A case of haemoglobinuria in a cat after near-drowning

The aim of this study is to describe a case of haemoglobinuria in a cat after near-drowning. A 6-year-old male neutered domestic short hair cat weighing 6.5 kg with a pre-existing seizure disorder presented to an emergency hospital after near-drowning in a swimming pool during a seizure episode. On presentation, the patient was obtunded, dyspnoeic, bradycardic and hypothermic. Imaging revealed evidence of severe bilateral pulmonary infiltrates. Treatment with intravenous diazepam, amoxicillin, fluid therapy, active warming and oxygen therapy was administered. The cat developed haemoglobinuria approximately 6 h after nearly drowning. Despite improvements in mentation, pulse quality and heart rate, respiratory compromise and poor oxygen saturation persisted, prompting euthanasia approximately 10 h after admission. To the author's knowledge, this is the first reported clinical case of haemoglobinuria following near-drowning in veterinary medicine.

Noncardiogenic pulmonary edema in small animals

OBJECTIVE

To review various types of noncardiogenic pulmonary edema (NCPE) in cats and dogs.

ETIOLOGY

NCPE is an abnormal fluid accumulation in the lung interstitium or alveoli that is not caused by cardiogenic causes or fluid overload. It can be due to changes in vascular permeability, hydrostatic pressure in the pulmonary vasculature, or a combination thereof. Possible causes include inflammatory states within the lung or in remote tissues (acute respiratory distress syndrome [ARDS]), airway obstruction (post-obstructive pulmonary edema), neurologic disease such as head trauma or seizures (neurogenic pulmonary edema), electrocution, after re-expansion of a collapsed lung or after drowning.

DIAGNOSIS

Diagnosis of NCPE is generally based on history, physical examination, and diagnostic imaging. Radiographic findings suggestive of NCPE are interstitial to alveolar pulmonary opacities in the absence of signs of left-sided congestive heart failure or fluid overload such as cardiomegaly or congested pulmonary veins. Computed tomography and edema fluid analysis may aid in the diagnosis, while some forms of NCPE require additional findings to reach a diagnosis.

THERAPY

The goal of therapy for all types of NCPE is to preserve tissue oxygenation and reduce the work of breathing. This may be achieved by removing the inciting cause (eg, airway obstruction) and cage rest in mild cases and supplemental oxygen in moderate cases and may require mechanical ventilation in severe cases.

PROGNOSIS

Prognosis is generally good for most causes of veterinary NCPE except for ARDS, although data are scarce for some etiologies of NCPE.

Characterization of Suspected Crimes against Companion Animals in Portugal

Simple Summary

Crimes against companion animals are universal and represent a major problem in human/animal interaction. This study characterizes forensic cases received at the Laboratory of Pathology of the National Institute of Agrarian and Veterinary Investigation (Vairão, Portugal) since the enforcement of the Portuguese law that criminalizes the mistreatment and abandonment of companion animals. Based on the consult of 160 data files of forensic necropsies analyzed for this study, the suspicion of prior crime against companion animal was confirmed in 38 cases (24%). Most of the assaulted animals were medium-size (57%) male (58%) dogs (87%) of crossbreed (55%), whose death was related to blunt force trauma (31%), firearms (27%), poisoning (27%), and asphyxiation (15%). However, in cats, death was related to blunt force trauma only (100%). In Portugal, violence against animals is a reality and the complaint of these crimes is gradually increasing due to the population’s raising awareness about animal rights.

Abstract

Animal crimes are a widespread phenomenon with serious implications for animal welfare, individual well-being and for society in general. These crimes are universal and represent a major problem in human/animal interaction. In Portugal, current law 69/2014 criminalizes the mistreatment and abandonment of companion animals. This study characterizes forensic cases received at the Laboratory of Pathology of the National Institute of Agrarian and Veterinary Investigation (Vairão) since the enforcement of the aforementioned legislation. A retrospective study was carried out based on the consult of 160 data files of forensic necropsies from 127 dogs and 33 cats. Necropsies confirmed prior crime suspicion in 38 cases (24%), from which 33 were dogs and five were cats. Among confirmed cases, most of assaulted animals were medium-size (57%), crossbreed (55%) male (58%) dogs (87%), which were the victims of blunt force trauma (31%), firearms (27%), poisoning (27%) and asphyxiation (15%). In cats, most of the assaulted animals were juvenile (60%) females (60%) of unknown breed (40%), which suffered blunt force trauma (100%) as the only cause of death. The present study shows that violence against animals is a reality, and complaints about these crimes are gradually increasing due to the population’s raising awareness about animal rights. Greater communication and coordination between clinicians, veterinary pathologists, and law enforcement officers are essential to validate and legally support these cases and subject them to trial.

