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In veterinary medicine, especially within large animal medical and surgical clinics, addressing cavitary defects is a primary concern. In bovines, umbilical hernias are the most common defect, and surgical repair often necessitates the use of prosthetic materials. However, there is a high rate of recurrence with sutures or synthetic meshes, largely due to tissue contamination. The development of biological patches for such repairs is still in its early stages in veterinary medicine, with no commercially tested prototypes available in Argentina. Tissues derived from the extracellular matrix are considered for this purpose, with bovine pericardium standing out due to its architectural characteristics and mechanical properties. For an ideal membrane, the pericardium must retain its biomechanical properties while being unreactive and safe for the host. This study aimed to biomechanically and histologically characterize a bovine pericardium patch through all stages of processing. The treatment involved fixation with 0.5 % glutaraldehyde, immersion in an antibiotic/antimycotic solution, and detoxification and storage in a 98 % sterile glycerin solution, with three sodium phosphate-buffered washes between steps. Histological examinations and stress-strain tests were performed at each processing stage, using native pericardium as a control. Despite some minor modifications in the histological and mechanical properties, the final patches appear to be a viable alternative for resolving cavitary defects., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

This article details the rise of surgical robots in the human surgical sphere as well as their use in veterinary medicine. Sections will describe in detail the equipment required for these procedures and the advantages and disadvantages of their use. Specific attention is given to the articulated instrumentation, which affords psychomotor benefits not only for surgical precision but also for surgeon ergonomics. A discussion of the possible indications and current use of robotics in veterinary medicine and the challenges to integrating robotics is also provided., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Veterinary minimally invasive surgery (MIS) training options are becoming more available. This article reviews new developments in this area and the current evidence for manual skills and cognitive training of MIS., Competing Interests: Disclosure The author is the developer of the veterinary assessment of laparoscopic skills, the VALS program. This program provides laparoscopic skill training and certifying assessment of basic laparoscopic skills and is run as a recharge operation without financial rewards to the author. The equipment for VALS is made commercially available through Limbs and Things Inc, and no royalty on sales are extended to the author. The author also collaborates with Surgical Science Inc, to provide veterinary-specific virtual reality training curricula that are commercially available. However, the author is not receiving any financial or other royalties from sales., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Veterinary minimally invasive surgery continues to grow as a specialty. With increasing experience in this field, comes improved accessibility as well as progressive complexity of procedures performed. Advancement in technology has been both a response to the growth and a necessary driver of continued refinement of this field. Innovative research leading to advancements in surgical equipment has led to the development of novel image acquisition platforms, cannulas, smoke evacuation systems, antifog devices, instrumentation, and ligating/hemostatic devices. These innovations will be reviewed and potential clinical applications are discussed., Competing Interests: Disclosure The author has no disclosures to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Reconstructive surgical techniques are used in both general and referral veterinary practice to facilitate closure of challenging wound defects. During veterinary studies, there are often limited opportunities for students to practice these techniques on live patients or cadavers. Surgical models, including suture pads and ovariohysterectomy models, have been successfully incorporated into veterinary teaching, providing students with additional practice. Models to simulate veterinary reconstructive surgical techniques are lacking. In the current study, a single pedicle advancement flap model was designed. The design consisted of a silicone model secured by a plate, providing tension. Fifth-year veterinary science students ( n = 34) were surveyed to assess the model's impact on surgical technique and confidence. Students were also assessed to determine surgical technique using the models. It was hypothesized that students who had two additional practice sessions using the models (Trial group, n = 17) would show greater improvement in technique than students who had no practice sessions between assessments (Control group, n = 17). Students strongly agreed (median score 5/5) that using the model helped to reinforce the subdermal plexus flap technique and improved their confidence in performing a subdermal plexus flap. Students from both groups performed significantly better in the follow-up assessment compared with the initial assessment. No significantly greater improvement was observed in technique between the control and the trial groups. Results suggest that the students' reconstructive surgical technique improved after a single practice session and that the single pedicle advancement flap model can be used synergistically with other teaching methods.

In the central nervous system, developmental and pathophysiologic conditions cause a large-scale reorganization of functional connectivity of neural circuits. Here, by using a mouse model for peripheral sensory nerve injury, we present a protocol for combined electrophysiological and anatomical techniques to identify neural basis of synaptic remodeling in the mouse whisker thalamus. Our protocol provides comprehensive approaches to analyze both structural and functional components of synaptic remodeling. For complete details on the use and execution of this protocol, please refer to Ueta and Miyata, (2021)., Competing Interests: The authors declare no competing interests., (© 2021.)

Pancreatic islet β cells secrete insulin in a biphasic manner when sensing high blood glucose level. This protocol describes the evaluation of different phases of insulin secretion, as well as basal, glucose-stimulated and total insulin secretion abilities, thereby enabling precise assessment of β cell function both in vivo and ex vivo. The in vivo assay consists of intravenous tube imbedding surgery and hyperglycemic clamp. The ex vivo assay consists of islet isolation, dynamic perfusion and static immersion. For complete details on the use and execution of this protocol, please refer to Sun et al. (2021)., Competing Interests: The authors declare no competing interests., (© 2021 The Authors.)

Objective: To determine the influence of a custom 3D-printed guide for placement of cortical bone screws in the equine navicular bone., Study Design: Ex vivo study., Sample Population: Eight pairs of normal adult equine forelimbs., Methods: A 3.5 × 55 mm cortical screw was placed in the longitudinal axis of each intact navicular bone. Screws were placed with a 3D-printed guide (3D) in one bone and with a traditional aiming device (AD) in the contralateral bone within each pair. Duration of surgery and the number of fluoroscopy images were compared between techniques. Screw placement was subjectively evaluated by gross examination and scored by three boarded veterinary surgeons., Results: The use of a 3D-printed guide reduced the duration of surgery by 6.6 min (±1.5 min) compared to traditional screw placement (20.7 min ± 4.8 min, p < .01). Fewer peri-operative fluoroscopic images were obtained when the 3D guide was used (18 images ± 2.6 images vs. 40 images ± 5.1, p < .01). No difference was detected in navicular screw placement., Conclusion: The use of a 3D guide decreased the time required to place screws and the number of intraoperative images taken without affecting screw placement in intact navicular bones., Clinical Relevance: 3D-printed guides can aid in the study, practice, and execution of surgical procedures reducing surgical time and radiation exposure throughout the operative period achieving similar results to those obtained with a conventional approach., (© 2021 American College of Veterinary Surgeons.)

