedures: Medical records were reviewed, and data extracted included signalment, history, clinical signs, radiographic and laryngeal examination findings, presence of esophageal abnormalities, date and reason for receiving a PT, postoperative complications, cause of death, and survival time. Dogs surviving < 2 weeks after receiving a PT were excluded., Results: Major complications occurred in 42 of 69 (61%) dogs, with aspiration pneumonia (13 [19%]), skinfold occlusion (13 [19%]), and stoma stenosis (12 [17%]) being most common. Revision surgery was performed in 24 of 69 (35%) dogs, most commonly because of stoma stenosis or skinfold occlusion (9/24 [38%] each). Brachycephalic dogs were more likely (OR, 3.5; 95% confidence interval, 1.2 to 10.2) to require revision surgery than were nonbrachycephalic dogs. The overall median survival time was 1,825 days, and dogs that received corticosteroids before receiving a PT, had tracheal collapse, or were older had shorter survival times., Conclusions and Clinical Relevance: Results of the present study indicated that creation of a PT was a viable treatment option for obstructive upper airway diseases in dogs and that long-term survival after receiving a PT was possible; however, a PT may not reduce the risk of aspiration pneumonia in dogs.

One challenge in veterinary education is bridging the divide between the nature of classroom examples (well-defined problem solving) and real world situations (ill-defined problem solving). Solving the latter often relies on experiential knowledge, which is difficult to impart to inexperienced students. A multidisciplinary team including veterinary specialists and learning scientists developed an interactive, e-learning case-based module in which students made critical decisions at five specific points (Decision Points [DPs]). After committing to each decision (Original Answers), students reflected on the thought processes of experts making similar decisions, and were allowed to revise their decisions (Revised Answers); both sets of answers were scored. In Phase I, performance of students trained using the module (E-Learning Group) and by lecture (Traditional Group) was compared on the course final examination. There was no difference in performance between the groups, suggesting that the e-learning module was as effective as traditional lecture for content delivery. In Phase II, differences between Original Answers and Revised Answers were evaluated for a larger group of students, all of whom used the module as the sole method of instruction. There was a significant improvement in scores between Original and Revised Answers for four out of five DPs (DP1, p =.004; DP2, p =.04; DP4, p <.001; DP5, p <.001). The authors conclude that the ability to rehearse clinical decision making through this tool, without direct individual feedback from an instructor, may facilitate students' transition from problem solving in a well-structured classroom setting to an ill-structured clinical setting.

The purpose of this study was to evaluate owner perception of outcome following permanent tracheostomy (PT) in dogs. Medical records of dogs who received PT from 2002 to 2016 were reviewed. A questionnaire was given to owners verbally or by e-mail to ascertain their perception of their dog's outcome after PT. Median time to questionnaire administration from PT surgery was 608 days (64-3,708). Owner satisfaction after PT was high (89.7%), with the majority stating they would have the procedure performed again (79.5%). Owners reported an improvement in their dog's personality (30.8%) and increased activity (41%). Median survival time was 1,825 days (64-2,663), with 6 of 39 dogs (15.4%) alive at study end. Of the 33 dogs who died, 11 (33.3%) died from underlying respiratory conditions suspected to be related to the PT. The overall complication rate was 82.1%, with mucus secretion being the most common. Revision surgery was required in 30.8% of dogs (most commonly due to skin occlusion), and aspiration pneumonia occurred in 17.9% of dogs. Overall, owner satisfaction after PT in dogs is high despite intensive postoperative management, and long survival times can be achieved.

Objectives The objective of this study was to compare the pharmacokinetics of compounded and commercially available aqueous formulations of buprenorphine after a single buccal dose to healthy cats and to evaluate the concentrations of a compounded buprenorphine solution over 21 days when stored at room temperature (RT; 22-24°C) with exposure to light or when refrigerated at 4°C while protected from light. Methods Six young healthy male cats were administered single buccal doses of compounded and commercially available formulations of buprenorphine (0.03 mg/kg) using a randomized, blinded, two-period crossover design. Blood samples were obtained over a 24 h period and plasma buprenorphine concentrations were determined using ultra-high-pressure liquid chromatography with mass spectrometry detection. Three batches of the compounded formulation were stored at RT or 4°C and aliquots were evaluated over 21 days for buprenorphine concentration using high-performance liquid chromatography with fluorescence detection. Results Plasma concentrations of buprenorphine were above the limit of quantification up to 6 h in some cats and up to 3 h in all cats. The area under the curve was significantly less for the compounded formulation ( P = 0.004). A significant difference was not detected between formulations for time to maximum concentration ( P = 0.11), maximum concentration ( P = 0.06), half-life ( P = 0.88) and mean residence time ( P = 0.57). Buprenorphine concentration in the compounded formulation was not affected by storage condition or time and remained between 90% and 110% of the target concentration at all time points. Conclusions and relevance A buprenorphine solution prepared from sublingual tablets is absorbed after buccal administration in healthy cats. The extent of absorption is significantly less than that of the commercially available formulation. The compounded solution maintains an acceptable buprenorphine concentration for at least 21 days when stored at RT or refrigerated.

