Veterinary Surgeons Research Articles

Companion Rabbits: A Case Study Concerning Sudden-Onset Inappropriate Urination

Abstract Despite their domestication some 1500 years ago, the behavioural repertoire of companion rabbits barely differs from that of wild rabbits. When presented with a companion rabbit behaviour issue, it is, therefore, necessary to consider their management in relation to the habitat, biology and behaviour of wild rabbits. Health factors may also be implicated; although as a prey species, rabbits naturally hide signs of disease or injury. This can complicate a health diagnosis. This case study concerns an elderly spayed female indoor rabbit, Meg, who shared a positive relationship with her caregiver. Meg had experienced degenerative musculoskeletal changes for which treatment was on-going, and had previously had treatment for dental spurs and pododermatitis. Prior to Meg’s behaviour assessment, her caregiver sought advice from their Veterinary Surgeon due to Meg’s recent-onset urination outside her litter-trays overnight and occasionally during the day. The Veterinary Surgeon referred Meg to a Certificated Clinical Animal Behaviourist (CCAB) for a behaviour assessment which was conducted remotely using a questionnaire, home-layout diagram, photographs, video-footage and video-conference software. A behaviour diagnosis was made regarding Meg’s emotional and motivational state, and additional stressors were identified. Due to likely health and behaviour overlap, the CCAB further liaised with the referring Veterinary Surgeon. A treatment plan was devised, which Meg’s caregiver diligently implemented. Meg responded well to her treatment plan and over the course of 3 weeks, inappropriate urination ceased. In turn, the welfare of Meg and her caregiver significantly improved. Information © The Author 2023

Electronic survey investigating UK veterinarians’ perceptions of the potential for veterinary prescription medication misuse or abuse

ObjectiveTo investigate veterinarians’ experience and perception of the risk of veterinary prescription medication (VPM) misuse and abuse by the public and veterinary professionals and to determine the clinical context in which respondent veterinarians prescribed certain VPMs. Study designAnonymous online voluntary survey. PopulationA total of 361 of 7126 veterinarians registered as practicing in the UK, who provided e-mail contact details to the Royal College of Veterinary Surgeons Knowledge for participation in research. Respondents included general practitioners, with or without further qualifications, and European specialists, covering charity, private or academic small, large or mixed animal practice. MethodsThe anonymous online survey, open from September to December 2021, posed 27 questions regarding personal experience and perception of VPM misuse or abuse, including which VPMs were considered most at risk of abuse by clients or veterinary staff. Thematic analysis was performed on free-text sections. ResultsThe participation rate was 5% (361/7126), and the completion rate 60% (216/361 respondents). Of these, 88% of respondents somewhat agreed, agreed or strongly agreed that some VPMs were at risk of abuse. A third (29.9%; 107/358) had suspected an owner of taking VPMs, and one fifth (20.1%; 72/358) had suspected veterinary staff. Perceptions regarding the likelihood of public VPM abuse ranged from not suspecting a problem to having first-hand experience. Drugs considered most at risk of owner abuse were opioids, benzodiazepines and gabapentin, and those for veterinary staff were opioids, benzodiazepines and ketamine. Numerous ‘red flags’ prompting suspicion of VPM abuse were identified alongside ways of mitigating risk. Conclusions and clinical relevanceVeterinarians in the UK reported varied experiences with, awareness of, and attitudes towards VPM abuse by the public and veterinary staff. Although not quantified, the UK veterinary industry could be a source of abusable drugs.

