1
|
Wells GM, Young K, Haskell MJ, Carter AJ, Clements DN. Mobility, functionality and functional mobility: A review and application for canine veterinary patients. Vet J 2024; 305:106123. [PMID: 38642699 DOI: 10.1016/j.tvjl.2024.106123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/22/2024]
Abstract
Mobility is an essential aspect of a dog's daily life. It is defined as the ability to move freely and easily and deviations from an animals' normal mobility capabilities are often an indicator of disease, injury or pain. When a dog's mobility is compromised, often functionality (ability to perform activities of daily living [ADL]), is also impeded, which can diminish an animal's quality of life. Given this, it is necessary to understand the extent to which conditions impact a dog's physiological ability to move around their environment to carry out ADL, a concept termed functional mobility. In contrast to human medicine, validated measures of canine functional mobility are currently limited. The aim of this review is to summarise the extent to which canine mobility and functionality are associated with various diseases and how mobility and functional mobility are currently assessed within veterinary medicine. Future work should focus on developing a standardised method of assessing functional mobility in dogs, which can contextualise how a wide range of conditions impact a dog's daily life. However, for a true functional mobility assessment to be developed, a greater understanding of what activities dogs do on a daily basis and movements underpinning these activities must first be established.
Collapse
Affiliation(s)
- Georgia M Wells
- SRUC (Scotland's Rural College), Barony Campus, Parkgate, Dumfries DG1 3NE, UK; The Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UK.
| | - Kirsty Young
- SRUC (Scotland's Rural College), Barony Campus, Parkgate, Dumfries DG1 3NE, UK
| | - Marie J Haskell
- SRUC (Scotland's Rural College), West Mains Road, Edinburgh EH9 3JG, UK
| | - Anne J Carter
- SRUC (Scotland's Rural College), Barony Campus, Parkgate, Dumfries DG1 3NE, UK
| | - Dylan N Clements
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, The University of Edinburgh, Easter Bush Campus, Midlothian EH25 9RG, UK
| |
Collapse
|
2
|
Jaffey JA, Chamberlin T, Hu J. Acute manganese toxicosis related to joint health supplement ingestion in two dogs. Top Companion Anim Med 2024; 61:100877. [PMID: 38788832 DOI: 10.1016/j.tcam.2024.100877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 04/11/2024] [Accepted: 05/20/2024] [Indexed: 05/26/2024]
Abstract
Two unrelated dogs residing in the same house including an 11-year-old, female spayed, mixed breed dog and a 7-year-old, female spayed, mixed breed dog ingested approximately 75 capsules of a human joint health supplement (Ligaplex I; Standard Process, WI, USA). A total of 2,062 mg of manganese was ingested between both dogs. Dog 1 developed acute fulminant liver failure and a severe coagulopathy that led to hepatic fractures and exsanguination from hemoabdomen. The estimated maximum time from ingestion of the joint health supplement to death was 36 to 48 h. Histologic examination revealed severe periportal hepatic necrosis with mild evidence of preexisiting liver disease and renal tubular epithelial necrosis. Manganese concentrations in liver and kidney tissue were severely increased. Dog 2 developed a severe acute liver injury and was hospitalized for 6 days. Therapies provided during hospitalization included intravenous fluids, maropitant, pantoprazole, N-acetylcysteine, vitamin C, S-adenosylmethionine, and silybin. The dog was treated long-term with S-adenosylmethionine, silybin, ursodiol, and vitamin C. Clinical and biochemical resolution occurred on the recheck examination that took place on day 44. The veterinary literature is comprised of only 2 reports containing 3 dogs that describe acute manganese intoxication. Here, we provide a detailed description of 2 dogs that developed manganese-induced toxicosis after ingestion of a human joint health supplement.
Collapse
Affiliation(s)
- Jared A Jaffey
- Department of Specialty Medicine, Midwestern University College of Veterinary Medicine, 19555 N 59th Ave, Glendale, AZ, USA.
| | - Tamara Chamberlin
- Department of Pathology and Population Medicine, Midwestern University College of Veterinary Medicine, 19555 N 59th Ave, Glendale, AZ, USA
| | - Jennifer Hu
- Department of Pathology and Population Medicine, Midwestern University College of Veterinary Medicine, 19555 N 59th Ave, Glendale, AZ, USA
| |
Collapse
|
3
|
Miceli DD, Guevara JM, Ferraris S, Pignataro OP, Gallelli MF. Therapy for feline secondary hypertriglyceridemia with fenofibrate. J Feline Med Surg 2022; 24:e251-e257. [PMID: 35713593 PMCID: PMC10812274 DOI: 10.1177/1098612x221104066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to assess the short-term safety and efficacy of fenofibrate in controlling secondary hypertriglyceridemia in cats. METHODS This was a prospective cohort study. Seventeen adult cats with hypertriglyceridemia (serum triglycerides [TG] >160 mg/dl) were enrolled. Cats received a median dose of 5 mg/kg (range 3.2-6) fenofibrate (q24h PO) for 1 month. Serum TG, total cholesterol (TC), creatine kinase and liver enzymes (alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase) were evaluated before (t0) and after 1 month (t1) of fenofibrate treatment. RESULTS The causes of secondary hypertriglyceridemia were diabetes mellitus (DM; 29.4%), obesity (29.4%), hyperadrenocorticism (HAC) and DM (11.7%), HAC without DM (5.9%), hypersomatotropism (HST) and DM (5.9%), hypothyroidism (5.9%), long-term treatment with glucocorticoids (5.9%) and chylothorax (5.9%). Serum TG (t0 median 920 mg/dl [range 237-1780]; t1 median 51 mg/dl [range 21-1001]; P = 0.0002) and TC (t0 median 278 mg/dl [range 103-502]; t1 median 156 mg/dl [range 66-244]; P = 0.0001) concentrations showed a significant decrease after 1 month of fenofibrate treatment. Fifteen cats normalized their TG concentration at t1 (88.2%). Of the eight cats that were hypercholesterolemic at t0, six (75%) normalized their TC concentrations at t1. One of 17 cats (5.9 %) presented with diarrhea; the remaining 16 did not show any adverse effects. CONCLUSIONS AND RELEVANCE DM and obesity are the most common endocrine causes of secondary hyperlipidemia, although it can also be found in cats with HAC, HST or hypothyroidism. This study suggests that fenofibrate treatment was associated with reduction and normalization of TG and TC concentrations in cats with moderate and severe hypertriglyceridemia, regardless of the cause of secondary hypertriglyceridemia. Further work should focus on controlled studies with a greater number of cases.