Background: Drilling accuracy is essential in the correct positioning of implants and avoidance of iatrogenic damage to surrounding tissues. The use of augmented drilling methods has been documented as an approach to improving the accuracy of drilling. The aim of this study was to compare the accuracy of two augmented drilling methods (fluoroscopically guided and aiming device) to freehand (FH) drilling., Methods: Three experienced specialist surgeons and three veterinary surgeons without primary orthopaedic experience drilled into synthetic bone towards a target using the three different methods at three different angles (0°, 10° and 20°). The duration of drilling was recorded, and the accuracy of drilling was measured using photographs before and after drilling., Results: The two augmented methods were more accurate than FH drilling in synthetic bone, with the aiming device producing the greatest accuracy. Increased angulation of drilling decreased the drilling accuracy. Surgeon experience did not impact on drilling accuracy. Surgeon inexperience and augmented drilling methods both increased the time taken to drill., Conclusion: The use of augmented drilling methods improved the accuracy of drilling, and surgeons should consider their use when drilling in anatomical regions where the margin of error is small., Competing Interests: Competing interests: None declared., (© British Veterinary Association 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

The anatomy and physiology of armadillos make anesthetic procedures and the placement of telemetry devices challenging. From June 2011 to November 2019, a total of 73 free-living armadillos were captured and anesthetized in the Pantanal, Brazil. Giant ( Priodontes maximus ), six-banded ( Euphractus sexcinctus ), southern naked-tailed ( Cabassous unicinctus ), and nine-banded ( Dasypus novemcinctus ) armadillos were divided into two groups. In group 1, 30 armadillos were anesthetized for collection of biological samples, body measurements, and placement of a microchip tag. Anesthetic combination BDM was applied: butorphanol tartrate, detomidine hydrochloride, and midazolam hydrochloride, each at 0.1 mg/kg. In group 2, 43 armadillos received ketamine hydrochloride at 10 mg/kg 20 min after BDM injection, and intra-abdominal radio transmitters were surgically implanted. The transmitter was inserted freely into the abdominal cavity. Vital signs were monitored during anesthesia every 10 min and varied within species and between groups. Rectal temperature varied from 33.1 ± 1.36 to 35.34 ± 1.21°C, heart rate (beats/min) from 19 ± 2.14 to 84.71 ± 9.25, respiratory rate (breaths/min) from 11 ± 4.16 to 31 ± 2.82, and oxygen saturation values (SPO2%) from 84.17% ± 2.39 to 98% ± 1.20. Both groups received the antagonist combination NYF: naloxone hydrochloride (0.02 mg/kg), yohimbine hydrochloride (0.125 mg/kg), and flumazenil (0.01 mg/kg). Recovery varied according to intravenous or intramuscular injection from 2 ± 4 to 8.08 ± 2.93 min respectively. BDM protocol was considered satisfactory and provided enough time to complete the procedures (60 ± 85 to 133.20 ± 9.12 min) according to the species and group. Ketamine added to the BDM provided enough time and a surgical plane of anesthesia (97 ± 22 to 137 ± 39.5 min). The surgical procedure technique chosen did not appear to have a negative impact on armadillos studied. Implantable transmitters provide a cost-effective method for long-term monitoring of wild individuals.

Aims: To compare the duration of anaesthesia, surgery, and postoperative hospitalisation, the proportion of tumours excised with complete histologic margins and immediate postoperative surgical site complications in dogs undergoing removal of cutaneous or subcutaneous soft tissue sarcomas (STS) by either carbon dioxide (CO 2 ) laser or non-laser surgical excision methods. Methods: Medical records of dogs that underwent surgical excision of cutaneous and subcutaneous STS at the University of Missouri between December 2004 and May 2018 were evaluated. The study population consisted of client-owned dogs that underwent CO 2 laser (n = 4) or non-laser (n = 20) excision of a single STS. Data recorded included: signalment, duration of anaesthesia, surgery and postoperative hospitalisation, tumour characteristics, completeness of histologic margins, postoperative complications, adjunctive therapy, and other procedures at the time of surgery. Results: There was no evidence of a difference in mean age, body weight or tumour size between groups. Similarly there was no evidence of a difference in the duration of anaesthesia or surgery, or in the proportion of dogs whose STS were removed with complete histologic margins between dogs whose STS was removed using laser or non-laser surgical excision methods. However, the duration of postoperative hospitalisation trended towards being longer for the laser excision group (p = 0.061). Conclusions: These data provide preliminary evidence that excision of cutaneous or subcutaneous STS with CO 2 surgical laser is comparable to non-laser methods for the measured outcomes.

Objective: To assess the prevalence of work-related musculoskeletal disorders (WRMD) associated with laparoscopy in veterinary surgery., Study Design: Cross-sectional survey., Sample Population: Veterinary surgeons who perform laparoscopy., Methods: Responses were collected with data regarding laparoscopic activities and experience as well as whether the respondents experienced pain as a result of laparoscopy and, if so, additional information on this topic. Variables associated with the risk of experiencing pain were determined by using χ 2 tests and odds ratios (OR)., Results: There were 149 respondents, an estimated 6% response proportion. Forty percent experienced pain that they attributed to the use of laparoscopic instruments during or after laparoscopic surgery. Surgeons who perform laparoscopic surgery frequently (at least monthly) were more likely to experience pain as a result of laparoscopic surgery compared with those who perform laparoscopic surgery infrequently (OR 2.25; 95% confidence interval 1.07-4.75; P = .033). Pain during or after laparoscopic surgery was most often experienced in the neck (81%), back (77%), and shoulders (75%), with 90% of respondents reporting that surgery exacerbated their pain. Fifty-four percent of respondents experienced the pain at home, 64% had taken painkillers for the pain, and 46% had sought other treatment for the pain such as physiotherapy, chiropractic treatment, or seeing a doctor., Conclusion: Laparoscopic surgery was a potential source of pain in a proportion of surgeons. Surgeons who frequently perform laparoscopic surgery were more likely to experience a WRMD., Clinical Significance: Work-related musculoskeletal disorders may occur as a result of performing laparoscopic surgery., (© 2020 The American College of Veterinary Surgeons.)

