Frequency of non-generalized tonic clonic seizures in a referral population of dogs

Absence seizures are a type of generalized onset seizure associated in humans with brief activity interruptions, unresponsiveness and staring. Absence seizures are infrequently reported in veterinary patients, visually indistinguishable from focal seizures, and so may be grouped as non-generalized tonic clonic seizures (non-GTCS). The objective of this retrospective study was to provide a preliminary understanding of the frequency of non-GTCS in dogs and estimate its prevalence by evaluating the distribution of seizure types presented to a referral hospital over 4 years (May 2017-April 2021), as determined from the medical record history and electroencephalography (EEG) diagnostic testing where available. A total of 528 cases were included via a medical record search for dogs with epilepsy and/or seizures presented to the neurology or emergency services. Cases were categorized into seizure types based on reported clinical signs. Each year, 53-63 % of seizure cases were described as generalized tonic clonic seizures (GTCS), 9-15 % GTCS with additional events and 29-35 % suspected non-GTCS. EEG confirmed absence seizures in 12 of 44 EEGs, 5 cases having a history of GTCS and seven without prior GTCS. This preliminary study suggests that non-GTCS may be relatively common as one third of seizure cases in the referral population presented with non-GTCS clinical signs. Prospective studies using EEG are merited to definitively determine the prevalence of these different seizure types in dogs. Acknowledging the impact of these seizures will improve awareness, aiding veterinarians in their recognition, diagnosis and potential treatment options.

Comparison of calculation methods used for the determination of anthelmintic resistance in sheep in a temperate continental climate

This study compared results obtained with five different fecal egg count reduction (FECR) calculation methods for defining resistance to ivermectin, fenbendazole, and levamisole in gastrointestinal nematodes of sheep in a temperate continental climate: FECR1 and FECR2 used pre-and posttreatment fecal egg count (FEC) means from both treated and control animals, but FECR1 used arithmetic means, whereas FECR2 used geometric means; FECR3 used arithmetic means for pre- and posttreatment FECs from treated animals only; FECR4 was calculated using only arithmetic means for posttreatment FECs from treated and control animals; and FECR5 was calculated using mean FEC estimates from a general linear mixed model. The classification of farm anthelmintic resistance (AR) status varied, depending on which FECR calculation method was used and whether a bias correction term (BCT, i.e., half the minimum detection limit) was added to the zeroes or not. Overall, agreement between all methods was higher when a BCT was used, particularly when levels of resistance were low. FECR4 showed the highest agreement with all the other FECR methods. We therefore recommend that small ruminant clinicians use the FECR4 formula with a BCT for AR determination, as this would reduce the cost of the FECRT, while still minimizing bias and allowing for comparisons between different farms. For researchers, we recommend the use of FECR1 or FECR2, as the inclusion of both pre- and posttreatment FECs and use of randomly allocated animals in treatment and control groups makes these methods mathematically more likely to estimate the true anthelmintic efficacy.

Comparison of calculation methods used for the determination of anthelmintic resistance in sheep in a temperate continental climate

This study compared results obtained with five different fecal egg count reduction (FECR) calculation methods for defining resistance to ivermectin, fenbendazole, and levamisole in gastrointestinal nematodes of sheep in a temperate continental climate: FECR1 and FECR2 used pre- and posttreatment fecal egg count (FEC) means from both treated and control animals, but FECR1 used arithmetic means, whereas FECR2 used geometric means; FECR3 used arithmetic means for pre- and posttreatment FECs from treated animals only; FECR4 was calculated using only arithmetic means for posttreatment FECs from treated and control animals; and FECR5 was calculated using mean FEC estimates from a general linear mixed model. The classification of farm anthelmintic resistance (AR) status varied, depending on which FECR calculation method was used and whether a bias correction term (BCT, i.e., half the minimum detection limit) was added to the zeroes or not. Overall, agreement between all methods was higher when a BCT was used, particularly when levels of resistance were low. FECR4 showed the highest agreement with all the other FECR methods. We therefore recommend that small ruminant clinicians use the FECR4 formula with a BCT for AR determination, as this would reduce the cost of the FECRT, while still minimizing bias and allowing for comparisons between different farms. For researchers, we recommend the use of FECR1 or FECR2, as the inclusion of both pre- and posttreatment FECs and use of randomly allocated animals in treatment and control groups makes these methods mathematically more likely to estimate the true anthelmintic efficacy.

