Showing papers in "Journal of The American Animal Hospital Association in 2015"
TL;DR: The 2015 guidelines summarize and offer a discriminating review of much of the new knowledge provided in the 2007 AAHA/AAFP Pain Management Guidelines for Dogs and Cats, and support veterinarians in incorporating pain management into practice, improving patient care.
Abstract: The robust advances in pain management for companion animals underlie the decision of AAHA and AAFP to expand on the information provided in the 2007 AAHA/AAFP Pain Management Guidelines for Dogs and Cats . The 2015 guidelines summarize and offer a discriminating review of much of this new knowledge. Pain management is central to veterinary practice, alleviating pain, improving patient outcomes, and enhancing both quality of life and the veterinarian-client-patient relationship. The management of pain requires a continuum of care that includes anticipation, early intervention, and evaluation of response on an individual-patient basis. The guidelines include both pharmacologic and nonpharmacologic modalities to manage pain; they are evidence-based insofar as possible and otherwise represent a consensus of expert opinion. Behavioral changes are currently the principal indicator of pain and its course of improvement or progression, and the basis for recently validated pain scores. A team-oriented approach, including the owner, is essential for maximizing the recognition, prevention, and treatment of pain in animals. Postsurgical pain is eminently predictable but a strong body of evidence exists supporting strategies to mitigate adaptive as well as maladaptive forms. Degenerative joint disease is one of the most significant and under-diagnosed diseases of cats and dogs. Degenerative joint disease is ubiquitous, found in pets of all ages, and inevitably progresses over time; evidence-based strategies for management are established in dogs, and emerging in cats. These guidelines support veterinarians in incorporating pain management into practice, improving patient care.
92 citations
TL;DR: The 2015 AAHA Canine and Feline Behavior Management Guidelines were developed to provide practitioners and staff with concise, evidence-based information to ensure that the basic behavioral needs of feline and canine patients are understood and met in every practice.
Abstract: The 2015 AAHA Canine and Feline Behavior Management Guidelines were developed to provide practitioners and staff with concise, evidence-based information to ensure that the basic behavioral needs of feline and canine patients are understood and met in every practice. Some facility in veterinary behavioral and veterinary behavioral medicine is essential in modern veterinary practice. More cats and dogs are affected by behavioral problems than any other condition. Behavioral problems result in patient suffering and relinquishment and adversely affect staff morale. These guidelines use a fully inclusive team approach to integrate basic behavioral management into everyday patient care using standardized behavioral assessments; create a low-fear and low-stress environment for patients, staff and owners; and create a cooperative relationship with owners and patients so that the best care can be delivered. The guidelines' practical, systematic approach allows veterinary staff to understand normal behavior and recognize and intervene in common behavioral problems early in development. The guidelines emphasize that behavioral management is a core competency of any modern practice.
64 citations
TL;DR: Cestodes were present in over half of the cats examined in this study, but the majority of these infections were not evident by the detection of external proglottids or recovery of characteristic stages on fecal flotation.
Abstract: Fecal flotation is routinely used to identify feline helminth infections in clinical practice, but it is known to have limitations of sensitivity, particularly for cestodes. To determine the prevalence of helminths in a contemporary population of cats and evaluate the ability of fecal flotation to detect these infections, helminths were recovered from intestinal tracts removed from 116 adult cats humanely euthanized by an animal control shelter in northeastern Oklahoma. Results were compared to those of fecal flotation performed using both passive and centrifugal techniques. Helminths were identified in 78/116 (67.2%) cats, including Toxocara cati (48/116; 41.4%), Ancylostoma tubaeforme (8/116; 6.9%), Dipylidium caninum (40/116; 34.5%), and Taenia taeniaeformis (30/116; 25.9%). Cats with T. cati were significantly more likely to harbor T. taeniaeformis (P = .001) than cats without ascarids. Centrifugal fecal flotation with sugar solution identified 37/48 (77.1%) T. cati infections, 8/30 (26.7%) T. taeniaeformis infections, and no D. caninum infections. Proglottids were detected on external examination in 19.0% (12/63) of cats with cestodes. Cestodes were present in over half of the cats examined in this study, but the majority of these infections were not evident by the detection of external proglottids or recovery of characteristic stages on fecal flotation.
31 citations
TL;DR: In female pet rabbits that are not breeding, either ovariohysterectomy should be performed at an early age or routine checks including ultrasonography of the abdomen are recommended on a regular basis.
