Sari Mölsä’s research while affiliated with University of Helsinki and other places

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Publications (5)


Bacteria associated with canine pyometra and concurrent bacteriuria: A prospective study
  • Article

December 2024

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15 Reads

Veterinary Microbiology

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Sari Mölsä

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Katariina Thomson

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[...]

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Thomas Grönthal

Consort diagram. Flow diagram of the “Efficacy of lumbosacral and sacrococcygeal epidural ropivacaine in dogs undergoing surgery for perineal hernia” -study according to CONsolidated Standards Of Reporting Trials (CONSORT).
Heart rate (HR) in dogs at the following time points: before (BLEpi); 30 min after (T30Epi) lumbosacral (LS, n = 30) or sacrococcygeal (SC, n = 26) epidural injections with 1% ropivacaine (0.2 mL kg⁻¹); baseline before perineal hernia repair (BLSurg) and 30 (T30Surg), 60 (T60Surg) and 90 (T90Surg) minutes from the incision. Data are presented as mean ± standard deviation. No significant difference (p < 0.05) between LS and SC group was detected.
Mean arterial pressure (MAP) in dogs at the following time points: before (BLEpi); 30 min after (T30Epi) lumbosacral (LS, n = 30) or sacrococcygeal (SC, n = 26) epidural injections with 1% ropivacaine (0.2 mL kg⁻¹); baseline before perineal hernia repair (BLSurg) and at 30 (T30Surg), 60 (T60Surg) and 90 (T90Surg) minutes from the incision. Data are presented as mean ± standard deviation. *Significant difference between LS and SC groups (p < 0.05).
Efficacy of lumbosacral and sacrococcygeal epidural ropivacaine in dogs undergoing surgery for perineal hernia
  • Article
  • Full-text available

September 2023

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52 Reads

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1 Citation

Epidural anesthesia is commonly administered as part of balanced anesthesia for perioperative analgesia. The main goal of this randomized clinical trial was to compare the efficacy of two epidural approaches in dogs undergoing surgery for a perineal hernia. A secondary aim was to compare motor blockade. Intact ASA 1 and 2 male dogs, weighing ≤25 kg with no previous surgery for perineal hernia were enrolled. After premedication with IM acepromazine 0.02 mg/kg and butorphanol 0.3 mg/kg, general anesthesia was induced with propofol and maintained with sevoflurane in oxygen. Dogs were randomly allocated to receive either a lumbosacral (LS, n = 30) or a sacrococcygeal (SC, n = 26) epidural injection with ropivacaine 1% (0.2 mL/kg) under computed tomography guidance. Successful analgesia was defined as no need of intraoperative rescue analgesia (fentanyl 3 μg/kg IV). Clinical failure was defined as the need of more than two boluses of fentanyl/h each dog received meloxicam 0.2 mg/kg IV at the end of the surgery. The Glasgow Composite Pain Scale short form (GCPS-SF), tactile sensitivity, pressure pain thresholds and motor blockade were assessed at 4, 6, 8, and 24 h after the epidural injection. Methadone (0.2 mg/kg, IV) was administered if the GCPS-SF was ≥6/24 points. Differences between groups were analyzed with the Mann–Whitney U test, Student’s t-test or Fisher’s Exact test, as appropriate. Success rate was assessed for non-inferiority between groups. The non-inferiority margin was set at −10%. Epidural analgesia was successful in 24 dogs in group LS and 17 dogs in group SC (p = 0.243), resulting in success rates of 80 and 65% in LS and SC groups, respectively. The non-inferiority of group SC versus group LS was confirmed. Clinical failure was recorded in two dogs in group LS and one dog in group SC. No significant differences between groups were detected in the GCPS-SF score, tactile sensitivity, pressure pain thresholds, need of post-operative methadone, or motor blockade. Both epidural techniques are valuable analgesic options for perineal hernia repair in dogs.

