Quiz Question
In Parlier 2024 et al., on insufflation effects on portal pressure in dogs, what clinical recommendation did the authors make regarding insufflation pressure?
🔍 Key Findings
- Portal pressure increased proportionally with insufflation pressure: 38% at 6 mmHg, 95% at 10 mmHg, and 175% at 14 mmHg.
- Exponential model: average increase of 7.45% per mmHg of insufflation pressure (CI: 4.7–10.2%).
- No systemic hemodynamic adverse effects were observed; MAP remained >60 mmHg throughout.
- Portal hypertension threshold (15 mmHg) predicted at ~6.4 mmHg insufflation pressure.
- No statistical impact from patient weight, pressure-to-weight ratio, or order of insufflation rounds.
- Measurement technique was feasible and safe, with only minor challenges (e.g., catheter kinking).
- The study supports use of the lowest insufflation pressure needed for visualization to avoid portal hypertension.
- Baseline portal pressures returned after desufflation, supporting comparison pre- and post-attenuation.
Veterinary Surgery
4
2024
Prospective, randomized, clinical trial on the effects of laparoscopic insufflation pressures on portal pressures in dogs
2024-4-VS-parlier-5
In Nash 2024 et al., on esophageal pH monitoring, what was the defined upper reference limit for distal GER events per hour in healthy nonbrachycephalic dogs?
🔍 Key Findings
- Esophageal pH-monitoring was well tolerated in all 35 nonbrachycephalic dogs, with no major adverse events reported.
- Distal GER occurred in 80% of dogs, but events were typically brief and non-productive; proximal GER occurred in only 39%.
- Upper reference limits for GER were 2.4 events/hour (distal) and 0.4 events/hour (proximal).
- Cumulative acid exposure was minimal: upper limits were 2.3% (distal) and 0% (proximal).
- Comparison with brachycephalic dogs shows significantly higher GER frequency and duration, validating the diagnostic utility of pH monitoring.
- Transnasal probe placement under light anesthesia was safe and less morbid compared to percutaneous or conscious techniques.
- No expelled or productive regurgitation occurred, despite some GER events, indicating efficient esophageal clearance in healthy dogs.
- Diet and fasting duration may affect GER, but these were not controlled variables in this study.
Veterinary Surgery
8
2024
Esophageal pH‐monitoring in nonbrachycephalic dogs: A reference
2024-8-VS-nash-1
In Nash 2024 et al., on esophageal pH monitoring, what percentage of dogs experienced proximal GER events during the recording period?
🔍 Key Findings
- Esophageal pH-monitoring was well tolerated in all 35 nonbrachycephalic dogs, with no major adverse events reported.
- Distal GER occurred in 80% of dogs, but events were typically brief and non-productive; proximal GER occurred in only 39%.
- Upper reference limits for GER were 2.4 events/hour (distal) and 0.4 events/hour (proximal).
- Cumulative acid exposure was minimal: upper limits were 2.3% (distal) and 0% (proximal).
- Comparison with brachycephalic dogs shows significantly higher GER frequency and duration, validating the diagnostic utility of pH monitoring.
- Transnasal probe placement under light anesthesia was safe and less morbid compared to percutaneous or conscious techniques.
- No expelled or productive regurgitation occurred, despite some GER events, indicating efficient esophageal clearance in healthy dogs.
- Diet and fasting duration may affect GER, but these were not controlled variables in this study.
Veterinary Surgery
8
2024
Esophageal pH‐monitoring in nonbrachycephalic dogs: A reference
2024-8-VS-nash-4
In Wylie 2025 et al., on femoral implant accuracy, what was the overall effect of internal brace augmentation on pivot shift grades at 6 weeks?
🔍 Key Findings
- Accurate femoral isometric placement was achieved in 63% of cases, significantly more with SwiveLock (78.6%) than FASTak (38.9%).
- Inaccurate placement was associated with increased internal tibial rotation at follow-up (p = .009), suggesting potential implant failure.
- Pivot shift grade improved in 90.9% of stifles postoperatively, regardless of implant positioning accuracy.
- SwiveLock implants had a faster learning curve and higher placement accuracy than FASTak.
- Higher patient weight was linked to more accurate implant placement (p = .012), likely due to easier anatomical landmark identification.
- No correlation found between implant type or positioning accuracy and final pivot shift grade at 6 weeks.
- Minor and major complications were low and not significantly different between implant types.
- A simplified 2-grade pivot shift system was proposed for clinical use (Grade 1: glide, Grade 2: clunk), aiding intraoperative decision-making.
Veterinary Surgery
7
2025
Evaluation of femoral isometric placement accuracy of internal brace implants and its impact on stifle stability in the management of pivot shift phenomenon following TPLO
2025-7-VS-wylie-3
In Otero Balda 2025 et al., on Short-term outcomes after feline cPSS surgery, which clinical variable was associated with the **lowest** odds of 30-day survival?
