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Tenório BG, Kollath DR, Gade L, Litvintseva AP, Chiller T, Jenness JS, Stajich JE, Matute DR, Hanzlicek AS, Barker BM, Teixeira MDM. Tracing histoplasmosis genomic epidemiology and species occurrence across the USA. Emerg Microbes Infect 2024; 13:2315960. [PMID: 38465644 DOI: 10.1080/22221751.2024.2315960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/04/2024] [Indexed: 03/12/2024]
Abstract
ABSTRACTHistoplasmosis is an endemic mycosis in North America frequently reported along the Ohio and Mississippi River Valleys, although autochthonous cases occur in non-endemic areas. In the United States, the disease is provoked by two genetically distinct clades of Histoplasma capsulatum sensu lato, Histoplasma mississippiense (Nam1) and H. ohiense (Nam2). To bridge the molecular epidemiological gap, we genotyped 93 Histoplasma isolates (62 novel genomes) including clinical, environmental, and veterinarian samples from a broader geographical range by whole-genome sequencing, followed by evolutionary and species niche modelling analyses. We show that histoplasmosis is caused by two major lineages, H. ohiense and H. mississippiense; with sporadic cases caused by H. suramericanum in California and Texas. While H. ohiense is prevalent in eastern states, H. mississipiense was found to be prevalent in the central and western portions of the United States, but also geographically overlapping in some areas suggesting that these species might co-occur. Species Niche Modelling revealed that H. ohiense thrives in places with warmer and drier conditions, while H. mississippiense is endemic to areas with cooler temperatures and more precipitation. In addition, we predicted multiple areas of secondary contact zones where the two species co-occur, potentially facilitating gene exchange and hybridization. This study provides the most comprehensive understanding of the genomic epidemiology of histoplasmosis in the USA and lays a blueprint for the study of invasive fungal diseases.
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Affiliation(s)
| | - Daniel R Kollath
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Lalitha Gade
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jeff S Jenness
- School of Forestry, Northern Arizona University, Flagstaff, AZ, USA
| | - Jason E Stajich
- Department of Microbiology & Plant Pathology and Institute for Integrative Genome Biology, University of California, Riverside, CA, USA
| | - Daniel R Matute
- Biology Department, University of North Carolina, Chapel Hill, NC, USA
| | - Andrew S Hanzlicek
- MiraVista Diagnostics, Indianapolis, IN, USA
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Bridget M Barker
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | - Marcus de Melo Teixeira
- Faculty of Medicine, University of Brasília, Brasília, Brazil
- Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
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Gronsky S, Di Girolamo N, Maranville R, Pathak D, Womble W, Hanzlicek AS, Sypniewski LA, Brandão J. A single injection of high-concentration buprenorphine significantly reduces food and water intake as well as fecal and urine production in New Zealand White rabbits (Oryctolagus cuniculus). Am J Vet Res 2024:1-8. [PMID: 38301359 DOI: 10.2460/ajvr.23.10.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVE To evaluate selected gastrointestinal side effects of high-concentration buprenorphine (HCB) in healthy rabbits. ANIMALS 10 healthy New Zealand White rabbits ranging in body weight between 3.0 and 3.8 kg. METHODS Eight, 6-month-old, New Zealand White rabbits received a single injection of HCB SC (0.24 mg/kg). The rabbits were previously randomized to receive SC and oral saline as a control. Two rabbits received saline for the purpose of blinding the outcome assessors. Food and water consumption, fecal and urine production, and fecal pellet number were recorded for all rabbits before HCB administration and the 3 days postinjection. RESULTS A clinically and statistically significant decrease in food and water consumption was observed in rabbits receiving an injection of HCB, compared to rabbits receiving saline. In the 24 hours after injection, HCB-treated rabbits consumed a median of 17 g of food (range, 0 to 82 g), while saline-treated rabbits consumed 122 g of food (31 to 181 g). Rabbits receiving HCB injections also produced significantly less feces both in terms of pellet numbers and overall quantity, along with decreased urine production. CLINICAL RELEVANCE A single administration of HCB has a clinically significant impact on multiple physiological functions in healthy rabbits. Administration of this drug could potentially worsen clinical signs of anorexia and decrease defecation in healthy rabbits. The effects of HCB on diseased or painful rabbits are not yet known.
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Urion R, Jaffey JA, Hostnik ET, Hanzlicek AS, Moore GE. Temporal tracheobronchial lymphadenopathy resolution is affected by initial severity and poorly correlated to serologic antibody testing in dogs with pulmonary coccidioidomycosis. J Am Vet Med Assoc 2023; 261:1-7. [PMID: 37481255 DOI: 10.2460/javma.23.04.0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/27/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVE To determine associations between antibody serologic tests and tracheobronchial lymphadenopathy (TBL) in dogs with pulmonary coccidioidomycosis and identify variables associated with time to resolution of TBL. ANIMALS 32 client owned dogs with newly diagnosed pulmonary coccidioidomycosis from October 2020 to February 2021. METHODS Prospective cohort study. Thoracic radiographs and anti-Coccidioides spp antibody serology were performed at baseline and once every 3 months until remission or for a maximum of 12 months. Radiographic tracheobronchial lymph node height, length, and area were measured and recorded as ratios via comparison with the length of the T4 vertebral body (LT4) and length of the manubrium. Severity of TBL was also subjectively categorized as mild, moderate, or severe. RESULTS Tracheobronchial lymphadenopathy was identified in 81% (26/32; 95% CI, 64% to 93%) of dogs. There was no relevant association between TBL presence or severity and antibody serology results. Tracheobronchial lymphadenopathy resolved in 72% (n = 18) of dogs at the 3-month evaluation. The median time to resolution of TBL after initiation of fluconazole was 96 days (range, 72 to 386 days). Univariate analysis identified increasing TBL severity (hazard ratio, 0.40; 95% CI, 0.19 to 0.84; P = .02) and length:LT4 ratio (hazard ratio, 0.41; 95% CI, 0.20 to 0.82; P = .01) as variables associated with reduced probability of resolution of TBL. CLINICAL RELEVANCE Antibody serologic test results are not clinically useful to predict TBL presence or severity in dogs with pulmonary coccidioidomycosis, and larger tracheobronchial lymph nodes are more likely to take longer to resolve. Resolution of TBL occurs in most dogs within 3 to 6 months after fluconazole administration.
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Affiliation(s)
- Rebecca Urion
- 1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - Jared A Jaffey
- 2Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, AZ
| | - Eric T Hostnik
- 1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | | | - George E Moore
- 4Department of Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, IN
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Tims R, Hanzlicek AS, Nafe L, Durkin MM, Smith-Davis J, Wheat LJ. Evaluation of an enzyme immunoassay and immunodiffusion for detection of anti-Histoplasma antibodies in serum from cats and dogs. J Vet Intern Med 2023; 37:1007-1014. [PMID: 37102374 DOI: 10.1111/jvim.16726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 04/08/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Histoplasma antigen and anti-Histoplasma antibody detection are used to support the diagnosis of histoplasmosis. There is a paucity of published data on antibody assays. OBJECTIVES Our primary hypothesis was that anti-Histoplasma immunoglobulin G (IgG) antibody detection using enzyme immunoassay (EIA) will be more sensitive as compared to immunodiffusion (ID). ANIMALS Thirty-seven cats and 22 dogs with proven or probable histoplasmosis; 157 negative control animals. METHODS Residual stored sera were tested for anti-Histoplasma antibodies using EIA and ID. Results of urine antigen EIA were reviewed retrospectively. Diagnostic sensitivity was calculated for all three assays and compared between immunoglobulin G (IgG) EIA and ID. The diagnostic sensitivity of urine antigen EIA and IgG EIA, interpreted in parallel, was reported. RESULTS Sensitivity of IgG EIA was 30/37 (81.1%; 95% confidence interval [CI], 68.5%-93.4%) in cats and 17/22 (77.3%; 95% CI, 59.8%-94.8%) in dogs. Diagnostic sensitivity of ID was 0/37 (0%; 95% CI, 0%-9.5%) in cats and 3/22 (13.6%; 95% CI, 0%-28.0%) in dogs. Immunoglobulin G EIA was positive in all animals (2 cats and 2 dogs) with histoplasmosis but without detectable antigen in urine. Diagnostic specificity of IgG EIA was 18/19 (94.7%; 95% CI, 74.0%-99.9%) in cats and 128/138 (92.8%; 95% CI, 87.1%-96.5%) in dogs. CONCLUSION AND CLINICAL IMPORTANCE Antibody detection by EIA can be used to support the diagnosis of histoplasmosis in cats and dogs. Immunodiffusion has an unacceptably low diagnostic sensitivity and is not recommended.
