B.2 -2016

The Royal College of Veterinary Surgeons

Diploma in Small Animal Surgery (Orthopaedics & Soft Tissue)

Specific Guidance Notes for Candidates[These notes must be read in conjunction with the B1 General Guidance Notes to Candidates]

Membership of the Royal College of Veterinary Surgeons

1. It is a requirement of the Small Animal Surgery Board that ALL Candidates entering for the Diploma are Members of the Royal College of Veterinary Surgeons (MRCVS).

Specific Experience

2. Candidates following a three year European College of Veterinary Surgeons residency (ECVS) should note that this only counts as one year towards their Royal College of Veterinary Surgeons (RCVS) experience.

Approved Centre Route

3. Candidates following an approved training programme at an approved centre will not be permitted to enter for the examination until they have been Members of the College or held an approved veterinary qualification for at least four years. They are required to offer experience in the subject over at least four years.

Centres currently approved are listed below:

Centre DisciplineUniversity of Cambridge Orthopaedics & Soft TissueUniversity of Liverpool Orthopaedics & Soft Tissue

North West Surgeons Orthopaedics

Anderson Abercromby Veterinary Referrals

Orthopaedics

Southern Counties Veterinary Specialists

Orthopaedics and Soft Tissue

University of Bristol Orthopaedics and Soft Tissue

Fitzpatrick Referrals OrthopaedicsCroft Veterinary Hospital OrthopaedicsAnimal Health Trust Soft Tissue

Willows Orthopaedics

NDSR Orthopaedics and Soft Tissue

Applications for approval of a Centre must be made directly by the Centre to the RCVS and not by the candidate. An application form can be obtained from the RCVS.

Approved Practice Route

4. Candidates following the approved practice route will not be permitted to enter for the examination until they have been Members of the College or held an approved veterinary qualification for at least five years and are required to offer experience in the subject over at least five years which must include 200 days at an approved centre.

5. If you are following the above route, you must ensure that the Board has approved the centre, where you are proposing to spend 200 days. (See above for a list of currently approved centres.) Please note it is for the centre to apply for “Approved” status.

6. There is no separate application form for practice approval other than the candidate applications forms included with this Information Pack. Practices are approved for each individual candidate.

7. The Board has discretion to increase the requirements for experience for any candidate above the minimum specified if it is considered to benefit the candidate.

8. Experience accepted for the Surgery Certificate may count towards the experience required for the Diploma, and this is at the discretion of the Board. Candidates would normally be holders of the Certificate in Small Animal Surgery but holders of the Certificate in Small Animal Orthopaedics would be eligible to apply for enrolment for the Small Animal Surgery (Orthopaedics) Diploma although not for the Surgery (Soft Tissue) Diploma. Following the closure of the ‘old style; Certificates, candidates who do not hold the Certificate in Small Animal Surgery or Certificate in Small Animal Orthopaedics are advised that obtaining the Certificate in Advanced Veterinary Practice would be the preferred route on to either Diploma. However, it is no longer a pre-requisite to hold an RCVS Certificate before enrolling and the Board will consider equivalent qualifications and each application will be considered on individual merit.

Final Approval of Experience/ Additional submitted work

9. Candidates will need to submit titles of the proposed submitted work at either their initial enrolment (E1 & E1a) or final approval (E2) stage. (Please see paragraphs 14 and 21 below)

10. Photocopies of your CPD Record Cards for the relevant period of experience must also be enclosed at the final approval of experience (E2) stage. You should note that seeing practice should be considered CPD and should therefore be recorded.

The Examination

11. The examination consists of three sections:

Two principal author published papers and one case report TWO x 3 hour written papers, and a clinical, oral, and practical examination.

Submitted Work for Examination

Requirements for Submitted work for Diploma in Small Animal Surgery (Soft Tissue and Orthopaedics)

12. Candidates are required to submit three copies of each of the following - two principal author published papers and one case report (suitable for publication).

Two Published Papers and one case report

13. Candidates following this route are required to submit as part of the Diploma examination, three copies of two papers published in refereed journals where they are the principal author. Candidates should submit full details of publications, including name of journal, title of paper, date, and page number. Please note that reprints from the journal are preferred, but if the papers are “in press”, a letter from the Editor confirming unconditional approval (i.e. no further amendments of any sort) must be supplied.

