Epidemiology, clinical management, and outcomes of dogs involved in road traffic accidents in the United Kingdom (2009-2014)

Traumatic pericardial rupture with secondary cardiac herniation in a dog

OBJECTIVE

To describe the unique finding and treatment of a dog with cardiac herniation due to traumatic pericardial rupture.

CASE SUMMARY

A 6.5-year-old entire male Yorkshire Terrier was presented for further management after being hit by a car. Despite suspected significant intrathoracic trauma at that time, the patient regained hemodynamic stability and had orthopedic surgery to correct a right iliac fracture. The patient was readmitted to the hospital 12 days following the initial visit due to considerable respiratory difficulty after accidentally being dropped several feet. Thoracic radiographs revealed an unusual severe mediastinal shift to the left with an atypical position of the cardiac silhouette against the left lateral thoracic wall. Due to the severe respiratory compromise of the patient and newly developed pneumothorax, an exploratory thoracotomy was recommended, where a complete rupture of the pericardium was identified, with secondary left-sided prolapse of the heart. Other more common intrathoracic injuries (ie, lung perforation, rib fractures) were also identified and partially repaired. The patient recovered successfully and was discharged 4 days postoperatively.

NEW OR UNIQUE INFORMATION PROVIDED

This is the first case report in the veterinary literature of traumatic pericardial rupture and cardiac herniation. According to human case descriptions, this is a rare and often fatal occurrence, which can be significantly challenging to diagnose preoperatively or antemortem. Emergency veterinary clinicians should be aware of this rare but important complication of blunt thoracic trauma. Surgical intervention may be necessary in cases with suspected or confirmed entrapment of great vessels or cardiac chambers, although these abnormalities were not present in this case.

Comparison of Trauma in Dogs due to Direct Motor Vehicle Collision or Fall from Open Pick-up Truck Bed during Transportation (2002-2020)

OBJECTIVE

 The aim of this study was to report injuries sustained by dogs following motor vehicle trauma: direct motor vehicle collision (MVC), and fall from an open pickup truck bed during transportation (PTB).

STUDY DESIGN

 Medical records of dogs involved in motor vehicle trauma between 2002 and 2020 were reviewed. Signalment, mode of injury, injuries sustained, and treatments performed were recorded. An owner questionnaire investigated effects of the trauma on the dog and owner.

RESULTS

 Six hundred and ninety-eight dogs met the inclusion criteria (569 MVC, 102 PTB). Orthopaedic trauma was significantly more common after PTB (90.2%) (MVC, 75.6%; p = 0.011). There were not any differences in the prevalence of soft tissue injuries between groups (76.4% MVC, 67.6% PTB; p = 0.058), however, MVC dogs had significantly more thoracic (26.9% MVC, 4.4% PTB) and abdominal (12.9% MVC, 0% PTB) trauma (p <0.001). Surgical treatments were performed significantly more often after PTB (71.6%) (MVC, 47.6%) (p <0.001). Discharge rate after PTB (95.0%) was significantly higher (MVC, 84.0%) (p <0.001). Aftercare was reported to be significantly more difficult after PTB (76.2%) (MVC, 34.0%; p = 0.002).

CONCLUSION

 MVC and PTB result in significantly different trauma. PTB causes predominantly orthopaedic and integument injuries, whereas MVC results in thoracic and abdominal trauma. Survival to discharge is greater following PTB than MVC.

Markers of tissue perfusion and their relation to mortality in dogs with blunt trauma

OBJECTIVE

To evaluate admission Animal Trauma Triage (ATT) score, shock index (SI), and markers of perfusion, including base excess (BE), plasma lactate, and lactate clearance in dogs with blunt trauma.

DESIGN

Prospective observational clinical study from 2013 to 2015.

SETTING

Private veterinary referral and emergency center.

ANIMALS

Forty-four client-owned dogs hospitalized following blunt trauma.

INTERVENTION

Within 1 hour of presentation and prior to fluid administration an initial hematocrit, total plasma protein, blood glucose, plasma lactate, blood gas, and electrolytes were obtained for analysis. Plasma lactate concentrations were also measured 4 and 8 hours following initial measurement, and a 4-hour lactate clearance was calculated if patients had an increased admission plasma lactate. ATT score and SI were calculated for each patient based on admission data. Outcome was defined as survival to hospital discharge.