Collapse
Affiliation(s)
- Diego D Miceli
- Hospital School of Veterinary Medicine, University of Buenos Aires, Faculty of Veterinary Sciences, Buenos Aires, Argentina
- Veterinary Science Center, Maimonides University, Buenos Aires, Argentina
| | | | - Sergio Ferraris
- Veterinary Science Center, Maimonides University, Buenos Aires, Argentina
| | - Omar P Pignataro
- Laboratory of Molecular Endocrinology and Signal Transduction, Institute of Experimental Biology and Medicine – CONICET, Buenos Aires, Argentina
| | - María F Gallelli
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| |
Collapse
|
4
|
Giralico LC, Makii R, Pray BA, Parker VJ. Myxedema Coma and Acute Hepatopathy in a Dog with Severe Atherosclerosis. Case Rep Vet Med 2021; 2021:6622767. [PMID: 34745683 PMCID: PMC8570892 DOI: 10.1155/2021/6622767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 10/13/2021] [Indexed: 11/17/2022] Open
Abstract
A 9-year-old male intact mixed-breed dog was presented to The Ohio State University Veterinary Medical Center for evaluation of two days' duration of weakness, lethargy, inappetence, and one episode of vomiting the day of presentation. On presentation, the dog was depressed and tetraparetic. He was noted to be icteric and dehydrated. Obesity and truncal alopecia with a "rat tail" appearance were observed. Diagnostic testing revealed evidence of an acute hepatopathy and peritonitis. Given the dog's neurologic status, physical examination abnormalities, including a "tragic facial expression", and hyperlipidemia, there was concern for possible myxedema coma. A thyroid panel was consistent with hypothyroidism. The dog experienced respiratory arrest prior to initiation of therapy, and an autopsy confirmed the presence of subacute necrotizing cholangiohepatitis, marked atherosclerosis, and severe thyroid atrophy. These clinical and pathologic changes were supportive of myxedema coma.
Collapse
Affiliation(s)
- Leah C. Giralico
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, USA
| | - Rebecca Makii
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, USA
| | - Betsy A. Pray
- Department of Veterinary Biosciences, The Ohio State University College of Veterinary Medicine, USA
| | - Valerie J. Parker
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, USA
| |
Collapse
|
5
|
Runft S, Mischke R, Hoppe S, Hewicker-Trautwein M. [Acute liver failure in a dog after mushroom intake, presumably of the genus Amanita]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2021; 49:382-389. [PMID: 34670314 DOI: 10.1055/a-1584-6098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
A 4-year-old, neutered male Husky-mix dog weighing 29.4 kg that reportedly ingested a mushroom most likely of the genus Amanita one day prior to presentation exhibited signs of diarrhea, vomitus, inappetence and progressively worsening lethargy. Clinical chemistry revealed hypoglycemia, hyperbilirubinemia, decreased prothrombin and thromboplastin time, as well as increased liver enzyme activities. Despite hospitalization and supportive therapy over a period of 3 days the dog's general condition worsened leading to euthanasia. The pathomorphological findings were characterized by hemorrhage in several organs, hemorrhagic ingesta, icterus, and marked hepatic cellular necrosis.
