Quiz Question

In Latifi 2024 et al., on fascial mapping in the canine hindlimb, what was the recommended surgical principle for distal limb resections where deep fascial margins are poor?

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Correct. This principle helps avoid unnecessary complexity and flap contamination when deep margins are not feasible.
Incorrect. The correct answer is If you can't go deep, don't go wide.
This principle helps avoid unnecessary complexity and flap contamination when deep margins are not feasible.

🔍 Key Findings

  • This anatomical study mapped fascial planes of the canine hindlimb and pelvis to aid superficial tumor resection.
  • Type I fascia (discrete sheets) was suitable for deep margins in fascia lata, lateral crus, and gluteal regions.
  • Areas with poor or absent fascia included the ischiorectal fossa, femoral triangle, stifle extensor mechanism, and pes.
  • Type IV fascia associated with periosteum (e.g., patella, tibial tuberosity) required partial ostectomy for inclusion in surgical margins.
  • Nerves at risk during deep dissection included obturator, superficial peroneal, and tibial nerves, particularly in regions with weak fascia.
  • In males, bulbospongiosus muscle could act as a fascial plane but dissection was challenging and potentially hemorrhagic.
  • In females, constrictor vulvae/vestibulae muscles were tightly associated with mucosa, limiting clean resection options.
  • Distal hindlimb resections often lacked a usable fascial plane, suggesting that amputation or adjuvant therapy may be more appropriate.

Latifi

Veterinary Surgery

3

2024

Fascial plane mapping for superficial tumor resection in dogs: Part III – Hindlimb and pelvis

2024-3-VS-latifi-5

Article Title: Fascial plane mapping for superficial tumor resection in dogs: Part III – Hindlimb and pelvis

Journal: Veterinary Surgery

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In Paul 2024 et al., on postoperative analgesia with BLIS vs fentanyl in amputation, how did postoperative vomiting compare between BLIS and fentanyl-treated dogs?

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Correct. Only fentanyl group dogs vomited (4/20); none in the BLIS group vomited.
Incorrect. The correct answer is Observed only in fentanyl group.
Only fentanyl group dogs vomited (4/20); none in the BLIS group vomited.

🔍 Key Findings

  • BLIS (bupivacaine liposome injectable solution) provided equivalent analgesia to fentanyl CRI based on CMPS-SF scores at all time points except 6h, where BLIS was superior
  • Fewer adverse effects (nausea, vomiting, sedation) were noted in the BLIS group
  • BLIS dogs ate sooner postoperatively (median 6h vs 9h in control)
  • Sedation occurred in 2/20 dogs in BLIS group vs 10/20 in fentanyl group
  • Vomiting occurred in 0/20 BLIS dogs vs 4/20 in fentanyl group
  • Rescue analgesia rates were similar (5 BLIS vs 4 fentanyl group), confirming noninferiority
  • Owner-reported VAS scores were lower for BLIS on day 1 a.m. and p.m. despite variability
  • Results suggest BLIS could reduce opioid reliance post-amputation

Paul

Veterinary Surgery

6

2024

Comparison of bupivacaine liposome injectable solution and fentanyl for postoperative analgesia in dogs undergoing limb amputation

2024-6-VS-paul-2

Article Title: Comparison of bupivacaine liposome injectable solution and fentanyl for postoperative analgesia in dogs undergoing limb amputation

Journal: Veterinary Surgery

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In Rocheleau 2025 et al., on infected total hip replacements, what was the overall infection resolution rate following arthroscopic management?

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Correct. Seven out of eight dogs (87.5%) experienced successful infection resolution.
Incorrect. The correct answer is 87.5%.
Seven out of eight dogs (87.5%) experienced successful infection resolution.

