Quiz Question

In Healy 2025 et al., on incidental PBBs, what recommendation is made regarding prophylactic lung resection?

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Correct. With no SP observed, authors do not recommend prophylactic lung removal for incidental PBBs.
Incorrect. The correct answer is Not justified based on study data.
With no SP observed, authors do not recommend prophylactic lung removal for incidental PBBs.

🔍 Key Findings

Population: 2,178 canine CTs reviewed retrospectively.
Prevalence: Incidental PBBs found in 1.37% (30/2178).
Outcome: None of the dogs with incidental PBBs developed clinical spontaneous pneumothorax (SP) over a median follow-up of 1255 days.
Significant Associations:

  • Age: Dogs with PBBs were significantly older (median 10.5 yrs vs. 8.2 yrs, p = .001).
  • CT indication: PBBs more likely during neoplastic staging (p = .006).

PBB Characteristics:

  • Total = 60 PBBs (median 1/dog; range 1–7).
  • Location: 35% in left caudal, 31.6% right caudal, only 13.3% in right cranial lobe.
  • Size-based: 25 bullae (>10 mm), 35 blebs (≤10 mm).

Conclusion: Prophylactic resection of incidental PBBs not justified given no observed SP risk in this population.

Healy

Veterinary Surgery

1

2025

Significance of incidentally identified bullae and blebs on thoracic computed tomography and prevalence of subsequent pneumothorax in dogs

2025-1-VS-healy-3

Article Title: Significance of incidentally identified bullae and blebs on thoracic computed tomography and prevalence of subsequent pneumothorax in dogs

Journal: Veterinary Surgery

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In Song 2024 et al., on CT vs cystoscopy for ectopic ureters in dogs, what percentage of dogs with normal ureters were missed by CT?

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Correct. CT correctly identified all ectopic ureters in 91% but missed half of normal ureters, limiting its negative predictive value.
Incorrect. The correct answer is 50%.
CT correctly identified all ectopic ureters in 91% but missed half of normal ureters, limiting its negative predictive value.

🔍 Key Findings

  • CT correctly identified ectopic ureters in 91% of dogs, but missed 50% of normal ureters, limiting its negative predictive value.
  • Sensitivity for intramural ectopic ureters was 65%, while specificity was 71%, indicating moderate diagnostic performance.
  • Sensitivity for extramural ectopic ureters was only 29%, despite a high specificity of 97%.
  • CT was inaccurate in predicting ureteral orifice location, with sensitivity ranging from 0% to 76% depending on the site.
  • 26% of dogs were misclassified for cystoscopic laser ablation (CLA) eligibility based on CT findings alone.
  • Overall CT accuracy for CLA candidacy was 74%, but a significant minority would have been inappropriately treated.
  • Multivariate analysis found no predictive factors (e.g., colon distension, body weight) for when CT would be incorrect.
  • Authors recommend confirmatory cystoscopy to verify CT findings prior to treatment planning.

Song

Veterinary Surgery

3

2024

Receiver operating characteristics of computed tomography (CT) compared to cystoscopy in diagnosis of canine ectopic ureters: Thirty-five cases

2024-3-VS-song-1

Article Title: Receiver operating characteristics of computed tomography (CT) compared to cystoscopy in diagnosis of canine ectopic ureters: Thirty-five cases

Journal: Veterinary Surgery

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In Matz 2022 et al., on stapler size comparison, what is the clinical significance of the finding that all stapler groups had ILPs exceeding 25 mmHg?

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Correct. The study used 25 mmHg as a reference threshold; all stapler groups exceeded this, suggesting functional closure under physiological conditions.
Incorrect. The correct answer is They exceed normal intraluminal pressures in dogs.
The study used 25 mmHg as a reference threshold; all stapler groups exceeded this, suggesting functional closure under physiological conditions.