MEASUREMENTS AND MAIN RESULTS

Twenty-nine dogs survived, 14 were euthanized, and 1 died. Nonsurviving dogs had a lower mean pH (7.28 ± 0.03 vs 7.36 ± 0.01, P = 0.006), lower median HCO₃ (15.7 vs 18.8 mmol/L, P = 0.004), lower median admission BE (-11.0 vs -7.0 mmol/L, P = 0.004), and higher median admission lactate (3.1 vs 2.4 mmol/L, P = 0.036) than those who survived. Median ATT was significantly higher in nonsurvivors (5 vsF 2, P < 0.001). The SI was not significantly different between survivors and nonsurvivors (P = 0.41). There was no difference in median 4-hour lactate (P = 0.34), median 8-hour lactate (P = 0.19), or 4-hour lactate clearance (P = 0.83) in survivors compared to nonsurvivors. No other statistically significant differences were noted between groups.

CONCLUSION

Dogs hospitalized following blunt trauma with a lower admission pH, HCO₃ , and BE and a higher admission plasma lactate were less likely to survive to hospital discharge. Median ATT score was also significantly higher in nonsurvivors. Although lactate clearance was not predictive of survival, the sample size was small, and additional studies with a larger study population are warranted.

Clinicoepidemiological profile and risk factors associated with mortality in traumatized cats admitted to a veterinary teaching hospital in Brazil

OBJECTIVES

The aim of this study was to evaluate possible risk factors for death in traumatized cats based on the clinicoepidemiological profile, the Animal Trauma Triage (ATT) scale score and the Modified Glasgow Coma Scale (MGCS) score at the time of presentation to the hospital.

METHODS

This was a cross-sectional study involving cats admitted to the emergency sector (ES) and the surgical clinic sector (SCS) of a veterinary teaching hospital (VTH) in northeastern Brazil over a 12-month period (2018-2019). Probable risk factors associated with non-survival after trauma were analyzed by calculating the prevalence ratio. The prediction of non-survival was evaluated by analyzing the receiver operating characteristic (ROC) curve employing the ATT scale score, MGCS score and rectal temperature.

RESULTS

In 1 year, 89 traumatized cats were admitted to the VTH, of which 90% (n = 80) were young, 54% (n = 48) were male, 79% (n = 70) were intact, 59% (n = 53) were indoor cats and 92% (n = 82) were considered as mixed breed. Blunt trauma was the most prevalent cause of injuries, reported in 76% (n = 68) of the cats. Accidents involving falls (30%; n = 27) that affected the pelvic limbs (50.6%) were the most commonly reported. The prevalence of death among cats admitted to the ES was 9.44 times higher than that of animals treated at the SCS. Trauma as result of being run over and chest trauma were associated with a higher probability of death. Most of the animals that died had a lower rectal temperature than those that survived. The ATT scale score, MGCS score and rectal temperature were predictive of mortality.

CONCLUSIONS AND RELEVANCE

Rectal temperature, ATT scale score and MGCS score were effective predictors of an unfavorable prognosis and point to the need for emergency procedures. Hypothermia, being run over and chest trauma were associated with a higher risk of mortality. Our findings highlight the importance of prompt and effective care for these conditions.

Lung Ultrasound for Pulmonary Contusions

Lung ultrasound (LUS) has high sensitivity for the rapid and reliable diagnosis of pulmonary contusions (PC) in patients who have sustained trauma. LUS diagnosis of PC exceeds that of thoracic radiographs in multiple animal and human studies. The sonographer should understand potential caveats and confounding variables for proper diagnosis of PC with LUS. LUS does not replace conventional radiography or computed tomography, especially in the polytrauma patient. LUS should be used concurrently with other point-of-care ultrasound trauma protocols to rapidly optimize patient assessment before movement to the radiology suite.

Unravelling the health status of brachycephalic dogs in the UK using multivariable analysis

Brachycephalic dog breeds are regularly asserted as being less healthy than non-brachycephalic breeds. Using primary-care veterinary clinical data, this study aimed to identify predispositions and protections in brachycephalic dogs and explore differing inferences between univariable and multivariable results. All disorders during 2016 were extracted from a random sample of 22,333 dogs within the VetCompass Programme from a sampling frame of 955,554 dogs under UK veterinary care in 2016. Univariable and multivariable binary logistic regression modelling explored brachycephaly as a risk factor for each of a series of common disorders. Brachycephalic dogs were younger, lighter and less likely to be neutered than mesocephalic, dolichocephalic and crossbred dogs. Brachycephalic differed to non-brachycephalic types in their odds for 10/30 (33.33%) common disorders. Of these, brachycephalic types were predisposed for eight disorders and were protected for two disorders. Univariable and multivariable analyses generated differing inference for 11/30 (30.67%) disorders. This study provides strong evidence that brachycephalic breeds are generally less healthy than their non-brachycephalic counterparts. Results from studies that report only univariable methods should be treated with extreme caution due to potential confounding effects that have not been accounted for during univariable study design or analysis.

