Quiz Question

In Larose 2024 et al., on laparoscopic liver biopsies in dogs, how did the 3 mm biopsy cup perform in larger dogs compared to smaller dogs?

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Correct. 3 mm instruments were easier in small dogs but more difficult in large dogs due to shaft length.
Incorrect. The correct answer is It was harder to manipulate.
3 mm instruments were easier in small dogs but more difficult in large dogs due to shaft length.

🔍 Key Findings

  • Histologic agreement between 3 mm and 5 mm biopsies was 90%, with a Gwet's AC1 of 0.81 (p < .0001).
  • 5 mm biopsies yielded significantly more portal triads and lobules than 3 mm samples (p = .0003 and p < .0001).
  • Crush artifacts were significantly higher in 3 mm samples (p = .035), though fragmentation scores were similar (p = .935).
  • Both forceps produced adequate samples for histopathology, copper quantification, and bacterial culture.
  • No hemorrhage requiring intervention occurred, and both sizes were deemed safe and minimally invasive.
  • Surface area ≥40 mm² strongly predicted ≥11 portal triads, a desirable threshold for reliable histopathology.
  • Use of 3 mm instruments was easier in small dogs (<12 kg), but more challenging in larger dogs due to shaft length.
  • Clinical diagnoses were unaffected by forceps size, even in the one discordant histologic pair.

Larose

Veterinary Surgery

4

2024

Comparing 3 mm and 5 mm laparoscopic liver biopsy samples in dogs

2024-4-VS-larose1-5

Article Title: Comparing 3 mm and 5 mm laparoscopic liver biopsy samples in dogs

Journal: Veterinary Surgery

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In Logothetou 2024 et al., on SPF complications, which anatomic site for SPF reconstruction was associated with the fewest complications?

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Correct. Flaps on the head had significantly fewer complications compared to other regions.
Incorrect. The correct answer is Head.
Flaps on the head had significantly fewer complications compared to other regions.

🔍 Key Findings

  • Complication rate for subdermal plexus flaps (SPFs) in dogs was 53.6%.
  • Skin staples had a numerically higher complication rate (72.2%) than sutures (49.3%), but not statistically significant due to small sample size.
  • Most common complication was wound dehiscence (35%), followed by seroma (14%) and wound discharge (14%).
  • Increased body weight was significantly associated with higher complication risk (OR = 1.056 per kg; p = .029).
  • Advancement flaps were associated with a lower incidence of complications on univariable analysis (p < .001).
  • Head region flap closures had fewer complications, while proximal pelvic limb closures had the highest complication rate.
  • Age was a risk factor—each additional year increased odds of complications (OR = 1.019; p = .004).
  • Closure technique did not significantly influence complication severity, though staple use was numerically worse.

Logothetou

Veterinary Surgery

3

2024

Complications and influence of cutaneous closure technique on subdermal plexus flaps in 97 dogs (2006–2022)

2024-3-VS-logothetou-3

Article Title: Complications and influence of cutaneous closure technique on subdermal plexus flaps in 97 dogs (2006–2022)

Journal: Veterinary Surgery

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In Ellis 2024 et al., which region showed significantly higher mean HU in Guide Dogs?

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Correct. Guide Dogs had significantly higher mean HU in the humeral trochlea (mean difference 146.49 HU, p < 0.01):contentReference[oaicite:1]{index=1}
Incorrect. The correct answer is Humeral trochlea.
Guide Dogs had significantly higher mean HU in the humeral trochlea (mean difference 146.49 HU, p < 0.01):contentReference[oaicite:1]{index=1}

🔍 Key Findings Summary

  • 86 elbows assessed: 32 Guide Dogs, 11 Border Collies
  • Guide Dogs showed significantly higher HU values in:
    • MCP: min (p = 0.022), mean (p < 0.01), max (p < 0.01)
    • Humeral trochlea: mean (p < 0.01), max (p < 0.01)
  • Results imply breed-associated HU variation, not necessarily pathologic sclerosis
  • Relevance: Important to avoid false positives for elbow dysplasia during CT-based breeding screens
  • Good interobserver agreement for mean HU values (ICC ~0.82–0.90)

Ellis

Veterinary and Comparative Orthopedics and Traumatology

3

2024

Comparison of Hounsfield Units within the Humeral Trochlea and Medial Coronoid Process in a Population of Labrador X Golden Retriever Guide Dogs and Border Collies

2024-3-VCOT-ellis-2

Article Title: Comparison of Hounsfield Units within the Humeral Trochlea and Medial Coronoid Process in a Population of Labrador X Golden Retriever Guide Dogs and Border Collies

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Schroeder 2022 et al., on fascial anatomy mapping, which fascial type is associated with periosteum and bony structures?