Pup mortality in New Zealand sea lions (Phocarctos hookeri) at Enderby Island, Auckland Islands, 2013-18

New Zealand sea lions (Phocarctos hookeri) are an endemic and endangered species. Pup mortality at Enderby Island (50.5°S, 166.28°E) in the New Zealand sub-Antarctic has been well studied, with subsequent investigations yielding more intricate detail of the causes of mortality, as new diagnostic methods become available. Klebsiella pneumoniae was first reported in 2001-02 at this site, causing a pup mortality epizootic and is now known to be present at several colonies. This bacterium is a common mucosal commensal of humans and animals, however the agent found in pups at necropsy is a hypervirulent strain, readily recognised in microbial culture as being hypermucoviscous. Infection causes septicaemia with a common syndrome of subsequent meningitis and polyarthritis. This investigation uses histopathology and microbiology, with new modalities such as matrix assisted laser desorption/ionisation-time of flight mass spectrometry to show that Klebsiella septicaemia could have historically been, and continues to be, the most important cause of pup mortality, but has been previously underrepresented due to the often cryptic presentation and sometimes peracute course of disease. Hypermucoviscous K. pneumoniae should be considered a serious threat to pup survival in the species, causing on average 60.2% of pup deaths annually at Enderby Island between 2013 and 2018, with likely more continuing mortality following pup dispersal and the cessation of the summer monitoring season. Less common causes of death included starvation (14.8%), trauma/asphyxiation (9.9%) and other infections (7%). This study forms the basis for further evaluation of risk factors for pup mortality in the species, with a view to developing active mitigation.

The rise of veterinary forensics

Veterinary forensics is rapidly emerging as a distinct branch of veterinary medicine, especially because of increasing mindfulness about animal cruelty, and of the link between acts of cruelty to animals and violence toward humans. Nevertheless, the application of forensic sciences in veterinary cases lags behind its application in medical cases. Although gaps persist in veterinarians' knowledge of forensics and in how to apply this field to medicolegal cases involving animals, continued research and publication in veterinary forensics are rapidly developing the evidence base in this area. Additionally, educational opportunities in veterinary forensics are also increasing at both undergraduate and postgraduate levels. Together, these changes will continue to improve veterinarians' abilities to investigate cases involving animals. To further strengthen these investigations, veterinarians should also collaborate with the appropriate experts in different disciplines of forensic science.

Diagnosis of Drowning and the Value of the Diatom Test in Veterinary Forensic Pathology

The detection of diatoms into the organs is considered an important “biological marker” for the diagnosis of drowning in human pathology, but it still has a high possibility for false positive results. The aims of this study were: (1) to evaluate the contribution of pathological examination in drowning cases and (2) to investigate the differences in the number and location of diatoms between animals who died in drowning and non-drowning conditions. For these purposes, 30 dead adult dogs were selected for the study and subdivided into five groups. The group A comprised six cadavers dead for drowning; the group B comprised six control animals; the groups C, D, and E comprised six animals dead for causes other than drowning and subsequently immersed in water for 24, 48, and 72 h, respectively. On each animal, a complete macroscopic and histological examination and diatom test were performed. Diatoms test and quantification were also performed on drowning mediums. Pathological findings of the animals in the group A showed pulmonary congestion, oedema, and hemorrages in the lung. However, similar injuries were also observed in control and experimentally submerged cadavers. In contrast, we observed a statistically differences between drowning animals and all experimentally submerged groups and control animals regarding diatom numbers recovered from organ tissue samples (p < 0.05). Therefore, these findings suggest that the number of diatoms may be used as a valid tool to differentiate animals who died in drowning and non-drowning conditions, even if the latter were found in an aquatic environment.

