Explore all the previous studies we have interpreted and highlighted over the years.
| February 2025 Short-term complications of internal versus external fixation of closed diaphyseal tibial fractures in skeletally immature dogs Veterinary surgery https://onlinelibrary.wiley.com/doi/full/10.1111/vsu.14221 When treating closed diaphyseal tibial fractures in skeletally immature dogs, the choice between internal fixation (IF) and external skeletal fixation (ESF) can have a significant impact on short-term outcomes. This study confirmed that ESF carries a higher complication rate (56%), mostly major and primarily due to pin-tract issues, compared to IF (20%). Interestingly, the use of prophylactic antibiotics was associated with more complications, particularly in ESF cases, suggesting they may not always be beneficial. My take home message is that surgeons should carefully balance the risks of complications with healing times, and if ESF is chosen, pin-tract morbidity should be a primary concern. Clinical outcomes and complications of tracheal resection and anastomosis in dogs and cats: 20 cases (2009–2022) JSAP https://onlinelibrary.wiley.com/doi/10.1111/jsap.13830 Tracheal resection and anastomosis (TRA) is the best option for tracheal reconstruction, but it’s far from a straightforward fix. This retrospective multicentre study reviewed 20 cases (8 dogs and 12 cats) treated with TRA across seven UK referral centres. The indications for TRA included traumatic tracheal rupture (5), tracheal avulsion (7), neoplasia (5), and stenosis (3). While 70% of patients survived to the latest follow-up, complications were common (75%), Non-anastomotic issues included cough (5), laryngeal paralysis (1), surgical site infection (1), and septic shock (2); anastomotic complications included dehiscence (1), stenosis (4), and fatal respiratory failure (2). What stood out to me was the contrast in outcomes depending on the underlying condition. Patients undergoing TRA for neoplasia tended to fare better than those with traumatic injuries, particularly dog bite cases, which had a universally poor prognosis. This makes sense to me, as a planned surgery is inherently different from an emergency procedure in a more compromised patient. Impact of suture materials polydioxanone and poliglecaprone 25 on non-infected clean orthopaedic stifle procedure incisional dehiscence rates Veterinary Surgery https://onlinelibrary.wiley.com/doi/10.1111/vsu.14224 Suture choice is one of those things that can spark debate among surgeons, especially in orthopaedic procedures where healing is critical. This study compared polydioxanone (PDS) and poliglecaprone 25 (Monocryl) for skin closure in dogs undergoing clean orthopaedic stifle surgeries, including TPLO. The results? As expected! No significant difference in incisional dehiscence rates between the two materials in non-infected wounds, so both are valid options for skin closure in these procedures. What did stand out was that postoperative antibiotics and signs of inflammation were linked to a higher risk of dehiscence, raising questions about whether routine antibiotic use is always justified. For me, the key takeaway is that preventing infection remains the bigger battle so probably we should be focusing more on perioperative management and identifying patients at higher risk for complications. Retrospective analysis of the incidence and clinicopathological findings associated with ammonium urate urolithiasis in dogs with congenital portosystemic shunts: 363 cases (2010-2023) JSAP https://onlinelibrary.wiley.com/doi/10.1111/jsap.13821 Portosystemic shunts (PSS) in dogs are a complex condition, and their association with ammonium urate urolithiasis adds another layer of clinical significance. This retrospective study of 336 dogs with PSS (98 with intrahepatic PSS and 265 with extrahepatic PSS) found that a total of 159/336 (44%) of dogs with PSS had urolithiasis based on diagnostic imaging. Interestingly, urolithiasis was documented more frequently in dogs with EHPSS (130/265, 49%) compared to those with IHPSS (29/98, 30%). Thoracic and abdominal diagnostic imaging findings in dogs diagnosed with immune-mediated polyarthritis: 71 cases (2011-2023) JSAP Open access https://onlinelibrary.wiley.com/doi/10.1111/jsap.13818 Immune-mediated polyarthritis (IMPA) is one of those frustrating conditions where clinical signs alone often don’t tell the full story. This study looked at the role of thoracic and abdominal imaging in diagnosing underlying causes in 71 dogs with IMPA in the UK. The study format was novel in that the cases were (retrospectively) appraised without the diagnostic imaging findings being available, with clinicians being asked “would immunosuppression be the treatment of choice based on the available information?” Clinicians initially considered 41 of 71 dogs (58%) as safe for immunosuppression based on clinical signs and laboratory findings. However, in 10 of these cases, imaging findings suggested an underlying cause that altered the treatment decision. Conversely, in 30 cases, clinicians deemed immunosuppression unsafe without further imaging and of these 22 were ultimately cleared for immunosuppression after imaging ruled out secondary causes. Overall, imaging revealed findings suggestive of an underlying cause in 18/71 (25%) cases, with secondary IMPA confirmed in 11 of those after cytology. The study concluded that abdominal imaging (ultrasound or CT) and echocardiography are more useful than thoracic radiography in diagnosing secondary IMPA as thoracic radiography revealed only normal or non-specific findings. Implementation of a standard perioperative protocol reduces postoperative respiratory distress events in dogs undergoing surgical correction of brachycephalic obstructive airway syndrome JAVMA https://avmajournals.avma.org/view/journals/javma/aop/javma.24.09.0598/javma.24.09.0598.xml Brachycephalic obstructive airway syndrome (BOAS) surgery is always a balancing act between improving airway function and managing the inevitable perioperative risks. This study evaluated the implementation of a perioperative protocol in dogs undergoing BOAS surgery, reporting findings from pre- and post-protocol. There was a reduced frequency of postoperative respiratory distress events (from 36% to 13%), though the frequencies with which regurgitation and aspiration were documented were similar across both groups. What really stood out to me was the emphasis on minimising opioid use and incorporating strategies like hypertonic saline nebulisation and mannitol-soaked swabs. While there’s no one-size-fits-all approach, tweaking these perioperative protocols may have a lot of scope for improving BOAS recoveries. Dehiscence rate and associated risk factors after gastrotomy for removal of foreign material in dogs and cats JAVMA https://avmajournals.avma.org/view/journals/javma/aop/javma.24.08.0531/javma.24.08.0531.xml This study retrospectively reviewed 271 dogs and 31 cats that had undergone a gastrotomy for foreign body retrieval. It reassures us that gastrotomy dehiscence is exceedingly rare. The overall dehiscence rate was reported as 0 to 0.66%, as there were no confirmed episodes of dehiscence reported. Two dogs that were euthanised having developed post-operative septic peritonitis were presumed to have had gastrotomy dehiscence for statistical analysis (creating a dehiscence rate of 0.66%) but they both also underwent intestinal resection and anastomosis, which is more commonly associated with dehiscence. No necropsy was performed on those dogs to confirm the source. What I take from this study is that, while we always need to be vigilant about post-op septic peritonitis, gastrotomy itself is a solid, reliable procedure when closed properly. And you, how do you close your gastrotomy?! Author special: Treatment, prognosis, and outcome of dogs treated for rectal plasmacytoma: a multicentric retrospective study JAVMA https://avmajournals.avma.org/view/journals/javma/aop/javma.24.10.0666/javma.24.10.0666.xml This multicentric retrospective study reviewed twenty cases of rectal plasmacytoma, with 19 dogs undergoing surgical treatment and one being managed conservatively. Having contributed to this study, I found it particularly interesting that while surgery remains the go-to treatment, recurrence was fairly common (31%), and metastasis (10%) was more frequent than previously reported. That said, survival times were long, and no cases progressed to multiple myeloma. Surgical complications were mostly minor, but factors like surgeon experience, tumour distance from the anus, and incomplete margins were associated with recurrence. While conservative surgery is effective, there’s still room to explore adjuvant treatments such as chemotherapy or radiation to improve outcomes. Significance of incidentally identified bullae and blebs on thoracic computed tomography and prevalence of subsequent pneumothorax in dogs Veterinary Surgery https://onlinelibrary.wiley.com/doi/10.1111/vsu.14144 Pulmonary bullae and blebs (PBBs) are air-filled lesions in the lungs that are often implicated in spontaneous pneumothorax (SP), a rare condition in dogs. However, the significance of these findings in patients undergoing CT for unrelated reasons and the risk of subsequent SP is unclear. In this retrospective study, thoracic CT scans that had been performed in dogs for reasons unrelated to pneumothorax or severe pulmonary disease were retrospectively reviewed. 