Treatment and survival of Norwegian cattle after uterine prolapse

BackgroundBovine uterine prolapse is a sporadic but life-threatening postpartum condition. The aims of this study were; (i) to determine which clinical findings determined the likelihood of treatment vs. culling, (ii) to identify the treatment methods currently employed by Norwegian veterinary surgeons and evaluate their effect on survival, (iii) to determine if clinical findings at the time of treatment could be used to determine prognosis. Practicing veterinary surgeons in Norway were contacted and asked to fill out a questionnaire on cases of bovine uterine prolapse they attended between February and October 2012. The questionnaires gathered data on signalment, clinical presentation, treatment, and outcome. These data were supplemented with culling data from the Norwegian Dairy and Beef Herd Recording Systems. The chi-squared test and logistic regression modelling was performed to identify likelihood of treatment and cox proportional hazard modelling was performed to identify the hazard of death after treatment.ResultsData from 126 cases of bovine uterine prolapse were collected (78 beef and 48 dairy cows). Twenty-six cows (21%) were emergency slaughtered, or underwent euthanasia, without treatment. Of the remaining 100 cases amputation of the uterus was performed once and repositioning was performed in 99 cases. Survival data were missing from 2 of the cases that had undergone treatment leaving a study sample of 97 cases (64 beef and 33 dairy cows). Multivariable logistic regression analysis of the explanatory variables showed that beef cows were more likely to be treated than dairy cows (OR = 0.32, 95% CI 0.13 to 0.81, P = 0.017) and that cows with a significantly oedematous or traumatised uterus were less likely to be treated (OR = 0.26, 95% CI 0.10 to 0.67, P = 0.006). Treatment methods amongst Norwegian practitioners were broadly similar. In a multivariable model cows general clinical state at time of treatment was positively correlated with survival (HR = 0.29, 95% CI 0.29 to 0.73, P = 0.008) and a history of a vaginal prolapse prepartum increased the hazard of death (HR = 2.31, 95% CI 1.08 to 4.95, P = 0.031) in the first 30 days after treatment of a uterine prolapse. In the first 180 days after treatment only veterinary assessment of a cows’ general clinical state was correlated with hazard of death (HR = 0.432, 95% CI 0.20 to 0.91, P = 0.046).ConclusionsThis study shows that the production system and extent of uterine damage affect the likelihood of treatment, and that practitioners use similar treatment methods. A cows’ general clinical state at time of treatment was positively correlated with survival, and a history of a vaginal prolapse prepartum increased the hazard of death in the first 30 days after treatment of a uterine prolapse.

Study of Effectiveness of Curcumin-Chitosan-Aloe Vera Healing Agent with Mupirocin for the Treatment of Aseptic Wounds in Dogs

Background: The study was conducted to evaluate the wound healing potential of nano-based curcumin-chitosan-aloe vera, an indigenously prepared healing agent, for treatment of aseptic surgical wounds in clinical canine cases presented to the Department of Veterinary Surgery and Radiology, College of Veterinary Science and Animal Husbandry, Odisha University of Agriculture and Technology, Bhubaneswar. Methods: The wounds were assigned into two therapeutic regimens, application of nano-based healing agent and mupirocin to the test and control group respectively as topical therapy along with parenteral antibiotics as per standard operative procedure (SOP). Results were statistically analyzed, using analysis of variance (ANOVA), paired t-test (parametric) and kruskal-wallis one way ANOVA test (non parametric). Result: Chitosan-curcumin-aloevera based healing agent resulted in early reduction of wound exudates and cast formation than control group. Time of appearance and filling of wound bed by granulation tissue was significantly better in test group than control group. Early appearance of epithelium and the percentage of wounds with epithelium were also higher in test group than control group. Histological and histo-chemical findings on day 14 after surgery suggested less inflammatory reaction, more fibroblasts and neo-vascularisation, wider and compact granulation tissue in test group than control group. The values of clinical, haematological and biochemical parameters remained within the normal physiological limits without any significant difference. The average duration taken for complete healing in test and control groups was 9 and 14 days respectively without any sign of infection during the treatment period.

Revisiting bovine respiratory disease

Despite significant investment and years of research bovine respiratory disease remains a significant economic and welfare issue to the cattle industry worldwide. The risk factors are well known and developments in preventative medicines, effective treatments and more recently technology to aid detection should enable us to better control the disease. In this review we will consider the barriers we face to adoption and how we as veterinary surgeons can work better with our clients to bring about lasting change on farm which will deliver effective control of this disease.

Worker and Work-Related Factors Influence on Musculoskeletal Symptoms among Veterinary Surgeons

Current literature on surgeons in human medicine provides evidence that surgeons often work in awkward positions for extended periods of time, suggesting there are significant physical ergonomic risk factors associated with the work demands of the role. These risk factors are likely also present in surgical work in veterinary medicine. In this study, 212 members of the American College of Veterinary Surgeons responded to a survey regarding various work-related activities and their experience with musculoskeletal symptoms in 10 different body regions. Across all 10 regions, reported pain increased significantly from before to after a typical day of surgery. Worker factors that were shown to be related to reported pain include gender, weight, age, and years performing surgery. Among work factors investigated, number of procedures, practice focus, and proportion of minimally invasive surgery were shown to influence reported pain. Our findings confirm that musculoskeletal symptoms are commonly experienced by veterinary surgeons.

