Quiz Question
In Enright 2022 et al., on adrenalectomy outcomes, which postoperative complication occurred in dogs and may support use of anticoagulants in hypertensive cases?
🔍 Key Findings
- 83% of dogs survived to discharge after adrenalectomy for pheochromocytoma.
- Median survival time post-discharge was 1169 days (3.2 years).
- Preoperative alpha-blocker therapy (e.g., phenoxybenzamine) was not associated with improved survival.
- Dogs receiving alpha-blockers had higher intraoperative systolic BP, with median values 170 mmHg vs. 142 mmHg in non-treated dogs (P = .01).
- Intraoperative arrhythmias occurred in 30% of cases, with no difference between dogs receiving alpha-blockers and those not.
- Histologic vascular invasion occurred in ~70% of tumors.
- Tumor recurrence was suspected in 3 dogs, and metastasis in 8 dogs, though not histologically confirmed in most cases.
- Postoperative complications included refractory hypotension, acute kidney injury, and hypertension persisting >48 hours in 10 dogs.
Veterinary Surgery
3
2022
Short‐ and long‐term survival after adrenalectomy in 53 dogs with pheochromocytomas with or without alpha‐blocker therapy
2022-3-VS-enright-5
In Fracka 2024 et al., on perioperative risk factors, which clinical feature had the strongest association with poor recovery outcomes?
🔍 Key Findings
- Staphylectomy was linked to higher risk of complicated recovery than folded flap palatoplasty (OR = 59.29, p = .0002).
- Laryngeal collapse > Grade 2 was strongly associated with poor recovery (OR = 97.13, p < .0001).
- Longer general anesthesia duration increased the risk of complications (OR = 1.01 per min, p = .0051).
- Increasing age significantly raised the odds of perioperative complication (OR = 1.04 per month, p = .0113).
- History of aspiration pneumonia was only found in dogs with complications, though not in final model due to instability.
- Complicated recovery included >12 h O₂ therapy, tracheostomy, or death.
- FFP may reduce pharyngeal-laryngeal edema, possibly improving immediate outcomes.
- Bulldogs comprised 80% of population, with French Bulldogs most common (63%).
Veterinary Surgery
4
2024
Risk factors for complicated perioperative recovery in dogs undergoing staphylectomy or folded flap palatoplasty: Seventy-six cases (2018–2022)
2024-4-VS-fracka-2
In Billas 2022 et al., on SSI risk after limb amputation, which muscle transection method was associated with increased infection odds?
🔍 Key Findings
- 12.5% overall incidence of SSI after limb amputation, and 10.9% for clean procedures.
- Bipolar vessel sealing device use for muscle transection significantly increased SSI risk (OR 2.5; P = .023).
- Monopolar electrosurgery and sharp transection were not associated with increased SSI risk.
- Non-clean wound classification increased SSI odds (OR 8.2; P = .003).
- Amputation for infection (OR 5.7) or trauma (OR 4.5) significantly increased SSI risk compared to neoplasia.
- Preoperative infections at distant sites did not significantly increase SSI risk.
- Neither surgery/anesthesia duration, hypothermia, hypotension, nor skin closure method significantly affected SSI risk.
- Study supports avoiding bipolar sealing devices for muscle transection in limb amputations to reduce SSI risk.
Veterinary Surgery
3
2022
Incidence of and risk factors for surgical site infection following canine limb amputation
2022-3-VS-billas-1
In Israel 2023 et al., on povidone-iodine lavage, what was the calculated break-even cost for the PrePIL protocol?
🔍 Key Findings
- No infections (0/102) occurred in cases where preclosure povidone-iodine lavage (PrePIL) was used, compared to 21/2111 (0.99%) with saline lavage.
- Break-even cost for PrePIL was calculated at $49.74, while the actual cost was only $2.07, confirming strong cost-effectiveness.
- No adverse reactions or healing complications were reported in the 102 PrePIL cases.
- The PrePIL protocol used 0.35% povidone-iodine for 3 minutes before closure, followed by sterile saline lavage.
- Majority of THRs (97%) used cementless fixation (BFX) in PrePIL group; only 3 cases used CFX components.
- Surgeries followed consistent perioperative antibiotic protocols, making PrePIL the only major protocol variable.
- Antibiotics were not added to lavage, aligning with WHO and CDC guidelines for antimicrobial stewardship.
- The infection reduction with PrePIL supports routine use in total hip replacement to reduce periprosthetic joint infections.
Veterinary Surgery
1
2023
Preclosure povidone‐iodine lavage in total hip replacement surgery: Infection outcomes and cost–benefit analysis
2023-1-VS-israel-2
In Cruciani 2022 et al., on feline pancreaticoduodenostomy, what was the final histopathologic diagnosis following euthanasia?
🔍 Key Findings
- Left pancreaticoduodenostomy successfully restored digestive continuity after right lobe and body pancreatectomy in a cat.
- No clinical signs of exocrine or endocrine insufficiency were observed postoperatively up to 225 days.
- Histopathology confirmed chronic pancreatitis with abscess formation and reactive lymphadenopathy.
- No postoperative pancreatitis developed, based on imaging and normal feline pancreatic lipase levels.
- Progressive focal ampulla-like dilation of the pancreatic duct occurred near the anastomosis without clinical signs.
- The cat maintained weight and improved clinically for several months post-op, indicating satisfactory outcomes.
- Surgical technique involved end-to-side anastomosis between the left pancreatic duct and duodenum.
- Ultimately, the cat was euthanized due to disseminated carcinoma, presumed unrelated to the pancreatic surgery.