14. One case report in a form suitable for publication in which the candidate is the principal author is also required at this stage (it is acceptable if the case report has already been published). The subject matter of the submitted work must receive the approval of the Board before submission of the papers; this would normally take place with the application for Final Approval of Experience E2. (Candidates are reminded that because a paper has been accepted for publication in a refereed journal, it does not necessarily mean it will pass section (a), and are also advised when submitting papers for publication, to allow time to receive and incorporate scrutinisers' comments and amendments, if any.)

15. The following statement should be inserted loosely at the front of the submitted work:

Published papers submitted in part fulfilment of the requirements for the RCVS Diploma in.........…………………………………….by (name of candidate).

Acknowledgements are due to: name………………......for (description of assistance given).

16. Candidates are asked to submit an electronic version of their submitted work together with their hard copies. This will be retained at RCVS unless requested by the examiners for purposes such as checking the word count. The electronic version should be Microsoft Office 2000 or XP compatible and should be submitted on CD. Please ensure that the disks are easily identifiable by placing them in an envelope with your name, and ‘Electronic version of submitted work for “Diploma in Small Animal Surgery (Orthopaedics)” or “Diploma in Small Animal Surgery (Soft Tissue) marked clearly on the front.

Grading Scheme

17. The submitted work will be graded “Good Pass”; “Pass” or “Fail”:

Good Pass—(60% or over)—the work will be lodged in the RCVS Library as a suitable example for future candidates.

Pass (defined as 50%)—The work is adequate to enable the candidate to proceed to the remaining sections of the examination, but the submitted work may need to be revised by the date of the clinical, oral and practical for lodging in the Library if the candidate is successful in the examination as a whole.

Fail (below 50%)—the work is not adequate to enable a candidate to proceed to the remaining sections of the examination for the year in question.

Written Examination

18. Candidates are warned that answers should be given specifically and that illegible handwriting may result in examiners being unable to award marks for information which candidates intended to convey. In addition, the Examiners will take into consideration spelling and whether or not the question has been answered in the form requested.

Format

Diploma in Small Animal Surgery (Soft Tissue)

19. This Section consists of two three-hour written papers:

Paper I—will consist of eighteen short answer questions of which the candidate must answer all.

Paper II—will consist of five questions of which the candidate must answer four.

Marks Scheme

Paper l—will be marked out of 50 marks Paper II—will be marked out of 50 marks

Total Mark for this Section (b) = 100 marks

Diploma in Small Animal Surgery (Orthopaedics)

20. This Section consists of two three-hour written papers.

Paper I—will consist of five questions of which the candidate must answer four. Paper II—will consist of five questions of which the candidate must answer four.

Marks Scheme

Paper l—will be marked out of 50 marks

Paper II—will be marked out of 50 marks

Total Mark for this Section (b) = 100 marks

Clinical, Oral, and Practical Examination

Format – Diploma in Small Animal Surgery (Orthopaedics)

21. Candidates will have three individual vivas of 60 minutes, each marked out of 50 and covering the following:

Case based (may include live cases) Imaging (may include radiographs, CT's, MRI scans, scintigraphy) Laboratory based (bloodwork, histology, cytology, pathology).

They will then have a panel viva with all the examiners, lasting around 60 minutes for each candidate and will also be marked out of 150.

A final mark calculated to be out of 100 will be awarded for all 4 vivas together.

Marks Scheme – Diploma in Small Animal Surgery (Orthopaedics)

22. This examination is composed of three short vivas (clinical, imaging and lab based) and one longer panel viva. The short vivas will each be marked out of 50, the panel viva out of 150. This will give a total for the COP out of 300 which will be converted to a percentage for the final mark scheme (giving a mark out of 100 for the written section and a mark out of 100 for the COP).

Format – Diploma in Small Animal Surgery (Soft Tissue)

23. The Clinical/Oral and Practical (PowerPoint presentation, 25 short answer questions) will be marked out of 100 and candidates must pass all sections in order to pass overall. Candidates must gain 50% in the clinical/oral examination, which will be conducted in an interview style with candidates being questioned on a number of elements within the syllabus and being asked to demonstrate the breadth of their knowledge.

