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Buote NJ, Hayes G, Bisignano J, Rosselli D. Retrospective comparison of open vs minimally invasive cystotomy in 28 cats using a composite outcome score. J Feline Med Surg 2022; 24:1032-1038. [PMID: 34904482 PMCID: PMC10812324 DOI: 10.1177/1098612x211066477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to compare the outcomes of cats undergoing open cystotomy with those undergoing minimally invasive surgery (MIS) for removal of cystic calculi by use of a composite outcome score. METHODS Twenty-eight cats were retrospectively enrolled and divided into two groups: open cystotomy (n = 14) and MIS (n = 14). The primary outcome measure was a composite outcome score, including three variables: pain scores ⩾2 at either 6 or 12 h postoperatively; failure to remove all stones as determined by postoperative radiographs; and postoperative complications requiring a visit to the hospital separate from the planned suture removal appointment. Other data collected included signalment, history, other procedures performed during anesthesia, willingness to eat the day after surgery and the financial cost of the procedures. RESULTS There was no significant difference in age, weight, sex or breed between the two groups. The risk of experiencing the composite outcome was 3/14 (21.4%) in the MIS group and 10/14 (71%) in the open procedure group (P = 0.02). The cats in the open surgery group had 8.3 times greater odds of developing the composite outcome than cats in the MIS group (odds ratio 8.3, 95% confidence interval 1.3-74.4; P = 0.02). In the MIS group, 10/14 cats were eating the day after surgery vs 3/14 in the open procedure group (P = 0.02). The procedural cost was higher in the MIS group, with a median cost of US$945 (interquartile range [IQR] US$872-1021) vs US$623 (IQR US$595-679) in the open group (P <0.01). CONCLUSIONS AND RELEVANCE In this study the composite outcome score provided evidence to support the use of MIS techniques in cats with cystic calculi. The composite outcome score should be considered in future veterinary studies as a promising method of assessing clinically relevant outcomes.
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Affiliation(s)
- Nicole J Buote
- VCA West Los Angeles, Los Angeles, CA, USA
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Galina Hayes
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA
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2
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Regier PJ. Current Concepts in Small Animal Gastrointestinal Surgery. Vet Clin North Am Small Anim Pract 2022; 52:437-454. [DOI: 10.1016/j.cvsm.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lacitignola L, Guadalupi M, Massari F. Single Incision Laparoscopic Surgery (SILS) in Small Animals: A Systematic Review and Meta-Analysis of Current Veterinary Literature. Vet Sci 2021; 8:vetsci8080144. [PMID: 34437466 PMCID: PMC8402624 DOI: 10.3390/vetsci8080144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/18/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022] Open
Abstract
In veterinary surgery, single incision laparoscopic surgery (SILS) techniques have been described since 2009, and, in recent decades, many authors have reported the application of SILS in small animals, thus, promoting the wide dissemination of this novel approach among veterinary laparoscopists. The aim of this literature review is to provide a critical evaluation of the scientific reports on SILS in the field of small animal laparoscopic surgery. A comprehensive literature review was performed including from 1 January 2009 to 1 July 2020. The following data were recorded from each study: the design, year of publication, surgical procedure, species, number of animals included, and surgical time. The type of SILS technique and type of control group technique were evaluated. In total, 90 articles were identified through database searches and manual searches. The qualitative analysis showed that most of the articles were retrospective studies, without a control group or case series. A meta-analysis was performed on the eight controlled studies, showing that SILS ovariectomy and gastrointestinal procedures had a comparable surgical time to multiport techniques. The study of the articles available in the veterinary literature did not allow for an adequate meta-analysis of the published results, especially regarding post-operative pain, evaluations of surgical times, and post-operative complications in comparison to multiport techniques. Therefore, veterinary surgeons who want to employ these techniques must consider the real advantages of SILS techniques.