Objective: To assess agreement between a point-of-care glucometer (POCG) and a laboratory chemistry analyzer for blood glucose measurements in goats., Design: Prospective study., Setting: University teaching hospital., Animals: Eighteen healthy adult goats., Investigations: Whole blood samples were obtained via jugular venipuncture prior to premedication with xylazine and butorphanol (T0), following premedication (T20), and after 1 hour of inhalant anesthesia (T60). Each sample was tested with a POCG and a laboratory analyzer (HITA). Agreement was assessed using concordance correlation coefficients and calculation of bias and 95% limits of agreement., Measurements and Main Results: Mean blood glucose concentration at T0 was 3.9 ± 0.6 mmol/L (70 ± 10 mg/dL; POCG) and 2.9 ± 0.4 mmol/dL (53 ± 8 mg/dL; HITA). Glucose concentrations at T20 were 6.7 ± 2.4 mmol/L (121 ± 43 mg/dL) and 5.4 ± 2.1 mmol/L (97 ± 37 mg/dL) and at T60 were 5.7 ± 1.7 mmol/L (102 ± 31 mg/dL) and 4.7 ± 1.3 mmol/L (85 ± 24 mg/dL) when measured with the POCG and HITA, respectively. The POCG overestimated blood glucose compared to the HITA. The bias ± SD was 1.08 ± 0.53 mmol/L (19.4 ± 9.5 mg/dL) (95% LOA 0.04 to 2.11 mmol/L [0.7 to 38.0 mg/dL]) and the concordance correlation coefficient was 0.82. After correcting the results of the POCG using a mixed-effects linear model, the bias was 0.0 ± 0.38 mmol/L (0.0 ± 6.8 mg/dL) (95% LOA ± 0.74 mmol/L [± 13.4 mg/dL]) and the concordance correlation coefficient was 0.98., Conclusions: The POCG overestimated blood glucose concentrations in goats, compared to the HITA, but when the POCG concentrations were corrected, the agreement was excellent., (© Veterinary Emergency and Critical Care Society 2017.)

Brachycephalic airway syndrome may predispose to gastroesophageal reflux (GER) because of the high negative intrathoracic pressures required to overcome conformational partial upper airway obstruction. To investigate this, 20 dogs presenting for elective correction of brachycephalic airway syndrome (cases) and 20 non-brachycephalic dogs (controls) undergoing other elective surgeries were prospectively enrolled. Dogs underwent a standardized anesthetic protocol, and esophageal pH was monitored. Signalment, body weight, historical gastrointestinal and respiratory disease, complete blood count, serum biochemical values, radiographic findings, and anesthetic and surgical time were compared between cases and controls, and dogs that did and did not have basic (pH > 7.5), acidic (pH < 4), or any GER. Controls had higher mean esophageal pH (6.3) compared to cases (5.6, P = .019), but there was no difference in % with GER (cases 60%, controls 40%, P = .34). When all dogs were evaluated, dogs with GER had increased creatinine (P = .01), % positive for esophageal fluid on radiographs (P = .05), and body weight (P = .04) compared to those without GER. GER was common in both cases and controls, and cases had lower esophageal pH; however, greater numbers are required to determine if a true difference exists in % GER.

