Quiz Question
In Israel 2022 et al., on cerclage wire in THR, which of the following statements about cerclage wire outcomes is CORRECT?
🔍 Key Findings
- No proximal femoral fractures occurred in any of the 184 hips with cerclage wire placement
- Cerclage wire was well tolerated, with no failures or complications related to the wire
- Application of a single cerclage wire took <10 minutes, was cost-effective, and required minimal instrumentation
- 3 postoperative complications (1 fissure, 2 fractures) occurred distal to the cerclage site, near the stem tip, requiring plate/screw fixation
- All dogs returned to normal activity, and all owners were satisfied with the outcome
- Cerclage placement location is critical—must be proximal to the lesser trochanter and close to the calcar to resist hoop strain
- Biomechanical evidence supports that cerclage wires improve resistance to hoop strain and subsidence of cementless stems
- Press-fit cementless stems may settle, but when supported by cerclage, this does not result in fractures even in undersized implants
Veterinary Surgery
2
2022
Outcome of canine cementless collared stem total hip replacement with proximal femoral periprosthetic cerclage application: 184 consecutive cases
2022-2-VS-israel-3
In Devriendt 2022 et al., on EHPSS blood testing, which single test had the highest **specificity** for confirming shunt closure after surgery?
🔍 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.
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-1
In O'Marra 2026 et al., on perioperative septic peritonitis, which of the following is a recommended strategy to mitigate intra-abdominal hypertension in at-risk veterinary patients?
🔍 Key Findings
- Early enteral nutrition (<24–48 hrs) is associated with improved survival and reduced hospitalization in dogs with septic peritonitis.
- Appropriate empirical antimicrobials improve survival in cats, but data are mixed in dogs.
- Recurrent septic peritonitis (RecSP) has poor survival (0%–43.9%); most common cause is gastrointestinal dehiscence.
- Intraoperative hypotension and preoperative hypoalbuminemia may increase dehiscence risk, though findings are inconsistent.
- Lidocaine CRI during surgery improves survival over opioids alone in dogs.
- Hydroxyethyl starch (HES) is not recommended due to risks of coagulopathy and kidney injury; albumin use is controversial.
- Intra-abdominal hypertension (IAH) is under-recognized but contributes to mortality; IAP monitoring should be considered.
- Diagnostic tests (effusion lactate, glucose, cytology) are unreliable for detecting RecSP; clinical judgment and ultrasound are advised.
Veterinary Surgery
1
2026
Perioperative management of septic peritonitis in small animals: A review
2026-1-VS-omarra-5
In Hertel 2025 et al., on portal venotomy for insulinoma, what was the primary reason the authors selected portal venotomy instead of en bloc vessel resection?
🔍 Key Findings
- Portal venotomy enabled successful en bloc resection of a pancreatic insulinoma and associated thrombus in the portal vein, a novel approach in veterinary literature.
- Temporary portal vein occlusion (15 min) was well tolerated, causing only transient small intestinal congestion without lasting hemodynamic compromise.
- No intraoperative hemorrhage occurred following vascular isolation and venotomy repair with 5–0 polypropylene in a simple continuous pattern.
- Postoperative complications were minimal, with only moderate pancreatitis managed medically and no portal hypertension observed on follow-up imaging.
- Histopathology confirmed insulinoma, with no initial metastasis; CT at 6 months revealed hepatic and peritoneal metastases but no local recurrence at the venotomy site.
- Portal vein luminal stenosis occurred post-repair but was clinically insignificant.
- Advanced CT imaging and 3D printed modeling significantly enhanced surgical planning and anatomical assessment.
- Surgical excision achieved good short-term outcomes, and the dog was alive and euglycemic one year later despite metastatic disease.
Veterinary Surgery
5
2025
Successful venotomy for portal tumor thrombus removal due to pancreatic carcinoma in a dog
2025-5-VS-hertel-1
In You 2025 et al., on barbed sutures for lung lobectomy, what was the observed leakage rate at physiological airway pressure (<20 cmH₂O)?
🔍 Key Findings
- Barbed sutures showed comparable leakage pressure to traditional sutures and stapling devices (p = .36).
- No bronchial leaks occurred at physiological pressure (<20 cmH₂O) in any group.
- Leakage at supraphysiologic pressure (20–80 cmH₂O) occurred in 90% of stapler, 80% of traditional, and 60% of barbed suture closures.
- Barbed sutures reduced ligation time significantly compared to traditional sutures (10.7 vs. 14.1 minutes, p < .01).
- Staplers remained fastest, with mean ligation time of 2.4 minutes.
- No knot failure or suture breakage was observed in barbed or traditional suture groups.
- Leakage in barbed sutures occurred mostly at the loop effector zone, but remained within acceptable limits.
- Barbed sutures may offer an effective alternative when staplers are unavailable, impractical, or cost-prohibitive.
Veterinary Surgery
7
2025
Evaluation of a knotless barbed suture for canine total lung lobectomy: An ex vivo study
2025-7-VS-you-1
In Gleason 2023 et al., on ala vestibuloplasty in cats, which of the following complications was reported after ala vestibuloplasty?