The Australian Veterinary Prescribing Guidelines for antimicrobial prophylaxis for surgery on dogs and cats are evidence-based guidelines for veterinary practitioners. Validation of these guidelines is necessary to ensure quality and implementability. Two validated tools, used for medical guideline appraisal, were chosen to assess the guidelines. The terminology from the GuideLine Implementability Appraisal (GLIA) and the Appraisal of Guidelines for Research and Evaluation version 2 (AGREE II) were adapted for use by veterinarians. A two-phase evaluation approach was conducted. In the first phase of the evaluation, the GLIA tool was used by two specialist veterinary surgeons in clinical practice. The results of this phase were then used to modify the guidelines. In the second phase, the AGREE II tool was used by 6 general practitioners and 6 specialists to appraise the guidelines. In phase 1, the specialist surgeons either agreed or strongly agreed that the guidelines were executable, decidable, valid and novel, and that the guidelines would fit within the process of care. The surgeons were neutral on flexibility and measurability. Additional clarity around one common surgical procedure was added to the guidelines, after which the surgeons agreed that the guidelines were sufficiently flexible. In phase 2, 12 veterinarians completed the assessment using the AGREE II tool. In all sections the scaled domain score was greater than 70%. The overall quality of the guidelines was given a global scaled score of 76%. This assessment has demonstrated that the guidelines for antimicrobial prophylaxis for companion animal surgery are valid and appear implementable., (© 2019 Australian Veterinary Association.)

Experimental and human studies have reported the advantages of a suture length to wound length (SL:WL) ratio greater than 4:1 in midline abdominal closure. This is achieved when the tissue bite (TB) is equal to or larger than the stitch interval (SI). Although TB and SI values are recommended in some textbooks, SL:WL ratios are rarely reported in veterinary textbooks. Additionally, no clinical data regarding these parameters could be found in small animals. Therefore, the aim of this study was to evaluate the SL:WL ratio of midline laparotomy closure in dogs and cats performed by surgeons with different levels of expertise and to compare the findings with current textbook recommendations. Midline laparotomy incisions of 100 dogs and 75 cats were closed in continuous pattern by diplomates and residents of both the European College of Veterinary Surgeons (ECVS) and the European College of Animal Reproduction (ECAR). The mean SL:WL ratio was 2.5 ± 0.7:1. The surgeons´ level of experience and the species and body weights of the animals did not have any significant influence on the SL:WL ratio. A moderate negative correlation was observed between the mean SI to mean TB (SI:TB) ratio and the SL:WL ratio. In this study, the mean SI matched the textbook recommendations both in feline and canine species, whereas the TB in cats was different. In this study, the SL:WL ratio was less than 4:1 without apparent complications. Because of the low prevalence of incisional hernia in dogs and cats larger studies are necessary to evaluate clinical significance of the presented data., Competing Interests: The authors have declared that no competing interests exist.

Objective: To evaluate the perceived efficacy of a high-fidelity synthetic canine model for simulating common gastrointestinal surgical procedures., Study Design: Survey of students and experienced clinicians., Sample Population: Twelve clinicians with >2 years of postgraduate experience in the field of small animal surgery and 102 senior year veterinary students., Methods: The model was subjectively evaluated by 12 clinicians with >2 years of postgraduate experience in the field of small animal surgery. Senior year veterinary students (n = 102) were asked to complete questionnaires before and after a laboratory on common gastrointestinal surgical procedures that included rating of perceived proficiency, anatomical knowledge, and the use of synthetic models compared with live animals., Results: Clinicians assessed most aspects of the model as moderately realistic and unanimously agreed that it would be helpful for students to train on this model prior to live surgery. Student survey response rates were 91% and 99% before and after the laboratory, respectively. The proportion of students that felt moderately-to-highly proficient with the procedures increased from 8% prior to the laboratories to 59% after the laboratories (P < .001). The proportion of students that felt that they had superior-to-excellent knowledge of abdominal surgical anatomy increased from 16% prior to the laboratories to 44% after the laboratories (P < .001). The proportion of students that were satisfied with synthetic models instead of live animals increased from 52% prior to the laboratories to 74% after the laboratories (P = .014)., Conclusion: Experienced clinicians considered the model to have moderate realism. A positive shift in the students' self-perceived proficiency with gastrointestinal surgery was evident after the use of the model., Clinical Impact: This synthetic model should be considered for training of veterinary gastrointestinal surgery. However, comparison studies are recommended to ascertain the relative educational value of this model., (© 2019 The American College of Veterinary Surgeons.)

Objective: To compare mechanisms of and pressures at failure of 4 methods of securing 2 types of cellophane bands around a vein., Study Design: Ex vivo mechanical evaluation., Methods: Cellophane bands composed of 3 or 4 layers were applied around a cadaveric external jugular vein (EJV) to create 25% or 50% attenuation. These bands were secured with a medium or medium-large polymer locking ligation clip (PLLC), or a medium or medium-large titanium ligation clip (TLC). Sterile saline 0.9% was instilled into the lumen of the EJV until a pressure of 100 mm Hg was reached. Failure mechanism and luminal pressure at failure were compared between groups., Results: Medium clips failed less often than medium-large clips (P < .001) and consistently sustained 100 mm Hg without failing. Three-layer cellophane bands were 4.1 times more likely to fail than 4-layer bands (P = .003, CI 1.6-10.2) and failed at lower pressures (28.32 ± 3.59 mm Hg and 44.81 ± 6.51 mm Hg, respectively, P = .027). Failure rates of the cellophane band constructs did not differ whether secured with PLLC or with TLC (P = .635) or with 25% vs 50% attenuation (P = .780)., Conclusion: A single medium clip withstood physiological forces and secured a cellophane band at up to 50% attenuation. A 3-layer cellophane band was more likely to fail compared with a 4-layer cellophane band., Clinical Significance: These ex vivo results provide evidence to support the application of a 4-layer cellophane band secured with a single medium PLLC or TLC for portosystemic shunt attenuation. A single medium PLLC should be used to eliminate computed tomography artifacts during postoperative evaluation of shunt closure., (© 2018 The American College of Veterinary Surgeons.)

