Progressive angiomatosis, resembling human skeletal-extraskeletal angiomatosis, arising in multiple digits in two dogs

Two dogs presented with progressive, expansile and invasive lesions on a hind paw. Case 1, a 10-year-old female Shetland sheepdog had diffusive and aggressive-looking lesions on the middle digits of the left hind paw. Radiographic examination showed invasion into and destruction of the underlying bone. A malignant tumour was suspected initially; however, histological features of atypical vascular proliferations without mitotic activity were consistent with progressive angiomatosis. Case 2, an 11-year-old female English springer spaniel presented with similar lesions in the same toes, also involving bone. Progressive angiomatosis was suspected clinically, as tumour cells were not detected by cytology and screening did not detect metastatic disease. Histopathology confirmed the diagnosis. Progressive angiomatosis is an uncommon non-malignant condition which should be considered as a differential diagnosis for radiographically lytic digital lesions.

A retrospective study of canine idiopathic renal haematuria: clinical findings and outcome following medical treatment

OBJECTIVES

To characterise and document the progression of idiopathic renal haematuria in a large cohort of medically managed UK dogs.

MATERIALS AND METHODS

Retrospective study of 41 client-owned dogs with confirmed (n=14), or suspected (n=27) idiopathic renal haematuria from 4 UK-based referral centres. Clinical findings and outcomes of dogs (2001 to 2018) were determined from the review of medical records and telephone follow-up.

RESULTS

Median survival time from diagnosis was long [1482 (152 to 1825) days] irrespective of treatment and clinical response. Only 1 case was euthanased due to idiopathic renal haematuria, and anaemia or azotaemia occurred infrequently. In total, 25 dogs received angiotensin-converting enzyme-inhibitor or angiotensin receptor blocker therapy, of which 23 received benazepril [0.44 (0.19 to 0.82) mg/kg/24 hours], two received enalapril (0.40 and 0.78 mg/kg/24 hours) and one received telmisartan (1 mg/kg/24 hours). In cases with follow-up urinalyses, complete resolution of haematuria was documented in eight of 19 (42%) dogs following angiotensin-converting enzyme-inhibitor/angiotensin receptor blocker treatment, with partial improvement in five of 19 (26%) and no improvement in six of 19 (31%). Conversely, of the two untreated dogs where outcome was available, one had partial improvement and the other had no improvement.

CLINICAL SIGNIFICANCE

In this study, idiopathic renal haematuria was associated with a good prognosis and low complication rate. Resolution or improvement in haematuria occurred in both angiotensin-converting enzyme-inhibitor/angiotensin receptor blocker-treated and untreated dogs, indicating that further studies are required to evaluate the effectiveness and safety of these interventions.

Diagnostic accuracy of three biopsy techniques in 117 dogs with intra-nasal neoplasia

OBJECTIVES

To determine if nasal biopsies taken at rhinoscopy are more accurate for diagnosing neoplasia than biopsies taken blindly or using advanced imaging for guidance.

METHODS

A retrospective study of 117 dogs with nasal mass lesions that were divided into three groups according to the method of nasal biopsy collection; advanced imaging-guided, rhinoscopy-guided and blind biopsy. Signalment, imaging and rhinoscopic findings, and histopathological diagnosis were compared between groups. The proportion of first attempt biopsies confirming neoplasia were determined for each group.

RESULTS

There were no statistically significant differences in the proportion of biopsies that confirmed neoplasia obtained via advanced imaging-guided, rhinoscopy-guided or blind biopsy techniques.

CLINICAL SIGNIFICANCE

In dogs with a high index of suspicion of nasal neoplasia, blind biopsy may be as diagnostic as rhinoscopy-guided biopsy. Repeated biopsies are frequently required for definitive diagnosis.

Exclusion of a brain lesion: is intravenous contrast administration required after normal precontrast magnetic resonance imaging?

Background

No evidence‐based guidelines are available for the administration of gadolinium‐based contrast media to veterinary patients.

Objective

To investigate whether administration of intravenous (IV) contrast media alters the likelihood of identifying a brain lesion in dogs and cats.

Animals

Four hundred and eighty‐seven client‐owned animals referred for investigation of intracranial disease.

Methods

Two reviewers retrospectively analyzed precontrast transverse and sagittal T1‐weighted (T1W), T2‐weighted, and fluid‐attenuated inversion recovery low‐field MRI sequences from each patient for the presence of a clinically relevant brain lesion. All sequences subsequently were reviewed in the same manner with additional access to postcontrast T1W images.

Results

Of the 487 precontrast MRI studies, 312 were judged to be normal by 1 or both reviewers. Of these 312 studies, a previously undetected lesion was identified in only 6 cases (1.9%) based on changes observed on postcontrast sequences. Final diagnoses included meningoencephalitis of unknown origin (n = 1), feline infectious peritonitis (n = 1), and neoplasia (n = 2). All 4 of these cases had persistent neurological deficits suggestive of an underlying brain lesion. Contrast enhancement observed in the 2 other cases was considered falsely positive based on the results of further investigations.

Conclusions and Clinical Importance

In patients with normal neurological examination and normal precontrast MRI, the subsequent administration of IV gadolinium‐based contrast media is highly unlikely to disclose a previously unidentified lesion, calling into question the routine administration of contrast media to these patients. However, administration still should be considered in animals with persistent neurological deficits suggestive of an underlying inflammatory or neoplastic brain lesion.