Marks Scheme – Diploma in Small Animal Surgery (Soft Tissue)

24. The Clinical/Oral/Practical examination will be marked out of 100.

TOTAL Mark for this Section (c) = 100 marks

25. Candidates must pass all sections in order to pass overall.

Syllabus and Reading List

26. A syllabus, with a brief commentary, and reading lists for the Certificates are provided for reference. There are no separate reading lists for the Diplomas as candidates at this level are expected to be familiar with all literature in the area of their elective and most particularly so in the topic of their dissertation or submitted papers. Candidates

should note that the Certificate reading list was frozen in 2002 and will eventually be withdrawn.

Advisers

27. Candidates should approach an adviser and obtain an agreement that they can work with them on a daily basis for the necessary period to complete the training programme. Advisers must be asked to sign all application forms before these are submitted to RCVS, thereby indicating that the candidate has made contact with them and that they are willing to act as adviser to the candidate. Candidates are urged to seek advice from their advisers.

28. Candidates should consult the RCVS Register of Members for a suitably willing and qualified individual (someone holding a Diploma or equivalent) who is familiar with the RCVS Certificate and Diploma examination system and clinically active.

Attendance at short courses

29. The Board wishes to encourage candidates to attend any appropriate short courses, and other events such as congresses, symposia and meetings which are relevant to small animal surgery and would be of benefit to the candidate's studies. The Board will take such attendance into account at the stage of considering a candidate's application for final approval of experience. Photocopies of your CPD Record Cards, appropriate to the period of experience offered must also be enclosed.

Abbreviation for Qualification

30. Successful candidates are permitted to use the abbreviation "DSAS(Orth)" or "DSAS(Soft Tissue)" after their names, in the RCVS Register of Members, and on practice plates and stationery etc.

Originated September 1994ReviewedMay95/Nov95/June96/Jan97/May97/June98/May99/June00/Feb01/Jan02/Jan03/Mar04/April 08

C(O)

Diploma in Small Animal Surgery (Orthopaedics)

Commentary and Syllabus

Candidates are reminded of their commitment as registered members of the Royal College of Veterinary Surgeons to pay attention to the welfare of animals under their care.

Commentary

The Diploma training system is designed so that knowledge, skill and understanding in small animal orthopaedic surgery to the level of an expert can be acquired through exposure to a wide variety of diseases under the close supervision and guidance of Diplomates, or approved specialists with equivalent training and experience in small animal orthopaedic surgery.

Candidates will be expected to acquire knowledge and understanding of the basic science of surgical diseases (anatomy, biochemistry, physiology, pharmacology, pathology and pathophysiology) through attendance at seminars and conferences, and reading texts and journals.

The centre at which the candidate gains the necessary experience should be of a satisfactory standard and have a suitable caseload. The training programme will allow candidates to assume total responsibility for the initial consultation, planning, execution and interpretation of diagnostic procedures, and the surgical management of a wide variety of cases.

The training programme will include the indications for, and the interpretation of, the results of investigations including routine clinical pathology and the cytology and histological examination of biopsy specimens of muscle, tendon, nerve, joint and bone. It will include the indications for, and the interpretation of, the results of immunological tests as they relate to disorders with an orthopaedic component.

The training programme will include the indications for, and the interpretation of, the results of diagnostic imaging examinations. These will include radiography, contrast radiography, ultrasonography and arthroscopy. The principles of computerised tomography, MRI, electromyography and scintigraphy should be understood.

The training programme will include the indications for, and the usage of, therapeutic measures in routine case management including pharmacotherapy, fluid therapy, and blood transfusions. It will include the nutritional management of musculoskeletal disorders and the dietary management of the critically ill patient (enteral and parenteral management).

The training programme will include participation in a small animal surgical emergency service in order to obtain competence in the management and monitoring of critically ill patients.