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Affiliation(s)
- Rebecca Tims
- Veterinary Specialists of North Texas, Fort Worth, Texas, USA
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
- MiraVista Diagnostics, Indianapolis, Indiana, USA
| | - Laura Nafe
- Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri, USA
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Hanzlicek AS, KuKanich KS, Cook AK, Hodges S, Thomason JM, DeSilva R, Ramachandran A, Durkin MM. Clinical utility of fungal culture and antifungal susceptibility in cats and dogs with histoplasmosis. J Vet Intern Med 2023; 37:998-1006. [PMID: 37092675 DOI: 10.1111/jvim.16725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 04/08/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Culture can be used for diagnosis and antifungal susceptibility testing in animals with fungal infections. Limited information is available regarding the diagnostic performance of culture and the susceptibility patterns of Histoplasma spp. isolates. HYPOTHESIS/OBJECTIVES Describe the clinical utility of culture and the susceptibility patterns of Histoplasma spp. isolates causing histoplasmosis in cats and dogs. ANIMALS Seventy-one client-owned animals, including 33 cats and 19 dogs with proven or probable histoplasmosis. METHODS Culture was attempted from tissue or fluid samples. Diagnostic performance of culture, cytopathology, and antigen detection were compared with final diagnosis. Susceptibility to antifungal agents was determined for a subset (11 from dogs, 9 from cats) of culture isolates. RESULTS Culture had a diagnostic sensitivity of 17/33 (52%; 95% confidence interval [CI], 34%-69%) and 15/19 (79%; 95% CI, 61%-97%) and specificity of 6/6 (100%; 95% CI, 54%-100%) and 10/10 (100%; 95% CI, 69%-100%) in cats and dogs, respectively. Culture was not positive in any animal in which cytopathology and antigen testing were negative. Target drug exposure (area under the concentration curve [AUC]/minimum inhibitory concentration [MIC] >25) should be easily achieved for all isolates for itraconazole, voriconazole, or posaconazole. Five of 20 (25%) isolates had fluconazole MIC ≥32 μg/mL and achieving target drug exposure is unlikely. CONCLUSIONS AND CLINICAL IMPORTANCE Fungal culture did not improve diagnostic sensitivity when used with cytopathology and antigen detection. Susceptibility testing might help identify isolates for which fluconazole is less likely to be effective.
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Affiliation(s)
- Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
- MiraVista Diagnostics, Indianapolis, Indiana, USA
| | - Kate S KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Audrey K Cook
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Steven Hodges
- Oklahoma Veterinary Specialists, Tulsa, Oklahoma, USA
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA
| | - Rupika DeSilva
- Oklahoma Animal Disease Diagnostic Laboratory, Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Akhilesh Ramachandran
- Oklahoma Animal Disease Diagnostic Laboratory, Department of Veterinary Pathobiology, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
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Hernandez B, Jaffey JA, Cohn LA, Backus RC, KuKanich K, Hanzlicek AS, Parker VJ, White ME, Ringold R, Westerback E, Freilich L, Bolch C. Evaluation of serum 25-hydroxyvitamin D, C-reactive protein, and haptoglobin as biomarkers in dogs newly diagnosed with histoplasmosis. J Vet Intern Med 2023; 37:476-483. [PMID: 36748822 DOI: 10.1111/jvim.16640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 01/26/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Serum 25-hydroxyvitamin (OH)D, C-reactive protein (CRP), and haptoglobin are useful biomarkers in various infectious diseases and inflammatory disorders in dogs, but their utility in histoplasmosis is unknown. OBJECTIVE Determine if serum 25(OH)D, CRP, and haptoglobin concentrations are different in dogs with histoplasmosis compared to healthy controls and whether serum globulin, albumin, CRP, or haptoglobin are associated with 25(OH)D concentration. ANIMALS Twenty-two client-owned dogs (histoplasmosis, n = 12; controls, n = 10). METHODS Prospective case-control study. Dogs with histoplasmosis were categorized as pulmonary, disseminated, or gastrointestinal (GI) tract. Serum 25(OH)D was measured using modified high-performance liquid chromatography (HPLC). Serum CRP and haptoglobin were measured with ELISA assays. RESULTS Dogs with histoplasmosis were grouped as disseminated (n = 8) and GI tract (n = 4). No dogs had pulmonary tract involvement alone. Dogs with histoplasmosis (median, interquartile range [IQR]; 11.6 ng/mL, 16.8) had lower serum 25(OH)D concentrations than controls (35.7 ng/mL, 17.6; P < .001). Serum CRP and haptoglobin concentrations were higher in dogs with histoplasmosis (CRP: median, IQR; 63.5 mg/L, 37.1 and haptoglobin: 459.7 mg/dL, 419.6) than controls (CRP: 1.9 mg/L, 2; P < .001 and haptoglobin: 85.5 mg/dL, 106.7; P = .003). Serum 25(OH)D concentration was positively associated with fold change in serum albumin concentration (ρ = 0.77; P < .001), and negatively associated with fold change in serum globulin (ρ = -0.61; P = .003) and CRP concentrations (ρ = -0.56; P = .01). CONCLUSION AND CLINICAL IMPORTANCE Assay of serum 25(OH)D, CRP, and haptoglobin could have clinical value in dogs with histoplasmosis.
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Affiliation(s)
- Betsy Hernandez
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Jared A Jaffey
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, Arizona, USA
| | - Leah A Cohn
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Robert C Backus
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Kate KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Andrew S Hanzlicek
- MiraVista Diagnostics, Indianapolis, Indiana, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Valerie J Parker
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Mary E White
- Department of Pathology and Population Medicine, College of Veterinary Medicine, Midwestern University, Glendale, Arizona, USA
| | | | - Emily Westerback
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, Arizona, USA
| | - Leah Freilich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Charlotte Bolch
- Department of Research and Sponsored Programs, Midwestern University, College of Graduate Studies, Glendale, Arizona, USA
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Langlois DK, Pritchard JC, Tolbert MK, Jergens AE, Block G, Hanzlicek AS, Jaffey JA, Steiner JM, Marsilio S, Jablonski SA. Clinical utility of an immunoglobulin A-based serological panel for the diagnosis of chronic enteropathy in dogs. Vet Med (Auckl) 2023; 37:446-454. [PMID: 36708202 DOI: 10.1111/jvim.16636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 01/06/2023] [Indexed: 01/29/2023]
Abstract
BACKGROUND A panel of IgA-based serologic assays might aid in the diagnosis of chronic enteropathy (CE) in dogs, a syndrome encompassing conditions such as food-responsive enteropathy, immunosuppressant-responsive enteropathy, and inflammatory bowel disease (also referred to as chronic inflammatory enteropathy). However, it is unclear whether these biomarkers discriminate between CE and other types of primary intestinal disorders. OBJECTIVES To evaluate a diagnostic panel that measures serum concentrations of IgA directed against OmpC (ACA), canine calprotectin (ACNA), and gliadin-derived peptides (AGA) in dogs with well-characterized intestinal diseases. ANIMALS Fifty-five dogs with primary intestinal disease. METHODS Serum ACA, ACNA, and AGA concentrations were measured in 30 dogs with CE and 25 dogs with other intestinal diseases (non-CE population), including histoplasmosis, parasitism, E. coli-associated granulomatous colitis, and lymphoma. Serum IgA concentrations were compared among populations, and sensitivities and specificities were calculated using laboratory-provided cut-points. RESULTS Twenty-six of 30 (87%) CE dogs and 21 of 25 (84%) non-CE dogs had abnormal concentrations (intermediate or high) of at least 2 markers; these proportions were not significantly different (P = .99). A serum ACA concentration ≥15 EU/mL was 86.7% (95% confidence interval [CI], 69.3%-96.2%) sensitive and 24.0% (95% CI, 9.4%-45.1%) specific for CE diagnosis. High AGA concentrations were observed in 16 of 25 (64%) non-CE dogs. CONCLUSIONS AND CLINICAL IMPORTANCE The evaluated serologic markers were poorly specific for CE diagnosis, which raises concerns that their use in clinical practice might lead to misdiagnoses and delayed or even detrimental treatments in dogs with non-CE intestinal diseases.