🔍 Key Findings

  • No significant difference in initial leak pressure (ILP) among TA 30 V3 2.5 mm, TA 60 3.5 mm, and TA 60 4.8 mm stapler sizes (P = .78).
  • All stapler types exceeded the physiological intraluminal pressure threshold (~25 mmHg), suggesting acceptable leak resistance.
  • Mean ILPs: TA 30 V3 (181.5 mmHg), TA 60 3.5 mm (112 mmHg), TA 60 4.8 mm (77.2 mmHg).
  • Leakage occurred at the staple line in 23 of 24 specimens; only one had ileal wall rupture.
  • No correlation found between ILP and cadaver weight, cecal wall thickness, or cecal length.
  • Cecal wall thickness averaged 4.9 mm, yet staple heights ranged only from 1.0–2.0 mm.
  • One specimen in each TA 60 group leaked near or below physiologic pressures, suggesting rare outliers.
  • Study supports clinical viability of all tested stapler sizes for canine typhlectomy, but highlights need for in vivo data on healing and complications.

Matz

Veterinary Surgery

4

2022

Ex vivo comparison of different thoracoabdominal stapler sizes for typhlectomy in canine cadavers

2022-4-VS-matz-4

Article Title: Ex vivo comparison of different thoracoabdominal stapler sizes for typhlectomy in canine cadavers

Journal: Veterinary Surgery

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In Lhuillery 2022 et al., on GDV stabilization timing, which preoperative intervention was key to enabling delayed surgery without compromising outcomes?

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Correct. These methods effectively decompressed the stomach and prevented redilatation during delay.
Incorrect. The correct answer is Trocarization and nasogastric tube placement.
These methods effectively decompressed the stomach and prevented redilatation during delay.

🔍 Key Findings

  • Survival rates did not differ between immediate (90 min) and delayed (≥5 h) surgical stabilization groups at discharge or 1-month post-op (approx. 80% survival in both).
  • Hyperlactatemia at 24 hours post-fluid therapy was significantly associated with in-hospital and 1-month mortality (P = .01 and P = .02).
  • Persistent tachycardia during hospitalization was linked to increased 1-month mortality (P = .015).
  • Partial gastrectomy was required in ~6–10% of cases, with high associated mortality.
  • Preoperative stabilization protocols (trocarization, nasogastric tube) allowed safe surgical delays up to 13.7 hours without impacting survival.
  • Degree of gastric torsion differed between groups; more 0° torsions in delayed cases, potentially due to decompression-induced derotation.
  • No difference in post-op complications such as arrhythmias, hypotension, or AKI between groups.
  • More intra-anesthetic deaths occurred in immediate surgery group, highlighting importance of adequate pre-op stabilization.

Lhuillery

Veterinary Surgery

5

2022

Outcomes of dogs undergoing surgery for gastric dilatation volvulus after rapid versus prolonged medical stabilization

2022-5-VS-lhuillery-3

Article Title: Outcomes of dogs undergoing surgery for gastric dilatation volvulus after rapid versus prolonged medical stabilization

Journal: Veterinary Surgery

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In Cola 2024 et al., on laparotomy-assisted endoscopy, what was the primary factor associated with the need to convert to enterotomy?

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Correct. Intestinal wall damage was significantly associated with surgical conversion (p = .043).
Incorrect. The correct answer is Intestinal wall damage.
Intestinal wall damage was significantly associated with surgical conversion (p = .043).

🔍 Key Findings

  • LAER was effective (partial or complete) in 35/40 cases, regardless of FB location or type.
  • Intestinal wall damage significantly increased the likelihood of conversion to enterotomy (p = .043).
  • LAER led to significantly shorter hospitalization (median 48 h vs 72 h; p = .006).
  • Patients in the LAER group required less postoperative analgesia (median 36 h vs 48 h; p < .001).
  • Faster return to spontaneous feeding was seen in LAER group (median 24 h vs 36 h; p = .012).
  • No significant difference in complication rate or postoperative ileus between LAER and enterotomy groups.
  • Sharp, linear, or multiple FBs did not significantly affect LAER effectiveness.
  • Conversion to surgery was required in 5/40 LAER attempts, mostly due to immovable FBs or intestinal damage.

Cola

Veterinary Surgery

7

2024

Laparotomy‐assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats

2024-7-VS-cola-1

Article Title: Laparotomy‐assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats

Journal: Veterinary Surgery

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In Winston 2023 et al., on LES-AS surgery outcomes, which preoperative treatment was discontinued postoperatively in all dogs?

