Javma-journal of The American Veterinary Medical Association最新文献

Objective: The purpose of this study was to develop random forest classifier models (a type of supervised machine learning algorithm) that could (1) predict students who will or will not complete the DVM degree requirements and (2) identify the top predictors for academic success and completion of the DVM degree.

Methods: The study utilized Ross University School of Veterinary Medicine student records from 2013 to 2022. Twenty-four variables encompassing demographic (eg, age, race), academic (eg, grade point average), and financial aid (eg, outstanding balances) data were assessed in 11 cross-validated random forest machine learning models. One model was built assessing all years of data and 10 individual models were developed for each enrollment year to compare how the top predictors of success varied among the years.

Results: Consistently, only academic and financial factors were identified as being features of importance (predictors) in all models. Demographic factors such as race were not important for predicting student success. All models performed very well to excellently based on multiple performance metrics including accuracy, ranging from 96.1% to 99%, and the areas under the receiver operating characteristic curves, ranging from 98.1% to 99.9%.

Conclusions: The random forest algorithm is a powerful machine learning prediction model that performs well with veterinary student academic records and is customizable such that variables important to each veterinary school's student population can be assessed.

Clinical relevance: Identifying predictors of success as well as at-risk students is essential for providing targeted curricular interventions to increase retention and achieve timely completion of a DVM degree.

Objective: To evaluate the specificity/sensitivity and predictive values of urine spot metanephrines-to-creatinine ratios to diagnose canine pheochromocytomas and to determine whether there is a correlation between urine catecholamine levels and tumor volume.

Methods: In a retrospective study, 32 client-owned dogs with adrenal tumors were identified (13 nonpheochromocytoma and 19 pheochromocytoma). Medical records were evaluated for patients undergoing adrenalectomy between August 2020 and August 2023. Patients were divided into groupings of pheochromocytoma and other adrenal tumor diagnosis on the basis of histopathology.

Results: Urine spot normetanephrine concentrations were significantly elevated in dogs with pheochromocytomas compared to dogs with other adrenal tumors. Sensitivity was 78.9%, specificity 76.9%, positive predictive value 83.3%, and negative predictive value 71.4% for discriminating between pheochromocytoma and nonpheochromocytoma. Spot urine metanephrine concentrations were not significantly different between the 2 groups. Only 5 of 19 pheochromocytoma patients had urine normetanephrine concentrations > 4 times the upper reference limit, which is the previously established diagnostic cutoff. Median tumor volume did not correlate with normetanephrine values, nor did those values correlate to patients that experienced intraoperative complications. Twenty-one percent of cases were biochemically silent pheochromocytomas.

Conclusions: Urine normetanephrine-to-creatinine levels but not metanephrine-to-creatinine levels can potentially differentiate a pheochromocytoma from a nonpheochromocytoma.

Clinical relevance: Previously published guidelines of 4 times the upper reference limit in spot urine metanephrines testing used to diagnose pheochromocytomas will lead to a significant number of missed diagnoses.

Objective: To assess the impact of dietary fiber supplementation with cellulose on clinical course, fecal consistency, and intestinal microbiota composition in dogs with uncomplicated acute diarrhea (AD).

Methods: From September 2022 to November 2023, a total of 19 dogs presenting with uncomplicated AD were included in this prospective, randomized, and double-blinded clinical trial. The time to resolution of diarrhea was evaluated via owner surveys and a fecal scoring chart. The client-owned dogs were randomly assigned to a cellulose group (CG) or control group. The intestinal microbiota was analyzed via quantitative PCR.

Results: A marginally significant, faster improvement in stool consistency on day 1 was observed in the CG (P = .09). All dogs improved clinically, with a median recovery time of 3.0 days in the CG and 3.2 days in the control group (range, 1 to 6 days in both groups). There was no significant difference regarding the Canine Acute Diarrhea Severity index or composition of the intestinal microbiota during the study.

Conclusions: All dogs with uncomplicated AD exhibited rapid clinical improvement and recovery of the core intestinal microbiota within the first few days. Cellulose improved the fecal consistency in a subset of dogs, and intestinal dysbiosis was mild and self-limiting.

Clinical relevance: The administration of dietary cellulose has the potential to accelerate improvements of stool consistency. Mild changes in pathobionts, such as an increased amount of Clostridium perfringens, are self-limiting; thus, antibiotic intervention is not warranted.

Objective: To describe the outcome of common medical therapies, intraoral dental procedures, extraoral surgical interventions, and resulting complications of treatment in client-owned rabbits diagnosed with dental disease.

Methods: The medical records of 51 client-owned domestic rabbits presenting for veterinary care and management of dental disease from 2013 to 2023 at 2 veterinary teaching hospitals were reviewed.

Results: Of the patients managed with coronal reduction and occlusal adjustment, none developed significant complications. Of the patients that required intraoral dental extractions, 41% developed postprocedural complications, including incomplete tooth extraction. Following periapical infection and the formation of an odontogenic abscess for which surgical intervention was implemented, 25% of patients developed complications, including abscess recurrence and sepsis. Meloxicam was the most frequently prescribed analgesic medication for all procedures reviewed. Trimethoprim-sulfamethoxazole combination oral suspension was the most frequently prescribed antibiotic following coronal reduction, occlusal adjustment, and dental extractions, and parenteral penicillin G procaine was the most frequently prescribed antibiotic following periapical infection-related interventions. Seven patients had documentation of natural death or humane euthanasia secondary to progressive dental disease.