Syllabus

Candidates should be familiar with the relevant surgical anatomy, pathophysiology, diagnosis and treatment of surgical disorders of muscle, tendon, nerve, joint and bone in the dog and

cat. Thus osseous and soft tissue conditions of the canine and feline axial and appendicular skeleton, including neurological disorders, will form the basis of the syllabus.

Candidates should be familiar with conditions in other species, including man, which have a comparative interest or relevance.

October 1994Reviewed May95/Nov97/Nov98/Jan00/Jan 02

C(ST)

Diploma in Small Animal Surgery (Soft Tissue)

Commentary and Syllabus

Candidates are reminded of their commitment as registered members of the Royal College of Veterinary Surgeons to pay attention to the welfare of animals under their care.

Commentary

The Diploma training system is designed so that knowledge, skill and understanding in small animal surgery to the level of an expert can be acquired through exposure to a wide variety of diseases under the close supervision and guidance of Diplomates, or approved experts with equivalent training and experience, in small animal surgery.

Candidates will be expected to acquire knowledge and understanding of the basic science of surgical diseases (anatomy, biochemistry, physiology, pharmacology, pathology and pathophysiology) through attendance at seminars and conferences, and reading texts and journals.

The centre at which the candidate gains the necessary experience should be of a satisfactory standard and have a suitable caseload. The training programme will allow candidates to assume total responsibility for initial consultation, planning, execution and interpretation of diagnostic procedures, and surgical management.

The training programme will include the indications for, and the interpretation of, the results of investigations including routine clinical pathological, cytological, and histological examinations.

The training programme will include the indications for, and the interpretation of, the results of diagnostic imaging examinations. These will include radiography, contrast radiography and ultrasonography. The principles of computerised tomography, MRI, electromyography, scintigraphy and endoscopic surgery should be understood.

The training programme will include the indications for, and the application of, therapeutic measures in routine case management including pharmacotherapy, fluid therapy, and blood transfusions. It will include the nutritional management of the surgical and critically ill patient (i.e. including enteral and parenteral feeding).

The training programme will include participation in a small animal surgical emergency service in order to obtain competence in the management and monitoring of critically ill patients.

Syllabus

Candidates should be familiar with the relevant surgical anatomy, pathophysiology, diagnosis and treatment of surgical disorders of the soft tissues of the dog and cat.

Candidates should be familiar with conditions in other species, including man, which have a comparative interest or relevance.

October 1994ReviewedMay95/Nov97/Dec98/Jan00/Jan 02

D

Diploma in Small Animal Surgery (Orthopaedic and Soft Tissue)

Reading List

There are no separate reading lists for the Diplomas as candidates at this level are expected to be familiar with all literature in the area of their elective and most particularly so in the topic of their dissertation or submitted papers. Candidates are are recommended to make use of the RCVS Library and Information Service for this purpose (http://www.rcvslibrary.org.uk , e-mail - library@rcvs.org.uk or telephone 020 7222 2021). Candidates should also seek advice on suitable reading matter from their Advisers.

April 2007

E1(A)

The Royal College of Veterinary Surgeons

Diploma in Small Animal Surgery Orthopaedics/Soft Tissue (Please delete as appropriate)

Details of the establishment in which experience is being gained to meet the requirements of the byelaws for the Diploma in Small Animal Surgery(If more than one practice/establishment, please photocopy this form and complete in respect of each such establishment)

1. Place of employment and address

2. Date of commencement of employment

(and date of leaving if you are no longer employed at this address:)

3. Experience: Please tick the route by which experience is being gained (see paper B2)

ii) Approved practice route plus 200 days experience gained at an approved centre*

Period of experience being offered (from/to) at:

Approved practice

Approved centre

Name of approved centre:

iii) Approved centre route*

Period of experience being offered (from/to):

Name of approved centre:

* Applications for approval as an approved centre must be made by the centre directly to the RCVS and not by the candidate. An application form can be obtained from the RCVS.

