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

Objective: To evaluate the accuracy and precision of user groups using common syringe-and-needle combinations found in small animal general practice.

Methods: 30 participants were divided into 3 groups (novice, beginner, and expert) based on level of experience. Participants prepared 180 syringes (sixty 0.5-mL insulin syringes, sixty 1-mL tuberculin syringes with 25-gauge needle, sixty 1-mL tuberculin syringes with 22-gauge needle) with 3 volumes of sterile water (0.02, 0.12, and 0.43 mL). Accuracy and precision were calculated, and mixed-effect modelling was used to evaluate the impact of syringe type, volume, and participant characteristics.

Results: The greatest precision was seen with the smallest needle for the smallest volume. All participants tended to overfill volumes with larger syringe-and-needle combinations. The 1-mL syringe with larger needles was the least accurate. However, with larger volumes the percent difference in prepared versus expected volume (ie, the effect of overfilling) was reduced compared to smaller volumes. The beginner group was nearly 2 times as likely to prepare an accurate volume within ± 20% of the intended volume compared to experts (OR, 2.29; 95% CI, 1.33 to 3.93).

Conclusions: Errors in volume preparation ± 20% of expected, especially with the smallest volumes, were most common when larger needles were used. Smaller syringe-and-needle combinations improved precision.

Clinical relevance: Clinical practitioners should be aware of the inaccuracies encountered when preparing small volumes of injectable medications frequently used in veterinary practice. Greater experience does not guarantee greater accuracy. Clinically significant errors of at least ± 20% are common, especially when preparing very small volumes.

Objective: Access to veterinary care remains a significant barrier for many pet owners. Community-based learning opportunities are increasingly recognized as a way to address these gaps while fostering student development. This qualitative study aimed to understand more about the student learning experience through veterinary community engagement opportunities.

Methods: Using a retrospective qualitative study design, we examined reflective journals from veterinary students following a shelter medicine rotation at the University of Pennsylvania between January 2015 and July 2019. The journals were analyzed with the use of collaborative qualitative content analysis.

Results: 53 veterinary students were included in the study. Eight major themes emerged from their journals, including student perspectives of owners, pets, neighborhoods, community outreach, and self; the learning process; the role of pets as social catalysts; and trust. Students frequently described shifts in their perceptions toward pet owners. Both the depth (time invested) and breadth (diversity of experiences) of community outreach experiences contributed uniquely to students' acquisition of soft skills critical to excellence in clinical practice, including social competence, cultural humility, and contextualized decision-making.

Conclusions: These findings suggest that structured, reflective, ethical community-based experiential learning can challenge the hidden curriculum, foster emotional intelligence, and better prepare veterinary students for real-world practice.

Clinical relevance: Incorporating sustained, diverse, and ethically grounded community engagement into veterinary curricula may empower future veterinarians to navigate complex social contexts and more effectively serve all types of populations.

Objective: The purpose of the study was to evaluate the proportional reporting of neurological adverse events (AEs) associated with feline topical parasiticide products containing macrocyclic lactones (MLs; including eprinomectin) and emodepside by use of postapproval pharmacovigilance data. The intent was to provide veterinarians prescribing these products for their feline patients with the overall comparative context of neurological AE reporting for these products, which have been characterized as substrates for P-glycoprotein transporters.

Methods: The openFDA and EudraVigilance Veterinary Data Warehouse databases were queried for neurological AEs cumulatively reported through December 31, 2024, for marketed parasiticide products containing MLs (eprinomectin, selamectin, moxidectin) and emodepside for topical administration to cats. The frequencies of neurological AE reporting were compared between products with proportional report rates and disproportionality statistical measures.

Results: The reporting frequencies of neurological AEs associated with these feline topical parasiticide products were similar. For all products, ataxia was the most frequently reported neurological AE, with proportional report rates ranging from 5.3% to 14.0%. Proportional report rates ranged from 1.7% to 10.7% for convulsion and muscle tremor.

Conclusions: An evaluation of pharmacovigilance data from 2 different sources revealed no evidence of greater proportional reporting for neurological AEs specific to the use of eprinomectin-containing products in cats than for other MLs or emodepside.

