Papers

Question 1

In Simpson et al JFMS 22 “Defining the safe corridor for transcondylar screw placement in the feline humeral condyle”, what recommendations for lateral to medial drilling entry point were made?

Answer 1

Humeral condyle diameter (hcd) x 0.3 cranial and 0.16 distal

Question 2

According to Haine et al Vet Surgery 2022, what rate of incomplete margins was attained for canine appendicular mast cell tumours excised using ‘planned narrow margins’ of 6-10mm and one fascial plane? STS?

Answer 2

26% were R1 classification for MCT
42% for STS

Question 3

Holroyd et al VCOT 2023 found which region of the metatarsals to be a risk for screw placement causing plantar necrosis during tarsal arthrodesis surgery? Specifically which MTs and which trajectory?
And 92% of dogs had evidence of screw placement in this region, what rate of plantar necrosis was reported in the paper?

Answer 3

Proximal 25%

Dorsal exit of the screw between MT II and III

8% plantar necrosis rate

Question 4

In Pilot et al Vet Surgery 2022, “Comparison of median sternotomy closure-related complication rates using orthopedic wire or suture in dogs: A multi-institutional observational treatment effect analysis”, they found suture, wire, or neither to be associated with reduced complications? What was the overall SSI rate?

Answer 4

Neither on multivariate analysis

14% complication rate across the board, higher rate in large dogs

Question 5

What is this device?

Answer 5

One lung ventilation device, specifically the EZ Blocker- selective inflation of balloon the occlude the respective bronchus
Placed bronchoscopically vs fluoroscopically

Question 6

Nakano et al JAVMA 2022 found what rate of metastasis overall for cats with appendicular/scapular osteosarcoma? What factor was associated with metastasisi?

Answer 6

46%

Humeral OSA had 9.56X OR for distant metastasis

This is in contradiction to the 10% rate given in older studies referenced in Tobias, however this present paper has about 10% metastasis rate present at the time of amputation, but follow-up identified 46% total mets. An important difference to historical perception of potential cure/long term survival in cats and no need for chemo- MST 527 days

Question 7

Crino et al JSAP 2023 reported what technique, with an 88.2% success rate, for the treatment of sharp-pointed metallic gastric foreign bodies in dogs and cats?

Answer 7

Conservative management
2 of 17 failed to show progression of the foreign bodies on serial rads after 24 hours went for surgery

Question 8

Hanson et al JFMS 2021 “Effect of prazosin on feline recurrent urethral obstruction” reported what finding?

Answer 8

No benefit to prazosin compared to a placebo for prevention of recurrent urethral obstruction in cats

Question 9

Maxwell et al Vet Surg 2021”Outcomes of dogs undergoing immediate or delayed surgical treatment for gastrointestinal foreign body obstruction: A retrospective study by the Society of Veterinary Soft Tissue Surgery” reported what to be more likely in dogs having GI FB surgery delayed?

Answer 9

Likelihood of enterectomy, inc surgical duration, inc anaesthesia duration
However no difference in overall outcome between groups

Question 10

Name this instrument

Answer 10

Intra-articular aiming device, used in
Rocheleau PJ, Holz KA, Peura AH. Ex vivo evaluation of arthroscopically assisted shoulder stabilization in dogs using an intra-articular aiming device. Veterinary Surgery. 2023;52(4):564‐574. doi:10.1111/vsu.13935

Question 11

In Anderson et al Vet Surg 2022 “Humeral condylar fractures and fissures in the French bulldog”, what repair technique used in a conjunction a transcondylar screw was found to increase major complication rate by 7.62X?

Answer 11

Use of a k-wire/anti-rotational pin

Question 12

Jenkins et al Vet Surg 2022 “Medial epicondylar fissure fracture as a complication of transcondylar screw placement for the treatment of humeral intracondylar fissure” recommend a TCS what percentage, or below, of the humeral condylar diameter in order to prevent the complication described in the paper?

Answer 12

41%

Question 13

Maniaki JFMS 2021 reported cats were more likely to have mobility issues at 6 years of age if they were: Neutered before or after 6 months old?

Answer 13

Neutered after 6 months old

Question 14

In the JSAP 2021 study by Friesen et al “Clinical findings for dogs undergoing elective and nonelective cholecystectomies for gall bladder mucoceles” what was the mortality rate for patients undergoing elective surgery? Emergency surgery?