Dysplasia of Trochlea femoris in Dogs

Abstract This article provides a comprehensive analysis of dysplasia trochlea in dogs, summarizing the most recent findings in the field and highlighting important new findings, as well as, areas that require further research. The anatomy of the knee and the trochlea femoris, as well as its function in maintaining knee joint stability, are covered in the first section. The accurate diagnosis of orthopaedic disorders, and injuries are necessary for efficient treatment, and this is made possible by understanding the anatomy of the knee. The factors that can affect the onset, development, and course of the disease are included in the section that follows, which discusses the etiology, and pathophysiology. Veterinary surgeons must measure trochlear femur dysplasia in dogs in order to determine the severity of the condition and the best course of treatment. It is typically assessed by looking at X-ray images and assigning a score, however, this can differ from one individual to another. New measurement techniques that give a better level of objectivity and precision, like CT scans or MRIs, are now being tested.

Survey of students' learning experience using a virtual slaughterhouse simulator in three UK veterinary schools during the COVID-19 pandemic.

Although visiting an abattoir is mandatory for all UK veterinary students, this was challenging during the COVID-19 pandemic and virtual simulators were temporarily approved by the Royal College of Veterinary Surgeons. Subsequently, the virtual slaughterhouse simulator (VSS) was used by the University of Nottingham School of Veterinary Medicine and Science, the University of Liverpool School of Veterinary Science and the Royal (Dick) School of Veterinary Studies in Edinburgh. This study aimed to evaluate the student learning experience using the VSS. An online survey containing satisfaction and assessment questions was distributed to all final-year students who used the VSS from September 2020 to August 2021. A total of 207 students completed the survey (n = 207/488, 42%). Students were mostly highly satisfied and found the VSS very useful for their learning (n = 164/207,79%); however, anxiety levels to visit a real abattoir lowered for less than half of the students (n = 97/207, 46%). Most students obtained an overall mark over 50% in the assessment questions (n = 197/207, 95%). Although the findings were very positive, extrapolation to other veterinary schools and postgraduate curricula should be done cautiously. The VSS is a valid tool for training veterinary students. However, more research is advised to compare virtual and real experiences and assess students' long-term performance.

Use of a Composed Simulator by Veterinarian Non-Experts in Minimally Invasive Surgery for Training and Acquisition of Surgical Skills for Laparoscopic Ovariectomy in Dogs.

This study aims to assess the acquisition of surgical skills for laparoscopic ovariectomy (LOE) in dogs by veterinary surgeons with no experience in minimally invasive surgery using the CALMA Veterinary Lap-trainer simulator (CVLTS) in an experimental and analytical setting. Veterinary surgeons with no experience in minimally invasive surgery (MIS) (experimental, n = 5), and MIS experts (experts, n = 3) were evaluated. Experimental and expert group participants watched an instructional video (initial time) before practicing the LOE on uterine tissues and ovaries freshly reconstituted after elective ovariohysterectomy (initial time evaluation). Then, the experimental group practiced five training sessions on the composite simulator with permanent feedback and then performed the LOE again (final time evaluation). Surgical performances in initial and final evaluations were video recorded and further evaluated by three external MIS experts using Global objective assessment of laparoscopic skills (GOALS) and LOE-specific rating scales (SRSs) in a double-blinded schedule. In addition, a hands movement assessment system (HMAS) attached to the back of the hands was used to quantitatively measure completion time, angularity, and movement smoothness. Data were analyzed with one-factor ANOVA and Tukey's contrast test. No statistically significant differences were found between the novice group's performance after training and the expert group's performance according to the GOALS (p < 0.01) and SRS (p < 0.05) scores. Moreover, the novices had significantly improved time, number of movements, and angularity in the final time compared with the initial time (p < 0.05), with no significant differences compared to the expert group (p > 0.05). LOE training using a composed simulator resulted in significantly improved laparoscopic skills and time, number, and angularity of movements data, providing evidence of the usefulness and reliability of CVLTS in training LOE.

