Retrospective evaluation of canine and feline maxillomandibular trauma cases. Comparison of lunar cycle and seasonality with non-maxillomandibular traumatic injuries (2003-2012)

Patient Triage, First Aid Care, and Management of Oral and Maxillofacial Trauma

Maxillofacial trauma is a common presentation in veterinary medical practice. Accurate assessment, diagnostics, pain management, and finally repair are tenants to treatment. In addition to typical tenants for fracture repair, the restoration of occlusion and return to function (eating, drinking, grooming) are unique to trauma management in these patients. Options for repair include conservative management (tape muzzles), noninvasive repair techniques (interdental wiring and composite splinting), and invasive repair techniques (interfragmentary wiring and plate and screw fixation).

Performance evaluation and validation of the Animal Trauma Triage score and modified Glasgow Coma Scale in injured cats: A Veterinary Committee on Trauma registry study

OBJECTIVES

To examine the Animal Trauma Triage (ATT) and modified Glasgow Coma Scale (mGCS) scores as predictors of mortality in injured cats.

DESIGN

Observational cohort study conducted September 2013 to March 2015.

SETTING

Nine Level I and II veterinary trauma centers.

ANIMALS

Consecutive sample of 711 cats reported on the Veterinary Committee on Trauma (VetCOT) case registry.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

We compared the predictive power (area under receiver operating characteristic curve; AUROC) and calibration of the ATT and mGCS scores to their components. Overall mortality risk was 16.5% (95% confidence interval [CI], 13.9-19.4). Head trauma prevalence was 11.8% (n = 84). The ATT score showed a linear relationship with mortality risk. Discriminatory performance of the ATT score was excellent (AUROC = 0.87 [95% CI, 0.84-0.90]). Each ATT score increase of 1 point was associated with an increase in mortality odds of 1.78 (95% CI, 1.61-1.97, P < 0.001). The eye/muscle/integument category of the ATT showed the lowest discrimination (AUROC = 0.60). When this component, skeletal, and cardiac components were omitted from score calculation, there was no loss in discriminatory capacity compared with the full score (AUROC = 0.86 vs 0.87, respectively, P = 0.66). The mGCS showed fair performance overall for prediction of mortality, but the point estimate of performance improved when restricted to head trauma patients (AUROC = 0.75, 95% CI, 0.70-0.80 vs AUROC = 0.80, 95% CI, 0.70-0.90). The motor component of the mGCS showed the best predictive performance (AUROC = 0.71); however, the full score performed better than the motor component alone (P = 0.004). When assessment was restricted to patients with head injury (n = 84), there was no difference in performance between the ATT and mGCS scores (AUROC = 0.82 vs 0.80, P = 0.67).

CONCLUSION

On a large, multicenter dataset of feline trauma patients, the ATT score showed excellent discrimination and calibration for predicting mortality; however, an abbreviated score calculated from the perfusion, respiratory, and neurologic categories showed equivalent performance.

Metal projectile injuries in cats: review of 65 cases (2012-2014)

OBJECTIVES

The objective of this study was to compare the prevalence of different types of injuries caused by various types of projectiles among urban, suburban and rural cats of different ages in order to predict the type of injury sustained.

METHODS

For the period 1 January 2012 to 30 April 2014, the medical records of cats with metal projectile injuries (PIs) were searched from the archive of the university's small animal diagnostic imaging centre. Age, sex, owner address, admission during a weekend or on a working day, month of admission, projectile position (head and neck; thoracic region; abdominal region, including lumbosacral spine; forelimbs; and hindlimbs, including tail), number of projectiles, presence of a wound and fracture related to the projectile, and the type of projectile were recorded for each cat.

RESULTS

Sixty-five cats with PIs were admitted during the defined period. In 38.5% of cats the projectiles found upon radiography were incidental findings. The frequency of PIs peaked in March. Airgun projectiles were found in 80.0% of the cats. PIs in two or more body regions were found in 29.2% of the cats. Among the cats that had only been shot in one body region, the projectile was most frequently found in the abdominal region, including the lumbosacral spine (41.3%).

CONCLUSIONS AND RELEVANCE

These results might prompt clinicians to evaluate closely and screen for feline PIs in emergency situations.