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Study design for a two-arm non-inferiority randomized controlled trial (RCT) evaluating incidence rate of postoperative infections associated with an uncomplicated pyometra surgery. ASA: American Society of Anesthesiologists
A double-blinded randomized placebo-controlled non-inferiority trial protocol for postoperative infections associated with canine pyometra

June 2023

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72 Reads

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2 Citations

BMC Veterinary Research

Background Pyometra is a common infectious condition, especially in elderly bitches. In addition to an infected uterus, dogs may have concurrent urinary tract infection (UTI). The preferred treatment is surgical removal of the ovaries and uterus, whereupon the general prognosis is excellent. In addition, antimicrobial therapy is frequently prescribed for postoperative treatment. However, no research exists on the benefit of postoperative antimicrobial treatment in uncomplicated canine pyometra. Antimicrobial resistance has become a major challenge in treatment of bacterial infections. Diminishing overuse of antimicrobial agents is essential for controlling the development of antimicrobial resistance in both animals and humans. Methods This double-blinded, randomized, placebo-controlled two-arm clinical trial is designed to compare the incidence of postoperative infections associated with surgical treatment of uncomplicated pyometra followed by two different treatment protocols. For the study, 150 dogs presenting with an uncomplicated pyometra and that are to undergo surgical treatment will be recruited. Dogs with body weight < 3 or > 93 kg, complicated pyometra, primary disease increasing the risk of infection, or immunosuppressive medication will be excluded. All dogs will receive one dose of sulfadoxine-trimethoprim intravenously as an antimicrobial prophylaxis. Postoperatively, dogs will be randomized to receive either a five-day course of placebo or an active drug, sulfadiazine-trimethoprim orally. During the surgery microbiological samples will be taken from urine and uterine content. The follow-up includes a control visit in 12 days and an interview of the owner 30 days after surgery. If bacteriuria is detected at the time of surgery, a urinary sample will be cultured for bacterial growth at the control visit. The primary outcome is the incidence of a postoperative surgical site infection (SSI), and the secondary outcome is the occurrence of clinical UTI with bacteriuria. Intention-to-treat and per-protocol analyses will be performed to compare outcome incidences between the treatment groups. Discussion Research-based evidence is necessary to create treatment guidelines for judicious use of antimicrobials. The goals of this study are to provide evidence for reducing the use of antimicrobials and targeting the treatment to patients proven to benefit from it. Publishing the trial protocol will increase transparency and promote open science practices.


Mediolateral radiograph of the antebrachium showing an example of each of the three categories of cranial ulnar cortical remodeling (CUCR). The ulnar cortical findings were graded as CUCR0 (A), CUCR1 (B), and CUCR2 (C).
Craniocaudal radiograph of the antebrachium showing two examples of measuring the humeroradial angle. An elbow with subjectively no radial head luxation (A) measured 84.61° for the humeroradial angle (B). An elbow with subjectively marked radial head luxation (C) measured 57.77° for the humeroradial angle (D).
Mediolateral antebrachial radiograph of a young Skye terrier (not from the study group) with visible open growth physis. The remodeling of the cranial metaphysis and physis is clearly visible (arrow).
Breed-typical front limb angular deformity is associated with clinical findings in three chondrodysplastic dog breeds

January 2023

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165 Reads

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3 Citations

Angular front limb deformity (ALD) refers to an excessively curved limb conformation, which is seen in some chondrodysplastic dog breeds. Common characteristics of ALD include carpal valgus (VALG), front limb rotation (ROT), elbow incongruity, and lateral radial head subluxation. These may cause lameness and discomfort in affected dogs. The clinical impact and breed-specific characteristics of front limb conformation in chondrodysplastic breeds are unknown. This prospective and cross-sectional study aimed to investigate differences in front limb conformation between three chondrodysplastic breeds. We further evaluate whether front limb conformation is associated with clinical findings and limb function. We propose novel methods to classify findings in the interosseous space and to quantify lateral radial head subluxation. Data from a total of 224 front limbs from 112 dogs of three chondrodysplastic dog breeds (30 Standard Dachshunds, 29 Skye terriers, and 53 Glen of Imaal terriers) were included in the study. Front limb VALG and ROT were measured with a goniometer. From the radiographs, the elbow joint was graded for incongruity (INC), and the humeroradial angle (HRA) was measured to assess lateral radial subluxation. The association of front limb conformation with clinical signs and limb function was investigated using orthopedic examination, goniometric and kinetic measurements, and radiography. The breeds differed significantly in their front limb conformation. The Dachshund had the least ROT and the least radial head subluxation. The Skye terrier had the most VALG, the most radial head subluxation, and the largest prevalence of moderate and severe INC. The Glen of Imaal terrier had the most ROT. In addition, INC, ROT, VALG, and HRA were found to be independent of each other and were associated with several measurable clinical abnormalities and limb function such as pain, lameness, limited range of motion, and elbow joint osteoarthritis. This implies that VALG, ROT, and HRA could be used in addition to INC grading when choosing musculoskeletal characteristics of dogs suitable for breeding.