Loeffler's endocarditis and bicavity eosinophilic effusions in a dog with visceral mast cell tumour and hypereosinophilia

A 9-year-old crossbred dog was presented with a 2-week history of diarrhoea and tachypnoea. Marked circulating eosinophilia was identified. Pleural and abdominal effusions were detected by radiography and ultrasonography and cytological examination of these fluids revealed a predominance of eosinophils. Splenic and hepatic cytology revealed mast cell neoplasia, which was confirmed as visceral mast cell tumour on post-mortem examination. Histological changes of myocardial inflammation, necrosis and fibrosis were found. These findings are consistent with Loeffler's endocarditis.

A comparison of factors that influence survival in dogs with adrenal-dependent hyperadrenocorticism treated with mitotane or trilostane

BACKGROUND

Trilostane is a recognized treatment for canine pituitary-dependent hyperadrenocorticism (PDH); however, its efficacy in dogs with adrenal-dependent hyperadrenocorticism (ADH) is unknown.

OBJECTIVES

To examine factors that might influence survival in the medical management of ADH, with particular emphasis on treatment selection.

ANIMALS

Thirty-seven animals referred to 4 centers over a period of 12 years that had been diagnosed with ADH and treated with either trilostane (22/37), mitotane (13/37), or both (2/37).

METHODS

Retrospective analysis of clinical records.

RESULTS

There was no statistically significant difference between the survival times of 13 dogs treated only with mitotane when compared with 22 dogs treated only with trilostane. The median survival time for animals treated with trilostane was 353 days (95% confidence interval [CI] 95-528 days), whereas it was 102 days (95% CI 43-277 days) for mitotane. Metastatic disease was detected in 8 of 37 dogs. There was a significantly lower probability of survival for dogs with metastatic disease when compared with those without metastatic disease (P < .001).

CONCLUSIONS AND CLINICAL IMPORTANCE

The choice of medical treatment for ADH may not have a major effect on survival times. However, the presence of metastatic disease considerably decreases survival time regardless of the choice of medical treatment.

Prevalence of hepatic lesions at post-mortem examination in dogs and association with pancreatitis

OBJECTIVES

To assess the prevalence of canine chronic hepatitis (CH) and other liver diseases in first opinion practice and identify associations with concurrent chronic pancreatitis (CP).

METHODS

One large section of left lateral lobe of liver was taken from 200 unselected canine post-mortem examinations from first opinion practices. Histological changes were categorised based on WSAVA criteria. Prevalence of CH and other liver diseases were calculated. Relative risks (RR) for liver histopathology in association with CP and for CH in different breeds were also calculated.

RESULTS

The prevalence of CH was 12%. Some breeds had an increased RR of CH, although sample sizes were small. Dogs with CP had an increased RR of reactive hepatitis but no significant association with the other liver diseases.

CLINICAL SIGNIFICANCE

CH is common in the first opinion dog population but less common than CP. CP was significantly associated with reactive hepatitis but not CH. Possible breed associations mirrored another recent UK study. Some dogs with CP may be erroneously diagnosed clinically as having CH on the basis of increased serum liver enzymes because of concurrent reactive hepatitis if the diagnosis is not confirmed histologically.

Prognostic significance of specific magnetic resonance imaging features in canine nasal tumours treated by radiotherapy

OBJECTIVES

To investigate the prognostic significance of the magnetic resonance (MR) findings of meningeal hyperintensity of the olfactory bulbs and tumour extension into the caudal nasal recess (CNR) in dogs with nasal tumours treated by radiotherapy.

METHODS

MR images of 41 dogs with nasal tumours treated with radiotherapy were reviewed. The occurrence of neurological signs and survival of patients with and without meningeal hyperintensity of the olfactory bulbs and tumour extension into the CNR were analysed together with possible confounding factors including intracranial extension and patient age.

RESULTS

There was no significant association between the presence of meningeal hyperintensity or CNR involvement and the occurrence of neurological signs. Although there was a tendency towards shorter survival in dogs with tumour extension into the CNR, multivariable analysis showed no significant difference in survival between dogs with/without CNR involvement, meningeal hyperintensity or intracranial tumour extension (P=0.12, 0.50 and 0.57, respectively).

CLINICAL SIGNIFICANCE

In dogs with nasal tumours treated with radiotherapy, tumour extension into the cranium is not necessarily associated with shorter survival in patients without neurological signs at time of diagnosis. Although a definite influence of CNR involvement on case outcome could not be demonstrated, studies with a larger population are warranted.

Haemophilia A (factor VIII deficiency) in a litter of Weimaraners

Inherited coagulopathies are reported in a number of dog breeds. However, to date, there is no report of Weimaraners suffering factor VIII deficiency (haemophilia A). We report the discovery of haemophilia A in both males from a single litter of Weimaraners. Haemophilia A in human beings often results from a de novo stochastic mutation. We found no evidence using currently available screening tests of haemophilia A in relatives as far back as three generations making a stochastic mutation possible in this litter.

Exogenous insulin treatment after hypofractionated radiotherapy in cats with diabetes mellitus and acromegaly

BACKGROUND

The optimal treatment for feline acromegaly has yet to be established. Surgical and medical therapies are minimally effective although radiotherapy might have greater efficacy. The purpose of this study was to review the response and outcome of cats with acromegaly and insulin-resistant diabetes mellitus (DM) to radiotherapy.

