Your Custom Quiz

In Devriendt 2022 et al., on EHPSS blood testing, which **combination** of tests yielded 100% sensitivity for confirming shunt closure?

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Correct. Combinations like SHA with MEGX T15 or SHA with postprandial SBA yielded 100% sensitivity with good specificity.
Incorrect. The correct answer is SHA + postprandial SBA.
Combinations like SHA with MEGX T15 or SHA with postprandial SBA yielded 100% sensitivity with good specificity.

🔍 Key Findings

  • Fasting ammonia (FA) was the most specific test (100%) for confirming EHPSS closure postoperatively.
  • Serum hyaluronic acid (SHA) and MEGX at 15 minutes post-lidocaine were the most sensitive tests (96.9% and 96.2%, respectively).
  • SHA combined with MEGX T15, or with FA or postprandial serum bile acids (SBA), provided 100% sensitivity with good specificity (72.4–82.8%).
  • SHA levels remained elevated in all dogs with persistent shunting, even when other tests were normal.
  • Paired SBA had moderate sensitivity (90%) and variable specificity (89%).
  • The L/MEGX test at 30 min was less useful than at 15 min for assessing closure.
  • Traditional SBA testing showed reduced utility postoperatively; normal values did not rule out persistent shunting.
  • Blood tests improved when combined, but imaging remains essential to definitively confirm EHPSS closure.

Devriendt

Veterinary Surgery

7

2022

Evaluation of different blood tests in dogs with extrahepatic portosystemic shunts to assess shunt closure after surgical treatment

2022-7-VS-devriendt-3

Article Title: Evaluation of different blood tests in dogs with extrahepatic portosystemic shunts to assess shunt closure after surgical treatment

Journal: Veterinary Surgery

In Viitanen 2023 et al., on zygomatic sialoadenectomy, which approach required zygomatic arch osteotomy?

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Correct. The modified LOA included a zygomatic arch osteotomy with preservation of the masseter insertion.
Incorrect. The correct answer is Modified lateral orbitotomy approach.
The modified LOA included a zygomatic arch osteotomy with preservation of the masseter insertion.

🔍 Key Findings

  • Intraoral approach (IOA) reduced surgical time compared to lateral orbitotomy (median: 42.0 vs 65.7 minutes, p = .005)
  • Ease of closure (Stage III) was better with IOA (p < .001), though gland removal (Stage II) was easier with LOA (p = .039)
  • Complete gland removal was achieved in 8/10 IOA vs 10/10 LOA cases in cadaveric study
  • All 3 clinical cases had uneventful recoveries post-IOA, including one carcinoma, with no intra- or short-term postoperative complications
  • LOA had superior surgical exposure, but was more invasive and time-consuming
  • IOA posed greater difficulty in complete gland removal in brachycephalic dogs, with remnant tissue noted in 2/10 cadavers
  • IOA avoids osteotomy, reducing potential complications like delayed union and postoperative pain
  • Cosmetic outcomes and healing were better with IOA, and no E-collar was required postoperatively

Viitanen

Veterinary Surgery

2

2023

Intraoral approach for zygomatic sialoadenectomy in dogs: An anatomical study and three clinical cases

2023-2-VS-viitanen-1

Article Title: Intraoral approach for zygomatic sialoadenectomy in dogs: An anatomical study and three clinical cases

Journal: Veterinary Surgery

In Pfeil 2024 et al., on fluoroscopic pinning, how many metabone fractures were treated across all animals?

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Correct. A total of 57 fractures were treated using fluoroscopic-guided pinning.
Incorrect. The correct answer is 57.
A total of 57 fractures were treated using fluoroscopic-guided pinning.

🔍 Key Findings

  • Fluoroscopically guided normograde metabone pinning (FGNMP) was used to treat 17 animals (15 dogs and 2 cats) with 57 metabone fractures, including various fracture configurations (short-oblique body, physeal, and comminuted).
  • All 57 fractures were stabilized using intramedullary pins via FGNMP. The study exclusively focused on pin fixation and did not include screws or combined fixation techniques.
  • Median surgical time was 54 minutes (range 26–99 min), indicating efficient procedural execution.
  • Radiographic bone union was achieved in all fractures, with a median time to union of 6 weeks (range 4–12 weeks). Union was confirmed in all initially non-united fractures on follow-up.
  • No major complications were reported. A single pressure sore at the olecranon resolved uneventfully, and no pin migration or osteomyelitis was observed.
  • Pin extensions were noted radiographically (e.g., 42% distal subchondral overextension), but were not associated with clinical problems.
  • Fluoroscopic guidance improved implant accuracy and preserved soft tissue, enabling effective fracture alignment and stabilization using this minimally invasive osteosynthesis (MIO) approach.
  • The authors concluded that FGNMP is an effective, safe, and minimally invasive method for a variety of metabone fracture types, yielding quick recovery, fast healing, and good to excellent long-term functional outcomes in all 17 cases.

Pfeil

Veterinary Surgery

5

2024

Outcomes of 15 dogs and two cats with metabone fractures treated with fluoroscopically guided normograde metabone pinning

2024-5-VS-pfeil-1

Article Title: Outcomes of 15 dogs and two cats with metabone fractures treated with fluoroscopically guided normograde metabone pinning

Journal: Veterinary Surgery

In Scheuermann 2024 et al., on 3D-printed reduction systems, what percentage of dogs in the 3D-MIPO group had near-anatomic or acceptable fracture reductions?

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Correct. All fractures in the 3D-MIPO group had near-anatomic or acceptable reduction, whereas the c-MIPO group had two unacceptable reductions.
Incorrect. The correct answer is 100%.
All fractures in the 3D-MIPO group had near-anatomic or acceptable reduction, whereas the c-MIPO group had two unacceptable reductions.

🔍 Key Findings

  • The study was a historic case-control trial comparing custom 3D-printed VSP-guided MIPO (3D-MIPO) to conventional MIPO (c-MIPO) in dogs with diaphyseal tibial fractures.
  • Surgical time was significantly shorter in the 3D-MIPO group (117 min vs. 151 min; p = .014), and fluoroscopy use was dramatically reduced (11 vs. 37 images; p < .001).
  • All 3D-MIPO reductions were acceptable or near-anatomic; 2 c-MIPO dogs had unacceptable reductions.
  • Tibial length, frontal, and sagittal alignment post-op were similar between groups; no significant difference in anatomic restoration (p > .1).
  • Radiographic union occurred in all dogs by 3 months. Time to union was similar between groups (3D-MIPO: 67 days vs. c-MIPO: 53 days; p = .207).
  • Postoperative complication rate was higher in 3D-MIPO (27% vs. 14%), including 2 major infections requiring implant removal.
  • 3D-MIPO required more pre-op time (~23 hours longer from presentation to surgery; p = .002), partly due to guide printing/sterilization.
  • Improved surgical efficiency and more consistent reductions were noted in the 3D-MIPO group, supporting its clinical utility despite increased pre-op logistics.

Scheuermann

Veterinary Surgery

6

2024

Virtual surgical planning and use of a 3D‐printed, patient‐specific reduction system for minimally invasive plate osteosynthesis of diaphyseal tibial fractures in dogs: A historic case control study

2024-6-VS-scheuermann2-3

Article Title: Virtual surgical planning and use of a 3D‐printed, patient‐specific reduction system for minimally invasive plate osteosynthesis of diaphyseal tibial fractures in dogs: A historic case control study

Journal: Veterinary Surgery

In García 2025 et al., on TIAS shunt confirmation, what confirmed complete shunt occlusion?

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Correct. Microbubbles appear in the right atrium when EHPSS is patent. Their absence after temporary occlusion confirms full attenuation.
Incorrect. The correct answer is No microbubbles seen in right atrium.
Microbubbles appear in the right atrium when EHPSS is patent. Their absence after temporary occlusion confirms full attenuation.

🔍 Key Findings

  • 40 dogs with congenital EHPSS were surgically treated using intraoperative transsplenic injection of agitated saline (TIAS) to assess full temporary occlusion.
  • TIAS was successful in 38/40 dogs; the remaining 2 had additional shunting vessels not originally seen and required further identification/ligation.
  • No intraoperative or postoperative complications occurred.
  • TIAS allowed real-time confirmation of attenuation success using ultrasound-visible microbubbles.
  • Median postoperative bile acids were 5 μmol/L (preprandial) and 25 μmol/L (postprandial).
  • Long-term outcomes: 29/39 dogs had excellent, 10/39 had good outcomes; 3 dogs died unrelated to EHPSS.
  • Technique is presented as a safe, quick, low-cost, accessible intraoperative assessment alternative to IOMP or SP.