Mental wellbeing and psychosocial working conditions of autistic veterinary surgeons in the UK.

Certain autistic characteristics (such as hyper-focus and attention to detail) are valued by veterinary surgeons and autistic adults may disproportionately self-select into the profession. Links between mental wellbeing and retention in the veterinary profession highlight an imperative to profile autistic veterinary surgeons' mental wellbeing and identify protective factors. The psychosocial work environment may represent one such protective factor. We aimed to assess autistic veterinary surgeons' mental wellbeing, the extent to which their psychosocial working conditions achieved UK government management standards and links between these. Eighty-five autistic veterinary surgeons completed the Warwick-Edinburgh Mental Wellbeing Scale and the Health and Safety Executive's Management Standards Indicator Tool. Descriptive comparisons were drawn with normative data; correlation and linear regression analyses examined relations between mental wellbeing and psychosocial working conditions. Mental wellbeing and psychosocial work environment quality were markedly below veterinary surgeon and general workforce norms. Psychosocial working conditions accounted for 44% of the unique variance in mental wellbeing, with 'control' and 'role' making a significant contribution. This exploratory study involved a small self-selecting sample, raising the possibility of response bias. Work design centred on the enhancement of control and role clarity would likely support mental wellbeing in this population.

Surgical Anatomy of the Gastrointestinal Tract in Cats.

In cats, the gastrointestinal tract is one of the regions in which surgical procedures are most frequently performed by veterinary surgeons; therefore, knowledge of the surgical anatomy of the feline gastrointestinal tract is of high importance. The main surgical procedures performed include gastrotomy, gastrectomy, enterotomy, and enterectomy, as well as procedures in the liver and pancreas. There are also anatomical differences between dogs and cats, increasing the need for deep knowledge of the anatomy treated in the different surgical approaches. The aim of the present review is to describe in detail the anatomy of the gastrointestinal tract in cats highlighting the anatomical regions of significant importance in different surgical procedures.

Derek Brian Edwards.

A great veterinary surgeon and a family man.

Publication rate and evidence-based evaluation of abstracts presented at the annual European College of Veterinary Surgeons scientific meeting.

To determine the publication rate of abstracts presented at 10 European College of Veterinary Surgeons conferences from 2006 to 2015, report the key publication milestones, and determine variables associated with full manuscript publication. Literature review. One thousand thirty-eight abstracts. All conference abstracts (n = 1038) from the 2006 to 2015 annual ECVS scientific meetings were reviewed, and final publication was determined through a comprehensive bibliographic search. Categories for the level of evidence (LoE), subject, discipline, and institution affiliation were assigned for each abstract. Dates of manuscript submission, acceptance, and publication were recorded. The overall publication rate for ECVS abstracts from 2006 to 2015 was 32%. Abstracts with levels 4 (60%) and 5 (23%) evidence were presented the most at ECVS conferences and had the highest publication rates at 38% and 36%, respectively. Key publication milestones showed that most abstracts (83%) received publication within the first 36 months with most LoE 2 abstracts (91%) being published within 24 months of presentation. Most published abstracts were affiliated with academic institutions (85%), on dog (29%) and horse (27%) subjects, focused on orthopedic (35%) and soft tissue disciplines (27%), and published in Veterinary Surgery (32%). The ECVS abstract publication rate was lower, and timeline was longer to publish than other veterinary surgical conferences. Publication occurred most frequently in academic institutions, in select journals, and was limited to orthopedic, soft-tissue, dog, and horse studies. Results from this study may help improve the publication fate of abstracts in veterinary surgery. Additionally, caution is warranted when using information from abstracts that have yet to be published to help guide clinical decisions.

Surgical antimicrobial prophylaxis: Current standards of care

SummaryAntimicrobial drug resistance is a critical problem in human and veterinary medicine. Antimicrobial drug use and particularly overuse or misuse drive resistance. Surgical antimicrobial prophylaxis (SAP) is one area where misuse and overuse (particularly prolonged SAP) is documented to be at a high level. Infection‐related complications can be devastating to the patient, harm the client/patient–surgeon relationship and damage the reputation of the surgeon. Consequently, surgeons tend to be reluctant to change their antimicrobial prescribing behaviour. There is a plethora of data from human surgery and emerging data from veterinary surgery describing appropriate SAP and supporting the use of shorter duration of SAP. Antimicrobial stewardship programs (ASPs) have been developed and evaluated in human hospitals and this type of collaborative approach would likely have benefit in veterinary hospitals.