Objective: To evaluate outcomes of dogs and owner satisfaction and perception of their dogs' adaptation following amputation of a thoracic or pelvic limb., Design: Retrospective case series., Animals: 64 client-owned dogs. Procedures-Medical records of dogs that underwent limb amputation at a veterinary teaching hospital between 2005 and 2012 were reviewed. Signalment, body weight, and body condition scores at the time of amputation, dates of amputation and discharge from the hospital, whether a thoracic or pelvic limb was amputated, and reason for amputation were recorded. Histologic diagnosis and date of death were recorded if applicable. Owners were interviewed by telephone about their experience and interpretation of the dog's adaptation after surgery. Associations between perioperative variables and postoperative quality of life scores were investigated., Results: 58 of 64 (91%) owners perceived no change in their dog's attitude after amputation; 56 (88%) reported complete or nearly complete return to preamputation quality of life, 50 (78%) indicated the dog's recovery and adaptation were better than expected, and 47 (73%) reported no change in the dog's recreational activities. Body condition scores and body weight at the time of amputation were negatively correlated with quality of life scores after surgery. Taking all factors into account, most (55/64 [86%]) respondents reported they would make the same decision regarding amputation again, and 4 (6%) indicated they would not; 5 (8%) were unsure., Conclusions and Clinical Relevance: This information may aid veterinarians in educating clients about adaptation potential of dogs following limb amputation and the need for postoperative weight control in such patients.

Unlabelled: Tumor recurrence following surgery is a common and unresolved medical problem of great importance since surgery is the most widely used treatment for solid-mass tumors worldwide. A contributing factor to tumor recurrence is the presence of residual tumor remaining at or near the surgical site following surgery., Goal: The primary objective of this study was to develop and evaluate an image-guided surgery system based on a near-infrared, handheld excitation source and spectrograph in combination with a widefield video imaging system., Methods: This system was designed to detect the fluorescence of near-infrared contrast agents and, in particular, indocyanine green (ICG). The imaging system was evaluated for its optical performance and ability to detect the presence of ICG in tumors in an ectopic murine tumor model as well as in spontaneous tumors arising in canines., Results: In both settings, an intravenous ICG infusion provided tumor contrast. In both the murine models and surgical specimens from canines, ICG preferentially accumulated in tumor tissue compared to surrounding normal tissue. The resulting contrast was sufficient to distinguish neoplasia from normal tissue; in the canine surgical specimens, the contrast was sufficient to permit identification of neoplasia on the marginal surface of the specimen., Conclusion: These results demonstrate a unique concept in image-guided surgery by combining local excitation and spectroscopy with widefield imaging., Significance: The ability to readily detect ICG in canines with spontaneous tumors in a clinical setting exemplifies the potential for further clinical translation; the promising results of detecting neoplasia on the marginal specimen surface underscore the clinical utility.

Surgical correction of an ingrown tail is indicated to relieve clinical signs of intertriginous dermatitis. The objective of this retrospective study was to identify the type and frequency of complications following caudectomy in dogs with ingrown tails. Medical records of dogs with ingrown tails treated with caudectomy from 2000 to 2010 at the University of Georgia Veterinary Teaching Hospital were reviewed. Data collected included signalment, preoperative infection status, surgical procedures performed, prophylactic antibiotic use, complications noted both during hospitalization and at suture removal, treatments instituted, and owner satisfaction. Seventeen dogs were identified for inclusion. At presentation, 4 of the 17 dogs (23.5%) were receiving antibiotics. Infection was present in 7 of the 17 dogs (41%), and 6 of the 7 cases resolved immediately postoperatively. All dogs received perioperative antimicrobial therapy, and 13 of the 17 dogs (76%) received antibiotics after surgery for an average of 13.5 days ± 5.2 days. Complications occurred in 2 of the 17 cases (12%) immediately after surgery, including decreased rectal sensation with adequate anal tone, failure to posture to defecate, and postoperative draining tracts. Complications were reported in 2 of 15 dogs (13%) at suture removal, including delayed wound healing and wound inflammation, persistent tail chasing behavior, and temporary changes in defecation habits. Caudectomy provided resolution of clinical signs with no long-term complications.

Effective clinical teaching rounds are facilitated by adequate and specific orientation, a positive climate, interpersonal rapport, and dynamic discussions. Using fewer and better-quality questions also promotes effective learning and saves valuable time, while providing multiple opportunities for student engagement and for assessing student performance. This paper provides a brief review of these key points and offers tips and examples for clinicians or other team members leading conference room rounds sessions in veterinary settings.