🔍 Key Findings
- 78% of cats that developed postattenuation neurologic signs (PANS) after congenital portosystemic shunt (cPSS) surgery survived to 30 days.
- Postattenuation seizures (PAS) were associated with significantly decreased 30-day survival (50% vs. 78%; OR: 0.015, p = .005).
- Treatment of PANS with propofol was a negative prognostic factor (OR: 0.112, p = .0008).
- Generalized PAS accounted for most seizure cases and were more frequently fatal than focal or unknown-type seizures.
- Pretreatment with levetiracetam (LEV1 protocol) showed a trend toward improved survival (100% vs. 60.6% in untreated cats), though not statistically significant (p = .06).
- Shunt morphology, method of attenuation, and study period (early vs. late) were not significantly associated with 30-day survival.
- Electrolyte, glucose, and ammonia abnormalities were not strongly linked to survival outcomes in this study.
- Majority of PAS-related deaths were due to uncontrolled generalized seizures or euthanasia because of severity.
Veterinary Surgery
5
2025
Prognostic factors for short‐term survival of cats that experienced postattenuation neurologic signs after surgical attenuation of single congenital portosystemic shunts
2025-5-VS-otero-2
In Fracka 2024 et al., on perioperative risk factors, which surgical technique was associated with a significantly higher odds of complicated recovery?
🔍 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-1
In Price 2024 et al., on left-sided TD ligation in dogs, which procedure was successfully completed via the same incision as TD ligation?
🔍 Key Findings
- Left fourth intercostal thoracotomy allowed successful thoracic duct (TD) ligation in 9/10 canine cadavers.
- 10/13 clinical cases had a single TD branch at the left fourth intercostal space, indicating lower anatomical complexity.
- All TD branches at this site were lateral to the esophagus, simplifying surgical access.
- Unilateral subphrenic pericardiectomy was successfully performed via the same incision in 10/10 cadavers.
- Fewer TD branches at the fourth intercostal space than traditional caudal sites may reduce the risk of missed collaterals.
- In contrast, traditional caudal TD ligation sites had up to 5 branches, requiring broader dissection.
- No cadaver had right-sided TD branches, reducing surgical complexity at the studied location.
- Contrast-confirmed ligation was effective in 90% (9/10) cadavers on CT imaging.
Veterinary Surgery
3
2024
Evaluation of thoracic duct ligation and unilateral subphrenic pericardiectomy via a left fourth intercostal approach in normal canine cadavers
2024-3-VS-price-5
In Fracka 2024 et al., on perioperative risk factors, how did increasing age affect the likelihood of a complicated recovery?
🔍 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-3
In Radke 2022 et al., on outcome measure validation, what feature contributed to recommending CBPI, COI, and LOAD for clinical use?
🔍 Key Findings
- CBPI, COI, and LOAD are recommended for assessing canine osteoarthritis based on COSMIN criteria.
- COI scored highest in development rigor and evidence quality among evaluated OROMs.
- Internal consistency, reliability, and responsiveness were commonly validated, though no OROMs reported measurement error.
- LOAD was considered formative, and internal consistency assessment was deemed unnecessary.
- CBPI and COI showed sufficient internal consistency, but CBPI’s factor structure was inconsistent across studies.
- All 6 evaluated OROMs (CBPI, COI, LOAD, BHSII, HCPI, HVAS) were quick to complete (under 5 min).
- Three tools—BHSII, HCPI, HVAS—need more evidence before recommendation; only CBPI, COI, and LOAD are Category A (recommended).
- Future studies should assess interpretability, including measurement error and clinically meaningful change scores (MIC, SDC).
Veterinary Surgery
2
2022
Evidence‐based evaluation of owner‐reported outcome measures for canine orthopedic care – a COSMIN evaluation of 6 instruments
2022-2-VS-radke-5
In Bresciani 2022 et al., on modified urethrostomy outcomes, what was the most common early postoperative complication in cats undergoing mPPU?
🔍 Key Findings
- Modified prepubic urethrostomy (mPPU) was effective for managing proximal urethral obstructions in male cats.
- All 8 cats regained voluntary urination within 24 hours postoperatively.
- Early urinary incontinence and peristomal dermatitis occurred in all cats but were self-limiting.
- Two cats (25%) required surgical revision due to stomal obstruction from weight gain and abdominal fat.
- No intraoperative complications were reported in any of the 8 cats.
- Follow-up (13–84 months) showed sustained urinary continence and owner satisfaction in all cases.
- The rectus abdominis muscle tunnel likely increased outflow resistance, minimizing persistent incontinence.
- Recurrent hematuria and dysuria occurred in 3 cats but were managed conservatively.
Veterinary Surgery
2
2022
Modified prepubic urethrostomy with body wall tunneling: Description of technique and long-term outcome in eight male cats
2022-2-VS-bresciani-1
Quiz Results
You answered 7 out of 10 questions correctly
Key Findings