Answer 14

6% elective, 23% for emergency
Postop hyperthermia in 35% dogs with retrograde flushing, but only 4% in dogs with normograde and 7% with no flushing

Question 15

Grossman et al JAVMA 2021 found what mortality rate for cats undergoing subtotal colectomy? And what was the recurrence rate of constipation?

Answer 15

14% mortality, 32% recurrence

Question 16

Cray et al JAVMA 2021 “Analysis of risk factors associated with complications following mandibulectomy and maxillectomy in dogs” reported incisional dehisence to be more common in which of these two categories of surgery?

Answer 16

Maxillectomy- dehis and oronasal fistula OR X1.8 risk compared to mandibulectomy

Question 17

Lopez et al JAVMA 2021 found that canine small intestinal foreign body resection and anastamosis had an odds ratio of dehisence of what magnitude, compared to enterotomy? And what other 2 factors were associated with dehisence?

Answer 17

OR 6.09 X (18% dehis vs 4% dehis for enterotomy)
Increased ASA grade and increased age were other factors associated with dehis

Question 18

What complication grading system did Barrett et al in Vet Surg 2022 compare to the ‘Cook system’ of orthopaedic complication classification?

Answer 18

Clavien-Dindo system

Question 19

Name of the radiolucent region around acetabular cup that can be seen in immediate post-op THR? Described by Liska et al Vet 2019

Answer 19

Polar gap- in Liska study of no clinical impact and gone on revisit radiographs
Represents reamed bone/implant gap on medial aspect of cup

Question 20

I-loc sizes in cats? Humerus/tibia? Femur?

Answer 20

I-loc 3 for humerus tibia, I-loc 4 for femur (Marturella Vet Surg 2021)

Question 21

Name this device, as reported for us by both Gotzens et al Vet Surg 2019 and Aoki et al Vet Surg 2021

Answer 21

Leipzig distractor
Distractor described in mentioned papers for stifle joint and for shoulder joint

Question 22

Name this instrument

Answer 22

GelPOINT, reported by Mayhew et al Vet 2020, for TAMIS (trans-anal minimally invasive surery) in cadaveric specimens

Question 23

Name this instrument. What were the findings of Sapora et al in Vet Surgery 2021 relating to it’s use?

Answer 23

End to end anastamosis circular stapler from Medtronic (EEA)
Cadaveric testing of leak pressures found lower initial leak pressures using this stapler compared for hand sewn anastamosis of the colon. Thereofre recommend the latter.

Question 24

According to Selmic et al JAVMA 2018, how many more times likely were dogs with historical TPLO to develop proximal tibial OSA? And what factor was found to incrementally increase the risk of proximal tibial OSA by 11%?

Answer 24

40X more likely in dogs with TPLO

For every 1kg increase in weight, 11% increase in risk of OSA

Question 25

Were surgeries more likely to occur in dogs following fall from pick up truck beds or from motor vehicle collisions? (Salmelin VCOT 2022)

Answer 25

Pick up truck falls (71.6% of patients had surgery) compared to MVC (47.6%)
Thoracic and abdominal injury more likely in dogs with MVC vs PTBF
Survival was more likely in PTBF at 95% vs MVC at 85%

Question 26

What is the Insall-Salvati ratio? How is it calculated?

Answer 26

IS is a ratio of patella ligament length divided by patella length
Determine patella baja and alta (>reference= alta, <reference=baja)

(reference intervals for the IS index were 1.04 to 2.16 in the small dogs, 1.19 to 2.27 in the medium dogs, 1.40 to 2.24 in the large dogs and 1.71 to 2.23 in the giant dogs) according to Ocal et al VCOT 2020

Question 27

In Folk et al JAVMA 2022 “Effect of empirical versus definitive antimicrobial selection on postoperative complications in dogs and cats undergoing total ear canal ablation with lateral bulla osteotomy: 120 cases (2009–2019”, what % of bulla contents sampled were positive on culture? And what impact did patients with a positive culture who were not given antimicrobials, have on the likelihood of revision surgery?