Traumatic skull fractures in dogs and cats: A comparative analysis of neurological and computed tomographic features

BACKGROUND

Traumatic skull fractures (TSF) are relatively frequent in dogs and cats, but little information is available regarding their clinical and imaging features.

HYPOTHESIS/OBJECTIVES

To describe the neurological and computed tomographic (CT) features of a large cohort of dogs and cats with TSF.

ANIMALS

Ninety-one dogs and 95 cats with TSF identified on CT.

METHODS

Multicenter retrospective comparative study. Signalment, cause of trauma, fracture locations and characteristics, presence of neurological deficits, and 1-week survival were recorded. Fractures were classified according to the extent of fragmentation and displacement.

RESULTS

The cranial vault was affected more frequently in dogs (P = .003), whereas the face and base of the cranium more often was affected in cats (P < .001). Cats presented with multiple fractures more frequently (P < .001). All animals with TSF in the cranial vault were more likely to develop neurological signs (P = .02), especially when depressed fractures were present (95% confidence interval [CI], 1.7-8.2; P = .001). Animals with TSF located only in the facial region were less likely to have neurological signs (odds ratio with Mantel-Haenszel's method [ORMH ], 0.2; 95% CI, 0.1-0.6; P = .004). Most affected animals (84.9%) survived the first week post-trauma. Death was more likely with fractures of the cranial vault (P = .003), especially when fragmented (P = .007) and displaced (P = .004).

CONCLUSIONS AND CLINICAL IMPORTANCE

Traumatic skull fracture distribution and patterns are different between dogs and cats. Cranial vault fractures were associated with neurological deficits and worse survival. The presence of TSF alone should not be considered a negative prognostic factor because most affected animals survived the first week.

Thyroid axis and adrenal activity in 28 day survivor and nonsurvivor dogs involved in recent road traffic accidents: A cohort study of 420 dogs

The objective of this retrospective cohort study was to determine the impact of a recent trauma on thyroid axis and adrenal activity in dogs and to assess the usefulness of urinary cortisol-to-creatinine ratio (UCCR), basal serum thyroid-stimulating hormone (TSH), total thyroxine (tT4), and free thyroxine (fT4) concentrations in predicting outcome in dogs traumatized by a road traffic accident (RTA). An RTA exposed group of 210 dogs was evaluated within 24  hours of the trauma. Their data were compared with data from a matched group of dogs with other diagnoses. UCCR was positively correlated with the trauma severity and was higher in the exposed group than in the nonexposed group (median 101.500 vs. 21.02; p < 0.0001). tT4 values were statistically similar between the two groups, but were correlated with a trauma score, while TSH (median = 0.050 vs. 0.080 ng/mL; p < 0.0001) and fT4 (median = 15.850 vs. 17.950 pmol/L; p = 0.0037) were significantly lower for the exposed group. Nonsurvivors in comparison to survivors presented and higher median UCCR (181.800 vs. 93.850 respectively; p = 0.020), and a lower serum fT4 (12.700 vs. 16.500 pmol/L, respectively; p = 0.0046). A similar pattern had been observed for tT4. TSH levels were not predictive of survival. This study provides insights into the endocrine characteristics of dogs suffering from acute trauma. UCCR was higher while fT4 and TSH were both lower in RTA-injured dogs than in dogs affected by other conditions. Furthermore low fT4 and tT4, and a high UCCR could be useful prognostic factors in dogs affected by RTA trauma.

Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK

Background

Conditions affecting the elbow joint are a common cause of lameness in dogs. Primary-care veterinary clinical data are now recognised as a valuable research resource. Using data from the VetCompass Programme, this study aimed to report the frequency and risk factors for elbow joint disease in dogs under primary veterinary care in the UK and describe clinical management.

