The Vet Scalpel, Oslo (2026)

27/09/2026

**Do Scandinavians think differently?** 🇳🇴🇸🇪🇩🇰

I sat down with my good colleague Kerstin, and we ended up talking about something I’ve wondered about for years. Why does veterinary surgery in Scandinavia feel so different from what we see in the rest of the world?

We landed on the same answer: we lean towards less. Before we reach for the scalpel, we often ask what the body can manage on its own.

Some part of that comes from the owners. Having worked in the UK, I’ve seen the difference first-hand. There, owners are often willing to go to great lengths. Both in Denmark, Sweden and Norway, I see people draw a firmer line. They ask not just «can this be done?» but «should my pet have to go through this?» That question shapes many conversations we have in the consult room.

History plays a role too. Until the 1990s, we were limited with regards to implants, so a whole generation of surgeons learned by watching how well (or bad) the body copes when you give it the chance.

And then there are the numbers. Norway, Sweden and Denmark together have almost half the population of California. Fewer patients means it’s hard for a surgeon to focus on only one joint or one procedure, and it’s expensive to keep a full range of specialised implants for all bones on the shelf.

Not better or worse. Just a different starting point - and something that has triggered my curiosity so much that it ended up becoming several PhD projects and a large clinical study. 🤓

What’s the mindset among owners where you work? 👇

🐾

25/09/2026

Do osteophytes tell you what’s happening to the medial meniscus? In our data, no.

Hear my PhD student Marte talk about the poster she presented at the World Veterinary Orthopaedic Congress in Rome! She looked at whether osteophyte formation in the canine stifle is associated with medial meniscal pathology, and she found no significant association between the two.

This is one small piece of a much larger project: a prospective randomised clinical study of 60 small dogs with cranial cruciate ligament disease at the Norwegian University of Life Sciences (NMBU), comparing conservative management with TPLO. We’ve collected a large body of data, with both subjective and objective outcome measures, and the full results will be published in due course.

So stay put, because there’s more to come. And if you see us at a congress, please come and say hello. We’d love to talk about all things cruciate (and other😜).

🎓

11/09/2026

This was me yesterday. Sick, at work, in scrubs, still trying to get through the day. I still go in anyway, because I tend to think I’m irreplaceable 😂 — which is, funnily enough, exactly the term the research uses: «ease of replacement.»

It’s measured, quite literally, by how much work is left waiting for you after you’ve been gone. The harder you are to replace, the more likely you are to show up sick.

Chances are you’ve done the same, for your own version of «irreplaceable.»

What’s the one thing that would actually make it easier for you to stay home?

07/09/2026

The evidence I couldn’t fit in 60 seconds.

In people, where the trials are much bigger, PRP is still contested. For tendons the pooled evidence says no better than placebo. For joints it splits: a network meta-analysis of 21 trials found PRP beat placebo, while RESTORE — 288 patients, PRP against saline, properly blinded — found nothing at a year. Two thousand patients and no agreement.

In dogs, the systematic review is the one I mentioned: 18 studies, 379 dogs, all reporting improvement, 8 at high risk of bias, only 7 using objective gait analysis. Eight didn’t report platelet concentration. A separate critical appraisal of the placebo-controlled trials concluded the evidence for reducing pain and lameness is weak.

Two things worth saying that make it more complicated, not less. There are canine trials where PRP genuinely beat intra-articular saline — Alves in police dogs with hip OA, Cook in an induced model. And in human trials, patients given plain saline improve meaningfully for up to six months, which makes every control arm harder to interpret than it looks.

So: safe, plausible, possibly effective, not proven. That’s not a reason to stop. It’s a reason to be careful about what we promise.

Cardona-Ramírez et al., JAVMA 2025. Cai, Aust Vet J 2025. Bennell et al., JAMA 2021.

03/09/2026

Vets got it wrong more often than the owners did.

This is the placebo effect in dogs, except the dog isn’t the one being fooled.

Dogs can’t form an expectation about a capsule. They don’t know they’ve been given anything. And expectation is supposed to be the whole mechanism in humans.

So what’s actually happening?

Partly it’s us. In 58 dogs on placebo, owners reported their dog was better 39.7% of the time. Vets: 44.8%. Force-plate gait analysis said 46 of those 58 hadn’t changed at all. The longer the trial ran, the stronger the effect got.

And partly the dog probably does improve a bit, just not from the capsule. Starting a treatment usually means shorter walks, more rest, a new bed, some weight off, an owner suddenly watching how the dog gets up off the floor. I don’t know how much of the 39.7% is that, and I’m not sure anyone does.

What I do know is that we want our patients to get better. That’s why we chose this job. I’ve stood in a consult room and watched a dog cross the floor and thought, yes, definitely better.

Who knows how many times I was actually right.

Is it not interesting how we can trick our minds like this?

The publication: Conzemius & Evans, JAVMA 2012.

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