Answer 27

85.5% positive culture

10.3X more likely

Question 28

According to Wainberg et al JAVMA 2019, what major post-operative complication was unique to patients having single stage bilateral ventral bulla osteotomy performed?

Answer 28

Respiratory obstruction and death

Question 29

Janssens et al Vet Surg 2020 reported a comparison of 12.5 degree to 20 degree plate for use in what procedure?

Answer 29

TPO
12.5 deg resulted in sufficient femoral head cover with a lower rate of excessive cover compared to 20 deg plate (11% vs 42%)

Question 30

Coppolla et al in JFMS 2022 “Traumatic stifle injury in 72 cats: a multicentre retrospective study” reported what specific post-operative immobilisation technique to have a significant increase in poorer outcome and complications? And overall what impact did all other post-operative immobilisation techniques have on outcome?

Answer 30

Trans-articular pinning maintained for post-op immoblisation was associated with worse outcome and complications

Post-operative immobilisation via TAESF/splint had no impact on outcome and so use is brought into question by this study

Question 31

In Watt et al Vet Surg 2020 “Otoscopic evaluation of epithelial remnants in the tympanic cavity after total ear canal ablation and lateral bulla osteotomy” what location was the most common place to identify epithelial remnants within the bulla? (dorsal/caudal, rostral/dorsal?) And what % of bulla had epithelial remnants on otoscopy?

Answer 31

Rostral had highest (36%) of remnants

All bulla (100%) had remnants present for all surgeons

Question 32

Alexander et al Vet Surg 2021 reported what % of dogs with routine TPLO, no client concerns, and normal findings on orthopaedic examination, required treatment change based on follow-up radiographs?

Answer 32

4%

Question 33

In a review by Budsberg et al Vet Surg 2021 “Efficacy of postoperative antibiotic use after tibial plateau leveling osteotomy in dogs: A systematic review”, did the two studies with the highest level of evidence provide evidence for or against the use of post-operative antibiotics in dogs undergoing TPLO?

Answer 33

Against/no evidence in favour of use in these two studies

Question 34

What surgical procedure are these patient-specific guides (PSG) being used to perform? And what benefit is offered by their usage?

Answer 34

These are 3D printed PSGs for use in total knee replacement
They were demonstrated in a cadaveric study to improve accuracy in frontal plane of tibial cut and the cranial and distal femoral osteotomy

Fracka AB, Oxley B, Allen MJ. 3D-printed, patient-specific cutting guides improve femoral and tibial cut alignment in canine total knee replacement. Veterinary Surgery. 2023;1‐12. doi:10.1111/vsu.13963

Question 35

What was the major finding of Walker et al Vet Surg 2022 “Evaluation of a modified radiographic union scale for tibial fractures scoring system in staged bilateral tibial plateau leveling osteotomy procedures and comparison of first and second side radiographic bone healing”?

Answer 35

Use of the mRUST scoring system improved inter-observer reliability (56% agree) compared to subjective assessment (33% agree)

Question 36

In Cinti et al Vet Surg 2021 “A novel technique to incorporate the sacrotuberous ligament in perineal herniorrhaphy in 47 dogs” the authors describe the technique, and they caution extreme care involving what anatomical structure?

Answer 36

Sciatic nerve (also the caudal gluteal vessels)

White arrowhead showing sciatic lateral to sacrotuberous ligament

Question 37

Latifi Vet Surg 2022 “Fascial plane mapping for superficial tumor resection in dogs. Part II: Forelimb” found the majority of the fascia of the brachium to be what type(s)?

Answer 37

Type II or III (fascia tightly adhered to thin or thick muscle, respectively)

Question 38

Karbe Vet Surg 2021 found incomplete resection of cutaneous mast cell tumours had what percentage of residual tumour on scar excision?

Answer 38

27%

Question 39

What was the prevalence of vertebral/epidural lesions reported in “Clinical, computed tomographic, surgical findings and outcome in dogs with sublumbar abscessation: 16 cases (2013‐2019)” Jacques et al JSAP 2022?

Answer 39

87.5%!

Question 40

In Lopez et al Vet Surg 2020 “Effect of subcutaneous closure technique on incisional complications and postoperative pain in cats undergoing midline celiotomy: A randomized, blinded, controlled trial”, what suture pattern was found to reduce the incidence of seroma by half?