Skeletotopy of the caudal vena cava of Yorkshire piglets

The venous system of animals always arouses a certain interest among veterinary specialists. On the one hand, there are issues related to comparative anatomy in different animal species, and on the other hand, there is a practical interest put forward by veterinary surgeons and clinicians. First of all, it is certainly the valve apparatus of this system, which gives reason to believe that the valves of the veins not only direct the movement of blood through the venous vessels, but also contribute to balancing the blood pressure in the entire cardiovascular system. The purpose of our study is to study the skeletotopy of the caudal vena cava of Yorkshire piglets, to give anatomical and topographic characteristics of veins, to carry out morphometry of main collectors. To study the branching of the caudal vena cava of Yorkshire piglets, ten corpses aged 28-30 days of life were obtained, which were delivered from the pig breeding complex to the Department of Animal Anatomy of the St. Petersburg State University of Veterinary Medicine. During the study, such methods as: fine anatomical dissection, vasorentgenography, morphometry, photographing were used. As a result of our study, skeletotopy of the caudal vena cava of Yorkshire piglets with anatomical and topographic characteristics of veins was established and morphometry of the main collectors was performed. The topography of the iliac veins in Yorkshire piglets has certain patterns associated with the conditions of maintenance and movement. No valves were found in the common iliac vein, which ensures the outflow of blood from the parietal and visceral branches. A large number of anastomoses were established between the circumferential deep iliac, gluteal and internal sacral veins.

Preliminary experience with robotic cholecystectomy illustrates feasibility in a canine cadaver model.

To evaluate the feasibility and describe the relevant differences between robotic cholecystectomy (RC) and laparoscopic cholecystectomy in a canine model. Canine cadavers (n = 4) weighing between 30 and 42 kg. Dogs were positioned in dorsal recumbency. A surgical robot was used to perform the RC and was placed at the cranial aspect of the surgical table. One 12-mm and 3 8-mm robotic ports and 1 5-mm laparoscopic port were placed as needed to perform the RC. The specific steps of the procedure were described and timed. Perceived differences between psychomotor skills between robotics and laparoscopy were noted. RC was successful in all dogs, but minor intraoperative complications did occur during the manipulation of the gallbladder in 1 dog. The median length of time for ports to be appropriately docked was 19.5 minutes, and the median procedure time was 119.5 minutes. Psychomotor skills specific to robotics can be learned during this procedure. Robotic cholecystectomy is feasible. RC allowed for experience with the different psychomotor skills utilized with robotic instrumentation and may be an appropriate training procedure for veterinary surgeons wishing to gain basic experience with robotic instrumentation.

Evaluating gender discrepancies in the time to successful match into a small animal surgery residency program.

To determine any association between gender and likelihood of first attempt match and overall time to match into an American College of Veterinary Surgery (ACVS)-registered small animal surgical residency program (SASRP). Online survey. A total of 100 (77 female, 23 male) ACVS small animal surgery residents or diplomates participating in a SASRP during the past 5 years. An online survey was sent to eligible individuals. Respondents anonymously provided information related to demographics, postgraduate internships, and qualifications at the time of each surgical residency application. First attempt and overall match success were evaluated by gender through univariable analysis and then via a multivariable model. Men were 2.89 times more likely to match directly into a SASRP following a rotating internship than women (p = .041), and women completed more total internships than men prior to successful match into a SASRP (p = .030); however, men were found to have more publications at the time of first residency application (p < .001) or successful match (p = .018). Multivariable analysis revealed no association between gender on overall match success or first attempt match rate when considering all other qualifications. No evidence for gender bias was found during the Veterinary Internship and Residency Matching Program (VIRMP) SASRP applicant selection process; however, gender specific patterns in research qualifications were identified. Gender-blinded assessment is not considered necessary for the VIRMP small animal surgical resident selection process. Efforts should be made to educate applicants about the impact of research on the residency selection process and encourage research engagement of female students and graduates.