4. Number of veterinary surgeons usually working in small animals in your place of employment:

5. Approximate total practice case load per month

of which are small animal casesof which are small animal (orthopaedic/soft tissue*) surgical casesof which are dogs, andof which are cats

* please delete as appropriate

6. Proportion of routine practice case load which you personally undertake per month:

Total cases:

Small animal cases

SA (orthopaedic/soft tissue*) surgical cases

Non-routine surgical cases (minimum of 8 per month) ______________

7. Proportion of candidate's time spent on work related to the Diploma syllabus during practice hours:

%

8. The main items of equipment and facilities available for the examination and treatment of small animal surgical cases are as follows:

PLEASE RETURN ORIGINAL FORM PLUS SIX COPIESThe following section should be completed by your Adviser

I have agreed that this candidate will be advised by me and that it is the candidate’s responsibility to approach me as necessary,

Name (Block capitals)

Signature Date

Note: If an acknowledgement is required please enclose a stamped addressed envelope.

Reformatted March 2001

E2The Royal College Of Veterinary Surgeons

Diploma in Small Animal SurgeryOrthopaedics / Soft Tissue (delete as appropriate)

Application for FINAL approval of experience and permission to submit an entry to the next examination

This form must be completed and returned to the RCVS, Belgravia House, 62–64 Horseferry Road, London SW1P 2AF by 1 November prior to the year in which you wish to enter the examination. Your application should be accompanied by six collated photocopies of the completed form together with six photocopies of your CPD Record Cards. The photocopies should be clear and of a good standard.

1. NAME in full (block letters)

2. DEGREES/DIPLOMAS/CERTIFICATES (in abbrev. form) and date obtained

ADDRESS for all correspondence (block letters)

4. (a) TELEPHONE No(s) (for contact during day)

(b) FAX No. (for contact during day)

5. DATE OF ENROLMENT (MONTH/YEAR)

If application for enrolment is being submitted concurrently with this application, please state 'concurrent'.

6. QUALIFICATION FOR ENTRY

Are you a Member of the RCVS? YES/NO

If Yes, please state veterinary degree obtained, name of awarding University, and date of graduation and date of obtaining Membership:

If No, please give details of the veterinary qualification which you hold that entitles you to practise veterinary surgery in your home country (i.e. full title, recognised abbreviation, awarding University or other examining body, date obtained, length of the course):

7. EXPERIENCE: Please tick the route by which experience has been gained.(see paper B2)

Approved practice route plus 200 days experience gained at an approved centre*

Approved centre route*

* Applications for approval as an approved centre must be made by the centre directly to the RCVS and not by the candidate. An application form can be obtained from the Board Secretary.

8. PERIODS OF EXPERIENCE BEING OFFERED to meet the requirements of the byelaws

Approved Veterinary Practice orCentre (name and address)

Period of employment(from/to)

Certified by Principal

If there has been any change in the work-load of the establishment, or in your personal work-load, since you applied for enrolment, please give details below:

9. ATTENDANCE AT RELEVANT SHORT COURSES

Candidates must attach a copy of their RCVS CPD Record Card for each year for which they are applying for final approval of experience. Details of all relevant short courses, conferences and meetings attended should be recorded on the Record Card. Candidates must comply with the annual recommended minimum hours of CPD otherwise final approval of experience and permission to sit the next examination will not be granted.

10. OTHER INVOLVEMENT IN RELATION TO SMALL ANIMAL SURGERY

List below any other relevant courses, conferences, congresses, meetings, and symposia etc, which are not detailed on your RCVS Record Card.

Attendance at relevant congresses, conferences, meetings, symposia, etc

Date and Venue

11. PUBLICATIONS/ARTICLES/PAPERS/LECTURES

Give details below (including any involvement in the instruction of others):

12. OTHER POSTGRADUATE STUDIES

During the period of experience being offered, have you been or are you studying for any other postgraduate qualification? YES/NO

If yes, please give brief details:

13. SUBMITTED WORK

Please confirm the titles of:

Paper 1

Paper 2

Dissertation

Case Report

14. I HEREBY APPLY FOR FINAL APPROVAL OF EXPERIENCE AND FOR PERMISSION TO SUBMIT AN ENTRY TO THE NEXT DIPLOMA EXAMINATION IN SMALL ANIMAL SURGERY Orthopaedics / Soft Tissue (delete as appropriate).

I certify that the period of experience being offered has not been/is not being offered to meet the requirements of the byelaws for any other RCVS Certificate or Diploma.