Abstract: Although the incidence of uterine disorders in pet rabbits is high there are only a few retrospective studies and case reports on genital tract disease in female rabbits. Uterine disorders were assessed in 50 pet rabbits. In 31 pet rabbits with suspected clinical uterine disease, medical records were further reviewed regarding clinical signs, diagnostic workup, treatment as well as the outcome itself. Uterine adenocarcinoma (54%) was most frequently diagnosed, followed by endometrial hyperplasia (26%). Serosanguineous vaginal discharge was the predominant clinical sign observed by the rabbit owners. In approximately 50% of the rabbits with suspected uterine disorders, abdominal palpation revealed enlarged and/or irregular masses in the caudoventral abdomen indicating uterine lesions. Out of 23 rabbits undergoing ovariohysterectomy, four were either euthanized or died shortly after surgery because they were clinically unstable. Overall, 80% of the ovariohysterectomized animals were still alive 6 mo after surgery. In female pet rabbits that are not breeding, either ovariohysterectomy should be performed at an early age or routine checks including ultrasonography of the abdomen are recommended on a regular basis.
26 citations
TL;DR: The Histoplasma antigen EIA test demonstrated high specificity and sensitivity for the diagnosis of histoplasmosis in dogs.
Abstract: The objective of this study was to evaluate the sensitivity and specificity of an antigen enzyme immunoassay (EIA) on urine samples for the diagnosis of histoplasmosis in dogs. This retrospective medical records review included canine cases with urine samples submitted for Histoplasma EIA antigen assay between 2007 and 2011 from three veterinary institutions. Cases for which urine samples were submitted for Histoplasma antigen testing were reviewed and compared to the gold standard of finding Histoplasma organisms or an alternative diagnosis on cytology or histopathology. Sensitivity, specificity, negative predictive value, positive predictive value, and the kappa coefficient and associated confidence interval were calculated for the EIA-based Histoplasma antigen assay. Sixty cases met the inclusion criteria. Seventeen cases were considered true positives based on identification of the organism, and 41 cases were considered true negatives with an alternative definitive diagnosis. Two cases were considered false negatives, and there were no false positives. Sensitivity was 89.47% and the negative predictive value was 95.35%. Specificity and the positive predictive value were both 100%. The kappa coefficient was 0.9207 (95% confidence interval, 0.8131-1). The Histoplasma antigen EIA test demonstrated high specificity and sensitivity for the diagnosis of histoplasmosis in dogs.
24 citations
TL;DR: It is suggested that LOVE in cats is safe, can be performed in a comparable amount of time as COVH, and may result in less postoperative discomfort.
Abstract: Laparoscopy is an established modality in veterinary medicine. To date, laparoscopy in feline surgery is rarely reported. The objectives of this study were to compare surgical time, complications, and postoperative pain in a group of cats undergoing laparoscopic ovariectomy (LOVE), laparoscopic-assisted ovariohysterectomy (LAOVH), and ovariohysterectomy via celiotomy (COVH). Eighteen healthy cats were randomly assigned to undergo LOVE, LAOVH, or COVH. Severity of pain was monitored 1, 2, 3, and 4 hr after surgery. Surgical time was significantly longer for LAOVH (mean ± standard deviation [SD], 51.6 ± 7.7 min) compared to COVH (mean ± SD, 21.0 ± 7.1 min) and LOVE (mean ± SD, 34.2 ± 11.2 min). There were no major intraoperative complications, although minor complications were more common in both laparoscopic groups. Cats sterilized via laparoscopy (LOVE and LAOVH) were statistically less painful than cats spayed via celiotomy (COVH) 4 hr following surgery. Results suggested that LOVE in cats is safe, can be performed in a comparable amount of time as COVH, and may result in less postoperative discomfort.
24 citations
TL;DR: Canine and feline urine culture reports and medical records were reviewed at a veterinary teaching hospital from 2006 to 2011 for enterococcal growth, coinfections, antimicrobial resistance, urine sediment findings, clinical signs, and concurrent conditions.
Abstract: Canine and feline urine culture reports and medical records were reviewed at a veterinary teaching hospital from 2006 to 2011 for enterococcal growth, coinfections, antimicrobial resistance, urine sediment findings, clinical signs, and concurrent conditions. Of all of the urine specimens with significantly defined colony-forming units/mL, Enterococcus (E.) faecalis was the only enterococci isolated from cats and predominated (77.4%) in dogs followed by E. faecium (12.9%), E. durans (3.2%), and other Enterococcus spp. (6.5%). The majority of specimens with significant enterococcal growth resulted in complicated urinary tract infections in 83.9% of dogs and 81.8% of cats. Specimens with only enterococcal growth were more common than those mixed with other bacterial species. Cocci were observed in urine sediments of 8 out of 8 cats and 21 out of 25 dogs with available concurrent urinalyses. Pyuria was noted in 5 out of 8 feline and 15 out of 25 canine urine sediments, and pyuria in dogs was associated with growth of only enterococci on aerobic urine culture. Multidrug resistance was identified in 6 out of 11 cats and 7 out of 31 dogs, and E. faecium isolates from dogs were 4.5× more likely to be multidrug resistant than E. faecalis.