Background: Current treatment of equine pituitary pars intermedia dysfunction (PPID) requires daily oral medication. Minimally invasive surgical palliation of this condition is appealing as a single treatment to alleviate the clinical signs of disease, dramatically improving the welfare of the horse., Objective: To develop a surgical approach to the equine pituitary gland, for subsequent treatment of PPID., Study Design: A cadaver study to develop methodology and a terminal procedure under anaesthesia in the most promising techniques., Animals and Methods: Four surgical approaches to the pituitary gland were investigated in cadaver animals. A ventral trans-basispheniodal osteotomy and a minimally invasive intravenous approach via the ventral cavernous sinus progressed to live horse trials., Results: Technical complications prevented the myeloscopic and trans-sphenopalatine sinus techniques from being successful. The ventral basisphenoidal osteotomy was repeatable and has potential if an intra-operative imaging guidance system could be employed. The minimally invasive approach was repeatable, atraumatic and relatively inexpensive., Conclusions: A minimally invasive surgical approach to the equine pituitary gland is possible and allows for needle placement within the target tissue. More work is necessary to determine what that treatment might be, but repeatable access to the gland has been obtained, which is a promising step.

Background: Diseased cheek teeth in horses often require invasive extraction techniques that carry a high rate of complications. Techniques and instrumentation were developed to perform partial crown removal to aid standing intraoral extraction of diseased cheek teeth in horses., Objectives: To analyse success rates and post-surgical complications in horses undergoing cheek teeth extraction assisted by partial crown removal., Study Design: Retrospective cohort study., Methods: This study included 165 horses with 194 diseased cheek teeth that were extracted orally assisted by partial crown removal between 2010 and 2016. Medical records were analysed, including case details, obtained radiographs, surgical reports and follow-up information. Follow-up information (≥2 months) was obtained for 151 horses (91.5%). There were 95 horses examined post-operatively by the authors and, 16 horses by the referring veterinarian; in 40 horses, post-operative follow up was obtained by informal telephone interviews with the owner., Results: Successful standing intraoral extraction of cheek teeth was obtained in 164/165 horses (99.4%). Twenty-five of these horses (15.2%) required additional intraoral extraction methods to complete the extraction, including minimally invasive transbuccal approach (n = 21) and tooth sectioning (n = 4). There was one (0.6%) horse with intraoral extraction failure that required standing repulsion to complete the extraction. The intraoperative complication of fractured root tips occurred in 11/165 horses (6.7%). Post-operative complications occurred in 6/165 horses (3.6%), including alveolar sequestra (n = 4), mild delay of alveolar healing at 2 months (n = 1), and development of a persistent draining tract secondary to a retained root tip (n = 1)., Main Limitations: Specialised instrumentation and additional training in the technique are recommended to perform partial crown removal in horses., Conclusion: Horses with cheek teeth extraction by partial crown removal have an excellent prognosis for a positive outcome. The term partial coronectomy is proposed for this technique., (© 2017 EVJ Ltd.)

Background: The Serra and Reimer emasculators are frequently used in equine orchiectomy. They differ in jaw profile and the mechanism by which they achieve haemostasis., Objectives: To investigate whether the haemostatic capacities of the Reimer and Serra emasculators in open and closed castration differ, to compare the haemostatic capacities of each emasculator in both open and closed castration, and to assess whether the tensile strength of the parietal tunic in closed castration differs according to whether a Reimer or Serra emasculator is used., Study Design: Ex vivo randomised study., Methods: Eighty equine cadaver testes were randomly assigned to two groups for, respectively, open and closed castration. Each group was divided into two subgroups for castration with a Serra or Reimer castrator, respectively. Testicular artery leaking pressure was measured by dye injection. In closed castration, the tensile strength of the parietal tunic was measured with a tensiometer., Results: In open castration, the Reimer emasculator resisted significantly higher pressure (median: 706.1 mmHg; interquartile range [IQR]: 597.6-735.5 mmHg) than the Serra emasculator (median: 349.4 mmHg; IQR: 261.1-468.9 mmHg) (P<0.001), whereas no difference was found in closed castration (Serra emasculator, median: 382.5 mmHg [IQR: 294.2-568.2 mmHg]; Reimer emasculator, median: 419.2 mmHg [IQR: 294.2-616.0 mmHg]). The Reimer emasculator resisted significantly higher pressure in the open (median: 706.1 mmHg; IQR: 597.6-735.5 mmHg) compared with the closed (median: 419.2 mmHg; IQR: 294.2-616.0 mmHg) technique (P = 0.03). Parietal tunic tensile strength did not differ significantly by emasculator (mean ± s.d.: Serra, 12.65 ± 7.35; Reimer, 17.55 ± 11.76)., Main Limitations: Limitations are inherent to the ex vivo study design. Post-surgery implications were investigated only in the short term and no account was taken of tissue inflammation and oedema, which may influence the integrity of the tissue., Conclusions: These results suggest it may be preferable to use a Reimer emasculator in open castration. In this ex vivo model of closed castration, no differences between the emasculators were observed., (© 2017 EVJ Ltd.)

Objective: To describe a modified rib pivot thoracotomy and its clinical application in client-owned dogs and cats., Study Design: Case series of 24 dogs and 1 cat requiring a thoracotomy., Methods: A lateral thoracic incision over the required thoracic segment was made. The latissimus dorsi muscle was reflected dorsally. The predetermined rib was identified and the periosteum overlying the rib was elevated circumferentially, avoiding the intercostal neurovascular structures. Holes were pre-placed above and below the proposed osteotomy site. The rib was osteotomised and pivoted cranially. The pleura was incised and the required intrathoracic procedure was then performed. The thoracic cavity was closed by pre-placement of a suture through the pre-placed holes within the osteotomised rib. The pleura and intercostal musculature were closed, avoiding the intercostal neurovascular structures. The rib was re-apposed and the lateral approach was closed. The cases included were reviewed for both the rib pivoted as per the procedure required and postoperative complications., Results: The study group comprised 8 Staffordshire Bull Terriers, 2 Poodles, 2 German Shepherd Dogs, 1 each of Basset Hound, Rhodesian Ridgeback, Golden Retriever, Australian Shepherd, Vizsla, Bull Mastiff, Schnauzer, Jack Russell Terrier, Bulldog, Deerhound, Labrador Retriever and Australian Terrier, and 1 cat. A modified rib pivot thoracotomy was performed for lung lobectomy (n = 11), oesophagectomy (7), subtotal pericardectomy (5), patent ductus arteriosus ligation (1) and thoracic duct ligation (1). Follow-up ranged from 2 to 40 weeks postoperatively. Postoperative complications included seroma formation in two dogs., Conclusion: A modified rib pivot thoracotomy should be considered as an alternative lateral thoracic approach with good exposure, minimal complications and low morbidity., (© 2018 Australian Veterinary Association.)

