Providing comparison normal examples alongside pathologic thoracic radiographic cases can improve veterinary students' ability to identify abnormal findings or diagnose disease

Learning by comparison is a frequently employed education strategy used across many disciplines and levels. Interpreting radiographs requires both skills of perception and pattern recognition, which makes comparison techniques particularly useful in this field. In this randomized, prospective, parallel-group study, students enrolled in second and third-year radiology veterinary courses were given a case-based thoracic radiographic interpretation assignment. A cohort of the participants was given cases with side-by-side comparison normal images while the other cohort only had access to the cases. Twelve cases in total were presented to the students, with 10 cases depicting examples of common thoracic pathologies, while 2 cases were examples of normal. Radiographs of both feline and canine species were represented. Correctness of response to multiple choice questions was tracked, as was year and group (group 1: non compare, Control; group 2: compare, Intervention). Students assigned to group 1 had a lower percentage of correct answers than students assigned to group 2 (45% Control vs. 52% Intervention; P = 0.01). This indicates that side-by-side comparison to a normal example is helpful in identifying disease. No statistical significance was noted for the correctness of responses according to the year of training (P = 0.90). The overall poor performance on the assignment, regardless of group or year, shows that students in the early years of undergraduate veterinary radiology training struggle with the interpretation of common pathologies, likely a result of a lack of exposure to a multitude of cases and normal variants.

Workers should take steps to mitigate surface lead exposure when using lead-containing personal protective equipment

Veterinary workers use lead shielding for protection against harm from ionizing radiation during diagnostic imaging. Surface lead on shielding has been reported as a potential exposure hazard. The purpose of this prospective, analytical, descriptive study was to measure surface lead on lead-containing shielding in the field service and small animal radiology areas of a veterinary teaching hospital, and to examine potential risk factors for surface lead. Surface lead on a convenience sample of 54 lead shielding items was measured in a commercial laboratory using inductively coupled plasma mass spectrometry. The median and range of surface lead for aprons, thyroid collars, and gloves were 3.6 μg/dm² (range, 1.3-22.4 μg/dm² ), 23.1 μg/dm² (range, 2.6-116 μg/dm² ), and 134 μg/dm² (range, 1.5-155 μg/dm² ), respectively. In the final multivariable analysis, the mean surface lead on thyroid collars and gloves was higher than on aprons (relative differences 4.8, 95% confidence interval [CI] 2.2, 10.5, P < 0.001; and 9.5, 95% CI 4.4, 20.6, P < 0.001, respectively). The mean surface lead on shielding in the worst condition was higher than on shielding in the intermediate and best conditions (P < 0.001). Lead shielding provides effective protection against the harmful effects of ionizing radiation, and shielding should always be worn during radiation exposure. Based on our findings and the common use of lead shielding in veterinary workplaces, we recommend that employers inform workers of this hazard and provide training on steps to mitigate exposure, including the use of disposable gloves when wearing lead shielding and handwashing after use.

Comparing Two Resources Used to Teach Pulmonary Patterns for a Flipped Veterinary Radiology Course

The flipped classroom has been gaining momentum within medical education circles. Pre-class assignments are an important component of this pedagogical approach. In this study, a section of the introductory course to veterinary medical imaging was taught using a flipped classroom, and the effectiveness of two different pre-classroom assignments was evaluated. The pre-classroom assignments consisted of either short videos or readings. Both had similar content, which included basic information about pulmonary patterns of disease on chest radiographs. Learning outcomes were assessed by in-classroom and final examination questions. Student learning self-assessments and student satisfaction were also evaluated via an online survey. Students in the video group answered more of the in-classroom questions correctly (71% video vs. 63% reading group; p = .01) and had higher scores on the final examination (83% video vs. 75% reading group; p = .02). There was also a higher student satisfaction with the videos versus the reading assignment. However, we found no significant difference in the student self-assessments of learning or participation in class. An additional finding of this study related to the ongoing difficulties students were having with the learning objectives, including differentiating a pathological process from a normal, or normal variant, recognizing the different pulmonary patterns, and developing a differential diagnoses list, despite the pre-classroom assignments and large group learning sessions. This speaks to the difficulty in developing confidence in pulmonary pattern recognition on chest radiographs, a skill that requires considerable training and time investment.

Beta-sarcoglycan-deficient muscular dystrophy presenting as chronic bronchopneumonia in a young cat

Case summary

A 5-month-old cat was evaluated for a 3 week history of cough, nasal discharge, decreased appetite and weight loss. Musculoskeletal examination was normal and serum creatine kinase (CK) activity was within the reference interval. The cat was treated during the next 10 months for chronic, persistent pneumonia. Weakness then became apparent, the cat developed dysphagia and was euthanized. Post-mortem evaluation revealed chronic aspiration pneumonia and muscular dystrophy associated with beta (β)-sarcoglycan deficiency.

Relevance and novel information

This is the first report of a cat with muscular dystrophy presenting for chronic pneumonia without obvious megaesophagus, dysphagia or prominent neuromuscular signs until late in the course of the disease. The absence of gait abnormalities, marked muscle atrophy or hypertrophy and normal serum CK activity delayed the diagnosis in this cat with β-sarcoglycan deficiency.

Retrospective survey of owners' experiences with palliative radiation therapy for pets

OBJECTIVE To describe animal owners' experiences with palliative radiation therapy (PRT) of pets and identify factors influencing satisfaction with their pets' treatment. DESIGN Retrospective, cross-sectional study. SAMPLE 118 owners of dogs, cats, or rabbits. PROCEDURES Medical records were searched to identify animals that underwent PRT between 2004 and 2013. Signalment, tumor-related data, and outcome information were recorded. Owners completed an electronic survey assessing satisfaction with treatment (ie, satisfaction with the decision for their pet to undergo PRT and indication that they would choose PRT for their pet again), expectations regarding PRT, and perceptions of their pets' quality of life (QOL) and signs of discomfort from acute adverse radiation effects. Additional data regarding practical aspects of treatment, pet death, communications with veterinarians, and owner demographics were collected. Variables were tested for association with measures of owner satisfaction. RESULTS 92 of 116 (79%) owners were satisfied with the decision to have their pets undergo PRT. Most (92/118 [78%]) owners reported their pet's QOL improved after PRT; these owners were significantly more likely to be satisfied than those who did not report improved QOL. Owners who perceived their pets had discomfort from adverse radiation effects (38/116 [33%]) were significantly less likely to be satisfied than owners who did not report this observation. Measures of satisfaction were not associated with patient survival time. Twenty-one of 118 (18%) owners indicated they expected PRT would cure their pet's tumor. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that short life expectancy should not deter recommendation of PRT for pets. Protocols that minimize risk of acute adverse effects may be advantageous. Veterinarians should attempt to ensure that owners understand the goals of PRT.