Animal abuse and domestic violence are linked issues, and pet ownership is reported to play a crucial role in the choice to leave an abusive situation. Although veterinarians witness the effects of abuse and violence over the course of their careers, they have limited training regarding these issues. One mechanism for educating veterinary students while providing a service for victims of domestic violence is the creation of partnerships between domestic violence shelters and veterinary schools. These extracurricular programs can provide both care for pets belonging to victims of domestic violence and an educational platform for student participants. The goals of this study were to determine the prevalence and characteristics of domestic violence shelter partnerships (DVSPs) at North American veterinary teaching hospitals and to determine whether the presence of a DVSP was associated with increased awareness among veterinary students regarding animal abuse and domestic violence. Nine of 33 veterinary schools surveyed described a DVSP program. Students at schools with DVSPs associated with their veterinary teaching hospitals were significantly more likely to indicate that their awareness of the link between animal abuse and domestic violence had increased during veterinary school. Most veterinary students reported that they felt poorly prepared to handle domestic violence and animal abuse issues in the workplace. This study indicates that extracurricular DVSPs are a viable means of educating veterinary students regarding domestic violence and animal abuse. A need for improved education on these topics in veterinary schools across North America is identified.

Incisional gastropexy (IG) is routinely performed as either a prophylactic procedure to prevent occurrence of gastric dilatation-volvulus (GDV) or at the time of surgical correction of GDV to prevent recurrence. Despite its common use, the long-term efficacy of the IG procedure has not been reported. The hypothesis of this study was that IG performed either during surgical treatment of GDV or as a prophylactic measure would effectively prevent GDV. Medical records of 61 dogs undergoing IG following either gastric derotation for treatment of GDV or as a prophylactic procedure were evaluated retrospectively. Median follow-up time for all dogs was 717 days (range, 49-2,511 days). Of the 61 dogs, 27 had prophylactic IG performed. The remaining 34 dogs presented for GDV and had an IG performed during surgical treatment of GDV. No dog experienced GDV after IG. Recurrence of gastric dilatation (GD) alone was noted in 3 of 34 patients (8.8%) undergoing IG during surgery for GDV and in 3 of 27 patients (11.1%) treated prophylactically with IG. This study confirmed the efficacy of IG for the long-term prevention of GDV in dogs.

Case Description: A 2.8-kg (6.1-lb) 4-month-old sexually intact female domestic shorthair cat was referred for evaluation of bilateral, subcutaneous lumbar masses that were presumed to be the kidneys., Clinical Findings: Physical examination findings included 2 mobile, nonpainful, 3×3-cm, bilaterally symmetric masses in the dorsolateral lumbar region. Abdominal radiography, ultrasonography, and CT confirmed bilateral body wall defects with renal herniation. Serum biochemistry profile, urinalysis, and excretory urography confirmed normal renal function., Treatment and Outcome: Exploratory laparotomy, reduction of the kidneys, repair of the body wall defects, bilateral nephropexy, and ovariohysterectomy were performed. There were no perioperative complications., Clinical Relevance: Lumbar hernia has not been reported previously in a cat. It is important for veterinarians to be aware that although rare, lumbar hernia should be included in the list of differential diagnoses for a lumbar mass or signs of chronic lumbar pain in cats.

Objective: To describe the use of vacuum-assisted peritoneal drainage (VAPD) in dogs and cats with septic peritonitis., Design: Retrospective descriptive study., Setting: University Veterinary Teaching Hospital., Animals: Six dogs and 2 cats with septic peritonitis., Interventions: Application of VAPD after abdominal exploration., Measurements: Pre- and post-operative physical and clinicopathologic data, surgical findings, treatment, VAPD fluid production, outcome, and survival are reported., Main Results: Eight nonconsecutive cases of septic peritonitis, consisting of 6 dogs and 2 cats, were treated surgically and had VAPD applied post-operatively. The mean duration of clinical signs prior to surgical intervention was 4 ± 3 days. VAPD therapy was applied for a mean of 2 ± 1.1 days and collected a median of 27 mL/kg/d of abdominal effusate. The median time in hospital was 5 days and abdominal closure was completed in 5 of the 8 patients. All specimens collected at surgery cultured positive for bacteria, most commonly Enterococcus spp. The peritoneum of 4 animals was cultured at the time of abdominal closure; 1 was negative and 3 were positive for Escherichia coli, Enterococcus spp. or gram-positive cocci. Cultures before and after surgery differed in 2 patients. Hypoproteinemia was present in all patients postoperatively. Three patients were considered survivors, all of which were dogs. Five patients died or were euthanized due to cardiopulmonary arrest (n = 3), pyothorax (n = 1), and acute, severe, septic peritonitis (n = 1)., Conclusions: VAPD is available for maintaining abdominal drainage for the treatment of septic peritonitis after surgical intervention; however, similar to open abdominal drainage and closed suction drainage, nosocomial infection and hypoproteinemia remain challenges in the treatment of septic peritonitis., (© Veterinary Emergency and Critical Care Society 2012.)