21 citations
TL;DR: Evaluating the literature to report the renal effects of NSAIDs in dogs found that NSAIDs that target COX-2 may be expected to adversely affect renal function in dogs, especially dogs with chronic kidney disease.
Abstract: The quality of life for dogs with osteoarthritis can often be improved with nonsteroidal anti-inflammatory drugs (NSAIDs); however, the number of adverse drug events associated with NSAID use reported to the Federal Drug Administration Center for Veterinary Medicine is higher than that for any other companion animal drug. Of those events, adverse renal reactions are the second most reported. NSAIDs produce pharmacologic effects via inhibition of cyclooxygenase (COX), which decreases production of prostanoids. Prostaglandins are synthesized by both the COX-1 and COX-2 enzymes in the healthy kidney and influence renal blood flow, glomerular filtration rate, renin release, and Na excretion. There are important species differences in the renal expression of COX-1 and COX-2. For example, dogs have higher basal levels of COX-2 expression in the kidney compared with humans. In addition, in dogs with chronic kidney disease, an increase in COX-2 expression occurs and synthesis of prostaglandins shifts to the COX-2 pathway. For those reasons, NSAIDs that target COX-2 may be expected to adversely affect renal function in dogs, especially dogs with chronic kidney disease. The purpose of this review was to evaluate the literature to report the renal effects of NSAIDs in dogs.
19 citations
TL;DR: ESWT may result in improved function based on subjective patient evaluation and did not have any negative side effects in dogs with lameness attributable to instability, calcifying, and inflammatory conditions of the shoulder.
Abstract: The purpose of this article was to describe the outcome of dogs with instability, calcifying, and inflammatory conditions of the shoulder treated with extracorporeal shockwave therapy (ESWT). Medical records for 15 dogs with lameness attributable to the shoulder that failed previous conservative management were retrospectively reviewed. ESWT was delivered to those dogs q 3-4 wk for a total of three treatments. Short-term, in-hospital subjective lameness evaluation revealed resolution of lameness in three of nine dogs and improved lameness in six of nine dogs available for evaluation 3-4 wk following the final treatment. Long-term lameness score via telephone interview was either improved or normal in 7 of 11 dogs (64%). ESWT may result in improved function based on subjective patient evaluation and did not have any negative side effects in dogs with lameness attributable to instability, calcifying, and inflammatory conditions of the shoulder.
17 citations
TL;DR: The combined analysis of the antimicrobial-resistance patterns shown by the isolates led to the hypothesis that there is a possible crosscontamination and dissemination of S. pseudintermedius species between the three types of carriers sampled in this study that could facilitate the spread of the methicillin-res resistance phenotype.
Abstract: Staphylococcus pseudintermedius is the most prevalent coagulase-positive Staphylococcus inhabitant of the skin and mucosa of dogs and cats, causing skin and soft tissue infections in these animals. In this study, coagulase-positive Staphylococcus species were isolated from companion animals, veterinary professionals, and objects from a clinical veterinary environment by using two particular culture media, Baird-Parker RPF agar and CHROMagar Staph aureus. Different morphology features of colonies on the media allowed the identification of the species, which was confirmed by performing a multiplex polymerase chain reaction (PCR). Among 23 animals, 15 (65.2%) harbored coagulase-positive Staphylococcus, being 12 Staphylococcus pseudintermedius carriers. Four out of 12 were methicillin-resistant S. pseudintermedius (MRSP). All veterinary professionals had coagulase-positive Staphylococcus (CoPS) species on their hands and two out of nine objects sampled harbored MRSP. The antimicrobial-resistance pattern was achieved for all isolates, revealing the presence of many multidrug-resistant CoPS, particularly S. pseudintermedius . The combined analysis of the antimicrobial-resistance patterns shown by the isolates led to the hypothesis that there is a possible crosscontamination and dissemination of S. aureus and S. pseudintermedius species between the three types of carriers sampled in this study that could facilitate the spread of the methicillin-resistance phenotype.