Collapse
Affiliation(s)
- Sandra Runft
- Institut für Pathologie, Stiftung Tierärztliche Hochschule Hannover
| | - Reinhard Mischke
- Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover
| | - Sonja Hoppe
- Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover
| | | |
Collapse
|
6
|
Nilsson CH, Svensson MBT, Säve SJM, Van Meervenne SAE. Transient hyperammonaemia following epileptic seizures in cats. J Feline Med Surg 2021; 23:534-539. [PMID: 33034248 PMCID: PMC10741304 DOI: 10.1177/1098612x20962747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to determine whether transient postictal hyperammonaemia exists in cats. METHODS The medical records of all feline patients that presented at a Swedish veterinary hospital between 2008 and 2018 were retrospectively reviewed to find those that had a recent or ongoing epileptic seizure. To qualify for inclusion, the medical record had to include information on at least one ammonia value taken in close proximity to, or during, an active seizure, the cat must have exceeded the normal upper limit of blood ammonia concentration on initial testing (reference interval 0-95 μmol/l), and there needed to be a follow-up ammonia value available within a maximum of 3 days. RESULTS Five cats were included in the study, and they had blood ammonia concentrations on initial testing ranging from 146 to 195 µmol/l. They were all retested within a period of 2 h to 3 days of the original reading. All five cats had a spontaneous decrease in ammonia levels without any specific treatment for hyperammonaemia. CONCLUSIONS AND RELEVANCE Pursuant to the findings of this retrospective study, transient hyperammonaemia may be noted after epileptic seizure in cats. Consequently, a differential diagnostic list in feline patients with hyperammonaemia could, depending on the context, include non-hepatic-related pathologies, such as epileptic seizures.
Collapse
|
7
|
Quintavalla F, Gelsi E, Battaglia L, Aldigeri R, Ramoni R. Mefepronic acid is associated with a decrease in serum liver enzyme activities in dogs with suspected hepatopathy. Vet Med Sci 2021; 7:1542-1550. [PMID: 33955681 PMCID: PMC8464281 DOI: 10.1002/vms3.521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/13/2021] [Accepted: 04/22/2021] [Indexed: 11/17/2022] Open
Abstract
Although suspected hepatopathy in dogs can be assessed by the blood levels of both liver enzyme activities and functional liver parameters, very often the precise diagnosis of primary or secondary hepatobiliary diseases can remain uncertain. Therefore, in a number of patients, the therapeutic intervention has the purpose of slowing the progression of fibrosis and provide for optimal hepatic support. Recently the PPARs (peroxisome proliferator‐activated receptors) have been identified as a family of hepatic nuclear hormonal receptors, involved in the regulation of lipid and glucose metabolism. The aim of this work is to assess the effect of mefepronic acid (PMPA), a PPAR agonist, on liver enzyme markers in blood samples of dogs with suspected hepatopathies. Twenty dogs, with suspected hepatopathies, were divided into two groups: ten of them received subcutaneously daily 10 mg/kg of PMPA for 7 days (treated, group T), while the remaining dogs were treated with a conventional supportive treatment for hepatopathies consisting of ursodeoxycholic acid (UDCA) 10 mg/kg PO SID for 45 days (control, group C). PMPA yielded a faster decrease in liver enzyme activities compared to UDCA, that in most cases was maintained after the suspension of the treatment. These data suggest that PMPA might be considered as supportive treatment for dogs with suspected hepatopathy.
Collapse
Affiliation(s)
| | | | - Luca Battaglia
- Veterinary Practitioner, Miller Veterinary Clinic, Cavriago - Reggio Emilia, Italy
| | | | - Roberto Ramoni
- Department of Veterinary Science, University of Parma, Italy
| |
Collapse
|
8
|
Kirk NM, Vieson MD, Selting KA, Reinhart JM. Cytotoxicity of Cultured Canine Primary Hepatocytes Exposed to Itraconazole Is Decreased by Pre-treatment With Glutathione. Front Vet Sci 2021; 8:621732. [PMID: 33681327 PMCID: PMC7930617 DOI: 10.3389/fvets.2021.621732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/25/2021] [Indexed: 11/22/2022] Open
Abstract
Objective: To identify the effect of glutathione (GSH) on cell survival in a novel in vitro model of itraconazole (ITZ)-associated hepatotoxicity using canine primary hepatocytes. Sample: Commercially sourced, cryopreserved male dog (Beagle) primary hepatocytes from a single donor. Procedures: Using a sandwich culture technique, canine primary hepatocytes were exposed to serial dilutions of ITZ. Calcein AM, 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT), and neutral red were investigated as potential cell viability assays. Hepatocytes were then pre-incubated with GSH, exposed to serial dilutions of ITZ, and cell viability determined at 4 and 24 h post-ITZ exposure. Each condition was performed in technical triplicate and the effect of time, GSH concentration, and ITZ concentration on % cytotoxicity assessed using a multivariate linear regression model. Tukey's post-hoc test was used to detect individual differences. Results: The neutral red cell cytotoxicity assay was chosen based on its superior ability to detect dose-dependent changes in viability. Hepatocyte cytotoxicity significantly increased with ITZ concentration (P < 0.001) and time (P = 0.004) and significantly decreased with GSH treatment (P < 0.001). Conclusions and Clinical Relevance: This in vitro model demonstrates dose- and time-dependent ITZ-induced cytotoxicity, which is similar to clinical changes observed in canine patients and in in vivo rodent studies. Pre-treating with GSH is protective against in vitro cell death. These results suggest that GSH precursors may have a role in the management or prevention of ITZ-associated hepatotoxicity in dogs. Clinical trials are needed to evaluate their utility for this adverse drug reaction.
