September 19, 2025 • 15 mins
Surgical options for our feline patients often lack the robust documentation available for canine procedures. Dr. Kristen Gabriel tackles this gap with her groundbreaking research on parasternal thoracotomy via sternocostal disarticulation in cats—a technique that offers promising results for thoracic exploration when traditional approaches fall short.
The conversation delves into the origins of this technique, which began with documentation in canine patients before Dr. Gabriel recognized its particular value for cats. As she explains, cats present unique challenges during median sternotomies due to their tiny sternums, where surgeons can accidentally slip off midline or even completely off the sternum. This alternative approach provides a solution to these anatomical challenges while delivering good short-term outcomes.
Perhaps most fascinating is Dr. Gabriel's candid discussion of the radiographic abnormalities discovered in nearly half of the post-operative cases. Despite this seemingly high complication rate, she emphasizes that most were minor or incidental findings without significant impact on patient recovery—a crucial distinction for both veterinarians and pet owners to understand. Looking forward, she outlines important research directions including longer-term follow-up studies and comparative analyses examining factors like patient comfort, surgical time, and visualization between different approaches. For practitioners, this technique offers not just a primary option but a valuable backup plan when median sternotomies don't go as expected.
Whether you're a cat surgeon facing the frustrations of traditional thoracic approaches, a general practitioner wanting to expand your surgical options, or simply passionate about advancing feline-specific medicine, this episode provides valuable insights into an underreported technique with promising clinical applications. Subscribe to Veterinary Vertex for more cutting-edge discussions at the intersection of research and clinical practice.
JAVMA article: https://doi.org/10.2460/javma.25.03.0153
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Greenies (00:00):
From the makers of vet-recommended Greenies dental
treats comes an easy way tosupport your dog's wellness.
Greenies Smart Essentials dryfood delivers complete, balanced
nutrition with science-backedrecipes.
Greenies Supplements, developedby a team of PhD animal
nutritionists, offers options tohelp support healthy joints,
(00:22):
digestion and more, Whether it'smealtime or mobility support
Greenies helps you care for yourdog from the inside out.
Learn more at Greeniescom.
Sarah Wright (00:35):
You're listening to Veterinary Vertex, a podcast
for the APMA Journals.
This episode we chat about howparasternal thoracotomy via the
sternocostal disarticulation canbe performed in cats with good
short-term outcomes, with ourguest Kristen Gabriel.
Lisa Fortier (00:53):
Welcome listeners.
I'm Editor-in-Chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today, we have Kristen joiningus to talk about a novel
surgical approach for our catpatients.
Kristen, thank you so much fortaking the time to be with us
here today.
Kristen Gabriel (01:09):
Yeah, thank you guys so much for having me.
I'm excited to be here.
Sarah Wright (01:13):
All right, let's dive right in.
So, kristen, your Jabma articlediscusses how a parasternal
thoracotomy may be a suitablealternative to traditional
approaches when thoracicexploration is indicated in cats
.
Please share with our listenersthe background on this article.
Kristen Gabriel (01:34):
Yeah, so the background kind of started with
one of my resident mates, anna,who actually was the first one
to publish this technique incanine patients and it's
something that we had seenseveral surgeons at our hospital
performing with you know,seemingly good outcomes and no
major concerns.
And then you know we all kind ofrealized, like this isn't
actually documented anywhere andpublished anywhere.
(02:00):
You know, discussed how they'dseen other people do it and
learned it from people and werelike this needs to be, you know,
written down so people canlearn from it and decide, you
know, if and when it should beused as opposed to other
approaches.
And particularly in cats, wefind that sometimes people have
issues with median sternotomies,particularly with their
(02:21):
sternums being so tiny and, youknow, accidentally getting off
midline and sometimes even offof the sternum when trying to
access the thorax that way.
And so I thought you know,particularly in a group of cats
where they're all kind ofsimilar size and they all have,
you know, that same issue whenyou're sometimes trying to do
other approaches that this wouldbe a really good thing to just
(02:42):
document and get out there, andthis is obviously a very
preliminary study, just puttingthings out in the world and in
the literature, but certainlykind of opens the door to do
more in-depth comparisons andanalysis of if and when this
approach is useful.