Garcia

Veterinary Surgery

2

2025

Use of intraoperative transsplenic injection of agitated saline to confirm temporary full attenuation of congenital extrahepatic portosystemic shunts in dogs

2025-2-VS-garcia-1

Article Title: Use of intraoperative transsplenic injection of agitated saline to confirm temporary full attenuation of congenital extrahepatic portosystemic shunts in dogs

Journal: Veterinary Surgery

In Thompson 2024 et al., on cyanoacrylate enterotomy sealants, which group had the highest initial leak pressure (ILP)?

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Correct. The HS + CE group achieved the highest ILP (83.3 mmHg), significantly exceeding all others (p < .001).
Incorrect. The correct answer is Handsewn + cyanoacrylate.
The HS + CE group achieved the highest ILP (83.3 mmHg), significantly exceeding all others (p < .001).

🔍 Key Findings

  • Highest initial leak pressure (ILP) observed in the handsewn + cyanoacrylate (HS + CE) group: 83.3 ± 4.6 mmHg (p < .001 vs. others).
  • Lowest ILP: cyanoacrylate-only group (CE): 18.6 ± 3.5 mmHg.
  • No significant MIP difference between handsewn (HSE) and HS + CE groups (p = .19); CE had significantly lower MIP (22.7 mmHg).
  • Leak location:
    • HSE: 60% from suture holes
    • CE: 100% from incisional line
    • HS + CE: 60% from incisional line, 40% from suture holes
  • Authors conclude cyanoacrylate augmentation significantly increases ILP and could reduce enterotomy leakage risk.

Thompson

Veterinary Surgery

2

2024

Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies

2024-2-VS-thompson-1

Article Title: Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies

Journal: Veterinary Surgery

In Mullen 2023 et al., on microvascular perfusion, which metric differed significantly between obstructed and healthy intestines?

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Correct. Microvascular density was significantly lower in obstructed intestines compared to controls (p < .01), making it a reliable indicator.
Incorrect. The correct answer is Microvascular density.
Microvascular density was significantly lower in obstructed intestines compared to controls (p < .01), making it a reliable indicator.

🔍 Key Findings

  • Microvascular density at the site of foreign body obstruction was significantly lower in obstructed dogs compared to healthy controls.
  • PBR (perfused boundary region) was paradoxically lower in obstructed dogs, indicating that PBR may not reliably correlate with tissue viability in this context.
  • No significant difference in microvascular perfusion between subjectively viable vs nonviable intestines, suggesting subjective assessment is unreliable.
  • No difference in perfusion parameters between handsewn and stapled enterectomies, indicating both techniques preserve vascular health equally.
  • Stapled enterectomy using green TA staples is safe and did not impair intestinal perfusion at the anastomosis site.
  • SDF videomicroscopy is feasible intraoperatively and can differentiate healthy from diseased intestine in dogs.
  • Surgeons' subjective evaluations led to potentially unnecessary enterectomies, as microvascular parameters did not differ.
  • No cases of dehiscence or mortality, suggesting both surgical approaches are effective when applied properly.

Mullen

Veterinary Surgery

4

2023

A quantitative evaluation of the effect of foreign body obstruction and enterectomy technique on canine small intestinal microvascular health

2023-4-VS-mullen-2

Article Title: A quantitative evaluation of the effect of foreign body obstruction and enterectomy technique on canine small intestinal microvascular health

Journal: Veterinary Surgery

In Ritson 2025 et al., on feline hilar lobectomy sealants, how were devices evaluated for seal integrity?

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Correct. Bronchial stumps were tested with increasing pressures in submerged cyclic ventilation simulation.
Incorrect. The correct answer is Leakage under cyclical positive pressure ventilation.
Bronchial stumps were tested with increasing pressures in submerged cyclic ventilation simulation.