HYPOTHESES

That radiotherapy improves glycemic control in cats with acromegaly and that improved glycemic control is due to remission of clinical acromegaly; demonstrated by a fall in serum insulin-like growth factor-1 (IGF-1) concentrations.

ANIMALS

Fourteen cats with naturally occurring acromegaly.

METHODS

Retrospective case review; records of all cats treated for acromegaly with radiotherapy were reviewed from 1997 to 2008. Cats were selected on the basis of compatible clinical signs, laboratory features, and diagnostic imaging findings. Fourteen cats received radiotherapy, delivered in 10 fractions, 3 times a week to a total dose of 3,700 cGy.

RESULTS

Thirteen of 14 cats had improved diabetic control after radiotherapy. These improvements were sustained for up to 60 months. DM progressed in 2 cats and 1 did not respond. Seven cats responded before the final treatment. Ten cats were euthanized, 1 as a consequence of radiotherapy. In 8 cats in which IGF-1 was measured after treatment, changes in its concentration did not reflect the clinical improvement in glycemic control.

CONCLUSIONS AND CLINICAL IMPORTANCE

Radiotherapy represents an effective treatment for cats with insulin-resistant DM resulting from acromegaly. IGF-1 concentration after treatment does not provide a suitable method by which remission from either acromegaly or insulin-resistant DM may be assessed.

Glomerular filtration rate estimated by 3-sample plasma clearance of iohexol in 118 healthy dogs

BACKGROUND

Glomerular filtration rate (GFR) decreases in the aging human kidney, but limited data exist in dogs.

HYPOTHESIS

There is an effect of age and body size on estimated GFR in healthy dogs.

ANIMALS

One hundred and eighteen healthy dogs of various breeds, ages, and body weights presenting to 3 referral centers.

METHODS

GFR was estimated in clinically healthy dogs between 1 and 14 years of age. GFR was estimated from the plasma clearance of iohexol, by a compartmental model and an empirical correction formula, normalized to body weight in kilograms or liters of extracellular fluid volume (ECFV). For data analysis, dogs were divided into body weight quartiles 1.8-12.4, 13.2-25.5, 25.7-31.6, and 32.0-70.3 kg.

RESULTS

In the complete data set, there was no trend toward lower estimated GFR/kg or GFR/ECFV with increasing age. GFR decreased with age in dogs in the smallest weight quartile only. A significant negative linear relationship was detected between body weight and estimated GFR/kg and GFR/ECFV. Reference ranges in different weight quartiles were 1.54-4.25, 1.29-3.50, 0.95-3.36, and 1.12-3.39 mL/min/kg, respectively. Standardization to ECFV rather than kilogram body weight did not produce substantial changes in the relationships between GFR estimates and age or weight.

CONCLUSIONS AND CLINICAL IMPORTANCE

Interpretation of GFR results for early diagnosis of renal failure should take into account the weight and the age of the patient for small dogs.

Retrospective review of 50 canine nasal tumours evaluated by low-field magnetic resonance imaging

OBJECTIVES

Low-field magnetic resonance imaging machines are being used more often in veterinary practice for the investigation of sinonasal disease. The aim of this retrospective study was to describe and characterise the low-field magnetic resonance imaging features of nasal tumours in dogs.

METHODS

The Queen's Veterinary School Hospital magnetic resonance imaging database (2001-2005) was searched for dogs with a magnetic resonance imaging diagnosis of a nasal tumour. Fifty cases with histological diagnosis of nasal tumour were found. The appearance and extent of the nasal tumour as well as the involvement of adjacent anatomic structures were examined against a checklist.

RESULTS

The most common magnetic resonance imaging findings were as follows. (1) Soft tissue mass replacing the destroyed nasal conchae and/or ethmoturbinates (98 per cent of cases). (2) Nasal septum destruction (68 per cent of cases). (3) Retained secretions with or without mass caudally in frontal sinuses (62 per cent of cases). (4) Nasal/frontal bone destruction (52 per cent of cases). Low-field magnetic resonance imaging allowed differentiation of tumour tissue from retained secretions or necrotic tissue. Magnetic resonance imaging was invaluable in assessing the extension of the tumour into the maxillary recesses, caudal recesses, nasopharynx, adjacent bones and cranial cavity. The tumour often extended caudally into the frontal sinuses, nasopharynx and perhaps most importantly into the caudal recesses. Tumour extension into the cranial cavity was not common (16 per cent), and only three of these cases showed neurological signs. However, 54 per cent of cases showed focal meningeal (dural) hyperintensity, although the significance of this is unclear. A significant difference (P<0.05) in tumour signal intensity between the sarcomas and carcinomas was found.

CLINICAL SIGNIFICANCE

The use of a low-field magnetic resonance imaging technique is excellent for the diagnosis and determination of extent of sinonasal tumours.

