Epidemiology of Anaplasma marginale and Anaplasma centrale infections in African buffalo (Syncerus caffer) from Kruger National Park, South Africa

Image 1.

Age of first infection across a range of parasite taxa in a wild mammalian population

Newborn mammals have an immature immune system that cannot sufficiently protect them against infectious diseases. However, variation in the effectiveness of maternal immunity against different parasites may couple with temporal trends in parasite exposure to influence disparities in the timing of infection risk. Determining the relationship between age and infection risk is critical in identifying the portion of a host population that contributes to parasite dynamics, as well as the parasites that regulate host recruitment. However, there are no data directly identifying timing of first infection among parasites in wildlife. Here, we took advantage of a longitudinal dataset, tracking infection status by viruses, bacteria, protists and gastro-intestinal worms in a herd of African buffalo (Syncerus caffer) to ask: how does age of first infection differ among parasite taxa? We found distinct differences in the age of first infection among parasites that aligned with the mode of transmission and parasite taxonomy. Specifically, we found that tick-borne and environmentally transmitted protists were acquired earlier than directly transmitted bacteria and viruses. These results emphasize the importance of understanding infection risk in juveniles, especially in host species where juveniles are purported to sustain parasite persistence and/or where mortality rates of juveniles influence population dynamics.

Quantitative evaluation of left atrial volume and function by one-dimensional, two-dimensional, and three-dimensional echocardiography in a population of normal dogs

OBJECTIVES

The primary goal of this study was to compare left atrial (LA) volume and functional indices in a population of normal dogs using transthoracic one-dimensional M-mode, two-dimensional (2D), and three-dimensional (3D) echocardiography.

ANIMALS

Forty clinically normal dogs of various breeds were stratified into four groups based on weight.

METHODS

Left atrial volume (LAV) was estimated by converting single linear measurements derived from M-mode and 2D images into volumes via the cube and sphere formulas. 2D echocardiography was employed to estimate LAV using linear measures and rectangular and ellipsoid formulas, as well as area-length and the monoplane method of disks. LAV was estimated using the biplane area-length method on 4- and 2-chamber 2D images. LAV was directly measured using 3D volume data obtained over four consecutive cardiac cycles. LAV estimates were compared amongst methods, correlated to body size, and evaluated for reproducibility. Functional indices derived from these various echocardiographic methods were compared to identify any systematic differences based on imaging modality. LA functional indices included LA ejection fraction (LAEF), total LA emptying volume, passive LA emptying volume/fraction, active LA emptying volume/fraction, and LA expansion index.

RESULTS

The M-mode derived estimates of LAV were significantly smaller than all 2D- and 3D-derived LAV (p<0.0001). The left-sided 3D LAV had the highest correlation with body weight (r² = 0.8806) for all phases of the LA cycle with acceptable interobserver variability (CV 11%).

CONCLUSIONS

3D echocardiography is a feasible, non-invasive method to measure LAV in a population of normal dogs.

Cardiac-gated computed tomography angiography in three alpacas with complex congenital heart disease

BACKGROUND

The prevalence of congenital heart disease is higher in camelids than in other domestic species and complex defects, often involving the great vessels, are more frequently encountered in llamas and alpacas than in other species. Some of these complex defects can be difficult to accurately characterize via echocardiography, the most commonly used diagnostic imaging technique to evaluate the heart in veterinary patients. Contrast-enhanced, electrocardiogram (ECG)-gated computed tomography (CT) has proven utility for the evaluation of human patients with certain congenital heart defects, including those with conotruncal septation defects and other abnormalities involving the formation of the great vessels.

METHODS

Three alpaca crias, 4 days, 5 weeks and 14 months of age were clinically evaluated and subjected to a complete color-flow Doppler echocardiogram and a contrast-enhanced ECG-gated CT.

RESULTS

These alpacas exhibited a variety of clinical findings including lethargy, failure to thrive, exercise intolerance, heart murmur, and/or respiratory difficulty. All three crias were subsequently diagnosed with complex cardiac defects including pulmonary atresia with a ventricular septal defect (VSD), a truncus arteriosus with a large VSD, and a double outlet right ventricle with a large VSD and aortic hypoplasia. In each case, the diagnosis was confirmed by postmortem examination.