2178 CT scans were reviewed and PBBs were identified incidentally in 30 (1.4%) of the studies. Over a median follow-up period of 1,255 days, none of these dogs developed SP, although one dog died suddenly from an unknown cause so SP could not be ruled out. Based on these findings, the risk of SP in dogs with incidentally identified PBBs is minimal, and prophylactic surgical removal of lung tissue containing PBBs is not warranted. Nevertheless, veterinarians and owners should remain mindful of the potential, albeit low, risk of SP in these cases. Comparison of three approaches for accessory lung lobectomy in the canine cadaveric model Veterinary Surgery https://onlinelibrary.wiley.com/doi/10.1111/vsu.14174 Accessory lung lobectomy (ALL) in dogs is challenging due to the lobe’s location near the diaphragm and vital thoracic structures. This study compared three surgical approaches: intercostal thoracotomy (ICT), median sternotomy (MS), and a novel transdiaphragmatic approach combined with caudal median sternotomy (TDCM) to assess exposure, ease of lobectomy, and tissue removal outcomes. In this cadaveric study, the TDCM approach provided the greatest exposure of the ALL compared to ICT and MS. However, all three approaches achieved similar percentages of lung tissue removal, with no differences in surgical time or staple line integrity during leak testing. These findings suggest that while TDCM may improve access to the ALL, it does not offer significant advantages in outcomes over the other approaches. Further studies would be needed to evaluate the TDCM approach in dogs with pathological conditions. Histologic findings of gastrointestinal biopsies and clinical outcomes in dogs undergoing cholecystectomy for gallbladder mucoceles JSAP https://onlinelibrary.wiley.com/doi/10.1111/jsap.13781 Gallbladder mucoceles (GBM) are a common indication for biliary surgery in dogs, with concurrent duodenal enteritis hypothesised to play a role in their pathogenesis. This study evaluated the presence and severity of duodenal enteritis in dogs that underwent both cholecystectomy and duodenal biopsy during management for GBM, plus its association with clinical outcomes. Of 71 dogs retrospectively identified, enteritis was detected in 61 (86%) of dogs, predominantly mild to moderate and lymphoplasmacytic in nature. There was no significant difference in enteritis severity between elective and emergent cases. Survival rates were high at 87%, with no significant association between enteritis severity and perioperative outcomes. Elevated white blood cell count was the only significant negative prognostic factor for survival. The findings suggest that while enteritis is common in dogs with GBM, it has no association with surgical outcomes. Routine duodenal biopsies may not be necessary unless gastrointestinal signs are chronic or severe. The study also highlights higher survival rates for emergent GBM cases compared to previous reports. Association of fracture gap with implant failure in radius and ulna fractures in toy breed dogs Veterinary Surgery https://onlinelibrary.wiley.com/doi/10.1111/vsu.14179 Fractures of the radius and ulna in toy breed dogs present unique challenges due to their thin bones and limited vascularity, leading to a higher risk of complications such as implant failure. This study investigated the association between a postoperative fracture gap in the caudal cortex and implant failure following radius and ulna fracture repairs in toy breed dogs using cranial bone plating. In this retrospective multicentre study of 80 toy breed dogs, a fracture gap was observed in 46% of cases. Implant failure occurred in 27% of cases with a gap, compared to only 2% of cases with apposed cortices. The presence of a fracture gap was significantly associated with a higher risk of implant failure. The absence of external coaptation was also associated with implant failure but such coaptation was linked to other complications, such as soft tissue damage and osteopenia. These findings emphasise the importance of achieving proper reduction of the caudal cortex during surgery to promote bone healing and reduce implant failure risk in transverse fractures of toy breed dogs. Clinical, imaging, and rhinoscopy findings of dogs and cats with nasal foreign bodies presenting to a UK referral