James Sutherland-Smith

Veterinary schools have traditionally used letter grading systems to assess the performance of students on clinical rotations, but pass-fail grading may enhance the learning environment and student wellbeing. When a decision to switch grading systems is discussed, concerns are often raised about the effect of removing clinical year grades from final grade point average (GPA) calculations. In order to inform the decision-making at our institution, retrospective analysis of the effects of clinical year grades on final grade point average (GPA) was performed. The specific hypothesis tested was that clinical year GPA would not have a significant effect on cumulative GPA, as defined by a decrease or increase of 0.10 points on average. When data from two classes were examined, median (range) difference final GPA (0–4 scale) compared to GPA at the end of the preclinical curriculum (referred to as delta GPA) was 0.02 (-0.19 to 0.18) for the graduating class of 2016 after removal of two outliers and 0.03 (-0.10 to 0.18) for the class of 2017. Correlations between preclinical GPA and delta GPA (were -0.83 (p < 0.001) for both classes. The hypothesis was supported leading to the conclusion that the overall effect of clinical letter grades on final GPA was close to zero when whole classes were considered, and delta GPA ranged between -0.2 and 0.2 for all except two students. Data from this study were distributed prior to conducting a faculty vote to switch grading systems, and the motion was supported.

There is a lack of consensus among educators regarding the ideal structure of radiology training in veterinary medicine. Research in the medical field suggests that early integration has positive short- and long-term impacts on student interest in radiology. This study evaluated the effect of a new radiology course in the first year of the veterinary curriculum. Authors hypothesized that students taught radiology in years 1 and 2 would have greater interest in and appreciation for the specialty of radiology and would perform better on tests of basic knowledge of medical imaging principles, entry-level image interpretation, and anatomy identification than students who were not taught until year 2. An online questionnaire was administered to different classes of students after completion of their radiology courses. Students with early and increased radiology training were significantly more likely to respond that radiology was more interesting than other veterinary specialties. Unexpectedly, students with early and increased training performed significantly better than students with less and later training on only one out of nine content knowledge questions, though they did perform significantly better on additional knowledge questions compared to students with only early exposure. This suggests early and increased training in radiology may increase student interest in and appreciation for the specialty, but may not lead to increased short-term knowledge retention compared to a traditional curriculum format.

Objective: To describe acute compartment syndrome (CS) of the muscles of mastication in a working dog associated with a traumatic training event.Case Summary: A 2.5‐year‐old male Belgian Malinois was evaluated for acute blindness, severe diffuse swelling of the head, and inability to close the jaw following a traumatic incident during a bite training drill. During the exercise, the maxillary canine teeth were locked on a bite sleeve. Magnetic resonance imaging of the head and ocular system identified diffuse muscle swelling and hyperintensity, most severe in the muscles of mastication. Ocular abnormalities were not identified. Rhabdomyolysis, CS, and indirect optic nerve injury were supported by measurement of increased intramuscular pressure. Bilateral decompressive fasciotomies over the masseter and temporalis muscles resulted in immediate and marked resolution of the swelling and jaw movement. Blindness, however, did not resolve.New or Unique Information Provided: CS involving the muscles of mastication may occur as a complication of bite training and may result in irreversible and even life‐threatening complications. Emergent decompressive fasciotomy is indicated to reverse swelling; however, visual deficits may not resolve.

OBJECTIVE To determine whether the degree of CT attenuation of muscle would differ between healthy old and young dogs. ANIMALS 10 healthy old (> 8 years old) and 9 healthy young (1 to 5 years old) Labrador Retrievers with a body condition score of 5 or 6 on a 9-point scale. PROCEDURES CT was performed with the dogs mildly sedated. A freehand closed polygon tool was used to define the outer margin of the left epaxial muscles on each transverse image obtained from the cranial to caudal endplates of T13. The CT attenuation values from every voxel from within these regions of interest were exported from DICOM software as a single dataset in an extensible markup language file. From these data, mean CT attenuation values were calculated for each dog and these mean values were compared between age groups. RESULTS Mean CT attenuation values for the epaxial muscles were significantly lower in old dogs than in young dogs. A significant negative correlation (r = –0.74) was identified between mean CT attenuation values and dog age. CONCLUSIONS AND CLINICAL RELEVANCE In addition to loss of skeletal muscle mass, low muscle CT attenuation values suggested that the old dogs in this study also had greater muscle fat content than did young dogs. Additional studies are warranted to evaluate qualitative and quantitative muscle changes in old dogs.