Case Description: A 1.5-year-old mixed-breed dog was examined because of a 1-month history of anorexia, vomiting, diarrhea, and weight loss., Clinical Findings: The dog was very thin on physical examination (body condition score, 3/9). Results of all diagnostic tests were within reference limits except intestinal thickening and lymphadenopathy were identified on abdominal ultrasound examination. During exploratory laparotomy, thickening at the ileocecal-colic junction and within the transverse colon and mesenteric lymphadenopathy were identified, and the ileocecal-colic junction was resected. Histopathologic evaluation of the ileocecal-colic junction and full-thickness biopsy specimens from other sites as well as results of a serum ELISA were diagnostic for gastrointestinal Pythium insidiosum infection., Treatment and Outcome: Pythiosis was initially treated medically with administration of itraconazole and terbinafine by mouth, but the colonic lesion was progressive with this regimen. Two months after diagnosis, a subtotal colectomy was performed; marginal excision (0.6 cm) was obtained at the aboral margin. The dog was treated with 3 doses of a pythiosis vaccine beginning approximately 2 weeks after surgery and was continued on itraconazole and terbinafine for 5 months. Parenteral and enteral nutrition as well as considerable general supportive care were required postoperatively. Six months after treatment, the dog had a normal serum ELISA titer. Two years after treatment, the dog had returned to preoperative weight and was clinically normal., Clinical Relevance: This patient had an unusually positive therapeutic response to chronic, extensive, marginally excised gastrointestinal pythiosis.

Objective: To identify risk factors for failure to survive and development of septic peritonitis following full-thickness gastrointestinal incision in dogs. Design-Retrospective cohort study., Animals: Dogs that underwent gastrointestinal surgery from 1998 through 2007 at the University of Georgia Veterinary Teaching Hospital. Procedures-Medical records of dogs undergoing a full-thickness gastrointestinal incision were reviewed, and information regarding dog history, clinicopathologic findings, surgery characteristics, and outcome was collected., Results: Records for 197 dogs (225 surgeries) were evaluated. In 35 (16%) surgeries, the dogs died prior to hospital discharge. After 28 (12%) surgeries, dogs developed septic peritonitis. For 45 (20%) surgeries, dogs had preoperative septic peritonitis; of those, approximately a third resulted in continued septic peritonitis (17/45; 38%) or death (15/45; 33%). Of the 180 surgeries performed in dogs lacking preoperative septic peritonitis, 11 (6%) resulted in development of septic peritonitis and 20 (11 %) resulted in death. When all surgeries were considered, common risk factors for development of septic peritonitis included preoperative septic peritonitis, low preoperative serum albumin and plasma protein concentrations, and intraoperative hypotension. Presence of a foreign body was a protective factor., Conclusions and Clinical Relevance: Multiple factors were associated with failure to survive and development of septic peritonitis after gastrointestinal surgery in dogs. Aggressive perioperative attempts to increase protein concentrations and intraoperative surgical strategies to decrease the chance of a poor outcome may be indicated in dogs with risk factors identified in this study.

This study compared the collateral tissue damage and incisional bridging with granulation tissue via histopathological examination following feline onychectomy performed by radiofrequency (RF) and carbon dioxide (CO(2)) laser. Two cats were euthanized, and their digits were harvested for histopathological evaluation on days 1, 3, and 7 post-onychectomy. Each digit was evaluated for total lesion width, total necrosis width, and degree of edema, hemorrhage, and inflammation. This study found few significant differences in collateral tissue damage between RF and CO(2) laser, but more incisional bridging by granulation tissue was noted with RF for feline onychectomies. These results indicate that RF for feline onychectomy is a reasonable alternative to CO(2) laser in regard to collateral tissue damage and bridging of the incision by granulation tissue. In addition, RF is not accompanied by the strict safety considerations and initial expense of acquisition of a CO(2) laser.

Discussing medical errors with affected clients can ultimately benefit your practice. This article provides tips on creating a protocol for resolving medical errors.

Thirty-six dogs were diagnosed with pancreatic abscess by the presence of purulent exudate within the parenchyma of the pancreas during exploratory laparotomy. Data regarding history, physical examination findings, clinicopathological data, diagnostic imaging findings, bacteriological culture results, abdominal drainage technique, and perioperative treatment were evaluated for factors predictive of survival. Elevated blood urea nitrogen, serum alkaline phosphatase activity, and rising bicarbonate ion concentration were each found to have statistically significant (P<0.05) influences on survival to discharge. Twenty-two (71%) of 36 dogs died or were euthanized prior to discharge from the hospital.