16 citations
TL;DR: This is the first report of a primary extradural hemangiosarcoma in the lumbar vertebral column in a dog, and the clinical presentation, diagnosis, treatment, and outcome are discussed.
Abstract: A 9 yr old castrated male golden retriever weighing 36 kg was presented for evaluation of progressive left pelvic limb paresis and fecal and urinary incontinence. MRI demonstrated an extradural, ovoid mass compressing the lumbar spinal cord. Surgical excision of the mass was performed. Histologically, the mass was consistent with hemangiosarcoma with no involvement of the adjacent vertebrae. The dog underwent a doxorubicin-based chemotherapy protocol with the addition of oral cyclophosphamide. After completion of chemotherapy, the dog was evaluated q 4 mo for restaging. Clinicopathological evidence of primary tumor recurrence or metastatic disease was not detected for 15 mo after initial diagnosis and treatment. To the authors' knowledge, this is the first report of a primary extradural hemangiosarcoma in the lumbar vertebral column in a dog. The clinical presentation, diagnosis, treatment, and outcome are also discussed.
TL;DR: An 11 yr old shih tzu that presented with skin lesions consisting of multiple annular, erythematous papules and plaques, hyperpigmentation, adherent scaling, and atrophic scars over the caudal dorsum, flanks, craniodorsal thorax, and lateroproximal extremities is described.
Abstract: Discoid lupus erythematosus (DLE) is a commonly reported canine autoimmune disease that normally presents with a phenotype consisting of erythema, depigmentation, scaling, erosions/ulcers, and scarring over the nasal planum and the proximal dorsal muzzle. Recently, two cases of a generalized variant of this disease have been reported, whose lesions responded to either systemic glucocorticoids or a combination of topical corticosteroids, topical tacrolimus, and the oral antimalarial hydroxychloroquine. The purpose of this report is to describe an 11 yr old shih tzu that presented with skin lesions consisting of multiple annular, erythematous papules and plaques, hyperpigmentation, adherent scaling, and atrophic scars over the caudal dorsum, flanks, craniodorsal thorax, and lateroproximal extremities. A diagnosis of generalized DLE was made based on the clinical presentation, histopathology, laboratory values, and direct immunofluorescence findings. Treatment consisted of oral tetracycline and oral niacinamide, which resulted in complete remission of clinical signs. This is the first documented report of generalized canine DLE responding to the described immunomodulating regimen. Such a combination might therefore be considered as a glucocorticoid and/or antimalarial alternative for the management of generalized DLE.
TL;DR: A 5 mo old male German shepherd dog was presented with an abdominal wall hernia and exercise intolerance and a congenital caudal sternal cleft, a supraumbilical diastasis rectus, and a patent ductus arteriosus were revealed.
Abstract: A 5 mo old male German shepherd dog weighing 15.5 kg was presented with an abdominal wall hernia and exercise intolerance. Physical examination showed a grade II/VI systolic heart murmur and an area of cutaneous atrophy overlying a midline supraumbilical wall defect. Thoracic radiography, computed tomography, and ultrasound examination revealed a congenital caudal sternal cleft, a supraumbilical diastasis rectus, and a patent ductus arteriosus. Exploratory surgery confirmed defects of the pars sternalis of the diaphragm and caudoventral pericardium and a persistent left cranial vena cava. Those findings were compatible with Cantrell's pentalogy. Surgical treatment included ligation of the patent ductus arteriosus through the sternal cleft, diaphragmatic reconstruction with paracostal extension of the diaphragmatic defect, pericardial and linea alba appositional reconstruction, and primary approximation of the sternal halves. Growth and exercise activity were normal 10 mo after surgery. The discovery of a ...
TL;DR: The mainstay of emergency treatment usually involves aggressive IV fluid diuresis, the use of diuretics, and, often, glucocorticoids, and theUse of bisphosphonates has become increasingly more common in veterinary medicine.
Abstract: Hypercalcemia is uncommonly encountered in veterinary patients. When it does occur, the effects can be severe, resulting in significant morbidity and mortality if not recognized and addressed in a timely manner. Causes of hypercalcemia are varied and include pituitary-dependent and pituitary-independent causes. A diagnosis of hypercalcemia should be made based on documentation of ionized hypercalcemia. The mainstay of emergency treatment usually involves aggressive IV fluid diuresis, the use of diuretics, and, often, glucocorticoids. The use of bisphosphonates has become increasingly more common in veterinary medicine.
TL;DR: It is suggested that the combination of cyclophosphamide and corticosteroids is well tolerated and may be considered as first-line therapy for cats with systemic MRD.