Objective: To determine the feasibility and agreement of margin assessment by imprint cytology, shaved margin histopathology, and radial section histopathology in canine cutaneous and subcutaneous mast cell tumors (MCT) and soft tissue sarcomas (STS)., Study Design: Prospective clinical study., Sample Population: Three hundred and forty margins from 72 excised tumors (52 MCT and 20 STS) in 54 client-owned dogs., Methods: Imprint cytology samples were acquired by pressing glass slides to the cut surgical margin of the freshly excised surgical specimen. Shaved margin samples were obtained from the patient wound bed using a scalpel immediately prior to closure. Radial section histopathology was performed as part of routine histopathologic processing. All margins were assessed as either positive or negative for presence of tumor cells at the surgical margin. Agreement among methods was calculated using Fleiss Kappa coefficients and an association of method, margin direction, and tumor type with positive margin status was evaluated using a general linear mixed model., Results: Positive margin detection rates differed for MCT (imprint cytology 21%, radial section histopathology 9%, and shaved margin histopathology 3%; P < .0001) but not for STS. Intermethod agreement was poor (Fleiss Kappa = 0.051 and 0.176 for MCT and STS, respectively). Margin direction did not influence margin status for either tumor type., Conclusion: Imprint cytology and shaved margin histopathology are feasible, but their results are frequently disparate from routine radial section histopathology. Future studies are needed to evaluate the correlation of each method with local recurrence rates., (© 2017 The American College of Veterinary Surgeons.)

OBJECTIVE To describe the learning curve for veterinary surgery residents performing hemilaminectomy surgeries in dogs. DESIGN Retrospective case review and learning curve evaluation. SAMPLE 13 individuals who completed a 3-year surgery residency program at a university teaching hospital and who had no prior experience performing hemilaminectomies. PROCEDURES The 13 residents performed hemilaminectomies on 399 dogs between July 2006 and July 2013. Medical records were reviewed, and operative time was recorded. Data were examined with a linear mixed-effects model to quantify fixed and random effects, a curve-fitting technique to find the best-fit curve, and a segmented 2-phase linear model to describe the domains and learning rates for 2 phases of learning. RESULTS The linear mixed-effects model indicated that increasing patient body weight and increasing surgical complexity (graded on the basis of number and contiguity of hemilaminectomy sites) were associated with longer operative times and that increasing exposure number was associated with shorter operative times. The monoexponential and biexponential parametric curves were of similar quality in modeling the data. The segmented 2-phase linear model showed an early phase of learning during which operative time decreased rapidly and a late phase when operative time decreased more gradually. CONCLUSIONS AND CLINICAL RELEVANCE The learning curve for the residents suggested that for early exposures, instruction in the form of direct supervision provided substantial benefit. By the tenth exposure, the benefit of instruction diminished and ongoing improvement was primarily a result of refinement. If validated by further study, this understanding of a 2-phase learning curve may inform the design of training programs in veterinary surgery.

The diagnosis and treatment of cancer in exotic species is a rapidly evolving area of veterinary medicine. In general, surgical excision remains pivotal in cancer treatment, although optimal outcomes are achieved when a coherent and thorough diagnostic and therapeutic plan is created prior to surgery. While surgical cure is not always achieveable, multimodal treatment plans can offer a variety of options, and palliative procedures may be used to improve quality of life. Treatment goals, whether curative intent or palliative intent, should be identified before surgery, and practitioners should endeavor to adhere to surgical principles in order to attain the best outcomes., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: To investigate the strength, size, and holding capacity of the self-locking forwarder knot compared to surgeon's and square knots using large gauge suture., Study Design: In vitro mechanical study., Study Population: Knotted suture., Methods: Forwarder, surgeon's, and square knots were tested on a universal testing machine under linear tension using 2 and 3 USP polyglactin 910 and 2 USP polydioxanone. Knot holding capacity (KHC) and mode of failure were recorded and relative knot security (RKS) was calculated as a percentage of KHC. Knot volume and weight were assessed by digital micrometer and balance, respectively. ANOVA and post hoc testing were used tocompare strength between number of throws, suture, suture size, and knot type. P<.05 was considered significant., Results: Forwarder knots had a higher KHC and RKS than surgeon's or square knots for all suture types and number of throws. No forwarder knots unraveled, but a proportion of square and surgeon's knots with <6 throws did unravel. Forwarder knots had a smaller volume and weight than surgeon's and square knots with equal number of throws. The forwarder knot of 4 throws using 3 USP polyglactin 910 had the highest KHC, RKS, and the smallest size and weight., Conclusion: Forwarder knots may be an alternative for commencing continuous patterns in large gauge suture, without sacrificing knot integrity, but further in vivo and ex vivo testing is required to assess the effects of this sliding knot on tissue perfusion before clinical application., (© Copyright 2016 by The American College of Veterinary Surgeons.)

Objective: To evaluate the effects of a new microfracture and ligament splitting procedure on ligament healing and to examine the usefulness of magnetic resonance (MR) imaging for monitoring ligament healing over time using a collagenase model of hind limb proximal suspensory desmitis., Study Design: Experimental in vivo study., Animals: Healthy adult horses (n=6)., Methods: Horses were free of lameness with normal hind limb proximal suspensory ligaments (PSL). The origin of both hind limb PSL was injected with collagenase and underwent MR imaging 2 weeks later, followed by the microfracture and ligament splitting procedure on 1 limb, with the opposite limb serving as the sham-operated control. Serial lameness and MR examinations were performed. Horses were euthanatized 210 days after surgery, the PSL harvested, and histology, biochemistry, and gene expression performed on both PSL., Results: Collagenase lesions viewed on MR images appeared similar to those seen clinically. Serial MR images demonstrated resolution of abnormal signal intensity and tissue formation in the microfracture sites within the third metatarsal bone. Treated limbs had histologic evidence of connective tissue appearing to originate from the small perforations and blending into the ligament but no statistical differences were identified. Gene expression for cartilage oligomeric matrix protein and decorin were significantly increased in treated compared to control limbs., Conclusion: The microfracture and ligament splitting procedure did incite a tissue response but further clinical investigation is necessary to determine if this tissue remodeling at the bone-ligament interface translates to improved clinical outcome. MR imaging may be useful to follow healing in horses with hind limb proximal suspensory desmitis., (© Copyright 2016 by The American College of Veterinary Surgeons.)