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Affiliation(s)
- Daniel K Langlois
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Jessica C Pritchard
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - M Katherine Tolbert
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Albert E Jergens
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA
| | - Gary Block
- Ocean State Veterinary Specialists, East Greenwich, Rhode Island, USA
| | | | - Jared A Jaffey
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, Glendale, Arizona, USA
| | - Jörg M Steiner
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Sina Marsilio
- Department of Medicine and Epidemiology, University of California, Davis, California, USA
| | - Sara A Jablonski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
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Pucket JD, Fentiman KE, McCool ES, Hanzlicek AS. Prevalence of ocular lesions in cats newly diagnosed with histoplasmosis: 55 cases (2015-2022). J Am Vet Med Assoc 2022; 260:1330-1333. [PMID: 35594204 DOI: 10.2460/javma.22.03.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the prevalence of ocular lesions in cats with newly diagnosed histoplasmosis. ANIMALS 55 client-owned domestic cats. PROCEDURES As part of this prospective case series, cats diagnosed with histoplasmosis between the years 2015 and 2020 underwent complete ophthalmic examinations by a board-certified veterinary ophthalmologist prior to the initiation of antifungal treatment. Histoplasmosis was diagnosed by consistent clinical findings and identification of Histoplasma yeast on pathology or by the use of a commercially available enzyme immunoassay to detect Histoplasma antigen in urine. RESULTS Of the 55 cats, 45 (82%; 95% CI, 72% to 92%) had signs of active anterior, posterior, or panuveitis. The most common lesions were identified in the posterior portion of the globe and included chorioretinitis and partial retinal detachments (44/55 [80%; 95% CI, 69% to 90%] cats). CLINICAL RELEVANCE Detailed ophthalmic examinations should be performed on all cats with diagnosed or suspected histoplasmosis, as ocular involvement and subsequent vision loss are common.
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Affiliation(s)
| | - Katelyn E Fentiman
- 2Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK
| | - Emily S McCool
- 2Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK
| | - Andrew S Hanzlicek
- 2Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK
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Jarrett KA, Dugat DR, Hanzlicek AS, Payton ME. In vitro effect of hydroxyethyl starch on coagulation in dogs as assessed by dynamic viscoelastic coagulometry. Am J Vet Res 2022; 83:ajvr.21.12.0203. [PMID: 35524956 DOI: 10.2460/ajvr.21.12.0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effect of 6% hydroxyethyl starch (HES) 670/0.75 and 6% HES 130/0.4 dilution of canine whole blood on coagulation using dynamic viscoelastic coagulometry (DVC). ANIMALS 56 healthy adult dogs. PROCEDURES 2 blood samples were obtained from each dog and randomized to 1 of 7 groups-undiluted or 2 dilutions (1:3 or 1:10) of 3 different fluids: saline (0.9% NaCl) solution, 6% HES 670/0.75, or 6% HES 130/0.4. Dilutions were calculated to simulate approximately a 10- or 30-mL/kg body weight IV bolus of each fluid. DVC was performed on each sample. Coagulation parameters compared between groups included clot rate (CR), platelet function (PF), and activated clotting time. RESULTS Dilution with saline solution did not significantly affect coagulation, while dilution with HES 670/0.75 and HES 130/0.4 caused a dose-dependent significant decrease in CR (1:3 HES 670/0.75, P = 0.007; 1:10 HES 670/0.75, P = 0.002; 1:3 HES130/0.4, P < 0.0001; and 1:10 HES 130/0.4, P = 0.0003) and PF (1:3 HES 670/0.75, P < 0.0001; 1:10 HES 670/0.75, P < 0.0001; 1:3 HES130/0.4, P < 0.0001; and 1:10 HES 130/0.4, P = 0.0015). CLINICAL RELEVANCE Dilution of canine blood with HES 670/0.75 and HES 130/0.4, at clinically relevant doses (10 and 30 mL/kg), led to significant hypocoagulability beyond dilutional effect. This was, in part, due to impaired PF, which was significantly greater with HES 670/0.75. Further research using DVC to assess the effects of HES on coagulation in dogs, ideally with clinical conditions warranting HES administration, is needed.
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Affiliation(s)
- Keith A Jarrett
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK
| | - Danielle R Dugat
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK
| | - Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK
| | - Mark E Payton
- Department of Statistics, Oklahoma State University, Stillwater, OK
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Grinstead CR, Hanzlicek AS, Largura HW, Wheat LJ. Invasive fungal rhinitis with adnexal involvement caused by Histoplasma capsulatum in a cat from a non-enzootic location. JFMS Open Rep 2021; 7:2055116921993385. [PMID: 33643661 PMCID: PMC7894697 DOI: 10.1177/2055116921993385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Case summary This report describes a cat with a rare form of histoplasmosis: invasive rhinitis with adnexal involvement, mimicking disease more commonly caused by cryptococcosis or aspergillosis. This case is especially noteworthy as it was from an area where histoplasmosis is not enzootic. Relevance and novel information Invasive fungal rhinitis causes significant morbidity in cats. Diagnostic investigation of more common pathogens includes detection of fungal antigen (Cryptococcus) or antifungal antibodies (Aspergillus). This case demonstrates that histoplasmosis can present as chronic nasal disease in cats. Histoplasma antigen testing provides a non-invasive diagnostic option. Moreover, this case serves as a reminder that histoplasmosis can affect cats anywhere, even in non-enzootic areas.
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Clark K, Hanzlicek AS. Evaluation of a novel monoclonal antibody-based enzyme immunoassay for detection of Histoplasma antigen in urine of dogs. J Vet Intern Med 2020; 35:284-293. [PMID: 33368653 PMCID: PMC7848336 DOI: 10.1111/jvim.16006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 11/24/2020] [Accepted: 12/02/2020] [Indexed: 01/01/2023] Open
Abstract
Background Commercially available, noninvasive testing options for histoplasmosis are limited outside of the United States. Objectives To describe the diagnostic performance of a novel Histoplasma antigen enzyme immunoassay (IM EIA) for the diagnosis of histoplasmosis in dogs. Animals Twenty dogs with histoplasmosis, 79 dogs without histoplasmosis, and 11 unclassified dogs providing 202 urine samples. Methods This a prospective study using stored urine samples. Samples were analyzed with the IM EIA and with the commercially available Histoplasma antigen EIA (MV EIA). Dogs were classified based on final proven diagnosis and performance of the IM EIA was described and compared with the MiraVista enzyme immunoassay (MV EIA). Results The diagnostic sensitivity (DSe), specificity (DSp), and accuracy (DAc) of the IM EIA were 70% (51%‐89%), 99% (97%‐100%), and 93% (81%‐100%), respectively. The DSe, DSp, and DAc for the MV EIA were 95% (85%‐100%), 99% (97%‐100%), and 98% (95%‐100%), respectively. The area under the receiver operator characteristic curve was significantly smaller for IM EIA (0.87) as compared with MV EIA (0.97, P = .03). This was primarily due to 6 false negative IM EIA results, 4 from dogs with disease localized to the gastrointestinal tract. The MV EIA was positive in 5/6 of these dogs. Conclusions and Clinical Importance The IM EIA might be useful for the diagnosis of disseminated histoplasmosis in dogs, but clinical usefulness will be limited in dogs with histoplasmosis localized to the GI tract.