Collapse
Affiliation(s)
- Natalie M Kirk
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, United States.,Department of Pathobiology, College of Veterinary Medicine, University of Illinois, Urbana, IL, United States
| | - Miranda D Vieson
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, United States
| | - Kim A Selting
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, United States
| | - Jennifer M Reinhart
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, United States
| |
Collapse
|
9
|
Martínez-Martínez L, Valdivia-Flores AG, Guerrero-Barrera AL, Quezada-Tristán T, Rangel-Muñoz EJ, Ortiz-Martínez R. Toxic Effect of Aflatoxins in Dogs Fed Contaminated Commercial Dry Feed: A Review. Toxins (Basel) 2021; 13:65. [PMID: 33467754 PMCID: PMC7830565 DOI: 10.3390/toxins13010065] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/08/2021] [Accepted: 01/12/2021] [Indexed: 01/20/2023] Open
Abstract
Since its first patent (1897), commercial dry feed (CDF) for dogs has diversified its formulation to meet the nutritional needs of different breeds, age, or special conditions and establish a foundation for integration of these pets into urban lifestyles. The risk of aflatoxicosis in dogs has increased because the ingredients used to formulate CDF have also proliferated, making it difficult to ensure the quality required of each to achieve the safety of the entire CDF. This review contains a description of the fungi and aflatoxins detected in CDF and the ingredients commonly used for their formulation. The mechanisms of action and pathogenic effects of aflatoxins are outlined; as well as the clinical findings, and macroscopic and microscopic lesions found in aflatoxicosis in dogs. In addition, alternatives for diagnosis, treatment, and control of aflatoxins (AF) in CDF are analyzed, such as biomarkers of effect, improvement of blood coagulation, rate of elimination of AF, control of secondary infection, protection of gastric mucosa, reduction of oxidative stress, use of chemo-protectors, sequestrants, grain-free CDF, biocontrol, and maximum permitted limits, are also included.
Collapse
Affiliation(s)
- Lizbeth Martínez-Martínez
- Centro de Ciencias Agropecuarias, Universidad Autonoma de Aguascalientes, Aguascalientes 20131, Mexico; (L.M.-M.); (T.Q.-T.); (E.J.R.-M.); (R.O.-M.)
| | - Arturo G. Valdivia-Flores
- Centro de Ciencias Agropecuarias, Universidad Autonoma de Aguascalientes, Aguascalientes 20131, Mexico; (L.M.-M.); (T.Q.-T.); (E.J.R.-M.); (R.O.-M.)
| | | | - Teódulo Quezada-Tristán
- Centro de Ciencias Agropecuarias, Universidad Autonoma de Aguascalientes, Aguascalientes 20131, Mexico; (L.M.-M.); (T.Q.-T.); (E.J.R.-M.); (R.O.-M.)
| | - Erika Janet Rangel-Muñoz
- Centro de Ciencias Agropecuarias, Universidad Autonoma de Aguascalientes, Aguascalientes 20131, Mexico; (L.M.-M.); (T.Q.-T.); (E.J.R.-M.); (R.O.-M.)
| | - Raúl Ortiz-Martínez
- Centro de Ciencias Agropecuarias, Universidad Autonoma de Aguascalientes, Aguascalientes 20131, Mexico; (L.M.-M.); (T.Q.-T.); (E.J.R.-M.); (R.O.-M.)
| |
Collapse
|
10
|
Cartwright JA, Pérez-Accino J, Timothy C, Simpson KW, Salavati Schmitz S. Acute Ulcerative Enterocolitis With Severe Protein Loss Due to Mucosal Invasion With Enterococcus spp. in a Dog With Exocrine Pancreatic Insufficiency: A Case Report. Front Vet Sci 2020; 7:577642. [PMID: 33195581 PMCID: PMC7644445 DOI: 10.3389/fvets.2020.577642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/27/2020] [Indexed: 11/18/2022] Open
Abstract
We describe an unusual case of severe acute protein-losing enteropathy in a dog, which presented with a systemic inflammatory response syndrome. This dog's condition could not be categorized as any well-known canine intestinal condition. Instead, components of several enteropathies like acute hemorrhagic diarrhea syndrome (AHDS), chronic inflammatory enteropathy (CIE), and ulcerative and granulomatous colitis were present. Thorough investigations identified concurrent exocrine pancreatic insufficiency (EPI) and hypocobalaminemia. On histopathology, marked diffuse chronic-active ileitis and ulcerative colitis with fibroplasia and neovascularization were present. Intestinal biopsy cultures identified E.coli and multiresistant Enterococcus spp. The latter was identified as mucosally invasive using fluorescent in situ hybridization (FISH). Protracted clinical signs following the acute presentation required intensive care including enteral and parenteral feeding for a successful outcome, but eventually stabilized with antibiotics and immunosuppressive doses of glucocorticoids. This case highlights a potentially previously unrecognized condition, suspected to be a form of CIE manifesting acutely after bacterial mucosal invasion. In this case, this might have been facilitated by EPI-induced dysbiosis. The use of FISH and mucosal culture in this context provided important clinical information and should be considered more frequently in CIE and non-responsive AHDS.