Objective: To evaluate outcome and adverse events following ventral stabilization of the atlantoaxial (AA) joint in dogs with clinical AA subluxation using screw/polymethymethacrylate (PMMA) constructs in a retrospective, multi-center cohort study., Study Design: Historical cohort study., Animals: 35 client-owned dogs., Methods: Medical records from 3 institutions were reviewed to identify dogs with AA subluxation treated with ventral screw and PMMA constructs. Data on signalment, pre- and postoperative neurologic status, imaging performed, and adverse events were retrieved. Neurologic examination data were abstracted to generate a modified Frankel score at admission, discharge, and re-examination. Telephone interview of owners >180 days postoperative was conducted., Results: Thirty-five dogs with AA subluxation treated with ventral screw/PMMA constructs were included. Most dogs were young (median age 1 year), small breed dogs with acute onset of neurologic signs (median duration 22.5 hours). Most dogs were non-ambulatory at the time of admission (median modified Frankel score 3). Adverse events were identified in 15/35 dogs including 9 dogs with major adverse events. Four dogs required a second surgery due to vertebral canal violation (n = 2) or implant failure (n = 2). Re-examination at 4-6 weeks postoperative reported 15/28 dogs with improved neurologic status and 19/28 dogs were ambulatory. Telephone follow-up was available for 23/35 dogs with 23/23 reported as ambulatory (median follow-up 390 days)., Conclusions: Ventral application of screw and PMMA constructs for AA subluxation, as described here, is associated with clinical improvement in the majority of dog. Major adverse events are infrequent and the technique is considered relatively safe., (© Copyright 2016 by The American College of Veterinary Surgeons.)

The objective of the study was to determine the proportion of practitioners from Ontario, Canada who perform onychectomy, identify the techniques utilized, and obtain practitioners views on the procedure. An anonymous survey was distributed to Ontario Veterinary Medical Association members. Mann-Whitney U-tests were used to compare responses of opinion questions related to declawing between respondents who indicated they perform declawing procedures and those who do not. Of 500 respondents, 75.8% reported performing onychectomy, with 60.1% of those reporting performing the procedure less than monthly and 73.3% only performing the procedure after recommending alternatives. Statistically significant differences were found between those who do and those who do not perform onychectomy for perception of procedural pain, concept of mutilation, perception of procedural necessity for behavior modification or prevention of euthanasia, and support of province-wide procedural bans.

Objective: To investigate whether soft palate resection and tonsillectomy with a bipolar vessel sealing device (BVSD) improves clinical respiratory score. To document histopathological changes to tonsillar tissue following removal with a BVSD., Methods & Results: Case series of 22 dogs with clinical signs of upper respiratory obstruction related to brachycephalic airway syndrome. Soft palate and tonsils were removed using a BVSD. Alarplasty and saccullectomy were also performed if indicated. A clinical respiratory score was assigned preoperatively, 24-h postoperatively and 5 weeks postoperatively. Excised tonsillar samples were measured and then assessed histologically for depth of tissue damage deemed to be caused by the device. Depth of tissue damage was compared between two power settings of the device. Soft palate resection and tonsillectomy with a BVSD lead to a significant improvement in respiratory scores following surgery. Depth of tissue damage was significantly less for power setting 1 compared with power setting 2. Using power setting 1, median calculated depth of tonsillar tissue damage was 3.4 mm (range 1.2-8.0). One dog experienced major complications., Conclusion: Soft palate resection and tonsillectomy with a BVSD led to significant improvement in clinical respiratory score., (© 2015 Australian Veterinary Association.)

Perioperative patients can be highly dynamic and have various metabolic, physiologic, and organ system derangements that necessitate smart monitoring strategies and careful fluid therapy. The interplay between changing patient status, therapeutic interventions, and patient response makes effective monitoring crucial to successful treatment. Monitoring the perioperative patient and an approach to fluid therapy are discussed in this text., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Reasons for Performing Study: Multicentre Confidential Enquiries into Perioperative Equine Fatalities (CEPEF) have not been conducted since the initial CEPEF Phases 1-3, 20 years ago., Objectives: To collect data on current practice in equine anaesthesia and to recruit participants for CEPEF-4., Study Design: Online questionnaire survey., Methods: An online questionnaire was prepared and the link distributed internationally to veterinarians possibly performing equine anaesthesia, using emails, posters, flyers and an editorial. The questionnaire included 52 closed, semiclosed and open questions divided into 8 subgroups: demographic data, anaesthetist, anaesthesia management (preoperative, technical equipment, monitoring, drugs, recovery), areas of improvements and risks and motivation for participation in CEPEF-4. Descriptive statistics and Chi-squared tests for comparison of categorical variables were performed., Results: A total of 199 questionnaires were completed by veterinarians from 14 different countries. Of the respondents, 43% worked in private hospitals, 36% in private practices and 21% in university teaching hospitals. In 40 institutions (23%) there was at least one diplomate of the European or American colleges of veterinary anaesthesia and analgesia on staff. Individual respondents reported routinely employ the following anaesthesia monitoring modalities: electrocardiography (80%), invasive arterial blood pressures (70%), pulse oximetry (60%), capnography (55%), arterial blood gases (47%), composition of inspired and expired gases (45%) and body temperature (35%). Drugs administered frequently or routinely as part of a standard protocol were: acepromazine (44%), xylazine (68%), butorphanol (59%), ketamine (96%), diazepam (83%), isoflurane (76%), dobutamine (46%), and, as a nonsteroidal anti-inflammatory drug, phenylbutazone (73%) or flunixin meglumine (66%). Recovery was routinely assisted by 40%. The main factors perceived by the respondents to affect outcome of equine anaesthesia were the preoperative health status of the animal and training of the anaesthetist., Conclusions: Current practice in equine anaesthesia varies widely, and the study has highlighted important topics relevant for designing a future prospective multicentre cohort study (CEPEF-4). The Summary is available in Chinese - see Supporting information., (© 2014 EVJ Ltd.)