Effects of hoof shape, body mass and velocity on surface strain in the wall of the unshod forehoof of Standardbreds trotting on a treadmill

The purpose of this work is to investigate the effects of body mass (BM), velocity (V), and hoof shape on compressive surface strains in the wall of the front hoof at the trot. Toe angle (TA), heel angle (HA), toe length (TL), medial and lateral wall length (MWL, LWL) and BM were measured for nine adult, unshod Standardbreds. Five rosette gauges were glued around the circumference of the left forehoof of each animal which was then trotted on a treadmill at a set range of velocities from 3.5 to 7.5 m s−1. Analysis of variance (ANOVA) of principal compressive strainsɛ2at midstance identified that all primary variables (BM,V, TA, HA, etc.) had a significant effect as did the interactions of TA×HA and BM×TA. These significant variables explained over 96% of the variation inɛ2. Multiple regression ofɛ2on these variables gave equations which accurately predictedɛ2within 3%, but the individual coefficients did not accurately describe how each variable affectedɛ2. Further tests using bivariate regression gave equations that enabledɛ2data to be standardized for BM andVat the gauge locations used here. Strainɛ2increased linearly with mass and curvilinearly with velocity (ɛ2∝V+V2), and both caused redistribution of strain to the dorsum and lateral quarter. Variation in each shape variable caused redistribution rather than simple increase or decrease in strains. The primary conclusion with regard to hoof shape is that the effects of change in any one measurement on strain magnitudes are affected by the values of all other measurements. Resolving the interplay among measurements in their effects onɛ2will need a considerably larger sample size than that used here.

The effect of glucocorticoids on canine lymphocyte marker expression and apoptosis

BACKGROUND

Glucocorticoids are commonly administered to dogs for the treatment of inflammatory disorders, autoimmunity and cancers such as lymphoma. Despite evidence of clinical efficacy, understanding of the effects of glucocorticoids on cells of the canine immune system is limited.

HYPOTHESIS

Glucocorticoids affect the expression of phenotypic markers on canine lymphocytes and induce apoptosis.

ANIMALS

Fifteen healthy mixed breed dogs.

METHODS

Prospective randomized study. Prednisone was administered orally for 3 days, and cells aspirated from the popliteal lymph node before prednisone administration, and on days 1, 3, 10, 17, 24, and 38, were labeled with antibodies against canine CD3, CD4, CD8alpha, CD18, CD21, CD45, CD45RA, and CD90 molecules, and analyzed by flow cytometry. Additional samples were cultured in media with prednisolone for 24 hours and analyzed by cytometry for marker expression, and by gel electrophoresis for DNA fragmentation.

RESULTS

Treatment of dogs with glucocorticoids resulted in reduced (p < or = .05) proportions of CD3 (days 1, 3, 17, and 24), CD4 (days 3 and 10), CD21 (day 1, 3, and 38), CD45RA (day 17) and CD90 (days 1, 10, and 17) expressing lymphocytes, and reduced intensity of CD18 (day 17) and CD45 (day 17 and 24) molecules on nodal lymphocytes. Culture oflymphocytes with prednisolone for 24 hours caused a significant reduction in the expression of all markers (p < or = .05) and DNA fragmentation.

CONCLUSIONS AND CLINICAL IMPORTANCE

Glucocorticoids significantly alter the expression of phenotypic markers on canine lymphocytes, and in vitro induce apoptosis. These findings identify potential mechanisms for clinical immunosuppression from glucocorticoid treatment.