OBJECTIVE To evaluate use of an ultrasonographically and radiographically determined value, the vertebral epaxial muscle score (VEMS), for assessing muscle mass in cats. ANIMALS 30 healthy neutered cats of various body weights and between 1 and 6 years of age. PROCEDURES Mean epaxial muscle height was calculated from 3 transverse ultrasonographic images obtained at the level of T13. Length of T4 was measured on thoracic radiographs, and the VEMS (ratio of epaxial muscle height to T4 length) was calculated and compared with body weight. Ratios of epaxial muscle height to various anatomic measurements also were compared with body weight as potential alternatives to use of T4 length. RESULTS 1 cat was excluded because of a heart murmur. For the remaining 29 cats, mean ± SD body weight was 5.05 ± 1.40 kg. Mean epaxial muscle height was 1.27 ± 0.13 cm, which was significantly correlated (r = 0.65) with body weight. The VEMS and value for epaxial muscle height/(0.1 × forelimb circumference) were not significantly correlated (r = −0.18 and −0.06, respectively) with body weight, which is important for measures used for animals of various sizes. CONCLUSIONS AND CLINICAL RELEVANCE The VEMS and value for epaxial muscle height/(0.1 × forelimb circumference) can both be used to normalize muscle size among cats of various body weights. Studies are warranted to determine whether these values can be used to accurately assess muscle mass in cats with various adiposity and in those with muscle loss.

OBJECTIVE To evaluate the knowledge of various veterinary specialists regarding various radiation safety matters and determine the availability of radiation safety training. DESIGN Cross-sectional study. SAMPLE 164 radiology, 81 internal medicine, and 108 emergency and critical care (ECC) specialists. PROCEDURES An online survey was developed regarding knowledge of and training in radiation safety, and invitations were sent via email through the email lists of the veterinary internal medicine, ECC, and radiology specialty colleges. Responses were summarized, and comparisons were made between radiologists and internal medicine and ECC clinicians. RESULTS 65.5% (38 /58) of respondents from academic institutions and 30.0% (33/110) of respondents from private practices indicated that radiation safety training was mandatory at their institution for personnel who work with ionizing radiation–emitting equipment, and 80.2% (85/106) and 56.6% (77/136), respectively, had received some radiation safety training. Low proportions of radiologists and internal medicine and ECC clinicians correctly identified the effective dose of ionizing radiation associated with 3-phase esophagography and 3-phase abdominal CT. Many radiologists (92/153 [60.1%]) and nonradiologists (92/179 [51.4%]) believed that the effective doses used in veterinary practice pose no increased risk of fatal cancer to their patients. CONCLUSIONS AND CLINICAL RELEVANCE Radiation safety training, although more common in academia, was not universally available and may not meet radiography equipment license requirements for some institutions. Most radiologists, internal medicine clinicians, and ECC clinicians had a poor understanding of the amount of ionizing radiation associated with medical imaging procedures and the potential hazards to their patients.

