Use of buprenorphine in cats undergoing ovariohysterectomy

Buprenorphine is a common analgesic used in a variety of surgical procedures, although it is not as effective an analgesic as pure opioid agonists.

Martin-Flores et al¹ performed a study to compare the analgesic effects and thermoregulation associated with high-dose buprenorphine compared to morphine in cats undergoing ovariohysterectomy.

A total of 94 cats were randomised to receive either buprenorphine or morphine subcutaneously during the recovery period after surgery. Body temperature and signs of pain were assessed at various intervals.

Cats receiving buprenorphine had a higher postoperative temperature compared to cats receiving morphine. Hyperthermia was more prevalent in the buprenorphine group than the morphine group. No differences in pain scores were noted. Similar numbers of cats in both arms required rescue analgesia in the first 24 hours.

The authors concluded that high-dose buprenorphine resulted in a higher incidence of hyperthermia compared to morphine, with no obvious advantage in analgesic effect. The authors noted that opioid-induced hyperthermia could create difficulties in making a diagnosis in cases of fever.

Double-limb amputation

The ethics of certain veterinary medical and surgical procedures can be controversial if they are deemed to not be in the animal’s best interests – for example, if they are overly invasive or increase quantity, but not quality of life. Many animals that require double-limb amputations would be euthanised for fear of a poor quality of life after the procedure.

Magidenko et al² performed a retrospective analysis of outcomes after double-limb amputation and assessed owner satisfaction. A total of 14 dogs and 4 cats were included in the study. In 12 cases, the indication for amputation was trauma. A total of 11 patients had both amputations carried out at the same time, while 9 patients had double partial limb amputations. In 12 cases, both pelvic limbs were amputated, in 4 both thoracic limbs were amputated, and in 2 cases a pelvic limb and contralateral thoracic limb were amputated.

Three patients had major complications in the follow-up period, with two requiring revision surgery. In total, 14 of the patients’ owners reported they were at least very satisfied with the outcome, while only one patient’s owners were strongly dissatisfied.

The authors concluded that double-limb amputation may be a good alternative to euthanasia or advanced limb-sparing techniques, given the owner satisfaction scores and low rate of complications.

Support staff

Staffing ratios are a vexing question for vet practice managers and owners. Although it is well-accepted that veterinary surgeons require support staff to perform their work efficiently and to a high standard, data is lacking as to how much support staff contribute to practice turnover and profitability.

Ouedraogo et al³ performed a survey of 409 owners of mixed and companion animal practices who took part in the 2020 American Veterinary Medical Association Practice Owner Survey, with the aim of determining the contributions of vets and non-vet support staff to revenue and productivity, and identify the staff-to-vet ratio that maximises these two values.

For each 10% increase in total vet hours worked per week, revenue increased by around 9%. However, a one unit increase in the total number of veterinary technician hours used to support one hour of veterinary work was associated with a 20.5% increase in revenue, although this was not associated with a change of productivity as measured by the number of patients seen per full‑time equivalent vet per week.

A one unit increase in non-medical staff hours per vet hour worked was associated with a 17% increase in revenue and a 14.4% increase in productivity. The optimal staffing ratios for veterinary technicians to vets for revenue was 9:1 and for non-medical staff 8:1. For productivity, the optimal rate for non-medical staff to vets was 10:1.

These findings confirm what most in the profession already were aware of – that non-veterinarian staff are vital in practice to improve productivity and revenue.

High-fibre diets and acute large bowel diarrhoea

Acute large bowel diarrhoea is usually self-limiting in dogs, despite a variety of causes. However, while the dog is suffering from the condition, it is unpleasant for patient and carers alike, and so various techniques have been recommended to shorten the course of the disease, such as dietary manipulation and probiotics.

Lappin et al⁴ performed a randomised prospective study to investigate whether diets high in fibre are beneficial in the management of dogs with acute large bowel diarrhoea. A total of 52 dogs with acute colitis signs in an animal shelter were enrolled into the study, and assigned to be fed a high or normal-fibre diet. A total of 11 dogs in each group completed the study.

Faecal scores were compared over the course of the study. All dogs fed the high-fibre diet had a faecal score less than five by day nine or the day of their adoption, compared to 6 out of 11 dogs in the standard diet group, which was statistically significant. The proportions of stools with a faecal score more than four were higher in the dogs fed the standard diet compared to dogs fed the high-fibre diet. The authors concluded that this study supports the feeding of high-fibre diets to dogs with acute colitis.

Bone foreign bodies

Oesophageal and gastric bone foreign bodies are commonly encountered in practice, but it is uncertain which cases require removal and which do not.

Barash et al⁵ performed a retrospective study of 129 dogs – 45 of which had oesophageal bone foreign bodies and 84 of which had gastric bone foreign bodies – to describe the management and outcomes of these cases.

Dogs with oesophageal bone foreign bodies tended to be younger than dogs with gastric bone foreign bodies, and the cross-sectional area of the bone compared to the dog’s bodyweight tended to be higher for oesophageal foreign bodies. In total, 42 of the 45 oesophageal foreign bodies were resolved by non-surgical methods, such as advancement into the stomach or endoscopic removal, while three required oesophagotomy.

Oesophageal erosions were more commonly seen in dogs with distal entrapment and a longer duration of blockage. By contrast, 62 of the gastric bone foreign bodies were left in place. In 22 cases, endoscopic removal of a gastric bony foreign body was attempted, and this was successful in 20 cases.

The authors concluded that since most gastric bony foreign bodies were left in place, and dissolved without reported complication, removal may not be necessary even for large bones. For oesophageal bone foreign bodies, advancement into the stomach is a viable alternative to endoscopic removal.

Canine leptospirosis

Canine leptospirosis was not reported in Sydney, Australia, between 1976 and 2017. However, from 2017‑20 the disease was confirmed in 17 dogs. Griebsch et al⁶ described this outbreak.

Five dogs were known to hunt rodents. Severe hepatorenal involvement was seen, and the disease had an unusually high fatality rate of 88%. Diagnosis was confirmed by clinical signs and real-time PCR using blood, kidney and urine, or by evidence of seroconversion. Seven dogs had antibodies to serovar Copenhageni, one for Hardjo and three negative for all – probably because of lack of time for seroconversion before death.

Dogs living in inner Sydney are now recommended to be given a monovalent Leptospira vaccine containing the serovar Copenhageni. Further research is required to assess the success of the vaccination programme and the reason for the outbreak.