stifle studies

Question 1

• Lampart (2023 Vet Surg): In acute CrCL tears, how accurate are common laxity tests, and which produced the greatest cranial translation/internal rotation?

Answer 1

• Cranial drawer, tibial thrust, and tibial pivot compression tests were reported as 100% accurate in this acute/ex vivo-style model (per summary)
• Tibial pivot compression test produced the greatest cranial translation and internal rotation

Question 2

• Pacheco (2023 JAVMA): What radiographic metric did they propose for diagnosing CrCL rupture, and what cutoff did they report?

Answer 2

• DPOI ratio (distance-based metric) proposed for CrCL rupture diagnosis
• Cutoff > 1.18 indicated CrCL rupture (reported 100% sensitivity and specificity in the study cohort)

Question 3

• Agnello (2022 VCOT): What was the prevalence and most common pattern of caudal cruciate damage in dogs with CrCL disease undergoing arthroscopy?

Answer 3

• Some degree of CdCL damage was reported in 95% of CrCL-diseased stifles
• Most common tear type was longitudinal (75%)
• Greater synovitis was associated with greater CdCL tearing

Question 4

• Alexander (2021 Vet Surg): In uncomplicated TPLO recoveries, how often did routine follow-up radiographs change recommendations?

Answer 4

• Change in recommendations occurred in ~5% of dogs without owner concerns/orthopedic abnormalities
• Bottom line: if no concerns and normal recovery, routine recheck radiographs rarely alter management

Question 5

• Geier (2021 Vet Surg): After TPLO, what factor was associated with patellar fracture risk, and what was the reported effect size?

Answer 5

• Lower final postoperative tibial plateau angle (TPA) was associated with higher odds of patellar fracture
• Odds increased ~20–21% for every 1° decrease in final TPA
• Median time to fracture ~69 days post-op

Question 6

• Peress (2021 VCOT): How did complications compare between single-session simultaneous bilateral TPLO vs staged TPLO?

Answer 6

• Overall complications: ~50% simultaneous vs ~20% staged
• Major complications: ~10% simultaneous vs ~5% staged
• Minor complications: ~40% simultaneous vs ~15% staged
• Conclusion: complications ~2–3× higher with single-session simultaneous bilateral TPLO

Question 7

• Moore (2020 Vet Surg): In long-term comparison of TPLO vs TTA, what were the key radiographic and functional findings?

Answer 7

• OA progressed more after TTA (per summary)
• Long-term functional outcomes favored TPLO (less pain/fewer mobility issues reported subjectively)
• Bottom line: TPLO provided better long-term radiographic and functional outcome than TTA

Question 8

• Knebel (2020 VCOT): In a randomized comparison of TPLO vs modified Maquet procedure, what did gait outcomes show through 6 months?

Answer 8

• Both groups improved significantly after surgery
• No significant differences between groups in post-op gait evaluations through 6 months (TPLO trended superior but not significant)

Question 9

• Budsberg (2021 Vet Surg): What did the systematic review conclude about postoperative antibiotics for preventing SSI after TPLO?

Answer 9

• Found little high-level evidence that postoperative antibiotics reduce SSI risk after TPLO
• The highest-level studies did not support a clear benefit; many remaining studies were low evidence

Question 10

• McDougall (2021 Vet Surg): For deep SSI requiring implant removal after TPLO, what incidence and timing were reported?

Answer 10

• Deep SSI with implant removal reported in ~5% (as summarized)
• Median time to implant removal ~300 days post-op
• Male dogs and German Shepherd Dogs were noted as higher-risk for plate removal (per summary)

Question 11

• Sanders (2024 Vet Surg): What SSI risk factors and effects were reported in this multicenter TPLO study (1422 dogs)?

Answer 11

• Simini antiseptic/nonantibiotic lavage group had higher SSI (15% vs 10% non-treated) in this dataset
• Single-session bilateral TPLO increased SSI odds ~2.5×
• Every 5 kg increase in body weight increased SSI odds by ~10%
• Postoperative antibiotics decreased SSI odds (OR ~0.5) (per summary)

Question 12

• Reader (2020 JAVMA): Liposomal bupivacaine (Nocita) vs 0.5% bupivacaine HCl after TPLO—what was the key analgesic finding?

Answer 12

• Dogs receiving liposomal bupivacaine were less likely to require rescue analgesia and used less opioids (per summary)
• No other major differences reported in measured variables (per summary)

Question 13

• Aldrich (2023 Vet Surg): In a blinded randomized placebo-controlled trial of liposomal bupivacaine in TPLO, what did they find?

Answer 13

• No difference in treatment success, postop opioid use, CMPS-SF scores, or force-plate %BW distribution (per summary)

Question 14

• Colthurst (2022 JSAP): What was the incidence of medial meniscal injury at TPLO, and how did subsequent tears differ by body size?

Answer 14

• Medial meniscal injury rate ~40% in both small and large dogs
• Subsequent meniscal tear post-op: ~1.5% small dogs vs ~8% large dogs
• Complete CrCL tears were more likely to have meniscal injury (per summary)

Question 15

• Jeong (2021/2023 Vet Surg): After TTA vs TPLO, what were the subsequent medial meniscal tear rates reported in the beagle model?

Answer 15

• Radiographic OA was worse in the TTA group
• Subsequent medial meniscal tears: 60% of TTA stifles at 12 weeks (per summary)
• TPLO group: 0% at 12 weeks; 20% (1/5) at 32 weeks (per summary)
• Bottom line: TPLO protected against subsequent meniscal tear better than TTA

Question 16

• Laube (2021 VCOT): What prevalence of bilateral meniscal tears did they report after TPLO, and what risk factors were noted?

Answer 16

• Prevalence of bilateral meniscal tears: ~50%
• Risk factors noted: Rottweilers, older dogs, smaller dogs/lower body weight, and complete cruciate tears (per summary)

Question 17

• Gleason (2020 Vet Surg): How accurate is a ‘meniscal click’ for meniscal tear morphology, and what tear type is it most associated with?

Answer 17

• Medial meniscal tears present in 40.5% of dogs; ~65.6% were bucket-handle tears (per summary)
• Meniscal click sensitivity ~38% (before or during anesthesia)
• Specificity: ~94.5% pre-anesthesia; ~98.2% under anesthesia
• Positive click more commonly associated with bucket-handle tear; absence of click does not rule out injury

Question 18

• Kmieciak (2022 VCOT): In stifle exploration for medial meniscal tears, how did a stifle distractor compare with Hohmann/Senn retractors?