A 14-year-old spayed female domestic shorthair cat presented with an interscapular mass. A computed tomography scan, biopsy, and histological examination revealed a fibrosarcoma adjacent to a pet identification microchip. Because the cat was previously vaccinated at this site, it is not possible to establish definitive causation of the fibrosarcoma, but this is the first report of a tumor in the vicinity of a microchip in a cat. Microchip-associated tumors have been reported in rodents and dogs. Veterinarians should be aware that because inflammation may predispose felines to tumor formation, separation and observation of vaccination and implantation sites are indicated. Adherence to American Association of Feline Practitioners (AAFP) vaccination guidelines and monitoring of microchip implantation sites are recommended.

Expectations of veterinary students during clinical rotations should be developed with the goal of bettering the veterinary profession as a whole. This article outlines five areas of expectations for the veterinary professional: treating colleagues with respect, providing excellent care for patients and clients, developing and maintaining skill sets to support intellectual curiosity and continued professional development, and improving upon and using self-care and life-balance skills.

An 8-year-old mixed-breed dog was anesthetized for colonoscopy. Moderate sedation was produced by premedication with glycopyrrolate, acepromazine, and hydromorphone, and anesthesia was induced by IV injection of diazepam and ketamine. Frothy, reddish-colored fluid flowed from the endotracheal tube immediately after endotracheal intubation but ceased after several minutes. Furosemide was injected IV. Anesthesia was maintained by sevoflurane in oxygen. Ventilation and arterial blood pressure were satisfactory, however, after oxygen was administered to maintain normal hemoglobin saturation. Radiography revealed changes consistent with a diagnosis of pulmonary edema. The following day, ventricular premature contractions developed and atrial dissociation, valvular regurgitation, and pulmonary hypertension were diagnosed on echocardiography. The proposed etiology is either profound transient hypotension and/or pulmonary hypertension induced by ketamine. The cardiac abnormalities that were present the following day suggest that myocardial dysfunction after induction of anesthesia was more severe than was apparent as assessed by routine physical examination and monitoring methods.

This article reviews three decision-making models for veterinary-client and physician-patient interactions and proposes adaptation of the 4E communication model from human medicine for application in veterinary-client interactions. These models incorporate specific communication skills for achieving the four components fo a client interview: engagement, empathy, education, and enlistment.

Medical records of 42 cats treated with mandibulectomy for oral neoplasia at eight institutions were reviewed to determine morbidity, progression-free interval, and survival time. Progression-free and survival rates at 1 and 2 years were 56% and 49%, and 60% and 57%, respectively. Cats with squamous cell carcinoma had significantly shorter survival than cats with fibrosarcoma or osteosarcoma. Seventy-two percent of cats were dysphagic or inappetent immediately postoperatively, and 12% never regained the ability to eat. Despite acute morbidity in 98% and long-term morbidity in 76% of cats, 83% of the 30 owners providing information were satisfied with the outcome of mandibulectomy.

Objective: To evaluate long-term neurologic outcome in dogs with atlantoaxial subluxation (AAS) that were treated nonsurgically with a cervical splint., Design: Retrospective study., Animals: 19 dogs with AAS and managed with a cervical splint., Procedure: Medical records from 2 university hospitals were reviewed. Information pertaining to trauma, duration of clinical signs prior to admission, medical treatments prior to admission, results of neurologic and physical examinations at the time of admission, results of laboratory testing, results of diagnostic imaging, neurologic status at the time of discharge, duration of time the cervical splint was used for treatment, and neurologic status at the time of splint removal and at a final reexamination was extracted from the medical records. Long-term outcome was defined as neurologic status greater than or equal to 1 year after splint removal. Factors associated with a good or poor long-term outcome were determined., Results: A good final outcome was reported in 10 of 16 dogs. Median duration of clinical signs prior to referral was 30 days; dogs that were affected < or = 30 days were significantly more likely to have a good long-term outcome, compared with dogs affected > 30 days. The neurologic grade at admission, radiographic appearance of the dens, age at onset of clinical signs, and history were not associated with outcome., Conclusions and Clinical Relevance: Nonsurgical management of AAS by use of a cervical splint is a viable treatment modality for young dogs with a first episode of acute-onset clinical signs, regardless of the severity of neurologic deficits at admission.