Fig. 1 Time since presentation of the first signs associated with perineal hernia according to the owner questionnaire in 66 dogs with perineal hernia
Current urinary signs according to the owner questionnaire in 66 dogs with perineal hernia
Exploring the association between canine perineal hernia and neurological, orthopedic, and gastrointestinal diseases

December 2022

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54 Reads

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5 Citations

Acta Veterinaria Scandinavica

Background Perineal hernia (PH) is a relatively common condition in intact male dogs, but the etiology remains unclear. The objective of this study was to assess the contribution of gastrointestinal (GI), neurological, and orthopedic conditions to the development of PH in male dogs. Patient history with a focus on chronic GI disease was assessed using an owner questionnaire. Neurological conditions were explored, applying neurological, electromyographic (EMG), and motor nerve conduction velocity (MNCV) examinations and combining these with computed tomography (CT) imaging. To exclude possible orthopedic diseases, an orthopedic examination was conducted together with CT analysis. The chi-squared test was used to assess the associations between categorical variables. Results Altogether, 66 male dogs with diagnosed PH were recruited for this study. The frequency of neurological, orthopedic, and GI diseases was low in dogs with PH. No signs of generalized neuro- or myopathies were detected. Still, perineal and bulbourethral reflexes were decreased or missing in 44.6% (29/65) and 40.0% (26/65) of dogs, respectively. Mild or moderate occlusion of the intervertebral foramen at the lumbosacral (LS) junction occurred in 18.5% (12/65) of dogs and was caused by spondylosis deformans in 83.3% (10/12). Moderate disc protrusion was evident in 9.2% (6/65) of dogs. Conclusion No evidence was found that PH is caused by gastrointestinal, orthopedic, or neurological conditions. Abnormalities in perineal and bulbourethral reflexes are most likely secondary to PH.

Citations (4)


... Em um ensaio clínico randomizado foi comparado a eficácia da epidural pela abordagem lombossacral e sacrococcígea em cães machos submetidos a cirurgia de correção de hérnia perineal e concluiu-se que ambas as abordagens foram valiosas no quesito analgesia cumprindo sem diferenças significativas requisitos como bloqueio nociceptivo transoperatório, resgate analgésico trans e pós-operatório e bloqueio motor (Salla et al., 2023). ...

Reference:

Anestesia epidural com abordagem sacrococcígea em cão da raça Spitz Alemão para colocação de prótese de tróclea em membro pélvico: Relato de caso
Efficacy of lumbosacral and sacrococcygeal epidural ropivacaine in dogs undergoing surgery for perineal hernia

... However, all 208 were included in the microbiological evaluation. The complete study design for the RCT, including ethical considerations and informed owner consent, has previously been described in detail (Ylhäinen et al., 2023). All bacterial specimens were analyzed at the Central Laboratory of the Veterinary Teaching Hospital. ...

A double-blinded randomized placebo-controlled non-inferiority trial protocol for postoperative infections associated with canine pyometra

BMC Veterinary Research

... Carpal valgus, although associated with FGF4L1 genotype, is uncommonly a clinical problem in dachshunds and is considered a fault according to the breed standard (17,18). In 30 dachshunds, thoracic limb angular limb deformity was noted upon radiographic evaluation, but lameness, elbow incongruity, and osteoarthritis were uncommonly present (19), suggesting that thoracic limb shape may differ in dachshunds compared to other breeds without causing welfare concerns. ...

Breed-typical front limb angular deformity is associated with clinical findings in three chondrodysplastic dog breeds

... The detected adverse finding was perineal pathology found in 8% of dogs, where the perineal hernia (36.4%) and urethrolithiasis (36.4%) were overrepresented. It should be noted that ASD might be the underlying cause of perineal hernia in dogs and cats [32,33]. Further studies would be necessary to evaluate the incidence of perineal hernias in dogs and cats with ASD. ...

Exploring the association between canine perineal hernia and neurological, orthopedic, and gastrointestinal diseases

Acta Veterinaria Scandinavica