CONCLUSION

Color flow echocardiographic evaluation identified all of the intra-cardiac lesions and associated flow anomalies but contrast-enhanced ECG-gated CT permitted more accurate assessment of the morphology of the extracardiac structures and permitted a more precise determination of the exact nature and anatomy of the great vessels.

Use of multidetector computed tomography in the assessment of dogs with pericardial effusion

Background

Contrast‐enhanced multidetector computed tomography (MDCT) allows high spatial and temporal resolution imaging of cardiac, thoracic, and abdominal structures. Accurate determination of the cause of pericardial effusion (PE) is essential to providing appropriate treatment and prognosis. Echocardiography and pericardial fluid analysis may not differentiate between causes of PE and cannot identify extracardiac metastasis.

Hypothesis/Objectives

Describe the thoracic and abdominal MDCT findings and evaluate the utility of MDCT to differentiate between neoplastic and nonneoplastic causes of PE in dogs.

Animals

Eleven client‐owned dogs with PE diagnosed by echocardiography.

Methods

Prospective observational study. Transthoracic echocardiography (TTE), 3‐view thoracic radiography, and contrast‐enhanced thoracic and abdominal MDCT images were evaluated for the presence of cardiac masses, pulmonary metastases, and abdominal masses. Histopathology in 5 dogs and survival analysis in all dogs were evaluated.

Results

A neoplastic cause was identified in 6/11 dogs and a nonneoplastic cause was identified in 5/11. Cardiac MDCT findings were consistent with TTE findings in all dogs with right atrial (5/5) and heart base masses (1/1). Pulmonary metastases were identified in 1/11 dogs by thoracic radiography and in 2/11 dogs by MDCT. MDCT identified splenic or hepatic lesions consistent with neoplasia in 6/11 and 5/11 dogs, respectively. Focal MDCT pericardial changes at the pericardiocentesis site were noted in 3/11 dogs.

Conclusions and Clinical Importance

Multidetector computed tomography did not improve the detection of cardiac masses in dogs with PE over echocardiography. The benefit of MDCT was primarily in the detection of pulmonary metastases and extracardiac lesions using a single imaging modality.

A chemical burn from a garlic poultice applied to the face to treat toothache: a case report

This case report is of a significant chemical burn to the face resulting from the use of an external garlic poultice for toothache. The patient used internet search engines to seek a toothache remedy and did not identify any reports of this complication. This report aims to inform all dentists of the risks of raw garlic application to the skin and also to ensure that in the future any patient using the internet for a toothache remedy will be made aware of the potential risk and how to avoid it.

Closure of large patent ductus arteriosus with a self-expanding duct occluder in two dogs

Of the different catheterisation methods described for closure of patent ductus arteriosus (PDA), coil embolisation is most commonly used in dogs. However, for a PDA larger than 4 to 5 mm in diameter, coil implantation is difficult. For these cases, the Amplatzer duct occluder (ADO) offers an alternative method. This report describes the successful implantation of an ADO in two dogs with large PDAs of approximately 6 mm diameter. The self-expandible device attached to an implantation wire was advanced through a long sheath antegrade to the femoral vein through the right heart and pulmonary artery to the duct and delivered into the PDA. Thereafter the device was released by unscrewing it from the delivery cable. The large PDA in both dogs was totally occluded by these means without any residual shunt. Thus, the ADO is a controlled release implant that also allows occlusion of a large PDA. Its high costs limit its general use in veterinary medicine at the present time.

Intrarenal effects of ecadotril during acute volume expansion in dogs with congestive heart failure