🔍 Key Findings

Study Design: Case series of 8 dogs with confirmed or suspected PJI after total hip replacement (THR)
Dogs were categorized into:

  • Curative intent (CI) group (n=5): short-duration infections, implant retention attempted
  • Non-curative intent (NCI) group (n=3): chronic infections, implants scheduled for removal or revision

Success Rate: 7 of 8 dogs had infection resolution, including 4 of 5 in the CI group
Sampling sensitivity:

  • Arthroscopic culture success was 80% in the CI group but only 33% in the NCI group
  • All explanted implants from NCI group yielded positive cultures

Common isolates: Staphylococcus pseudointermedius (including MRSP), S. epidermidis, Stenotrophomonas maltophilia, and E. coli
Ancillary treatments included:

  • Partial synovectomy, high-volume lavage (5–10 L), biofilm-depleting lavage, and/or amikacin-impregnated calcium sulfate beads

Mean follow-up: >1 year (mean 812 days); no signs of recurrence in successfully treated cases
Conclusions: Arthroscopic management of THR infections is feasible and effective in appropriately selected dogs. Success aligns with human literature when infection type is favorable (Type 1, 3, 4). Sensitivity of arthroscopic culture is higher in early/acute infections.

Rocheleau

Veterinary Surgery

4

2025

Arthroscopic sampling, diagnosis and treatment of infected total hip replacements in dogs: Eight cases

2025-4-VS-rocheleau-1

Article Title: Arthroscopic sampling, diagnosis and treatment of infected total hip replacements in dogs: Eight cases

Journal: Veterinary Surgery

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In Fracka 2025 et al., on cementless knee replacement, which advantage of cementless TKR is emphasized in the discussion?

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Correct. Cementless TKR offers enhanced bone integration, eliminates cement-related complications, and preserves bone stock【57†Veterinary Surgery†L1-L20】
Incorrect. The correct answer is Enhanced osseointegration and bone preservation.
Cementless TKR offers enhanced bone integration, eliminates cement-related complications, and preserves bone stock【57†Veterinary Surgery†L1-L20】

🔍 Key Findings

Subject: 7-year-old Labrador underwent cementless total knee replacement (TKR) due to severe stifle OA.

Clinical function:

  • Improved ROM from 90° pre-op to 120° post-op.
  • Weight-bearing increased from toe-touching to 70% bodyweight by 6 weeks post-op.
  • No visible lameness by 14 weeks.

Implant performance:

  • No complications at any follow-up points.
  • No osteolysis, loosening, or metallosis at 6-year necropsy.

Wear evaluation:

  • Mild UHMWPE insert wear, localized to caudal edges.

Histologic findings:

  • Robust osseointegration at implant-bone interface.
  • Fibrous tissue only in areas lacking porous coating.

Conclusion:

  • Cementless TKR demonstrated excellent 6-year survival and functional outcomes.
  • Support for considering early surgical intervention in severe stifle OA.

Fracka

Veterinary Surgery

3

2025

Long‐term clinical outcomes and retrieval analysis of a cementless total knee replacement in a dog

2025-3-VS-fracka-5

Article Title: Long‐term clinical outcomes and retrieval analysis of a cementless total knee replacement in a dog

Journal: Veterinary Surgery

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In Miller 2024 et al., on intestinal obstruction and catheter technique in cats, which intraoperative factor did NOT differ significantly between LFBO and DFBO groups?

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Correct. Intraoperative hypotension was not statistically different between LFBO and DFBO groups (p = .4756).
Incorrect. The correct answer is Intraoperative hypotension.
Intraoperative hypotension was not statistically different between LFBO and DFBO groups (p = .4756).

🔍 Key Findings

  • Cats with linear (LFBO) and discrete (DFBO) small intestinal obstructions had similar survival (98.2% vs. 97%, p = 1.0).
  • Postoperative complications were not significantly different between LFBO and DFBO cases (p = .1386).
  • Intestinal dehiscence was rare (only 2 cats), both in DFBOs, with no statistical difference between groups.
  • Red rubber catheter technique (RRCT) successfully removed LFBOs in 83% (20/24) of attempts.
  • All failed RRCTs occurred in cats with perforations or tissue nonviability.
  • Cats with failed RRCTs had longer clinical signs pre-surgery (median 6.5 vs. 2.0 days).
  • Surgical time was longer in LFBO cats (median 77 min vs. 58 min, p = .0018).
  • Preoperative septic peritonitis was rare (4/169 cats), but occurred only in linear or mixed FBO cases.