The persistent problem of drowning - A difficult diagnosis with inconclusive tests

Although the diagnosis of drowning may appear straightforward the reality is that it is sometimes one of the most difficult in forensic pathology. To begin with, there is no universal agreement on what constitutes drowning with some definitions using the term in the absence of a lethal outcome. Next are the significant problems that arise in finding immersed bodies and in assessing the death scene. Prolonged post mortem intervals are associated with artefactual modifications of the body from putrefaction and post mortem animal predation. Both of these may create and disguise injuries. The absence of pathognomonic pathological features at autopsy and the presence of potentially life threatening underlying organic illnesses complicate determination of both the cause and manner of death. There may even be no autopsy findings to indicate that immersion had occurred. Finally, the unreliability of laboratory tests with significant overlap with control cases where death had no association with immersion presents further problems. Thus lethal drowning remains a complex event that requires the use of a wide variety of information sources, not just data gleaned from the dissection table.

New insights into odontological exploration of drowning using rat model - A pilot study

Dental forensics for the resolution of unnatural death remains an underdeveloped field. Accordingly, an experimental study was conducted with six to seven months old Wistar rats that were drowned in order to identify key postmortem features and pattern of dental decomposition. The visual, structural and elemental changes were assessed periodically. Based on mode of death, they were designated as SB (euthanized and soil buried), FWD (fresh water drowned) and SWD (sea water drowned). Postmortem features as well as the structural and elemental patterns of decomposition of teeth were analyzed with Field Emission Scanning Electron Microscopy (FE-SEM) and Energy Dispersive Spectroscopy (EDAX) periodically for two months. The periodic observation of elemental changes in the teeth of SB, FWD and SWD rats allowed us to derive an equation using linear regression analysis to relate the degree of dental decomposition with the time since death. The difference in pattern of surface deterioration was also observed. The present findings could provide a better knowledge in resolving unnatural deaths and supporting evidence for legal prosecution.

Can pulmonary foam arise after postmortem submersion in water? An animal experimental pilot study

It is difficult to differentiate drowning from postmortem submersion. Pulmonary foam can be found in bodies retrieved from water. It is unknown whether foam is a result of drowning or if it also forms after postmortem submersion. We divided deceased piglets into three groups: postmortem saltwater submersion (N = 20), postmortem freshwater submersion (N = 20) and dry-land controls (N = 20). All carcasses underwent endoscopic examination within 24 h of death and the presence of external and internal pulmonary foam was scored. No external foam was detected in the postmortem freshwater or the postmortem saltwater group. Internal foam was seen in 35% of the postmortem freshwater and 40% of the postmortem saltwater group. No external or internal foam was detected in the dry land control group. The literature shows external as well as internal foam in drowned humans. Internal foam is seen in postmortem submersion in the current piglet study and antemortem submersion in the literature in humans, and can therefore not be used to support/refute the diagnosis of drowning. No external foam was present in the postmortem submersed piglets, yet has been described in drowned humans. Hence the presence of external foam in bodies recovered from water may be indicative for drowning. The presence of external foam is a potentially valuable clinical sign in distinguishing drowning from postmortem submersion.

Assessment of Google Glass for Photographic Documentation in Veterinary Forensic Pathology: Usability Study

Background

Google Glass is a head-mounted device designed in the shape of a pair of eyeglasses equipped with a 5.0-megapixel integrated camera and capable of taking pictures with simple voice commands.

Objective

The objective of our study was to determine whether Google Glass is fit for veterinary forensic pathology purposes.

Methods

A total of 44 forensic necropsies of 2 different species (22 dogs and 22 cats) were performed by 2 pathologists; each pathologist conducted 11 necropsies of each species and, for each photographic acquisition, the images were taken with a Google Glass device and a Nikon D3200 digital single-lens reflex (DSLR) camera. The pictures were collected, divided into 3 groups (based on the external appearance of the animal, organs, and anatomical details), and evaluated by 5 forensic pathologists using a 5-point score system. The parameters assessed were overall color settings, region of interest, sharpness, and brightness. To evaluate the difference in mean duration between necropsies conduced with Google Glass and DSLR camera and to assess the battery consumption of the devices, an additional number of 16 necropsies were performed by the 2 pathologists. In these cases, Google Glass was used for photographic reports in 8 cases (4 dogs and 4 cats) and a Nikon D3200 reflex camera in the other 8 cases. Statistical evaluations were performed to assess the differences in ratings between the quality of the images taken with both devices.

