Quiz Question

In Zweig 2025 et al., on healed tibial tuberosity avulsion fractures, what conclusion was reached regarding non-surgical management?

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Correct. Non-surgical management resulted in good to excellent outcomes but was associated with medial patellar luxation in some dogs.
Incorrect. The correct answer is It is acceptable but may increase patellar luxation risk.
Non-surgical management resulted in good to excellent outcomes but was associated with medial patellar luxation in some dogs.

🔍 Key Findings

  • Surgically managed TTAF resulted in excellent clinical outcomes at skeletal maturity, with all dogs having normal limb function and no stifle instability.
  • Surgical treatment significantly altered proximal tibial morphology, including decreased tibial plateau angle (TPA) and increased patellar position (PP) compared with the contralateral limb.
  • Axial tibial tuberosity position (TTP-A) increased and transverse position (TTP-T) decreased in surgically treated stifles, indicating distal and caudal tuberosity migration.
  • Non-surgically managed TTAF did not significantly alter tibial morphology or PP, but outcomes were more variable.
  • Medial patellar luxation developed in 2/6 non-surgically treated dogs, whereas none occurred in surgically managed cases.
  • Pins-only and pin–tension band constructs produced similar radiographic changes and outcomes.
  • Despite morphologic changes, no dogs developed cruciate ligament instability at follow-up.
  • Non-surgical management yielded good to excellent owner-reported outcomes, but carried a potential increased risk of patellar luxation.

Zweig

Veterinary and Comparative Orthopaedics and Traumatology

6

2025

Treatment outcome and radiographic appearance of healed tibial tuberosity avulsion fractures in skeletally mature dogs: 21 cases (2016–2023)

2025-6-VCOT-zweig-5

Article Title: Treatment outcome and radiographic appearance of healed tibial tuberosity avulsion fractures in skeletally mature dogs: 21 cases (2016–2023)

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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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 Song 2024 et al., on CT vs cystoscopy for ectopic ureters in dogs, what did the authors conclude regarding CT's role in surgical planning?

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Correct. CT misclassified too many dogs to serve as the sole diagnostic tool; cystoscopy is recommended for confirmation.
Incorrect. The correct answer is CT should be confirmed with cystoscopy.
CT misclassified too many dogs to serve as the sole diagnostic tool; cystoscopy is recommended for confirmation.

🔍 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-5

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 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 Kalmukov 2022 et al., on cell salvage efficacy, what was the average red blood cell mass (rbcM) recovery percentage?

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Correct. Swab washing recovered an average of 84.74% of rbcM.
Incorrect. The correct answer is 84.7%.
Swab washing recovered an average of 84.74% of rbcM.

🔍 Key Findings

  • Direct suction salvaged more red blood cell mass (rbcM) than swab washing: 88.43% vs 84.74% (p = .015)
  • Swab washing still achieved high recovery (84.74%), making it a viable adjunct when suction is not possible
  • No significant difference in post-salvage PCV between methods (~34% for Su and ~33.9% for Sw)
  • Total salvaged blood volume was significantly higher using direct suction (143 mL vs 139.8 mL; p < .001)
  • Leukocytes are removed during salvage, potentially lowering risk of cytokine-mediated transfusion reactions
  • Expired pRBCs were used, but device still achieved high RBC recovery, supporting clinical utility
  • Swab washing via manual agitation may cause more RBC destruction than direct suction
  • Cell salvage may avoid complications of allogeneic transfusions, like storage lesions and immunologic reactions

Kalmukov

Veterinary Surgery

8

2022

Ex vivo evaluation of a novel cell salvage device to recover canine erythrocytes

2022-8-VS-kalmukov-2

Article Title: Ex vivo evaluation of a novel cell salvage device to recover canine erythrocytes

Journal: Veterinary Surgery

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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 Kalmukov 2022 et al., on cell salvage efficacy, what was the mean percentage of red blood cell mass (rbcM) recovered using direct suction?

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Correct. Direct suction recovered a mean of 88.43% of the red blood cell mass.
Incorrect. The correct answer is 88.4%.
Direct suction recovered a mean of 88.43% of the red blood cell mass.