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Correct. Type IV fascia is associated with the periosteum and requires careful subperiosteal elevation or bone resection for clear margins.
Incorrect. The correct answer is D. Type IV.
Type IV fascia is associated with the periosteum and requires careful subperiosteal elevation or bone resection for clear margins.

🔍 Key Findings

  • Fascial planes in dogs were consistently classifiable into four surgical types:
  • Type I (discrete sheets), Type II (tightly adhered to thin muscle), Type III (tightly adhered to thick muscle), and Type IV (periosteum-associated).
  • Two junction types were identified: Type A (easily elevated) and Type B (higher risk of disruption).
  • Disruption-prone areas include the scapular spine (type IV fascia) and lateral thorax near the 13th rib, where rib resection may be needed to preserve margins.
  • The latissimus dorsi transition zones and fascial areas near the thoracic inlet and scapulohumeral joint were prone to fascial thinning or disruption.
  • Partial muscle resections or periosteal elevations may be required in areas with fragile fascia to maintain oncologic margins.
  • Dorsal spinous processes (T6–L6) showed type IV fascia; however, osteotomy may be needed in some dogs for clear margins.
  • Blended fascial transitions (e.g., rectus abdominis: type II cranially, type I caudally) necessitate intraoperative judgment on resection depth.
  • Cutaneous trunci may suffice as a deep margin for small, low-grade tumors in well-muscled dogs, but not reliably for high-grade or larger masses.

Schroeder

Veterinary Surgery

1

2022

Fascial plane mapping for superficial tumor resection in dogs. Part I: Neck and trunk

2022-1-VS-schroeder-5

Article Title: Fascial plane mapping for superficial tumor resection in dogs. Part I: Neck and trunk

Journal: Veterinary Surgery

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In Mullins 2023 et al., on thoracolumbar pin placement, which of the following best explains the design advantage of 3DPGs?

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Correct. 3DPGs were created from CT data and designed for anatomic conformity, enhancing accuracy.
Incorrect. The correct answer is Custom fit based on CT-derived anatomy.
3DPGs were created from CT data and designed for anatomic conformity, enhancing accuracy.

🔍 Key Findings

  • Both free-hand probing (FHP) and 3D-printed guides (3DPG) enabled accurate spinal pin placement, with 87.5% vs 96.4% of pins graded as optimal (Grade I).
  • 3DPGs had fewer intraoperative deviations (0/56 pins) compared to 6/56 with the FHP technique.
  • No pins using either method fully breached the medial vertebral canal (Grade IIb) — a critical safety outcome.
  • Pins placed using 3DPGs required less time overall (mean 2.6 min) than FHP (mean 4.5 min).
  • FHP required specific experience and has a learning curve, whereas 3DPG use requires CAD software and 3D printing access.
  • FHP had more lateral canal violations (Grade IIIa: 4/56 vs 0/56 for 3DPG), suggesting slightly less precision.
  • Both techniques were safe, and all deviations were recognized and corrected intraoperatively.
  • 3DPGs may offer practical advantages in clinical settings lacking surgical expertise, while FHP allows immediate intervention without 3D printing delay.

Mullins

Veterinary Surgery

5

2023

Accuracy of pin placement in the canine thoracolumbar spine using a free-hand probing technique versus 3D-printed patient-specific drill guides: An ex-vivo study

2023-5-VS-mullins-5

Article Title: Accuracy of pin placement in the canine thoracolumbar spine using a free-hand probing technique versus 3D-printed patient-specific drill guides: An ex-vivo study

Journal: Veterinary Surgery

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In Quitzan 2022 et al., on staple line configuration, what was concluded about the vertical staple line?