hospital: 71 cases (2010–2022) JSAP https://onlinelibrary.wiley.com/doi/10.1111/jsap.13790 Nasal foreign bodies (FBs) are a relatively uncommon but important cause of nasal disease in dogs and cats, often leading to sneezing and nasal discharge. This study reviewed clinical presentations, imaging findings, and rhinoscopy outcomes in 71 confirmed cases of nasal FBs in dogs and cats. Dogs were more frequently affected than cats, and sneezing was the most common clinical sign in both species. Cats presented with more chronic signs than dogs, with a median duration of 45 days compared to 7 days in dogs. CT was the most common imaging modality used, though it successfully identified the FB in only 35% of cases. Most FBs were grass awns, and rhinoscopy was the preferred method for both diagnosis and removal, enabling successful extraction in 92% of cases. This study highlighted that while unilateral nasal discharge is more typical, bilateral discharge should not exclude FBs as a differential diagnosis. CT remains a valuable tool despite its limitations in FB visualisation, with rhinoscopy being essential for definitive diagnosis and treatment. Grass awns were the most common FB identified, with summer being the peak season for presentations. Comparison of outcomes in dogs undergoing hiatal hernia repair with and without use of a gastropexy JSAP https://onlinelibrary.wiley.com/doi/10.1111/jsap.13797 Hiatal hernia in dogs often requires surgical repair, commonly including oesophagopexy, phrenoplasty, and gastropexy. This study compared outcomes in 41 dogs undergoing hiatal hernia repair with and without gastropexy to evaluate its necessity. Dogs were divided into two groups: those with oesophagopexy and phrenoplasty alone and those with an additional left-sided gastropexy. Both groups showed significant improvement in gastrointestinal clinical signs at short- and long-term follow-ups. However, dogs that underwent gastropexy were more likely to require further surgery for persistent clinical signs or complications, although this association was not significant when dogs undergoing brachycephalic obstructive airway syndrome (BOAS)-related interventions were excluded. The findings suggest that oesophagopexy and phrenoplasty alone are effective for hiatal hernia repair in dogs, and the routine inclusion of a gastropexy may not be necessary. This approach could reduce surgical morbidity and simplify the procedure, particularly in cases without concurrent BOAS. Epicardial pacemaker placement in cats is associated with resolution of clinical signs and excellent quality of life JAVMA https://doi.org/10.2460/javma.24.09.0586 Bradyarrhythmias, such as atrioventricular blocks, are a common reason for artificial cardiac pacing in cats, with epicardial pacemaker (EP) placement being the preferred method due to anatomical and size constraints. This study investigated complications, outcomes, and health-related quality of life (HRQoL) in 39 cats undergoing EP placement across four UK referral hospitals. The primary indications were collapsing episodes and bradycardia, with third-degree atrioventricular block being the most frequent diagnosis. Surgery was successful in all cases, with complications in 14/39 of cats. These were mostly minor, but included pacing-related issues such as lead dislodgement or generator failure. All cats survived to discharge, with a median survival time of 1,384 days. Owner-reported HRQoL significantly improved post-surgery, with high levels of satisfaction and a resolution of clinical signs, particularly collapse. Epicardial pacemaker placement effectively resolves clinical signs of bradyarrhythmias in cats and leads to substantial improvements in HRQoL. Despite some complications, outcomes are excellent, making EP the preferred method for artificial cardiac pacing in symptomatic cats. Stapled functional end-to-end intestinal anastomosis with endovascular gastrointestinal anastomosis staplers in cats and small dogs JSAP https://onlinelibrary.wiley.com/doi/epdf/10.1111/jsap.13756?saml_referrer Stapled functional end-to-end intestinal anastomosis using endovascular gastrointestinal staplers is a surgical approach that can be used for small dogs (<10kg) and cats. This retrospective study evaluated the safety and effectiveness of this technique in 25 patients (10 dogs and 15 cats) across five veterinary referral centers. Median body weight was 4.6 kg, and conditions ranged from neoplasia to non-neoplastic intestinal disease. No major postoperative complications were observed, and minor complications, such as surgical site infections of