Sarah Wright (02:57):
Very cool.
And since this is a technique,have you heard of our technical
tutorial videos?
Kristen Gabriel (03:01):
Yes, I have and I've been thinking about, you
know, if we need to make a videodemonstration, that would
probably be very helpful.
Very cool yeah.
Sarah Wright (03:10):
Especially with cats.
We don't have a lot of just catvideos in general, or cat
articles either, for that matter.
Kristen Gabriel (03:15):
So looking for those and what are some
important take-home messagesfrom this Javma article I think
the biggest take-home messagesright now are again just kind of
knowing that this technique isout there and that so far, with
our kind of preliminary data, itseems non-inferior to a lot of
the other techniques that areout there and that you know,
(03:38):
even though there is kind of ahigh complication rate noted in
the paper, that a lot of thosecomplications are very minor and
even really more incidentalfindings that we identified and
they don't really seem to have asignificant morbidity or
mortality to our patients.
Lisa Fortier (03:54):
Kristen.
I'm an equine orthopedicsurgeon, so we do everything
with a scope.
Why not do an exploratory witha?
Now they have like tiny needlescopes that have curved lenses
too.
Kristen Gabriel (04:04):
Yeah, and that's definitely something that
people are doing.
It's very equipment dependentNow.
Even a lot of specialtyhospitals, you know, don't have
all the equipment for for acoscopy, and sometimes the like
one lung ventilation is veryhelpful for that and not
everyone is comfortable or hasthe equipment to do that
(04:24):
successfully.
The other big issue is withthose minimally invasive
procedures you can't remove alarge like mediastinal mass or a
large lung mass.
You end up having to make apretty big incision to get some
of those things out of thethorax anyway.
So it's certainly a usefultechnique for exploration but
not always, you know, useful forremoving or performing what we
(04:45):
need to do.
Lisa Fortier (04:47):
Great Plays right into the spectrum of care.
Yeah, absolutely.
What sparked your interest infeline surgery?
Kristen Gabriel (04:53):
I've always been a cat person and so as I've
kind of progressed in my careeras a doctor and then as a
resident and everything youstart realizing, kind of like we
alluded to earlier, there'sjust not as much information out
there about cats and we knowthere are some differences
obviously between them and dogsand the way they heal and just
(05:14):
some of their you knowmusculature and their anatomy
differs just in subtle ways, andso I think it's really nice to
be able to have separateinformation on cats.
A lot of times they just kindof get lumped together into some
of the bigger studies that aremajority dogs and then a couple
of cats and you don't reallyknow how that plays into things.
Lisa Fortier (05:36):
Yeah, when I took over as editor, it was one of
the most striking things to meis how popular cats are as
patients and as veterinarypatients.
Yeah, but very, very littleliterature on them.
Kristen Gabriel (05:47):
Yeah, I feel like it's newer, Like as we're
advancing our technology andable to do more things.
I feel like people are able andwilling to do more for cats,
whereas previously it was very,very dog heavy just in
veterinary care in general, insmall animal at least.
Lisa Fortier (06:06):
What surprised you from this article?
Kristen Gabriel (06:09):
I think for me personally, one of the surprises
I had in kind of gathering allthe data and putting it together
was the amount of abnormalitiesthat we did identify on
radiographs.
I had, like I said previously,seen some of these procedures
being done and seen some ofthese post-op radiographs that
we had.
I kind of expected the numberof complications or
(06:32):
abnormalities that we found tobe lower, just again because of
my clinical experience beingthat you know these patients do
really well.
And so when our radiologistcame back and said you know,
almost half of these radiographsthat you sent me have some sort
of abnormality, I was kind oflike oh, that's not what I
expected, but certainly notsomething I wanted to hide or
(06:53):
try to cover up in theliterature.
You know it's out there andit's something we need to be
aware of and keep an eye on tomake sure that it is not a
clinically significant problemgoing forward.
Sarah Wright (07:03):
Kristen, I'm also a fellow cat lady.