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Correct. No FEESA constructs leaked from the vertical staple line in the study.
Incorrect. The correct answer is No leakage occurred from this location.
No FEESA constructs leaked from the vertical staple line in the study.

🔍 Key Findings

  • All FEESA configurations leaked at lower pressures than intact segments, confirming reduced integrity vs. native tissue.
  • FEESA with 3-row transverse staples (3V/3T or 2V/3T) had significantly higher leak pressures than 2-row configurations.
  • 3V/3T configuration had the highest ILP (69.88 ± 21.23 mmHg) among all groups, significantly greater than 2V/2T and 3V/2T (P < .001).
  • Leakage consistently occurred at the transverse staple line (not vertical), regardless of configuration.
  • No significant difference in maximum intraluminal pressure (MIP) between FEESA groups.
  • All FEESA constructs withstood intraluminal pressures >25 mmHg, exceeding normal physiological jejunal pressure in dogs.
  • No leaks occurred from the vertical staple line, highlighting it as a more robust closure site.
  • Third staple row in transverse line may be a viable alternative to suture oversew, pending further clinical evaluation.

Quitzan

Veterinary Surgery

5

2022

Influence of staple line number and configuration on the leakage of small intestinal functional end-to-end stapled anastomosis: An ex vivo study

2022-5-VS-quitzan-5

Article Title: Influence of staple line number and configuration on the leakage of small intestinal functional end-to-end stapled anastomosis: An ex vivo study

Journal: Veterinary Surgery

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In Grimes 2022 et al., on PDA rupture risks, what best describes the utility of the Jackson-Henderson technique?

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Correct. Jackson-Henderson eliminates medial dissection, which is beneficial after rupture.
Incorrect. The correct answer is Used to avoid dissecting medial to PDA in rupture cases.
Jackson-Henderson eliminates medial dissection, which is beneficial after rupture.

🔍 Key Findings

  • Rupture occurred in 7.0% of dogs undergoing surgical PDA ligation (20/285).
  • Overall mortality was low (0.4%), with only one death occurring post-rupture.
  • Residual flow occurred in 9.4% of dogs; significantly more common in dogs with rupture.
  • Residual flow odds were not increased when ligation was successfully performed despite rupture.
  • No significant associations between rupture and age, weight, suture size, or dissection technique.
  • Jackson-Henderson and intrapericardial techniques were helpful in managing rupture or fibrosis.
  • Major complications (non-rupture) were rare (1.4%), including pulmonary artery ligation and cardiac arrest.
  • Surgeon preparedness (e.g., hemostatic tools, alternate techniques) was key to successful outcomes.

Grimes

Veterinary Surgery

4

2022

Surgical ligation of patent ductus arteriosus in dogs: Incidence and risk factors for rupture

2022-4-VS-grimes-4

Article Title: Surgical ligation of patent ductus arteriosus in dogs: Incidence and risk factors for rupture

Journal: Veterinary Surgery

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In Longo 2023 et al., on CT trochlear measurements, what difference in FTGA was observed between small and medium/large breed dogs without MPL?

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Correct. Small breed dogs without MPL had significantly greater (shallower) FTGA than medium/large breeds, suggesting breed-specific anatomy.
Incorrect. The correct answer is FTGA was greater (shallower) in SB dogs.
Small breed dogs without MPL had significantly greater (shallower) FTGA than medium/large breeds, suggesting breed-specific anatomy.

🔍 Key Findings

  • Dogs with MPL had significantly shallower femoral trochlear grooves compared to controls, based on CT-measured femoral trochlear groove angle (FTGA).
  • FTGA >134° in small breeds (SB) and >128° in medium/large breeds (MLB) were associated with MPL and can serve as surgical thresholds for considering trochleoplasty.
  • FTA and FTRIA measurements were less reliable, showing lower sensitivity/specificity than FTGA.
  • Inter-rater reliability for FTGA was excellent (ICC > 0.9), supporting its use in clinical decision-making.
  • FTGA differed significantly between SB and MLB dogs, suggesting anatomical variation influences MPL predisposition.
  • Dogs with MPL but with FTGA below threshold may not benefit from trochleoplasty, supporting individualized surgical planning.
  • CT provides more precise and reproducible evaluation of trochlear morphology than radiography or ultrasound.
  • The study introduces a CT protocol using P25 and P50 reference points for consistent FTGA measurement.