Answer 18

• No significant difference in accuracy between approaches (per summary)
• Takeaway: a distractor may help when you lack assistants, but accuracy was similar

Question 19

• Brincin (2023 Vet Surg): In postoperative management of canine MPL, how often did routine follow-up radiographs change recommendations?

Answer 19

• Isolated radiographic abnormalities identified in ~5% of dogs without concerns (per summary)
• Recommendations changed in ~5% (~3% cited) of dogs without owner/clinician concerns (per summary)
• Bottom line: routine radiographic follow-up rarely influences decision-making absent clinical concern

Question 20

• Cortina (2023 Vet Surg): What were the reported outcomes and complication rates for modified tibial tuberosity transposition in MPL correction?

Answer 20

• Retrospective: 235 dogs / 300 stifles (per summary)
• Minor complication rate ~15%; major complication rate ~5% long-term
• Long-term complications often related to pin migration; high-grade reluxations and TT fractures resolved with revision surgery
• Owner satisfaction reported as 100% (per summary)

Question 21

• Ericksen (2023 JAVMA): What complication rates were reported for dome trochleoplasty in dogs >20 kg?

Answer 21

• Overall complication rate ~50%
• Major complication rate ~45% (pin migration and re-luxation)
• Authors suggested limiting use due to higher complication rates (per summary)

Question 22

• Engel (2024 Vet Surg): In a randomized trial of silver-coated vs noncoated TPLO implants, what SSI rates were reported?

Answer 22

• Overall SSI rate ~10% (per summary)
• Silver-coated group ~2.5% vs noncoated ~12% (difference reported as not statistically significant; possible type II error noted)

Question 23

• Pownall (2021 Vet Surg): What did long-term follow-up suggest about chronic postsurgical pain after TPLO (HCPI)?

Answer 23

• Helsinki Chronic Pain Index suggested chronic postsurgical pain in ~40% of dogs with long-term follow-up (per summary)
• No difference by type of preemptive analgesia (spinal/epidural vs sciatic-femoral block) (per summary)
• Higher weight was a negative prognostic factor for chronic pain scores (per summary)

Question 24

• Sanders (2024 Vet Surg): What was the effect of single-session bilateral TPLO on SSI odds? Other risk factos?

Answer 24

• Single-session bilateral TPLO increased odds of SSI by ~2.5× (per summary)
• Every 5 kg increase in body weight increased SSI odds by ~10% (per summary)

Question 25

• McDougall (2021 Vet Surg): What was the median time to implant removal for deep SSI after TPLO?

Answer 25

• Median time to implant removal was ~300 days post-op (per summary)

Question 26

• Geier (2021 Vet Surg): What was the median time to patellar fracture after TPLO?

Answer 26

• Median time to patellar fracture was ~69 days post-op (per summary)

Question 27

• Gleason (2020 Vet Surg): What are the sensitivity/specificity values of a meniscal click under anesthesia?

Answer 27

• Sensitivity ~38% • Specificity ~98.2%

Question 28

• Colthurst (2022 JSAP): What were subsequent meniscal tear rates by size category after TPLO?

Answer 28

• Small dogs: ~1.5% • Large dogs: ~8%

Question 29

* Peress (2021 VCOT): What were the overall complication rates for simultaneous vs staged bilateral TPLO?

Answer 29

* Overall complications: ~50% simultaneous vs ~20% staged

Question 30

• Brincin (2023 Vet Surg): What clinical factors were associated with changes in postoperative plan after MPL surgery?

Answer 30

• Lameness and administration of analgesics at follow-up were associated with changes in postoperative plan (per summary) • Absence of owner/clinician concerns: routine radiographs did not meaningfully influence plan

Question 31

• Agnello (2022 VCOT): What was the most common CdCL tear pattern in CrCL-diseased stifles on arthroscopy?

Answer 31

• Longitudinal tear pattern (~75%) (per summary)

Question 32

* Lampart (2023 Vet Surg): What is a key practical take-away about performing the tibial pivot compression test (TPCT)?

Answer 32

* TPCT can be performed in dorsal or lateral recumbency * It produced the greatest cranial translation + internal rotation among laxity tests evaluated

Question 33

* Gollnick (2024 Vet Surg): With Arthrex 3.5 mm self-tapping screws (STS) during TPLO, what was the incidence of transcortical tibial fracture (TCTF) and what major complication was reported?

Answer 33

* Radiographic TCTF identified in 42% (33/78) of cases; 14% (36/250) of STS screws distal to the osteotomy * TCTFs were only identified distal to the osteotomy * Among dogs with TCTF, 6% (2/33) had major complication req sx stabilization of complete tibial fracture (associated with screw angulation relative to the plate) * Avoid off-axis screw placement; place screws perpendicular to plate to reduce risk

Question 34

* Evers (2023 Vet Surg): How accurate is needle arthroscopy (NA) for diagnosing medial meniscal tears in dogs with CrCL rupture compared to standard arthroscopy (SA)?

Answer 34

* Prospective study (26 dogs); SA used as reference standard * Sensitivity 95% and specificity 100% for medial meniscal tear diagnosis with NA * NA had shorter procedure time than SA, but meniscal visibility was lower and probing the lateral meniscus was harder

Question 35

* Peycke (2022 Vet Surg): What were the outcomes and key complications of CORA-based leveling osteotomy (CBLO) in skeletally immature dogs with CrCL injury?

Answer 35

* Retrospective case series: 15 dogs (16 stifles) with open proximal tibial physis and tibial tuberosity apophysis * Mean TPA: 26° pre-op, 9° post-op, 9° at final recheck * Complications: 1 dog developed ~10° recurvatum from inadvertent over-rotation (TPA 3°); 2 dogs developed valgus deformity from plate screw engaging proximal tibial physis (both revised) * At mean ~23 months follow-up, owners reported full function for all dogs

Question 36

* Sadowitz (2023 Vet Surg): How do screw insertion angle and speed affect transcortical fracture (TCF) rate in a canine tibial diaphyseal model?