Abstract: Myeloma-related disorder (MRD) is an uncommon disease in cats, for which there is no established standard of care. In this retrospective study, we evaluated presentation, response to treatment, and toxicity in cats with MRD receiving systemic treatment. Previously reported prognostic factors were evaluated for their impact on survival in cats receiving chemotherapy. Of fifteen cases identified, thirteen received melphalan or cyclophosphamide +/- corticosteroids as first-line therapy. Chlorambucil was commonly used as rescue therapy in cats with progressive disease, or in cases of chemotherapy-related toxicity with first line agents. Overall response rates were 71% and 83% for melphalan- and cyclophosphamide-treated cats, respectively. Discontinuation of melphalan due to toxicity was common. Survival times for cats initially treated with melphalan or cyclophosphamide were not significantly different (median 252 and 394 days, respectively), and no statistically significant prognostic factors were identified. This study suggests that the combination of cyclophosphamide and corticosteroids is well tolerated and may be considered as first-line therapy for cats with systemic MRD.
TL;DR: A 6 mo old male puppy was presented as an emergency for an acute onset of lethargy, ptyalism, and vomiting and laparoscopy was used to identify and remove the torsed testis.
Abstract: A 6 mo old male puppy was presented as an emergency for an acute onset of lethargy, ptyalism, and vomiting. On physical examination, the dog was painful on abdominal palpation. A torsed intra-abdominal testis was diagnosed via abdominal ultrasonography and radiography. Laparoscopy was used to identify and remove the torsed testis. The dog recovered uneventfully and was described as doing well by the owners at the 6 mo follow-up telephone contact. This is the first report of an abdominal testicular torsion treated with laparoscopy.
TL;DR: Timely use of negative-pressure wound therapy appears to be a viable management tool to accompany surgical debridement, appropriate antibiotics, and analgesics in Akita and German shorthaired pointer cases.
Abstract: A 5 mo old female Akita and a 1 yr, 5 mo old male German shorthaired pointer were both evaluated for soft-tissue lesions characterized by rapidly expanding edema, erythema, and pain. Ultrasound was utilized to locate and sample fluid accumulations, and β-hemolytic Streptococcus was isolated from the wounds. Development of systemic symptoms including fever, tachycardia, and tachypnea as well as a lack of response to medical management prompted surgical intervention in both cases. During surgical exploration and debridement, disruption of intermuscular tissue planes was appreciated and necrotizing fasciitis (NF) was suspected. Negative-pressure wound therapy systems utilizing 120 mm Hg of continual negative pressure were applied to wounds for 5 and 4 days for the Akita and German shorthaired pointer, respectively. Resolution of infection was achieved and although the lesions were associated with limbs, amputation was avoided. In both cases, the results of histopathology were consistent with NF. NF is recognized as a rapidly progressive infection associated with high rates of morbidity and mortality. Timely use of negative-pressure wound therapy appears to be a viable management tool to accompany surgical debridement, appropriate antibiotics, and analgesics.
TL;DR: Two dogs were diagnosed with chronic splenic torsion based on changes in splenic position, echogenicity, and/or echotexture identified on B-mode abdominal ultrasonography, as well as either decreased or absent splenic blood flow on color-flow Doppler ultrasonographic.
Abstract: A 5 yr old spayed female poodle (case 1) was presented with a 4 mo history of lethargy, inappetence, and nonregenerative anemia. A 5 yr old castrated male French bulldog (case 2) was presented with a 2 wk history of mild abdominal pain, dyschezia, and intermittent anorexia. Both dogs were diagnosed with chronic splenic torsion based on changes in splenic position, echogenicity, and/or echotexture identified on B-mode abdominal ultrasonography, as well as either decreased or absent splenic blood flow on color-flow Doppler ultrasonography. Both dogs underwent splenectomy and had full resolution of clinical signs. Presentation of chronic splenic torsion is variable, and clinical signs can be nonspecific. Abdominal ultrasound with Doppler evaluation is an important diagnostic step that can lead to appropriate surgical intervention and good long-term prognosis.
TL;DR: Six unrelated dogs from three households were subsequently determined to have developed alopecia as a result of accidental transdermal exposure to their owners' topical hormone replacement therapy (THRT) and all dogs had complete resolution of their clinical signs by 5.5 mo after the owners started THRT.