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Affiliation(s)
- Luca Lacitignola
- Dipartimento dell’Emergenze e Trapianti di Organi (D.E.T.O.), Sezione di Cliniche Veterinarie e Produzioni Animali, Università Degli Studi di Bari “Aldo Moro”, 70010 Bari, Italy;
- Correspondence:
| | - Marta Guadalupi
- Dipartimento dell’Emergenze e Trapianti di Organi (D.E.T.O.), Sezione di Cliniche Veterinarie e Produzioni Animali, Università Degli Studi di Bari “Aldo Moro”, 70010 Bari, Italy;
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Lacitignola L, Imperante A, Trisciuzzi R, Zizzo N, Crovace AM, Staffieri F. Swine Small Intestine Sealing Performed by Different Vessel Sealing Devices: Ex-Vivo Test. Vet Sci 2021; 8:vetsci8020034. [PMID: 33671834 PMCID: PMC7926574 DOI: 10.3390/vetsci8020034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/19/2021] [Indexed: 02/01/2023] Open
Abstract
This study aimed to evaluate the sealing quality of swine small intestine using different laparoscopic radiofrequency vessel sealing devices (two 5 mm: RFVS-1 and -2; one 10 mm: RFVS-3) and a harmonic scalpel (HS) compared to golden standard closure technique. The study was divided into two arms. In study arm 1: n = 50 swine intestinal loops (10 per group) were transected with each instrument and the loops in which the devices provided complete sealing, at the gross inspection, were tested for maximum burst pressure (BP) and histological evaluation and compared to an automatic linear stapler. After the BP tests, the devices that achieved significantly lower BP values were excluded from the second arm. The RFVS-1 and -3 provided statistically significant results and were used in study arm 2, to obtain full-thickness biopsies along the antimesenteric border of the loop and were compared with hand-sewn intestinal closure (n = 30; 10 per group). The biopsies were histologically evaluated for thermal injury and diagnostic features, and intestinal loops tested for BP. RFVS-3 achieved comparable results (69.78 ± 4.23 mmHg, interquartile range (IQR) 5.8) to stapler closing technique (71.09 ± 4.22 mmHg, IQR 4.38; p > 0.05), while the RFVS-1 resulted in significantly (p < 0.05) lower BP (45.28 ± 15.23 mmHg, IQR 24.95) but over the physiological range, conversely to RFVS-2 (20.16 ± 7.19 mmHg, IQR 12.02) and HS (not measurable). RFVS-3 resulted not significantly different (p > 0.05) (45.09 ± 8.75 mmHg, IQR 10.48) than Suture (35.71 ± 17.51 mmHg, IQR 23.77); RFVS-1 resulted significantly lower values (23.96 ± 10.63 mmHg, IQR 9.62; p < 0.05). All biopsies were judged diagnostic. Data confirmed that RFVS-1 and -3 devices provided suitable intestinal sealing, with BP pressures over the physiological range. Conversely, the HS and RFVS-2 should not be considered for intestinal sealing. RFVS devices could be employed to obtain small intestine stump closure or full-thickness biopsies. However, further studies should be performed in live animals to assess the role of the healing process.
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Affiliation(s)
- Luca Lacitignola
- Dipartimento dell’Emergenze e Trapianti di Organi (D.E.T.O.), Sezione di Cliniche Veterinarie e Produzioni Animali, Università degli Studi di Bari “Aldo Moro”, 70124 Bari, Italy;
- Correspondence:
| | - Annarita Imperante
- Dottorato di Ricerca in “Trapianti di Tessuti ed Organi e Terapie Cellulari”, Dipartimento dell’Emergenza e Trapianti di Organi (D.E.T.O.), Università degli Studi di Bari “Aldo Moro”, 70124 Bari, Italy; (A.I.); (R.T.)
| | - Rodrigo Trisciuzzi
- Dottorato di Ricerca in “Trapianti di Tessuti ed Organi e Terapie Cellulari”, Dipartimento dell’Emergenza e Trapianti di Organi (D.E.T.O.), Università degli Studi di Bari “Aldo Moro”, 70124 Bari, Italy; (A.I.); (R.T.)