Conclusions: The risk of postprocedural complications during the management of dental disease must be considered and discussed given the high rate of potential complications.

Clinical relevance: With the increasing popularity of rabbits as companion animals, dental disease is considered one of the most common reasons for veterinary care in this species. Rabbits undergoing intraoral dental procedures and extraoral surgical interventions for the treatment of acquired and progressive dental disease are at risk of developing adverse postprocedural sequelae that must be considered before attempting intervention. This report adds to the growing body of scientific literature related to the management of this challenging disease process.

Objective: To evaluate the effect of hand walking exercise on myoelectrical activity and contractility in normal, healthy horses.

Methods: Prospective experimental design. A convenience sample of 8 horses were randomized to a control or hand walking treatment group; each horse underwent both treatments. After a 30-minute baseline electrointestinography (EIG), horses were stall rested or hand walked for 15 minutes. Electrointestinography was repeated immediately and at 2 hours. Ultrasonography and auscultation monitored cecal and left ventral colon (LVC) contractions during EIG. Electrointestinography spectral analysis obtained dominant frequency (DF), dominant power (DP), total power (TP) frequency distribution, and changes in slow-wave rhythmic activity.

Results: The median (IQR) DF in cycles per minute (cpm) was higher for the cecum (2.067 cpm; IQR, 0.633 cpm) compared to the LVC (2.0 cpm; IQR, 0.396 cpm) but was unchanged by either treatment. Cecal DP (0.0086 mV; IQR, 0.0070 mV) was higher than LVC DP (0.0068 mV; IQR, 0.0051 mV) in the hand walking group, but DP and TP were unaffected by either treatment over time. Borborygmi at all time points were unchanged in both treatment groups. Ultrasonographic contractions were similar across time in both treatment groups and correlated with borborygmi (ρ = 0.63). Dominant power did not correlate with contractions or borborygmi (P > .2081).

Conclusions: Brief hand walking as a single strategy to increase gastrointestinal motility did not affect contractility or EIG in normal horses.

Clinical relevance: Fasting and stall rest may not represent the spectrum of severity of gastrointestinal stasis observed in clinical cases. This model is directly applicable to horses fasted prior to surgical procedures.

Objective: To describe a simultaneous surgical approach to the abdominal cavity and perineum for complete vaginectomy performed in dorsal recumbency and to create a schematic for guiding the procedure without the need for patient repositioning.

Animals: 3 client-owned dogs with urogenital pathology.

Clinical presentation: The first dog, an 11-year-old neutered female Border Collie, presented with stranguria and tenesmus. The second dog, a 13-year-old intact female Cocker Spaniel, was referred for further investigation of a vaginal mass. The third dog, a 12-year-old intact female Border Collie, presented with polyuria/polydipsia and vaginal discharge.

Results: Data concerning complete vaginectomies performed in dorsal recumbency between June 2023 and June 2024 were retrospectively reviewed. A single intraoperative complication, involving perforation of the caudal urethra, was encountered in the third dog. Postoperative complications included intermittent urinary incontinence responsive to medical treatment in the first dog and transient self-limiting urinary incontinence in 2 dogs. Long-term follow-up revealed excellent outcomes with satisfactory cosmetic results for the first, second, and third dogs, with follow-up periods of 12, 8, and 4 months, respectively. No complications related to positioning were encountered, and no conversions were required.

Clinical relevance: The combination of ventral midline celiotomy with episiotomy in dorsal recumbency is a feasible, well-tolerated technique that provides optimal surgical access and visualization. Eliminating the need for intraoperative repositioning reduces anesthetic and surgical times while maintaining sterility, stability, and continuous monitoring.

Objective: To explore client preferences for how value is communicated via written means and to assess the consistency of this preference with how veterinary clinic websites present this information for preventive care services.

Methods: First, a questionnaire was developed to assess clients' preference between 2 researcher-developed paragraphs recommending senior pet screening (one focused on the function of screening, the other on pet benefits of screening) and distributed from August 17 to November 2, 2023. Second, veterinary clinic websites were retrieved with a search engine using predefined search phrases related to 4 preventive care topics (flea and tick prevention, heartworm prevention, dental cleaning, and senior bloodwork). Each website was coded for the frequency of 4 codes related to how the value of the preventive care service was communicated (feature, function, pet benefit, or client benefit).

Results: From the questionnaire, 58.0% (166/286) of participants preferred the benefit-focused communication. Those who saw the benefit-focused paragraph were more likely to indicate being "extremely likely" to discuss senior pet screening with a veterinarian. Of the 128 website pages coded, the mean text percentages for each code were 13.3% feature, 10.5% function, 6.4% pet benefit, and 1.0% client benefit.

Conclusions: Results suggest that opportunities exist to increase communication of the benefits of veterinary care on veterinary clinic websites, which may align more with clients' preferences.

Clinical relevance: Through online communication, veterinary professionals may have an opportunity to increase client engagement with preventive care services by emphasizing the benefits of preventive care services in addition to the function.