Objectives: To document the fine needle aspiration methods used by UK veterinary practitioners for the assessment of cutaneous masses and relate this to the achievement of a representative sample., Methods: An internet-based questionnaire was designed and publicised in the UK national veterinary press, at a national surgical meeting, and in letters to veterinary surgeons., Results: One hundred and seventy respondents replied to the questionnaire: 58 · 2% sampled cutaneous masses on the basis of appearance or behaviour; 41 · 3% sampled every cutaneous mass. Practitioners with a greater oncological caseload or who graduated more recently were more likely to recommend fine needle aspiration for every cutaneous mass (P = 0 · 019 and P = 0 · 0002 respectively); 66 · 5% of respondents applied suction during fine needle aspiration; 89% of all respondents used a 2 or 5 mL syringe in combination with a 21 or 23 G needle. There was no statistically significant association between achievement of a representative sample and syringe (P = 0 · 64) or needle size (P = 0 · 63)., Clinical Significance: Fine needle aspiration is widely used in UK practice, but may be underutilised in practices with lower oncological caseloads. Survey participants reported a high rate of representative samples obtained using all the commonly used techniques. Further work is required to confirm these observations., (© 2014 British Small Animal Veterinary Association.)

Objectives: To report the complication rate for bilateral closed anal sacculectomy in the dog and to evaluate potential risk factors for the development of postoperative complications. To identify breed groups at risk of requiring anal sacculectomy., Methods: A retrospective review of medical records of dogs undergoing bilateral closed anal sacculectomy between 2003 and 2013., Results: Sixty-two dogs were included in the study of which 32·3% developed mild and self-limiting complications including 14·5% dogs that experienced postoperative defaecatory complications. No dog developed permanent faecal incontinence. Dogs less than 15 kg bodyweight were more likely to develop postoperative complications. Dogs that used gel to distend the anal sac were more likely to have postoperative complications than those that did not. Previous abscess formation, recurrent disease and pretreatment with antibiotics had no significant effect on postoperative complication rates. Cavalier King Charles spaniels and Labrador-type dogs were over-represented within this study population., Clinical Significance: Anal sacculectomy is a safe procedure with a relatively high rate of short-term but self-limiting, minor, postoperative complications. Smaller (<15 kg) dogs are more likely to experience postoperative complications but the risk of permanent faecal incontinence is low., (© 2014 British Small Animal Veterinary Association.)

A six-year-old male neutered Yorkshire terrier was evaluated for severe, acute-onset, inspiratory dyspnoea. Laryngoscopy revealed retroversion of the epiglottis with intermittent occlusion of the rima glottidis during inspiration. The dog underwent both temporary and permanent epiglottopexy procedures that were unsuccessful. Subtotal epiglottectomy was performed and resulted in permanent resolution of dyspnoea without evidence of dysphagia or aspiration. This case highlights potential complications associated with management of this condition as well as describing the successful use of subtotal epiglottectomy in the dog., (© 2014 British Small Animal Veterinary Association.)

Objective: To determine the relationship between students' perceptions of 2 assessment methods and academic performance., Study Design: A 2-year prospective survey study in a 4-year Doctor of Veterinary Medicine (DVM) curriculum., Sample Population: Year 3 DVM students (n = 44)., Methods: An assessment of learning gain questionnaire was used to investigate students' perceptions regarding multiple-choice examination (MCE) versus take-home case-based continuous assessment (CA) in a 3rd year small animal surgery lecture course. Academic performance and student assessment of learning gain in the 2 course components were compared. Relationships between student perceptions and academic performance were examined. A follow-up survey was conducted during clinical rotations in 4th year to determine change in student perceptions over time., Results: Academic performance in 3rd year was significantly enhanced by use of CA, particularly for students with weaker grades. Academic performance in 4th year clinical rotations was not closely related to 3rd year performance. Many students preferred an instructional approach with provision of comprehensive notes and assessment with multiple-choice questions based on the notes. However, students recognized that feedback on work submitted for CA grading significantly facilitated learning. Student assessment of learning gain was correlated with academic performance in the 3rd year course component examined by CA, but not the component assessed using MCE., Conclusion: Our data suggest that perceptions of learning gain, academic accomplishment, and clinical performance in 4th year are weakly correlated. Teachers should better explain to veterinary students that learning to be a clinician is more than replication of knowledge., (© Copyright 2014 by The American College of Veterinary Surgeons.)

The frequency of claw regrowth, bony remnants, and complications in cats that underwent forelimb onychectomy using laser, scalpel, or guillotine techniques were evaluated. Eighty-seven client-owned cats were recruited from 27 veterinary clinics in the Canadian Atlantic provinces. At least 1 year after onychectomy the cats underwent a physical examination, gait analysis, and radiographic evaluation by 1 of 2 authors. There was no significant difference in the frequency of claw regrowth among the 3 methods (P = 0.283). Significantly more cats had bony remnants following guillotine onychectomy (P < 0.001). Bony remnants were significantly associated with claw regrowth (P = 0.001). Cats that underwent laser onychectomy had significantly less post-operative complications (P = 0.023). The long-term outcome was not significantly different among the 3 methods. We conclude that leaving remnants of the third phalanx in situ is associated with an increased frequency of claw regrowth. Laser onychectomy may be preferred to reduce the risk of post-operative complications, bony remnants, and claw regrowth.

Objective: To compare level of difficulty, deviations from technical description and postoperative assessment during the training of veterinary students, small animal surgical residents, and a board certified surgeon for Tightrope® (TR) and percutaneous lateral fabella suture (pLFS) techniques for cranial cruciate ligament (CCL) repair., Study Design: Prospective study., Sample Population: Cadaveric canine pelvic limbs (n = 32)., Methods: Sixteen 3rd year veterinary students, 6 small animal surgical residents and a Diplomate of the American College of Veterinary Surgeons performed the TR and pLFS techniques on paired limbs. Perceived level of difficulty, duration of surgery, and technical deviations were assessed by questionnaire, radiographs, and dissection. Results were compared between techniques with McNemar's test., Results: The TR procedure was perceived as more technically demanding than the pLFS by veterinary students and residents. Technical deviations were overall more common after TR than pLFS, and in limbs repaired by students, regardless of procedure. The most difficult aspect of the TR consists of the bone tunnels whereas for pLFS it was passing the suture around the femorofabellar ligament. The sensitivity of radiographs for detection of technical deviations was 39% after TR and 50% after pLFS., Conclusion: Technical deviations are more common during the training phase of TR than pLFS, and the sensitivity of radiographs to detect those is low. Repeated practice on cadavers followed by dissection is recommended before use in patients., (© Copyright 2014 by The American College of Veterinary Surgeons.)