Clinical relevance: These findings supported the conclusion that ML-containing products (including eprinomectin-containing products) and emodepside are comparable in the frequencies and types of neurological AEs associated with feline topical parasiticide products described as substrates for P-glycoprotein transporters.

Objective: The objective of this study was to determine the median time to return of negative thoracic pressure via thoracostomy tube following thoracic surgery in canines and felines without preoperative pneumothorax or pleural effusion and discuss complications associated with their use.

Methods: This was a retrospective case series with client-owned canines (n = 31) and felines (7). Medical records of canines and felines presented to a referral hospital for surgery during which a thoracostomy tube(s) was placed were reviewed. Animals with preoperative pneumothorax or pleural effusion were excluded. Total volumes of air and fluid were recorded in addition to respiratory rate, effort, and postoperative complications.

Results: 31 canines and 7 felines met inclusion criteria. Included procedures were diaphragmatic herniorrhaphy (44.7%), pericardioperitoneal herniorrhaphy (5.0%), lung lobectomy for mass excision or torsion (31.5%), vascular anomaly correction (15.8%), and other thoracic procedures (5.2%). Overall postoperative thoracostomy tube complication rate was 5.2%. Two patients died prior to discharge from complications unrelated to the thoracostomy tube. The median time to reestablish negative pressure was 0.5 hours (95% CI, 0 to 2 hours), and the median duration a thoracostomy tube was maintained was 8 hours (95% CI, 6 to 9.75 hours).

Conclusions: The duration for which thoracostomy tubes were maintained exceeded that needed for reestablishment and maintenance of negative thoracic pressure.

Clinical relevance: Clinicians should consider limiting thoracostomy tube use to the immediate 2-hour postoperative period, as the majority of cases did not exceed 10 mL/kg of air and fluid production across the duration of thoracostomy tube use. Overall complication rate was low (5%).

Objective: To highlight clinical and clinicopathologic differences between kittens with feline infectious peritonitis-associated uveitis (FIP-AU) versus those with an otherwise similar feline undifferentiated resolving uveitis (FURU).

Methods: Clinical and clinicopathologic data were compared between 22 kittens with FURU and 8 with necropsy-confirmed FIP-AU examined between January 1, 1985, and December 31, 2022.

Results: Sex, lifestyle, seasonality, household cat numbers and systemic signs were similar in both groups. Feline undifferentiated resolving uveitis occurred predominantly in domestic-breed kittens from shelters, whereas FIP-AU was more frequent in purebred or stray cats. Duration of ocular signs before presentation was 1 to 2 weeks for FURU versus > 2 months for FIP-AU. Feline undifferentiated resolving uveitis was more commonly associated with episcleral hyperemia while FIP-AU was more commonly associated with corneal edema, dyscoria, rubeosis iridis, iridal congestion/thickening, posterior synechia, or keratic precipitates. Corneal edema and chemosis were more severe in FIP-AU. No eyes with FURU had fundic abnormalities whereas 6 of 11 eyes with FIP-AU had chorioretinitis. All kittens with FIP-AU presented bilaterally whereas 5 of 15 kittens in which FURU was ultimately bilateral, initially presented unilaterally. Hyperproteinemia, hyperglobulinemia, and hyperbilirubinemia occurred only with FIP-AU. Neither likelihood of a positive coronavirus titer nor titer magnitude differed between groups.

Conclusions: Kittens can develop bilateral fibrinous uveitis with keratic precipitates, systemic signs of illness, and serum coronavirus antibodies which resolves without sequelae following empirical treatment. Syndromic assessment-including careful fundic examination-can help differentiate FURU from FIP-AU and should precede antiviral therapy.

Clinical relevance: Resolution of uveitis during antiviral treatment does not confirm FIP. Comprehensive diagnostic evaluation is essential to avoid misdiagnosis and inappropriate treatment.

