Development of a valid, cost-effective laparoscopic training program

BACKGROUND

Practical programs for training and evaluating surgeons in laparoscopy are needed to keep pace with demand for minimally invasive surgery.

METHODS

At the University of Kentucky five inexpensive simulations have been developed to train and assess surgical residents. Residents are videotaped performing laparoscopic procedures on models. Five surgeons assess the taped performances on 4 global skills.

RESULTS

Creating mechanical models reduces training costs. Trainees agreed procedures were well represented by the simulations. Blinded assessment of performances showed high interrater agreement and correlated with the trainees' level of experience. Nonclinician evaluations on checklists correlated with evaluations by surgeons.

CONCLUSIONS

Inexpensive simulations of laparoscopic appendectomy, cholecystectomy, inguinal herniorrhaphy, bowel enterotomy, and splenectomy enable surgical residents to practice laparoscopic skills safely. Obtaining masked, objective, and independent evaluations of basic skills in laparoscopic surgery can assist in reliable assessment of surgical trainees. The simulations described can anchor an innovative educational program during residency for training and assessment.

Determinants of competency judgments by experienced laparoscopic surgeons

BACKGROUND

The definitive criteria for assessing competence remain elusive. In our study, we aimed to identify the determinants of competence assessment used by individual laparoscopic surgeons.

METHODS

In a blinded fashion, five laparoscopic surgeons rated 27 subjects on three laparoscopic simulations in four skill categories: clinical judgment, dexterity, serial/simultaneous complexity, and spatial orientation. The raters then assessed overall subject competence for each procedure. Point-biserial correlational analyses and cluster analyses were performed to ascertain the relationships among the various scales.

RESULTS

All of the correlations between the skills' ratings and competence judgments were statistically significant ( p <.05). No skill rating was consistently more highly correlated with the competence rating. There were no distinct patterns of correlations for each rater or each procedure. One factor emerged from each cluster analysis of the skills measures.

CONCLUSIONS

The results suggest that the four skills scored in the study are highly correlated with each other and are important in determining competence. The cluster analyses revealed that the surgeon raters shared a common perception of competence.

Using immersive VR as a tool for preoperative planning for minimally invasive donor nephrectomy

For surgeons approaching minimally invasive donor nephrectomy it is important to identify variant anatomy preoperatively since this anatomy can vary significantly from patient to patient. The goal of this operation is to preserve the architecture and function of the organ so it can be transplanted and function successfully. The ability of the surgeon to navigate through an individual patient's anatomy in a virtual three-dimensional (3D) immersive environment augments understanding of anatomical relationships particular to that individual patient and facilitates conveying that information to other physicians and students. Utilizing automated 3D reconstruction of high contrast computed tomography (CT) scan files viewed in this way, surgeons reported a better preoperative understanding of the anatomical variations and encountered fewer surprises at the time of surgery.

Immersive virtual reality used as a platform for perioperative training for surgical residents

Perioperative preparations such as operating room setup, patient and equipment positioning, and operating port placement are essential to operative success in minimally invasive surgery. We developed an immersive virtual reality-based training system (REMIS) to provide residents (and other health professionals) with training and evaluation in these perioperative skills. Our program uses the qualities of immersive VR that are available today for inclusion in an ongoing training curriculum for surgical residents. The current application consists of a primary platform for patient positioning for a laparoscopic cholecystectomy. Having completed this module we can create many different simulated problems for other procedures. As a part of the simulation, we have devised a computer-driven real-time data collection system to help us in evaluating trainees and providing feedback during the simulation. The REMIS program trains and evaluates surgical residents and obviates the need to use expensive operating room and surgeon time. It also allows residents to train based on their schedule and does not put patients at increased risk. The method is standardized, allows for repetition if needed, evaluates individual performance, provides the possible complications of incorrect choices, provides training in 3-D environment, and has the capability of being used for various scenarios and professions.

Feline respiratory diseases

Respiratory diseases in kittens can quickly result in life-threatening emergencies if not identified and managed early. Congenital anomalies of young cats are extremely uncommon. Viral respiratory infections in the cat are primarily caused by feline herpesvirus type 1 and feline calicivirus. Primary bacterial respiratory infections occur sporadically in cats. Bordetella bronchiseptica may cause severe respiratory signs in young kittens.