OBJECTIVE To describe the ultrasonographic appearance of the urinary bladder incision site in dogs that underwent cystotomy for treatment of urolithiasis. DESIGN Prospective, longitudinal study. ANIMALS 18 client-owned dogs. PROCEDURES Dogs underwent urinary bladder ultrasonography at baseline (≤ 1 day before surgery) and at 1 day and approximately 2, 6, and 12 weeks after cystotomy for urocystolith removal. A baseline ratio between ventral (cystotomy site) and corresponding dorsal midline wall thickness was calculated and used to account for measurement variations attributable to bladder distension at subsequent visits. Patient signalment, weight, medications administered, urocystolith composition, and culture results were recorded. Clinical signs, reoccurrence of hyperechoic foci, and suture visualization were recorded at follow-up examinations. Variables were evaluated for association with cystotomy site thickening and resolution of thickening. RESULTS Median wall thickness at the ventral aspect of the bladder was significantly greater than that of the corresponding dorsal aspect at baseline. Cystotomy site thickening peaked 1 day after surgery and decreased at subsequent visits in a linear manner. Twelve weeks after surgery, 5 of 10 clinically normal dogs evaluated had persistent cystotomy site thickening. Eleven of 18 dogs had reoccurrence of hyperechoic foci within the bladder at some time during the study (median time to first detection, 17 days after surgery). CONCLUSIONS AND CLINICAL RELEVANCE Persistent cystotomy site thickening can be present up to 3 months after cystotomy for urolithiasis in dogs without lower urinary tract signs. Reoccurrence of hyperechoic foci in the bladder, although subclinical, was detected earlier and at a higher rate than anticipated.

Muscle loss associated with disease (cachexia) or with aging (sarcopenia) is common in dogs, but clinically relevant methods for quantifying muscle loss are needed. We previously validated an ultrasound method of quantifying muscle size in dogs in a single breed. The goal of this study was to assess the variability and reproducibility of the Vertebral Epaxial Muscle Score (VEMS) in other dog breeds. Static ultrasound images were obtained from 38 healthy, neutered dogs of 5 different breeds between 1- and 5-years-old. The maximal transverse right epaxial muscle height and area at the level of the 13th thoracic vertebra (T13) were measured. Length of the 4th thoracic vertebra (T4) was measured from thoracic radiography. Ratios of the muscle height and area to vertebral length (height/T4 and area/T4, respectively) were calculated to account for differences in body size among breeds. Reproducibility testing was performed on 2 dogs of each breed (26% of the total) to determine intra- and inter-investigator reproducibility, as well as intra-class correlation. Mean height/T4 = 1.02 ± 0.18 and mean area/T4 = 3.32 ± 1.68. There was no significant difference for height/T4 (P = 0.10) among breeds, but breeds were significantly different in area/T4 (P < 0.001). Intra-class correlation ranged from 0.80 to 0.99. Testing showed better reproducibility for height/T4 compared to area/T4. The VEMS using height/T4 was valid and reproducible for healthy dogs of different sizes and body conformations. Studies assessing this technique in dogs with congestive heart failure and other diseases associated with muscle loss are warranted.

There are limited criteria for the detection of pulmonary hypertension in dogs undergoing computed tomography (CT) for pulmonary disease. This retrospective analytical exploratory study compared a CT pulmonary trunk to aorta ratio with echocardiographic estimates of pulmonary hypertension. Dogs having both a contrast thoracic CT and echocardiogram were selected and maximal pulmonary trunk and descending aorta diameters were measured by two observers on a single transverse CT image. Computed tomographic diameter ratios were compared with the echocardiographic parameters of tricuspid regurgitation gradient, right ventricular acceleration time‐to‐ejection time ratio, pulmonary insufficiency gradient, and pulmonary artery to aorta diameter. A total of 78 dogs were sampled, with 44 dogs having one or more finding suggestive of pulmonary hypertension. A moderate positive correlation was shown between tricuspid regurgitation gradient and CT pulmonary trunk to aorta ratio (r = 0.61, P‐value < 0.0001). Mean CT pulmonary trunk to aorta ratio of dogs with moderate (P = 0.0132) and severe (P < 0.0003) pulmonary hypertension were significantly higher than normal dogs. There was no significant difference in mean CT pulmonary trunk to aorta ratio between normal and mild pulmonary hypertension dogs (P = 0.4244). The intraclass correlation coefficient (0.72) showed good reproducibility of the ratio. Findings indicated that CT pulmonary trunk to aorta ratio is a reproducible and potentially useful method to predict moderate and severe pulmonary hypertension in dogs, but not mild pulmonary hypertension. In dogs undergoing thoracic CT for pulmonary disease, an increased ratio should prompt follow up echocardiography.