Longo

Veterinary Surgery

3

2023

Computed tomographic measurements of the femoral trochlea in dogs with and without medial patellar luxation

2023-3-VS-longo-4

Article Title: Computed tomographic measurements of the femoral trochlea in dogs with and without medial patellar luxation

Journal: Veterinary Surgery

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In Latifi 2024 et al., on fascial mapping in the canine hindlimb, which fascial structure was most suitable as a consistent surgical deep margin in the lateral thigh?

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Correct. The fascia lata was a robust type I sheet suitable for pseudocompartmental resection.
Incorrect. The correct answer is Fascia lata.
The fascia lata was a robust type I sheet suitable for pseudocompartmental resection.

🔍 Key Findings

  • This anatomical study mapped fascial planes of the canine hindlimb and pelvis to aid superficial tumor resection.
  • Type I fascia (discrete sheets) was suitable for deep margins in fascia lata, lateral crus, and gluteal regions.
  • Areas with poor or absent fascia included the ischiorectal fossa, femoral triangle, stifle extensor mechanism, and pes.
  • Type IV fascia associated with periosteum (e.g., patella, tibial tuberosity) required partial ostectomy for inclusion in surgical margins.
  • Nerves at risk during deep dissection included obturator, superficial peroneal, and tibial nerves, particularly in regions with weak fascia.
  • In males, bulbospongiosus muscle could act as a fascial plane but dissection was challenging and potentially hemorrhagic.
  • In females, constrictor vulvae/vestibulae muscles were tightly associated with mucosa, limiting clean resection options.
  • Distal hindlimb resections often lacked a usable fascial plane, suggesting that amputation or adjuvant therapy may be more appropriate.

Latifi

Veterinary Surgery

3

2024

Fascial plane mapping for superficial tumor resection in dogs: Part III – Hindlimb and pelvis

2024-3-VS-latifi-4

Article Title: Fascial plane mapping for superficial tumor resection in dogs: Part III – Hindlimb and pelvis

Journal: Veterinary Surgery

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In Maeta 2022 et al., on total cystectomy in cats, what describes the surgical modification to the ureter for the stomal anastomosis?

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Correct. This fish-mouth design allowed the ureter to match the rectangular skin defect for secure stoma creation.
Incorrect. The correct answer is Two longitudinal incisions forming a fish-mouth aperture.
This fish-mouth design allowed the ureter to match the rectangular skin defect for secure stoma creation.

🔍 Key Findings

  • First reported case of total cystectomy and bilateral cutaneous ureterostomy in a cat using a modified Toyoda technique.
  • Histologically complete tumor resection was achieved, with tumor-free ureter and urethral margins >20 mm.
  • The modified Toyoda technique involved shaping the ureter into a fish-mouth aperture and anastomosing it to a rectangular skin defect for stomal formation.
  • Incontinence was managed using a diaper changed every 6–8 hours, with no dermatological complications.
  • Obstruction of the right ureter occurred 14 months post-op, associated with a subcutaneous nodule at the anastomosis site.
  • Despite incontinence, owner satisfaction and perceived quality of life were high, with the cat living ~16 months post-op.
  • The stents were removed on days 7 (left) and 28 (right) postoperatively, with initial patency maintained until 14 months.
  • This surgical approach may offer palliative or curative benefit for feline trigonal TCC where partial cystectomy is not feasible.

Maeta

Veterinary Surgery

8

2022

Modified Toyoda technique for total cystectomy and cutaneous ureterostomy in a cat

2022-8-VS-maeta-4

Article Title: Modified Toyoda technique for total cystectomy and cutaneous ureterostomy in a cat

Journal: Veterinary Surgery

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Quiz Results

Topic: Anatomy & Surgical Approach
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