Answer 40

Quilting pattern

Question 41

Enright et al Vet Surg 2022 “Short- and long-term survival after adrenalectomy in 53 dogs with pheochromocytomas with or without alpha-blocker therapy” found that the outcome was favourable for the majority of dogs with long term survival. What was the other major conclusion of the study?

Answer 41

Pre-operative phenoxybenzamine did not improve survival in this study

Question 42

Neal et al Vet Surg 2023 reported what incidence of intra-articular incursion of the elbow joint when using using an aiming device to place a transcondylar screw in comparison to use of fluoroscopy?

Answer 42

8 times more likely using aiming device in this cadaveric study comparing the two techniques

Question 43

Worden 2023 JAVMA reported what anatomical boundaries for the identification of the superficial cervical lymph node? Axillary? Inguinal?

Answer 43

-Superficial cervical: wing of atlas, acromium process, greater tubercle of humerus
-Axillary: Caudal border of superficial pectoral, caudal triceps, ventral midline
-Inguinal: Origin of pectineus, ventral midline, ipsilateral inguinal mammary gland

Question 44

Fowler et al JFMS 2022 “Outcome of thoracolumbar surgical feline intervertebral disc disease” reported what as the most common clinical sign in cats presenting?

Answer 44

Difficult walking (54.2%)

Question 45

In “Surgical techniques used in the management of intra‐arachnoid diverticula in dogs across four referral centres and their immediate outcome” by Jones et al JSAP 2022, what technique was associated most commonly with an initial neurological deterioration but then recovery in longer term?

Answer 45

The use of an intra-arachnoid shunt

Question 46

In “Analysis of feline humeral fracture morphology and a comparison of fracture repair stabilisation methods: 101 cases (2009–2020)” Gall et al JFMS 2022, what stabilisation method was associated with the highest risk of complications? Bone plating, plate/rod combo, ESF?

Answer 46

ESF (but majority relating to pin tract morbidity so paper highlights clinical relevance of this may be of question)

Question 47

“Complications after proximal abducting ulnar osteotomy and prognostic factors in 66 dogs” Danieleski et al Vet Surg 2022 reported what, to be the most common major complication? And what patient factor was identified as increasing the risk of complications?

Answer 47

Non-union

Increasing body weight increased the risk of complications

Question 48

Agnello et al VCOT 2022 “Arthroscopic Caudal Cruciate Ligament Damage in Canine Stifles with Cranial Cruciate Ligament Disease” found what percentage of dogs undergoing arthroscopic evaluation of CCLR stifles to have a degree of caudal cruciate ligament pathology?

Answer 48

94%

Question 49

What angle, relative to the tibial tuberosity osteotomy, did Hawbecker et al VCOT 2022 “Influence of Kirschner-Wire Insertion Angle on Construct Biomechanics following Tibial Tuberosity Osteotomy Fixation in Dogs” report as being superior?

Answer 49

0 degrees, placed perpendicular to osteotomy, resulted in increasing yield, peak, and failure forces by 1.6 times, 1.3 times, and 1.4 times, respectively, to those placed in a caudodistal (30 degrees) orientation

Question 50

Mullins Vet Surg 2019 “Effect of prophylactic treatment with levetiracetam on the incidence of postattenuation seizures in dogs undergoing surgical management of single congenital extrahepatic portosystemic shunts” reported what rate of PAS in dogs across this multi-centre study? And what effect was found for prophylactic levetiracetam?

Answer 50

8% incidence of PAS (of which only 31% survived, compare to survival rate in Strickland Vet Surg 2018 with 11% incidence of PANS, 18% mortality- differences may be due to reporting of PANS tonic-clonic vs facial twitching etc)

No effect for levetiracetam

Question 51

What was the mortality rate reported by Mayhew et al Vet Surg 2019 “Perioperative morbidity and mortality in dogs with invasive adrenal neoplasms treated by adrenalectomy and cavotomy”?
What finding was associated with a higher risk of death?

