Readability of postoperative discharge instructions is associated with complication rate in companion animals undergoing sterilisation.

BACKGROUND: Readability of client communications is a commonly overlooked topic in veterinary medical education. In human medicine, it has been advised that the readability of patient materials should be at USA schooling sixth-grade level or below. We hypothesised that student written discharge instructions would be of an inappropriate readability level, and discharges scored with higher reading grade levels would be associated with more complications. METHODS: The cohort comprised 149 dogs and cats presenting for sterilisation. The readability of discharge instructions was assessed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) formulas. Records were examined for evidence of postoperative complications. RESULTS: The mean FRE score of the discharge instructions was 61.97, with 30.87% being classified as 'difficult' or 'fairly difficult', 60.4% as 'standard' and 8.72% as 'fairly easy'. The mean FKGL was 8.64, with 98% being above reading level 6. Overall, there was an association between FKGL and complication occurrence (p = 0.005). Stratification by species demonstrated FRE and FKGL to be associated with complication occurrence in dogs (FRE score, p = 0.038; FKGL, p = 0.002), but not cats (FRE score, p = 0.964; FKGL, p = 0.679). LIMITATIONS: Due to the retrospective nature of the study, there were difficulties associated with extracting relevant complication information from the medical records. CONCLUSION: Only 2% of owner-directed discharge instructions were written at readability levels aligning with the recommendations set forth in the human guidelines.

Splenic torsion in a cat with chronic anemia.

Case summary: A 4-year-old female spayed domestic shorthair cat with chronic anemia was evaluated for acute-onset lethargy, vomiting, abdominal distension, and a palpably enlarged and firm spleen. Abdominal ultrasound confirmed marked splenomegaly and concern for a splenic infarct, prompting exploratory abdominal surgery, where splenic torsion was diagnosed. A splenectomy was performed, and the cat recovered uneventfully. Splenitis was diagnosed on histopathology. Anemia improved postoperatively. The role of chronic anemia and other concurrent findings in the development of splenic torsion in this case remains unknown. Relevance and novel information: Splenic torsion has not been previously reported in cats, making this the first case of its kind. In cases of splenomegaly and abnormal splenic blood flow, splenic torsion should be considered a differential diagnosis in cats.

Fluorescent In Situ Hybridization for the Detection of Intracellular Bacteria in Companion Animals.

FISH techniques have been applied for the visualization and identification of intracellular bacteria in companion animal species. Most frequently, these techniques have focused on the identification of adhesive-invasive Escherichia coli in gastrointestinal disease, although various other organisms have been identified in inflammatory or neoplastic gastrointestinal disease. Previous studies have investigated a potential role of Helicobacter spp. in inflammatory gastrointestinal and hepatic conditions. Other studies evaluating the role of infectious organisms in hepatopathies have received some attention with mixed results. FISH techniques using both eubacterial and species-specific probes have been applied in inflammatory cardiovascular, urinary, and cutaneous diseases to screen for intracellular bacteria. This review summarizes the results of these studies.

Resolution of megaesophagus after correction of a paraesophageal hernia.

Case summary: A 6-year-old female Siamese cat presented with an 8-week history of vomiting and progressive hyporexia. On presentation, the cat was found to have a hypochloremic alkalosis. Imaging demonstrated hiatal hernia and megaesophagus. Exploratory laparotomy demonstrated a paraesophageal hiatal hernia. The hernia was reduced, phrenoplasty and esophagopexy were performed, and a gastrotomy tube was placed. Treatment of the hernia led to resolution of the megaesophagus. Relevance and novel information: Megaesophagus can occur secondarily to paraesophageal hernia in the cat. In this case, correction of the paraesophageal hernia led to complete resolution of the esophageal dilation and all associated clinical signs.

Overall good agreement of smartphone-based and standard base-apex electrocardiography in healthy sheep.

OBJECTIVE: To assess and compare the quality of smartphone ECG tracings to standard (base-apex) ECG tracings and assess agreement of ECG parameters between smartphone-based ECG and standard ECG. ANIMALS: 25 rams. PROCEDURES: The rams were consecutively examined with standard ECG and smartphone-based ECG (KardiaMobile; AliveCor Inc) after physical examination. ECGs were compared for quality score, heart rate, and ECG waves, complexes, and intervals. Quality scores were based on the presence or absence of baseline undulation and tremor artifacts using a 3-point scoring system (lowest possible = 0; highest possible = 3). A lower score was indicative of a better-quality ECG. RESULTS: Smartphone-based ECGs were interpretable in 65% of cases, while 100% of standard ECGs were interpretable. Standard ECG quality was superior to smartphone-based ECG quality, with no agreement in the quality between devices (κ coefficient, -0.0062). There was good agreement for heart rate with mean difference 2.86 beats/min (CI, -3.44 to 9.16) between the standard and smartphone ECGs. Good agreement was observed for P wave amplitude with mean difference 0.02 mV (CI, -0.01 to 0.05), QRS duration with mean difference -10.5 ms (CI, -20.96 to -0.04), QT interval with mean difference -27.14 ms (CI, -59.36 to 5.08), T wave duration with mean difference -30.00 ms (CI, -66.727 to 6.727), and T wave amplitude with mean difference -0.07 mV (CI, -0.22 to 0.08) between the 2 devices. CLINICAL RELEVANCE: Our findings indicate good agreement between standard and smartphone ECG for most parameters, although 35% of smartphone ECGs were uninterpretable.