Miller

Veterinary Surgery

7

2024

Linear and discrete foreign body small intestinal obstruction outcomes, complication risk factors, and single incision red rubber catheter technique success in cats

2024-7-VS-miller-4

Article Title: Linear and discrete foreign body small intestinal obstruction outcomes, complication risk factors, and single incision red rubber catheter technique success in cats

Journal: Veterinary Surgery

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In Redolfi 2024 et al., what was the long-term rate of MPL resolution following TPLO-TTT?

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Correct. Long-term exam showed 23 of 24 stifles had resolved MPL; one dog had asymptomatic grade II reluxation
Incorrect. The correct answer is 23/24 stifles.
Long-term exam showed 23 of 24 stifles had resolved MPL; one dog had asymptomatic grade II reluxation

🔍 Key Findings Summary

  • Study of 24 stifles in 22 dogs with concurrent CCLR and grade III–IV MPL treated via TPLO-TTT
  • Major complications: 4/24 (3 surgical site infections, 1 MPL reluxation); minor complications: 5/24
  • Long-term follow-up (median 27 months): 21/22 dogs sound, 23/24 stifles resolved
  • Patellar ligament thickening observed post-op in 4 cases, resolved with rehab
  • The only case of MPL reluxation involved untreated tibial torsion, suggesting case selection is critical

Redolfi

Veterinary and Comparative Orthopedics and Traumatology

1

2024

Complications and Long-Term Outcomes after Combined Tibial Plateau Leveling Osteotomy and Tibial Tuberosity Transposition for Treatment of Concurrent Cranial Cruciate Ligament Rupture and Grade III or IV Medial Patellar Luxation

2024-1-VCOT-redolfi-1

Article Title: Complications and Long-Term Outcomes after Combined Tibial Plateau Leveling Osteotomy and Tibial Tuberosity Transposition for Treatment of Concurrent Cranial Cruciate Ligament Rupture and Grade III or IV Medial Patellar Luxation

Journal: Veterinary and Comparative Orthopedics and Traumatology

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In Karydas 2025 et al., on follow-up radiography, which combination of clinical indicators most strongly predicted a need for plan adjustment?

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Correct. Abnormal clinical exam had the highest OR (44.8), especially when combined with lameness.
Incorrect. The correct answer is Lameness + abnormal exam findings.
Abnormal clinical exam had the highest OR (44.8), especially when combined with lameness.

🔍 Key Findings

139 immature dogs with humeral condylar fractures (HCF) reviewed retrospectively.
Postoperative plan changed in 17% (23/139) of cases.
Key risk factors for plan change:

  • Owner concerns (OR: 7.6)
  • Analgesic use at follow-up (OR: 7.9)
  • Lameness (OR: 5.9)
  • Abnormal clinical exam (OR: 44.8)
  • Radiographic abnormalities (OR: 51.9)

No plan changes were based solely on radiographs when clinical signs were absent.
Supracondylar K-wire migration noted in 3.5% of dogs without affecting the clinical plan.
Authors conclude that routine follow-up radiographs offer limited value without concurrent clinical indicators.

Karydas

Veterinary Surgery

2

2025

Impact of postoperative radiography on the management of humeral condylar fractures in immature dogs

2025-2-VS-karydas-4

Article Title: Impact of postoperative radiography on the management of humeral condylar fractures in immature dogs

Journal: Veterinary Surgery

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In Nash 2024 et al., on esophageal pH monitoring, which technique was used to place the pH probe?

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Correct. This method was chosen for safety and tolerability, reducing morbidity compared to percutaneous or conscious placement.
Incorrect. The correct answer is Transnasal placement under light anesthesia.
This method was chosen for safety and tolerability, reducing morbidity compared to percutaneous or conscious placement.