Abstract: Alopecia is a common presenting complaint in veterinary medicine and is known to occur secondary to numerous primary conditions. In this report, six unrelated dogs from three households were subsequently determined to have developed alopecia as a result of accidental transdermal exposure to their owners' topical hormone replacement therapy (THRT). All cases presented with alopecia ranging in duration from 2 mo to 2.5 yr. All dogs demonstrated alopecia affecting the ventral neck, thoracic and abdominal surfaces, proximal lateral extremities, and lateral trunk. At the time of initial presentation, five of six dogs were also noted to have physical exam findings suggestive of feminization. In all cases, serum total thyroxine was within normal reference range. Affected skin was biopsied in five dogs, and all samples demonstrated four similar histological characteristics: basal melanosis, epidermal and infundibular follicular hyperkeratosis, kenogen hair follicles, and small sebaceous glands. All dogs had eleva...
TL;DR: This is the first known report of porcupine quill migration through the heart of a German shorthaired pointer, presented with progressive respiratory distress and lethargy.
Abstract: A 7 yr old German shorthaired pointer presented with progressive respiratory distress and lethargy. Two weeks prior to presentation, the dog had porcupine quills removed from the left forepaw, muzzle, and sternal area. At the time of presentation, the dog had bounding pulses and friction rubs in the right dorsal lung field. Harsh lung sounds and decreased lung sounds were ausculted in multiple lung fields. Radiographs revealed a pneumothorax and rounding of the cardiac silhouette suggestive of pericardial effusion. Computed tomographic imaging was performed and revealed multiple porcupine quills in the thoracic cavity. Surgery was performed and quills were found in multiple lung lobes and the heart. Following surgery the dog remained hypotensive. A post-operative echocardiogram revealed multiple curvilinear soft-tissue opacities in the heart. Given the grave prognosis the dog was subsequently euthanized and a postmortem examination was performed. A single porcupine quill was discovered in the left atrium ...
TL;DR: The dog presented bilateral ovotestes and a 2n = 78, XX chromosomal complement lacking the sex determining region Y gene, consistent with a diagnosis of true hermaphroditism, resulting in an intersex condition.
Abstract: This report describes a disorder of the sexual development in a beagle dog resulting in an intersex condition. A 6 mo old beagle was presented for evaluation of a protruding structure from the vulva consistent with an enlarged clitoris. Ultrasonographic examination revealed the presence of both gonadal and uterine structures. Retrograde cystourethrovaginogram showed the presence of an os clitoris and severe vaginal stenosis. Histological studies revealed the presence of bilateral ovotestes and uterus. The gonad had interstitial cells within seminiferous-like tubules lined only with Sertoli cells and abundant interstitial cells among primordial, primary, and secondary follicles. Hormone assays completed before and after gonadohysterectomy showed an elevation in the levels of progesterone and dihydrotestosterone that returned to baseline 3 mo after surgery. Testosterone levels that were within the male reference ranges before surgery decreased to basal levels postsurgically. 17-β-Estradiol levels showed little variation and values were always within the reference ranges for a male. Cytogenetic analysis showed a normal female karyotype (2n = 78, XX) and polymerase chain reaction analysis revealed the absence of the sex-determining region Y gene. In summary, the dog presented bilateral ovotestes and a 2n = 78, XX chromosomal complement lacking the sex determining region Y gene, consistent with a diagnosis of true hermaphroditism.
TL;DR: Describing the extended, fluctuating clinical abnormalities that were associated with envenomation together with the development of hypersensitivity reactions that were presumably secondary to antivenom administration is information that can be useful for the management of patients afflicted with severe pit viper en venomation.
Abstract: This manuscript describes the extended clinical abnormalities that can occur in severe snake envenomation and the clinical signs associated with antivenom hypersensitivity in a 3 yr old dog. Treatment consisted of IV fluid therapy, analgesics, a vasopressor, cardiac antiarrhythmia drugs, and polyvalent pit viper antivenom. Following initial response to treatment, relapse of clinical signs occurred. Most interesting was the recrudescence of clinical signs on day 7 that may have been caused by the release of deposited venom during surgical debridement of necrotic skin. The resulting extensive clinical signs required multiple vials of antivenom (22 vials over a 7 day period). Both F(ab')2 antivenom and antivenin (Crotalidae) polyvalent were used in this dog because of availability logistics. It is thought that this large amount of antivenom resulted in type I (anaphylaxis) and type III hypersensitivity (serum sickness) reactions. The dog made a complete clinical recovery. This description of extended, fluctuating clinical abnormalities that were associated with envenomation together with the development of hypersensitivity reactions that were presumably secondary to antivenom administration is information that can be useful for the management of patients afflicted with severe pit viper envenomation.