Answer 36

* Cadaveric experimental study: 66 canine tibiae; 3.5 mm locking self-tapping screws * 0° insertion (coaxial): 0% TCF at 650 rpm (0/80) and 0% TCF at 1350 rpm (0/80) * 5° at 650 rpm: 3.75% TCF (3/80) * 10° at 650 rpm: 12.5% TCF (10/80) * 10° at 1350 rpm: 17.5% TCF (14/80) * 10° hand insertion: 3.75% TCF (3/80) * Clinical takeaway: Keep screws coaxial with pilot hole; avoid off-axis insertion and consider slower/controlled insertion to reduce TCF risk

Question 37

• Boekhout (2012 Vet Surg): In a canine TPLO model, how did transcortical fracture incidence compare between self-tapping (STS) and non-self-tapping screws (NSTS)?

Answer 37

• Case series: 106 dogs; immediate post-TPLO radiographs evaluated • STS: 18.0% incidence of transcortical fractures • NSTS: 0.8% incidence of transcortical fractures • STS material (stainless vs titanium) did not significantly affect incidence • Proposed mechanism: shorter cutting flutes of STS vs a tap used with NSTS

Question 38

* Morgera (2022 Vet Surg): Did using a dual-layer incise/adhesive extremity drape reduce SSI after stifle surgery?

Answer 38

* SSI rate was <5% in both groups * No difference in SSI between drape types

Question 39

* Clark (2020 Vet Surg): Did postoperative antibiotics reduce SSI or increase antibiotic resistance after TPLO?

Answer 39

* Postoperative antibiotics were not protective against SSI and did not predispose to antibiotic resistance * SSI rates: Superficial 5% vs 15% (no abx/abx); Deep 5% vs 10% (no abx/abx); Resistant deep SSI 5% vs 5% * Risk factors noted: BW (deep SSI/resistance) and longer surgery/anesthesia time (superficial, deep, resistance); surgeon effect on deep SSI

Question 40

* Garcia (2020 Vet Surg): Is screening/treating subclinical bacteriuria indicated before TPLO?

Answer 40

* Subclinical bacteriuria prevalence 6.5% * SSI incidence 22% overall (20% without SBU vs 33% with SBU) * Organisms from SSI differed from urine isolates * Conclusion: screening for and treating SBU prior to TPLO likely not indicated

Question 41

* Hagen (2020 Vet Surg): What SSI rate and key antimicrobial timing findings were reported after TPLO?

Answer 41

* SSI rate 10%; MRSP accounted for ~30% of SSI cases (≈3% overall, per summary) * Protective factors: postoperative antimicrobials and timing of preoperative antimicrobials * Preoperative antimicrobials were more protective when administered >60 minutes before incision versus within 30–60 minutes (per summary)

Question 42

* Matchwick (2021 Vet Surg): What were the overall/major complication rates and postliminary meniscal tear rate after forkless TTA?

Answer 42

* Overall complication rate ~15% * Major complications ~10%; minor complications ~10% (per summary notes ~7.5% each subgroup) * Postliminary meniscal tears reported ~5% (≈3% highlighted), with increased risk reported with larger cage size

Question 43

* Terreros (2020 Vet Surg): In dogs with CrCL disease and excessive TPA treated with modified CCWO, what outcomes and complication rates were reported?

Answer 43

* Major complications 10%; minor complications 20% * Outcomes: ~50% excellent, 45% acceptable, 5% unacceptable (per summary) * Progressive OA reported in 100% long-term; owner satisfaction 95% * Conclusion: modified CCWO provided acceptable morbidity and satisfactory functional outcomes for excessive TPA

Question 44

* Redolfi (2023 VCOT): For combined TPLO + tibial tuberosity transposition (TTT) in dogs with CrCL rupture and MPL, what were long-term outcomes and complication rates?

Answer 44

* Major complications ~15% (SSI and recurrent MPL); SSI treated successfully with implant removal + antibiotics (≈10% removal noted) * Minor complications ~20% * At ~2 years follow-up: ~95% clinically sound and ~95% complete MPL resolution (per summary)

Question 45

* Giansetto (2023 VCOT): After modified Maquet procedure (mTTA), what happened to patellar position and what was the incidence of postoperative patellar luxation?

Answer 45

* Distal displacement of patella (patella baja) occurred after modified Maquet procedure, especially at ~135° stifle opening angle * Postoperative patellar luxation incidence ~1% (0.7%) * Conclusion: mTTA can induce patella baja but did not predispose to patellar luxation in this cohort

Question 46

• Volz (2024 JSAP): In a randomized controlled trial, did intra-articular PRP or hyaluronic acid injections improve outcomes after CCLR treatment?

Answer 46

• Prospective randomized controlled trial: 62 dogs with CCLR (per summary) • No benefit of PRP or HA intra-articular injections; no differences through 6 months • TPLO improved lameness in all dogs (per summary)

Question 47

• MacCormick (2023 JAVMA): In dogs >50 kg undergoing TPLO with a 3.5/4.0 mm 'jumbo' TPLO plate, what complication and SSI rates were reported?

Answer 47

• Postoperative complications reported in 45% overall (5% minor, 40% major, 5% catastrophic) (per summary) • SSI rate reported as 20% • TPA increased during convalescence (≈0.83° to 1.17°) (per summary) • Despite high complication rates, all achieved healing and owners perceived long-term outcomes as excellent (per summary)

Question 48

• Walker (2022 Vet Surg): In dogs undergoing bilateral TPLO within 6 months, was bone healing different between first and second side?

Answer 48

• Retrospective: 48 dogs / 96 stifles (per summary) • No difference in bone healing between the first and second side

Question 49

• Bascunan (2020 Vet Surg): Vascular ring anomalies in cats: 20 cases — what are the key findings/clinical takeaways?

Answer 49

• Cats: 90% survival, persistent clin signs 70% and megaesophagus 30%; 85% PRAAs, 25% with concurrent aberrant left subclavian

Question 50

• Grimes (2020 JAVMA): Characteristics & long-term outcomes of dogs w/ gastroesophageal intussusception — what are the key findings/clinical takeaways?

Answer 50

• Median age 13 months; males, German Shepherds most common 35% (33%) • Vomiting and regurgitation most common clinical signs (67%/33%) • 30% (28%) of dogs euthanized without treatment • 90% of treated dogs (25 surgically, 1 endoscopically) survived to discharge – MST = 995 days • At last follow up, 35% of dogs that survived to discharge died for reasons related to persistent regurgitation • Endoscopic attempted in 6, only successful in 1 (incidental finding) • Dogs w/acute signs or ME were more likely to have persistent regurgitation

Question 51

• Heald (2022 Vet Surg): Electroceutical treatment of infected chronic wounds in a dog and a cat — what are the key findings/clinical takeaways?

Answer 51

• Decreased wound sizes after 10-17 days of printed electroceutical dressing treatment, neg culture • Wounds healed at 70 days (dog) and 50 days (cat) • Application of PED lead to closure of two chronic wounds and resolution of persistent infection • Printed electroceutical dressing treatment may provide a new modality to mitigate infection and promote healing of chronic wounds

Question 52

• Pieczynski (2024 Vet Surg): Description of a cricotracheostomy technique for permanent tracheostomy in 8 dogs — what are the key findings/clinical takeaways?

Question 53

• Erickson (2021 JAVMA): Incidence, survival time & surgical treatment of parathyroid carcinomas in dogs: 100 cases — what are the key findings/clinical takeaways?

Answer 53

• Clin signs: PU/PD 44%, HL paresis 22%, lethargy 21%, hyporexia 20% • US 100% diagnostic: single nodule 70%, two nodules 25%, >=3 nodules in 5% • W/in 1 wk after sx: hyperCa resolved in 93% dogs, 33% dogs developed hypoCa • MST 2 yrs

Question 54

• Peng (2025 Vet Surg): Comparison of remote and in-person respiratory function grading of brachycephalic dogs — what are the key findings/clinical takeaways?

Answer 54

• Poor to moderate RFG (resp function grading) agreement

Question 55

• Solari (2025 AJVR): Laparoscopic US identifies more liver lesions in dogs compared to transabdominal US — what are the key findings/clinical takeaways?

Question 56

• Eiger (2024 Vet Surg): Near-infrared fluorescence angiography with ICG to evaluate direct cutaneous arteries used for canine axial pattern flaps — what are the key findings/clinical takeaways?

Answer 56

• Agreement was poor for THO and OMO with higher chance for adjustment based on poor visualization

Question 57

• Miller (2024 Vet Surg): Linear and discrete foreign body small intestinal obstruction outcomes, complication risk factors, and single incision red rubber catheter technique success in cats — what are the key findings/clinical takeaways?

Answer 57

• No difference in survival for LFBO vs DFBO; 2/169 (1%) dehiscence rate; no difference in complication rates; Red rubber cath successful in 20/24 cases (85%).

Question 58

• Williams (2025 AJVR): Endoscopic evaluation of the feline tympanic bulla is feasible for detection of epithelial remnants following ventral bulla osteotomy in a cadaveric model — what are the key findings/clinical takeaways?

Question 59

• Hildebrandt (2024 JAVMA): Surgery and postoperative definitive radiotherapy for management of canine soft tissue sarcoma: a multi-institutional retrospective study — what are the key findings/clinical takeaways?

Answer 59

• 40% grade 1, 50% grade 2, 10% grade 3; • Use of radiation was associated with decreased local progression; • Age, grade, previous recurrence, and institution type for surgery were associated with overall survival.

Question 60

• Hildebrandt (2023 Vet Surg): Buccal transposition flap for closure of maxillary lip defects in 5 dogs — what are the key findings/clinical takeaways?

Answer 60

• Buccal transposition flap perfused by branches of angularis oris and superior labial artery • Complications: 60%, oronasal fistula 40%, partial flap dehiscence 20%

Question 61

• McNamara (2023 JAVMA): Risk factors for intraoperative hemorrhage & perioperative complication & short- & long-term outcomes during surgical PDA ligation — what are the key findings/clinical takeaways?

Answer 61

• Intraoperative hemorrhage: 10% (10.8%), intraoperative mortality 2% • 95% of dogs experiencing intraoperative hemorrhage survived to discharge • Overall survival to discharge was 97% • No association of age, weight, or increasing La:Ao ratio

Question 62

• Mickelson (2021 Vet Surg): Evaluation of a microvascular anastomotic coupler for end-to-side arterial and venous anastomosis for feline renal transplantation — what are the key findings/clinical takeaways?

Answer 62

• Intraop hemorrhage negligible and renal perfusion excellent • Venous anastomosis: 10 min (11 min), arterial anastomosis: 20 min (22 min) • 1 cat euthanized 5 hrs postop: hemorrhage from dorsal aorta branch (15%) • Renal perfusion & RI normal at all times • 30d postop: complete anastomotic endothelization with fibrosis surrounding MAC

Question 63

• Herron (2024 JAVMA): Muzzle-shortening rhinoplasty as a novel reconstructive technique to prevent ventral nasal deviation after bilateral rostral maxillectomy in a dog — what are the key findings/clinical takeaways?

Question 64

• Ludwig (2021 JAVMA): Toxoplasma gondii infection in feline renal transplant recipients — what are the key findings/clinical takeaways?

Answer 64

• 100% SN-UNK cats developed inf after renal transplant & immunosuppressives • 75% fatal • 5% SP cats w/ prophylactic T. gondii tx developed nonfatal inf 🡪 allograft rejection • 0% fatal infection • Screen carefully post op for toxoplasma gondii in seronegative cats, treat seropositive lifelong with clindamycin, have T.gondii on ddx for cats with respiratory signs, if hits that point often fatal • Laura Peycke DVM DACVS

Question 65

• Peycke (2022 Vet Surg): Center of rotation of angulation-based leveling osteotomy for stifle stabilization in skeletally immature dogs — what are the key findings/clinical takeaways?

Answer 65

• recurvatum 5%, tibial valgus 15% (revised due to o- req), 100% fxn well 2 yr post

Question 66

• Schlag (2020 Vet Surg): Center of rotation of angulation-based leveling osteotomy combined with a coplanar cranial closing wedge ostectomy to manage cranial cruciate ligament insufficiency in dogs with excessive tibial plateau angle — what are the key findings/clinical takeaways?

Answer 66

• Average 10 degrees postop TPA (ideal for CBLO); grade 4 healing occurred in 100% at 8 weeks postop • 30% complication rate • Tangent of number of degrees to be corrected with CCWO * diameter of bone at the CORA = wedge resection

Question 67

* Thieman (2021 Vet Surg): Adaptation of a hands-on veterinary surgical training course from a traditionally taught laboratory to a remotely taught laboratory during a global pandemic — what are the key findings/clinical takeaways?

Question 68

* Grimes (2025 JAVMA): Folded-flap palatoplasty is not superior to cut-and-sew staphylectomy for the treatment of brachycephalic obstructive airway syndrome in English bulldogs — what are the key findings/clinical takeaways?

Answer 68

* SS (Cut & sew) resulted in shorter soft palate length compared to FFP (Folded flap) * No other variable different (exercise-tolerance testing, ABG, head CT, owner survey, pharyngeal volume, soft palate thickness)

Question 69

• Hatch (2025 JAVMA): Dogs neutered prior to perineal herniorrhaphy or that develop postoperative fecal incontinence are at an increased risk for perineal hernia recurrence — what are the key findings/clinical takeaways?

Answer 69

• 4.4x increased risk if neuter performed prior to hernia • 15% recurrence overall • Fecal incontinence 3.4x increased risk of recurrent hernia

Question 70

• Baker (2024 JFMS): Risk factors affecting all-cause mortality in cats hospitalized by a referral soft tissue service — what are the key findings/clinical takeaways?

Answer 70

• Overall mortality of 6.1% • Increased ASA status and emergency surgery significant risk factors

Question 71

• Hillier (2024 JAVMA): Dogs receiving cyclooxygenase-2-sparing NSAIDs &/or nonphysiologic steroids are at risk of severe GI ulceration — what are the key findings/clinical takeaways?

Answer 71

• All dogs getting 2 NSAIDs had full thickness ulceration

Question 72

• McAlexander (2024 JAVMA): Diagnostic and surgical treatment for traumatic bile peritonitis in dogs and cats — what are the key findings/clinical takeaways?

Answer 72

• Rupture occurred most common at CBD in dogs and cystic duct in cats • Most common surgery was cholecystoduodenostomy & CBD repair in dogs and cholecystectomy in cats • 90% survival

Question 73

• McGrath (2022 JFMS): Clinical presentation and outcome in cats with aural squamous cell carcinoma: a review of 25 cases (2010-2021) — what are the key findings/clinical takeaways?

Answer 73

• Median survival 168 days (surgery) vs 85 days (medical management, RT, chemo) groups • SCC of ear canal/middle ear in cats with a locally aggressive tumor with poor px • Notes: 25% ear canal tumors in cats will have bulla involvement; In this group, 30% were canal only, 55% had middle ear involvement, and 15% (n=2) had neoplasms localized to middle ear alone (rare)

Question 74

• Walter (2024 Vet Surg): Treatment of retroperitoneal sarcoma results in improved outcomes — what are the key findings/clinical takeaways?

Answer 74

• Hemangiosarcoma was most common 75% • Cytoreductive sx in 55%, biopsy only in 45% • 40% of surgery dogs had local recurrence, no diff in survival time with cytoreductive or curative intent • MST 250d, RF surviv: surgical excision, adjuvant chemo • Hemangiosarcoma assoc w/ death

Question 75

• Dickerson (2023 Vet Surg): Outcome in 38 dogs surgically treated for hepatic abscessation — what are the key findings/clinical takeaways?

Answer 75

• Preoperative peritoneal effusion in 84% (septic peritonitis in 91% of samples, 55% total) • Liver lobectomy most common procedure 27 (71%), omentalization in 9 (6 only), debridement in 1, 2 liver biopsies only • Single organism in 70% (E. coli), hepatic neoplasia identified in 30% • Complications in 55% (regurg, asp pneumonia, panc), 21% in hospital mortality (79% survive to discharge) • MST for those discharged = 638 days (~1.7 yrs) – long term px good, no recurrence • Dogs undergoing sx for hepatic abscess have high periop mortality but good long term prognosis w/low risk of recurrence

Question 76

• Hixon (2023 JAVMA): Bupivacaine liposomal injectable suspension does not provide improved pain control in dogs undergoing abdominal surgery — what are the key findings/clinical takeaways?

Answer 76

• BLIS or saline infusion into muscle fascia, subcutaneous tissue, and intradermal layer, postop measurement of pain via electron algomoeter, short version of Glasgow Compositive Measure Pain Scale, and indirect measures of pain (sys BP, HR, and cortisol) • No difference in algometer readings, GCMPS scores, need for rescue analgesia between BLIS and saline. No difference in postoperative incisional infection rates or complications

Question 77

• Enright (2022 Vet Surg): Short- and long-term survival after adrenalectomy in 53 dogs with pheochromocytomas with or without alpha-blocker therapy — what are the key findings/clinical takeaways?

Answer 77

• Intraop: hypertension in 87%, arrhythmias in 30%; most had preop alpha-blocker tx, not associated with survival and intraop SAP was ~20% higher in dogs treated preop w/ alpha-blocker • Survival to discharge: 83% • MST 1169d • Recurrence susp in 7% dogs, mets susp in 18% dogs

Question 78

• Michael (2023 JAVMA): Perioperative ventricular arrhythmias are increased with hemoperitoneum and are associated with increased mortality in dogs undergoing splenectomy for splenic masses — what are the key findings/clinical takeaways?

Answer 78

• Ventricular arrhythmia occurred in 45% of dogs (40% postop, 15% intraop, 10% preop; 15% had more than 1) • Factors associated with intra and postop VA: increasing heart rate and body weight, decreasing PCV and platelet count, hemoabdomen, transfusion, and diagnosis of hemangiosarcoma • Multivariate analysis: hemoabdomen, increasing body weight, and increasing heart rate • Mortality rate: 6% overall; 10% with VA, 4% without • Intraoperative and postoperative VA associated with in-hospital mortality

Question 79

• Bush (2023 Vet Surg): Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi-institutional, retrospective, Veterinary Society of Surgical Oncology study — what are the key findings/clinical takeaways?

Answer 79

• Overall MST 1886 d., local recurrence in 42% with DFI 191 days • Metastatic rate: 32%, overall DFI 299d. • LN metastasis present in 29% of dogs at which lymphadenectomy was performed at same time, sig shorter DFI 98 days and shorter MST 248 d • Nodal mets is a big negative prognostic indicator, otherwise prognosis with this disease is more favorable than has been previously reported

Question 80

• Grossman (2021 JAVMA): Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats — what are the key findings/clinical takeaways?

Answer 80

• Major complication rate: 10% • Mortality rate: 14% • Shorter survival: BCS < 4/9, preexisting heart dz, major periop complications, long-term postop liquid feces • Constipation recurred in 32% cats (median 344d) • Not assoc w/ ICJ retention versus removal • ICJ removal assoc with liquid feces & fair/poor outcome on owner assessment • Survival time longer with surgery (10.9 yrs) than medical mgmt (3.4 yrs) • Continued clinical signs at 6-12 mo after dx: surgery 14% vs MM 40% • Perioperative mortality rate: 7.3%

Question 81

• Schick (2022 JAVMA): Evaluation of the validity of the double two-thirds rule for diagnosing hemangiosarcoma in dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass: a systematic review — what are the key findings/clinical takeaways?

Answer 81

• 73% malignant splenic lesion (3/4), of which 87% were HAS; higher than the 2/3 2/3 rule

Question 82

* Rajeev (2022 JAVMA): Surgical treatment of deep neck infections in 19 dogs — what are the key findings/clinical takeaways?

Answer 82

* Increased neutrophil-to-lymphocyte ratio on CBC was correlated to decreased duration of CS’s before presentation and an increased length of hospitalization * Polymicrobial infections common (42%) * Change in abx treatment based on culture was NOT common (15%) * CT useful to plan surgery; Empirical tx with clavamox (broad spectrum abx) should be considered

Question 83

• Chen (2024 Vet Surg): Accuracy, precision, and interobserver and intraobserver agreements related to pressure-measurement devices — what are the key findings/clinical takeaways?

Answer 83

• Water man w/ builtin gauge most accurate/precise, followed by art pressure transducer • All ok to use, all within 1.3 cmH2O, but use WMr or WMg first

Question 84

• Gollnick (2023 JFMS): Retrospective evaluation of surgical treatment of linear and discrete gastrointestinal foreign bodies in cats: 2009-2021 — what are the key findings/clinical takeaways?

Answer 84

• All cats survived, no postop septic peritonitis (likelihood < 5.2%) • LFB had sig higher BCS, albumin, ASA, surgery length, and total cost of visit than DFB • LFB more likely to develop SSI (43% vs. 4%) and be administered postop abx (44% vs. 15%)

Question 85

• Snipes (2023 JAVMA): Acute kidney injury is common in dogs with septic peritonitis and is associated with increased mortality — what are the key findings/clinical takeaways?

Answer 85

• AKI in 40% (grade I: creatinine increases >= 0.3 mg/dL within nonazotemic range during 48 hour interval; grade II mild AKI if creatinine was between 1.7 to 2.5, grade III with mild AKI in 2.6 to 5, grade IV: 5-10, grade V: >10). 25% presented with it, 15% developed postoperatively (60% continued to have it from presentation) • Risk factors for presenting with AKI: increased baseline respiratory rate, decreased systolic blood pressure, increased body condition score • No significant factors for developing AKI postoperatively • Mortality rate of 20%, of which 75% had an AKI and 25% did not; AKI decreased odds of survival

Question 86

• Grimes (2020 JAVMA): Characteristics and long-term outcomes of dogs with gastroesophageal intussusception — what are the key findings/clinical takeaways?

Answer 86

• Median age 13 months; males, German Shepherds most common 35% (33%) • Vomiting and regurgitation most common clinical signs (67%/33%) • 30% (28%) of dogs euthanized without treatment • 90% of treated dogs (25 surgically, 1 endoscopically) survived to discharge – MST = 995 days • At last follow up, 35% of dogs that survived to discharge died for reasons related to persistent regurgitation • Endoscopic attempted in 6, only successful in 1 (incidental finding) • Dogs w/acute signs or ME were more likely to have persistent regurgitation

Question 87

• Ogden (2020 Vet Surg): Outcomes associated with vaginectomy and vulvovaginectomy in 21 dogs — what are the key findings/clinical takeaways?

Answer 87

• 70% were smooth muscle origin (leiomyomas, leiomyosarcomas, leiomyofibromas) • Major complications requiring revision: 10% • Postop incontinence in 30% dogs, half of these resolved spontaneously w/in 60d • 30% malig tumors, MST 626d (at least 71d), recurrence in 33% • 70% benign tumors, MST not reached (at least 104d), no recurrence

Question 88

• Billas (2022 Vet Surg): Incidence of and risk factors for surgical site infection following canine limb amputation — what are the key findings/clinical takeaways?

Answer 88

• SSI incidence was 10% • RF for SSI included: muscle transection with BVSD (2.5x), procedures other than clean, and amputation for bacterial infection or traumatic injury (v. neoplasia)

Question 89

• Grimes (2022 Vet Surg): Surgical ligation of patent ductus arteriosus in dogs: Incidence and risk factors for rupture — what are the key findings/clinical takeaways?

Answer 89

• PDA rupture rate: 7% (no diff in age or weight found), mortality rate 0.4% • Major complications rate: 1.4% (all in nonruptured group) • Residual flow rate: 10% (9.4%); more likely in dogs with rupture, but similar flow rate if ligation performed after rupture (rather than hemostasis only)

Question 90

• Guest (2023 JAVMA): Performing an ovariohysterectomy at the time of c-section does not pose an increase in risk of mortality, intra- or postoperative complications, or decreased mothering ability of the bitch — what are the key findings/clinical takeaways?

Answer 90

• No difference btw groups in anesthesia duration, intraop/postop complications, mothering ability, puppy survival to weaning • CSOVH bitches had: • Longer sx times (55 min vs 47 min) – not clinically sig • Longer time from delivery to nursing (75 min vs 65min) – not clinically sig • More frequently perceived as painful postop by owner • All 90 bitches survived until puppy weaning

Question 91

• Hillier (2023 JAVMA): Improved predictability is needed for calculators used to preoperatively determine the etiology of splenic masses in dogs: an external validation study of the HeLP score and T-STAT — what are the key findings/clinical takeaways?

Question 92

• Dickson (2021 JAVMA): Surgical management and outcome of dogs with primary spontaneous pneumothorax: 110 cases (2009-2019) — what are the key findings/clinical takeaways?

Answer 92

• 90% median sternotomy vs. 8% intercostal thoracotomy; 2% thoracoscopy • Most common sites for bullous lesion: 35% (33%) in left cranial lung lobe, 25% (24%) in right cranial

Question 93

• Cray (2021 JAVMA): Analysis of risk factors associated with complications following mandibulectomy and maxillectomy in dogs — what are the key findings/clinical takeaways?

Answer 93

• Each add’n hr of sx, odds of comp incr by 36% • Incisional dehiscence or oronasal fistula formation with preop RT or chemo (OR 3) or maxillectomy (OR 1.8) • 90% comps occurred within first 3 mo postop • Increased odds of blood transfusion with caudal maxillectomy (univariate analysis)

Question 94

• Dickerson (2020 Vet Surg): Dorsal offset rhinoplasty for treatment of stenotic nares in 34 brachycephalic dogs — what are the key findings/clinical takeaways?

Answer 94

• No major complications • 10% (11%) had collapse of 1 or 2 nares, 95% (94%) owners very satisfied with outcome

Question 95

• Larose (2020 Vet Surg): Clinical findings and outcomes of 153 dogs surgically treated for intestinal intussusceptions — what are the key findings/clinical takeaways?

Answer 95

• Most common location: ileocolic (43%), no cause found in 67% of cases • IRA 84%, 18% enteroplication (13 with and 15 without IRA) • Intraoperative complications: 7% (intestinal dmg during manual reduction) • Postop complications: 35%, most common diarrhea, regurgitation, septic peritonitis • Severe events 14% (grade 3 or 4, considered life threatening) • Recurrence rate: 3% (all w/in 72 hrs postop) • Mortality rate at 14d postop: 6%

Question 96

• Adams (2022 Vet Surg): Risk factors for neonatal mortality prior to hospital discharge in brachycephalic and nonbrachycephalic dogs undergoing cesarean section — what are the key findings/clinical takeaways?

Answer 96

• Overall neonatal survival to discharge 95% • Brachycephalics 95%, non-brachycephalics 90% (similar survival for both groups) • Puppies survived elective c-section with higher survival (99%) than emergency c-section (90%) • Puppies delivered in large c-section litters had higher survival

Question 97

• Iodence (2021 JAVMA): Dogs undergoing surgical excision of mast cell tumors are not at increased risk of incisional complications — what are the key findings/clinical takeaways?

Answer 97

• Same complication rates: 15% MCT (13%) and STS (14%) • Increased odds of incisional complications: post-operative chemotherapy • Caution using chemo < 30 days postop for MCT

Question 98

• Sakai (2021 Vet Surg): Influence of doxapram and intermittent 10% carbon dioxide inspiration on cardiovascular and laryngeal functions in anesthetized dogs — what are the key findings/clinical takeaways?

Answer 98

• Doxapram caused hypertension (mean arterial BP up to 81%) and tachycardia (up to 79%) but inhaled CO2 didn’t • Inspiratory normalized glottic gap areas incr with all groups • Greater with 2.2 mg/kg doxapram than 0.55 mg/kg doxapram and inhaled CO2; consider using inhaled 10% CO2 instead of doxapram

Question 99

• Lux (2021 JAVMA): Evaluation of short-term risk factors associated with dehiscence and death following full-thickness incisions of the large intestine in cats: 84 cases (1993-2015) — what are the key findings/clinical takeaways?

Answer 99

• Dehiscence rate: 8% • Risk factors: hypoalbuminemia, renal dysfunction, receiving blood products or >2 classes of abx, and intra-abdominal fecal contamination • Survival to discharge: 94% • Risk factors for nonsurvival: low globulin, repair of colonic trauma/dehiscence, postop colonic dehiscence

Question 100

• Sirochman (2020 Vet Surg): Influence of use of a bipolar vessel sealing device on short-term postoperative mortality after splenectomy: 203 dogs (2005-2018) — what are the key findings/clinical takeaways?

Answer 100

• 7% in hospital mortality, 3% post-discharge, total 10% short term mortality rate, no difference between groups • Duration of anesthesia was longer without BVSD • Multivariate analysis factors associated with death prior to discharge: intraoperative or postoperative administration of blood products (OR 15, 13), increasing duration of anesthesia (1.15), and intraoperative ventricular arrhythmias • Multivariate analysis factors with death prior to suture removal: administration of blood products intraoperative (3.2) or postop (7.7) • Conclusion: Use of a bipolar vessel sealing device did not increase short-term mortality after splenectomy. • Dogs undergoing splenectomy that require intraop or postop transfusions, experience intraop ventricular arrhythmias, or have prolonged anesthesia may be at risk for death in the short-term postop periop

Question 101

• Morgan (2020 Vet Surg): Outcome after surgical and conservative treatments of canine peritoneopericardial diaphragmatic hernia: A multi-institutional study of 128 dogs — what are the key findings/clinical takeaways?

Answer 101

• 91 surgical treatment (70%), 37 conservative treatment (30%) • Surgical group: younger, sexually intact, had more clin signs, had other congenital abnormalities • 97% survived to discharge • Complications (most were low-grade): intraop 20% (22%) (minor hypothermia, hypotension) vs. postop 40% (41% ) (mostly minor with pneumopericardium, pneumothorax, hypoxemia being most common) • MST: surgical 8.2 yrs vs. conservative 5 yrs • Liver was most commonly herniated (65%) followed by SI (50%); multiple organs were herniated in 70% of dogs - usu. liver, gallbladder and SI • Weimaraners most common breed • Other congenital defects: umbilical hernia, sternal deformities, cardiac abnormalities • Significant adhesions present in 15% of dogs • Primary closure of PPDH was possible in 93% of dogs - PDS simple continuous most common

Question 102

• (2021 JAVMA): JAVMA 2021. — what are the key findings/clinical takeaways?

Question 103

• Dickerson: Management of a urethral tear with porcine small intestinal submucosa-augmented urethroplasty and balloon dilation for subsequent urethral stricture in a cat — what are the key findings/clinical takeaways?

Answer 103

• PU attempted but large urethral tear noted 4 mm – urethroplasty performed with porcine SIS and PU performed, left u-cath in place for 5 days. • Following stranguria stricture was diagnosed – ballooning performed and then repeated with triamcinolone injection at 10 weeks post op, doing well at 18 month follow up • Nina Kieves DVM DACVS

Question 104

• Lotsikas (2025 Vet Surg): Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: a cadaveric study — what are the key findings/clinical takeaways?

Answer 104

• No damage to LDE • Superficial iatrogenic articular cartilage injury in all specimens with no difference between distractor and non-distractor group

Question 105

• Biggo: Characteristics, surgical treatment, and outcomes of injuries involving the tarsus in greyhounds — what are the key findings/clinical takeaways?

Answer 105

• Greyhound 55% CTB fx, 55% calc fx, 35% prox IT sublux; most common was CTB + calc fx 30% • 99% surv discharge, 40% SSI, 50% explant; bilat approach ↑ SSI risk

Question 106

• Zann: Long-term outcome of dogs treated by surgical debridement of proximal humeral osteochondrosis — what are the key findings/clinical takeaways?

Answer 106

• All received orthopedic exam, kinetic gait analysis, shoulder radiographs, shoulder CT, and arthroscopy • Affected OC limb: decreased brachial circumference, decreased max shoulder extension, and less flexion • No difference in peak vertical force or vertical impulse between affected and nonaffected limb but 5% decrease load on operated limb • OA was present in all shoulders treated for OC lesions and was increased compared to contralateral and limb as evaluated on CT and radiograph in unilateral cases • Arthroscopically, all had incomplete cartilaginous infilling (<60% in all) and moderate to severe synovitis in all OC joints; all owners however perceived mobility was satisfactory (LOAD score 6; mild)

Question 107

• Stoneburner: Conservative nonsurgical treatment for cranial cruciate ligament disease can be an effective management strategy in cats based on validated owner-based subjective assessment in some cases — what are the key findings/clinical takeaways?

Answer 107

• 75% cats able to bear weight within a week of medical management • 85% clinically normal within 3 months • 95% owners felt cats had good to excellent outcome with medical management • Surgery might not always be necessary in cats with CCL tear

Question 108

• Markley: Internet-based survey of the frequency and types of orthopedic conditions and injuries experienced by dogs competing in agility — what are the key findings/clinical takeaways?

Answer 108

• 40% experienced an injury that kept them from participating for >1 week; most common injury locations were shoulder (30%) and iliopsoas (20%) • Highest injury rate Australia and lowest injury rate USA

Question 109

* Bertran (2021 Vet Surg): Penile urethral resection and anastomosis augmentation with regional tissue tension relieving technique: A cadaveric mechanical study and clinical outcome in two dogs — what are the key findings/clinical takeaways?

Answer 109

* Augmentation technique improved tensile properties of penile resection and anastomosis and was associated with successful outcomes in two dogs; use of tunica albuginea as reinforcement * Augmentation higher minimal tensile strength and maximal tensile strength compared to simple

Question 110

* Upchurch: Effect of Duration and Onset of Clinical Signs on Short-Term Outcome of Dogs with Hansen Type I Thoracolumbar Intervertebral Disc Extrusion — what are the key findings/clinical takeaways?

Answer 110

* Clin sign duration & rate of onset did NOT correlate with return of pain sensation, urinary continence, and ambulation * Only preop neuro grade assoc with outcome * Survival time longer with surgery (10.9 yrs) than medical mgmt (3.4 yrs) * Continued clinical signs at 6-12 mo after dx: surgery 14% vs MM 40% * Perioperative mortality rate: 7.3%

Question 111

• Friesen (2021 JSAP): - Clinical findings for dogs undergoing elective and nonelective cholecystectomies for gall bladder mucoceles — what are the key findings/clinical takeaways?

Answer 111

• Mortality rate: 6% (elective) vs. 23% (nonelective) • Complication rate: 52% (elective) vs. 50% (nonelective) • Most in elective were grade 1 (mild) • Postop hyperthermia • 35% in duodenotomy + retrograde cath • 4% in normograde cath • 7% in no cath • Jason Syrcle DVM DACVS

Question 112

• Huerta (2025 VCOT): Evaluation of osteotomy healing in boxer dogs undergoing TPLO using two radiographic scoring systems — what are the key findings/clinical takeaways?

Answer 112

• Both 5 & 10 point systems had good consistency • Boxers had significantly lower healing at 8 weeks compared to labs

Question 113

• Castaldo (2021 VCOT): Biomechanical Comparison of External Fixation and Double Plating for Stabilization of a Canine Cadaveric Supracondylar Humeral Fracture Gap Model — what are the key findings/clinical takeaways?

Answer 113

• No constructs failed during cyclic testing or lost stiffness • Double plate was stronger in load to failure and mean stiffness in the final 100 cycles was greater; either can be used but double plate better if uncooperative patient • More than one exam committee member on the paper: • Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats.

Question 114

* Evaluation of outcomes following subtotal colectomy for the treatment of idiopathic megacolon in cats. Grossman.

Answer 114

* Major complication rate: 10% * Mortality rate: 14% * Shorter survival: BCS < 4/9, preexisting heart dz, major periop complications, long-term postop liquid feces * Constipation recurred in 32% cats (median 344d) * Not assoc w/ ICJ retention versus removal * ICJ removal assoc with liquid feces & fair/poor outcome on owner assessment

Question 115

* Simple ostectomy to address quadriceps impingement caused by distal femoral malunion in four dogs. Jones SC.

Answer 115

* Ostectomy of the fracture segment that was causing quadriceps impingement performed * Long-term showed femur remodeling with increase in femoral length and return to near-normal femoral procurvatum * Owners deemed QOL/function as excellent in all

Question 116

* Blinded, randomized, placebo-controlled study of the efficacy of bupivacaine liposomal suspension using static bodyweight distribution and subjective pain scoring in dogs after tibial plateau leveling osteotomy surgery Aldrich

Answer 116

* Compare nocita to placebo, double blinded placebo randomized prospective study; 15 dogs with TPLO * No difference in glascow coma score, body weight distribution, rescue opioids needed in nocita vs non-nocita groups

Question 117

* Thoracolumbar Intervertebral Disk Extrusion in Dogs: Do Onset of Clinical Signs, Time of Surgery, and Neurological Grade Matter? Compagnone

Answer 117

* 0-12hr, 12-24hr, and >24hr * Acute onset of clinical signs was significantly assoc. with worse neurologic grade and outcomes * Significant difference between S1, S2, and S3 with neurologic grade at presentation and discharge * Significance lost when adjusted for grade at presentation * Disc fenestration associated with faster return to ambulation * Duration of clinical signs and time of surgery NOT associated with time to recovery, return of pain sensation, urinary continence, or ambulation * Take home: dogs with more severe neurologic status or acute signs usually had surgery quicker, but outcomes were poorer; no significant evidence for better outcome when surgery was performed quicker