In the thoracolumbar vertebral column of Dachshunds with clinical signs of intervertebral disk disease, MRI is a valuable technique for determining location and craniocaudal length of EIDM. Compared with T1-weighted and STIR images, T2-weighted images appeared to be more accurate and precise and are potentially more reliable for determination of the length of EIDM in those dogs.

Physeal fractures of the distal femur are among the most commonly encountered fractures in skeletally immature dogs. These fractures respond poorly to conservative management and thus early surgical reduction and stabilisation are recommended. A 7-month-old intact male Border collie presented with a history of chronic lameness. Clinical examination revealed a predominantly non-weight-bearing lameness of the right hindlimb and concurrent muscle atrophy. A pronounced, but atypical, procurvatum deformity of the right distal femur was diagnosed on survey radiographs. Malunion of a Salter–Harris Type III physeal fracture was suspected as there was an associated history of trauma. A cranially based closing wedge ostectomy was performed to address the femoral deformity and subsequently stabilised using a supracondylar bone plate. The dog recovered well and was moderately weight-bearing lame on the right hindlimb 6 weeks post-operatively. Ten months following the operation the range of motion had improved in the right stifle and no signs of lameness were evident at a walk. We advocate surgical correction of sagittal plane deformities of the distal femur using the CORA method. Overall, a good functional outcome was achieved, which is consistent with previously reported cases with similar deformities.

Some aspects of the NP's accountability and responsibilities have as yet not been adequately addressed in the current legislative framework and will certainly increase the risk for malpractice. South African NPs will have to establish partnerships with important role players, not only in South Africa, but also internationally, to ensure that an enabling environment for quality health services is created.

Ambiguities and role confusion exist with regard to specialist and clinically advanced nursing/midwifery practice globally and in most healthcare settings. This confusion requires clarification in such a way that specialist/clinical advanced nursing and midwifery practice (as a category of the clinical specialist) are clearly delineated. In South Africa, this is further complicated by the introduction of the Occupation Specific Dispensation (OSD) of the Department of Health (2007) which makes provision for a grade called Professional Nurse (Specialty Nursing) and also for a further grade called Clinical Nurse Specialist (Level 3 Hospitals). The Specialty Nursing category has been implemented in most health services and nurses who have qualifications at post-basic and postgraduate diploma level in the areas described in Regulation 212 can benefit from this progression. The higher level of Clinical Nurse Specialist (OSD term for advanced specialist) has not yet been implemented. The OSD document indicates that appointments to these posts will require significant clinical experience and a clinical master's degree. This is in line with the ICN stance that clinical advanced specialist nursing and midwifery practice require masters and PhD-level education linked to significant clinical practice experience. This chapter presents a differentiation between the two levels of specialist practice − the advanced nurse/midwife practitioner and the specialist nurse/midwife from a South African perspective and in line with the International Council of Nurses (ICN) framework.