Histopathologic, Immunohistochemical, and Cytologic Analysis of Feline Myeloma-Related Disorders: Further Evidence for Primary Extramedullary Development in the Cat

Feline myeloma-related disorders (MRD) are rare neoplasms of plasma cells. The multistep transformation model of myeloma in humans is based on the premise that plasma cells undergo neoplastic transformation primarily within the intramedullary compartment and that over time they become poorly differentiated and metastasize to extramedullary locations. Historically, diagnostic criteria used for human multiple myeloma have been applied to the cat, with the assumption that feline MRD commonly arises in the intramedullary compartment. Our objectives were to describe the features of feline MRD confirmed by cytology, histopathology, histochemistry, and immunohistochemistry and to categorize these tumors. A priori hypotheses were 1) tumor category predicts survival and 2) cats with well-differentiated tumors commonly have extramedullary involvement in contrast to human myeloma patients. This multicenter, retrospective study identified 26 MRD cases. There was good agreement between histopathologic and cytologic tumor categorization. Histochemistry and immunohistochemistry were shown to be valuable adjunct tests in the diagnosis of MRD. Cats with well-differentiated tumors had increased median survival relative to those with poorly differentiated tumors (254 versus 14 days). We have reported that marked extramedullary involvement at initial clinical presentation is significantly more common in the cat than in human MRD patients. In this study, we demonstrate that cats with well-differentiated tumors more commonly have extramedullary involvement than human myeloma patients with well-differentiated tumors (90% versus 20%, P < 0.0002). These results contrast strongly with the human myeloma model of primary intramedullary neoplastic transformation and suggest that primary extramedullary neoplastic transformation may be more common in feline MRD.

Panniculitis, polyarthritis and osteomyelitis associated with pancreatic neoplasia in two dogs

A 12-year-old crossbred dog (case 1) and a 12-year-old Shetland sheepdog (case 2) were presented with a history of lameness and distal limb swelling. Physical examination revealed joint effusions and asymmetrical swellings of the extremities. In case 1, a diagnosis of arthritis and cellulitis was made on fine-needle aspiration biopsy of the synovium and subcutis. In case 2, bone biopsies and synovial aspirates diagnosed osteomyelitis and arthritis. A diagnosis of pancreatic disease was made on the findings of marked elevations of serum lipase concentrations and ultrasonographic identification of pancreatic masses in both cases. Both the cases were non-responsive to symptomatic management and were subsequently euthanased. Postmortem examination confirmed the diagnosis of panniculitis, arthritis and osteomyelitis in both cases. A pancreatic exocrine adenoma was identified in case 1 and a pancreatic adenocarcinoma with widespread metastases in case 2. To the authors' knowledge the association of panniculitis, polyarthritis and osteomyelitis with pancreatic disorders has not been reported previously in canine clinical cases.

Prevalence and breed distribution of chronic pancreatitis at post-mortem examination in first-opinion dogs

OBJECTIVES

To assess the prevalence of canine chronic pancreatitis in first-opinion practice and identify breed associations or other risk factors.

METHODS

Three sections of pancreas were taken from 200 unselected canine post-mortem examinations from first-opinion practices. Sections were graded for inflammation, fibrosis and other lesions. Prevalence and relative risks of chronic pancreatitis and other pancreatic diseases were calculated.

RESULTS

The prevalence of chronic pancreatitis was 34 per cent omitting the autolysed cases. Cavalier King Charles spaniels, collies and boxers had increased relative risks of chronic pancreatitis; cocker spaniels had an increased relative risks of acute and chronic pancreatitis combined. Fifty-seven per cent of cases of chronic pancreatitis were classified histologically as moderate or marked. Forty-one per cent of cases involved all three sections. Dogs with chronic pancreatitis were more commonly female and overweight, but neither factor increased the relative risk of chronic pancreatitis. There were breed differences in histological appearances and 24.5 per cent of cases were too autolysed to interpret with an increased relative risk of autolysis in a number of large breeds.

CLINICAL SIGNIFICANCE

Chronic pancreatitis is a common, under-estimated disease in the first-opinion dog population with distinctive breed risks and histological appearances.

Esophageal dysmotility in young dogs

BACKGROUND

Abnormal esophageal motility can exist without megaesophagus, although its prevalence in dogs is unknown and its cause has not been elucidated.

HYPOTHESIS

Esophageal dysmotility without overt megaesophagus exists in both symptomatic and asymptomatic young dogs, and motility can improve with age.

ANIMALS

Dogs examined at the Department of Veterinary Medicine, University of Cambridge for regurgitation, but without evidence of megaesophagus on radiographs, and a further group of asymptomatic dogs.

METHODS

Dogs underwent an initial and a repeat videofluoroscopic swallowing study. Images were reviewed and 5 criteria of esophageal motility evaluated.

RESULTS

Eight affected dogs were identified (median age 9 months), and terrier dogs predominated (6 terriers of 3 breeds). Esophageal motility was reduced either globally (n = 3) or segmentally (n = 5). Repeat examination at a median of 3 months revealed that regurgitation had reduced or resolved in the majority of terrier dogs, and 4 of 6 cases demonstrated an improvement in esophageal motility. Videofluoroscopic evaluation of young (median age 11 months) asymptomatic dogs of various breeds (n = 22) revealed evidence of esophageal dysmotility in 4 of 5 control terrier dogs. Repeat evaluation demonstrated an improvement in esophageal motility in 3 dogs.

CONCLUSION AND CLINICAL IMPORTANCE

Esophageal dysmotility without overt megaesophagus occurs in young terrier dogs, and affected animals can be symptomatic or asymptomatic. Further, an improvement in esophageal motility occurs with time in some dogs, and might represent a syndrome of delayed esophageal maturation.