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Affiliation(s)
- Kristen Clark
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
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KuKanich K, KuKanich B, Lin Z, Rankin AJ, Hanzlicek AS, Palerme JS, Bach J, Cook AK, Juracek A, Joo H. Clinical pharmacokinetics and outcomes of oral fluconazole therapy in dogs and cats with naturally occurring fungal disease. J Vet Pharmacol Ther 2020; 43:547-556. [PMID: 32656792 DOI: 10.1111/jvp.12888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/28/2020] [Accepted: 06/07/2020] [Indexed: 11/30/2022]
Abstract
This multi-institutional study was designed to determine the clinical pharmacokinetics of fluconazole and outcomes in client-owned dogs (n = 37) and cats (n = 35) with fungal disease. Fluconazole serum concentrations were measured. Pharmacokinetic analysis was limited to animals at steady state (≥72 hr of treatment). The mean (range) body weight in 31 dogs was 25.6 (2.8-58.2) kg and in 31 cats was 3.9 (2.4-6.1) kg included in pharmacokinetic analyses. The dose, average steady-state serum concentrations (CSS ), and oral clearance in dogs were 14.2 (4.5-21.3) mg/kg/d, 26.8 (3.8-61.5) µg/mL, and 0.63 ml min-1 kg-1 , respectively, and in cats were 18.6 (8.2-40.0) mg/kg/d, 32.1 (1.9-103.5) µg/mL, and 0.61 ml min-1 kg-1 , respectively. Random inter-animal pharmacokinetic variability was high in both species. Two dogs had near twofold increases in serum fluconazole when generic formulations were changed, suggesting lack of bioequivalence. Median CSS for dogs and cats achieving clinical remission was 19.4 and 35.8 µg/ml, respectively. Starting oral doses of 10 mg/kg q12h in dogs and 50-100 mg total daily dose in cats are recommended to achieve median CSS associated with clinical remission. Due to the large pharmacokinetic variability, individualized dose adjustments based on CSS (therapeutic drug monitoring) and treatment failure should be considered.
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Affiliation(s)
- Kate KuKanich
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Butch KuKanich
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Zhoumeng Lin
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Amy J Rankin
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Andrew S Hanzlicek
- Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Jean-Sebastien Palerme
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA
| | - Jonathan Bach
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Audrey K Cook
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
| | - Amy Juracek
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Hyun Joo
- Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
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Holbrook ED, Greene RT, Rubin SI, Renschler JS, Book BP, Hanzlicek AS, Durkin MM, Smedema ML, Wheat LJ. Novel canine anti-Coccidioides immunoglobulin G enzyme immunoassay aids in diagnosis of coccidioidomycosis in dogs. Med Mycol 2020; 57:800-806. [PMID: 30649403 DOI: 10.1093/mmy/myy157] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 11/20/2018] [Accepted: 12/20/2018] [Indexed: 11/15/2022] Open
Abstract
The diagnosis of coccidioidomycosis (CM) in dogs is typically based on clinical presentation, serology, and (less frequently) spherule identification. Agar gel immunodiffusion (AGID) is the most commonly employed serological method, but AGID is slow (requiring up to a week for titer). A Coccidioides antigen enzyme immunoassay (EIA) is also available; however, sensitivity is low in CM dogs. An antibody EIA was developed to detect canine immunoglobulin G (IgG) reacting to Coccidioides antigens. Serum was evaluated from dogs with pathology proven CM and/or AGID positive CM, as well as dogs with histoplasmosis, blastomycosis, non-fungal infections, or healthy dogs. A standard curve was used to convert optical density (OD) values into EIA units (EU). Serum and urine samples from CM dogs were also tested in the antigen EIA. Sensitivity and specificity for IgG were 89.2% and 97.2%, respectively, upon evaluation of dogs with proven or probable CM and control dogs. Cross-reactivity was observed in 7.7% and in 6.4% of dogs with histoplasmosis or blastomycosis, respectively. The antigen EIA alone was insensitive (33.8%). Combined IgG and antigen testing increased sensitivity to 93.2%, as three dogs were IgG-negative but had detectable serum or urine antigen. In 22 dogs with proven CM, sensitivity was statistically similar for antibody EIA and AGID (86% and 73%; P = .487). The MiraVista® canine Coccidioides antibody IgG EIA may aid in the diagnosis of CM by improving turnaround time with comparable sensitivity to AGID. Serial or concurrent testing by antibody and antigen EIAs may be beneficial when screening dogs for CM.
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Affiliation(s)
| | - Russell T Greene
- Phoenix Veterinary Internal Medicine Services, Phoenix, Arizona, USA
| | - Stanley I Rubin
- Department of Veterinary Clinical Medicine, University of Illinois at Urbana Champaign, Urbana, Illinois, USA
| | | | - Bradley P Book
- South Texas Veterinary Specialists, San Antonio, Texas, USA
| | - Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma, USA
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Rodenbaugh CI, Lyon SD, Hanzlicek AS, Kanda I, Payton ME, Rizzi TE, Holland LA, Brandão J. Dynamic viscoelastic coagulometry of blood obtained from healthy chickens. Am J Vet Res 2019; 80:441-448. [PMID: 31034267 DOI: 10.2460/ajvr.80.5.441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess feasibility of the use of a dynamic viscoelastic coagulometer on chicken blood and compare coagulation variables for fresh whole blood and sodium citrate-preserved whole blood as well as effects of 3 coagulation activators on blood from chickens. SAMPLE Blood samples from 30 hens. PROCEDURES Chickens were allowed to rest undisturbed for 1 hour. A blood sample was collected from an ulnar vein; 1.4 mL was analyzed immediately, and 1.8 mL was mixed with sodium citrate and subsequently recalcified and analyzed. A separate coagulation activator (glass beads, kaolin clay, or tissue factor) was in each of the 2 channels of the analyzer. Chickens were allowed a 1-hour rest period, and another blood sample was collected from the contralateral ulnar vein; it was processed in the same manner as for the first sample, except both channels of the analyzer contained the same coagulation activator. RESULTS Compared with fresh samples, citrated samples had higher values for activated clotting time and platelet function and lower clotting rates. Intra-assay coefficients of variation of coagulation profiles for citrated samples were markedly greater than the limit of 10%, whereas values for fresh samples were close to or < 10%. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that use of a dynamic viscoelastic coagulometer on chicken blood was feasible and that analysis of fresh whole blood from healthy chickens provided results with less variability than did analysis of citrated blood. Samples preserved with sodium citrate were associated with significant relative hypocoagulability, compared with results for fresh blood.