Pediatric health care and management

Pediatric health care is an integral part of providing for the general health needs of puppies and kittens from birth to 6 months of age. Successful rearing of puppies and kittens requires providing them with a suitable environment; the correct quantities and quality of nutrients for growth; a regular schedule of feeding, sleeping, grooming, and exercise; and the stimulus that provokes micturation and defecation. The intestinal parasites, such as hookworms, roundworms, whipworms, tapeworms, Giardia, and Cryptosporidium, occur commonly in puppies and kittens. The advantages of early-age spay/neuter far outweight the risks.

Isolation and characterization of Bordetella bronchiseptica from cats in southern Louisiana

The role of Bordetella bronchiseptica in respiratory disease of domestic cats is currently being explored. Clinical and experimental studies in the United Kingdom have shown Bordetella bronchiseptica to be a primary respiratory pathogen in cats; similar studies in the United States are limited. The purpose of this study is to report on the isolation, seroprevalence, and partial characterization of Bordetella bronchiseptica from shelter cats in southern Louisiana. A total of 614 cats from four local shelters were studied. All cats appeared to be asymptomatic for signs of respiratory disease. Bordetella bronchiseptica was isolated in 19/614 (3.1%) cats by oropharyngeal swab and in 6/614 cats by bronchial lavage. Using an antibody capture ELISA method, 148/614 (24.1%) cats were seropositive for Bordetella bronchiseptica. The 25 isolates of Bordetella bronchiseptica were further characterized by ribotype analysis, and a total of 17 different ribotypes were identified. Specific pathogen-free kittens were experimentally infected with five of the isolates, and four of the five isolates induced clinical signs typical of feline bordetellosis. It is concluded that Bordetella bronchiseptica is present in the cat population in southern Louisiana, the organism can be isolated from asymptomatic cats, some of these isolates can produce disease in specific pathogen-free kittens, and that Bordetella bronchiseptica isolates from cats in a relatively small geographic area are genetically diverse. This and other studies indicate that Bordetella bronchiseptica should be considered in cases of feline respiratory disease.

Geriatric care in the late 1990s

Geriatric health care remains a virtually untapped area in spite of changing public views and scientific knowledge on aging. The number of older dogs and cats will continue to grow into the next century. Owners of older dogs and cats are willing to invest in quality health care services. A geriatric health care program can expand veterinary services in a practice and is a natural extension of pediatric and adult maintenance programs.

Musculoskeletal system. Joint and vertebral column diseases

Owner complaints that refer to the musculoskeletal system are common in older dogs and cats. When the veterinarian is presented with these types of complaints, the differential lists include chronic intervertebral disk disease, diskospondylitis, degenerative joint disease, spondylosis with nerve root compression, joint/ ligament instability, and/or cancer. The diagnosis and management of some of these conditions is presented in detail with the general goal in mind that the older dog or cat is provided the best quality of life possible through good mobility along with being pain free.

Feline neonatal sepsis

When bacterial infections exceed or overcome the ability of a kitten's immune system to provide protection, life-threatening illnesses such as neonatal sepsis often occur. Many kittens with neonatal sepsis show unusual presentations or a wide variety of clinical presentations that may not be immediately recognized as being associated with sepsis. Because neonatal sepsis causes unexpected sudden death, kittens suspected of having sepsis should be treated immediately. In most instances, initial antimicrobial therapy is selected empirically. Kittens are treated by giving intravenous or intraosseous fluids for dehydration, oxygen to counter tissue hypoxemia, and glucose if hypoglycemia is present. The beta-lactam antimicrobial agents such as the penicillins, cephalosporins, and the combination of beta-lactam antimicrobials and beta-lactamase inhibitors are considered to be the first choice in the treatment of any septicemic kittens.

Coronavirus infection in cats

Cats are susceptible to natural infection with several strains of feline coronavirus that may result in either effusive and noneffusive FIP disease or in subclinical to severe enteritis. Investigators are still unsure of the routes by which strains of coronavirus are transmitted between cats. Excretion of coronavirus by infected cats into the environment occurs by way of feces, oronasal secretions, and, possibly, urine. FIP coronavirus remains stable outside the host for as long as 3 to 7 weeks and is rapidly inactivated by most household disinfectants. Clinical diagnosis of coronavirus infection is made by evaluating the presenting history, physical findings, laboratory results, coronavirus antibody titers, and by excluding analogous disease. The presence of coronavirus antibodies can be used to screen cats for the presence of coronavirus infection and as an adjunct in diagnosing clinical coronavirus infection. A intranasal TS-FIPV vaccine that protects against natural coronavirus challenge is available for healthy cats 16 weeks of age or older.