TL;DR: Larger-scale prospective studies evaluating different chemotherapy protocols are required to elucidate the discrepancy between lack of survival benefit with administration of chemotherapy and improvement in survival time with positive response to chemotherapy.
Abstract: This was a multi-institutional retrospective study evaluating the outcome and clinical parameters associated with the postoperative prognosis of 36 cats with splenic mast cell tumors treated with splenectomy. Clinical parameters reviewed included signalment, clinical history, results of staging tests, surgical variables, administration of blood products, presence of metastasis, postoperative complications, administration of chemotherapy postoperatively, chemotherapy protocol, and response to chemotherapy. Overall median survival time was 390 days (range, 2-1737 days). Administration of a blood product (P < .0001), metastasis to a regional lymph node (P = .022), and evidence of either concurrent or historical neoplasia (P = .037) were negatively associated with survival. Response to chemotherapy (P = .0008) was associated with an improved median survival time. Larger-scale prospective studies evaluating different chemotherapy protocols are required to elucidate the discrepancy between lack of survival benefit with administration of chemotherapy and improvement in survival time with positive response to chemotherapy.
TL;DR: The case of a 10 mo old, male dog of mixed breed that developed progressive neurological signs including ataxia, postural deficit, and visual deficits and finally died at the age of 21 mo is presented.
Abstract: GM2 gangliosidosis variant 0 (Sandhoff disease, SD) is a fatal, progressive, neurodegenerative lysosomal storage disease caused by simultaneous deficiencies of acid β-hexosaminidases A and B. Canine SD has so far been identified only in two purebreeds. In this article, we present the case of a 10 mo old, male dog of mixed breed that developed progressive neurological signs including ataxia, postural deficit, and visual deficits and finally died at the age of 21 mo. The dog was diagnosed with SD on the basis of the results of biochemical and histopathological analyses. This is the third report of canine SD and the first time it has been identified in a mixed breed.
TL;DR: DOP is an acceptably accurate and highly specific means of detecting hypotension in small dogs under general anesthesia and has met all of the performance criteria for noninvasive blood pressure monitors recommended by the American College of Veterinary Internal Medicine.
Abstract: The objectives of this study were to determine if Doppler (DOP) blood pressure measurements more closely estimate either invasive systolic or invasive mean arterial blood pressures (ISAP or IMAP, respectively) in small dogs under general anesthesia and to assess the ability of DOP to detect anesthesia-related hypotension in small dogs. Blood pressure measurements (n = 203) were obtained from 10 client-owned dogs. DOP, ISAP, and IMAP were recorded simultaneously, and the data were categorized into two groups: hypotensive (ISAP <90 mm Hg) and normotensive (ISAP ≥90 mm Hg and ≤160 mm Hg). DOP overestimated ISAP and IMAP in both the normotensive and hypotensive groups. The DOP was highly specific (97%) but poorly sensitive (56%) for detecting hypotension. The smallest bias was achieved when using DOP as an estimate of systolic arterial blood pressure in both normotensive and hypotensive dogs, suggesting that DOP measures systolic arterial blood pressure in dogs <5 kg. For dogs with hypotension, DOP met all of the performance criteria for noninvasive blood pressure monitors recommended by the American College of Veterinary Internal Medicine. DOP is an acceptably accurate and highly specific means of detecting hypotension in small dogs under general anesthesia.
TL;DR: The importance of considering this entity in the case of sudden death of a patient with an indwelling catheter in order to pursue either appropriate diagnostic tests or necropsy techniques to aid in the diagnosis of venous air embolism is emphasized.
Abstract: An apparently healthy adult female Chihuahua was presented for elective ovariohysterectomy After induction of general anesthesia, but prior to the start of the surgery, air was inadvertently administered to the patient via the iv fluid line The patient convulsed, became apneic, arrested, and died despite attempted cardiopulmonary resuscitation At necropsy, the pericardial sac was incised and filled with water to entirely submerge the intact heart The right ventricular free wall was punctured, releasing several air bubbles from the right ventricle Death was attributed to venous air embolism based on the clinical history, gross findings, and paucity of underlying gross and microscopic pathology that might have predisposed the dog to an anesthetic-related death The discussion of this case includes a review of previously reported veterinary cases of fatal venous air embolism, including the varied mechanisms of embolus formation, the potential impact of pre-existing cardiopulmonary disease, and the methods used to detect emboli This report outlines the events of fatal iatrogenic venous air embolization and emphasizes the importance of considering this entity in the case of sudden death of a patient with an indwelling catheter in order to pursue either appropriate diagnostic tests or necropsy techniques to aid in the diagnosis
TL;DR: The size of the pancreatic abscess was reduced after 5 mo, and the cat achieved diabetic remission and remained healthy at the time this report was prepared.