Reticulocyte changes after experimental anemia and erythropoietin treatment of horses

Availability of recombinant human erythropoietin (EPO) has facilitated use to enhance red blood cell production, and therefore aerobic performance, in human and equine athletes. Recombinant human EPO promotes growth and differentiation of equine erythroid precursor cells, but in some horses repeat administration induces immune interference with endogenous EPO resulting in fatal anemia. Although blood reticulocyte parameters acquire unique changes in humans treated with EPO, with manual enumeration methods, horses were not considered to release reticulocytes from the bone marrow into circulation, even under severe erythropoietic stress. The goals of this study were to determine whether reticulocytes could be detected and characterized in horses that are anemic or have been treated with EPO using a modern hematology analyzer. Anemia was induced in six horses by removal of 30 ml of blood/kg of body wt over 24 h. After 28 days, the horses were treated twice with 55 U/kg of EPO (Eprex), and after 65 days they were treated thrice with 73 U/kg of EPO. Blood samples were analyzed with the ADVIA120 instrument every 3–5 days and bone marrow samples 7 days after anemia and EPO treatments. Analysis of blood reticulocyte parameters by ANOVA in a randomized complete block design determined that anemia and EPO induced significant ( P ≤ 0.05) increases in red cell distribution width and reticulocyte mean cell volume. Parameters changed only after EPO treatment were cellular hemoglobin concentration mean, mean cell volume, reticulocyte concentration, proportion of macrocytic reticulocytes, and reticulocyte cellular hemoglobin. These findings indicate that horses under erythropoietic stress and after EPO treatment release reticulocytes with unique characteristics into circulation.

Comparison of test characteristics of urine dipstick and urinalysis at various test cutoff points

STUDY OBJECTIVE

We compare the test characteristics of urine dipstick and urinalysis at various test cutoff points in women presenting to emergency departments and an intermediate care center with symptoms of urinary tract infection.

METHODS

This was a prospective, observational study of adult women presenting to 1 of 2 community hospital EDs or an intermediate care center with dysuria, urgency, or urinary frequency on history, or suprapubic or costovertebral angle tenderness on examination. Patients who had taken antibiotics in the past 72 hours, had indwelling Foley catheters, symptomatic vaginal discharge, diabetes mellitus, immunodeficiency disorders, or were unable to provide a reliable history were excluded. The patient's clean-catch or catheterized urine specimen was tested immediately by a nurse using a Multistix 9 SG reagent strip. A second aliquot was sent within 1 hour of collection to the hospital laboratory, where a semiautomated microscopic urinalysis and a urine culture were performed. A positive urine culture was defined as more than 100,000 colonies of 1 or 2 uropathogenic bacteria per mL of urine at 48 hours. Dipstick and urinalysis data were compared with urine culture results. Sensitivity, specificity, and predictive values were calculated at various definitions of a positive test, or "test cutoff points," for combinations of leukocyte esterase, nitrite, and blood on dipstick and for RBCs and WBCs on urinalyses. The probability of an erroneous decision to withhold treatment on the basis of a negative test result was defined as "undertreatment," or 1 minus the negative predictive value. "Overtreatment" was defined as 1 minus the positive predictive value.

RESULTS

Three hundred forty-three patients were enrolled in this study. Twelve patients were withdrawn because of missing laboratory results. Forty-six percent (152/331) of patients had positive urine cultures. If urine dipstick results are defined as positive when leukocyte esterase or nitrite is positive or blood is more than trace, the overtreatment rate is 47% (156/331) and the undertreatment rate is 13% (43/331). If urinalysis results are defined as positive when WBCs are more than 3 per high-power field or RBCs are more than 5 per high-power field, the overtreatment rate is 44% (146/331) and the undertreatment rate is 11% (36/331). Matched pairs of test characteristics were identified when the analysis was repeated using more than 10,000 colonies per mL as a positive culture.

CONCLUSION

In this patient population, similar overtreatment and undertreatment rates were identified for various test cutoff points for urine dipstick tests and urinalysis. Although a urine dipstick may be equivalent to a urinalysis for the diagnosis of urinary tract infection, the limitations in the diagnostic accuracy of both tests should be incorporated into medical decisionmaking.