Collapse
Affiliation(s)
- Jennifer A Cartwright
- Centre for Inflammation Research, Queen's Medical Research Institute, University of Edinburgh, Edinburgh BioQuarter, Edinburgh, United Kingdom.,Royal (Dick) School of Veterinary Studies and The Roslin Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Easter Bush, Midlothian, United Kingdom
| | - Jorge Pérez-Accino
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Easter Bush, Midlothian, United Kingdom
| | - Clare Timothy
- Department of Clinical Sciences, Tufts University School of Veterinary Medicine, North Grafton, MA, United States
| | - Kenneth W Simpson
- Simpson Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Silke Salavati Schmitz
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Easter Bush, Midlothian, United Kingdom
| |
Collapse
|
11
|
Cook S, Greensmith T. Supporting the intoxicated patient: toxicants affecting the gastrointestinal and hepatobiliary systems. IN PRACTICE 2020. [DOI: 10.1136/inp.m3152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
12
|
Lake BB, Edwards T, Atiee G, Stone R, Scott L. The characterization of cycad palm toxicosis and treatment effects in 130 dogs. Aust Vet J 2020; 98:555-562. [PMID: 32839978 DOI: 10.1111/avj.13007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/12/2020] [Accepted: 07/24/2020] [Indexed: 12/19/2022]
Abstract
The purpose of this retrospective study is to characterize the clinical signs, laboratory values, treatment modalities and mortality outcomes related to cycad palm toxicosis in dogs and to identify medical interventions that potentially correlate with mortality. Dogs with confirmed cycad palm ingestion were identified by reviewing medical records from two private veterinary referral centres for key terms and phrases indicative of cycad palm toxicosis. Of 130 dogs included, 107 (82.3%) presented with clinical signs. A total of 2 (1.5%) died and 14 (10.8%) were euthanized. Diarrhea, lethargy and mortality were all associated with an elevated initial alanine transaminase (ALT) concentration. Overall mortality was 12.3%, with a significantly higher proportion of dogs with an ALT concentration <125 U/L surviving compared to dogs with an elevated ALT concentration. Treatment with activated charcoal reduced the odds of death among all dogs by 82% and was even more protective among dogs with an elevated initial ALT concentration. Among dogs that had an initial platelet count performed, the presence of thrombocytopenia (<200,000/μL) was a negative prognostic indicator and was associated with a significant increase in mortality. Given the high mortality rates reported for cycad palm toxicosis, it is imperative to identify early clinical indicators of mortality as well as treatments that reduce mortality.
Collapse
Affiliation(s)
- B B Lake
- Emergency Service, Blue Pearl Pet Hospital, San Antonio, Texas, 78258, USA
| | - T Edwards
- Regional Vice President of Medicine, US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, 78234, USA
| | - G Atiee
- Emergency Service, Blue Pearl Pet Hospital, San Antonio, Texas, 78258, USA
| | - R Stone
- Blue Pearl Specialty + Emergency Pet Hospital, Spring, Texas, 77388, USA
| | - L Scott
- Regional Vice President of Medicine, US Army Institute of Surgical Research, JBSA Fort Sam Houston, San Antonio, Texas, 78234, USA
| |
Collapse
|
13
|
Lane WG, Sinnott-Stutzman VB. Retrospective evaluation of fresh frozen plasma use in 121 cats: 2009-2016. J Vet Emerg Crit Care (San Antonio) 2020; 30:558-566. [PMID: 32643232 DOI: 10.1111/vec.12972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/19/2018] [Accepted: 10/31/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To document indications for fresh frozen plasma (FFP) use in cats, doses administered, and frequency of adverse transfusion reactions (ATR). DESIGN Retrospective observational study from January 2009 to November 2016. SETTING Large urban referral and emergency facility. ANIMALS One hundred twenty-one client-owned cats that received FFP. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Signalment, indication(s), dose, pre- and posttransfusion total plasma protein, prothrombin time, activated partial thromboplastin time, as well as possible ATR, primary disease process, and outcome were recorded. Doppler blood pressure was increased posttransfusion (mean pre 99.5 ± 30.8 mm Hg; post 108.5 ± 32.5 mm Hg, P = .027). Cats were significantly less likely to be coagulopathic posttransfusion (P < 0.001). Most common indications were suspected coagulopathy (n = 105, 83%), hemorrhage (n = 45, 35%), and hypotension (n = 32, 25%). Median dose was 6 mL/kg (interquartile range = 3 mL/kg) and was negatively correlated with body weight (r = -.598, P < 0.001). Possible ATR occurred in 17 of 108 (16%, 95% confidence interval [CI], 10-24%) of transfusions. Increased body temperature was most common in 11 of 108 (10%, 95% CI, 5-18%), followed by tachypnea/dyspnea in 8 of 108 (7%, 95% CI, 3-13%). Common primary disease processes included liver disease (n = 41, 34%), neoplasia (n = 19, 16%), and sepsis (n = 15, 12%). Overall mortality was 54%. Improvement of clotting times was associated with increased odds of survival (odds ratio = 2.4; 95% CI, 1.1-5.3; P = 0.023). CONCLUSIONS Clinician justifications for FFP transfusions are comparable to that reported in dogs; however, the mL/kg dose is lower. Coagulopathy and blood pressure significantly improve posttransfusion. Possible ATR were as frequent as that reported with feline packed RBCs transfusions and classified as mild.