Germfree technique for the rearing of kittens--a research tool

Techniques to derive and rear germfree kittens (Felis catus) for biomedical research were explored and refined. The isolator units, equipment, sterilization procedures, husbandry techniques, and safety issues are discussed. This method proved to be successful for the surgical derivation and hand-rearing of germfree kittens.

Quantitative urinalysis in kittens from four to thirty weeks after birth

To evaluate renal function and obtain reference values for measurements of urinary excretion of various substances, quantitative urinalysis was performed in healthy, growing kittens from 4 to 30 weeks after birth. Endogenous creatinine clearance, 24-hour urine protein excretion, and urine protein-to-creatinine ratio were determined. Additionally, fractional excretion to creatinine clearance was calculated for calcium, inorganic phosphorus, sodium, potassium, and chloride. Mean +/- SD endogenous creatinine clearance values (range, 3.80 +/- 0.48 to 4.74 +/- 0.61 ml/min/kg) were significantly (P less than 0.0001) higher in kittens 9 to 19 weeks old, compared with younger (range, 1.39 +/- 0.85 to 3.59 +/- 0.86 ml/min/kg) and older kittens (range, 2.69 +/- 0.40 to 3.46 +/- 0.37 ml/min/kg). Mean values for all kittens for 24-hour urine protein excretion (range, 2.54 +/- 1.81 mg/kg at 4 weeks to 11.39 +/- 7.61 mg/kg at 14 weeks) and for urine protein-to-creatinine ratio (range, 0.14 +/- 0.03 to 0.34 +/- 0.18) varied from week to week of age. The urine protein-to-creatinine ratio in kittens greater than or equal to 9 weeks old correlated well (R2 = 0.861) with 24-hour urine protein excretion. Urinary fractional excretion of calcium, inorganic phosphorus, sodium, potassium, and chloride in kittens varied among age groups, being significantly (P less than 0.01) different for potassium and calcium in young kittens (4 to 6 weeks) and older kittens (greater than or equal to 7 weeks).

Disseminated infection with Neospora caninum in a ten-year-old dog

Naturally-occurring neosporosis with multiple organ involvement was identified in a 10-year-old neutered male Basset hound dog. Clinical signs were first noticed 3 weeks prior to referral and consisted of crouched stance and mild pelvic limb ataxia. Dexamethasone administration had provided transient improvement. On presentation to the teaching hospital, clinical signs included depression, pelvic limb ataxia, inability to stand without assistance, and pain on deep palpation of the cervical and lumbar vertebral column. Lesions were found in the myocardium, liver, spleen, adrenal glands, brain, and spinal cord. Tachyzoites of Neospora caninum were found in the myocardium and adrenal glands. Organisms stained with anti-Neospora caninum, but not to anti-Toxoplasma gondii serum in an immunohistochemical test.

Ehrlichial diseases of dogs

Ehrlichial diseases of dogs currently are recognized to be caused by Ehrlichia canis, Ehrlichia platys, Ehrlichia equi, and Ehrlichia risticii. Information on each disease's history, transmission, pathogenesis, clinicopathologic findings, diagnosis, therapy, and prevention is presented in this article. Ehrlichia canis is the most common cause of clinical illness. Case reports are included to illustrate common presentations of Ehrlichia canis infections.

Canine haemobartonellosis, canine hepatozoonosis, and feline cytauxzoonosis

Although Lyme borreliosis (Lyme disease), ehrlichiosis, Rocky Mountain spotted fever, and babesiosis occur more frequently in dogs or cats, from a clinical standpoint, other tick-borne diseases such as canine haemobartonellosis, canine hepatozoonosis, and feline cytauxzoonosis are just as important to recognize. Information concerning these less common tick-borne diseases are discussed, including their causative agents and their relationship to disease pathogenesis, diagnosis, treatment, and prevention.