Advancements in soft tissue minimally invasive surgery have been rapid and comprehensive since its inception in human medicine approximately 25 years ago. From its origins in traditional laparoscopy, followed rapidly by video-assisted thoracoscopic surgery, minimally invasive surgery in human medicine has evolved through a number of different platforms that now include single-port approach devices, robotic surgery as well as natural orifice transluminal endosurgery. Whilst some of these remain beyond the reach of veterinary medicine for now, largely because of technical challenges and the prohibitive costs of some single-use disposable components, veterinary minimally invasive surgery is advancing rapidly allowing our small animal patients to benefit from some of the many documented advantages that a minimally invasive approach affords the patient., (© 2013 British Small Animal Veterinary Association.)

Objective: To describe veterinarians' treatment recommendations and decision-making factors for dogs with cranial cruciate ligament disease (CCLD)., Methods: An online survey of American College of Veterinary Surgeons (ACVS)-Diplomates (surgeon group) and primary care veterinarians (practitioner group) was performed. The survey included questions on treatment recommendations for common case scenarios (small or large breed dog with complete or partial CCLD), treatment decision factors, non-surgical treatment options, and actual treatment, if any, provided for a client-owned dog as well as one owned by their family or close friend., Results: The response rate was 42% for the surgeon group (n = 305/723) and four percent for the practitioner group (n = 1145/ 27,771). Extracapsular stabilization (ES) was the most common treatment recommendation for CCLD in small (9.1 kg) breed dogs amongst surgeons and practitioners. Tibial plateau levelling osteotomy (TPLO) was the most common treatment recommendation for CCLD in large (27.2 kg) breed dogs amongst both groups. The two most important treatment decision factors were dog size (78% of practitioners, 69% of surgeons) and activity level (63% of practitioners, 52% of surgeons). The most common treatment provided for a dog of their own or close relation in the surgeon group was TPLO (64%) followed by ES (15%), whereas in the practitioner group it was ES (38%) followed by TPLO (30%)., Clinical Significance: Extracapsular stabilization and TPLO are the most commonly employed surgical procedures in the surveyed population; dog size and activity level (but not age) are the major factors influencing treatment decisions.

Objectives: To compare the lateral pre-iliac approach to the lumbar plexus combined with lumbar paravertebral sciatic nerve block, and the dorsal paravertebral approach to the lumbar plexus combined with sciatic nerve block in dogs., Methods: Retrospective examination of case records of dogs that received the blocks and underwent pelvic limb orthopaedic surgery between 2010 and 2012. Success rate (intraoperative fentanyl consumption <2·1 µg/kg/hour), type and dose of local anaesthetic used, multiple of minimum alveolar concentration of volatile anaesthetic agent administered, incidence of intraoperative hypotension, postoperative methadone administration, postoperative contralateral limb paralysis and neurological complication at 6 weeks re-examination were analysed., Results: Ninety-six and 95 records were retrieved in which lateral pre-iliac - lumbar paravertebral sciatic nerve and dorsal paravertebral - sciatic nerve were used, respectively. Success rates were 82·3% in lateral pre-iliac - lumbar paravertebral sciatic nerve and 74·7% in dorsal paravertebral - sciatic nerve groups. Bupivacaine, levobupivacaine and ropivacaine were used. Total local anaesthetic doses, intraoperative hypotension and postoperative methadone administered were similar between groups; minimum alveolar concentration multiple was significantly (P<0·001) lower in lateral pre-iliac - lumbar paravertebral sciatic nerve group. No neurological complications were noted., Clinical Significance: Although success rates and perioperative analgesic requirements were not significantly different, the different exposure to anaesthetic agents suggests that the two techniques may not be equivalent., (© 2013 British Small Animal Veterinary Association.)

Objective: To compare 2 preoperative surgical site protocols for standing laparotomy in cattle in a field setting., Study Design: Cohort study., Animals: Dairy cows (n = 73) undergoing a clean standing laparotomy (no visceral perforation during surgery)., Methods: Cows were randomly assigned to 1 of 2 preoperative skin-preparations protocols with chlorhexidine used as an antiseptic. A standard protocol (3 minutes [min] cleansing scrub, tap water rinse, 3 minutes surgical scrub with a sterile one-use chlorhexidine scrub and alternate passage of alcohol and 2% chlorhexidine solution (7 minutes; n = 32) was compared with a 3 minutes abbreviated preoperative protocol, consisting of two 90 seconds period of cleansing scrub and 3 passages of 0.5% chlorhexidine gluconate in 70% in isopropyl alcohol solution (4 minutes; n = 32). Pre- and postoperative skin bacterial counts and clinical assessment of wounds 10-15 days after surgery, as well as standardized interview with the producers focused on wound infection 30 days after the surgery were used to compare both protocols., Results: There was no difference between protocols for absolute colony forming units (CFU) and percentage CFU reduction perioperatively as well as for surgical wound clinical score 10-15 days after the surgery. The infection rate at 30 days was 10.5% (6/57) but no significant difference was observed between protocols 10% (3/30) versus 11.5% (3/27)., Conclusions: An abbreviated preoperative protocol using nonsterile reusable material can be as effective as a standard protocol using sterile one-use brush in reducing skin microflora and preventing surgical wound infection., (© Copyright 2013 by The American College of Veterinary Surgeons.)

Objectives: To survey the current management of cranial cruciate ligament rupture in small dogs (<15 kg) by veterinarians., Methods: A questionnaire was distributed to veterinarians attending the British Veterinary Orthopaedic Association Spring meeting and British Small Animal Veterinary Association Annual Congress which took place in April 2010. Respondents were surveyed on their management of small dogs with cranial cruciate ligament rupture., Results: Immediate surgical management was chosen by 15.5% of the respondents. Following that, 77.6% of respondents suggested that case management would depend on severity of lameness (81%), age (72.6%), bodyweight (70.4%), degree of instability (64.8%), and duration of lameness (64.0%). Conservative management included non-steroidal anti-inflammatory drugs (91.1%), short leash walks (91.1%), weight loss (89.0%), hydrotherapy (53.6%), physiotherapy (41.9%), and cage rest (24.2%). Where surgical management was chosen, 71.4% would perform the procedure rather than refer it to another practice. Surgical techniques included extra-capsular stabilisation (63.4%), corrective osteotomies (32.9%), and intra-articular stabilisation (6.8%). The demographic characteristics of the responding veterinarians had no effect on their initial management of the case. General practice veterinarians were less likely to perform a corrective osteotomy than to refer the case, but were no less likely to perform an extracapsular technique., Clinical Significance: Conservative management is still widely used for treatment of cranial cruciate ligament rupture in dogs weighing less than 15 kg; this is in agreement with previous publications on the management of this condition in small dogs.