Collapse
Affiliation(s)
- William G Lane
- Department of Emergency and Critical Care, Angell Animal Medical Center, Boston, Massachusetts
| | | |
Collapse
|
14
|
Amorim C. Acute, fulminant hepatic and renal failure and subsequent death following
Amanita phalloides
ingestion in a 4‐month‐old puppy. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-000997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Catarina Amorim
- Beaumont Sainsburys Animal HospitalRoyal Veterinary CollegeLondonLondonUK
| |
Collapse
|
15
|
Evidences on Molecules Most Frequently Included in Canine and Feline Complementary Feed to Support Liver Function. Vet Med Int 2020; 2020:9185759. [PMID: 32454964 PMCID: PMC7232710 DOI: 10.1155/2020/9185759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 04/21/2020] [Indexed: 11/18/2022] Open
Abstract
Numerous complementary feeds to support liver function are commercially available for small animals. Aiming to furnish a scientific support for clinicians/nutritionists that necessitate a complementary feed to support liver function in dogs and cats, with the present paper, we analyzed scientific evidences supporting the use, for this purpose, of ingredients/additives such as artichoke (Cynara scolymus), curcumin, dandelion (Taraxacum officinale), milk thistle (Silybum marianum), phosphatidylcholine, and S-adenosylmethionine. Although sustained by significant results, our review found only few scientific papers, and albeit we believe that they represent a significant aid in handling hepatopathies, in the authors' opinion, this topic probably deserves, and would benefit of, further studies.
Collapse
|
16
|
Ning Q. Main Complications of AECHB and Severe Hepatitis B (Liver Failure). ACUTE EXACERBATION OF CHRONIC HEPATITIS B 2019. [PMCID: PMC7498917 DOI: 10.1007/978-94-024-1603-9_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Qin Ning
- Department of Infectious Disease, Tongji Hospital, Wuhan, China
| |
Collapse
|
17
|
Griebsch C, Whitney J, Angles J, Bennett P. Acute liver failure in two dogs following ingestion of cheese tree (Glochidion ferdinandi) roots. J Vet Emerg Crit Care (San Antonio) 2018; 29:190-200. [PMID: 30507024 DOI: 10.1111/vec.12790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 10/15/2017] [Accepted: 11/07/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To describe the management and resolution of acute liver failure (ALF) in two dogs following ingestion of cheese tree (Glochidion ferdinandi) roots. CASE SUMMARIES A 2-year-old male entire Bullmastiff and a 5-year-old female neutered German Shepherd dog were presented for acute-onset lethargy and vomiting after chewing on tree roots of a cheese tree. Both dogs developed clinical abnormalities consistent with ALF, including hepatic encephalopathy, marked increase in alanine aminotransferase activity and bilirubin concentration, and prolonged coagulation times. Treatment included administration of intravenous fluids, hepatoprotectants, vitamin K1 , antibiotics, lactulose, antacids, antiemetics, and multiple fresh frozen plasma transfusions. Follow-up examinations performed 30 days after initial presentation revealed the dogs to be clinically healthy with serum biochemical and coagulation profiles within reference intervals. NEW OR UNIQUE INFORMATION This is the first report describing ALF in two dogs following ingestion of cheese tree (G. ferdinandi) roots. In this clinical setting, despite a poor prognosis, survival and recovery of adequate liver function were possible with medical management.
Collapse
Affiliation(s)
| | - Joanna Whitney
- University Veterinary Teaching Hospital, Sydney, Australia
| | - John Angles
- Animal Referral Hospital, Homebush, Australia
| | - Peter Bennett
- University Veterinary Teaching Hospital, Sydney, Australia
| |
Collapse
|
18
|
Morgan RK, Cortes Y, Murphy L. Pathophysiology and aetiology of hypoglycaemic crises. J Small Anim Pract 2018; 59:659-669. [PMID: 30102417 PMCID: PMC7166581 DOI: 10.1111/jsap.12911] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/24/2018] [Accepted: 06/15/2018] [Indexed: 01/09/2023]
Abstract
Hypoglycaemia is a common, life-threatening complication that occurs as a component of a wide variety of disease processes. Despite its frequent occurrence, information concerning the aetiology, characteristics and outcomes of hypoglycaemic crises in veterinary medicine is limited. This review summarises the current understanding of the pathophysiology of hypoglycaemia, the body's counter-regulatory response, underlying aetiologies, diagnosis and treatment. Disease mechanisms are discussed and published evidence in veterinary literature regarding prognostic indicators, prevalence, diagnosis and treatment is examined for hypoglycaemia-related disease processes including insulinoma, glucose-lowering toxins and medications.