🔍 Key Findings

  • Esophageal pH-monitoring was well tolerated in all 35 nonbrachycephalic dogs, with no major adverse events reported.
  • Distal GER occurred in 80% of dogs, but events were typically brief and non-productive; proximal GER occurred in only 39%.
  • Upper reference limits for GER were 2.4 events/hour (distal) and 0.4 events/hour (proximal).
  • Cumulative acid exposure was minimal: upper limits were 2.3% (distal) and 0% (proximal).
  • Comparison with brachycephalic dogs shows significantly higher GER frequency and duration, validating the diagnostic utility of pH monitoring.
  • Transnasal probe placement under light anesthesia was safe and less morbid compared to percutaneous or conscious techniques.
  • No expelled or productive regurgitation occurred, despite some GER events, indicating efficient esophageal clearance in healthy dogs.
  • Diet and fasting duration may affect GER, but these were not controlled variables in this study.

Nash

Veterinary Surgery

8

2024

Esophageal pH‐monitoring in nonbrachycephalic dogs: A reference

2024-8-VS-nash-3

Article Title: Esophageal pH‐monitoring in nonbrachycephalic dogs: A reference

Journal: Veterinary Surgery

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In Cola 2024 et al., on laparotomy-assisted endoscopy, how did LAER affect the need for postoperative analgesia compared to traditional enterotomy?

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Correct. LAER patients had a shorter duration of analgesia (median 36 h vs 48 h, p < .001).
Incorrect. The correct answer is LAER reduced analgesia duration.
LAER patients had a shorter duration of analgesia (median 36 h vs 48 h, p < .001).

🔍 Key Findings

  • LAER was effective (partial or complete) in 35/40 cases, regardless of FB location or type.
  • Intestinal wall damage significantly increased the likelihood of conversion to enterotomy (p = .043).
  • LAER led to significantly shorter hospitalization (median 48 h vs 72 h; p = .006).
  • Patients in the LAER group required less postoperative analgesia (median 36 h vs 48 h; p < .001).
  • Faster return to spontaneous feeding was seen in LAER group (median 24 h vs 36 h; p = .012).
  • No significant difference in complication rate or postoperative ileus between LAER and enterotomy groups.
  • Sharp, linear, or multiple FBs did not significantly affect LAER effectiveness.
  • Conversion to surgery was required in 5/40 LAER attempts, mostly due to immovable FBs or intestinal damage.

Cola

Veterinary Surgery

7

2024

Laparotomy‐assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats

2024-7-VS-cola-3

Article Title: Laparotomy‐assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats

Journal: Veterinary Surgery

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In Cortez 2024 et al., on feline ectopic ureters, what was the most common anatomical classification of ectopic ureters in cats?

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Correct. Eight cats had extramural ureters, supporting the finding that extramural presentation is more common in cats.
Incorrect. The correct answer is Extramural.
Eight cats had extramural ureters, supporting the finding that extramural presentation is more common in cats.

🔍 Key Findings

  • Ectopic ureters in cats are rare, but most are extramural and bilateral.
  • Surgical techniques used included ureteroneocystostomy (UNC), neoureterostomy (NU), nephroureterectomy, and cystoscopic laser ablation (CLA).
  • All cats showed improvement in urinary continence postoperatively, with 11/12 achieving complete resolution.
  • Major complications were rare; one cat developed uroabdomen requiring revision surgery.
  • Diagnostic imaging was effective, with abdominal ultrasound diagnosing 8/10 and CT 3/3 cases.
  • Short- and long-term complications included urethral spasms, UTIs, stranguria, and rectal prolapse; all were manageable.
  • CLA was successful in 2 cats and is noted as a first-time described technique in feline ectopic ureter cases.
  • Median postoperative follow-up was 340 days, supporting good long-term outcomes.

Cortez

Veterinary Surgery

6

2024

Presentation, diagnosis, and outcomes of cats undergoing surgical treatment of ectopic ureters

2024-6-VS-cortez-2

Article Title: Presentation, diagnosis, and outcomes of cats undergoing surgical treatment of ectopic ureters

Journal: Veterinary Surgery

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Topic: Postoperative Care & Outcomes
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