I have two cats that arecurrently laying in the sun
grooming themselves right now aswe record this episode.
So what are the next steps forresearch in this topic?
Kristen Gabriel (07:14):
I think the next steps kind of have to be
two different directions.
One, just longer term follow-up, again making sure that some of
those abnormalities we'reseeing on x-rays are truly not
causing issues down the line,and just getting a little bit
more information on it'ssub-disease, dependent with this
type of surgery that you know.
(07:35):
Obviously some of thesepatients you know they like
media and sternopne and saying,okay, well, let's compare things
like patient comfortpostoperatively, let's compare
(07:58):
surgical time visualization thatyou're able to get during
surgery.
I think all of those things areimportant in order to help
people make decisions goingforward as far as you know what
approach is going to be best fortheir patients.
Sarah Wright (08:10):
And AI is such a hot topic right now.
It's everywhere.
Do you see a role for AI in?
Kristen Gabriel (08:14):
this area of research, I think in any
research, I think it can behelpful just as far as you know,
extracting data from recordsand kind of speeding that
process up for people.
I also was thinking like Idon't know how this would work.
I don't know enough of thedetails of the technology, but I
(08:35):
feel like there's probably away to if we're comparing things
like visibility in surgery, tohave AI or some sort of
technology calculate based on acouple examples you give them of
.
This is what we were able tosee and here's our kind of
(08:55):
landmarks in surgery.
They can probably apply that tolike a bunch of CT scans that
you know are patients you don'teven necessarily have to have
done surgery on.
They could do a theoreticalcalculation of.
You know, with this approach.
Here's what you can easily see,here's what you can maybe reach
surgically, and that way youget a lot more patients that
(09:16):
didn't actually have to undergosurgery and you can kind of
start collecting some of thattheoretical data.
Lisa Fortier (09:21):
Yeah, we don't even know how AI can help us yet
in many ways, right?
So many unknowns.
I love how you have a curiousclinical mind.
How did your training inprevious work help you to write
this article?
Kristen Gabriel (09:33):
am seeing frequently in my hospital, and
so it made for a good projectbecause it sparked that interest
of, like you know, why is thissomething that's not documented
anywhere else?
Why are we doing thisdifferently?
(09:54):
What are the advantages as faras actually writing the paper
itself?
That's actually something Ihope to get more comfort with in
the future and to continue tokind of grow in that aspect of
my career going forward, becauseit definitely is challenging in
some ways to balance clinicalpractice and doing all that on
(10:16):
top of research and publishing.
And I found that as Iprogressed, you know, from a
student to an intern and then aresident, at first I was like,
oh, I don't know what I wouldwant to research, like there's,
you know, you don't know whatquestions to be asking.
And then, as you get a littlebit more experience, you start
(10:36):
seeing all these cases andseeing all these things that
make you think of questions thatyou're like, oh, no one
actually knows the answer tothis question or people just
have anecdotal experience.
So I think you start learning alot more questions that you
have and sometimes it's hard toanswer those questions,
especially in medicine, likedoing a really good, you know
(10:58):
prospective study with enoughpatients for meaningful data is
often really difficult, and soit's something that I hope to
keep trying to contribute to inmy career.
Lisa Fortier (11:10):
Yeah, my words of wisdom would be to find somebody
to help with study design, sothat you don't get all the way
down and you're gathering thewrong data or it's not
randomized correctly or any ofthose things.
It's heartbreaking for oureditorial staff to get a review
back on a manuscript that islike you can't fix it, right,
(11:32):
right, and it's all the time.
Sarah Wright (11:34):
Yeah.
So Kristen's next set ofquestions is going to be really
important for our listeners, andthe first one's going to
revolve around theveterinarian's perspective.
Kristen Gabriel (11:55):
So, kristen, what is one piece of information
the veterinarian should knowabout?
Parasternal thoracotomy viasternocostal disarticulation in
cats.