Critique of Approaches for Evaluating Teaching and Proposal for a New Institutional Policy.

A review of current literature provides ample evidence that Student Evaluation of Teaching, as currently practiced, can be a biased and flawed evaluation of educator performance and student learning. Due to this, many institutions have developed their own internal multimodal approach for faculty evaluation and professional advancement review that removes the underlying bias associated with survey results. Ross University School of Veterinary Medicine created a taskforce to evaluate the current teaching assessment practices and provide an alternative method. Based on an extensive literature review, an institutional policy was created using a multimodal approach, combining student evaluations of teaching scores with peer review of teaching, review of teaching materials, mentorship, self-ratings, and self-reflection. The implementation plan for this policy is described to allow for a teaching evaluation process built on a philosophy of mentorship, guidance, and self-reflection; as well as the use of external professional exam metrics to review the institutional academic quality at large.

Feline pulmonary hypertension: are we overlooking an important comorbidity?

Pulmonary hypertension (PH) is a potential complication in many disease states, yet it has been largely overlooked in feline medicine. Recently, increased awareness of potential underlying causes has led to a wider understanding of the disease process in humans, with a focus on tailoring therapy to include specific treatment of the underlying etiology. Most of these treatments are not yet available in veterinary medicine, but as they move from the human to the veterinary field, it would be beneficial to better understand the forms of PH encountered in different species. Recently, diagnosis and classification of PH in dogs has been the focus of an American College of Veterinary Internal Medicine consensus statement, yet this condition has received little attention in cats. It is therefore our intention to raise awareness of this condition in cats and to propose a classification system for the types of PH seen in feline patients. As new medications are developed for the treatment of PH, it is important to recognize which forms of PH are seen in feline patients and understand the etiology of the disease. There are many reports of PH (or suspected PH based on echocardiographic assessment) in cats. In this review, we highlight the large number of conditions, and different etiologies, that are associated with PH. Improving understanding of this condition will bring us closer to being able to investigate the benefits of potential new diagnostics and therapies as they become available.

Giant splenic myelolipoma in a cat with hyperthyroidism.

Case summary: A 15 shorthair cat presented after having fallen down the stairs. Examination by the referring veterinarian had demonstrated tachycardia and a large abdominal mass. The cat was referred for investigations. Blood tests demonstrated hyperthyroidism. A large, poorly vascularised abdominal mass was identified on ultrasonography. The mass was hyperechoic compared with the normal liver; however, the origin could not be determined. Fine-needle aspirate biopsies of the mass demonstrated extramedullary haematopoiesis. Surgical exploration revealed a 12 cm × 8 cm × 8 cm pale mass arising from the spleen. Histopathology determined this was a giant splenic myelolipoma. Relevance and novel information: Splenic myelolipoma is rarely reported in the domestic cat, with only five cases documented within the literature, and none of these having described giant myelolipoma. Indeed, giant myelolipomas are rarely reported in the human literature and are most commonly adrenal in origin. The pathogenesis of these masses is unclear; there have been several incidences in people with endocrine disorders, and it has been hypothesised that their occurrence may be related to endocrine stimulation. Here we report the first case of giant myelolipoma in a hyperthyroid cat.

Infectious Causes of Neoplasia in the Domestic Cat.

In recent years, growing attention has been paid to the influence/role of infectious diseases in tumour development and progression. Investigations have demonstrated that some infectious organisms can have a direct role in the development of neoplasia, whereas others can predispose to neoplasia by alterations in the immune response, or by creating a pro-inflammatory environment. Feline leukaemia virus was one of the first infectious agents recognised as an oncogenic organism, and along with feline immunodeficiency virus has received the most attention. Since the discovery of this retrovirus, several other organisms have been associated with neoplastic processes in cats, these include gammaherpes virus, mouse mammary tumour virus, papillomaviruses, hepadnavirus, Helicobacter species, and the parasitic infections Platynosomum fastosum and Opisthorchis viverrini. This review summarises the findings to date.