| | - Nicola Zizzo
- Dipartimento di Medicina Veterinaria, Sez. di Anatomia Patologica, Università degli Studi di Bari “Aldo Moro”, 70010 Bari, Italy;
| | - Alberto Maria Crovace
- Dipartimento di Scienze Mediche di Base, Neuroscienze e Organi di Senso, Università degli Studi di Bari “Aldo Moro”, 70124 Bari, Italy;
| | - Francesco Staffieri
- Dipartimento dell’Emergenze e Trapianti di Organi (D.E.T.O.), Sezione di Cliniche Veterinarie e Produzioni Animali, Università degli Studi di Bari “Aldo Moro”, 70124 Bari, Italy;
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Corrêa LM, Demetriou JL. Retrospective assessment of the clinical relevance of surgical biopsies of abdominal lymph nodes in cats: 51 cases (2014-2018). J Feline Med Surg 2020; 22:1168-1175. [PMID: 32419573 PMCID: PMC10814371 DOI: 10.1177/1098612x20916387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aims of this study were to assess surgical biopsy of abdominal lymph nodes (LNs) in cats taken at the time of exploratory laparotomy and to evaluate any additional benefit of histopathology compared with LN cytology. METHODS We carried out a retrospective study from a single institution of cats that had abdominal ultrasound and LN biopsies as part of an exploratory laparotomy (2014-2018). Clinical records were reviewed for presenting signs, medical investigations, ultrasound, cytology, surgical findings and histopathology. RESULTS Fifty-one cats were included. In total, 60 LNs were biopsied. Forty-four cats had evident LN enlargement at the time of surgery. Nine of those cases were reported to have normal-sized LNs on ultrasound, including one cat that was subsequently diagnosed with lymphoma. Ultrasound-guided LN aspiration was performed in 19 cases. Five of these cats had a histological diagnosis of neoplasia following biopsy, but only one was correctly identified with cytology. Histopathology results were reactive hyperplasia (n = 41), tumour metastasis (n = 11), lymphadenitis (n = 6), inconclusive (n = 1) and normal (n = 1). The most common final diagnoses were inflammatory bowel disease (n = 17/51) and gastrointestinal lymphoma (n = 10/51). There were 15 cats with neoplastic disease; LN biopsies confirmed metastatic disease in 10 and ruled out nodal involvement in five. CONCLUSIONS AND RELEVANCE Surgical biopsy of grossly enlarged or normal abdominal LNs provides additional information to LN cytology in cats and in the majority of cases is associated with a positive histological diagnosis. There appears to be the potential to underdiagnose neoplasia with cytology alone.
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Shamir SK, Singh A, Mayhew PD, Runge JJ, Case JB, Steffey MA, Balsa IM, Culp WTN, Giuffrida MA, Kilkenny JJ, Zur Linden A. Evaluation of minimally invasive small intestinal exploration and targeted abdominal organ biopsy with use of a wound retraction device in dogs: 27 cases (2010-2017). J Am Vet Med Assoc 2020; 255:78-84. [PMID: 31194657 DOI: 10.2460/javma.255.1.78] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe surgical technique, biopsy sample quality, and short-term outcome of minimally invasive small intestinal exploration and targeted abdominal organ biopsy (MISIETB) with use of a wound retraction device (WRD) in dogs. ANIMALS 27 client-owned dogs that underwent MISIETB with a WRD at 1 of 4 academic veterinary hospitals between January 1, 2010, and May 1, 2017. PROCEDURES Medical records were retrospectively reviewed, and data collected included signalment; medical history; findings from physical, ultrasonographic, laparoscopic, cytologic, and histologic evaluations; surgical indications, procedures, duration, and complications; and short-term (14-day) outcomes. The Shapiro-Wilk test was used to evaluate the normality of continuous variables, and descriptive statistics were calculated for numeric variables. RESULTS Laparoscopic exploration was performed through a multicannulated single port (n = 18), multiple ports (5), or a single 6-mm cannula (4). Median length of the incision for WRD placement was 4 cm (interquartile [25th to 75th percentile] range, 3 to 6 cm). All biopsy samples obtained had sufficient diagnostic quality. The 2 most common histologic diagnoses were lymphoplasmacytic enteritis (n = 14) and intestinal lymphoma (5). Twenty-five of 27 (93%) dogs survived to hospital discharge, and 3 (12%) dogs had postsurgical abnormalities unrelated to surgical technique. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that MISIETB with WRD was an effective method for obtaining diagnostic biopsy samples of the stomach, small intestine, pancreas, liver, and mesenteric lymph nodes in dogs. Prospective comparison between MISIETB with WRD and traditional laparotomy for abdominal organ biopsy in dogs is warranted.