Results

From 455,069 dogs under veterinary care, the one-year period prevalence for elbow joint disease diagnosis was 0.56% (95% CI: 0.53-0.60). Of 616 incident cases, the most common specific variants of elbow joint disease were osteoarthritis (n = 468, 75.97%), elbow dysplasia (190, 30.84%) and traumatic (41, 6.66%). The most common signs described by the owners were lameness (n = 466, 75.65%), difficulty exercising (123, 19.97%) and pain (86, 13.96%). The most common findings recorded on veterinary examination were pain (n = 283, 45.94%), lameness (278, 45.13%) and reduced range of movement (243, 39.45%). Common medications used included non-steroidal anti-inflammatory drugs (n = 544, 88.31%), tramadol (121, 19.64%) and disease modifying agents (118, 19.16%). Of 109 deaths involving euthanasia with information available from the 616 incident cases, elbow joint disease contributed to the decision to euthanase in 45 (41.28%) dogs.Five breeds showed increased odds of elbow joint disease compared with crossbred dogs: Rottweiler (OR: 6.16, 95% CI 3.89-9.75), Labrador Retriever (OR: 5.94, 95% CI 4.65-7.60), German Shepherd Dog (OR: 4.13, 95% CI 2.88-5.93), Golden Retriever (OR: 3.11, 95% CI 1.93-5.00) and English Springer Spaniel (OR: 2.00, 95% CI 1.26-3.18). Additional risk factors included having an adult bodyweight that was equal or higher than their breed/sex mean, advancing age, being male, being neutered, being insured and larger bodyweight.

Conclusions

Elbow joint disease is a relatively common diagnosis in dogs and has a high welfare impact as evidenced by the high proportion of cases recorded with pain, lameness and analgesic therapy. There are strong breed predispositions, in particular for large breed dogs. These findings present a clear case for improved breeding programmes to reduce the burden of elbow joint disease.

2019 AAHA Canine Life Stage Guidelines*

The guidelines are an update and extension of the AAHA Canine Life Stage Guidelines published in 2012. A noteworthy change from the earlier guidelines is the division of the dog’s lifespan into five stages (puppy, young adult, mature adult, senior, and end of life) instead of the previous six. This simplified grouping is consistent with how pet owners generally perceive their dog’s maturation and aging process and provides a readily understood basis for an evolving, lifelong healthcare strategy. The guidelines provide the following recommendations for managing 10 health-related factors at each of the first four canine life stages: lifestyle effect on the patient’s safety, zoonotic and human safety risk, behavior, nutrition, parasite control, vaccination, dental health, reproduction, breed-specific conditions, and a baseline diagnostic profile.

Greyhounds under general veterinary care in the UK during 2016: demography and common disorders

Background

The greyhound is a sighthound known for its speed and agility. Greyhounds were selectively bred as functional racing animals but increasingly are kept as pets in the UK, often after their racing careers are over. The VetCompass™ Programme collates de-identified clinical data from primary-care veterinary practices in the UK for epidemiological research. Using VetCompass™ clinical data, this study aimed to characterise the demography, mortality and common disorders of the general population of pet greyhounds under veterinary care in the UK.

Results

Greyhounds comprised 5419/ 905,544 (0.60%) dogs under veterinary care during 2016 from 626 clinics. Mean adult bodyweight was 29.7 kg (standard deviation [SD] 4.5 kg). Males (32.3 kg, SD 4.1 kg) were heavier than females (27.2 kg, SD 3.3 kg) (P < 0.001). Mean age was 7.6 years (SD 3.4). The most common colours were black (39.2%), black and white (20.8%), brindle (12.0%). Based on 474 deaths, median longevity was 11.4 years (range 0.2–16.5). Females (11.8 years) outlived males (11.2 years) (P = 0.002). The most common grouped causes of death were neoplasia (21.5%, 95% CI: 17.4–26.0), collapse (14.3%, 95% CI: 10.9–18.2) and musculoskeletal disorder (7.8%, 95% CI: 5.3–11.0). Based on a random subset of 2715/5419 (50.1%) greyhounds, 77.5% had > 1 disorder recorded during 2016. The most prevalent specific disorders were periodontal disease (39.0%, 95% CI: 37.2–40.9), overgrown nails (11.1%, 95% CI 10.0–12.4), wound (6.2%, 95% CI: 5.3–7.1), osteoarthritis (4.6%, 95% CI: 3.8–5.4) and claw injury (4.2%, 95% CI: 3.4–5.0).

Conclusions

These findings highlight the greyhound as a relatively common pet dog breed in the UK, accounting for 0.6% of dogs under primary veterinary care. Dental disease, trauma and osteoarthritis were identified as common health issues within the breed. Knowledge of common disorders can help greyhound breeders and regulators to prioritise breeding, rearing and racing management to mitigate some of the most prevalent issues. Greyhound rehoming organizations can also better inform adopters about prophylactic care.