Ixodid and argasid ticks. Keys to their identification

Ticks of the Ixodidae family are important ectoparasites of humans and animals. Of the 80 or so species found in the United States, about 20 are of veterinary importance. Ticks are second only to mosquitoes as carriers of human pathogens. The ixodid (or hard) ticks are the most common and are represented by the genera Ixodes, Haemaphysalis, Boophilus, Rhipicephalus, Amblyomma, and Dermacentor. Accurate identification of the species of ixodid ticks within an area is a prerequisite to control and eradication. Therefore, veterinarians should have a working knowledge of the biology and identity of the more common mammalian-parasitizing ticks in the United States. In the United States, the argasid (or soft) ticks are less common than the ixodid (or hard) ticks. Argasids are represented by the genera Argas, Ornithodoros, and Otobius. Although the overall anatomy of the various species of argasids is similar, their functional approaches to feeding, reproduction, host finding and preference, tick-host behavior, tick relationship to their environment, and disease association vary among species. Accurate identification of the species of argasid ticks within an area is useful in their control.

Temporal study of staphylococcal species on healthy dogs

During a 1-year period, specimens were obtained monthly from 5 hair coat and 7 mucous membrane sites of 11 healthy dogs. Among 804 isolates of staphylococci, 13 species were identified. Staphylococcus intermedius was the most frequently isolated (40.2% of total isolates) coagulase-positive species, and S xylosus was the most frequently isolated (17.3%) coagulase-negative species. Moreover, S intermedius was the most frequently isolated species from the 12 sites evaluated and was isolated persistently from 8 of the 9 dogs that completed the 1-year study. On the basis of a commercial identification system, 14 profile numbers were identified for isolates of S intermedius. However, 2 profile numbers accounted for a majority (70.9%) of the isolates. Specific S intermedius biotypes identified on the basis of hemolysis, coagulase production, beta-lactamase activity, and antimicrobial susceptibility patterns were found repeatedly in 3 dogs. Seemingly, S intermedius was a resident of the normal bacterial microflora of these dogs; however, the inability to isolate S intermedius from 1 dog during the study year indicated that not all dogs harbor S intermedius as a resident microorganism.

Antibodies to Ehrlichia canis, Ehrlichia platys, and spotted fever group rickettsiae in Louisiana dogs

Antibodies to Ehrlichia canis, Ehrlichia platys, and spotted fever group (SFG) rickettsiae were detected by indirect immunofluorescence in sera from 27 ill individually owned thrombocytopenic dogs (platelet concentrations less than 200,000 platelets/microliters) and 59 healthy kenneled dogs located in southern Louisiana. Platelet concentrations less than 100,000 platelets/microliters were detected in 63% of ill thrombocytopenic dogs and 6.8% of healthy kennel dogs. One ill thrombocytopenic dog had intracytoplasmic E platys morulae detected within platelets. The prevalence of increased serum antibody titers to E canis and E platys was 25.9% and 40.7% for the ill thrombocytopenic dogs and 20.3% and 54.2% for the healthy kennel dogs, respectively. All dogs with seropositivity to E canis had increased antibody titers of greater than or equal to 1:100 to E platys. Simultaneous examination of increased serum antibody titers (greater than or equal to 1:64) to four SFG rickettsiae indicate that Rickettsia rhipicephali and Rickettsia montana accounted for the majority of the antibodies detected in these dogs. Of 86 dogs tested, 44.2% were seronegative to E canis, E platys, and SFG rickettsiae.

Comparative morphology of esophageal mucosa and submucosa in dogs from 1 to 337 days of age

Scanning electron microscopy, light microscopy, and morphometric analyses were used to examine the morphology of the tunica mucosa-tela submucosa of the cervical, thoracic, and abdominal parts of the esophagus of healthy dogs from birth to 337 days of age from 3 litters of dogs whelped and reared under controlled conditions. Apart from the absence of a lamina muscularis mucosae from the cervical part of the esophagus of all dogs examined, little regional variation was detected. However, morphologic variation associated with age was observed. The number and complexity of microplicae on surface epithelial cells, as observed with the scanning electron microscope, increased with age, particularly between 1-day-old and 21-day-old dogs. Although scanning electron microscopy revealed typical duct openings from the submucosal glands in 1-day-old dogs, light microscopy revealed few functional glands. These glands gradually developed into a complex strata of tubules and acini during the time that secretory activity and the volume fraction of the tunica mucosa-tela submucosa occupied by glands increased with age. The presence of ciliated cells in the esophagus of 1-day-old dogs was apparent with scanning electron and light microscopes. Ciliated cells were always most abundant in the abdominal part of the esophagus. Finally, morphometric analyses revealed a significant increase in epithelial and connective tissue compartment thicknesses, as well as a marked increase in the volume fraction occupied by glands between 1 day and 161 days after dogs were whelped. A smaller decrease in all 3 measures occurred between 161 and 337 days after the dogs were whelped.