Collapse
Affiliation(s)
- R K Morgan
- Metropolitan Veterinary Associates, Norristown, Pennsylvania, USA
| | - Y Cortes
- Emergency Department, Oradell Animal Hospital, Paramus, New Jersey, USA
| | - L Murphy
- Veterinary Specialty Center of Delaware, New Castle, Delaware, USA
| |
Collapse
|
19
|
Sharkey LC, Little KJ, Williams KD, Todd JM, Richardson R, Gwynn AD, Rendahl A. Performance characteristics of the turbidimetric ACL-TOP CTS 300 coagulation analyzer in dogs and cats. J Vet Emerg Crit Care (San Antonio) 2018; 28:317-325. [PMID: 29901847 DOI: 10.1111/vec.12727] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 07/05/2016] [Accepted: 07/29/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the technical performance of the turbidimetric ACL-TOP CTS 300 coagulation analyzer (IL) in dogs and cats and to create reference intervals for standard and novel parameters. DESIGN Coagulation testing results from dogs and cats generated by the IL were prospectively compared with another mechanical clot detection system. Precision was documented and reference intervals were created for prothrombin time, activated partial thromboplastin time, and Clauss fibrinogen and D-dimer values, as well as for the quantitative clot curve parameters (high and low amplitude, delta, and first and second derivative curves). Clot curve signatures containing common artifacts due to lipemia, hemolysis, or preactivation were demonstrated. ANIMALS Residual frozen plasma from 20 dogs and 10 cats was used for method comparison; prospectively recruited healthy dogs (n = 48) and cats (n = 45) were used for reference interval and precision studies. MEASUREMENTS AND MAIN RESULTS Bland-Altman analysis showed a proportional positive bias in the IL compared with mechanical clot detection in dogs and a suggestion of a similar pattern in cats. Precision was good and met manufacturer's recommendations for all assays. Reference intervals are reported. Clot curve artifacts were similar in animals to those reported in people. CONCLUSIONS The turbidimetric system had a slight high proportional positive bias compared with mechanical clot detection. Thus, new reference intervals were generated including for novel parameters generated by clot curve analysis. Some preanalytical errors can be identified by inspection of clot curves. This robust novel technology compares favorably with mechanical endpoint detection methods and can be used in dogs and cats.
Collapse
Affiliation(s)
- Leslie C Sharkey
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, 55108
| | - Kim J Little
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, 55108
| | - Kevin D Williams
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, 55108
| | - Jeffrey M Todd
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, 55108
| | - Rae Richardson
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, 55108
| | - Angela D Gwynn
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, 55108
| | - Aaron Rendahl
- Veterinary Clinical Sciences Department, University of Minnesota, St. Paul, MN, 55108
| |
Collapse
|
20
|
Dirksen K, Burgener IA, Rothuizen J, van den Ingh TSGAM, Penning LC, Spee B, Fieten H. Sensitivity and Specificity of Plasma ALT, ALP, and Bile Acids for Hepatitis in Labrador Retrievers. J Vet Intern Med 2017; 31:1017-1027. [PMID: 28543991 PMCID: PMC5508325 DOI: 10.1111/jvim.14716] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 02/11/2017] [Accepted: 03/16/2017] [Indexed: 12/28/2022] Open
Abstract
Background Biochemical indicators for diagnosing liver disease are plasma alanine aminotransferase activity (ALT), alkaline phosphatase activity (ALP), and bile acid concentration (BA). Objectives To determine the sensitivity and specificity of ALT, ALP, and BA for detecting primary hepatitis (PH) in clinically healthy Labrador retrievers and investigate whether ALT and ALP can discriminate between dogs with PH and nonspecific reactive hepatitis (RH). Animals 191 clinically healthy and 51 clinically ill Labrador retrievers with hepatic histopathology. Methods Retrospective study. Medical records were reviewed for ALT, ALP, preprandial BA, liver histopathology, and hepatic copper concentrations. Results In 64% (122/191) of the clinically healthy Labrador retrievers, hepatic histology revealed inflammatory infiltrates. This frequency might be biased because part of them was included as first‐line relatives of dogs with copper‐associated hepatitis. Sensitivity of ALT, ALP, and BA in this population for detecting acute hepatitis was 45, 15, and 15%, respectively. For chronic hepatitis, sensitivity was 71, 35, and 13%, respectively. Specificity of ALT, ALP, and BA was >90% for AH, CH, and RH. When increased liver enzymes were present, median ALT was significantly higher in PH cases (312 U/L, range 38–1,369) compared to RH cases (91 U/L, range 39–139) (P < .001). There was no difference in ALP between dogs with a PH and a RH (P = .361). Conclusions and Clinical Importance Histopathologic abnormalities in the liver were present in the majority of apparent clinically healthy Labrador retrievers. The sensitivity of ALT, ALP, and BA for detecting acute and chronic hepatitis in this population was low. More sensitive biomarkers are needed for early detection of liver disease in apparent clinically healthy dogs.
Collapse
Affiliation(s)
- K Dirksen
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - I A Burgener
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - J Rothuizen
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | | | - L C Penning
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - B Spee
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - H Fieten
- Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
21
|
McFarland SE, Bronstein AC, Banerji S, LeBlond J, Mischke RH, Begemann K, Desel H, Greiner M. Comparison of the Poisoning Severity Score and National Poison Data System schemes for the severity assessment of animal poisonings: a pilot study. Clin Toxicol (Phila) 2017; 55:629-635. [PMID: 28349722 DOI: 10.1080/15563650.2017.1304554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
CONTEXT To date, there are no publicly available schemes designed and evaluated specifically for severity assessment of animal poisonings. This poses challenges for the evaluation and comparison of animal poisoning exposure data. OBJECTIVE Our objective for this pilot study was to evaluate agreement between raters using the Poisoning Severity Score (PSS) and National Poison Data System (NPDS) medical outcome scheme for severity assessment of canine exposures reported to a multistate poison center (PC) and to identify issues regarding their use for severity assessment of animal poisonings. Agreement between both schemes was also assessed. METHODS The first 196 canine exposures reported to a multistate PC between 1 January and 31 August 2016 were selected and initial inquiry data from exposures was scored by four independent raters. Interrater agreement and agreement between the severity systems was calculated using weighted kappa (Κ) (Light's kappa). Reported clinical effects were also described. RESULTS Interrater agreement for both the PSS (Κ 0.31; 95% CI 0.19, 0.43) and NPDS schemes (Κ 0.34; 95% CI 0.22, 0.44) was low. Agreement between the schemes was slight (Κ 0.05; 95% CI -0.08, 0.16) for pooled results from all four raters. For the PSS, 71.7% (n = 281) of ratings were minor, 23.0% (n = 90) moderate, and 5.4% (n = 21) severe. For the NPDS, 69.6% (n = 273) of ratings were minor, 27.0% (n = 106) moderate, and 3.3% (n = 13) severe. The top three reported clinical effects included vomiting (n = 86, 29.9%) drowsiness/lethargy (n = 38, 13.2%), and diarrhea (n = 24, 8.3%). DISCUSSION AND CONCLUSIONS This study shows considerable variability between raters using either the PSS or NPDS schemes for canine exposures severity assessment. The subjective nature of the schemes, the influence of intra- and interrater variation, and predominance of minor cases on the study findings should be taken into account when interpreting this data. Further evaluation of these schemes is warranted and could help inform their future use for animal poisoning severity assessment.
