Journal of Small Animal Practice最新文献

Objective

To evaluate clinical, pathological and prognostic features and outcomes of dogs with surgically excised cutaneous and subcutaneous digital or distal limb mast cell tumours.

Materials and Methods

Medical records between 2014 and 2024 were reviewed, and signalment, clinicopathological testing, tumour location, recurrence, complications and histological characteristics were recorded. Additionally, progression-free interval and overall survival time were evaluated. One hundred and fifteen client-owned dogs with mast cell tumour admitted to two academic institutions were included.

Results

Surgical complications occurred in 38% of dogs with surgical site infection and incisional dehiscence most common. Local recurrence occurred in 23% of dogs overall, with completely excised tumours having 10% recurrence, narrowly excised 20% and incompletely excised 35%. Higher recurrence rates occurred with incomplete surgical margins, mitotic count >5 and histologically high-grade mast cell tumours. The median progression-free interval was significantly longer for wide excision (2270 days) compared to marginal excision (888 days). The overall survival time was 7 years for all dogs overall, was not reached for low-grade mast cell tumours and was 3 years for high-grade mast cell tumours. The progression-free interval and overall survival time were affected by tumour grade but not lymph node status.

Clinical Significance

The behaviour of canine mast cell tumours affecting the digits and distal limb was affected primarily by tumours grade. Recurrence rates were highest in dogs with high-grade mast cell tumours, incomplete surgical resection and a mitotic count of >5. The outcome with surgical excision is excellent. Future studies are needed to further evaluate the effects of adjuvant chemotherapy, metastatic lymph node status and lymph node extirpation in high-grade mast cell tumour cases.

Objectives

To report the impact of the surgical approach (T-shaped or circular incision) on intraoperative and postoperative complications associated with total ear canal ablation and lateral bulla osteotomy.

Materials and Methods

Medical records of dogs that underwent total ear canal ablation and lateral bulla osteotomy with T-shaped or circular incisions between 10 referral hospitals were retrospectively reviewed. Intraoperative and postoperative complications and follow-up were analysed and compared between groups using Fisher’s exact test for categorical data and the Mann–Whitney rank-sum test for numerical data, with P < 0.05 considered significant.

Results

One hundred and forty-two dogs were included, totalling 156 surgeries: 84 were performed via circular incision (O-group) and 72 with a T-shaped incision (T-group). The groups were similar for sex (P = 0.182) and body weight (P = 0.836) distribution; the T-group was older at the time of surgery (P = 0.019).

Intraoperative bleeding occurred in 13/156 (8%) dogs and significantly more frequently in the O-group (P = 0.03; 11 O-group [7%], two T-group [1%]). Postoperative complication rate was 38.6% (n = 60): wound complications occurred in 31/156 (20%) dogs, more frequently in the T-group (P ≤ 0.001; eight O-group [5%], 23 T-group [15%]); postoperative facial nerve neuropathy occurred in 31/156 (20%) dogs, and weakly associated with the O-group (P = 0.045; 22 O-group [14.1%], nine T-group [5.8%]).

Clinical Significance

Surgical preference may guide the choice between performing T-shaped or circular incisions during total ear canal ablation with lateral bulla osteotomy. Circular incisions were associated with a higher incidence of intraoperative haemorrhage and postoperative facial nerve neuropathy, while T-shaped incisions may increase the risk of wound complications. Most complications in both groups were minor or self-limiting.

Objectives

This study aimed to examine the association between pterygoid bone medialisation and treatment outcomes after upper airway surgery in three brachycephalic breeds.

Materials and Methods

Dogs that underwent CT of the head followed by routine surgery for brachycephalic obstructive airway syndrome were recruited in this study. Measurements obtained from the CT images included the width of the basisphenoid bone, interpterygoid distance and cross-sectional area of the nasopharynx. A ratio of width of the basisphenoid bone to interpterygoid distance allowed quantification of pterygoid bone medialisation. Pearson's correlations were calculated to assess the relationship between width of the basisphenoid bone: interpterygoid distance and cross-sectional area of the nasopharynx. Additionally, width of the basisphenoid bone: interpterygoid distance was compared across breeds, as well as between dogs with good and poor surgical outcomes (post-operative brachycephalic obstructive airway syndrome index ≥50%).