Complications following thiacetarsamide sodium therapy in Louisiana dogs with naturally-occurring heartworm disease

Four hundred and sixteen dogs with naturally-occurring heartworm disease were evaluated for complications following thiacetarsamide sodium therapy. Of these, 109 dogs (26.2%) experienced complications. Increased lung sounds was the most commonly seen complication, followed by fever and coughing. In dogs with complications, 83.5% of them presented without clinical evidence of pulmonary thromboembolism or heart failure. There were no statistically significant differences between the age, sex, breed and body size of dogs that experienced complications following thiacetarsamide therapy and dogs that did not. Complications were most frequently seen 5 to 9 days following thiacetarsamide therapy although some dogs experienced initial complications as late as 28 days. Thirty-three of 109 dogs (33.0%) with complications responded to exercise restriction. The remaining 76 dogs with complications prior to or following thiacetarsamide required adjunct drug therapy. Of these, 35 dogs responded favorably to anti-inflammatory doses of prednisolone or prednisone. Five dogs died or were euthanatized because of the complications experienced. Eighteen of 416 dogs (4.3%) presented with clinical evidence of pulmonary thromboembolism or heart failure prior to the thiacetarsamide therapy. All 18 dogs experienced complications in spite of adjunct drug therapy and exercise restriction prior to, during, and following thiacetarsamide therapy. Survival rate following resolution of the thiacetarsamide-induced complications was greater than 98%.

Distribution of staphylococcal species on clinically healthy cats

Among 827 isolates derived from 113 clinically healthy cats, 12 species of staphylococci were identified. Staphylococci were isolated from each cat and from 54.9% of the anatomic sites evaluated. A mode of 6 (range = 2 to 11) of the 11 anatomic sites evaluated per cat yielded staphylococci. A mode of 8 (range = 2 to 12) isolates were found per cat. Staphylococcus simulans was the most isolated (43.9% of total) coagulase-negative species. Moreover, S simulans was the most isolated species from each of the 11 sites evaluated and, except for the mouth and haircoat, comprised greater than 50% of the isolates from each site. Staphylococcus intermedius was the most isolated (13.5% of the total) coagulase-positive species. Three other species (S epidermidis, S xylosus, and S aureus) comprised 32.2% of the isolates, and 7 species (S haemolyticus, S hominis, S hyicus, S capitis, S warneri, and S saprophyticus) comprised 10.4% of the isolates. Six species (S intermedius [96 of 112 isolates], S haemolyticus [20 of 22], S sciuri [17 of 18], S warneri [10 of 13], S hyicus [10 of 10], and S capitis [7 of 8]) were isolated primarily from household cats. Only 1 species, S xylosus (75 of 87), was isolated primarily from cattery cats. Haircoat specimens (n = 452) yielded 508 isolates (61.4% of the total) distributed among all 12 staphylococcal species and included greater than 50% of the isolates of all species other than S simulans and S sciuri. A more heterogeneous population of staphylococci was isolated from household cats than was isolated from cattery cats.

Detection of beta-lactamase produced by Staphylococcus intermedius

One iodometric, 2 chromogenic, and 3 acidometric methods were compared for the detection of beta-lactamase produced by Staphylococcus intermedius (n = 105) isolated from dogs. Of 575 tests performed, using the 6 methods evaluated, 316 (55.0%) were positive for beta-lactamase production. The iodometric method was the reference method. With the exception of a high correlation (r = 0.962) between 1 acidometric method and 1 chromogenic method, the 5 commercial methods had correlation coefficients less than 0.900 when comparisons were made among them. The 6 methods were in agreement for 69 (65.7%) of the isolates. Based on the findings of this study, an inexpensive, laboratory-prepared, paper strip iodometric method was as reliable as 5 commercial methods for beta-lactamase detection and is recommended for routine use in clinical laboratories.

Comparison of coagulase test methods for identification of Staphylococcus intermedius from dogs

Staphylococcus intermedius isolates from dogs were tested for coagulase activity by 6 commercial methods and by conventional methods, using rabbit and dog plasma. When compared with the conventional tube method using rabbit plasma, none of the 6 commercial methods was suitable for identification of S intermedius, although the 6 tests performed well using strains of S aureus. Use of rabbit plasma identified more S intermedius isolates than did use of dog plasma.