Traditional cystostomy tubes (used for temporary or permanent diversion of urine in dogs and cats) are long (> or = 22 cm) and cumbersome to stabilize, requiring sutures or bandages to hold the tube against the body. Use of a low-profile gastrostomy port system as a low-profile cystostomy tube (LPCT) in 4 dogs and a cat was investigated; owner satisfaction with the device was assessed. Technical difficulty associated with placement and management of LPCTs was similar to that for traditional cystostomy tubes; with LPCTs, activity and mobility of pets was not compromised, and bandaging was not required. Complications included lower urinary tract infection, mild peristomal leakage of urine and leakage from components of the system, and subcutaneous peristomal infection. Four of 5 owners considered the tube to be easy to use; all owners said they would be comfortable repeating their decision to use the LPCT in their pet.

Contrast enhanced helical computed tomography (CT) of the liver and portal system is routinely performed in human patients. The purpose of this project is to develop a practical protocol for helical CT portography in the dog. Ten clinically normal dogs were initially evaluated to develop a protocol. Using this protocol, ten dogs with confirmed portosystemic shunts (PSS) were then evaluated. Each patient was anesthetized, and a test dose of sodium iothalamate (400 mg I/ml) at 0.55 ml/kg was injected. Serial images were acquired at the level of T12-13 or T13-L1. The time to maximum enhancement of the portal vein was determined. This time period was used as the period between the second injection (2.2 ml/kg) and the start of the helical examination of the cranial abdomen. Delay times for normal dogs ranged from 34.5 s-66.0 s (median: 43.5 s) or 1.41 s/kg-4.12 s/kg (median: 2.09 s/kg). For patients with a PSS, the delay times were 16.5-70.5 s (median: 34.5 s) or 1.47-19.17 s/kg (median: 3.39 s/kg). The aorta, caudal vena cava, portal vein, shunt vessels, and their respective branches were well visualized on the CT images. Clinical case results were surgically confirmed. The surgeons reported that the information gained from the CT portography resulted in a subjective decrease in surgical time and degree of dissection necessary compared with similar surgeries performed without angiographic information. We believe that helical CT portography in the dog will be a useful adjunct in the diagnosis of PSS. The use of helical CT portography may allow clinicians to give clients a more accurate prognosis prior to surgery and will allow patients with lesions that are not surgically correctable to avoid a costly and invasive procedure.

A 2-year-old, male, mixed-breed dog presented with a 12-day history of vomiting, depression, and weight loss after ingestion of industrial-strength wood glue containing diphenylmethane diisocyanate as its active ingredient. A diagnosis of gastric foreign body was made from survey abdominal radiographs. A large aggregate of solidified wood glue was surgically removed, and the dog recovered uneventfully. Fourteen other cases have been reported to the Animal Poison Control Center at the American Society for the Prevention of Cruelty to Animals (ASPCA). Eight of those 14 cases required surgical intervention. All cases recovered completely.

Objective: To compare complication and recurrence rates in dogs treated for intussusception that underwent enteroplication to rates in dogs treated for intussusception that did not undergo enteroplication., Design: Retrospective study., Animals: 35 dogs with intestinal intussusception., Procedure: Information on signalment, clinical signs, potential predisposing causes, surgical technique, opioid administration, use of enteroplication, postoperative complications, and whether the intussusception recurred was obtained from the medical records., Results: Dogs ranged from 8 weeks to 10 years old. Opioids were administered in the perioperative period in 34 dogs. Enteroplication was performed in 16 dogs. Complications of enteroplication that required a second surgery were identified in 3 dogs. None of the 16 dogs that underwent enteroplication had a recurrence of intussusception, whereas 1 of the 19 dogs that did not undergo enteroplication had a recurrence. Rate of intussusception recurrence and likelihood that a second surgical procedure would be required were not significantly different between dogs that underwent enteroplication and dogs that did not., Conclusions and Clinical Relevance: Results suggest that enteroplication may be associated with life-threatening complications in dogs, but the likelihood of a dog requiring a second surgical procedure following surgical correction of intussusception was not different between dogs that underwent enteroplication at the time of the initial surgery and dogs that did not.