Answer 51

24% mortality

Patients with a caval thrombus extending post-diaphragmatic (Young et al Vet Surg 2022 case reported extracting thrombus using ballon catheter)
Worth looking at Knight et al 2019 Vet Surg cavotomy techniques, same mortality and post-diaphragm finding as Mayhew
And lastly Chiti et al Vet Surg 2021 short case series describing renal venotomy for extraction with preservation of kidney

Question 52

According to Jones et al Vet Surg 2023 “Comparison of mortality of brachycephalic dogs undergoing partial staphylectomy using conventional incisional, carbon dioxide laser, or bipolar vessel sealing device”, what technique for staphylectomy was associated with an increased risk of mortality post-operatively? And what patient factor was also associated with mortality?

Answer 52

BVSD (odds ratio 6.0)

Higher stage/grade laryngeal collapse (stage II/III) OR 4.6

Question 53

Hennet JFMS 2022 “Closure-related complications after median sternotomy in cats: 26 cases (2010–2020)” reported what rate of sternotomy closure related complications? Most common reason for median sternotomy in a cat in this study?

Answer 53

7.7%
Thymoma

Question 54

Forster JSAP 2022 “Outcome of caudal superficial epigastric axial pattern flaps in dogs and cats: 70 cases (2007-2020)” reported what rate of uncomplicated healing of this flap in dogs? Cats?
What was the most common complication in dogs?

Answer 54

33% uncomplicated healing in dogs, 47% uncomplicated healing in cats

Dehiscence 31% (necrosis 29%, seroma/oedema 26%, SSI 16%)

Question 55

Bush Vet Surg 2023 “Outcomes and clinical features associated with surgically excised canine salivary gland carcinoma: A multi‐institutional, retrospective, Veterinary Society of Surgical Oncology study” reported what MST? (39 days, 292 days, 1886 days, not reached)
What was the rate of recurrence?

Answer 55

1886 day MST
42% recurred locally

Question 56

What is the name of this test described by Lampart et al Vet Surg 2023 “ Evaluation of the accuracy and intra- and interobserver reliability of three manual laxity tests for canine cranial cruciate ligament rupture—An ex vivo kinetic and kinematic study”?
Additionally what is this manual test demonstrating to the clinician performing it?

Answer 56

Tibial pivot compression test - like a tibial compression but with the addition, prior to compression, of valgus and external rotation

Demonstrating rotational instability as well as the expected cranial/caudal. Relevant to pivot shift phenomenon etc

Question 57

“Humeral condylar fractures and fissures in the French bulldog” Anderson et al Vet Surg 2023 reported what percentage of FB to have contralateral HIFs?

Answer 57

58.1%

Question 58

What is the name of the measurement being made in this image, as reported by Longo et al Vet Surg 2022 “Computed tomographic measurements of the femoral trochlea in dogs with and without medial patellar luxation”
What is considered a cut-off for this value in small breed dogs? Medium/large?

Answer 58

Femoral trochlear groove angle (FTGA)- saggital view allows selection of correction place to take measurement, the three transverse images show how measurement is made

Small breed dogs <134 is normal (more acute angle=deeper groove)
Large/medium breed <128

Question 59

What condition is shown in this CT and gross path image series? What is the prognosis overall for the condition?

Answer 59

Traumatic pulmonary pseudocyst
Good prognosis, majority resolve without intervention

“Traumatic pulmonary pseudocysts in nine dogs and two cats” Montano et al Vet Surg 2023- 3 had surgery due pneumothorax, one euthanised due to comorbidities, rest survived with medical management

Question 60

Moore et al Vet Surg 2023 “Association between divisional location and short-term outcome of liver mass resection in 124 dogs” reported what rate of intra-operative complications? What was the location associated with intraop complication?
What was the effect of the use of a TA stapler in this study?

Answer 60

11.1% intraop complications (mainly haemorrhage), more common with right sided compared to left sided

Not using a TA stapler increased the risk of intraoperative complications by 19 times.
Postop complications were also less likely when using a TA stapler, when performed by an experienced surgeon, and in heavier dogs

Question 61

Cherzan Vet Surg 2023 reported what factors relating to subcutaneous mast cell tumours to impact the DFI and MST for patients?

Answer 61

-Lymph node metastasis (DFI 194 days, not reached in dogs without, MST also much lower)
-Local recurrence, which occured in 17.8% (MST 551 compared to no recurrence- 1771 days)
-Infiltrative tumour (DFI 268 days, not reached without)