Table of Contents and Abstracts

A 4-year-old, neutered male, mixed-breed dog initially presented to a tertiary referral center for suspected mushroom intoxication and subsequent necrotizing fasciitis of the right thoracic limb. One day after presentation, a fasciotomy was carried out to remove necrotic tissue, leaving an extensive cutaneous defect spanning from axilla to carpus and occupying 75 to 100% of the circumference of the limb. Following establishment of a bed of granulation tissue, a distant, direct, single-pedicle flap was performed using the lateral thoracoabdominal skin. The limb was flexed at the shoulder and secured to the body wall during flap healing. Staged division of the flap was initiated 20 d after flap harvesting and completed 3 d later. Complete reconstruction of the large circumferential cutaneous defect was obtained 56 d after initial presentation. No major complications were encountered. At 387 d postoperatively, the dog had clinically normal limb function and was free of lameness.

Key clinical message:
This case report demonstrates the successful use of a distant, direct, single-pedicle hinge flap for reconstruction of a large thoracic limb wound spanning from axilla to carpus in a dog. This technique should be considered a viable limb-sparing, surgical option for resolution of extensive cutaneous thoracic limb wounds.

Primary squamous cell carcinoma of the head and neck occurs in the skin or squamous epithelial lining tissues of the oral cavity, pharynx, larynx, and sinonasal tract. Although it is a common tumor in horses, distant metastatic spread to the lung is rare. This report describes a case of metastatic pulmonary squamous cell carcinoma in a 23-year-old Morgan gelding. The clinical signs displayed by this gelding in some ways mimicked the typical presentation of equine multinodular pulmonary fibrosis or thoracic lymphoma. The postmortem diagnosis in this case was head and neck squamous cell carcinoma, but a primary site of origin could not be ascertained. Cancer-associated heterotopic ossification (HO) was also identified in this case; this is an exceedingly rare finding with equine pulmonary neoplasia.

Key clinical message:
Careful physical examination should be undertaken in all horses presenting with clinical signs of intrathoracic disease. Clinical and radiographic abnormalities in this case of pulmonary metastatic disease resembled some of those associated with interstitial pneumonia. Rarely encountered in domestic animal species, there has been only 1 previous report of HO in a case of oronasal carcinoma in a horse.

A 6-week-old intact female coton de Tulear dog presented to a veterinary teaching hospital (VTH) internal medicine service for dysphagia that was persistent since birth. The patient was diagnosed with cricopharyngeal achalasia based on a fluoroscopic swallow study. To facilitate surgical intervention, a percutaneous endoscopic gastrostomy (PEG) tube was placed to bypass the upper esophageal sphincter and provide nutritional support until the dog was larger. At 6 mo of age, the dog underwent unilateral cricopharyngeal and thyropharyngeal myectomy. Marked improvement in dysphagia was noted immediately postoperatively. Improvement in dysphagia persisted in this dog, with continued marked improvement in clinical signs noted 1 y postoperatively.

Key clinical message:
Cricopharyngeal achalasia can be successfully managed with surgical intervention with a good long-term prognosis. Before surgical intervention, nutritional support is of critical importance. A combined procedure of cricopharyngeal and thyropharyngeal myectomy may be associated with outcomes superior to those of alternative procedures.

Copper-associated hepatitis in dogs results from elevated copper levels secondary to increased intake or decreased clearance. Treatment is through establishing a negative copper balance and can include chelation therapy. Traditionally, chelation therapy in dogs is uses D-penicillamine, which has been shown to have severe side effects in humans. Side effects have not been well-documented in dogs but can include nephrotoxicity and dermatologic reactions. This article is the first to report neutropenia in a dog secondary to chelation therapy using D-penicillamine. In this case, a complete blood (cell) count (CBC) collected before initiation of chelation therapy was normal and neutropenia was documented 4 mo after starting therapy. A cytologic examination of bone marrow confirmed a myeloid hypoplasia. Following discontinuation of D-penicillamine, the neutropenia resolved. Based on this case report, periodic CBC rechecks following the initiation of D-penicillamine chelation therapy are recommended to guide treatment decisions.