Neutral endopeptidase 24.11 (NEP) inhibitors are known to have vascular, diuretic, and natriuretic effects that may be helpful in the treatment of congestive heart failure (CHF). Most NEP inhibitors may act principally through intrarenal mechanisms, which are not completely understood. The purpose of this study was to determine the principal renal effects of the NEP inhibitor ecadotril in dogs with progressive CHF induced by rapid ventricular pacing. Renal function was measured before, during, and after acute i.v. infusion of normal saline in a total of six dogs during normal cardiac function, early left ventricular dysfunction, and overt CHF. During overt CHF, each dog was treated with either ecadotril or placebo orally for 1 week. Parameters measured included glomerular filtration rate, renal blood flow, urine output, sodium clearance, sodium fractional excretion, and proximal and distal sodium reabsorption. Ecadotril treatment resulted in increased urine output, sodium clearance, and renal sodium excretion relative to placebo-treated controls. The principal intrarenal effect of ecadotril was decreased distal renal tubular sodium reabsorption. Both glomerular filtration rate and renal blood flow declined during overt CHF and were unaffected by ecadotril treatment. The results of this study are consistent with the principal action of ecadotril occurring by way of intrarenal events as opposed to changes in renal hemodynamics. The principal effect of ecadotril on distal tubular sodium reabsorption suggests that inhibition of NEP activity in the proximal renal tubules may allow increased binding of filtered atrial natriuretic peptide to natriuretic peptide receptor sites in the distal renal tubules and collecting ducts.

Aquaporin-2 as a biomarker of distal renal tubular function using lithium as an experimental model

Aquaporin-2 protein levels can be detected in the urine of normal of subjects if measured after fluid deprivation. By contrast, in patients with nephrogenic diabetes insipidus caused by mutations in the aquaporin-2 gene, urine aquaporin-2 protein excretion cannot be detected. We propose that properly standardized measurements of urinary aquaporin-2 protein may provide a useful biomarker of distal tubular function in a variety of acquired conditions that impair concentrating ability including some nephrotoxic agents.

Clinical assessment of left ventricular relaxation

Ventricular relaxation is altered in a number of cardiac disorders affecting domestic animals. Clinical determination of the ventricular relaxation rate can provide useful information regarding disease severity and response to therapy. We believe that the current gold standard for assessing left ventricular relaxation requires measurement of ventricular luminal pressure at end-expiration using a high-fidelity catheter. Ventricular pressure should be digitized at > or = 200 Hz for the period of pressure fall between the minimum rate of change of ventricular pressure and 10 mm Hg above left ventricular end-diastolic pressure of the preceding beat. The rate of relaxation then should be determined from the digitized data by Marquardt nonlinear least squares parameter estimation using an exponential decay model with nonzero asymptote. The major disadvantage in using an invasive method for evaluating left ventricular relaxation is that it requires general anesthesia in animals that frequently are categorized as high-risk anesthetic patients. Noninvasive estimates of ventricular relaxation using echocardiographic parameters such as isovolumic relaxation time, peak early filling rate, and time from end-systole to peak filling rate provide a crude and nonspecific assessment of ventricular relaxation that can be obtained from conscious animals. Determinations of these echocardiographic indices are of limited usefulness in assessing changes in ventricular relaxation associated with disease progression or therapeutic intervention, unless concurrent estimates of left atrial pressure, mitral valve characteristics, and left ventricular compliance are available.

Effects of metformin on fibrinogen levels in obese patients with type 2 diabetes

OBJECTIVE

To determine fibrinogen levels in obese patients with type 2 diabetes and assess its changes with the use of metformin.

METHODS

60 obese patients (BMI > 27) with type 2 diabetes were studied in an open, two phase, prospective, randomized and comparative study. The pre-treatment phase was a period of four weeks of a controlled diet. In the treatment phase they were divided in two subgroups of 30. One received metformin as a daily single tablet of 850 mg and increasing the dosage to two or three tablets depending on their metabolic control. The second subgroup received 24 units of DNA-recombinant insulin subcutaneously (two thirds of dose before breakfast, and the remaining third before dinner). The insulin dosage was adjusted according to the metabolic response. A control group was formed by 60 non diabetic obese patients with only the controlled diet.

RESULTS

The mean values of plasma glucose, fibrinogen levels and body mass index did not change in the pretreatment phase in controls and diabetics. These parameters decreased significantly in the metformin subgroup in the treatment phase (p < 0.001). Only glucose decreased in the insulin subgroup. There were no changes in the controls.

CONCLUSIONS

In addition to improving metabolic control, metformin showed to be a good therapeutic alternative in modifying fibrinogen levels in type 2 diabetic patients.