Miniature Schnauzers under primary veterinary care in the UK in 2013: demography, mortality and disorders

BACKGROUND

Individual dog breeds are often reported as predisposed to specific breed-related disorders but reliable epidemiological data on disease prevalence are sparse. The Miniature Schnauzer in the UK is a popular small breed dog that is often considered as relatively healthy and long-lived, but is this really true? This study aimed to use data from the VetCompass™ Programme at the Royal Veterinary College to characterise the demography, mortality and common disorders of the general population of Miniature Schnauzers under veterinary care in the UK.

RESULTS

The study population of 455,557 dogs from 304 clinics in the VetCompass™ database under veterinary care during 2013 included 3857 Miniature Schnauzers (0.85%). For dogs with data available, 1771 (56.9%) were neutered and 1893 (49.2%) were females. Mean adult bodyweight overall was 9.9 kg (SD 2.2 kg) and median longevity was 11.6 years (IQR 9.3-13.1, range 0.5-17.0). The most prevalent fine-level precision disorders recorded were periodontal disease (n = 343, prevalence 17.4, 95% CI: 15.7-19.1), obesity/overweight (164, 8.3, 95% CI: 7.1-9.6), anal sac impaction (114, 5.8, 95% CI: 4.8-6.9), vomiting (100, 5.1, 95% CI% 4.1-6.1) and otitis externa (99, 5.0, 95% CI% 4.1-6.1). The most prevalent grouped-level precision disorders were dental (n = 378, prevalence: 19.2, 95% CI: 17.5-21.0), enteropathy (270, 13.7, 95% CI: 12.2-15.3), cutaneous (250, 12.7, 95% CI: 11.2-14.2) and aural (197, 10.0, 95% CI: 8.7-11.4).

CONCLUSIONS

This study provides generalisable evidence on the demography, longevity and most prevalent disorders in the Miniature Schnauzer breed in the UK. Awareness of common diseases and breed predispositions can support evidence-based policies to improve breed health, guide veterinary surgeons when producing differential diagnosis lists, and assist owners when purchasing or caring for their pets.

Lipoma in dogs under primary veterinary care in the UK: prevalence and breed associations

Background

Lipomas are masses of mesenchymal origin, comprising of adipocytes, and are often clinically unremarkable but can be alarming to owners. Although lipomas are reportedly common in dogs, no studies have specifically investigated risk factors associated with their occurrence. This study was a large-scale retrospective analysis of electronic patient records of dogs attending practices participating in VetCompass™. Univariable and multivariable logistic regression methods were used to evaluate associations between risk factors and primary-care veterinary diagnosis of lipoma.

Results

From 384,284 dogs under veterinary care during 2013 at 215 primary practice clinics in the UK, there were 2765 lipoma cases identified giving a one-year prevalence of 1.94% (95% CI: 1.87–2.01). Breeds with the highest lipoma prevalence included Weimaraner (7.84%, 95% CI 6.46–9.40), Dobermann Pinscher (6.96%, 95% CI 5.67–8.44), German Pointer (5.23%, 95% CI 3.93–6.80), Springer Spaniel (5.19%, 95% CI 4.76–5.66), and Labrador Retriever (5.15%, 95% CI 4.90–5.41). Dogs with an adult bodyweight equal or higher than their breed/sex mean had 1.96 (95% CI 1.81–2.14, P <  0.001) times the odds of lipoma compared with dogs that weighed below their breed/sex mean. The odds of lipoma increased as adult bodyweight increased. Increased age was strongly associated with increasing odds of lipoma. Compared with dogs aged 3.0 to < 6.0 years, dogs aged 9.0 - < 12.0 years had 17.52 times the odds (95% CI 14.71–20.85, P <  0.001) of lipoma. Neutered males (OR: 1.99, 95% CI 1.69–2.36, P <  0.001) and neutered females (OR: 1.62, 95% CI 1.37–1.91, P <  0.001) had higher odds than entire females. Insured dogs had 1.78 (95% CI 1.53–2.07, P <  0.001) times the odds of lipoma compared with uninsured dogs.

Conclusions

Lipomas appear to be a relatively common diagnosis in primary-care practice. Certain breeds were identified with remarkably high lipoma prevalence, highlighting the risk that owners should be prepared for. Lipoma predisposition of larger bodyweight individuals within breed/sex suggests that being overweight or obese may be a predisposing factor but would need further work to confirm.