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Correct. Oral sildenafil was stopped after surgery, supporting the idea that surgical treatment alone was effective in maintaining clinical improvement.
Incorrect. The correct answer is Sildenafil.
Oral sildenafil was stopped after surgery, supporting the idea that surgical treatment alone was effective in maintaining clinical improvement.

🔍 Key Findings

  • Modified Heller myotomy with Dor fundoplication improved vomiting/regurgitation scores by 180%, QoL by 100%, and owner-perceived body weight by 63% (P < .05).
  • 6 of 9 dogs with postoperative VFSS showed objective improvement in gastric filling scores; others remained stable.
  • Oral sildenafil was discontinued postoperatively in all dogs, indicating surgical success comparable to medical management.
  • 12 of 13 dogs survived to discharge; one dog was euthanized due to aspiration pneumonia postoperatively.
  • 50% of dogs experienced gastrostomy tube complications, higher than reported in previous literature.
  • Most complications were gastrostomy-tube related, with some requiring surgical correction (e.g., tube migration, leakage).
  • Feeding strategies (Bailey chair, elevated bowls) and food consistency (gruel/liquid) remained essential postoperatively to control regurgitation.
  • 9 of 11 owners would opt for the surgery again; those who wouldn’t cited risk or lack of efficacy.

Winston

Veterinary Surgery

2

2023

Management and outcomes of 13 dogs treated with a modified Heller myotomy and Dor fundoplication for lower esophageal sphincter achalasia-like syndrome

2023-2-VS-winston-4

Article Title: Management and outcomes of 13 dogs treated with a modified Heller myotomy and Dor fundoplication for lower esophageal sphincter achalasia-like syndrome

Journal: Veterinary Surgery

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In González Montaño 2023 et al., on traumatic pulmonary pseudocysts (TPP), which management strategy was used in the majority of TPP cases?

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Correct. Most (7/10) cases were managed conservatively with full recovery.
Incorrect. The correct answer is Conservative management with monitoring.
Most (7/10) cases were managed conservatively with full recovery.

🔍 Key Findings

  • Traumatic pulmonary pseudocysts (TPP) were diagnosed in 11 patients (9 dogs, 2 cats) using CT after blunt trauma.
  • TPPs were identified on radiographs in 64% of cases that were CT-confirmed, highlighting the superior sensitivity of CT.
  • Most cases (7/10) were managed conservatively, with complete recovery and no TPP-related mortality.
  • Thoracic surgery (lung lobectomy) was performed in 3 dogs, due to persistent pneumothorax or large TPP with perceived risk of complications.
  • All pneumothorax cases were managed with thoracostomy tubes, and chest drains were used in 73% of cases.
  • Pneumothorax was present in 100% of patients, often bilateral, and pulmonary contusions were reported in 73%.
  • One cat was euthanized due to unrelated maxillofacial trauma; no deaths were attributed to TPP itself.
  • Long-term follow-up (median 768 days) revealed only 1 case with possible TPP-related pneumonia; others had no complications.

González Montaño

Veterinary Surgery

4

2023

Traumatic pulmonary pseudocysts in nine dogs and two cats

2023-4-VS-gonzalezmontano-3

Article Title: Traumatic pulmonary pseudocysts in nine dogs and two cats

Journal: Veterinary Surgery

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In Ibrahim 2022 et al., on scrotal arterial supply, what was concluded regarding the use of scrotal flaps in neutered dogs?

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Correct. Neutered or cryptorchid dogs may have insufficient scrotal tissue for reliable flap design.
Incorrect. The correct answer is Scrotum may be too small or absent.
Neutered or cryptorchid dogs may have insufficient scrotal tissue for reliable flap design.