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Gibson E, Culp W, Mayhew P, Runge JJ, Peterson LC, Balsa IM, Kim SY. Laparoscopic‐assisted gastrotomy for foreign body retrieval in four dogs. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-000966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Erin Gibson
- Veterinary Medical Teaching HospitalUniversity of California‐DavisSchool of Veterinary MedicineDavisCaliforniaUSA
| | - William Culp
- Department of Surgical and Radiological SciencesUniversity of California‐DavisSchool of Veterinary MedicineDavisCaliforniaUSA
| | - Philipp Mayhew
- Department of Surgical and Radiological SciencesUniversity of California‐DavisSchool of Veterinary MedicineDavisCaliforniaUSA
| | - Jeffrey J Runge
- Department of Clinical SciencesUniversity of PennsylvaniaSchool of Veterinary MedicinePhiladelphiaPennsylvaniaUSA
| | - Lindsay C Peterson
- Department of Clinical SciencesUniversity of PennsylvaniaSchool of Veterinary MedicinePhiladelphiaPennsylvaniaUSA
| | - Ingrid M Balsa
- Department of Surgical and Radiological SciencesUniversity of California‐DavisSchool of Veterinary MedicineDavisCaliforniaUSA
| | - Sun Y Kim
- Department of Surgical and Radiological SciencesUniversity of California‐DavisSchool of Veterinary MedicineDavisCaliforniaUSA
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Moretti G, Birettoni F, Caivano D, Nannarone S, Crovace A, Porciello F, Bufalari A. Mini-invasive approach for removal of iliopsoas migrating grass awns with an atraumatic wound retractor. J Small Anim Pract 2019; 62:150-155. [PMID: 31512264 DOI: 10.1111/jsap.13066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/11/2018] [Accepted: 12/27/2018] [Indexed: 11/29/2022]
Abstract
This case series describes a novel mini coeliotomy approach using a radial, atraumatic self-retaining retractor for the retrieval of migrant plant foreign bodies from the iliopsoas muscles of six male dogs under intra-operative ultrasonographic guidance. Four dogs had a history of pulmonary disease potentially compatible with inhalation of a foreign body approximately 2-4 months before presentation. Under ultrasonographic guidance, the grass awns were identified in the iliopsoas muscle and were completely removed. In this case series, the annular ring device provided an excellent view of the surgical field for intra-abdominal manipulations. Patient follow-up at 15 days and 6 to 12 months after surgery indicated a full recovery, and no grass awn fragment residues were identified.
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Affiliation(s)
- G Moretti
- Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4 (PG), 06126, Italy
| | - F Birettoni
- Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4 (PG), 06126, Italy
| | - D Caivano
- Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4 (PG), 06126, Italy
| | - S Nannarone
- Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4 (PG), 06126, Italy
| | - A Crovace
- Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4 (PG), 06126, Italy
| | - F Porciello
- Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4 (PG), 06126, Italy
| | - A Bufalari
- Department of Veterinary Medicine, University of Perugia, Via S. Costanzo n.4 (PG), 06126, Italy
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Ellison GW, Case JB, Regier PJ. Intestinal surgery in small animals: historical foundations, current thinking, and future horizons. Vet Surg 2019; 48:1171-1180. [PMID: 31286544 DOI: 10.1111/vsu.13275] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/23/2019] [Accepted: 06/01/2019] [Indexed: 12/12/2022]
Abstract
Intestinal wounds require precise closure after intestinal biopsy, enterotomy, or enterectomy in small animals. Preexisting factors such as intra-abdominal sepsis and hypoalbuminemia as well as poor surgical technique increase the risk of intestinal dehiscence, with considerable negative impact on patient morbidity and mortality. Live dog studies have demonstrated the dangers of mucosal eversion especially in the septic abdomen. Approximating patterns preserve luminal diameter, heal optimally, and have equal bursting strength compared with inverting patterns after 24 hours. Simple interrupted and simple continuous suture patterns and disposable skin staples are established alternatives for manual wound closure. Knotless quilled suture currently used in laparoscopic gastropexy techniques shows bursting strength equal to monofilament sutures in dog cadaveric intestine. Dehiscence rates with hand sewn vs titanium automated stapling anastomosis are similar in uncomplicated cases; however, auto stapling devices may be the preferred method of anastomosis when preexisting abdominal sepsis is present and when patient size allows it. Regardless of the technique, current standard of care involves leak testing and omental wrapping, followed by early postoperative feeding. The past decade has ushered in an exciting new era of laparoscopic assisted techniques that have the potential to reduce postoperative pain and patient morbidity. An understanding of these applications will establish the future of minimally invasive small animal intestinal surgery for veterinary specialists. In summary, surgeons have a variety of methods at their disposal for optimal clinical outcome in small animal intestinal surgery.