Effect of Serum Hyaluronic Acid on Wound Healing in Wister Rats

Wound healing is of paramount importance in Veterinary Surgery whenever skin integrity is breached. The faster the healing rate, the better chances to mitigate contamination and infections. There is paucity of information on the use of hyaluronic acid in wound healing in Veterinary medicine. Twenty (20) clinically healthy Wister rats of both sexes were randomly grouped in to four groups (A, B, C, D) of five rats each and allowed to acclimatize for two weeks. Anesthesia was carried out using a combination of xylazine and ketamine at a dosage rate of 5mg/kg and 50mg/kg respectively, intraperitoneal. Circular skin excision was made on each rat after shaving and scrubbing using 70% ethyl alcohol. Group A rats served as negative control while group B and C served as positive controls povidone iodine and oxytetracycline spray were applied topically respectively, group D served as test group where hyaluronic acid serum was applied topically, healing was monitored for 18 days. Results (macroscopy and histology) shows group D having significant healing rate (p&lt;0.05) compared to A, B and C. Hyaluronic acid serum used in this study was seen to have a significant wound healing contraction potential compared to povidone iodine, oxytetracycline spray and the negative control.

Endoscopic treatment of acute oropharyngeal stick injuries in dogs: 46 cases (2010-2020).

To review long-term outcomes of dogs with acute oropharyngeal stick injuries managed with rigid endoscopy at a UK referral centre. Retrospective analysis and follow-up with referring veterinary surgeons and owners of patients treated between 2010 and 2020. A medical record search was performed and data regarding signalment, clinical presentation, treatment and long-term outcomes were recorded. Sixty-six dogs with acute oropharyngeal stick injury were identified and 46 (70.0%) of these had endoscopy of the wound. The dogs were of various breeds, ages (median=3 years; range 0.6 to 11 years) and weights (median=20.4 kg; range 7.7 to 38.4 kg) and 58.7% of patients were male. The median time from injury to referral was 1 day (range 2 hours to 7 days). Patients were anaesthetised, and injury tracts were explored using 0° and 30° forward-oblique, 2.7 mm diameter, 18 cm length rigid endoscopes with a corresponding 14.5 French sheath using saline infusion via gravity. All foreign material that could be grasped was removed using forceps. Tracts were flushed with saline and reinspected to confirm removal of all visible foreign material. Out of 40 dogs with long-term follow-up, 38 (95.0%) had no major long-term complications. The remaining two dogs developed cervical abscessation after endoscopy, one of which resolved after repeat endoscopy and the other resolved after open surgery. Long-term follow-up of dogs with acute oropharyngeal stick injury managed with rigid endoscopy showed an excellent outcome in 95.0% of cases.

Performances of novel custom 3D-printed cutting guide in canine caudal maxillectomy: a cadaveric study.

Caudal maxillectomies are challenging procedures for most veterinary surgeons. Custom guides may allow the procedure to become more accessible. A cadaveric study was performed to evaluate the accuracy and efficiency of stereolithography guided (3D-printed) caudal maxillectomy. Mean absolute linear deviation from planned to performed cuts and mean procedure duration were compared pairwise between three study groups, with 10 canine cadaver head sides per group: 3D-printed guided caudal maxillectomy performed by an experienced surgeon (ESG) and a novice surgery resident (NSG), and freehand procedure performed by an experienced surgeon (ESF). Accuracy was systematically higher for ESG versus ESF, and statistically significant for 4 of 5 osteotomies (p < 0.05). There was no statistical difference in accuracy between ESG and NSG. The highest absolute mean linear deviation for ESG was <2 mm and >5 mm for ESF. Procedure duration was statistically significantly longer for ESG than ESF (p < 0.001), and for NSG than ESG (p < 0.001). Surgical accuracy of canine caudal maxillectomy was improved with the use of our novel custom cutting guide, despite a longer duration procedure. Improved accuracy obtained with the use of the custom cutting guide could prove beneficial in achieving complete oncologic margins. The time increase might be acceptable if hemorrhage can be adequately controlled in vivo. Further development in custom guides may improve the overall efficacy of the procedure.