the surgical approach, were resolved with conservative management. The Kaplan–Meier survival estimate suggested a longer survival for non-neoplastic cases as expected. Histopathology revealed inflammatory changes or neoplasia in most cases. This technique demonstrates safety and practicality, with promising outcomes, though further research on optimal stapler dimensions and long-term effects is encouraged. Complications and putative risk factors for cecal or colonic surgery in dogs: 79 cases (2002-2015) JSAP https://onlinelibrary.wiley.com/doi/10.1111/jsap.13763 This multi-institutional retrospective study identified 79 dogs undergoing caecal or colonic surgery, distinguishing between full-thickness (eg. resection and anastomosis) and partial-thickness procedures (eg. colopexy and partial thickness mass removals). Of these, 55 dogs underwent full-thickness surgeries, and 24 underwent partial-thickness surgeries. The overall complication rate was 25%, with no significant difference between the two groups (30.9% full thicknesss vs. 12.5% partial thickness). Postoperative dehiscence occurred in 4/47 cases undergoing resection and anastomosis, consistent with prior studies. Mortality rates were 12.7% for full-thickness surgeries and 0% for partial-thickness surgeries, with no statistically significant difference. Emergency out-of-hours surgeries were associated with increased complications and mortality on univariable analysis but on multivariable analysis, no factors were associated with survival to discharge or complications. Caecal and colonic surgery can be performed with similar risk profiles regardless of incision type, with emergency surgeries posing the primary potential risk. Histopathological diagnosis and surgical complications following bilateral anal sacculectomy for the treatment of unilateral canine apocrine gland anal sac adenocarcinoma: 35 cases (2019-2023) JSAP. Open access https://onlinelibrary.wiley.com/doi/10.1111/jsap.13731 In 35 dogs undergoing bilateral anal sacculectomy for unilateral apocrine gland anal sac adenocarcinoma (AGASACA), 7 of them (20%) had AGASACA in the contralateral anal sac, whereas 23 had non-neoplastic disease (sacculitis or adenoma) affecting the contralateral anal sac. Complications were seen in 9% of dogs intraoperatively and 14% of dogs postoperatively, commonly involving tumour capsule disruption and surgical site infection, respectively. The study supports the notion that bilateral anal sacculectomy for unilateral AGASACA has complication rates comparable to unilateral procedures, supporting its use for potentially improving outcomes by addressing undiagnosed bilateral disease. A retrospective observational cohort study on the postoperative respiratory complications and their risk factors in brachycephalic dogs undergoing BOAS surgery: 199 cases (2019-2021) JSAP. Open access https://onlinelibrary.wiley.com/doi/10.1111/jsap.13707 Brachycephalic breeds are prone to upper respiratory tract disorders and pose significant anaesthetic risks, especially during corrective surgery for brachycephalic obstructive airway syndrome (BOAS). This study indicated that high BOAS grade and aspiration pneumonia (preoperative or postoperative) are significant risk factors for complications such as dyspnoea requiring tracheostomy. All dogs that underwent postoperative tracheostomy survived to discharge, and the tracheostomy tubes were removed between 2 and 5 days after placement. Postoperative sedation was not associated with increased risk of respiratory complications. Caudoventral hip luxation in 160 dogs (2003–2023): A multicenter retrospective case series Vet Surgery https://onlinelibrary.wiley.com/doi/10.1111/vsu.14093 Hip luxation, particularly craniodorsal hip luxation, is common in dogs, with motor vehicle accidents being a common cause. Caudoventral hip luxation (CvHL), though rare, often occurs due to low-trauma incidents like falls or collisions. This study demonstrated that nonsurgical treatment of CvHL, primarily through closed reduction and hobbles, had a success rate of around 61.8%, which is lower than previously reported. Factors such as increasing age, the use of hobbles, and treatment by specialist surgeons were associated with higher success rates. Surgical options, particularly toggle rod stabilisation, showed high efficacy when nonsurgical treatments failed. These findings underscore the importance of hobbles in nonsurgical management and highlight the need for repeated attempts before opting for surgical interventions. Complications and influence of cutaneous closure technique on subdermal