Results

One hundred and forty-four brachycephalic dogs (47 Pugs, 64 French Bulldogs and 33 Bulldogs) and 30 non-brachycephalic controls were included in the analysis. The width of the basisphenoid bone: interpterygoid distance ratio in brachycephalic dogs was significantly higher (1.982 ± 0.379) than that of controls (1.646 ± 0.239, P < 0.001). A negative correlation was observed between width of the basisphenoid bone: interpterygoid distance and cross-sectional area of the nasopharynx in Pugs (ρ = −0.29, P = 0.048), French Bulldogs (ρ = −0.47, P < 0.001), Bulldogs (ρ = −0.71, P < 0.001) and controls (ρ = −0.55, P = 0.002). French Bulldogs with poor surgical outcomes exhibited a significantly higher width of the basisphenoid bone: interpterygoid distance (2.366 ± 0.327) than those with good surgical outcomes (1.813 ± 0.271, P < 0.0001).

Clinical Significance

Pterygoid bone medialisation is associated with nasopharyngeal narrowing, which limits the effectiveness of surgical interventions in brachycephalic obstructive airway syndrome in affected French Bulldogs. As there are no surgical options currently reported to address this condition, these findings are important in guiding clinicians in providing prognostic information to owners during elective brachycephalic obstructive airway syndrome surgery.

Objectives

A thorough understanding of common practice patterns in a particular specialty can help identify and design new interventions to improve care delivery and access to care. The goals of this study were to document current practice patterns among veterinary “neurologists” and small animal “surgeons” in the surgical management of acute canine thoracolumbar intervertebral disc extrusion, to compare approaches between these two groups and to discuss current results compared to those published in 2016.

Materials and Methods

A web-based survey was distributed in October 2024 to collect responses from board-certified and regionally recognised neurology and surgery specialists in North America and Europe. Data were summarised using descriptive statistics. Chi-squared analysis assessed differences in response distribution between “neurologists” and “surgeons” for specific questions.

Results

A total of 385 survey responses were received. There was a significant difference in the distribution of responses related to caseload between specialties, where “surgeons” most reported 1 to 25 cases per year and “neurologists” most reported managing >100 cases per year. “Surgeons” and “neurologists” did not differ with respect to surgical recommendations based on the severity of neurologic signs. Eighty per cent of “neurologists” and 47% or “surgeons” reported performing concurrent fenestration at the time of surgical decompression. Compared to 2016, utilisation of methylprednisolone sodium succinate and performance of after-hours surgery were reduced in both groups.

Clinical Significance

Results of the present survey indicate substantial shifts in practice patterns for surgical management of this disease, some in alignment with current literature and some not. Future work should focus on the comparison of clinical outcomes in dogs imaged with CT versus MRI. Results also suggest a continued lack of clinical equipoise around prognostic factors for recovery and risk factors for progressive myelomalacia, such that future prospective studies could help improve clinician confidence in these areas.

Objectives

To understand perceptions and analgesic practices for acute pain management in cats and dogs by veterinarians in Africa.

Materials and Methods

Data from small animal veterinarians were collected using an online questionnaire (English/French) and convenience sampling. Pain management practices and perceptions of veterinarians were analysed using multiple correspondence analysis.