Comparative evaluation of a commercial microdilution method and a conventional disk diffusion method for determination of antibiograms of gram-positive cocci

A commercial broth microdilution system for testing the antimicrobial susceptibility of gram-positive cocci was compared with the standardized disk agar-diffusion method by testing 254 clinical strains of staphylococci and streptococci using both methods. A total of 2,794 parallel determinations were made with 92.3% complete agreement between the 2 methods; of the discrepancies encountered, 3.0% were minor, 2.5% were major, and 2.1% were very major. The results indicate that the commercial microdilution system may provide a reliable quantitative method for antimicrobial susceptibility testing of clinical isolates from animals.

Antimicrobial susceptibility of coagulase-positive staphylococci isolated from Louisiana dogs

Disk diffusion susceptibility tests were done on 1,178 clinical strains of coagulase-positive staphylococci (CPS) isolated from dogs during a 7-year period. Relative decreases of 7% to 33% were found in the percentages of CPS sensitive to 8 antimicrobics. Relative percentages of CPS sensitive to 9 other antimicrobics were increased or decreased less than 5%. Sensitivity to the beta-lactam antibiotics showed the least relative change. Regression analysis demonstrated that the greatest change in percentage sensitivity of CPS occurred to gentamicin and cephalothin and the least change occurred to penicillin and ampicillin. Recent canine clinical isolates of CPS, specifically identified as Staphylococcus intermedius (n = 109), were uniformly sensitive to novobiocin, amikacin, tobramycin, spectinomycin, and amoxicillin-clavulanic acid. Twenty-two isolates were also sensitive to 17 other antimicrobics. Eighty-seven isolates were resistant to 1 or more antimicrobics tested. Resistance was most common to sulfonamides, penicillin G, ampicillin, tetracycline, and streptomycin. Differences in susceptibility results between S intermedius and unspecified CPS were not statistically significant.

Effect of beta-lactamase of Staphylococcus intermedius on disk agar diffusion susceptibility tests

Clinical strains of canine Staphylococcus intermedius (n = 120) were tested for susceptibility to beta-lactam antimicrobics (n = 6) by the standardized disk agar diffusion method and for beta-lactamase (BL) production. Significant differences between susceptibilities for BL producing (n = 68) and non-producing (n = 52) strains were found for penicillin G and ampicillin. Zone sizes of BL producing strains were significantly smaller than those of non-producers for penicillin G, ampicillin, cephalothin, carbenicillin and amoxicillin-clavulanic acid but not for methicillin. However, all strains were sensitive to cephalothin and amoxicillin-clavulanic acid; only one strain was resistant to methicillin; and one strain was intermediate in susceptibility to carbenicillin. Although 62 (52%) strains were sensitive to penicillin G and ampicillin based on established zone size interpretive criteria, 15 (24%) of these strains produced BL. Zone size measurements obtained with beta-lactam antimicrobics that are highly susceptible to inactivation by BL are not reliable and should be disregarded for canine S. intermedius which produce BL.

Species of Staphylococcus isolated from animal infections

One hundred randomly selected clinical strains of staphylococci were identified by species using a commercial micromethod system. Eight species of staphylococci were identified. Staphylococcus intermedius was the most frequent (n = 74) species identified and accounted for 70/74 (94.6%) of the coagulase-positive strains and 70/79 (88.6%) of the total isolates from dogs. Other species identified, in order of their frequency, included S. epidermidis (8), S. aureus (7), S. simulans (4), S. sciuri (2), S. xylosus (2), S. hyicus (2) and S. saprophyticus (1). These results show that at least 8 different species of staphylococci can be recovered from animal infections and that coagulase-positive species such as S. intermedius may be more common than S. aureus. The relative significance of these other species in animal infections needs to be assessed.

Serum hyperviscosity syndrome associated with Ehrlichia canis infection in a dog

A 10-year-old male Lhasa Apso was examined because of pyrexia, vomiting, weight loss, lethargy, and disorientation. The clinical and laboratory findings were supportive of a diagnosis of serum hyperviscosity syndrome associated with an Ehrlichia canis infection. After tetracycline therapy the serum hyperviscosity syndrome and E. canis infection were successfully resolved.