This approach right away, likeI said before, if you are doing
median sternotomies and you findthat you've slipped off of the
sternum at one point, this is, Ithink, a very helpful article
to have just to say that's okay,here's how you can close it
still and they're going to dowell, and just having that kind
(12:21):
of reassurance and that backupplan when things maybe don't go
quite as planned for them, Ithink it's also a good option
for you know, if you don't havesome of that equipment available
, like we talked about spectrumof care earlier, like sometimes
you know you might not be ableto be referred somewhere else
for certain procedures and thisis sometimes an alternative that
(12:43):
could be done with differentequipment.
Sarah Wright (12:49):
On the other side of the relationship.
What's one thing that clientsshould consider when your
veterinarian is proposing asurgical option to them.
Kristen Gabriel (12:53):
Yeah, I think from a client perspective,
especially, you know, in thisday and age where people can
just like Google things reallyquick and see some of these
articles pop up, just knowingthat, again, that like 50%
complication rate does notnecessarily mean you know this
is terrible and 50% of them aregoing to not do well, you know.
(13:15):
That's to just not be scared bythat and to dig a little bit
deeper and see that you know alot of these are minor
complications and really more so, just a means for us to
document all of these thingsthat we're seeing.
Lisa Fortier (13:28):
Oh fantastic, what a great article.
Yeah, as we come to a close, weask a little more of a fun
question.
I think I can probably predictthis, but we'll see.
When you complete a puzzle,kristen, do you do the inside or
the border, or do you do, likea mosaic, part of it, like part
of the scenery?
(13:48):
How do you feel about attackinga puzzle?
Kristen Gabriel (13:51):
I am definitely a border person and I, yeah,
growing up I thought that wasthe universal answer and I
remember the first time I sawsome of my friends doing a
puzzle, um, in kind of that moremosaic fashion, and and I was
like, where are the edges?
Lisa Fortier (14:07):
What are you doing here?
Sarah and I have a hypothesisthat those that are surgically
oriented do the borders and themore medicine sort of folks do
interior.
So we have to look back at ourdata to see if our hypothesis
holds.
Kristen Gabriel (14:22):
I could see that being true.
Sarah Wright (14:23):
I've spoken like a true surgeon.
As soon as I asked thatquestion, I was like we know
what you're going to say.
Greenies (14:29):
That's so funny.
Sarah Wright (14:30):
I think before we had one person who was like
maybe like a surgeon or theysaid like middle, but they said
they wanted to be an internistat first or something.
So, there's high results.
But thank you so much, Kristen,we appreciate you being here
with us today, and also forsubmitting your manuscript, too,
to JAVMA.
Kristen Gabriel (14:45):
Much, Kristen, we appreciate you being here
with us today and also forsubmitting your manuscript to
JAVMA.
Yeah, absolutely, thank you,guys again so much for having me
and to our listeners.
Sarah Wright (14:50):
You can read Kristen's article on JAVMA.
I'm Sarah at Lisa Fortier.
Be on the lookout for nextweek's episode and don't forget
to leave us a rating and reviewon Apple Podcasts or whatever
platform you listen to.
From the makers of vet-recommended Greenies dental
treats comes an easy way tosupport your dog's wellness.
Greenies Smart Essentials dryfood delivers complete, balanced
nutrition with science-backedrecipes.
Greenies Supplements, developedby a team of PhD animal
nutritionists, offers options tohelp support healthy joints,
(00:22):
digestion and more, Whether it'smealtime or mobility support
Greenies helps you care for yourdog from the inside out.
Learn more at Greeniescom.
Sarah Wright (00:35):
You're listening to Veterinary Vertex, a podcast
for the APMA Journals.
This episode we chat about howparasternal thoracotomy via the
sternocostal disarticulation canbe performed in cats with good
short-term outcomes, with ourguest Kristen Gabriel.
Lisa Fortier (00:53):
Welcome listeners.
I'm Editor-in-Chief LisaFortier, and I'm joined by
Associate Editor Sarah Wright.
Today, we have Kristen joiningus to talk about a novel
surgical approach for our catpatients.
Kristen, thank you so much fortaking the time to be with us
here today.
Kristen Gabriel (01:09):
Yeah, thank you guys so much for having me.
I'm excited to be here.
Sarah Wright (01:13):
All right, let's dive right in.