Results

The images taken with Google Glass received significantly lower ratings than those acquired with reflex camera for all 4 assessed parameters (P<.001). In particular, for the pictures of Groups A and B taken with Google Glass, the sum of frequency of ratings 5 (very good) and 4 (good) was between 50% and 77% for all 4 assessed parameters. The lowest ratings were observed for the pictures of Group C, with a sum of frequency of ratings 5 and 4 of 21.1% (342/1602) for region of interest, 26% (421/1602) for sharpness, 35.5% (575/1602) for overall color settings, and 61.4% (995/1602) for brightness. Furthermore, we found a significant reduction in the mean execution time for necropsy conduced with the Google Glass with respect to the reflex group (P<.001). However, Google Glass drained the battery very quickly.

Conclusions

These findings suggest that Google Glass is usable in veterinary forensic pathology. In particular, the image quality of Groups A and B seemed adequate for forensic photographic documentation purposes, although the quality was lower than that with the reflex camera. However, in this step of development, the high frequency of poor ratings observed for the pictures of Group C suggest that the device is not suitable for taking pictures of small anatomical details or close-ups of the injuries.

The relationship between the intramuscular bleeding of the tongue and cause of death

Intramuscular bleeding of the tongue (ImBT) is occasionally found during post mortem examination. Despite its frequent reports, its cause has not yet been clarified. In this study, forensic autopsy data of 799 cadavers were examined and the relationship between ImBT and cause of death was investigated. A total of 74 cases showed ImBT (16 of 66 cases of fire fatality, 17 of 108 cases of drowning, 23 of 74 cases of asphyxiation, and 18 of 551 cases of other causes of death). The frequency of bleeding was significantly greater in cases with causes of death including fire fatality, drowning, and asphyxiation compared to those with other causes of death (p < 0.01). Among asphyxiation cases, ImBT was confirmed in two of five cases of typical hanging, three of 16 cases of atypical hanging, six of six cases of ligature strangulation, two of two cases of manual strangulation, eight of 38 cases of airway obstruction, and two of seven cases of oxygen deficiency. Among fire fatalities, the carboxyhemoglobin (CO-Hb) concentration of cases with ImBT was significantly lower than that in cases without ImBT (p < 0.01). In addition, the frequency of bleeding was significantly higher (p < 0.05) in cases where the blood cyanide concentration was 0.05 ppm or less. These observations suggested that ImBT during fire fatality occurs in a manner similar to that of ligature or manual strangulation, in which the flames cause the contraction and decrease in elasticity of the skin. Past reports indicated that bleeding frequency in cases of drowning did not significantly differ from that in cases with other causes of death. However, our cases showed a statistically higher incidence of bleeding compared to that in the other causes of death (p < 0.01). These results suggested that ImBT is a characteristic finding in cases of asphyxia and is an important evaluation for the diagnosis of death. When the relationship between ImBT and petechial hemorrhage was examined in three of the causes of death, no significant difference was observed between fire fatality and asphyxiation, but drowning was significantly different (p < 0.05). In cases without ImBT, the secretion of noradrenaline and adrenaline was significantly higher (p < 0.01). This finding suggests that it is unlikely that excessive secretion of catecholamine causes ImBT.

Eternally Vulnerable: The Pathology of Abuse in Domestic Animals

Animals are amongst the most vulnerable of all sentient beings. Animal neglect and abuse may involve a single animal and one person, or hundreds of animals and many people. Animals and people are victims of the same types of fatal injury and severe neglect; however, the anatomy and physiology of different animal species and even breeds of animals are a unique challenge for veterinary pathologists. Identifying and describing external lesions of blunt force trauma and projectile wounds requires that the entire skin be reflected from the animal because fur and feathers partially or totally mask the injuries. Because quadrupeds or birds may react differently to the same traumatic force applied to bipedal humans, extrapolating from medical forensic pathology must be done with caution. Animal abuse, however, does not occur in a vacuum. An established link exists between animal abuse, interpersonal violence, and other serious crimes. Using examples, this paper describes specific injuries in abused and neglected animals in the context of domestic violence, interpersonal violence, mental illness, and drug addiction. Medical examiners should be aware that animal abuse affects not only the animal, but individuals, families, and society as a whole.