🔍 Key Findings

  • Direct suction salvaged more red blood cell mass (rbcM) than swab washing: 88.43% vs 84.74% (p = .015)
  • Swab washing still achieved high recovery (84.74%), making it a viable adjunct when suction is not possible
  • No significant difference in post-salvage PCV between methods (~34% for Su and ~33.9% for Sw)
  • Total salvaged blood volume was significantly higher using direct suction (143 mL vs 139.8 mL; p < .001)
  • Leukocytes are removed during salvage, potentially lowering risk of cytokine-mediated transfusion reactions
  • Expired pRBCs were used, but device still achieved high RBC recovery, supporting clinical utility
  • Swab washing via manual agitation may cause more RBC destruction than direct suction
  • Cell salvage may avoid complications of allogeneic transfusions, like storage lesions and immunologic reactions

Kalmukov

Veterinary Surgery

8

2022

Ex vivo evaluation of a novel cell salvage device to recover canine erythrocytes

2022-8-VS-kalmukov-1

Article Title: Ex vivo evaluation of a novel cell salvage device to recover canine erythrocytes

Journal: Veterinary Surgery

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In de Moya 2023 et al., on FGPP of femoral capital physeal/neck fractures, what was the most common preoperative fracture displacement classification?

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Correct. 10 of 13 fractures were mildly displaced preoperatively, making them good candidates for FGPP.
Incorrect. The correct answer is Mild in majority of cases.
10 of 13 fractures were mildly displaced preoperatively, making them good candidates for FGPP.

🔍 Key Findings

  • 11 dogs, 13 fractures (mostly Salter-Harris type I) were repaired with FGPP using Kirschner wires.
  • 10/13 fractures achieved satisfactory healing with good limb function at ~43 days median follow-up.
  • Major complications occurred in 5 dogs: intra-articular pin placement, implant migration (2), implant failure with nonunion, and malunion.
  • 2 dogs presenting >15 days post-injury with radiographic remodeling were poor candidates → higher risk of nonunion/malunion.
  • Preoperative displacement was mostly mild (10/13 fractures); these had better outcomes than chronic or severely displaced cases.
  • Median surgical time: 60 minutes (range 45–75), all performed percutaneously without conversion to open.
  • Elective pin removal was performed in 5 cases; migration occurred with both short and long cut wires.
  • Femoral neck resorption (“apple-coring”) was rare (2/10 healed cases) and thought to be less frequent than after ORIF due to reduced vascular disruption.

de Moya

Veterinary Surgery

7

2023

Closed reduction and fluoroscopic-guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs

2023-7-VS-demoya-3

Article Title: Closed reduction and fluoroscopic-guided percutaneous pinning of femoral capital physeal or neck fractures: Thirteen fractures in 11 dogs

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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In Power 2022 et al., on liposomal bupivacaine use, what was concluded about its use in off-label orthopedic procedures?

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Correct. The study found no significant difference in complication rates between labeled and off-label orthopedic uses.
Incorrect. The correct answer is It appeared safe.
The study found no significant difference in complication rates between labeled and off-label orthopedic uses.

🔍 Key Findings

  • Overall complication rate was 19.7% (43/218), with most being mild (CSS 1).
  • Soft tissue procedures had higher complication rates (26%) than orthopedic procedures (11.6%) (P < 0.01).
  • No difference in complication rates between clean, clean-contaminated, and contaminated wounds (P = 0.55).
  • No difference in complication rates between labeled use (CCL surgery) and off-label orthopedic procedures (P = 0.21).
  • Majority of complications (63%) were mild, resolving without intervention or with topical therapy.
  • Severe complications requiring revision surgery were rare (2.3%) and occurred mainly in soft-tissue surgeries.
  • Most common complications included SSI (25.6%), dehiscence (16.3%), and seroma (14%).
  • Liposomal bupivacaine appears safe for use in broader orthopedic procedures beyond current labeling.

Power

Veterinary Surgery

4

2022

Incidence and severity of short‐term incisional complications after intraoperative local infiltration of liposomal bupivacaine in dogs

2022-4-VS-power-3

Article Title: Incidence and severity of short‐term incisional complications after intraoperative local infiltration of liposomal bupivacaine in dogs

Journal: Veterinary Surgery

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Quiz Results

Topic: Conservative vs Surgical
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