Background: Pet dogs and men share a vulnerability for the development of prostate carcinoma. The purpose of this study was to further characterize the clinical and pathologic features of spontaneous canine prostate carcinoma., Methods: A multiinstitutional, retrospective study was conducted using 76 dogs with prostate carcinoma that underwent postmortem evaluation. For each case, clinical and pathologic data were tabulated and hematoxylin/eosin-stained tissue sections from the primary tumor and metastatic lesions were evaluated. Prostatic carcinomas were subclassified based upon the presence of glandular, urothelial, squamoid, or sarcomatoid differentiation. We focused our analysis on dogs that differed with respect to morphologic features of the primary tumor, lifetime duration of testicular hormone exposure, and presence of skeletal metastases., Results: The vast majority of canine prostate carcinomas affected elderly sexually intact dogs or dogs that underwent surgical castration after sexual maturity. Adenocarcinoma was the most frequent histologic type, although more than half of canine prostate carcinomas exhibited intratumoral heterogeneity. In many cases, primary tumors showed mixed morphology, characterized by two or more types of differentiation. Duration of testicular hormone exposure was significantly different between dogs with adenocarcinoma and dogs with mixed morphology tumor, but did not appear to influence the frequency or pattern of metastases. Overall, gross metastases were present in 80% of dogs with prostate carcinoma. Skeletal metastases were present in 22% of cases, and the predominantly axial skeletal distribution of these lesions was similar to that reported in men with prostate carcinoma. Young dogs were at highest risk for development of skeletal metastases., Conclusions: This study provides a more complete characterization of spontaneous prostate carcinoma of dogs in terms of morphologic heterogeneity, skeletal metastases, and the influence of testicular hormones. Prostate carcinoma in pet dogs provides an immunocompetent, autochthonous tumor system that mimics certain aspects of human prostate cancer. This spontaneous model may contribute to our understanding of the factors that regulate carcinogenesis within the aged prostate, and to the development of chemoprevention strategies or bone-targeted therapies.

Knowledge of the regional anatomy and healing characteristics of the urinary bladder are crucial to successful surgical intervention in common disorders of the bladder. Innervation and blood supply enter the neck region of the bladder on the dorsal surface. Surgical approach to the bladder is via a ventral midline incision. Cystotomy is most commonly performed on the ventral surface of the bladder and the incision is closed using absorbable suture material in a single-layer, appositional closure. Removal of urinary calculi is the most common indication for cystotomy and should be accompanied by mucosal biopsy and culture. After cystotomy for removal of calculi, a lateral radiograph should be made to confirm removal of all calculi. Partial cystectomy is indicated for bladder trauma, neoplasia, patent urachus, and urachal diverticula. A large percentage of the bladder wall can be excised with gradual return to near normal function when the trigone region is preserved. Complete cystectomy is not recommended because of the patient morbidity and client dissatisfaction with these procedures. Tube cystostomy is performed routinely for temporary or permanent urinary diversion. Temporary diversion may be performed concurrently with surgical repair of urethral trauma or to relieve acute urethral obstructions. Permanent cystostomy may be performed in cases of neurogenic bladder atony or bladder cancer.

We present near-infrared frequency-domain photon migration imaging for the lifetime sensitive detection and localization of exogenous fluorescent contrast agents within tissue-simulating phantoms and actual tissues. We employ intensity-modulated excitation light that is expanded and delivered to the surface of a tissue or tissue-simulating phantom. The intensity-modulated fluorescence generated from within the volume propagates to the surface and is collected using a gain-modulated image-intensified charge-coupled device camera. From the spatial values of modulation amplitude and phase of the detected fluorescent light, micromolar volumes of diethylthiatricarbocyanine iodide (tau = 1.17 ns) and indocyanine green (ICG) (tau = 0.58 ns) embedded 1.0 cm deep in a tissue phantom are localized and discriminated on the basis of their lifetime differences. To demonstrate the utility of frequency-domain fluorescent measurements for imaging disease, we image the fluorescence emitted from the surface of in vivo and ex vivo canine mammary gland tissues containing lesions with preferential uptake of ICG. Pathology confirms the ability to detect spontaneous mammary tumors and regional lymph nodes amidst normal mammary tissue and fat as deep as 1.5 cm from the tissue surface.

A strain injury to the infraspinatus muscle was a potential cause of forelimb lameness in a dog. Ultrasonography was used for evaluation of infraspinatus muscle injury. The ultrasonographic appearance of a typical infraspinatus muscle, contracture of an infraspinatus muscle, acute strain of an infraspinatus muscle, and progression of healing of the infraspinatus muscle are described.