Plasma concentrations of parathyroid hormone-related protein in dogs with potential disorders of calcium metabolism

The plasma concentrations of total calcium, ionised calcium, albumin, parathyroid hormone and parathyroid hormone-related protein (PTHrp) were measured in 25 dogs with lymphoma, nine dogs with primary hyperparathyroidism and seven dogs with adenocarcinoma of the apocrine gland of the anal sac. Plasma total calcium, ionised calcium, albumin and parathyroid hormone-related protein were measured in 18 clinically normal control dogs. The concentration of PTHrp was high in 12 of the 14 dogs that were hypercalcaemic because of an underlying malignancy but was within the reference range in all the control dogs, in the 17 normocalcaemic dogs with lymphoma and in the seven dogs which were hypercalcaemic because of a parathyroid adenoma.

Management of 13 cases of canine respiratory disease using inhaled corticosteroids

OBJECTIVES

To determine the value of inhaled corticosteroids in the management of chronic inflammatory airway disease in dogs.

METHODS

Medical records of dogs that were presented for the investigation of respiratory disease were reviewed retrospectively. Criteria for inclusion were knowledge of previous medical treatment including side effects, diagnosis of the underlying disease, use of inhaled corticosteroids and at least two-months follow-up data.

RESULTS

Thirteen dogs that fulfilled the criteria were identified. Ten dogs were diagnosed with chronic bronchitis and three with eosinophilic bronchopneumopathy. Four dogs had not previously received corticosteroid treatment for their respiratory disease, and all these showed a reduction or a resolution of clinical signs without obvious side effects after inhaled corticosteroid therapy. Nine dogs had previously received oral or parenteral corticosteroids for treatment of their respiratory disease, and all had exhibited side effects. Five of these dogs were treated with inhaled corticosteroids alone, and all exhibited an improvement in clinical signs without observable side effects. The remaining four dogs were treated with a combination of inhaled and oral corticosteroids, and all showed improvement in clinical signs and reduction in side effects. Inhaled medication was well tolerated in all dogs.

CLINICAL SIGNIFICANCE

Inhaled corticosteroids were used for the management of chronic bronchitis and eosinophilic bronchopneumopathy in 13 dogs, and these may have the advantage of reducing side effects associated with oral corticosteroids.

Hypercalcaemia associated with granulomatous lymphadenitis and elevated 1,25 dihydroxyvitamin D concentration in a dog

A seven-year-old Labrador was presented with weight loss and mild generalised lymphadenopathy. Histopathology of an excised lymph node by the referring veterinarian demonstrated granulomatous lymphadenitis. At the time of referral, fine-needle aspirates of the lymph nodes confirmed the presence of ongoing granulomatous inflammation. Further investigations revealed marked hypercalcaemia, a low parathyroid hormone concentration, a parathyroid hormone related protein concentration within the reference range, and an elevated serum concentration of 1,25 dihydroxyvitamin D. An underlying cause of the granulomatous lymphadenitis could not be identified. The clinical signs, hypercalcaemia and elevated serum concentrations of 1,25 dihydroxyvitamin D resolved following prednisolone treatment. In contrast to dogs, hypercalcaemia occurred secondarily to granulomatous disease and elevated 1,25 dihydroxyvitamin D concentrations is a well-recognised condition in human beings. To the authors' knowledge, this is the first case report to describe elevated serum calcium and 1,25 dihydroxyvitamin D concentrations in a dog with histologically confirmed granulomatous disease.

Hypercalcaemia in two dogs caused by excessive dietary supplementation of vitamin D

A three-year-old Border collie was presented with a two-week history of lethargy, stiff gait, polydipsia and polyuria. Biochemical analysis revealed hypercalcaemia. Serum concentrations of 25-hydroxyvitamin D (25[OH]D) and 1,25-dihydroxyvitamin D (1,25[OH]2D) were markedly elevated and parathyroid hormone was undetectable. Subsequent analysis of the dog's diet revealed that the food contained excessive amounts of vitamin D. The hypercalcaemia resolved following treatment with bisphosphonates and dietary change. Hypervitaminosis D was diagnosed in a second unrelated dog, which had been fed the same brand of dog food as case 1. The dog was also hypercalcaemic and had markedly elevated serum concentrations of 25(OH)D and 1,25(OH)2D. Hypervitaminosis D in dogs has been reported to occur secondarily to ingestion of either rodenticides containing cholecalciferol or antipsoriatic ointments that contain vitamin D analogues. Hypervitaminosis D has also been reported following the treatment of hypoparathyroidism. To the authors' knowledge, this is the first report of hypervitaminosis D in dogs following the accidental over supplementation of a commercial diet with vitamin D. While the benefits of adequate dietary vitamin D are well established in dogs, the potential deleterious effects of over supplementation of vitamin D should also be acknowledged.

Hypocalcaemia associated with low serum vitamin D metabolite concentrations in two dogs with protein-losing enteropathies

Protein-losing enteropathies were diagnosed in two dogs that were initially presented with diarrhoea and weight loss. Plasma biochemistry in both cases revealed low concentrations of albumin, calcium and ionised calcium. Both dogs had an elevated plasma parathyroid hormone concentration and low serum 25-hydroxyvitamin D (25[OH]D) concentration. The first dog was diagnosed with lymphangiectasia on postmortem examination, and the second dog was diagnosed with chronic lymphocytic/ plasmacytic enteritis and severe cystic mucoid changes based on endoscopic duodenal biopsies. While a causal effect was not demonstrated, the protein-losing enteropathies may have caused reduced intestinal absorption of vitamin D leading to low plasma concentrations of ionised calcium and secondary hyperparathyroidism. To the authors' knowledge, this is the first report of low ionised calcium concentrations, low 25(OH)D and 1,25-dihydroxyvitamin D concentrations, and high parathyroid hormone concentrations in dogs with protein-losing enteropathies.

