5 Aug 2025
Alex Gough MA, VetMB, PhD, CertSAM, CertVC, MRCVS takes a look at the most up-to-date information in the veterinary sector, including aseptic techniques for students
Alex Gough
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Image: Issara/ Adobe Stock
Aseptic technique is essential during surgery to prevent infection, even more so in current times when antibiotic usage is being reduced as much as possible.
It is necessary for veterinary students to learn to perform surgery by scrubbing in alongside qualified surgeons, but as they are inexperienced, errors could be made that break asepsis.
Souders et al1 report an observational cross-sectional study aiming to assess the frequency of aseptic protocol breaches (APBs) among veterinary students participating in surgery.
Students on clinical rotations in a small animal teaching hospital were observed while they scrubbed, gowned and gloved into surgery. At least one APB was noted in nearly half of 96 procedures observed.
Common mistakes included allowing the sterile towel or gown to contact non-sterile surfaces, touching sterile objects with a bare hand and improper scrubbing technique. No correlation was found between APBs and stage of rotation, (that is early or late) or previous scrubbing experience, but there was an association between longer gowning and gloving times and APBs. The authors conclude that breaches of asepsis are common when students are scrubbing into surgery.
Faecal microbiota transplantation is becoming more accepted as a procedure in veterinary medicine to treat chronic gastrointestinal disease.
Lee et al2 report a series of cases where faecal transplantation had been performed in cats, to document the adverse events (AEs). AEs were graded according to standardised criteria. Nine cats were included in the study, four of which were treated for chronic enteropathy and five for treatment-resistant diarrhoea. AEs noted included seven cats showing lethargy, while vomiting, diarrhoea, weight loss, inappetence and dehydration were also common. Treatments given included antibiotics, anthelminthics, fluids, ondansetron and mirtazapine.
However, seven cats showed a complete response to the presenting complaint, and another showed a partial, transient response. Adverse events are common with faecal transplants in cats, but a positive response is often achieved.
Histopathological evaluation of intestinal biopsies is crucial for the categorisation of feline chronic enteropathy. Evaluating lymphocyte numbers is necessary for classification and grading, but the normal techniques have a low interobserver agreement, which limits diagnostic accuracy.
Wulcan et al3 performed a study utilising artificial intelligence (AI) to detect lymphocytes in stained feline small intestinal biopsies, and the sensitivity and positive predictive value (PPV) were compared to the majority opinion of eleven veterinary pathologists. The median sensitivity was 100% and the PPV was 57% for intraepithelial lymphocytes. Median sensitivity was 89% and PPV was 67% for lamina propria lymphocytes. False negatives occurred in images with faded stain, and false positives included misidentification of enterocyte nuclei.
However, low interobserver agreement was noted between the pathologists. The authors conclude that with expert supervision, the AI model allowed the production of a quantitative, objective, reproducible assessment of feline intestinal lymphocytes. The authors conclude this technique has the potential to improve the diagnostic accuracy of histopathological assessment of biopsies in cases of feline chronic enteropathy.
Another study also assesses the use of AI in histopathology. The prognosis of canine mast cell tumours (MCTs) is determined with the aid of a variety of histological and immunohistological methods. Polymerase chain reaction (PCR) can be used to detect mutation in the c-KIT gene, which helps predict the response of the neoplasia to treatment with tyrosine kinase inhbitors.
Puget et al4 trained a deep learning model (DLM) to identify mast cell tumours based on their morphology. Slides from 368 MCTs with and without mutations were stained in two different laboratories and scanned with three different slide scanners, giving six different data sets.
The DLM correctly identified mutation status in 87% of cases, a sensitivity of 0.90 and a specificity of 0.83.
The authors conclude that the DLM based examination is highly accurate in predicting c-KIT mutation, but note that staining protocol and scanner type have an influence on accuracy.
Ketamine has long been used in anaesthesia in dogs and cats, but is now becoming increasingly used for analgesia. Wickstead et al5 performed a systematic review to examine the published literature on the administration of ketamine for acute pain relief in dogs and cats.
Fourteen relevant studies were identified, eleven involving dogs and three involving cats. The quality of the evidence was moderate, with low risk of bias, but studies were often underpowered with low numbers of participants.
The results of the review showed that ketamine may have an influence on pain scores more than 12 hours post-operatively, but it does not influence the requirements for rescue analgesia. Plasma concentrations decrease quickly after bolus injection or stopping infusion. The authors recommend future studies are performed with higher doses of ketamine and in a wider range of procedures.
Immune-mediated polyarthritis (IMPA) can cause pyrexia and lameness in dogs, but the amount of literature on the condition is relatively small, especially concerning reactive IMPA.
Cervone et al6 performed a study that aimed to report the clinical findings of dogs with primary and reactive IMPA in France and to find biomarkers that can assess treatment response. Fifty-eight dogs were included in the study, 15 with reactive IMPA and 43 primary cases.
Concurrent diseases in dogs with reactive IMPA included leishmaniosis, gastrointestinal disease and eosinophilic bronchopneumonopathy.
Physical signs included joint swelling and pain, and clinicopathological findings included anaemia, leucocytosis and low serum albumin. In total, 90% of cases had elevated C-reactive protein (CRP); 74% of dogs showed a complete remission, with a median time to remission of 37 days. Serum protein levels were associated with time to remission. In eight out of nine dogs, no relapse was noted on withdrawal of immunosuppressive treatment.
Giardia infection can cause acute diarrhoea in dogs, but in humans it is known that there is a high prevalence of long-term irritable bowel syndrome after acute infection.
Walz et al7 performed a study to assess the prevalence of chronic gastrointestinal and dermatological signs in dogs that have had acute giardiasis.
A total of 49 dogs with acute gastroenteritis with confirmed Giardia infection and 50 healthy matched controls were included in this retrospective longitudinal study.
Follow-up after 12 months was performed by owner-completed questionnaire. Dogs that had had acute giardiasis at a young age were significantly more likely to have chronic intestinal signs than healthy controls (29% versus 10%) and were also more likely to suffer from pruritus when older (33% versus 8%).
Severity of diarrhoea during the acute phase and metronidazole treatment were associated with an increased risk of developing chronic gastrointestinal signs.
The authors conclude that juvenile dogs with acute gastroenteritis associated with giardiasis led to a higher risk of chronic pruritus and gastrointestinal signs, with severity and metronidazole administration increasing the likelihood of experiencing chronic gastrointestinal signs.
Alex Gough qualified from the University of Cambridge in 1996, and worked in mixed and small animal practice until 2002, when he co-founded a referral centre in south-west England. He gained an RCVS Certificate in Small Animal Medicine in 2001, an RCVS Certificate in Veterinary Cardiology in 2005, a Postgraduate Certificate in Neuroimaging for Research from The University of Edinburgh in 2009 and a PhD in Applied Health Research from the University of Birmingham. Alex is co-author of Breed Predispositions to Disease in Dogs and Cats, and the author of Differential Diagnosis in Small Animal Medicine.