Intrapericardial cysts in the dog

Intrapericardial cysts were identified as the cause of impaired cardiac filling in six young dogs. Pneumopericardiography and two-dimensional echocardiography showed the cysts in 2 of 2 dogs and in 4 of 4 dogs, respectively. One dog, which was also infected with heartworms, died before surgical excision of the cyst could be performed. In the remaining dogs, surgical excision of the cysts and subtotal pericardiectomy was successfully accomplished. Histologic examination of the excised tissue from one dog suggested that it was a pericardial coelomic cyst. The gross and histologic characteristics of the cysts removed from the other five dogs resembled those of acquired cystic hematomas. The etiopathogenesis of these cysts was uncertain, but all cysts were connected to a fatty pedicle of tissue. In one dog, a stalk of tissue was observed to enter the pericardium through a small peritoneopericardial diaphragmatic hernia. In four dogs, the stalk of tissue was adhered to the apex of the parietal pericardium. These observations suggested that intrapericardial cysts, in some dogs, develop in association with, and possibly as a result of, congenital herniation and entrapment of omentum or a portion of the falciform ligament into the pericardial sac.

Permanent transvenous pacemaker implantation in forty dogs

Permanent transvenous cardiac pacemakers were implanted in 40 dogs. Electrocardiographic diagnoses included persistent atrial standstill (3 dogs), sick sinus syndrome (8 dogs), and high-grade second-degree or third-degree atrioventricular (AV) block (29 dogs). Thirteen dogs were alive and well 4 to 42 months after pacemaker implantation (mean, 16.9 months). The mean and median survival times of the 26 dogs that died or were euthanatized during the study were 17.9 months and 13 months, respectively. Most of these dogs succumbed to problems unrelated to the arrhythmia and pacemaker implant. One dog was lost to follow-up. Complications associated with permanent transvenous pacemaker implantation included lead dislodgement, infection, hematoma formation, skeletal muscle stimulation, ventricular arrhythmia, migration of the pulse generator, and skin erosion. Lead dislodgement was the most common complication, occurring in 7 of 9 dogs paced using untined electrode leads and in 6 of 30 dogs paced using tined leads. Lead dislodgement did not occur in the only dog paced using an actively fixed endocardial lead. It was concluded that permanent transvenous cardiac pacing is a feasible, less traumatic alternative to epimyocardial pacing in dogs, but that successful use of this technique requires careful implantation technique and anticipation of the potential complications.

Changes in linear dimensions of the heart, relative to body weight, as measured by M-mode echocardiography in growing dogs

The growth of the heart, relative to body weight, was measured by M-mode echocardiography in dogs during the first year of life. Echocardiographic measurements were obtained from 16 English Pointers at 1, 2, 4, and 8 weeks of age and at 3, 6, 9, and 12 months of age. Left atrial (LA), aortic (AO), left and right ventricular internal dimensions, interventricular septal and left ventricular wall thickness measurements increased in curvilinear fashion relative to increasing body weight. Least-squares regression analysis, performed on logarithmically transformed data, was used to develop power-law equations describing the relationship of echocardiographic measurements to body weight. Linear dimensions of the LA, AO, left and right ventricular internal dimensions and interventricular septal and left ventricular wall thickness changed proportionally to slightly differing exponential powers of body weight (BW), varying from 0.31 to 0.45 (BW0.31 to BW0.45). Fractional shortening and the LA to AO ratio decreased slightly, but significantly, as body weight increased. Indexing echocardiographic measurements to BW1/3 was more appropriate than indexing such measures linearly to body weight, offering a practical method for developing accurate normative graphs or tables for M-mode echocardiographic dimensions in growing dogs.

Evidence for or against the efficacy of afterload reducers for management of heart failure in dogs

Therapeutic decision making is facilitated by knowledge of the short-term and long-term hemodynamic effects of the available vasodilating agents, the nature and prevalence of their adverse side effects, and their abilities to ameliorate the signs of heart disease, to improve exercise capacity, and to prolong patient survival. This article is intended to provide the reader with a comprehensive list of the available afterload-reducing agents, to review the relevant studies of these drugs in humans and dogs with heart failure, and to provide guidelines for their use in commonly encountered clinical situations.