Primary hyperparathyroidism in 29 dogs: diagnosis, treatment, outcome and associated renal failure

OBJECTIVES

To review the records of 29 dogs diagnosed with primary hyperparathyroidism and see if any factors correlate with renal failure.

METHODS

Dogs were selected retrospectively from case files from the QVSH and the QMH.

RESULTS

The majority of dogs were middle-aged and four were keeshonds. The primary presenting complaints were polyuria and polydipsia. All dogs had an elevated total and ionised plasma calcium concentration. Plasma phosphate concentrations were variable. Ultrasonography of the parathyroid gland revealed nodular enlargement which was found to correlate well with surgical findings. The majority of dogs underwent surgical parathyroidectomy. Five cases were treated by ultrasound-guided chemical ablation of the parathyroid gland, of which only two cases showed a partial response. Three dogs were euthanased within a week of presentation. Seven other dogs had renal failure diagnosed either at presentation or up to six months after parathyroidectomy. The development of renal failure was correlated with total calcium concentration but did not correlate with any other factor, including the calcium phosphate product. Thirteen treated dogs were known to be alive at the time of writing, which was six months to 3.5 years after parathyroidectomy.

CLINICAL SIGNIFICANCE

Primary hyperparathyroidism cases with high total calcium were more likely to develop renal failure in this group of dogs; however, the calcium phosphate product did not seem to be a useful predictor. Ultrasound-guided chemical ablation seemed to have limited advantage over surgery.

A comparison of the survival times of dogs treated with mitotane or trilostane for pituitary-dependent hyperadrenocorticism

The survival times of 148 dogs treated for pituitary-dependent hyperadrenocorticism were studied using clinical records from 3 UK veterinary centers between 1998 and 2003. Of these animals, 123 (83.1%) were treated with trilostane, while 25 (16.9%) were treated with mitotane. Treatment groups were compared using t-tests and analysis of variance (or their nonparametric equivalents) and chi-square tests. Survival data were analyzed using Kaplan-Meier survival plots and Cox proportional hazard methods. There was no significant difference between the population attributes from each center or between treatment groups. The median survival time for animals treated with trilostane was 662 days (range 8-1,971) and for mitotane it was 708 days (range 33-1,399). There were no significant differences between the survival times for animals treated with trilostane and those treated with mitotane. In the multivariable model (including drug, center, breed group, weight, diagnostic group, and age at diagnosis), only age at diagnosis and weight were significantly negatively associated with survival. Importantly, there was no significant effect of drug choice on survival.

Immune-mediated haemolytic anaemia and thrombocytopenia associated with Anaplasma phagocytophilum in a dog

A 10-year-old, crossbreed dog was presented with a history of severe lethargy, pyrexia and inappetence of several days' duration. Clinical examination revealed pallor of the mucous membranes, petechiae, generalised lymphadenopathy and effusions in multiple joints. Laboratory evaluation showed severe anaemia and thrombocytopenia, with positive in-saline agglutination and the presence of antiplatelet antibodies. The DNA of Anaplasma phagocytophilum, an endemic granulocytic rickettsial parasite, was detected by PCR. A poor response to doxycycline and immunosuppressive therapy with corticosteroids was seen. Euthanasia was performed after the development of disseminated intravascular coagulation. Postmortem examination demonstrated changes consistent with the development of disseminated intravascular coagulation and infection with granulocytic ehrlichiosis. This case documents the presence of canine granulocytic ehrlichiosis caused by A phagocytophilum in the U.K., and highlights the range of clinical signs and clinicopathological abnormalities that may be observed in infected dogs.

Hyperparathyroidism in dogs with hyperadrenocorticism

OBJECTIVES

To assess the effect of canine hyperadrenocorticism (HAC) on parathyroid hormone (PTH), phosphate and calcium concentrations.

METHODS

PTH concentrations and routine biochemical parameters were measured in 68 dogs with HAC. Ionised calcium was measured in 28 of these dogs. The results obtained were compared with an age- and weight-matched group of 20 hospital patients that did not show signs of HAC.

RESULTS

There were significant differences between the PTH, phosphate, alkaline phosphatase, creatinine and albumin concentrations between the two groups. Total and ionised calcium concentrations were not significantly different. Most of the dogs (92 per cent) with HAC had PTH concentrations that were greater than the reference range (10 to 60 pg/ml), and in 23 dogs they were greater than 180 pg/ml. There were significant positive correlations between the PTH and basal cortisol, post-adrenocorticotropic hormone (ACTH) cortisol and alkaline phosphatase concentrations, and also the phosphate and post-ACTH cortisol concentrations.

CLINICAL SIGNIFICANCE

Adrenal secondary hyperparathyroidism is a cause of increased PTH concentrations and may be associated with abnormalities in calcium and phosphate metabolism in dogs with HAC. The findings of this study could explain why canine HAC may cause clinical signs such as calcinosis cutis that are associated with altered calcium metabolism.