Canine osteoarthritis (OA) is a major contributor to chronic pain, mobility loss, and premature euthanasia. Although multimodal care is standard, many dogs experience incomplete relief, adverse events, or limited access to care. Radiosynoviorthesis (RSO) is a targeted IA therapy that delivers localized radiation to inflamed synovial tissue, reducing synovial effusion and alleviating joint pain. While various RSO agents have been used for over 70 years in human medicine to manage inflammatory joint disease, tin-117m (Sn-117m) is the first RSO agent adapted for veterinary use and approved for the treatment of canine OA. Sn-117m is a radionuclide emitting low-energy conversion electrons with minimal tissue penetration and, unlike systemic radiotherapeutics, Sn-117m remains confined within the joint capsule and does not form radioactive metabolites. This containment minimizes environmental contamination and limits caregiver exposure. This narrative review synthesized current evidence on the clinical use of Sn-117m RSO in dogs, addressing therapeutic efficacy and effectiveness, safety, and caregiver radiation exposure. Sn-117m offers a minimally invasive alternative to fill this treatment gap. Following a single injection for OA, prospective clinical trials report sustained improvements in objective gait analysis and caregiver-reported pain scores with benefits lasting up to 12 months. Modeled and measured radiation exposures for caregivers remain below US Nuclear Regulatory Commission limits, allowing outpatient use without isolation. This review evaluated existing data, highlighted regulatory and implementation considerations, and identified areas of potential further research. Long-term outcome tracking and expanded joint-specific data could help refine the use of RSO in human and veterinary medicine.

Objective: To test the efficacy of a novel hemostatic agent to control high-pressure, high-flow hemorrhage in a large animal model.

Methods: A randomized controlled trial was performed with 18 Holstein calves from January 2023 through January 2024. Following calf randomization, a single carotid arteriotomy incision (3 to 5 mm) was made. In the treatment group, a novel hemostatic hydrogel (TRAUMAGEL) was immediately applied at the site of hemorrhage followed by direct pressure with gauze pads. Calves in the control group received hemorrhage control with direct pressure with gauze pads only. The pads were removed and the arteriotomy site observed at 3, 9, and 19 minutes. Time to hemostasis and severity of any continued hemorrhage were compared.

Results: Calves treated with TRAUMAGEL (n = 9) had decreased time to hemostasis and less severe hemorrhage compared with control animals (9; median time to hemostasis, 170 vs 1,134 seconds).

Conclusions: Application of TRAUMAGEL followed by direct pressure decreased time to hemostasis and severity of hemorrhage compared to direct pressure alone.

Clinical relevance: TRAUMAGEL may be valuable in large animals for traumatic injury or during surgery for controlling hemorrhage that is accessible to hydrogel application and direct pressure.

Objective: Evaluate the feasibility of measuring plasma concentrations of 4 endothelial glycocalyx components and their correlation to patient and treatment characteristics in canine trauma patients.

Methods: This was an observational study of dogs presenting to a university-based emergency department between August 2021 and March 2022 within 2 hours of traumatic injury and healthy, age-matched controls. We obtained EDTA plasma at arrival and 3, 6, and 24 hours later. Degree of injury was classified based on Animal Trauma Triage score (mild, 0 to 3; moderate, 4 to 6; and severe, ≥ 7). Data collected included signalment, modified Glasgow Coma Scale score, interventions, diagnostic results, and patient outcomes. Plasma concentrations of syndecan-1, hyaluronan, heparan sulfate, and vascular endothelial-cadherin (cadherin-5) were determined via ELISA.

Results: 19 canine trauma patients and 16 age-matched controls were enrolled. Hyaluronan was significantly lower at arrival versus 24 hours later and demonstrated a significant increase over all time points. There was a significant negative correlation between heparan sulfate and lactate. Vascular endothelial cadherin was significantly higher in penetrating trauma than blunt trauma at arrival and 6 hours later.

Conclusions: Measurement of the 4 markers of endothelial glycocalyx damage in canine trauma patients was generally feasible, and further study may determine clinical application.

Clinical relevance: This was the first evaluation of these glycocalyx biomarkers in canine trauma patients. Additional studies evaluating these and other glycocalyx biomarkers longitudinally are needed to determine the effect of injury and fluid resuscitation on the glycocalyx and outcome in canine trauma patients.