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Wilson AG, KuKanich KS, Hanzlicek AS, Payton ME. Clinical signs, treatment, and prognostic factors for dogs with histoplasmosis. J Am Vet Med Assoc 2018; 252:201-209. [PMID: 29319442 DOI: 10.2460/javma.252.2.201] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the clinical manifestations of histoplasmosis in a large sample of dogs, compare outcomes achieved with fluconazole versus itraconazole, and identify variables available at the time of diagnosis with prognostic value. DESIGN Retrospective case series with nested cohort study. ANIMALS 79 dogs with confirmed histoplasmosis evaluated at 2 veterinary teaching hospitals from 1999 through 2015. PROCEDURES Medical records were reviewed and data extracted regarding clinical signs at evaluation, physical examination findings, clinical laboratory values, other diagnostic test results, treatments, and outcomes. Data were compared between antifungal agents used (fluconazole or itraconazole) and between other variables. RESULTS Various breeds were represented. Working and herding breeds had mostly disseminated histoplasmosis, and toy breeds had mostly the gastrointestinal form. The diagnosis was often achieved with noninvasive techniques, such as cytologic evaluation of rectal scrape samples (n = 24) or blood films (15). Clinical remission was achieved in 16 of 25 (64%) dogs receiving fluconazole and 17 of 24 (71%) dogs receiving itraconazole. No differences were identified between antifungal agents in survival, clinical remission, or disease relapse rates. Identified negative prognostic factors included Great Pyrenees breed, dyspnea, need for oxygen supplementation, icterus, palpable abdominal organomegaly, anemia, thrombocytopenia, hypercalcemia, high serum alkaline phosphatase activity, and hyperbilirubinemia, whereas diarrhea was a positive prognostic factor. CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that histoplasmosis should be considered in a sick dog of any breed in an endemic area. Clinical signs may be nonspecific. Diagnosis may often be possible with noninvasive and inexpensive tests. Either fluconazole or itraconazole may be an effective treatment option.
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Rothenburg L, Hanzlicek AS, Payton ME. A monoclonal antibody-based urine Histoplasma antigen enzyme immunoassay (IMMY®) for the diagnosis of histoplasmosis in cats. J Vet Intern Med 2018; 33:603-610. [PMID: 30557457 PMCID: PMC6430878 DOI: 10.1111/jvim.15379] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/13/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND An in-house Histoplasma urine antigen test for cats might be desirable in certain situations. OBJECTIVE To validate and compare the diagnostic performance of a monoclonal antibody-based IMMY urine Histoplasma antigen enzyme immunoassay (IMMY EIA) to the commercially available urine Histoplasma antigen enzyme immunoassay (MiraVista Diagnostics, MV EIA). ANIMALS One hundred ninety-three urine samples from 105 client-owned and purpose-bred research cats. METHODS Cats were classified as Histoplasma positive or negative based on diagnostic investigation. The IMMY EIA and MV EIA were performed on all urine samples. Correlation and agreement between the assays were determined. Diagnostic performance was determined and compared between assays. RESULTS The IMMY EIA, with a 0.25 ng/mL diagnostic cutoff, provided a diagnostic sensitivity (DSe), diagnostic specificity (DSp), and diagnostic accuracy (DAc) of 89% (95% confidence interval [CI]; 73%-97%), 80% (67%-89%), and 83% (74%-90%), respectively. The IMMY EIA, with a 1.1 ng/mL diagnostic cutoff, provided a DSe, DSp, and DAc of 77% (95% CI 60%-90%), 97% (88%-100%), and 89% (81%-95%), respectively. The MV EIA provided a DSe, DSp, and DAc of 94% (95% CI 81%-99%), 97% (89%-100%), and 96% (90%-99%), respectively. Moderate overall agreement was found between MV EIA and IMMY EIA using the 0.25 ng/mL cut-off (к = 0.44; 95% CI 0.31-0.57) and the 1.1 ng/mL cut-off (к = 0.43, 95% CI, 0.31-0.56). CONCLUSIONS AND CLINICAL IMPORTANCE The IMMY EIA might be useful as a diagnostic test for histoplasmosis in cats. Further modifications of the IMMY EIA are required to achieve the diagnostic performance of the MV EIA.
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Affiliation(s)
- Lana Rothenburg
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma
| | - Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, Oklahoma
| | - Mark E Payton
- Department of Statistics, Oklahoma State University, Stillwater, Oklahoma
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17
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Fielder SE, Meinkoth JH, Rizzi TE, Hanzlicek AS, Hallman RM. Feline histoplasmosis presenting with bone and joint involvement: clinical and diagnostic findings in 25 cats. J Feline Med Surg 2018; 21:887-892. [PMID: 30407138 DOI: 10.1177/1098612x18806706] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this study was to describe clinical and diagnostic findings in cats with bone and joint disease associated with histoplasmosis. METHODS Medical records from between 2011 and 2017 were reviewed. Inclusion criteria required: (1) diagnosis of histoplasmosis by cytology, histology, urine or serum Histoplasma antigen testing, or culture; and (2) lameness or joint effusion as a presenting complaint or physical examination finding. RESULTS Twenty-five cases met the inclusion criteria. Four had incomplete records, but available data were included when applicable. Lameness was a presenting complaint in 17/21 cats and was the only complaint in 9/21 cats. Initial diagnosis was made by cytology in 22/25 cats and by culture, urine antigen and necropsy in one case each. Diagnostic cytology samples included synovial fluid (n = 13), lymph node (n = 5), skin (n = 2), lung (n = 1) and bone (n = 1). Two additional cases had synovial fluid examined but no organisms present. Inflammation was present in all synovial fluid samples examined. Biopsy was obtained in two cats and histologic diagnoses included osteomyelitis with no infectious organisms identified and severe lymphoplasmacytic synovitis suggestive of feline periosteal proliferative polyarthritis. Histoplasma urine antigen test was positive in 7/12 cats. CONCLUSIONS AND RELEVANCE Inflammatory arthritis is common in cats with histoplasmosis, with lameness a common presenting complaint. Organisms are found in synovial fluid cytology in most cases. If not, appropriate additional diagnostics must be pursued.
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Affiliation(s)
- Susan E Fielder
- Veterinary Pathobiology, Oklahoma State University Center for Veterinary Sciences, Stillwater, OK, USA
| | - James H Meinkoth
- Veterinary Pathobiology, Oklahoma State University Center for Veterinary Sciences, Stillwater, OK, USA
| | - Theresa E Rizzi
- Veterinary Pathobiology, Oklahoma State University Center for Veterinary Sciences, Stillwater, OK, USA
| | - Andrew S Hanzlicek
- Veterinary Clinical Sciences, Oklahoma State University Center for Veterinary Sciences, Stillwater, OK, USA
| | - Ruth Mackenzie Hallman
- Veterinary Clinical Sciences, Oklahoma State University Center for Veterinary Sciences, Stillwater, OK, USA
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18
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McGill JE, Hanzlicek AS, Kukanich KS, Norsworthy GD, Cook AK. Pretreatment Histoplasma capsulatum urine enzymatic immunoassay concentrations do not correlate with outcome but may be influenced by renal function in cats with histoplasmosis. J Feline Med Surg 2018. [PMID: 29513156 DOI: 10.1177/1098612x18761440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The objective of this study was to determine if urine Histoplasma antigen (HAg) enzyme immunoassay (EIA) concentrations at the time of diagnosis and prior to the administration of antifungal agents are predictive of outcome for cats infected with Histoplasma capsulatum and to determine if compromised renal function affects urine HAg EIA measurements. METHODS Medical records at four institutions were searched to identify cats diagnosed with histoplasmosis between April 2012 and December 2015. Pretreatment urine Histoplasma EIA values were recorded, along with patient signalment, serum creatinine concentration, urine specific gravity, site(s) of infection and survival data. RESULTS Pretreatment urine HAg EIA measurements were available for 50 cats, and ranged from 0-19.1 ng/ml (median 6.3 ng/ml). Thirty-five cats were alive at day 180, 12 had died or were euthanized (median survival time 24 days; range 2-124 days) and three were lost to follow-up. The median urine HAg EIA at the time of diagnosis for cats alive at 6 months was 5 ng/ml (range 0-19.1); this was similar to findings for the non-survivors (median 7.29 ng/ml; range 0.78-19.1; P = 0.54). Surviving cats were significantly younger (mean age 6.9 years) than non-survivors (mean age 9.9 years; P = 0.03) but median body weights (3.8 kg vs 3.6 kg) and rates of pulmonary involvement (22/35 vs 9/12) were similar for the two groups. Median urine HAg EIA concentration was lower in cats with evidence of renal compromise than cats with acceptable renal function (0.54 ng/ml vs 7.2 ng/ml; P <0.013). CONCLUSIONS AND RELEVANCE Urine HAg EIA concentrations at the time of diagnosis are not predictive of outcome in cats with histoplasmosis and should not be used as a prognostic indicator in this species. Renal function may influence urine HAg EIA concentrations in cats; further investigation is needed to see if concurrent kidney disease impacts test sensitivity.