The relationship between clinical signs and brain herniation associated with rostrotentorial mass lesions in the dog

Retrospective analysis of magnetic resonance imaging and clinical findings in a referral population of dogs was used to determine the relationship between rostrotentorial space-occupying lesions and the development of secondary neurological signs. Brain herniation was detected in 54/153 cases of uni-focal rostrotentorial space-occupying lesions; of these 30 had caudal transtentorial herniation (CTH) and 24 had both transtentorial and foramen magnum herniation (CTH/FMH). Masses associated with herniation were larger and situated more dorsally and caudally within the cranial vault. Clinical signs classically associated with CTH, e.g., oculomotor nerve palsy, were seen in only one case of isolated CTH and seven (14%) of all herniation cases. Deficits in caudal cranial nerve function were detectable in 39% of cases with FMH. We conclude that severe shifts in brain parenchyma can exist in the absence of detectable localising signs.

Neutrophilic dermatitis and immunemediated haematological disorders in a dog: suspected adverse reaction to carprofen

This report describes the clinical and pathological findings of a suspected idiosyncratic adverse drug reaction in a young dog. The patient presented with sudden onset, severe skin lesions together with episodes of collapse. Investigations revealed a neutrophilic dermatitis with vasculitis, immune-mediated haemolytic anaemia and thrombocytopenia. Similar pathology has been described in human cases of Sweet's syndrome. The chronology of events suggested an adverse drug reaction to carprofen, although two antibiotics had been prescribed within the dog's recent history. Lymphocyte transformation tests were performed and tended to exclude both antibiotics as the cause of the reaction. To the authors' knowledge, lymphocyte transformation tests have not previously been described with regard to drug hypersensitivity assessment in the veterinary literature, and this is the first peer-reviewed case report of neutrophilic dermatitis and vasculitis with immune-mediated haemolytic anaemia and thrombocytopenia occurring as a suspected adverse drug reaction to carprofen in the dog.

Long-term survival of 23 dogs with pericardial effusions

Twenty-three dogs with pericardial effusions were identified from case records made between 1992 and 2000. Fourteen of the 23 were diagnosed with idiopathic pericardial effusions, and three of these were treated successfully by one pericardiocentesis. In the remaining 11 cases the pericardial effusion recurred; six cases were managed long-term by either two (three cases), three (two cases), or 11 repeated pericardiocenteses, and the remaining five were treated by pericardiectomy. The median survival time of the six dogs treated by repeated pericardiocentesis was five years and nine days.

Study of 253 dogs in the United Kingdom with diabetes mellitus

Clinical information and blood samples were collected from 253 dogs with naturally occurring diabetes mellitus. Over half of them were labrador retrievers, collies, Yorkshire terriers or crossbred dogs, and approximately 80 per cent of them were diagnosed between the ages of five and 12 years. The majority of the dogs were receiving insulin therapy once a day, but in the dogs receiving insulin injections twice a day there was a trend for lower serum fructosamine concentrations, suggesting better glycaemic control. The proportion of female dogs with diabetes was lower than in previous surveys. The disease was diagnosed more commonly in the winter months, a seasonal pattern also observed in human beings with diabetes, suggesting that similar environmental factors might be involved in the disease.

Survey of mistakes made by recent veterinary graduates

To investigate the incidence and types of mistakes made in veterinary practice, and to assess the impact the mistakes had on the veterinarians involved, a questionnaire was sent in November 2002 to all the veterinary graduates of the Universities of Bristol, Edinburgh, Glasgow, London and Liverpool in 2001. One hundred and eight (27 per cent) of 402 questionnaires were returned completed; 87 of 106 respondents (82 per cent) worked frequently or always unsupervised and only 46 (43 per cent) could always rely on support from other veterinarians in the practice. Since starting work, 82 of 105 respondents (78 per cent) stated that they had made a mistake, defined as an erroneous act or omission resulting in a less than optimal or potentially adverse outcome for a patient and in many cases these mistakes had had a considerable emotional impact on the veterinarians involved. The survey highlights that a large number of recently graduated veterinarians work with little supervision and that many veterinarians beginning their year in practice do not always have access to assistance from other veterinary colleagues.

THE RADIOGRAPHIC APPEARANCE OF THE PULMONARY VASCULATURE IN THE CAT

The purpose of this study was to determine the dimensions of the pulmonary arteries and veins in the cat, both in normal animals and those with evidence of intrathoracic disease. The radiographs of 50 normal cats, 35 cats with hypertrophic cardiomyopathy (HCM), and 15 cats with other intrathoracic disease were assessed. The normal range for the right cranial lobar artery compared with the proximal third of the fourth rib was 0.5-1.0, with a mean artery-to-rib ratio of 0.70 (standard deviation +/- 0.13). Normal cats had a mean vein diameter of (0.20 +/- 0.03 cm) (P = 0.034) compared with cats with HCM, which had a significantly greater mean vein diameter (0.22 +/- 0.04 cm).

Serum antibody titres to canine parvovirus, adenovirus and distemper virus in dogs in the UK which had not been vaccinated for at least three years

Antibody titres to canine distemper (CDV), canine parvovirus (CPV) and canine adenovirus (CAV) were measured in 144 adult dogs that had not been vaccinated for between three and 15 years. Protective antibodies to CPV were present in 95 per cent of the population, to CDV in 71.5 per cent and to CAV in 82 per cent. The prevalence of protective titres did not decrease with increasing time interval from the last vaccination for any of the three diseases studied. Booster vaccination increased the dogs CAV titres. For comparative purposes, 199 puppies were sampled at the time of their first and second vaccination. In the case of CPV and CAV a significantly higher proportion of the adult dogs were protected than of the puppies immediately after they were vaccinated. Natural CPV boosting was strongly suspected because the dogs had significantly higher titres three years after their primary vaccination than two weeks after it and three unvaccinated dogs had acquired protective antibody levels uneventfully. There was no evidence of natural exposure to CDV.