Pulmonary lymphomatoid granulomatosis in seven dogs (1976-1987)

Seven dogs with pulmonary lymphomatoid granulomatosis were reviewed. The disease occurred in six large-breed and one small-breed dogs. The dogs were five to 14 years old (mean, 8.4; median, 7), and four of seven dogs were males. Three dogs had been previously treated with adulticide therapy for canine dirofilariasis. Clinical histories included a progressive respiratory disease characterized by varying degrees of cough, dyspnea, exercise intolerance, and weight loss. Thoracic radiographic features included hilar lymphadenopathy, pulmonary masses of varying sizes, and mixed pulmonary patterns of lobar consolidation with ill-defined interstitial and alveolar pulmonary infiltrates. Cardiovascular changes compatible with chronic dirofilariasis were present in three dogs. The clinical course was usually progressive and fatal. The survival time ranged from six days to four years (mean, 12.5 mos; median, 3 mos). Gross and histologic features included mass lesions with areas of necrosis that replaced normal pulmonary architecture. Cytologically, these lesions were characterized by infiltration with pleomorphic, angioinvasive mononuclear cells that often resulted in vascular obliteration. The infiltrating cells resembled large lymphoid cells that possessed large hyperchromatic nuclei and small amounts of cytoplasm. Systemic lymphoid neoplasia with peripheral lymphadenopathy was diagnosed in two dogs. In both cases, lymph-node cytology was similar to the cellular infiltrates found in the lungs and consistent with a diagnosis of lymphomatoid granulomatosis. These features are compared with previously reported cases of canine lymphomatoid granulomatosis and those features identified in a similar disease described in man.

Sensitivity and specificity of the indirect-fluorescent antibody test and two enzyme-linked immunosorbent assays in canine dirofilariasis

Ninety dogs naturally infected with Dirofilaria immitis and 103 noninfected dogs, as determined by necropsy, were used to compare the sensitivity and specificity of the cuticular and somatic reactions of the indirect fluorescent antibody test (IFA-C and IFA-S, respectively) and 2 enzyme-linked immunosorbent assays (ELISA). In microfilaremic and amicrofilaremic heartworm-infected dogs, negative results were common for all serotests. In dogs without adult heartworms at necropsy, 32% to 49% were positive, using 1 ELISA, 27% to 29% were positive with the other ELISA, 15% to 36% were positive with the IFA-S, and 0% to 1% were positive using the IFA-C, depending on the classification of borderline reactions. The prevalence of false positive serotests was probably not due to the detection of precardial stages of D immitis in dogs obtained from areas of low endemicity. Until the causes of the false-positive tests are resolved, the use of currently available serotests for routine diagnostic screening or as criteria for instituting treatment is not recommended.

Endocarditis of the aortic valve in the dog

The clinical features of endocarditis of the aortic valve in 24 dogs were reviewed. This condition was found most commonly in large-breed, middle-aged male dogs. Evidence of antecedent infection or immunosuppression was usually not historically verified or found at necropsy. However, an association with congenital heart disease, especially discrete subaortic stenosis, was demonstrated. The most frequent clinical findings were systolic and diastolic murmurs and bounding arterial pulses, with or without signs of congestive heart failure. The most commonly isolated organisms were Corynebacterium sp, Erysipelothrix rhusiopathiae, and Streptococcus sp. In addition to antibiotic therapy, treatment for congestive heart failure often was required. Despite aggressive therapy, most affected dogs died as a result of congestive heart failure, arrhythmias, infarction, sepsis, or renal failure.

Diagnostic value of pericardial fluid analysis in the dog

The physical, chemical, and cytologic characteristics of 50 pericardial effusions were reviewed to determine their value to the clinician for distinguishing a variety of pericardial disorders in the dog. Pericardial fluid analysis allowed identification of chylous and bacterial pericardial effusions. Overlap in the ranges of RBC counts, nucleated cell counts, and protein concentrations between dogs with neoplastic and nonneoplastic disorders precluded identification of the cause of the effusion. Of 19 neoplastic effusions, 74% were not detected on the basis of cytologic findings and 13% of 31 nonneoplastic effusates were falsely reported as positive or suspect for a neoplasm. It was concluded that pericardial fluid analysis, including cytologic examination, did not reliably distinguish neoplastic from nonneoplastic disorders.