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Affiliation(s)
- Jennifer E McGill
- 1 Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, LA, USA
| | - Andrew S Hanzlicek
- 2 Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Kate S Kukanich
- 3 Department of Clinical Sciences, Kansas State University, Manhattan, KS, USA
| | | | - Audrey K Cook
- 5 Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, USA
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Ludwig HC, Hanzlicek AS, KuKanich KS, Payton ME. Candidate prognostic indicators in cats with histoplasmosis treated with antifungal therapy. J Feline Med Surg 2017; 20:985-996. [DOI: 10.1177/1098612x17746523] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives The aim of this study was to retrospectively identify candidate prognostic indicators in cats with histoplasmosis treated with antifungal therapy. Methods Medical records of cats diagnosed with histoplasmosis were reviewed. Candidate prognostic indicators were assessed for an association with survival to hospital discharge and survival to 1 and 6 months after diagnosis. Potential indicators included easily obtained data at the time of the initial hospital visit derived from cat signalment, historical information, physical examination, laboratory data, form of disease and initial treatment. Results Approximately 88% of cats survived to discharge, with 77% and 67% surviving to 1 and 6 months, respectively. Clinical variables significantly associated with death at more than one outcome time point included the presence of dyspnea, adventitial lung sounds, fungemia, neurologic disease, neutropenia, lymphopenia, multiple cytopenias (anemia, neutropenia, thrombocytopenia), hyperbilirubinemia and increased creatinine kinase activity. Cats that did not survive were more likely to have received corticosteroids, oxygen supplementation and required hospitalization. In addition, cats that did not survive required significantly longer hospitalization. There was no significant difference between initial antifungal drug and survival. Conclusions and relevance Potential prognostic indicators were associated with more severe respiratory, hepatic, hematologic or neurologic disease. Prospective investigation concerning clinical indicators of disease severity of these body systems is indicated.
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Affiliation(s)
- Hilary C Ludwig
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Kate S KuKanich
- Department of Clinical Sciences, Kansas State University, Manhattan, KS, USA
| | - Mark E Payton
- Department of Statistics, Oklahoma State University, Stillwater, OK, USA
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Jamieson CA, Hanzlicek AS, Payton ME, Holbrook TC. Normal reference intervals and the effects of sample handling on dynamic viscoelastic coagulometry (Sonoclot) in healthy adult horses. J Vet Emerg Crit Care (San Antonio) 2017; 28:39-44. [DOI: 10.1111/vec.12687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 04/21/2016] [Accepted: 06/06/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Camilla A. Jamieson
- Department of Veterinary Clinical Sciences; Oklahoma State University; Stillwater OK 74078
| | - Andrew S. Hanzlicek
- Department of Veterinary Clinical Sciences; Oklahoma State University; Stillwater OK 74078
| | - Mark E. Payton
- Department of Statistics; Oklahoma State University; Stillwater OK 74078
| | - Todd C. Holbrook
- Department of Veterinary Clinical Sciences; Oklahoma State University; Stillwater OK 74078
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21
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Baumwart RD, Hanzlicek AS, Lyon SD, Lee PM. Plasma N-terminal pro-brain natriuretic peptide concentrations before and after pericardiocentesis in dogs with cardiac tamponade secondary to spontaneous pericardial effusion. J Vet Cardiol 2017; 19:416-420. [PMID: 28988688 DOI: 10.1016/j.jvc.2017.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 06/19/2017] [Accepted: 08/28/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine if concentrations of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) are increased in dogs with cardiac tamponade and if there is a significant increase in plasma NT-proBNP after pericardiocentesis. ANIMALS Ten client-owned dogs with spontaneous cardiac tamponade. METHODS Prospective clinical study. Cardiac tamponade was suspected from physical examination and confirmed with echocardiography. Blood was collected and plasma NT-proBNP concentrations were measured before and 30-60 min following pericardiocentesis and resolution of cardiac tamponade. Within-subject changes in plasma NT-proBNP were compared by the Wilcoxon signed-rank test. RESULTS The plasma NT-proBNP concentrations measured within the reference interval in seven of 10 dogs before pericardiocentesis and in six of 10 dogs following pericardiocentesis. Following pericardiocentesis, there was a statistically significant increase in median NT-proBNP concentration (733 pmol/L, range 250-3,297) compared with the values measured before (643 pmol/L, range 250-3,210, P = 0.004). The NT-proBNP concentration increased in 90% of the dogs following pericardiocentesis. CONCLUSIONS An upper reference limit of 900 pmol/L for plasma NT-proBNP is insensitive for the diagnosis of pericardial effusion and cardiac tamponade in dogs. Plasma NT-proBNP concentration commonly increases following pericardiocentesis, perhaps related to improved ventricular filling and stretch.
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Affiliation(s)
- R D Baumwart
- Department of Veterinary Clinical Sciences, Oklahoma State University, 2065 W. Farm Rd., Stillwater, OK 74078, United States.
| | - A S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, 2065 W. Farm Rd., Stillwater, OK 74078, United States
| | - S D Lyon
- Department of Veterinary Clinical Sciences, Oklahoma State University, 2065 W. Farm Rd., Stillwater, OK 74078, United States
| | - P M Lee
- Department of Veterinary Clinical Sciences, Washington State University, PO Box 647060, Pullman, WA 99164-7060, United States
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Renschler JS, Norsworthy GD, Rakian RA, Rakian AI, Wheat LJ, Hanzlicek AS. Reduced susceptibility to fluconazole in a cat with histoplasmosis. JFMS Open Rep 2017; 3:2055116917743364. [PMID: 29225910 PMCID: PMC5714094 DOI: 10.1177/2055116917743364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Case summary An 11-year-old neutered male domestic longhair cat was diagnosed with histoplasmosis from fine-needle aspirates of an abdominal lymph node. Lymph node size initially decreased with fluconazole therapy (11.8 mg/kg PO q12h); however, after 13 months of continuous fluconazole therapy, lymphadenomegaly worsened and samples were collected for culture and antifungal susceptibility. The Histoplasma capsulatum isolate had a very high fluconazole minimum inhibitory concentration (MIC) of 64 µg/ml and an itraconazole MIC of 0.06 µg/ml. The owner declined a change to itraconazole and, ultimately, the cat developed neurologic signs and was euthanized. Owing to the initial response to fluconazole followed by treatment failure and high MIC value, acquired fluconazole resistance was suspected. Clinical breakpoints for fluconazole for the dimorphic fungi are not available to define true antifungal resistance. Relevance and novel information This is the first published report of reduced susceptibility to fluconazole in a cat being treated for histoplasmosis. Fluconazole failure and increases in MIC between pretreatment and long-term treatment isolates are known to occur in humans with histoplasmosis. Practitioners should be aware of this possibility when treating cats with fluconazole (particularly in cases with long-term [>1 year] fluconazole therapy or in cases with disease recrudescence).