Delete section 15 if you do not intend to sit the next examination.

15 CONFIRMATION OF INTENT TO SIT THE EXAMINATIONIf approval of experience is granted, I do/do not (delete as appropriate) intend to submit an entry to the next examination (closing date for receipt of entries: 1 March).

Name

Signature Date

PLEASE RETURN ORIGINAL FORM PLUS SIX COPIES

the following section should be completed by your adviser.

I confirm that I am acting as this candidate's Adviser.

Name

Signature Date

Important Notes:Please ensure your application is accompanied by six collated photocopies of the completed form, together with appropriate CPD Record Cards. The photocopies should be clear and of a good quality.If an acknowledgement is required please enclose a stamped addressed envelope.Candidates will be advised of the outcome of their application by mid-January and MUST NOT telephone or write for this information in the interim.No late applications will be accepted

DIPLOMA IN SMALL ANIMAL SURGERY (ORTHOPAEDICS)

TUESDAY 3 JULY 2012

PAPER I(3 hours)

Candidates are required to answer FOUR of the following five questions.

Allow 45 minutes per question

Please start the answer to each question on a separate sheet; failure to do so could lose you marks.

Illegible handwriting or failure to answer the question in the form required may result in examiners being unable to award marks for information which candidates intended to convey.

If insufficient time is available to answer a question fully, it will be acceptable to complete it in note form.

1. Describe in detail the physical properties of polymethylmethacrylate (5 marks). With respect to cemented total hip replacement, discuss how these properties have influenced surgical technique and implant design in both humans and dogs. (5 marks).

2. With reference to the literature, discuss the use of bone grafts and bone graft substitutes in dogs, cats and humans. (10 marks)

3. Discuss the evidence supporting the role of obesity in the development (6 marks) and treatment (2 marks) of canine, feline and human osteoarthritis. Briefly discuss the molecular pathogenesis by which obesity is believed to affect the osteoarthritic joint (2 marks).

4. With reference to the published literature, justify why juvenile pubic symphysiodesis could be introduced as the definitive preventative treatment for hip dysplasia in the United Kingdom dog population (5 marks), and describe how you would propose to achieve this (1 mark). Detail how you would select dogs for the procedure (3 marks), and give a description of the technique (1 mark).

5. Compare and contrast the use of intramedullary implants for the repair of diaphyseal fractures in man with the dog and cat (10 marks).

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DIPLOMA IN SMALL ANIMAL SURGERY (ORTHOPAEDICS)

TUESDAY 3 JULY 2012

PAPER ll(3 hours)

Candidates are required to answer FOUR of the following five questions.

Allow 45 minutes per question

Please start the answer to each question on a separate sheet; failure to do so could lose you marks.

Illegible handwriting or failure to answer the question in the form required may result in examiners being unable to award marks for information which candidates intended to convey.

If insufficient time is available to answer a question fully, it will be acceptable to complete it in note form.

1. Humeral condylar fractures are encountered commonly in spaniel breeds. With reference to the literature, describe the pathogenesis of these fractures (5 marks). Discuss factors that can influence clinical outcome when treating these cases (5 marks).

2. You are presented with a two year-old 30kg Labrador Retriever with a chronic grade 4/4 medial patellar luxation and apparent genu varum. With reference to the literature, describe in detail the investigation (5 marks), treatment (3 marks) and prognosis for this case (2 marks).

3. Describe how the temporomandibular joint (TMJ) can be assessed using conventional radiography (2 marks). Include a written description of where the X-ray beam is centred, and line diagrams of the images produced. Discuss in detail conditions of canine and feline TMJ, including their aetiology, clinical and radiographic features, and treatment options (8 marks).

4. What is a bi-apical angular limb deformity? Provide a detailed definition (2 marks). Describe with the use of diagrams how you would investigate and correct this type of deformity in the antebrachium of an adult chondrodystrophic dog (8 marks).

5. Describe how you would investigate (5 marks) and treat (5 marks) an 8 year-old German shepherd dog with degenerative lumbosacral stenosis. Include details of how imaging findings influence your decision making process.