So, kristen, your Jabma articlediscusses how a parasternal
thoracotomy may be a suitablealternative to traditional
approaches when thoracicexploration is indicated in cats
.
Please share with our listenersthe background on this article.
Kristen Gabriel (01:34):
Yeah, so the background kind of started with
one of my resident mates, anna,who actually was the first one
to publish this technique incanine patients and it's
something that we had seenseveral surgeons at our hospital
performing with you know,seemingly good outcomes and no
major concerns.
And then you know we all kind ofrealized, like this isn't
actually documented anywhere andpublished anywhere.
(02:00):
You know, discussed how they'dseen other people do it and
learned it from people and werelike this needs to be, you know,
written down so people canlearn from it and decide, you
know, if and when it should beused as opposed to other
approaches.
And particularly in cats, wefind that sometimes people have
issues with median sternotomies,particularly with their
(02:21):
sternums being so tiny and, youknow, accidentally getting off
midline and sometimes even offof the sternum when trying to
access the thorax that way.
And so I thought you know,particularly in a group of cats
where they're all kind ofsimilar size and they all have,
you know, that same issue whenyou're sometimes trying to do
other approaches that this wouldbe a really good thing to just
(02:42):
document and get out there, andthis is obviously a very
preliminary study, just puttingthings out in the world and in
the literature, but certainlykind of opens the door to do
more in-depth comparisons andanalysis of if and when this
approach is useful.
Sarah Wright (02:57):
Very cool.
And since this is a technique,have you heard of our technical
tutorial videos?
Kristen Gabriel (03:01):
Yes, I have and I've been thinking about, you
know, if we need to make a videodemonstration, that would
probably be very helpful.
Very cool yeah.
Sarah Wright (03:10):
Especially with cats.
We don't have a lot of just catvideos in general, or cat
articles either, for that matter.
Kristen Gabriel (03:15):
So looking for those and what are some
important take-home messagesfrom this Javma article I think
the biggest take-home messagesright now are again just kind of
knowing that this technique isout there and that so far, with
our kind of preliminary data, itseems non-inferior to a lot of
the other techniques that areout there and that you know,
(03:38):
even though there is kind of ahigh complication rate noted in
the paper, that a lot of thosecomplications are very minor and
even really more incidentalfindings that we identified and
they don't really seem to have asignificant morbidity or
mortality to our patients.
Lisa Fortier (03:54):
Kristen.
I'm an equine orthopedicsurgeon, so we do everything
with a scope.
Why not do an exploratory witha?
Now they have like tiny needlescopes that have curved lenses
too.
Kristen Gabriel (04:04):
Yeah, and that's definitely something that
people are doing.
It's very equipment dependentNow.
Even a lot of specialtyhospitals, you know, don't have
all the equipment for for acoscopy, and sometimes the like
one lung ventilation is veryhelpful for that and not
everyone is comfortable or hasthe equipment to do that
(04:24):
successfully.
The other big issue is withthose minimally invasive
procedures you can't remove alarge like mediastinal mass or a
large lung mass.
You end up having to make apretty big incision to get some
of those things out of thethorax anyway.
So it's certainly a usefultechnique for exploration but
not always, you know, useful forremoving or performing what we
(04:45):
need to do.
Lisa Fortier (04:47):
Great Plays right into the spectrum of care.
Yeah, absolutely.
What sparked your interest infeline surgery?
Kristen Gabriel (04:53):
I've always been a cat person and so as I've
kind of progressed in my careeras a doctor and then as a
resident and everything youstart realizing, kind of like we
alluded to earlier, there'sjust not as much information out
there about cats and we knowthere are some differences
obviously between them and dogsand the way they heal and just
(05:14):
some of their you knowmusculature and their anatomy
differs just in subtle ways, andso I think it's really nice to
be able to have separateinformation on cats.
A lot of times they just kindof get lumped together into some
of the bigger studies that aremajority dogs and then a couple
of cats and you don't reallyknow how that plays into things.
Lisa Fortier (05:36):
Yeah, when I took over as editor, it was one of
the most striking things to meis how popular cats are as
patients and as veterinarypatients.
Yeah, but very, very littleliterature on them.