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Affiliation(s)
| | | | - Rubie A Rakian
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Audrey I Rakian
- Department of Cellular and Integrative Physiology, University of Texas Health Science Center, San Antonio, TX, USA
| | | | - Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK, USA
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Hanzlicek AS, Meinkoth JH, Renschler JS, Goad C, Wheat LJ. Antigen Concentrations as an Indicator of Clinical Remission and Disease Relapse in Cats with Histoplasmosis. J Vet Intern Med 2016; 30:1065-73. [PMID: 27158815 PMCID: PMC5084835 DOI: 10.1111/jvim.13962] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/29/2016] [Accepted: 04/18/2016] [Indexed: 11/29/2022] Open
Abstract
Background Treatment monitoring is subjective and disease relapse is common in cats with histoplasmosis. The Histoplasma antigen enzyme immunoassay (EIA) is a noninvasive test used for determining disease remission and detecting disease relapse in humans with histoplasmosis. The utility of the antigen EIA for these purposes in cats remains unknown. Hypothesis/Objectives Those Histoplasma antigen concentrations in urine and serum would decline with antifungal treatment and that antigen elimination would be an indicator of clinical remission in cats with histoplasmosis treated with antifungal treatment. Animals Fifteen client‐owned cats with histoplasmosis. Methods Masked observational study. Cats were monitored monthly during antifungal treatment. Time of clinical remission and serum and urine antigen elimination were determined for each cat. Results Twelve of 15 cats achieved clinical remission. At the time of diagnosis, antigen was detectable in urine in 14/15 (93%) cats and in serum in 11/15 (73%) cats. Both serum (P < .0005) and urine (P < .0001) antigen concentrations significantly decreased over time with effective treatment. Antigen elimination was sensitive [urine, 90.0% (95% CI 72.3–97.4%); serum, 90.4% (68.2–98.3%)] but less specific [urine, 64.6% (51.7–75.8%); serum, 52.1% (37.4–66.5%)] for disease remission. Urine antigen was positive in both cats and serum antigen was positive in 1 cat at the time of disease relapse. Conclusions and Clinical Importance Measurement of Histoplasma antigen in urine and serum might be useful tests for determining disease remission and relapse in cats with histoplasmosis. Further research is needed to investigate the importance of low‐level antigenemia and antigenuria.
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Affiliation(s)
- A S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK
| | - J H Meinkoth
- Department of Veterinary Pathobiology, Oklahoma State University, Stillwater, OK
| | | | - C Goad
- Department of Statistics, Oklahoma State University, Stillwater, OK
| | - L J Wheat
- MiraVista Diagnostics, Indianapolis, IN
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Hanzlicek AS, Baumwart RD, Payton ME. Systolic arterial blood pressure estimated by mitral regurgitation velocity, high definition oscillometry, and Doppler ultrasonography in dogs with naturally occurring degenerative mitral valve disease. J Vet Cardiol 2016; 18:226-233. [PMID: 27037058 DOI: 10.1016/j.jvc.2016.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 12/07/2015] [Accepted: 01/13/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION To determine if systolic blood pressure estimated by mitral regurgitation (MR) velocity can be used interchangeably with that estimated by high definition oscillometry (HDO) and Doppler ultrasonography (DU) in dogs with naturally occurring mitral valve disease (MVD). ANIMALS Forty-nine client-owned dogs with naturally occurring MVD. MATERIALS AND METHODS This is a retrospective study. Medical records were reviewed and dogs with MR caused by degenerative MVD were included if systolic blood pressure was estimated from MR velocity determined by continuous wave Doppler (CW), DU and HDO at the same visit. A Pearson product moment correlation coefficient was determined for each combination of measures and tested for significance with a paired t-test. Limits of agreement between 2 measures were determined by the 95% confidence interval of the average difference of the means and illustrated by Bland-Altman plots. RESULTS Systolic pressure estimated from CW was significantly but only moderately correlated to DU (r = 0.42, p=0.0015) and HDO (r = 0.40, p=0.0021). Pressure estimated from DU was significantly but only moderately correlated to HDO (r = 0.57, p≤0.0001). Limits of agreement were wide for all measures including DU and CW (-61.9to 44.6 mmHg), HDO and CW (-65.2to 26.9 mmHg), and HDO and DU (-63.1 to 42.06 mmHg). DISCUSSION Systolic blood pressure estimated by CW cannot be used interchangeably with HDO or DU in dogs with naturally occurring MVD.
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Affiliation(s)
- A S Hanzlicek
- Department of Veterinary Clinical Sciences, Oklahoma State University, 2065 W. Farm Rd., Stillwater, OK, 74078, United States.
| | - R D Baumwart
- Department of Veterinary Clinical Sciences, Oklahoma State University, 2065 W. Farm Rd., Stillwater, OK, 74078, United States
| | - M E Payton
- Department of Statistics, Oklahoma State University, 301 MSCS, Stillwater, OK, 74078, United States
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Hanzlicek AS, Roof CJ, Sanderson MW, Grauer GF. The Effect of Chinese rhubarb, Rheum officinale, with and without benazepril on the progression of naturally occurring chronic kidney disease in cats. J Vet Intern Med 2014; 28:1221-8. [PMID: 24773179 PMCID: PMC4857960 DOI: 10.1111/jvim.12365] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 02/27/2014] [Accepted: 03/18/2014] [Indexed: 01/26/2023] Open
Abstract
Background Renal fibrosis is common in progressive kidney disease. Transforming growth factors β (TGF‐β) are important mediators of all types of fibrosis, including renal fibrosis. Chinese rhubarb has been shown to have antifibrotic properties in part because of inhibition of TGF‐β and has slowed the progression of kidney disease in rodent models. Hypothesis That administration of a Chinese rhubarb supplement will slow the progression of chronic kidney disease (CKD) in cats and the concurrent administration of Chinese rhubarb and benazepril will be more effective than either alone. Animals Twenty‐nine client‐owned cats with naturally occurring IRIS Stage 2 or early Stage 3 CKD and without comorbidity such as cancer, urinary tract obstruction, urinary tract infection, poorly controlled hyperthyroidism, or systemic hypertension were enrolled in the study. Methods A randomized, positive‐controlled, prospective study was performed. Cats received Chinese rhubarb, benazepril, or both in addition to standard treatment for CKD. Repeated measures ANOVA was used to assess changes in serum creatinine concentration, body weight, hematocrit, urine protein: urine creatinine ratio (UPC), and systemic arterial blood pressure over time between and within treatment groups over an average of 22 months. Results No significant differences were detected in serum creatinine concentration, body weight, hematocrit, UPC, and systemic arterial pressure over time between or within treatment groups. Conclusions and Clinical Importance This study failed to detect a significant difference in the progression of CKD in cats treated with Chinese rhubarb, benazepril, or both. Further study in specific subsets of cats with CKD is warranted.
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Affiliation(s)
- A S Hanzlicek
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS
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Hanzlicek AS, Roof CJ, Sanderson MW, Grauer GF. Comparison of urine dipstick, sulfosalicylic acid, urine protein-to-creatinine ratio and a feline-specific immunoassay for detection of albuminuria in cats with chronic kidney disease. J Feline Med Surg 2012; 14:882-8. [DOI: 10.1177/1753193412454519] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The performance of the urine dipstick, sulfosalicylic acid (SSA), and urine protein-to-creatinine (UPC) tests for the detection of albuminuria was assessed in cats with chronic kidney disease (CKD). Two hundred and thirty-nine urine samples from 37 cats with CKD were used. Test results were dichotomized as either positive or negative, compared with those for the feline-specific rapid urine albumin immunoassay and test performance variables calculated for each test. A positive urine dipstick (≥trace) and positive SSA (≥5 mg/dl), positive SSA alone or ≥2+ urine dipstick alone were indicative of albuminuria. In these cases, protein quantification would be warranted if proteinuria/albuminuria is persistent. In the case of a negative urine dipstick result the addition of the SSA added little diagnostic value. Of the tests investigated, the single best test for the detection of albuminuria was the UP/C (≥0.2) in which either a negative or positive test result provided useful information.
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Affiliation(s)
- Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Clinton J Roof
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Michael W Sanderson
- Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Gregory F Grauer
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
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Abstract
Two 12-year-old cats were diagnosed with chronic kidney disease (CKD) based on physical examination, clinicopathologic data and, in one case, abdominal ultrasound findings. Approximately 1 year after the initial diagnosis of CKD both cats developed renal transitional cell carcinoma (TCC) — bilateral in one cat. Based on post-mortem examination, one cat had no evidence of metastasis and the other had metastasis to the large intestine, heart and lungs. This is the first report of de novo bilateral renal TCC in a cat, as well as the first report of renal TCC developing in cats with previous history of confirmed CKD.