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DIPLOMA IN SMALL ANIMAL SURGERY (SOFT TISSUE)

TUESDAY 3 JULY 2012

PAPER I(3 hours)

• Candidates are required to answer ALL EIGHTEEN questions.

Allow 10 minutes per question.

• Please start the answer to each question on a separate sheet; failure to do so could lose you marks

Illegible handwriting or failure to answer the question in the form required may result in examiners being unable to award marks for information which candidates intended to convey.

1. Briefly compare the techniques described for laparoscopic gastropexy in the dog.

2. What is thromboelastography and what role does it have in the management of surgical patients?

3. What is layered debridement and when is it indicated?

4. Compare and contrast the use of cellophane banding and suture ligation as methods of attenuating portosystemic shunts.

5. Why are NOTECHS (non-technical skills) important in the operating theatre and what do they consist of?

6. What are possible indications for an angularis oris axial pattern flap in the dog and cat? Draw an annotated diagram illustrating the landmarks for this flap in the dog.

7. Which technique is suggested by surgical texts, to be the preferred method for performing stapled functional end to end intestinal anastomosis in dogs and why? Describe with diagrams how you would perform a functional end to end anastomosis using this technique.

8. What are tyrosine kinase inhibitors and which veterinary patients are they used in? Which patients are not suitable candidates for tyrosine kinase inhibitors?

9. What is the proposed link between hiatal hernia and gastro-oesophageal reflux disease (GORD) in dogs? Briefly contrast the surgical techniques for treatment of GORD in dogs and humans.

10. Briefly describe the technique for extra-vesicular ureteroneocystostomy. In which patients is this technique advocated for ureteral reimplantation and why?

11. Compare the anatomy and topographical relationships of the right and left adrenal glands and comment on how this might affect surgical adrenalectomy. What prognostic factors have been identified for adrenalectomy in dogs?

12. What is waterless surgical hand preparation? What are the advantages and disadvantages compared to traditional surgical hand antisepsis?

13. Write brief notes on the pathophysiology of cardiac tamponade secondary to pericardial effusion.

14. Write brief notes on the comparative aspects of laryngeal paralysis in dogs, horses and humans.

P.T.O. for Questions 15 - 18

15. Based on the most recently available information (Phelps et al JAVMA 2011), how does radical excision of feline injection site sarcomas (ISS) influence the rate of metastasis and local recurrence? What characteristics differentiate ISS from non-ISS?

16. Why are serial lactate measurements more appropriate than single values when using lactate measurements in clinical cases? In a study from Zacher et al in JAVMA 2010, what values for final lactate concentration, overall change and percentage change were associated with a poorer prognosis in dogs with gastric dilatation and volvulus?

17. What are the potential causes of post-laparoscopic pain? How can the duration of surgery affect postoperative pain in laparoscopic procedures?

18. What effect does surgical approach (minimally invasive versus open) have on surgical site infection rate? Comment on the strength of the evidence from the recent study by Mayhew et al (JAVMA, January 2012).

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DIPLOMA IN SMALL ANIMAL SURGERY (SOFT TISSUE)

TUESDAY 3 JULY 2012

PAPER II(3 hours)

Candidates are required to answer FOUR of the following five questions.

Allow 45 minutes per question.

Please start the answer to each question on a separate sheet; failure to do so could lose you marks.

Illegible handwriting or failure to answer the question in the form required may result in examiners being unable to award marks for information which candidates intended to convey.

1. Do you consider it still appropriate for general practices to have a set bitch and cat spay protocol? Provide an evidence based point of view and advice for a general practitioner wanting an update.

2. What is the difference between a mucosal graft and mucosal flap? Use specific examples to describe the indications, application and potential advantages and disadvantages of mucosal flaps and grafts.

3. Haemorrhage is a significant potential complication of hepatic surgery. Discuss the mechanisms that can be used to prevent and control peri-operative bleeding and their indications and contraindications.

4. Describe the pre and peri-operative investigation and surgical options for a dog with chylothorax. Discuss the factors which influence your surgical decision making process.

5. Discuss how an improved knowledge and appreciation of tumour behaviour and disease patterns has helped to inform our approach to surgical margins using mast cell tumours as an example.

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