Abstract: An 11 yr old spayed female Maine coon cat was referred with uncontrolled diabetes mellitus. The cat had a 2 mo history of weight loss and intermittent vomiting. An abdominal ultrasound identified the presence of a large cavity measuring a maximum of 4.6 cm in the pancreas that was filled with a homogeneous echogenic fluid. Cytological analysis and culture of the fluid obtained from the pancreatic mass indicated the presence of a bacterial abscess. The application of nonsurgical drainage and the administration of glargine insulin and antibiotics resolved the clinical signs. The size of the pancreatic abscess was reduced after 5 mo, and the cat achieved diabetic remission and remained healthy at the time this report was prepared. This case report describes the successful treatment of a pancreatic bacterial abscess concurrent with diabetes mellitus in a Maine coon cat.
TL;DR: This is the first known report of neuromuscular signs recognized and rapidly corrected in a dog, and hypophosphatemia should be recognized as a differential diagnosis in patients with tremors and/or muscle weakness.
Abstract: The purpose of this report was to describe the successful recognition and management of neuromuscular dysfunction secondary to severe, acute hypophosphatemia in an adult dog with a 2 day history of vomiting, anorexia, and abdominal pain. Radiographs were suggestive of a foreign body obstruction, and surgery was recommended. Resection and anastomosis of the distal duodenum and proximal jejunum was performed. The dog recovered uneventfully, but approximately 36 hr postoperatively, he was found to have significant weakness and muscle tremors that were accompanied by hyperthermia. The only significant abnormality on a serum biochemical profile was a phosphorous level of 0.26mmol/L. Within 6 hr of initiating phosphorous supplementation, the patient fully recovered and had no residual signs of neuromuscular dysfunction. Signs of neurologic dysfunction secondary to hypophosphatemia are commonly recognized in human patients. Reports of patients with severe muscle weakness, some of which necessitate ventilation du...
TL;DR: An 8 wk old male Yorkshire terrier was presented with a 2 wk history of recurrent hypoglycemia, lethargy, and seizures and was diagnosed with methylmalonic aciduria due to cobalamin malabsorption.
Abstract: An 8 wk old male Yorkshire terrier was presented with a 2 wk history of recurrent hypoglycemia, lethargy, and seizures. Investigations revealed a marked increase in blood ammonia, low serum cobalamin, and increased levels of urinary methylmalonic acid (MMA) excretion. No liver vascular abnormality was detected. The patient was diagnosed with methylmalonic aciduria due to cobalamin malabsorption. The patient responded well to parenteral cobalamin administration, and the urinary MMA levels normalized rapidly following instigation of treatment. Due to the suspected hereditary nature of selective cobalamin deficiency, one sibling of this dog was screened and found to be normal. This is the first reported case of MMA secondary to hypocobalaminemia in Yorkshire terriers, and the second report of this disease in a dog in the United Kingdom. Given the fact that clinical signs of MMA are similar to those seen in dogs with portosystemic shunts and that Yorkshire terriers are predisposed to liver vascular abnormalities, this case report adds important clinical information to the current available literature.
TL;DR: This report documents successful treatment of pyloric/duodenal pythiosis and the long-term consequences associated with the Billroth II, partial pancreatectomy, and biliary rerouting in the dog.
Abstract: A 5 yr old, male, neutered mixed-breed dog was referred for persistent vomiting 2 wk following a pyloric biopsy for a pyloric outflow obstruction. Histopathology at the time of initial surgery was suggestive of pythiosis. Following referral, the dog underwent radical surgical treatment with a Billroth II procedure, partial pancreatectomy, and cholecystoduodenostomy. Histopathology and serology confirmed the diagnosis of pythiosis and medical treatment consisting of itraconazole and terbinafine was started postoperatively. Serology titers were checked again at 8, 12, and 24 wk postoperatively revealing a positive response to treatment and no reoccurrence of pythiosis. Since surgery, the patient experienced waxing and waning elevations of liver values and laparoscopic liver biopsies 10 mo postoperatively revealed hepatic cirrhosis with fibrosis, bile duct hyperplasia, and chronic inflammation. This report documents successful treatment of pyloric/duodenal pythiosis and the long-term (17 mo) consequences associated with the Billroth II, partial pancreatectomy, and biliary rerouting in the dog.