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Affiliation(s)
- Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, OK, USA
| | - Chanran Ganta
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, KS, USA
| | - Carl B Myers
- Department of Diagnostic Medicine/Pathobiology, College of Veterinary Medicine, Kansas State University, KS, USA
| | - Gregory F Grauer
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, KS, USA
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Hanzlicek AS, Harkin KR, Dryden MW, Chun R, Payne PA, Nietfeld JC, Debey BM. Canine Schistosomiasis in Kansas: Five Cases (2000–2009). J Am Anim Hosp Assoc 2011; 47:e95-e102. [DOI: 10.5326/jaaha-ms-5580] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This is a retrospective case series consisting of five dogs diagnosed with schistosomiasis. The purpose of this article is to report the presence of naturally occurring canine schistosomiasis in Kansas and to provide clinical details regarding schistosomiasis. Medical records of dogs diagnosed with schistosomiasis from 2000 to 2009 were reviewed, and information extracted included signalment, history, clinical signs, diagnostic test results, treatment, and outcome. Affected dogs were primarily medium to large breed and young to middle aged. All dogs were considered outdoor dogs, with three having known access to surface water. Common clinical signs included gastrointestinal disease and signs associated with hypercalcemia. Fecal flotation was negative in all dogs in contrast to fecal saline sedimentation and fecal polymerase chain reaction, which were both positive in all dogs in which it was performed. All dogs treated specifically for schistosomiasis fully recovered. This article describes the first reported cases of canine schistosomiasis in the Midwest and the first reported case of intestinal intussusception secondary to schistosomiasis. Recognizing that canine schistosomiasis is present in Kansas and possibly other Midwestern states should prompt veterinarians to perform appropriate diagnostic investigation in suspect animals as the diagnosis is straight forward and relatively inexpensive.
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Affiliation(s)
- Andrew S. Hanzlicek
- Department of Clinical Sciences (A.H., K.H.) and Department of Diagnostic Medicine/Pathobiology (M.D., P.P., J.N., B.D.), Kansas State University, Manhattan, KS; and Department of Medical Sciences, University of Wisconsin, Madison, WI (R.C.)
| | - Kenneth R. Harkin
- Department of Clinical Sciences (A.H., K.H.) and Department of Diagnostic Medicine/Pathobiology (M.D., P.P., J.N., B.D.), Kansas State University, Manhattan, KS; and Department of Medical Sciences, University of Wisconsin, Madison, WI (R.C.)
| | - Michael W. Dryden
- Department of Clinical Sciences (A.H., K.H.) and Department of Diagnostic Medicine/Pathobiology (M.D., P.P., J.N., B.D.), Kansas State University, Manhattan, KS; and Department of Medical Sciences, University of Wisconsin, Madison, WI (R.C.)
| | - Ruthanne Chun
- Department of Clinical Sciences (A.H., K.H.) and Department of Diagnostic Medicine/Pathobiology (M.D., P.P., J.N., B.D.), Kansas State University, Manhattan, KS; and Department of Medical Sciences, University of Wisconsin, Madison, WI (R.C.)
| | - Patricia A. Payne
- Department of Clinical Sciences (A.H., K.H.) and Department of Diagnostic Medicine/Pathobiology (M.D., P.P., J.N., B.D.), Kansas State University, Manhattan, KS; and Department of Medical Sciences, University of Wisconsin, Madison, WI (R.C.)
| | - Jerome C. Nietfeld
- Department of Clinical Sciences (A.H., K.H.) and Department of Diagnostic Medicine/Pathobiology (M.D., P.P., J.N., B.D.), Kansas State University, Manhattan, KS; and Department of Medical Sciences, University of Wisconsin, Madison, WI (R.C.)
| | - Brad M. Debey
- Department of Clinical Sciences (A.H., K.H.) and Department of Diagnostic Medicine/Pathobiology (M.D., P.P., J.N., B.D.), Kansas State University, Manhattan, KS; and Department of Medical Sciences, University of Wisconsin, Madison, WI (R.C.)
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Abstract
INTRODUCTION Dibucaine is a potent, long-lasting local anesthetic (LA). Topical dibucaine ointments are marketed directly to consumers in the USA without prescription. Dibucaine ointment is intended to treat discomfort associated with sunburn, eczema, minor rashes, minor scratches, insect bites, and poison ivy and is used alone or in combination with other active ingredients to treat pain associated with hemorrhoids or other anorectal disorders. Oral dibucaine toxicosis has been reported in children and includes gastrointestinal upset and neurologic and cardiovascular dysfunction. CASE REPORT An 18-month-old, female, Parson Russell terrier ingested approximately 23 g of 1% dibucaine ointment (approximately 38 mg/kg dibucaine) recommended to the owner for the treatment of hemorrhoids. Onset and resolution of clinical signs were relatively rapid, 5 min and 60 min, respectively. Clinical signs included vomiting, ptyalism, whole-body muscle fasciculations, disorientation, and severe ataxia. DISCUSSION Oral dibucaine toxicosis in dogs is similar to oral dibucaine toxicosis in children. Dibucaine ointment poses a real and potentially serious toxicological risk to pets and thus should be stored in a safe location.
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Affiliation(s)
- Andrew S Hanzlicek
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, 1800 Denison Ave, Manhattan, KS 66506, USA.
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Saunders AB, Hanzlicek AS, Martinez EA, Stickney MJ, Steiner JM, Suchodolski JS, Fosgate GT. Assessment of cardiac troponin I and C-reactive protein concentrations associated with anesthetic protocols using sevoflurane or a combination of fentanyl, midazolam, and sevoflurane in dogs. Vet Anaesth Analg 2009; 36:449-56. [PMID: 19709049 DOI: 10.1111/j.1467-2995.2009.00483.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To report serum cardiac troponin I (cTnI) and C-reactive protein (CRP) concentrations in dogs anesthetized for elective surgery using two anesthetic protocols. STUDY DESIGN Prospective, randomized clinical study. ANIMALS Twenty client-owned dogs presenting for elective ovariohysterectomy or castration. METHODS The dogs were randomized into two groups. All dogs were premedicated with glycopyrrolate (0.011 mg kg(-1)) and hydromorphone (0.1 mg kg(-1)) i.m. approximately 30 minutes prior to induction of anesthesia. Anesthesia in dogs in group 1 was induced with propofol (6 mg kg(-1)) i.v. to effect and in dogs in group 2 with diazepam (0.2 mg kg(-1)) i.v. followed by etomidate (2 mg kg(-1)) i.v. to effect. For maintenance of anesthesia, group 1 received sevoflurane (adjustable vaporizer setting 0.5-4%) and group 2 received a combination of fentanyl (0.8 microg kg(-1) minute(-1)) and midazolam (8.0 microg kg(-1) minute(-1)) i.v. plus sevoflurane (adjustable vaporizer setting 0.5-4%) to maintain anesthesia. Serum cTnI and CRP concentrations were measured at baseline and 6, 18, and 24 hours post-anesthetic induction. Biochemical analysis was performed at baseline. Lactate was obtained at baseline and 6 hours post-anesthetic induction. Heart rate and mean arterial blood pressure were measured intra-operatively. RESULTS Baseline serum cTnI and CRP concentrations were comparable between groups. A significant difference in serum cTnI or CRP concentrations was not detected post-operatively between groups at any time point. Serum CRP concentrations were significantly increased post-anesthetic induction in both groups, which was attributed to surgical trauma. CONCLUSIONS AND CLINICAL RELEVANCE There was no significant difference in serum cTnI and CRP concentrations between anesthetic protocols. Further investigation in a larger number of dogs is necessary to confirm the current findings.
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Affiliation(s)
- Ashley B Saunders
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX 77843-4474, USA.
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