Key clinical message:
Dogs with confirmed copper-associated hepatitis should be treated cautiously with D-penicillamine for chelation therapy. D-penicillamine may adversely affect bone marrow, causing a leukopenia characterized by neutropenia. It is recommended that clinicians periodically monitor neutrophil counts while treating dogs with D-penicillamine.

Three dogs were diagnosed with spontaneous pneumothorax and referred to the Ontario Veterinary College Health Sciences Centre for management. The 3 dogs were diagnosed with secondary spontaneous pneumothorax due to paragonimosis. The diagnosis was made by visualization of adult trematodes during surgical exploration with histopathological confirmation in 1 dog, and detection of trematode eggs via fecal sedimentation in the other 2 dogs. Two of the dogs developed unusual additional lesions, including hemoabdomen, muscle abscess, and abdominal adhesions. These were suspected to be secondary to aberrant fluke larval migration. All 3 dogs lived within a relatively small geographical area of Ontario and were hospitalized between December 2021 and March 2022. Each dog survived to discharge with surgical or medical management of the pneumothorax and treatment with a prolonged course of fenbendazole.

Key clinical message:
Paragonimosis should be considered as a differential diagnosis for canine spontaneous pneumothorax in areas where Paragonimus kellicotti is, or may be, endemic, or in dogs that have travelled to endemic areas — particularly if the patient has a history of cough or potential exposure to freshwater crayfish. Routine anthelmintic treatment does not prevent infection and standard fecal floatation methods may not detect the eggs. Therefore, diagnostic testing should include a fecal sedimentation test and thoracic radiographs to screen for P. kellicotti.

An 8-year-old intact male degu (Octodon degus) was examined with a 48-hour history of paraphimosis. The penis was devitalized and medical management was unsuccessful. A subtotal penile amputation was performed and a urethral-to-preputial anastomosis was created as part of a circumferential preputial urethrostomy. The immediate outcome in this case was good, with no complications.

Key clinical message:
Surgical intervention for paraphimosis in degus may be required in extreme cases of penile necrosis or due to an inability to replace the penis within the prepuce. Despite the degu’s small size, surgery is feasible, as has been described in other species.

Objective
To evaluate client satisfaction with telerehabilitation consultations compared to in-person consultations for veterinary rehabilitation referrals.

Animals
We surveyed the owners of 32 client-owned dogs.

Procedure
Dog owners were scheduled for telemedicine (telerehabilitation group) or in-person (control group) based on a combination of owner requests and medical recommendations. Medical records were obtained before evaluation. Owners were sent an electronic questionnaire following in-person or telerehabilitation consultations. A total of 32 surveys were received (16 for each group). The response rate was 55% (32/58 surveys sent). Mann-Whitney U tests were used to compare ordinal characteristics between satisfied and unsatisfied clients. Descriptive statistics for the client population, including ranges and medians, were calculated for owner travel distance and patient signalment.

Results
Satisfaction regarding scheduling appointments was higher in the telerehabilitation group compared to the group receiving in-person consultations (P < 0.001). For all other aspects of client satisfaction, there were no significant differences between groups.

Conclusion
This study demonstrated high client satisfaction with using telemedicine for canine rehabilitation consultations that was comparable to that for in-person consultations.

Clinical relevance
Telerehabilitation is a viable option that can be easily implemented by rehabilitation practitioners for assessment, progression, and monitoring of canine patients. Further studies are indicated to evaluate the efficacy of telerehabilitation.

Objective
To report on operative technique and outcomes following prophylactic total laparoscopic gastropexy (PTLG) using a novel knotless tissue control device (KTCD) in dogs.

Animals
This study included 44 dogs.

Procedure
Medical records were reviewed, and perioperative data were collected. Right-sided incisional gastropexy was performed using 2 strands of KTCD introduced through a 12-millimeter cannula in a single-incision multi-channeled port. Dog owners were contacted to obtain outcome data.