Morphology of the laminar junction in relation to the shape of the hoof capsule and distal phalanx in adult horses (Equus caballus)

The purpose was to investigate whether differences in equine hoof shape, which are inferred to alter foot function, are accompanied by differences in morphology of the laminar junction. Ten fore feet from adult horses were segregated into normal and low-angle groups, depending on the dorsal angle of the hoof wall. Twenty measurements of external hoof shape and four of the enclosed distal phalanx were tested for differences between groups, and for intragroup correlations. Three measurements of laminar morphology (spacing, orientation and degree of bend) were recorded for samples of up to 50 primary epidermal laminae at each of 20 sample sites. Sites were distributed over the foot in 5 circumferential columns and 4 proximodistal rows. Intergroup differences were investigated, as were correlations among sample sites of the laminar variables with the shape measurements. Results show differences in hoof shape between groups (but not bone shape) and laminar morphology. Six shape measurements are significantly different between groups: dorsal angle, medial and lateral angles, lateral sole width, solar circumference, and dorsal length. In the normal group, shape measurements show patterns of correlation among regions of the hoof, and between hoof and bone measurements. In the low-angle group, shape correlations occur largely within one region of the hoof (the heels) and in the bone measurements. Laminar spacing tends to be nonsignificantly greater in the low-angle group, while variances for laminar spacing and orientation are significantly greater in this group. Laminar spacing correlates with bone width and coronary circumference (CC) of the hoof in the normal group, but only with CC in the low-angle group. When taken as a whole, and interpreted in light of a model of foot mechanical function, the results appear to indicate a deterioration in structural coherence of the foot in the low-angle group.

Components of variation of surface hoof strain with time

The relative contribution of a number of random and fixed variables to variation in surface strain magnitudes on the hoof capsule was assessed for healthy feet under normal conditions. Principal strains were recorded in vivo from 5 rosette gauges glued around the circumference of the right forefeet of 4 horses on 4 occasions over a 9 month period. Recordings were made at every other trimming and reshoeing. During each session, gauges were positioned with a template for repeatability. Strains were recorded at the trot and canter (at consistent speeds), for straight motion and turns, and before and after the hoof was trimmed and reset. Up to 30 strides were recorded for each combination of these variables. ANOVAs were performed on midstance strains of 7008 strides to determine the relative contributions to strain variation of individual horse, test day, gait and direction combined as one factor, gauge position on the hoof, trimming, interstride variability and the interactions among these factors. The ANOVA model explained 87% of the variation, of which approximately 84% was due to fixed effects and 16% to random effects. Circumferential position of the gauges and several of the interactions including this term were by far the greatest contributors to strain variation. Differences among gauge positions, individuals and gait + direction are consistent with previous work. This study has added the relative effects, which are small but significant, of trimming on a regular basis and of time. The change in strain magnitudes with trimming was different for each horse, which leads to the possibility that over- and underuse may have to be quantified on an individual basis.

Key issues to address with bottle-feeding

Proper feeding during a baby's first year of life is crucial for a sound nutritional foundation. Because of this, there are several issues that must be addressed to ensure the child is fed properly. First, bottle-feeding moms should not be made to feel guilty about their feeding decision. It is also important to review feeding practices to avoid overfeeding and encourage positive nurturing techniques. Mothers should learn the key signals to watch for from their baby, such as sleep patterns and bowel movements. Also, it is crucial to teach parents the essential issues related to preparing bottles, such as cleaning the bottles and nipples and properly mixing the formula.

Understanding cultural differences when advising mothers about feeding choices

Cultural teachings and practices greatly influence a mother's feeding decisions. It is important for all health care professionals to understand the cultures within their community and how various beliefs impact infant nutrition. For example, studies have shown the African American and Hispanic mothers are more likely to gain feeding information from family members. There are significant misconceptions being passed down through the generations which can lead to serious nutritional problems, such as overfeeding and the early introduction of cow's milk and food.

Counseling at-risk mothers

Special consideration should be given when counseling at-risk mothers. Although local health departments and offices for the Women, Infants, and Children Program (WIC) are teaching mothers about proper feeding practices, there is a large section of the population that does not qualify for government programs and does not have the financial resources to properly feed their children. Considering this group of parents, and the shrinking number of clinics, it is essential that health care professionals educate mothers in at-risk environments to watch for cues from the infant while determining feeding practices.