Scanning electron microscopic study of the small intestine of dogs from birth to 337 days of age

The surface morphology of the small intestine of dogs from birth to 337 days of age was studied by scanning electron microscopy. The small intestinal surface morphology was similar to that described for other species, except for irregular villous length in the duodenum, jejunum, and ileum of the dog from birth to 21 days of age. The absorptive epithelial cells and goblet cells were similar in morphology and distribution from birth to 337 days. Segmented filamentous bacteria were attached to the ileal mucosa of dogs 54 to 161 days of age.

Prevalence of parasitism diagnosed by fecal examination in Louisiana dogs

The prevalence of canine intestinal parasitism was evaluated by fecal examination of 4,058 dogs admitted to the Louisiana State University Veterinary Teaching Hospital and Clinics from March 1977 to March 1980). One or more species of parasites was identified in 2,048 (50.5%) dogs. Hookworms were encountered in 38.5% of the dogs examined, whipworms in 14.9%, ascarids in 8.5%, coccidia in 2.6%, tapeworms in 2.2%, and giardia in 0.8%. Single parasitic infection was present in 1,456 (35.9%) dogs. For hookworm and whipworm infections, male dogs were significantly (P less than .05) more often affected, compared with females or spayed females. Ascarid, coccidia, and giardia infections were more prevalent in pups than in mature dogs, whereas whipworm infections were detected less often in dogs less than 6 months of age. Hookworms were the most prevalent parasites in male (39.2%) and female (35.7%) dogs less than 6 months of age and maintained high prevalence in mature dogs. Tapeworm infections were diagnosed sporadically in all age groups. In female dogs greater than 24 months of age, significantly less parasitism was present as compared with younger females. In male dogs, the prevalence of parasitism diminished less markedly with increasing age.

A questionnaire for the clinical assessment of veterinary adverse drug reactions

Despite widespread occurrence of adverse drug reactions (ADRs), their clinical identification has been a nonreproductible act of unspecified subjective judgment. Adequate criteria have not been available for diagnostic decisions about the cause of an observed clinical manifestation. To improve scientific precision in diagnosis of ADRs, the ADR questionnaire has been developed to rank the probability of linking a drug to a suspected clinical manifestation. The questionnaire provides a scoring system for six axes of decision strategy: previous general experience with the drug, alternative etiologic candidates, timing of events, drug levels and evidence of overdose, dechallenges and rechallenges. The sum of the scores is partitioned to rate the candidate ADR as definite, probable, or unlikely.

Feline respiratory tract disease in Louisiana

An investigation of feline respiratory tract disease (FRD) was made involving 65 affected cats (group 1) and 65 control cats (group 2) matched for age, sex, and residence. Feline calicivirus strains (FCV), feline herpesvirus-1 (FHV-1), or both, were isolated from 59% of group 1 cats and from 7% of group 2 cats. Isolation of these viruses showed a significantly greater (P < 0.05) relative risk for group 1 cats. Virus isolations were three times more frequent from males than from females older than 1 year (both groups), but were equally distributed between males and females younger than 1 year. Bacteria and fungi had a secondary role in both FCV- and FHV-1 associated FRD. Intestinal infections of Ancylostoma spp, Dipylidium caninum, and Toxocara cati were diagnosed more frequently in group 1 cats than in control (group 2). Paragonimus kellicotti was diagnosed in 3 group 1 cats, Taenia taeniaeformis in 1 group 1 cat, Isospora rivolta in 1 group 1 cat, and Giardia cati in 1 control cat. The present study supports the current concept of a primary viral cause for development of FRD.

Studies on the pathogenesis of Escherichia coli in the bursa of Fabricius (cloacal bursa) of the turkey

Turkey poults were inoculated with avirulent or virulent strains of Escherichia coli by direct application to anal lips and were killed at postinoculation hours (PIH) 0.1, 2, 5, 10, 24, 48, 72, and 96. Bursae of Fabricius (cloacal bursae) were collected, cultured, and examined by light, fluorescent, and electron microscopy. The virulent strain of E coli was not recovered from the bursae after PIH 24, although the avirulent strain was recovered up to PIH 96. The E coli strains neither localized at nor associated with the bursal fold epithelium, passed through the follicular pad epithelium, nor caused cytopathologic changes in the lymphoid follicle. A mild catarrhal bursitis was observed at PIH 48 with the avirulent strain of E coli.