Kristen Gabriel (05:47):
Yeah, I feel like it's newer, Like as we're
advancing our technology andable to do more things.
I feel like people are able andwilling to do more for cats,
whereas previously it was very,very dog heavy just in
veterinary care in general, insmall animal at least.
Lisa Fortier (06:06):
What surprised you from this article?
Kristen Gabriel (06:09):
I think for me personally, one of the surprises
I had in kind of gathering allthe data and putting it together
was the amount of abnormalitiesthat we did identify on
radiographs.
I had, like I said previously,seen some of these procedures
being done and seen some ofthese post-op radiographs that
we had.
I kind of expected the numberof complications or
(06:32):
abnormalities that we found tobe lower, just again because of
my clinical experience beingthat you know these patients do
really well.
And so when our radiologistcame back and said you know,
almost half of these radiographsthat you sent me have some sort
of abnormality, I was kind oflike oh, that's not what I
expected, but certainly notsomething I wanted to hide or
(06:53):
try to cover up in theliterature.
You know it's out there andit's something we need to be
aware of and keep an eye on tomake sure that it is not a
clinically significant problemgoing forward.
Sarah Wright (07:03):
Kristen, I'm also a fellow cat lady.
I have two cats that arecurrently laying in the sun
grooming themselves right now aswe record this episode.
So what are the next steps forresearch in this topic?
Kristen Gabriel (07:14):
I think the next steps kind of have to be
two different directions.
One, just longer term follow-up, again making sure that some of
those abnormalities we'reseeing on x-rays are truly not
causing issues down the line,and just getting a little bit
more information on it'ssub-disease, dependent with this
type of surgery that you know.
(07:35):
Obviously some of thesepatients you know they like
media and sternopne and saying,okay, well, let's compare things
like patient comfortpostoperatively, let's compare
(07:58):
surgical time visualization thatyou're able to get during
surgery.
I think all of those things areimportant in order to help
people make decisions goingforward as far as you know what
approach is going to be best fortheir patients.
Sarah Wright (08:10):
And AI is such a hot topic right now.
It's everywhere.
Do you see a role for AI in?
Kristen Gabriel (08:14):
this area of research, I think in any
research, I think it can behelpful just as far as you know,
extracting data from recordsand kind of speeding that
process up for people.
I also was thinking like Idon't know how this would work.
I don't know enough of thedetails of the technology, but I
(08:35):
feel like there's probably away to if we're comparing things
like visibility in surgery, tohave AI or some sort of
technology calculate based on acouple examples you give them of
.
This is what we were able tosee and here's our kind of
(08:55):
landmarks in surgery.
They can probably apply that tolike a bunch of CT scans that
you know are patients you don'teven necessarily have to have
done surgery on.
They could do a theoreticalcalculation of.
You know, with this approach.
Here's what you can easily see,here's what you can maybe reach
surgically, and that way youget a lot more patients that
(09:16):
didn't actually have to undergosurgery and you can kind of
start collecting some of thattheoretical data.
Lisa Fortier (09:21):
Yeah, we don't even know how AI can help us yet
in many ways, right?
So many unknowns.
I love how you have a curiousclinical mind.
How did your training inprevious work help you to write
this article?
Kristen Gabriel (09:33):
am seeing frequently in my hospital, and
so it made for a good projectbecause it sparked that interest
of, like you know, why is thissomething that's not documented
anywhere else?
Why are we doing thisdifferently?
(09:54):
What are the advantages as faras actually writing the paper
itself?
That's actually something Ihope to get more comfort with in
the future and to continue tokind of grow in that aspect of
my career going forward, becauseit definitely is challenging in
some ways to balance clinicalpractice and doing all that on
(10:16):
top of research and publishing.
And I found that as Iprogressed, you know, from a
student to an intern and then aresident, at first I was like,
oh, I don't know what I wouldwant to research, like there's,
you know, you don't know whatquestions to be asking.
And then, as you get a littlebit more experience, you start
(10:36):
seeing all these cases andseeing all these things that
make you think of questions thatyou're like, oh, no one
actually knows the answer tothis question or people just
have anecdotal experience.