Store brand formulas--a new alternative for bottle-feeding moms

There are more infant formula options on the market today than ever before. Health care professionals must help mothers determine what type of formula to feed their child, such as an iron-fortified, milk-based formula or a soy-based formula. It is also key to realize that the Federal Food and Drug Administration tightly regulates infant formula so they are all nutritionally equivalent. The only significant difference among today's term formula options is price. Most leading retailers around the country carry a store brand of formula that bears the store's name, is made by Wyeth Nutritionals, regulated by the FDA, and available at a significant savings.

Drinking water quality and health-care utilization for gastrointestinal illness in greater Vancouver

The risk of microbial disease associated with drinking water is presently a priority concern among North American water jurisdictions. Numerous past outbreaks, together with recent studies suggesting that drinking water may be a substantial contributor to endemic (non-outbreak related) gastroenteritis, demonstrate the vulnerability of many North American cities to waterborne diseases and have fuelled ongoing debates in Canada and the United States concerning the need for stricter water quality guidelines, changes in watershed management policies, and the need for additional water treatment. The Greater Vancouver Regional District (GVRD) water supply system serves approximately two million consumers from a system consisting of three unfiltered surface water supplies (Figure 1). Although GVRD policies reduce the potential for fecal contamination of the source water supplies by humans and domestic animals, the GVRD watersheds support many wildlife species that can potentially shed organisms pathogenic to humans. Because GVRD's water treatment strategy relies principally on watershed protection and chlorination*, and these two strategies together do not eliminate all risk of waterborne disease transmission, it is possible that some disease-causing organisms reach the consumer.

Dynamics of Ascospore Release by Apiosporina morbosa from Sour Cherry Black Knots

Ascospore discharge was monitored from black knots excised from sour cherry trees in May 1992 and 1993, and March, April, and May 1994 and 1995. Rain, temperature, and wetness duration were monitored and a regression model was developed to describe the relationship between environmental conditions and ascospore discharge. Regardless of the date of excision, the peak period for ascospore release occurred from late May (shuck split) through the end of June (shoots 20 cm long), considerably later than previously reported from knots on plum. Fewer ascospores were released from knots excised in early March compared to later dates in 1994. In 1995, the spring was much warmer than in 1994 and ascospore release from March-excised knots was comparable to that from knots excised later in the spring. The period of release and total number of ascospores released was similar from non-excised knots and from knots excised in April or May 1994. Release of ascospores was dependent on rainfall and temperature, but not on the duration of wetness.

Decoding the E-code

Injury is a major public health problem. E-coding is an important epidemiologic tool that would allow for quantitative estimates of injury morbidity and mortality. This information could then be used to develop and evaluate injury control interventions. E-coding has been successfully implemented at the county level in Nebraska and efforts should be supported to expand this effort statewide.

Prediction of stability of cervical spine fracture managed in the halo vest and indications for surgical intervention

A retrospective study was made of 173 cases of acute cervical spine injury with halo vest management to compare initial injury features with outcome. The object was to determine whether a mathematical model could be developed enabling a prediction to be made at the time of the initial assessment as to the probability of success or failure of conservative management using the halo vest alone, and thus perhaps avoid lengthy, unsuccessful treatment. Patients with facet joint dislocation were found to form a distinct subgroup of the injury population. Of the 70 patients in this subgroup, 44% achieved stability with the halo vest alone, but half of these had a "poor anatomical result." No mathematical model or associated injury features could be found to assist in the outcome prediction in this subgroup. Of the 103 patients without facet joint dislocation, 70% achieved stability with the vest alone and over 75% of these had a "good anatomical result." A useful model of outcome prediction was found for this subgroup by logistic regression analysis; the two most important predictors in the model were the amount of subluxation and the degree of angulation in the sagittal plane.

Tiger mauling: fatal spinal injury

A 33 year old zoo keeper was attacked by a Sumatran tiger in captivity. Apart from severe lacerations and penetrating wounds to the head and neck, the patient sustained comminuted fractures of C1 and C2 vertebrae with resultant high laceration of the spinal cord. Major vascular injury as well as trauma to pharynx also occurred. The patient survived these injuries for 15 h.