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Affiliation(s)
- Gary W Ellison
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - J Brad Case
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Penny J Regier
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
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Morris KP, Singh A, Holt DE, Stefanovski D, Singhal S, Bosco J, Capps M, McCallum M, Runge JJ. Hybrid single-port laparoscopic cisterna chyli ablation for the adjunct treatment of chylothorax disease in dogs. Vet Surg 2019; 48:O121-O129. [PMID: 30927322 DOI: 10.1111/vsu.13195] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/20/2019] [Accepted: 02/26/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To describe a hybrid, single-port, minimally invasive cisterna chyli ablation (CCA) technique in clinical cases of canine idiopathic chylothorax and evaluate this technique as a method for mesenteric lymphangiography (ML) in canine cadavers and clinical cases of idiopathic chylothorax. STUDY DESIGN Cadaveric and retrospective study. ANIMALS Six canine cadavers and 14 client-owned dogs with naturally occurring idiopathic chylothorax. METHODS Both cadaveric and clinically affected dogs were placed in sternal recumbency. A wound retractor device (WRD) and a single-port device were placed in the abdominal flank 2-3 cm caudal to the 13th rib. Mesenteric lymphangiography was evaluated by using indocyanine green (ICG) in 6 canine cadavers. Single-port laparoscopic CCA was performed in all clinical cases with idiopathic chylothorax. RESULTS Successful ML was completed by using ICG in all 6 canine cadavers. A right- or left-sided single-port laparoscopic CCA was successfully performed in 14 dogs with naturally occurring idiopathic chylothorax. Mesenteric lymphangiography was successfully performed through the WRD in 11 of these cases. No intraoperative complications were reported. Three dogs developed severe chyloabdomen postoperatively, with 1 dog requiring multiple abdominocenteses. CONCLUSION Direct ML and single-port laparoscopic CCA was performed through a WRD in dogs positioned in sternal recumbency. Although minimal operative complications were noted, postoperative chyloabdomen was reported. CLINICAL SIGNIFICANCE This hybrid single-port laparoscopic technique performed in sternal recumbency allows both a CCA and an intraoperative ML through the same incision. This procedure may be combined with thoracoscopic thoracic duct ligation and pericardectomy for the treatment of idiopathic chylothorax in dogs.
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Affiliation(s)
- Katherine P Morris
- Department of Clinical Studies, Section of Surgery, Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - David E Holt
- Department of Clinical Studies, Section of Surgery, Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Darko Stefanovski
- Department of Biostatistics, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Sunil Singhal
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Jessica Bosco
- Department of Clinical Studies, Section of Surgery, Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michelle Capps
- Department of Clinical Studies, Section of Surgery, Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael McCallum
- Department of Clinical Studies, Section of Surgery, Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jeffrey J Runge
- Department of Surgery, Guardian Veterinary Specialists, Brewster, New York
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Otomo A, Singh A, Valverde A, Beaufrere H, Mrotz V, Kilkenny J, Linden AZ. Comparison of outcome in dogs undergoing single‐incision laparoscopic‐assisted intestinal surgery and open laparotomy for simple small intestinal foreign body removal. Vet Surg 2018; 48:O83-O90. [DOI: 10.1111/vsu.13131] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 06/25/2018] [Accepted: 06/27/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Aki Otomo
- Department of Clinical Studies, Ontario Veterinary CollegeUniversity of Guelph Guelph Ontario Canada
| | - Ameet Singh
- Department of Clinical Studies, Ontario Veterinary CollegeUniversity of Guelph Guelph Ontario Canada
| | - Alexander Valverde
- Department of Clinical Studies, Ontario Veterinary CollegeUniversity of Guelph Guelph Ontario Canada
| | - Hugues Beaufrere
- Department of Clinical Studies, Ontario Veterinary CollegeUniversity of Guelph Guelph Ontario Canada
| | - Victoria Mrotz
- Department of Clinical Studies, Ontario Veterinary CollegeUniversity of Guelph Guelph Ontario Canada
| | - Jessica Kilkenny
- Department of Clinical Studies, Ontario Veterinary CollegeUniversity of Guelph Guelph Ontario Canada
| | - Alex zur Linden
- Department of Clinical Studies, Ontario Veterinary CollegeUniversity of Guelph Guelph Ontario Canada
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