Results

A total of 249 participants completed the survey from 20 countries. The readily available opioids, non-steroidal anti-inflammatory drugs and local anaesthetics were morphine (n = 90; 36.1%), meloxicam (n = 200; 80.3%) and lidocaine (n = 245; 98.4%), respectively. The majority of participants reported not using pain assessment instruments for perioperative pain in cats (n = 169; 67.9%) or dogs (n = 170; 68.3%). Feline Grimace Scale (n = 27; 10.8%) and Glasgow Composite Measure Pain Scale (n = 30; 12.0%) were the most commonly used instruments in cats and dogs, respectively. Multiple correspondence analysis identified one cluster representing high knowledge of pain assessment, use of peri-operative non-steroidal anti-inflammatory drugs and opioids, pain assessment instruments and recommendations of ongoing non-steroidal anti-inflammatory drug therapy after ovariohysterectomy. The second cluster represented low knowledge of pain assessment, non-use of peri-operative non-steroidal anti-inflammatory drugs and opioids, non-use of pain assessment instruments and no recommendations for ongoing non-steroidal anti-inflammatory drug therapy after ovariohysterectomy.

Clinical Significance

Low knowledge and limited access to analgesics were associated with the non-use of perioperative non-steroidal anti-inflammatory drugs and opioids, pain assessment tools and non-steroidal anti-inflammatory drug therapy following ovariohysterectomy. Continuing education programs and improved drug availability are essential for improving pain management in cats and dogs.

Objectives

While direct-to-consumer genetic tests are widely used in veterinary medicine, claims regarding communication and counselling issues have not been investigated so far. Our aim was to evaluate the communication channels encountered by clients when direct-to-consumer genetic tests are ordered, as well as access to genetic counselling to investigate whether these concerns are justified.

Materials and Methods

Checklists, email inquiries and direct-to-consumer genetic test kits were used to survey access to pre- and post-test counselling, as well as adherence to quality standards and guidelines of the website and test reports from 11 laboratories, spread across mainland Europe and the United Kingdom.

Results

Laboratories scored between 50% and 80% on a quality check of their websites using published standards. Prior to ordering genetic tests, counselling requests response rates were 69%, with most replies received within one business day. Genetic test report quality scores ranged between 67% and 78% for the administrative part and 67% to 100% for the test-related part. Seventy-five per cent of laboratories provided post-test counselling. Marked differences in genetic test recommendations were observed within and between laboratories for both Border Collies and Maine Coons, and this was not linked to geographical location, patents, or allele frequency.

Clinical Significance

The highly variable quality of websites and reports, access to counselling and recommendations on which genetic tests to use can have serious consequences for animal health and welfare. This substantiates the concerns expressed in the scarce veterinary literature.

Objectives

Identify alterations in biochemical and haemostatic variables between tumour-bearing dogs with and without metastasis that can be used to predict the presence of metastasis.

Materials and Methods

Thirty dogs with sarcoma and 29 with carcinoma were included in the analysis. Serum biochemistry profiles and haemostatic variables (haematocrit value, platelet count, thromboelastography (TEG), fibrinogen, Factor X, VII, antithrombin activity and D-dimer concentration) were measured for all dogs. All dogs underwent complete post-mortem and histopathological evaluations. For tumour-bearing dogs without intracavitary haemorrhage, measured variables were compared between dogs with and without metastasis, and univariate and multivariable analysis were performed to identify predictors of metastasis.

Results

Metastasis was identified in 31 of 59 (53%) dogs, of which 5 of 31 (16%) had metastasis to the regional lymph node only and 26 of 31 (84%) had distant metastasis. Sodium, ionised calcium, TEG lysis % at 30 and 60 minutes (Ly60) were significantly lower in tumour-bearing dogs without intracavitary haemorrhage with metastasis compared to dogs without metastasis. Multivariable analysis identified sodium <142.5 mmol/L as 64% sensitive (CI_95%:45% to 82%) and 63% specific (CI_95%:44% to 81%); and Ly60 < 1.0% as 68% sensitive (CI_95%: 49% to 88%) and 78% specific (CI_95%:61% to 95%) for prediction of the presence of metastasis. Parallel interpretation of lower sodium and decreased Ly60 resulted in high sensitivity (96%) for the presence of metastasis.

Clinical Significance

Sodium and TEG-based decreased fibrinolysis were associated with metastasis in tumour-bearing dogs without haemorrhage; when identified, they should prompt further diagnostics to detect possible metastasis of a primary carcinoma or sarcoma.