2017 - 86 (5)

Because of the way the human brain functions, we are very susceptible to making mistakes. Inthis article, twenty thinking errors, which may lead to wrong diagnoses and treatments in veterinarymedicine, are described. How sensitive we are in making these mistakes depends rather on rationalitythan on intelligence. Rationality can be measured and trained, but only if we realize there is a problemin the first place.

Canine cutaneous mast cell tumors (cMCT) are a commonly encountered neoplasia in small animalpractice. Ninety-six percent of the cMCT can be diagnosed with cytology. Because of the variatingbiological character, it’s difficult to establish a prognosis. Therefore, the prognosis is assessed withmultiple prognostic factors: tumor location, systemic complaints, metastases, histological and cytologicalgrading, proliferation markers, KIT-staining pattern, KIT-mutation and tumor free margins. Thetreatment of choice is based upon the results of these prognostic factors, the clinical stage and the tumorlocation. Possible treatments include surgery, radiotherapy, chemotherapy, electrochemotherapy,tyrosine kinase inhibitors, cryotherapy and intraregional therapy with deionized water.

By means of a survey, the authors attempted to determine the work situation of graduated veterinarystudents and the perception of the quality of education at the Ghent University. Three veterinariancohorts were contacted who graduated at different time intervals: between 2002 and 2004, 2009 and2011 and between 2014 and 2016. Out of 488 completed surveys (47% of the contacted respondents),it became apparent that veterinarians in Flanders work on average 47 hours per week and are relativelyhappy about their day-to-day tasks. Eighty percent (most recently graduated group) and 68% (longestgraduated group) of the respondents work as a veterinary practitioner and 81% of these practitionerswork in a group practice. Veterinarians with Belgian nationality are mostly self-employed, while mostDutch veterinarians work on the payroll of someone else. The results of the survey show that therespondents are happy with the theoretic part of the veterinary study, but believe that there is notenough focus on the practicing part, which is too limited. According to the respondents, veterinarytraining should be more focused on first-line veterinary medicine, on the developing of communicationskills with clients and colleagues and on business management.

A four-month-old English bulldog presented with an acute onset of facial twitching, headtilt and abnormal mentation. Neurological examination was consistent with a multifocal brainlesion. Hematology and biochemistry were unremarkable and MR imaging of the brain revealedmarked enlargement of the left lateral ventricle with associated calvarial enlargement andperiventricular T2W and fluid-attenuated inversion recovery (FLAIR) lesions with moderatecontrast enhancement. Cerebrospinal fluid (CSF) analysis revealed a moderate mixedmononuclear pleocytosis and infectious disease testing returned negative. The diagnosis of leftunilateral internal hydrocephalus and presumed periventricular encephalitis was made. Thepatient was treated with prednisolone and phenobarbitone with successful outcome despitethe poor prognosis. This is the first report of unilateral hydrocephalus and periventricularencephalitis with MR imaging in a dog.

A ten-year-old Warmblood dressage gelding was presented with acute instability of thenuchal ligament after paddock turnout. Based on the clinical signs, orthopedic and neurologicexamination, diagnostic imaging and electromyography, cervical neuromuscular dysfunction ofthe M. obliquus capitis caudalis on the right side of the neck was diagnosed. Conservative treatmentincluding steroidal anti-inflammatory medication in combination with oral supplementationwith vitamin B1 and box rest resulted in complete recovery of the horse within six months.

Subcutaneous abscesses or granulomas in the lower extremities of dogs commonly occursecondary to the penetration and migration of vegetal foreign bodies (FBs). The aim of thisstudy was to describe the clinical presentation and ultrasonographic appearance of intact grassawn FBs in the lower extremities of dogs, and their ultrasound-guided retrieval with particularemphasis on the feasibility, effectiveness and prognosis associated with this technique. In thisretrospective study, 22 FBs were identified ultrasonographically in 19 dogs. The procedureresulted in the successful retrieval of the FB in 100% of dogs, and the clinical signs resolved in90% (n=17) in less than ten days. No complications or recurrence were encountered. This studyshows that ultrasonographic examination should be the first-choice modality when a vegetal FBis suspected within the distal extremity, as it allows both identification and removal of the FBwith a minimally invasive procedure, with short- and long-term effectiveness and good prognosis.

Training in the fasted state has beneficial effects on performance in the human athlete. In the horse,training in the fasted state is associated with an increased mobilization of non-esterified fatty acids(NEFA) as an energy source. This is in contrast with postprandial (grain-fed) training, during whichlipolysis is suppressed. A higher NEFA availability is thought to reduce muscle glycogen depletion andmuscle acidification. This could aid in delaying muscle fatigue. The equine gastrointestinal tract androughage rich diet do not allow a real ‘fasted’ state. Luckily, roughage does not induce high plasmainsulin peaks, and therefore does not have the same negative effects as grain feeding. Furthermore,the roughage-containing hindgut serves as a fluid and electrolyte buffer and continuously provides theliver with propionic acid, a precursor used in gluconeogenesis. In horses, unlike in human athletes,there is still a lot to discover when it comes to optimal pre-exercise feeding management throughoutcompetition and training. However, whatever approach is chosen, high quality roughage needs to be thekey ingredient of the equine diet. In sport horses with high energy demands, feeding good quality roughagemay be combined with fibre rich concentrates, pelleted roughages sources or vegetal oil insteadof starch rich concentrates to reach the energy requirements for intensive work. Last but not least,feeding multiple small meals throughout the day is preferred over feeding a larger meal twice a day.