Collapse
Affiliation(s)
- Sarah E McFarland
- a Department of Exposure , Federal Institute for Risk Assessment , Berlin , Germany
| | - Alvin C Bronstein
- b Hawaii State Department of Health , Emergency Medical Services & Injury Prevention System Branch , Hawaii , USA
| | | | - Jane LeBlond
- d Creighton University School of Pharmacy , Omaha , NE , USA
| | - Reinhard H Mischke
- e Small Animal Clinic , University of Veterinary Medicine Hannover Foundation , Hannover , Germany
| | - Kathrin Begemann
- a Department of Exposure , Federal Institute for Risk Assessment , Berlin , Germany
| | - Herbert Desel
- a Department of Exposure , Federal Institute for Risk Assessment , Berlin , Germany
| | - Matthias Greiner
- a Department of Exposure , Federal Institute for Risk Assessment , Berlin , Germany.,f Virtual Center for Animal Health and Food Quality , University of Veterinary Medicine, Foundation , Hannover , Germany
| |
Collapse
|
22
|
Abstract
Acute liver injury and acute liver failure are syndromes characterized by a rapid loss of functional hepatocytes in a patient with no evidence of pre-existing liver disease. A variety of inciting causes have been identified, including toxic, infectious, neoplastic, and drug-induced causes. This article reviews the pathophysiology and clinical approach to the acute liver injury/acute liver failure patient, with a particular emphasis on the diagnostic evaluation and care in the acute setting.
Collapse
Affiliation(s)
- Vincent Thawley
- Emergency and Critical Care Medicine, Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania, 3900 Delancey Street, Philadelphia, PA 19104, USA.
| |
Collapse
|
23
|
Kilpatrick S, Dreistadt M, Frowde P, Powell R, Milne E, Smith S, Morrison L, Gow AG, Handel I, Mellanby RJ. Presence of Systemic Inflammatory Response Syndrome Predicts a Poor Clinical Outcome in Dogs with a Primary Hepatitis. PLoS One 2016; 11:e0146560. [PMID: 26808672 PMCID: PMC4726575 DOI: 10.1371/journal.pone.0146560] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/18/2015] [Indexed: 12/12/2022] Open
Abstract
Primary hepatopathies are a common cause of morbidity and mortality in dogs. The underlying aetiology of most cases of canine hepatitis is unknown. Consequently, treatments are typically palliative and it is difficult to provide accurate prognostic information to owners. In human hepatology there is accumulating data which indicates that the presence of systemic inflammatory response syndrome (SIRS) is a common and debilitating event in patients with liver diseases. For example, the presence of SIRS has been linked to the development of complications such as hepatic encephalopathy (HE) and is associated with a poor clinical outcome in humans with liver diseases. In contrast, the relationship between SIRS and clinical outcome in dogs with a primary hepatitis is unknown. Seventy dogs with histologically confirmed primary hepatitis were enrolled into the study. Additional clinical and clinicopathological information including respiratory rate, heart rate, temperature, white blood cell count, sodium, potassium, sex, presence of ascites, HE score, alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin and red blood cell concentration were available in all cases. The median survival of dogs with a SIRS score of 0 or 1 (SIRS low) was 231 days compared to a median survival of 7 days for dogs with a SIRS score of 2, 3 or 4 (SIRS high) (p<0.001). A Cox proportional hazard model, which included all other co-variables, revealed that a SIRS high score was an independent predictor of a poor clinical outcome. The effect of modulating inflammation on treatment outcomes in dogs with a primary hepatitis is deserving of further study.
Collapse
Affiliation(s)
- Scott Kilpatrick
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | - Margaret Dreistadt
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | - Polly Frowde
- Davies Veterinary Specialists Limited, Manor Farm Business Park, Higham Gobion, Herts, United Kingdom
| | - Roger Powell
- PTDS, Unit 2a, Manor Farm Business Park, Higham Gobion, Herts, United Kingdom
| | - Elspeth Milne
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | - Sionagh Smith
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | - Linda Morrison
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | - Adam G. Gow
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | - Ian Handel
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
| | - Richard J. Mellanby
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian, United Kingdom
- * E-mail:
| |
Collapse
|