Veterinary Surgery
8
2022
Left pancreaticoduodenostomy after removal of the right lobe and the head of the pancreas in a cat
2022-8-VS-cruciani-3
In Carvajal 2023 et al., on serum biomarkers post-THA, which statement best describes SAA trends after surgery?
🔍 Key Findings
- C-reactive protein (CRP) and serum amyloid A (SAA) levels remained low at 3 and 6 months after uncomplicated THA in dogs.
- No significant differences were observed in CRP or SAA between preoperative, 3-month, and 6-month time points.
- Mean CRP values were 3.8 mg/L pre-op, 0.8 mg/L at 3 months, and 1.4 mg/L at 6 months.
- Mean SAA values were 13.9 mg/L pre-op, 14.1 mg/L at 3 months, and 18.4 mg/L at 6 months.
- All dogs recovered normally with no complications or persistent signs of inflammation at follow-up.
- Study establishes baseline CRP and SAA levels for dogs post-THA, useful for comparison in suspected PJI.
- These markers may help differentiate periprosthetic joint infection (PJI) if values deviate from baseline post-THA.
- NSAID therapy was discontinued by 6 months in all dogs, possibly reflecting decreased inflammation.
Veterinary Surgery
1
2023
Serum acute-phase protein concentrations following uncomplicated total hip arthroplasty in dogs
2023-1-VS-carvajal-2
In Glenn 2024 et al., on client-based SSI surveillance, which of the following statements best describes Algorithm 1?
🔍 Key Findings
- Algorithm 3 had the highest overall accuracy (95.5%) in diagnosing SSIs from client questionnaires.
- Active surveillance identified 19.4% more SSIs compared to passive surveillance alone.
- SSI rate was 8.22% across 754 surgeries; 33.9% of SSIs required revision surgery.
- Client-based responses were 37.9% more frequent than those from referring veterinarians.
- Deep/implant SSIs could be missed if not associated with visible wound healing problems.
- Two late SSIs (after 90 days) occurred, both linked to implant surgeries.
- Algorithm 1 was the most sensitive (87.1%) but less specific; useful for screening.
- Algorithm 2 had the highest specificity (97.9%); useful as a “rule-in” diagnostic method.
Veterinary Surgery
8
2024
Evaluation of a client questionnaire at diagnosing surgical site infections in an active surveillance system
2024-8-VS-glenn-3
In Bergen 2024 et al., on biliary stent use, what complication occurred only in cats long-term?
🔍 Key Findings Summary
- Subjects: 11 animals (8 dogs, 3 cats)
- Technique: Uncovered balloon-expandable metallic biliary stents (BEMBS)
- Indications: Cholelithiasis, strictures, neoplasia, cholangiohepatitis, etc.
- Success: Patency achieved in all animals surviving to discharge
- Complications:
- Short-term mortality: 2/11 (1 euthanized for SIRS, 1 unknown)
- Long-term issues: cholangiohepatitis, choledocholithiasis, stent occlusion (in cats only)
- Long-term patency:
- Dogs: median 650.5 days
- Cats: median 446 days
- Stent removal possible even after >600 days in some cats
- Clinical outcome: Viable alternative to plastic stents or cholecystoenterostomy
Veterinary Surgery
2
2024
Clinical use of uncovered balloon‐expandable metallic biliary stents for treatment of extrahepatic biliary tract obstructions in cats and dogs: 11 cases (2012–2022)
2024-2-VS-bergen-4
In Janas 2024 et al., on ARC outcomes in cats, what best describes the relationship between seizures and postoperative bloodwork?
🔍 Key Findings:
- Study design: Retrospective, 20 cats with congenital EHPSS treated with ameroid ring constrictor (ARC).
- Perioperative complication rate: 25% (5/20), including seizures, blindness, ascites, and one death.
- Short-term outcomes (18 cats):
- Excellent: 14
- Good: 2
- Poor: 2
- Long-term outcomes (18 cats):
- Excellent: 15
- Good: 1
- Poor: 2
- Persistent seizures: Noted in some cats despite normal bile acids and CBC/chemistry.
- Preoperative blindness resolved in most cats.
- Mean follow-up duration: Median 8 years.
Veterinary Surgery
2
2024
Clinical outcomes for 20 cats with congenital extrahepatic portosystemic shunts treated with ameroid constrictor ring attenuation (2002–2020)
2024-2-VS-janas-5
In Welker 2024 et al., on thoracic duct anastomosis with MAC device, what percentage of dogs had patent anastomoses at 30 days?
🔍 Key Findings
- Anastomosis of the thoracic duct (TD) to the intercostal vein (ICV) using a microvascular anastomotic coupler (MAC) was feasible in all 6 healthy dogs
- Immediate postoperative patency was confirmed in all dogs, but only 4/6 had patent anastomoses at 30 days, with 2 failing due to ICV kinking
- Kinking of the ICV near the azygos vein insertion was the primary failure mechanism, likely from MAC malalignment
- No intraoperative or major postoperative complications occurred, though 2 dogs developed mild seromas
- Use of the MAC device simplified microsurgical anastomosis versus hand suturing, especially in the deep thoracic cavity
- Contrast lymphangiography showed faster clearance from the cisterna chyli postoperatively, suggesting effective flow redirection
- Persistent branches of the thoracic duct may impact outcomes, and should be ligated during surgery
- This technique may be a potential novel treatment for idiopathic chylothorax, improving outcomes by reducing collateral flow stimuli
Veterinary Surgery
7
2024
Anastomosis of the caudal thoracic duct and intercostal vein using a microvascular anastomotic coupler device: Experimental study in six dogs
2024-7-VS-welker-2
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings