Clinical Small Animal Research Articles

Abdominocentesis and intra-abdominal pressure measurement in small animals.

To provide a video tutorial detailing how to perform "blind" and ultrasound-guided abdominocentesis for diagnostic and therapeutic guidance, and to provide a brief demonstration of intra-abdominal pressure measurement (IAP). Any cat or dog with suspicion of free abdominal effusion or patients requiring measurement of IAP. Abdominocentesis should be performed when there is high suspicion for peritoneal effusion based on physical exam and/or diagnostic imaging. The 4-quadrant tap uses 20-gauge or larger needles placed blindly in ≥ 1 of the 4 quadrants of the abdomen to collect abdominal fluid. In contrast, ultrasound allows visualization of fluid in the abdomen prior to percutaneous insertion of a needle and syringe to collect fluid. Regardless of collection technique, fluid should have immediate cytologic analysis and later can be submitted for biochemical parameters, additional cellular analysis by a pathologist, and culture and sensitivity (in rare cases if indicated). Intravesicular bladder pressure measurement using a manometer-urinary catheter system approximates the IAP when there is concern for organ hypoperfusion and compartment syndrome. Abdominocentesis can be performed with and without the use of ultrasound guidance. Intravesicular bladder pressure measurement is used to diagnose and trend IAP values before and after treatments are performed. Abdominocentesis is a simple and safe technique that all small animal clinicians should be comfortable performing. Effusion sampling can guide further diagnostics and treatments. Measurement of IAP is simple and requires no specialized equipment.

Career transition plans of veterinarians in clinical practice.

Gain an understanding of the career transition plans of veterinarians in clinical practice. Veterinary members of the Veterinary Information Network (VIN) working as small animal clinicians. An electronic survey distributed via the VIN data collection portal. A total of 1,256 responses from veterinarians in clinical practice were analyzed, with 61% indicating they plan to decrease their clinical work, and 31% to stop entirely within the next 5 years. The most common reasons for these choices were to have more free time for oneself and/or family/friends (76%), to maintain good health (59%), and feeling burned out (50%). Factors that might entice them to retain their current number of clinical hours included reduced workload or shorter hours (42%), financial incentivization (38%), and improved working conditions (26%). Concerns related to retirement were common with 47% of participants in our study reported feeling concerned about the loss of professional identity, 34% reported concern about reduced social connections, and 28% reported concern as to how they would fill their time. The reported desire to reduce/stop one's clinical work within the next 5 years by 42% of veterinarians ≤44 years of age, with burnout a primary predictor, offers insights into the necessity of change at the organizational, systemic (versus individual) level. The fact that many participants reported concerns related to retirement and 32% reported that they did not have adequate retirement information suggests a need for supportive services to help ensure a successful transition.

Prevalence of burnout syndrome among veterinarians in Spain.

Burnout is a syndrome of emotional distress common in health-care professions. The aim of this study was to assess the potential levels of burnout syndrome among veterinarians in Spain as well as different factors involved in its prevalence. 282 Spanish veterinarians (57.4% women and 42.6% men). All data were obtained through an online survey. The instrument utilized for this purpose was the Maslach Burnout Inventory Human Services Survey (adapted to a Spanish-speaking population), with analyses performed using statistical software. Moreover, a sociodemographic questionnaire was utilized. Within the considered population, 23% suffered from burnout syndrome and the average scores were 29 points for emotional exhaustion, 14 points for depersonalization, and 35 points for personal accomplishment. A higher prevalence of burnout was associated with small animal clinicians (75.3%) and women (66.1%), in comparison to large animal clinicians (24.6%) and men (33.8%). This study showed for the first time that burnout syndrome is a current and highly relevant risk for Spanish veterinarians. The results obtained could help to raise awareness of this reality and the factors involved in the development or exacerbation of this syndrome.

Percepções do médico veterinário a respeito da eutanásia animal e a relação com sua saúde mental

ABSTRACT: Ethical and moral issues surround the practice of animal euthanasia, which often damages the veterinarian’s mental health, leading to psychological problems and even suicide. This study aimed to evaluate veterinarians’ perceptions about euthanasia and the possible implications of the practice for their mental health and seek to identify gaps in the training of these professionals. Data collection occurred by applying an online questionnaire sent to veterinarians working in the Brazilian territory. Among the 243 participants, 78% said they did not have classes that broadly addressed the practice of animal euthanasia and dysthanasia during undergraduate disciplines; in addition, 71% claimed that they did not address subjects such as medical ethics, psychology, mental health, and verbal communication. The vast majority (90%) considered not trained to deal with patient death, and 67% have already questioned whether the procedure was the best alternative. The presence of sadness after performing euthanasia was frequent among participants. Small animal clinicians were more susceptible to the presence of this feeling when compared to a veterinarian from other areas. Most veterinarians (86%) believed that the practice of animal euthanasia poses risks to the performer’s mental health, and 89% claimed that it influences their mental health. 17% of the participants were using controlled medications during the research period. So, given these findings, it is evident that animal euthanasia negatively affects the mental health of those who perform it. Measures are needed to minimize the impacts arising from the practice, aiming to improve this population’s health and well-being.

Salmonella Infection, Isolation and Antimicrobial Resistance in Diarrhoeic Dogs Presenting to Clinics in Northwestern Nigeria

Salmonella is one of the most common food-borne bacteria incriminated in gastroenteritis in dogs. The emergence of multidrug resistance (MDR) genes raises spectre of intractable disease and constitute significant public health risk. Already, there are various reports of resistance to several antimicrobials by Salmonella isolates from canine patients. This study was therefore conceived to investigate for the first time in the studied region, Salmonella isolates circulating in canine population in Sokoto State, northwestern Nigeria. Presenting canine out-patients and those admitted for emergencies with overt clinical signs for salmonellosis were recruited for the study. Salmonella was isolated from blood and faecal samples using standard laboratory techniques as required by the Clinical and Laboratory Standards Institute (CLSI). The Gram stain, Salmonella-Shigella agar (SS agar), Brilliant Green Salmonella agar (BGSA) and finally the xylose lysine deoxycholate agar (XLD) at specified temperatures and carbon dioxide adjustments were all applied on samples to isolate Salmonella as pure culture. The Kirby Bauer Disk diffusion method was used to test for antimicrobial resistance. Overall, a prevalence of 19.7% was recorded with pyrexia (18.5%) and diarrhea (13.7%) showing statistically significant (P<0.05) non-random association with Salmonella isolation in patients. The puppy age groups (from day one to five months) recorded prevalence of 31(21.2%) followed by middle-age dogs (6-months to a year) recording prevalence of 24(22.2%). Male dogs presented preponderance of cases compared to the females with prevalence of 48(76.1%). The Nigerian local dog was the highest in the number of cases with a statistically significant (P<0.05) prevalence of 23(36.5%), the German shepherd recorded isolation rate of 19(30.2%) that was also statistically significant (P<0.05). Various antimicrobials used recorded varying degree of resistance patterns when tested with isolates. A total of 19 isolates accounting for 43.2% were resistant to tetracycline, 15(35.7%) isolates recorded resistance for ceftriaxone, 13 isolates accounting for 38.2% presented resistance for metronidazole and 11(27.5%) recorded resistance for amoxicillin. Conversely, isolates were 100% susceptible to chloramphenicol and cotrimoxazole. It is imperative for small animal clinicians, diagnosticians, researchers and public health policy makers to have credible time-tested data on resistance status of Salmonella isolates in dogs, as this is a roadmap to a healthy canine and human population.

Evaluation of new and old biomarkers in dogs with degenerative mitral valve disease

BackgroundDogs with degenerative mitral valve disease are commonly presented to small animal clinicians. Diagnosis, clinical staging, and therapeutic design are based on a combination of clinical examination, radiography, and echocardiography. To support diagnosis and clinical monitoring, a multi-marker-based approach would be conceivable. The aim of this study was to investigate the suitability of Galectin-3 and interleukin-1 receptor-like 1 protein (ST2) in dogs with degenerative mitral valve disease in accordance with N-terminal-prohormone-B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI). For this purpose, serum concentrations of Galectin-3 and ST2 of 64 dogs with different stages of mitral valve disease and 21 dogs without cardiac disease were analyzed at the first examination and six months later. Echocardiography, blood cell count and clinical chemistry were performed and established biomarkers NT-proBNP and cTnI were measured additionally. Differences in the biomarker concentrations between all groups at both timepoints and the change in biomarker concentrations from first to second evaluation was investigated. Furthermore, correlations of each biomarker, between biomarkers and echocardiographic measurements, were calculated. Finally, the receiver-operating characteristic curve and the area under the curve analysis were performed to differentiate between disease stages and controls.ResultsSerum concentrations of Galectin-3 and ST2 were not statistically different between canine patients in the respective stages of mitral valve disease or in comparison to dogs in the control group at any timepoint. A significant increase in ST2 concentrations from the baseline to the follow-up examination was observed in dogs classified as stage B1 and the control group. The concentrations of NT-proBNP and cTnI in stage C dogs were significantly increased in comparison to the other groups.ConclusionsIn this study, no relation between Galectin-3 and ST2 levels to the presence or stage of mitral valve disease could be detected. Nevertheless, considering the increase in ST2 concentrations from the first to second measurement, its value on monitoring disease progress could be feasible. In agreement with previous studies, NT-proBNP and cTnI have once more proven their utility in assessing disease severity. The approach of examining new cardiac biomarkers in dogs is still worth pursuing.

Blood pressure regulation and mechanism of hypertension development in dogs and cats: A review

The review article aims at discussing the mechanisms of blood pressure regulation and hypertension development in dogs and cats. This will enhance the knowledge of clinicians and researchers on the pathophysiology of hypertension and mechanisms of normal blood pressure regulation in small animals. Hypertension is a risk factor for other cardiovascular diseases in man and animals, however, most small animal clinicians do not routinely check the blood pressure until the animals are presented with complications. Hypertension in animals can be essential or secondary but the secondary type is predominant. Blood pressure is regulated by vasoactive agents and hormones such as nitric oxide, bradykinin, endothelin-1, angiotensin II and aldosterone. The blood vessels and the kidney also play major roles in blood pressure regulation. Alterations in the regulation frameworks result in hypertension and cardiovascular diseases as elucidated in this review article. It is therefore essential that the body maintain good anatomic, physiologic and biochemical functions to maintain blood pressure. In conclusion, adequate knowledge of the mechanism by which blood pressure is regulated and the pathophysiology of hypertension will enhance research and potentiate the management of cardiovascular diseases and associated disorders in small animals.

Discussing overweight in dogs during a regular consultation in general practice in the Netherlands.

In previous studies, it has been demonstrated that, similar to general practitioners, veterinarians find it difficult to discuss overweight in dogs. This study aimed to provide insight in the barriers and motivators for veterinarians to discuss overweight in dogs and to compare the results with findings from human medicine. Sub‐hypotheses were postulated based on existing literature to investigate if lack of time, fear of offending clients, or lack of skills were potential barriers, and if feeling responsible and feeling compassion were potential motivators for veterinarians to discuss overweight in dogs. To this end, an online survey (n = 59) was conducted. Furthermore, 15 small animal clinicians working in general practice were interviewed by semi‐structured face‐to‐face interviews. Results from the online survey indicated that veterinarians find it sometimes difficult to discuss overweight in dogs. Veterinarians who responded to the online survey did not experience strong barriers but did make use of motivators (e.g. feeling responsible and feeling compassion) when discussing overweight in dogs. Interestingly, results from the semi‐structured face‐to‐face interviews showed that the responding veterinarians did experience strong barriers, as well as motivators, when discussing overweight in dogs with their clients. The most prominent barrier was customer dissatisfaction, whereas lack of time and lack of skills were also experienced. The most prominent motivator was feeling responsible for animal health and preventive veterinary medicine. These findings were strikingly similar to previous research on discussing childhood overweight by general practitioners. To improve treatment and prevention of overweight in dogs, veterinarians need more communication skills and should be more aware of the motivators that drive their self‐motivation. Improving awareness on overweight and its comorbidities should be a One Health issue.

The new age of renal biomarkers: doesSDMA solve all of our problems?

Within clinical small animal practice, diagnosis of both chronic kidney disease and acute kidney injury is common. To assess renal function, measurement of glomerular filtration rate is considered the gold standard. Currently, routine tests of kidney function include surrogate markers of glomerular filtration rate such as serum creatinine, and urea, each with their own limitations, whilst urine protein to creatinine ratio gives an indication of glomerular and tubular handling of protein, and urine specific gravity information about urine concentrating ability by the kidney. These parameters are used together with historical and physical examination data to give a diagnosis of kidney disease following which creatinine, proteinuria and blood pressure are used to stage chronic kidney disease and, together with urine output, grade acute kidney injury according to the International Renal Interest Society. However, there has been much concern that creatinine is insensitive when used to indicate early decline in renal function and this has highlighted the need for additional methods of diagnosing and monitoring these patients, with the potential to allow earlier therapeutic intervention. Symmetric dimethylarginine is a novel biomarker, which has been shown to perform as a surrogate marker of glomerular filtration rate in small animals. This article will review current research on symmetric dimethylarginine and the ways in which it may be utilised in small animal practice; current research supports the use of symmetric dimethylarginine as a screening test for detection of early chronic kidney disease according to International Renal Interest Society guidelines, but further research is required in to the usefulness of symmetric dimethylarginine as a tool for monitoring disease and the effect of non-renal influences.

Clinicians perception and assessment of risk factors for surgical site infections in small animal practice in South-West, Nigeria

This study evaluated the prevalence of Surgical Site Infections (SSIs), the enhancing risk factors in small animal hospitals and clinics, and clinicians’ perception of SSIs in South-west, Nigeria. Ten years (2007-2017) surgical patients’ case records from four government veterinary hospitals were initially studied. Fifty-seven copies of structured pre-tested questionnaires were further administered to practice representatives in government and private small animal facilities in 6 states of South-West, Nigeria. Data were analyzed with descriptive statistics and Pearson Chi-square at 95% confidence intervals. One hundred and twenty-six out of 584 small animal surgical patients satisfied the inclusion criteria. Eight (6.3%) cases from the case records had SSIs. Fifty out of 57 retrieved questionnaires satisfied the inclusion criteria for analysis. Sixty-four percent of respondents had the Doctor of Veterinary Medicine (DVM) degree while 36% had additional degrees. The majority (64%) of respondents had 1 to 3 years practice experience with the rest having above 3 years. Most of the respondents (96%) had good knowledge of SSI, 78.7% usually manage SSI cases and 18% had lost patients due to SSIs. Only 48% of the practices perform surgery in designated operating rooms. The environment (94%), hands of clinicians/caregiver (80%) and patients’ skin (62%) were the main sources of SSIs in respondents’ practice. Few respondents (19.1%) administer prophylactic antibiotics for all surgeries, 6.1% discontinue within 24 h post-surgery, while 75.5% continue antibiotic therapy for 3 to 7 days post-surgery. Lack of facilities (40%) and funds (54%) prevented some clinicians from keeping up with SSIs prevention measures. There was an association between the risk factors of post-operative wound dehiscence (P=0.006), classification of the surgical procedures (P=0.032) and SSI occurrence. Although many small animal practitioners are aware of SSIs risk factors, only few adhere to prevention protocols. Key words: Surgical site infection (SSI), risk factors, small animal clinicians, perception.

Clinical and Diagnostic Studies on Common Causes of Canine Meningeo-Encephalitis in Egypt

Canine meningeo-encephalitis triggered many causes, some of them can be distinguished and others are invisible and have a great challenge with small animal clinicians. The present study was conducted to detect the common causes of meningeo-encephalitis among dogs that were admitted to the small animal clinic, Faculty of veterinary medicine, Cairo University, Egypt from March to December 2019. About twenty-eight dogs were studied and included thirteen apparently healthy dogs while fifteen dogs suffered from meningeo-encephalitis. All dogs subjected to thorough clinical examination. Whole blood and serum samples were taken for evaluation of hematobiochemical changes. In addition, conjunctival and nasal swabs were taken for rapid detection of canine distemper virus infection (CDV) infection. Also, fecal samples were taken for detection of parasitic infection. Results showed that CDV is the most recorded cause for meningeo-encephalitis. Other causes were recorded included Toxocara canis, Toxascaris leonina, Babesia canis and head trauma. Physical examination revealed significant increase in both respiration and heart rates in affected dogs. Hematological status revealed significant decrease in RBCs count and relative lymphocytes in affected dogs while there was a significant increase in WBCs count and relative neutrophils. Biochemical status indicated significant decrease in serum albumin and A/G ratio while there was a significant increase in serum activity of aspartate amino transferase (AST) and C-reactive protein (CRP) level among diseased dogs. CDV infection is the most recorded cause for meningeo-encephalitis in dogs beside Toxocara spp., Babesia canis and head trauma. Infectious causes have an impact on physical, hematological and biochemical status in affected dogs.

Follow up the Treatment Process of Mitral Valve Diseases by Radiography and Echocardiography in Dogs

Background: Mitral valve disease is the most common acquired heart disease in dogs. Mitral valve regurgitation (MR) due to endocardiosis is an important cause of morbidity and mortality in dog. Echocardiography as a non-invasive tool is routinely used to evaluate and diagnose different disorders in the heart. Objectives: The purpose of this study is to determine the efficacy of medical treatments and follow-up administration by the veterinarians in Tehran, using radiography and echocardiography. Methods: A total of 35 dogs from various breeds with cardiac heat failure (CHF) because of MR were selected for prospective randomized study. After clinical examination and radiography, progressive mitral endocardiosis was confirmed by echocardiography. After that, patients were treated by a routine plans recommended by the general practitioners (12 active small animal clinicians). Follow-up radiography and echocardiography were performed again after 3 months for checking the efficacy of treatment protocol on cardiac output. Results: None of the medically treated patients statically showed significant improvement in their radiographic or echocardiographic parameters, that can be the outcome of incompatibility of using protocols with the standard ones. Conclusions: Although more studies are needed, based on the present results there was no significant change in cardiac parameters after 3 months of treatment. It seems that the current routine medication used by the active practitioner is not effective and cannot make a better quality of life in short term and requires changing the dose, the drugs producers or use of different prescription items.

Insights on the canine mitral valve in the course of myxomatous mitral valve disease

Myxomatous mitral valve disease (MMVD) is the most common heart alteration in dogs. A vast extent of research has been focused on echocardiographic tissue Doppler and strain indices and the medical treatment of this condition, which are beyond the scope of this article. This review intends to include less known information of the mitral valve, acknowledge the American College of Veterinary Internal Medicine (ACVIM) consensus on MMVD and state different surgical approaches and devices, all valuable information for small animal clinicians and cardiologists. Also, during the last decade studies have been oriented towards to understand valve’s mechanical structure and function, genes involved in the etiology and molecular signaling pathways. Advances have been made in understanding the mitral valve, but more assessment and efforts are needed in this specific area.

Ethical dilemmas encountered by small animal veterinarians: challenging the status quo?

Ethical dilemmas frequently arise in veterinary practice and can be a cause of work-related stress. The study by Kipperman and others,1 summarised on p 548 of this week’s Vet Record...

Suspected toxicity by biological waste and air sac nematode infestation in a free-living peregrine falcon (Falco peregrinus)

This case report describes an uncommon complex of mortality in a free living peregrine falcon (Falco peregrinus). The bird was found rinsed with biologic waste and the integument was mildly inflamed. No respiratory signs were detected at first. In addition, no alterations were detected during. During orthopaedic, neurologic, ophthalmologic and radiographic examinations. Parasitological pharyngeal and faecal examination revealed Capillaria spp. and Serratospiculum spp. eggs. The therapeutic scheme included stress reduction, supportive therapy with fluids, antifungals, antibiotics, anti-inflammatory, antiparasitic agents and nutritional management. Cleaning with dishwashing gel to remove the biological waste took place, but its removal was partial. Despite the intensive care, the patient developed respiratory distress and succumbed on the fifth day of hospitalization. Pathological examination revealed adult Serratospiculum tendo parasites in the air sacs and Capillaria spp. in the large intestine. Bacteriological and mycological cultures revealed significant growth of Klebsiella pneumoniae isolated from the skin, heart, lung, liver, kidney and intestine and a mild presence of Candida albicans in the large intestine. Their probable role was judged as secondary. Mild multifocal haemorrhages with heterophilic and lymphohistiocytic infiltrates, fibrin and rod‑like bacteria were detected in the skin histopathologically, confirming the clinical integument inflammation. Cause of death was asphyxia caused by oedema, haemorrhages and blood congestion of the lung. The contribution of S. tendo in the initial spill event and case evolution is discussed. This unusual case highlights the complexity of the wildlife cases, with which avian or small animal clinicians (consulting rehabilitation centres or falconers) might be confronted. Although the application of ancillary and advanced diagnostic tools, the in-depth knowledge of the species and the intensive monitoring are important, this might lead to an unrewarding outcome. Financial constraints in wildlife casualty cases urge the critical choice of diagnostic, therapeutic and post-mortem laboratory testing. Serratospiculum tendo should be considered in the differential diagnosis of acute respiratory distress in free-living peregrine falcons, presented in rehabilitation centres or in private practise by falconers in Greece and Europe.

Charity begins at work

If asked to describe himself during his final year at the Liverpool veterinary school, Terry Ogdin says he would have answered “a farm animal vet to the very core”. Eight years on, he is earning his living as a small animal clinician at the PDSA Pet Hospital in Blackpool. He told John Bonner why he changed his mind about his professional career.

Aspectos morfológicos e ultraestruturais de células sanguíneas de Crotalus durissus terrificus

RESUMO: A avaliação hematológica, de importância comprovada como um meio auxiliar de diagnóstico ao clínico de pequenos animais domésticos, vem se tornando comum em animais selvagens não apenas para a clínica, mas para a avaliação do manejo e como estudo auxiliar para a fisiologia das várias espécies. Tendo em vista o aumento da demanda para a produção de várias drogas de importância farmacêutica, a criação de serpentes peçonhentas vem se tornando comum a ponto destes animais já serem reconhecidos como sendo de produção. O conhecimento do manejo e da clínica destes animais ainda é escasso e a mortalidade é elevada nos criatórios, tornando urgente a ampliação destes. Embora alguns estudos hematológicos já tenham sido realizados em cascavéis (Crotalus durissus) os dados analisados ainda são insipientes, notadamente em relação à caracterização das células do sangue e poucos estudos em microscopia eletrônica foram realizados em serpentes. Com o objetivo de caracterizar as células sanguíneas morfologicamente, sob microscopia óptica e ultraestrutural, foram coletadas amostras de sangue de 52 de indivíduos da subespécie Crotalus durissus terrificus para a realização de esfregaços sanguíneos e avaliação ultraestrutural. Concluiu-se que a coloração hematológica de Giemsa permite a avaliação morfológica e a diferenciação das células sanguíneas em serpentes assim como a visualização de hemoparasitos. A avaliação ultraestrutural permite evidenciar as organelas celulares e a diferenciação entre as células, inclusive entre os tipos leucocitários, porém ainda são necessários outros estudos para que seja elucidada a hipótese da existência dos eosinófilos na espécie estudada assim como é necessária melhor caracterização dos grânulos dos azurófilos para que se confirme uma possível diferença entre os monócitos típicos e os azurófilos.

Heart murmurs in puppies and kittens

A heart murmur is a relatively frequent finding during routine examination of puppies and kittens. This article considers the decision-making process that the small animal clinician faces when presented with a murmur in a paediatric patient, and the features of pathological versus non-pathological murmurs. Options for investigating murmurs in these patients, and the benefits of interventional cardiology for managing congenital heart disease, are also reviewed.

Reporting and interpreting red blood cell morphology: is there discordance between clinical pathologists and clinicians?

Clinical pathologists (CPs) report RBC morphologic (RBC-M) changes to assist clinicians in prioritizing differential diagnoses. However, reporting is subjective, semiquantitative, and potentially biased. Reporting decisions vary among CPs, and reports may not be interpreted by clinicians as intended. The aims of this study were to survey clinicians and CPs about RBC-M terms and their clinical value, and identify areas of agreement and discordance. Online surveys were distributed to small animal clinicians via the Veterinary Information Network and to CPs via the ASVCP listserv. A quiz assessed understanding of RBC-M terms among respondent groups. Descriptive statistics were used to analyze responses to survey questions, and quiz scores were compared among groups. Analyzable responses were obtained from 1662 clinicians and 82 CPs. Both clinicians and CPs considered some terms, e.g., agglutination, useful, whereas only CPs considered other terms, e.g., ghost cells, useful. All groups interpreted certain terms, e.g., Heinz bodies, correctly, whereas some clinicians misinterpreted others, e.g., eccentrocytes. Responses revealed that CPs often do not report RBC-M they consider insignificant, when present in low numbers. Twenty-eight percent of clinicians think CPs review all blood smears while only 19% of CPs report reviewing all smears. Important differences about the clinical relevance of certain RBC-M terms exist between clinicians and CPs. Inclusion of interpretive comments on CBC reports is the clearest way to ensure that RBC-M changes are interpreted as intended by the CP. Reporting practices should be examined critically to improve communication, transparency, and ultimately medical decisions.

Improving the diagnostic quality of thoracic radiographs of dogs and cats

Evaluating a series of thoracic radiographs may be one of the most challenging imaging tasks confronting the small animal clinicians in their daily practice. Pathological changes can sometimes be quite...