🔍 Key Findings

  • Dorsal scrotal arteries, branching from the ventral perineal arteries, are the dominant arterial supply to the scrotum in dogs.
  • The ventral scrotal arteries, arising from the external pudendal arteries, perfused only the cranial scrotal border and were inconsistently present or absent in some dogs.
  • A scrotal flap based on the dorsal scrotal arteries showed strong perfusion and may be a viable axial pattern flap.
  • Perfusion was consistent across fresh and frozen cadavers, showing no difference due to preservation method.
  • Poor flap survival (27%) occurred when based on cranial supply alone (i.e., ventral scrotal arteries), confirming importance of preserving caudal supply.
  • There are anastomoses between dorsal and ventral scrotal arteries, offering collateral flow but insufficient alone for complete perfusion.
  • Scrotal flaps based on the caudal pedicle may be applicable for reconstruction of proximal medial/lateral thigh wounds.
  • Proposed flap requires careful preservation of ventral perineal arteries, ideally designed 2.5–3 cm lateral to midline in large dogs.

Ibrahim

Veterinary Surgery

4

2022

Arterial supply to the scrotum: A cadaveric angiographic study

2022-4-VS-ibrahim-4

Article Title: Arterial supply to the scrotum: A cadaveric angiographic study

Journal: Veterinary Surgery

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In Korchek 2025 et al., on fracture gap risk, how did absence of external coaptation affect implant failure risk?

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Correct. Absence of external coaptation was significantly associated with implant failure (OR = 10.1, p = .04).
Incorrect. The correct answer is It increased the risk of implant failure.
Absence of external coaptation was significantly associated with implant failure (OR = 10.1, p = .04).

🔍 Key Findings

80 toy breed dogs with surgically repaired transverse radius/ulna fractures were analyzed.
Fracture gap in the caudal cortex was present in 46% of cases.
Implant failure rate:

  • 27% in cases with fracture gap
  • 2% in cases without fracture gap

Fracture gap significantly associated with implant failure:

  • OR = 23.0, 95% CI: 2.7–197.9, p = 0.004

Absence of external coaptation also associated with increased implant failure risk:

  • OR = 10.1, 95% CI: 1.1–89.6, p = 0.04

Prolonged external coaptation (>1 week) linked to non-implant complications (skin wounds, osteopenia, osteomyelitis):

  • OR = 5.4, p = 0.04

Plate thickness, type, open screw holes, and working length were not statistically significant predictors of implant failure after multivariable analysis.

Korchek

Veterinary Surgery

2

2025

Association of fracture gap with implant failure in radius and ulna fractures in toy breed dogs—A multicenter retrospective cohort study

2025-2-VS-korchek-4

Article Title: Association of fracture gap with implant failure in radius and ulna fractures in toy breed dogs—A multicenter retrospective cohort study

Journal: Veterinary Surgery

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In Low 2025 et al., on gonadectomy and CrCLD, which subgroup comparison showed no significant increase in CrCLD risk?

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Correct. Subgroup analysis showed no significant increase in CrCLD odds in dogs neutered after 1 year of age compared to intact dogs.
Incorrect. The correct answer is Dogs gonadectomized >1 year vs entire dogs.
Subgroup analysis showed no significant increase in CrCLD odds in dogs neutered after 1 year of age compared to intact dogs.

🔍 Key Findings

Increased risk with gonadectomy:

  • Pooled OR for CrCLD:
    • Females: 2.29 (95% CI: 1.77–2.95)
    • Males: 2.12 (95% CI: 1.67–2.69)

Early gonadectomy (≤1 year) further increased risk:

  • OR vs >1 year:
    • Females: 3.39
    • Males: 3.13

Late gonadectomy (>1 year) had no significant difference vs intact dogs.

Breed-specific findings:

  • Female Labradors: No increased CrCLD risk from gonadectomy (OR = 1.19; 95% CI: 0.54–2.64)
  • Male Labradors: Increased risk persisted (OR = 2.13; 95% CI: 1.53–2.98)

Study type: Systematic review + meta-analysis of 24 observational studies (n = 1.85 million dogs)

Low

Veterinary Surgery

2

2025

The association between gonadectomy and timing of gonadectomy, and the risk of canine cranial cruciate ligament disease: A systematic review and meta-analysis

2025-2-VS-low-5

Article Title: The association between gonadectomy and timing of gonadectomy, and the risk of canine cranial cruciate ligament disease: A systematic review and meta-analysis

Journal: Veterinary Surgery

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Quiz Results

Topic: Conservative vs Surgical
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