plexus flaps in 97 dogs (2006–2022) Vet Surgery https://onlinelibrary.wiley.com/doi/10.1111/vsu.14051 Subdermal plexus skin flaps (SPFs) in dogs, used for wound reconstruction, have a complication rate of about 51%, primarily due to necrosis at the flap’s distal part. This study examined whether closure technique (sutures vs. staples) and body weight were associated with complications. Data from 97 dogs revealed a higher complication rate with skin staples (72.2%) compared to sutures (49.3%), though the sample size was too small for definitive conclusions. Common complications included wound dehiscence (34, 35%), discharge (14, 14%), and infections (10, 10%). Larger dogs had an increased risk of complications, likely due to the need for larger flaps and longer surgeries. Age was also a factor, with older dogs experiencing more complications. Further research is needed to confirm these findings and explore additional risk factors. Performance time and leak pressure of hand-sewn and skin staple intestinal anastomoses and enterotomies in cadaveric cats Vet Surgery https://onlinelibrary.wiley.com/doi/10.1111/vsu.14082 While intestinal stapling devices are popular in dogs, they are less feasible in cats due to smaller intestinal lumen size. The use of skin staples in intestinal surgery has been reported in dogs but rarely in cats. This study compared hand-sewn and skin staple techniques for jejunal anastomoses and enterotomies in feline cadavers. It documented that skin staple techniques were faster than hand-sewn techniques. Leak pressures were comparable for anastomoses, but lower in stapled vs hand sewn enterotomy sites. Skin staple enterotomies leaked and failed frequently (40%) so they cannot be recommended without further studies. Risk factors for complicated perioperative recovery in dogs undergoing staphylectomy or folded flap palatoplasty: Seventy-six cases (2018–2022) Vet Surgery. Open Access https://onlinelibrary.wiley.com/doi/10.1111/vsu.14086 This study investigated risk factors for complicated perioperative recovery in 76 dogs undergoing surgery for brachycephalic obstructive airway syndrome (BOAS), focusing on staphylectomy and folded flap palatoplasty (FFP). Postoperative complications occurred in 30 dogs, with 16 dogs experiencing major complications. A key finding of this study was that FFP was associated with a less complicated short-term recovery compared to staphylectomy. Additionally, older age, high-grade laryngeal collapse, and prolonged anaesthesia were significant risk factors for complicated recovery, which included prolonged oxygen treatment, tracheostomy, or death. Abnormalities detected on digital rectal examinations in dogs are common and influence diagnostic and treatment plans JAVMA. Open access https://avmajournals.avma.org/view/journals/javma/262/6/javma.23.12.0695.xml This study assessed the utility of digital rectal examination in dogs presenting to a university veterinary hospital. It found that abnormal digital rectal examination findings were common, occurring in 36.4% of cases, especially in dogs presenting with gastrointestinal issues or mixed complaints involving multiple body systems. Abnormal findings frequently led to changes in diagnostic and treatment plans, underscoring the importance of digital rectal examination in routine physical examinations, particularly in emergency and referral settings. Unilateral nephrectomy in dogs is associated with a high rate of intraoperative and postoperative complications JAVMA. Free access https://avmajournals.avma.org/view/journals/javma/262/6/javma.24.01.0005.xml Unilateral nephrectomy is commonly performed in dogs with renal disease and is considered a well-tolerated procedure. The aim of the study was to assess the perioperative and long-term complication rates for this procedure and identify risk factors of chronic kidney disease (CKD). Among the 69 dogs included in the study, 45% experienced complications during surgery, and 43% faced complications postoperatively. Although most of these complications were of lower grade in both categories, there were 7 postoperative deaths. Additionally, acute kidney injury (AKI) was diagnosed in 12 dogs, and 24 dogs (45.3%) developed CKD over the long term. The development of AKI or preoperative glomerular filtration rate assessment of the contralateral kidney were not predictors of CKD development in this population. The findings indicate that unilateral nephrectomy in dogs is associated with high rates of complications both during and after surgery, with nearly half of the dogs with long-term follow-up developing CKD. |