🔍 Key Findings

  • No leakage occurred using pretied ligature loops (PLL) or double-shank (DS) titanium clips up to 40 cm H₂O airway pressure.
  • 1/10 stapled lobes leaked at supraphysiologic pressure (40 cm H₂O), but this was not statistically significant (p = .33).
  • All techniques sealed effectively under physiologic and supraphysiologic pressures in cadaveric feline lungs.
  • PLL and DS clips required less working space than staplers, making them more practical for small thoracic cavities.
  • DS titanium clips offer enhanced security due to dual shanks and tissue-gripping design, reducing clip slippage.
  • Leak testing was cyclic and submerged, simulating physiologic ventilation and allowing robust evaluation.
  • Stapling failure occurred along the staple line, highlighting risks of air leakage due to staple misalignment or poor hilar access.
  • PLL and DS clips may be cost-effective and efficient alternatives for open or minimally invasive feline lung lobectomy.

Ritson

Veterinary Surgery

7

2025

Ex vivo comparative evaluation of feline hilar lung lobectomy using linear stapler, pretied ligature loop, and double-shank titanium clips

2025-7-VS-ritson-4

Article Title: Ex vivo comparative evaluation of feline hilar lung lobectomy using linear stapler, pretied ligature loop, and double-shank titanium clips

Journal: Veterinary Surgery

In Miller 2025 et al., on spinal drill guide accuracy, what was the reported mean deviation between planned and actual screw entry/exit points?

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Correct. The mean deviation was less than 1 mm across all entry and exit points, supporting guide accuracy.
Incorrect. The correct answer is Less than 2 mm.
The mean deviation was less than 1 mm across all entry and exit points, supporting guide accuracy.

🔍 Key Findings

  • 3D-printed, SOP plate-specific guides enabled safe screw placement from T12–L5 in canine cadavers and models.
  • All 140 screw trajectories were classified as Zdichavski Grade 1, indicating optimal placement without vertebral canal breach.
  • Screw angles (cranial-caudal and transverse) matched preoperative planning, with no significant deviation.
  • Entry/exit point deviations were <1 mm on average, deemed clinically negligible.
  • Drill guides were quick to place (<30 sec per vertebra) and improved ease of surgery.
  • Plates acted as effective reduction tools, guiding alignment during screw placement in mobile spines.
  • Minor technical challenges arose from cadaveric spine mobility, mitigated by sequential screw insertion.
  • Technique may enable future use in fracture/luxation reduction, pending further cadaveric and clinical trials.

Miller

Veterinary Surgery

6

2025

Development and testing of an animal-specific and string-of-pearls (SOP) plate specific, three-dimensionally (3D) printed drilling guide: A proof of concept study for canine thoracolumbar spinal stabilization

2025-6-VS-miller-1

Article Title: Development and testing of an animal-specific and string-of-pearls (SOP) plate specific, three-dimensionally (3D) printed drilling guide: A proof of concept study for canine thoracolumbar spinal stabilization

Journal: Veterinary Surgery

In Guevara 2024 et al., on implant placement accuracy, what was the rate of acceptable pin placement using 3D-printed guides?

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Correct. The 3DPG group had an acceptable placement rate of 87.5% vs 69.8% in FH group.
Incorrect. The correct answer is 87.5%.
The 3DPG group had an acceptable placement rate of 87.5% vs 69.8% in FH group.

🔍 Key Findings:

  • Sample: 24 canine cadavers, 477 total pins across 240 vertebrae.
  • Technique Comparison: 3D printed guides (3DPG) vs freehand (FH).
  • Acceptable Placement Rates: 3DPG = 87.5%, FH = 69.8% (p < .0001).
  • Odds Ratio for FH: 0.28 (95% CI 0.16–0.47), significantly less likely to yield acceptable placement.
  • Worst Accuracy Locations: T10 (OR 0.10), T11 (OR 0.35).
  • Surgeon Impact: Surgeon 2 outperformed others (OR 9.61, p = .001).
  • Modified Zdichavsky Classification used to score implant accuracy (Grades I–IIIb).
  • Primary Benefit of 3DPG: Increased safety and precision, regardless of surgeon experience.

Guevara

Veterinary Surgery

2

2024

Ex vivo comparison of pin placement with patient-specific drill guides or freehand technique in canine cadaveric spines

2024-2-VS-guevara-1

Article Title: Ex vivo comparison of pin placement with patient-specific drill guides or freehand technique in canine cadaveric spines

Journal: Veterinary Surgery

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