Results
Median age and weight of dogs were 17 mo (6 to 60 mo) and 48.5 kg (14 to 73.3 kg). Median surgical and anesthesia times were 90 min (60 to 150 min) and 195 min (135 to 270 min). Major intraoperative complications were not reported. Follow-up data were available for 40/44 (91%) dogs. Median follow-up time was 522 d (43 to 983 d). Gastric dilatation volvulus (GDV) was not reported in any dog. One dog developed suspected colonic entrapment around the gastropexy that required surgical revision. All owners were satisfied with the procedure and indicated they would repeat the procedure with future pets.

Conclusion
The PTLG procedure using novel KTCD in this cohort of dogs was effective at preventing GDV for the duration of follow-up and was associated with low perioperative complication rate and high owner satisfaction.

Clinical relevance
This retrospective study reports on operative technique and outcomes associated with KTCD use in PTLG. Our findings warrant prospective evaluation of KTCD use in PTLG.

Objective and animals
Acute diarrhea is among the most common causes of veterinary consultations for dogs. A double-blind, placebo-controlled intervention trial was done with 120 puppies with gastroenteritis. These dogs were 1 to 4 mo old, male and female, of various breeds and sizes.

Procedure
Dogs were randomly allocated into 2 groups: Those in the treated group (TG) received a multi-strain probiotic with Lactobacillus johnsonii CRL1693, Ligilactobacillus murinus CRL1695, Limosilactobacillus mucosae CRL1696, and Ligilactobacillus salivarius CRL1702 (1 × 10⁹ CFU/mL) daily for 7 d, whereas those in the control group (CG) received a placebo. All puppies received intravenous fluids, an antiparasitic, amoxicillin PO, and enrofloxacin SC.

Results
At the start of the trial, the 2 groups were similar. Probiotic administration for 7 d normalized fecal consistency, with 69, 50, and 80% of small, medium, and large puppies in the TG achieving a fecal score of 1 (separate hard lumps) at 7 d, significantly better than puppies in the CG. After 7 d of treatment, most puppies (70%) in the TG had an excellent recovery, whereas in the CG, recoveries were 35.7% “bad” and 30.4% “fair.” Therefore, treatment with probiotics hastened recovery (P < 0.0001). At the end of the trial, there was a significant increase of cultivable lactobacilli in the feces of TG puppies, but no significant differences between the 2 groups in numbers of total mesophylls, enterobacteria, or Gram-positive cocci. Total mortality was 5.8%, including 4 puppies from the CG and 3 from the TG.

Conclusion
In a randomized, double-blind, placebo-controlled study, puppies with gastroenteritis symptoms receiving a multi-strain probiotic had rapid improvement, implying beneficial effects on the microbiota and its functionality.

Background
Sleep insufficiency is a worldwide affliction with serious implications for mental and physical health. Occupational factors play a large role in determining sleep habits. Healthcare workers are particularly susceptible to job-mediated sleep insufficiency and inadequate rest in general. Little is published on sleep practices among veterinarians, and overall recognition of the impacts of inadequate rest within the veterinary profession is poor.

Objectives and procedures
This review describes occupational factors affecting sufficiency of rest and recovery, reviews veterinary-specific and relevant adjacent literature pertaining to sleep patterns, and discusses potential solutions for addressing occupational schedules contributing to sleep insufficiency and inadequate rest. Online databases were searched to extract contemporary literature pertaining to sleep, insufficient rest, and occupational factors, with a focus on veterinary medicine and other healthcare sectors.

Results
Occupational factors leading to inadequate rest among healthcare workers include excessive workloads, extended workdays, cumulative days of heavy work hours, and after-hours on-call duty. These factors are prevalent within the veterinary profession and may contribute to widespread insufficient rest and the resulting negative impacts on health and well-being among veterinarians.

Conclusion and clinical relevance
Sufficient sleep quantity and quality are critical to physical and mental health and are negatively affected by many aspects of the veterinary profession. Critical review of current strategies employed in clinical practice is essential to promote professional fulfillment, health, and well-being among veterinarians.