So I think you start learning alot more questions that you
have and sometimes it's hard toanswer those questions,
especially in medicine, likedoing a really good, you know
(10:58):
prospective study with enoughpatients for meaningful data is
often really difficult, and soit's something that I hope to
keep trying to contribute to inmy career.
Lisa Fortier (11:10):
Yeah, my words of wisdom would be to find somebody
to help with study design, sothat you don't get all the way
down and you're gathering thewrong data or it's not
randomized correctly or any ofthose things.
It's heartbreaking for oureditorial staff to get a review
back on a manuscript that islike you can't fix it, right,
(11:32):
right, and it's all the time.
Sarah Wright (11:34):
Yeah.
So Kristen's next set ofquestions is going to be really
important for our listeners, andthe first one's going to
revolve around theveterinarian's perspective.
Kristen Gabriel (11:55):
So, kristen, what is one piece of information
the veterinarian should knowabout?
Parasternal thoracotomy viasternocostal disarticulation in
cats.
This approach right away, likeI said before, if you are doing
median sternotomies and you findthat you've slipped off of the
sternum at one point, this is, Ithink, a very helpful article
to have just to say that's okay,here's how you can close it
still and they're going to dowell, and just having that kind
(12:21):
of reassurance and that backupplan when things maybe don't go
quite as planned for them, Ithink it's also a good option
for you know, if you don't havesome of that equipment available
, like we talked about spectrumof care earlier, like sometimes
you know you might not be ableto be referred somewhere else
for certain procedures and thisis sometimes an alternative that
(12:43):
could be done with differentequipment.
Sarah Wright (12:49):
On the other side of the relationship.
What's one thing that clientsshould consider when your
veterinarian is proposing asurgical option to them.
Kristen Gabriel (12:53):
Yeah, I think from a client perspective,
especially, you know, in thisday and age where people can
just like Google things reallyquick and see some of these
articles pop up, just knowingthat, again, that like 50%
complication rate does notnecessarily mean you know this
is terrible and 50% of them aregoing to not do well, you know.
(13:15):
That's to just not be scared bythat and to dig a little bit
deeper and see that you know alot of these are minor
complications and really more so, just a means for us to
document all of these thingsthat we're seeing.
Lisa Fortier (13:28):
Oh fantastic, what a great article.
Yeah, as we come to a close, weask a little more of a fun
question.
I think I can probably predictthis, but we'll see.
When you complete a puzzle,kristen, do you do the inside or
the border, or do you do, likea mosaic, part of it, like part
of the scenery?
(13:48):
How do you feel about attackinga puzzle?
Kristen Gabriel (13:51):
I am definitely a border person and I, yeah,
growing up I thought that wasthe universal answer and I
remember the first time I sawsome of my friends doing a
puzzle, um, in kind of that moremosaic fashion, and and I was
like, where are the edges?
Lisa Fortier (14:07):
What are you doing here?
Sarah and I have a hypothesisthat those that are surgically
oriented do the borders and themore medicine sort of folks do
interior.
So we have to look back at ourdata to see if our hypothesis
holds.
Kristen Gabriel (14:22):
I could see that being true.
Sarah Wright (14:23):
I've spoken like a true surgeon.
As soon as I asked thatquestion, I was like we know
what you're going to say.
Greenies (14:29):
That's so funny.
Sarah Wright (14:30):
I think before we had one person who was like
maybe like a surgeon or theysaid like middle, but they said
they wanted to be an internistat first or something.
So, there's high results.
But thank you so much, Kristen,we appreciate you being here
with us today, and also forsubmitting your manuscript, too,
to JAVMA.
Kristen Gabriel (14:45):
Much, Kristen, we appreciate you being here
with us today and also forsubmitting your manuscript to
JAVMA.
Yeah, absolutely, thank you,guys again so much for having me
and to our listeners.
Sarah Wright (14:50):
You can read Kristen's article on JAVMA.
I'm Sarah at Lisa Fortier.
Be on the lookout for nextweek's episode and don't forget
to leave us a rating and reviewon Apple Podcasts or whatever
platform you listen to.
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