Urethral haemangiosarcoma in a boxer

A seven-year-old, entire female boxer presented with a history of restless behaviour and inappetence. Physical examination revealed that the dog was listless and had a hunched gait. Neurological examination was normal. Abdominal ultrasonography revealed a 4 cm x 4 cm mass in the cranial pelvic canal. Neurological abnormalities were detected three days after presentation, and progressed from proprioceptive deficits to loss of deep pain sensation in the pelvic limbs over a two-day period. The dog was euthanased and postmortem examination revealed that the pelvic mass was a urethral haemangiosarcoma with metastasis to the second lumbar vertebra. This case is unusual as urethral tumours are usually transitional cell carcinomas and frequently present with signs of dysuria.

Left ventricular myxosarcoma in a dog

An entire male Neopolitan mastiff, aged two years and eight months, presented with a history of chronic diarrhoea and weight loss. The diarrhoea had been present for approximately 12 months and had progressively worsened, with weight loss developing over an eight-week period prior to presentation. No primary gastrointestinal or metabolic cause for the diarrhoea could be identified. Echocardiography revealed a large, multilocular, cyst-like structure within the pericardium compressing the heart and displacing it to the right. The mass was surgically excised from the left ventricular myocardium. Histopathological examination showed it to be a low-grade malignant myxosarcoma. The dog made a full recovery and was still clinically normal nine months postoperatively, with no evidence of tumour recurrence or metastases. However, 11 months postsurgery, the clinical signs of diarrhoea and weight loss returned. Tumour recurrence with local metastasis was diagnosed and the dog was euthanased 358 days after the original surgery.

Immune-mediated haemolytic anaemia associated with a sarcoma in a flat-coated retriever

A seven-year-old flat-coated retriever presented with a history of lethargy, dyspnoea and inappetence of several days' duration. Clinical examination revealed pale mucous membranes and tachypnoea, and haematology demonstrated marked autoagglutination. Thoracic radiographs revealed an increased opacity in the perihilar region. The owners declined further evaluation and the dog was treated symptomatically with immunosuppressive doses of prednisolone and azathioprine. The dog's demeanour improved, although it was eventually euthanased seven weeks later because of dysphagia and worsening dyspnoea. Postmortem examination revealed a widespread, poorly differentiated sarcoma involving the lungs, pericardium, thoracic lymph nodes and spleen. Immune-mediated haemolytic anaemia is a well recognised condition in dogs and is occasionally associated with neoplastic conditions. This is the first case report to describe immune-mediated haemolytic anaemia associated with a diffuse, poorly differentiated sarcoma.

Magnetic resonance imaging in the diagnosis of lymphoma involving the brachial plexus in a cat

An 11-year-old, neutered, female Domestic Long Hair cat had a 3-week history of left forelimb lameness. Conscious proprioception and postural reflexes were absent on the left thoracic limb. The cat had slightly reduced placing and hopping responses on the left pelvic limb, absent cutaneous trunci muscle reflex on the left side, and left triceps muscle atrophy. Magnetic resonance imaging revealed a 2 x 2 x 2 cm mass in the region of the left brachial plexus. The cat was treated by left forelimb amputation and hemilaminectomy. Histopathology of the brachial plexus revealed lymphoma.

Retrospective study of 25 young weimaraners with low serum immunoglobulin concentrations and inflammatory disease

Twenty-five weimaraners with recurrent infections or inflammatory disease were investigated; their median age was four months (range two to 36 months), and 11 of them were male and 14 female. Twenty of them showed signs of lethargy, anorexia or pyrexia, 13 had been vomiting or had diarrhoea, 12 had shown signs of pain in the joints or bones and been lame, five had had reactions at the site of an injection, five had generalised lymphadenopathy, three had urinary tract infections and two had recurrent or severe pyoderma. They all had a lower concentration of one or more classes of serum immunoglobulin (IgG, IgM and IgA) than the standard control ranges, and their mean concentration of IgG was significantly lower (P<0.005) than the mean concentration of IgG in 15 clinically normal weimaraners. Of 10 cases for which a complete vaccination history was available, nine had developed clinical signs within five days of being vaccinated. Follow-up data were available from 21 of the 25 dogs for a median period of 24.5 months. One dog died during a symptomatic episode, three were euthanased, six were alive at follow-up but had continued to show clinical signs and 11 had made a full recovery.

Evaluation of a continuous glucose monitoring system in diabetic dogs

The generation of a blood glucose curve is important for assessing the response to insulin therapy in diabetic dogs. Disadvantages of this technique include patient discomfort and the potential for missing transient hypo- or hyperglycaemic episodes. The aim of the current study was to evaluate a continuous glucose monitoring system (CGMS) for use in diabetic dogs. Interstitial fluid glucose concentrations were recorded in 10 diabetic dogs, every five minutes for up to 48 hours, using a subcutaneous sensor attached to the CGMS device. Blood glucose concentrations were measured simultaneously using a glucometer. The correlation between interstitial fluid and blood glucose values was 0.81 (P < 0.01). The largest discrepancies between the two sets of data were seen during the one- to three-hour period following feeding, suggesting that postprandial hyperglycaemia might not be reflected in the interstitial fluid. The authors conclude that the CGMS is a potentially valuable tool in the management of canine diabetic patients.