🔍 Key Findings
- Ala vestibuloplasty significantly reduced normalized pulmonary transit time (nPTT) (mean 5.43 → 3.89 sec; p <.001), suggesting improved cardiopulmonary function.
- Clinical respiratory signs improved, including reduced snoring, sneezing, nasal discharge, and open-mouth breathing (all p <.01).
- Activity tolerance increased, with less dyspnea during activity and longer time to onset of dyspnea (p <.005).
- Paradoxical sternal motion resolved in all affected cats after surgery.
- Hiatal hernias resolved in 75% of affected cats on follow-up CT.
- No serious complications occurred, with only mild, self-limiting epistaxis and hypersalivation in a few cases.
- Aberrant turbinates were detected on CT in all cats, though only 1 showed obstructive CATs endoscopically.
- Total clinical severity scores improved significantly postoperatively (median reduction of 30 points; p <.001).
Veterinary Surgery
4
2023
Ala vestibuloplasty improves cardiopulmonary and activity‐related parameters in brachycephalic cats
2023-4-VS-gleason-4
In Miller 2024 et al., on intestinal obstruction and catheter technique in cats, what key factor was significantly associated with failed RRCT attempts?
🔍 Key Findings
- Cats with linear (LFBO) and discrete (DFBO) small intestinal obstructions had similar survival (98.2% vs. 97%, p = 1.0).
- Postoperative complications were not significantly different between LFBO and DFBO cases (p = .1386).
- Intestinal dehiscence was rare (only 2 cats), both in DFBOs, with no statistical difference between groups.
- Red rubber catheter technique (RRCT) successfully removed LFBOs in 83% (20/24) of attempts.
- All failed RRCTs occurred in cats with perforations or tissue nonviability.
- Cats with failed RRCTs had longer clinical signs pre-surgery (median 6.5 vs. 2.0 days).
- Surgical time was longer in LFBO cats (median 77 min vs. 58 min, p = .0018).
- Preoperative septic peritonitis was rare (4/169 cats), but occurred only in linear or mixed FBO cases.
Veterinary Surgery
7
2024
Linear and discrete foreign body small intestinal obstruction outcomes, complication risk factors, and single incision red rubber catheter technique success in cats
2024-7-VS-miller-2
In Billas 2022 et al., on SSI risk after limb amputation, which variable was **not** associated with increased SSI risk?
🔍 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-4
In Downey 2023 et al., on thoracoscopic lobectomy, what factor was associated with conversion to open thoracotomy?
🔍 Key Findings
- Thoracoscopic (TL) or thoracoscopic-assisted (TAL) lobectomy was successfully performed in 12 dogs with non-neoplastic pulmonary consolidation (PC).
- 44% (4/9) of TL cases were converted to open thoracotomy due to adhesions or poor visualization—higher than rates for neoplastic lobectomies.
- OLV was successful in 7/9 TL dogs; unsuccessful attempts were managed with intermittent ventilation, mostly in brachycephalic breeds.
- Median hospital stay was 3 days; 91.7% (11/12) survived to discharge, and 100% of survivors showed no recurrence at median 24-month follow-up.
- Complications were mostly minor: pneumothorax (2), minor hemorrhage (3), dehiscence (1), and 1 fatality due to BOAS complications.
- Histopathology showed infectious pneumonia in 10 dogs, and in 4 cases, foreign body migration was suspected as the underlying cause.
- Median surgical time for TL was 90 minutes; conversion correlated with longer symptom duration (median 90 vs. 7 days).
- Postoperative recovery was excellent in all surviving dogs, with one case of persistent cough attributed to concurrent heart disease.
Veterinary Surgery
7
2023
Evaluation of long‐term outcome after lung lobectomy for canine non‐neoplastic pulmonary consolidation via thoracoscopic or thoracoscopic‐assisted surgery in 12 dogs
2023-7-VS-downey-2
In Mullen 2024 et al., on NIRF for GDV, how did near-infrared imaging alter the surgical plan in affected dogs?
🔍 Key Findings
- NIRF altered surgical strategy in 3 of 20 GDV dogs, identifying necrosis not appreciated subjectively.
- Fundic fluorescence <10% indicated histologically confirmed gastric necrosis.
- In 1 dog, NIRF revealed nonviability despite the surgeon’s impression of viability.
- Staple line fluorescence resembled viable tissue in the only stapled gastrectomy, suggesting preservation of perfusion.
- GDV dogs (even “viable”) showed lower fluorescence vs. healthy controls, indicating subclinical vascular compromise.
- Histology confirmed full-thickness necrosis in all 4 dogs with NIRF-defined nonviability.
- Pre-op lactate was significantly higher in nonviable GDV dogs (8.55 vs 4.89 mmol/L, p=0.03).
- No complications were reported from ICG use; imaging was safe and repeatable.
Veterinary Surgery
4
2024
Use of real-time near-infrared fluorescence to assess gastric viability in dogs with gastric dilatation volvulus: A case-control study
2024-4-VS-mullen-2
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings