Radiation toxicity grading after chemoradiotherapy of canine urinary tract carcinomas: Comparing VRTOG to VRTOG_v2.0

Radiation toxicities may be underestimated after treatment of transitional cell carcinoma in dogs' lower urinary tract. Assessing acute and late toxicities and differentiating them from progressive disease (PD) impacts further therapeutic approach. We retrospectively assessed dogs treated with definitive-intent chemoradiotherapy (12 × 3.8 Gy, various first-line chemotherapeutics). Local tumour control, radiation toxicities and survival were evaluated. We classified radiation toxicities according to the previously published radiation toxicity scheme "VRTOG" as well as the updated version, "VRTOG_v2.0". Fourteen dogs with transitional cell carcinoma of bladder ± urethra (n = 8), +prostate (n = 3) or solely urethra (n = 3), were included. Median follow-up was 298 days (range 185-1798 days), median overall survival 305 days (95%CI = 209;402) and 28.6% deaths were tumour-progression-related. Acute radiation toxicity was mild and self-limiting with both classification systems: In VRTOG, 5 dogs showed grade 1, and 1 dog grade 2 toxicity. In VRTOG_v2.0, 2 dogs showed grade 1, 3 dogs grade 2, and 3 dogs grade 3 toxicity. Late toxicity was noted in 14.2% of dogs (2/14) with the VRTOG, both with grade 3 toxicity. With VRTOG_v2.0, a larger proportion of 42.9% of dogs (6/14) showed late toxicities: Four dogs grade 3 (persistent incontinence), 2 dogs grade 5 (urethral obstructions without PD resulting in euthanasia). At time of death, 5 dogs underwent further workup and only 3 were confirmed to have PD. With the updated VRTOG_v2.0 classification system, more dogs with probable late toxicity are registered, but it is ultimately difficult to distinguish these from disease progression as restaging remains to be the most robust determinant.

Updates in Osteosarcoma

Clinical care of osteosarcoma (OSA) in dogs has seen little change during the past 2 decades, relying on amputation and platinum-based chemotherapy for pain control and survival. Recent advancements offer hope for improved outcomes. Genomic research reveals shared genetic abnormalities between canine and human OSA. Multidimensional imaging provides valuable staging and prognostic information. Limb-sparing approaches including stereotactic body radiation therapy are routine. Ablative therapies such as microwave ablation and histotripsy show promise. Immunotherapy including cell therapy and immune checkpoint inhibition are available. Radiopharmaceuticals are tuned to target OSA cells directly. These innovations may enhance treatment and prognosis for dogs with OSA.

The most common congenital malformations in dogs: Literature review and practical guide

Congenital malformations can affect almost 7% of canine newborns. The increase of commercial dog breeding and inbreeding used to maintain the striking characteristics of each breed, the appearance of malformations has become increasingly common, especially in brachycephalic dogs. The causes are diverse, and include genetic, nutritional, iatrogenic, and infectious factors, often making it difficult to establish a cause-consequence relationship. The high mortality associated with malformations comes not only from the fact that some are incompatible with life, but also because even if many undergo surgical treatment or correction, they require specific management, monitoring, and clinical treatment for an indefinite period of time. The most common malformations such as cleft lip and palate, hydrocephalus and anasarca have been studied for a long time, and it is currently known that brachycephalic dogs have a greater predisposition, however, for other less common conditions as gastroschisis and hypospadias, there is only a few case reports. The appearance of congenital defects in a litter leads to financial losses for the breeder, emotional losses for the owner and the veterinarian and harms the well-being of that individual. For this reason, the aim of this review article is to gather relevant information on the characteristics, diagnosis, and management of the main malformations in puppies. It is essential that the veterinarian is prepared to diagnose and treat these conditions, reducing negative impacts on animals and owners.

New Therapies in Veterinary Oncology

The expanding number of specialized oncology therapeutics available in veterinary oncology can make staying updated on the most recent advances challenging. This article summarizes the mechanism of action, available supporting data, and clinical use of three key veterinary cancer/supportive care therapeutics: Laverdia-CA1, Canalevia-CA1, and Stelfonta. This information will help guide clinical use within your practice and can be incorporated into discussions with clients regarding the newest available options for their dogs with cancer.

Client's understanding of instructions for small animals in a veterinary neurological referral center

BACKGROUND

It is not known how much information clients retrieve from discharge instructions.

OBJECTIVE

To investigate client's understanding of discharge instructions and influencing factors.

ANIMALS

Dogs and cats being hospitalized for neurological diseases.

METHODS

Clients were presented questionnaires regarding their pet's disease, diagnostics, treatments, prognosis and discharge instructions at time of discharge and 2 weeks later. The same questions were answered by discharging veterinarians at time of discharge. Clients answered additional questions regarding the subjective feelings during discharge conversation. Data collected included: data describing discharging veterinarian (age, gender, years of clinical experience, specialist status), data describing the client (age, gender, educational status). Raw percentage of agreement (RPA) between answers of clinicians and clients as well as factors potentially influencing the RPA were evaluated.

RESULTS

Of 230 clients being approached 151 (65.7%) and 70 (30.4%) clients responded to the first and second questionnaire, respectively (130 dog and 30 cat owners). The general RPA between clinician's and client's responses over all questions together was 68.9% and 66.8% at the 2 time points. Questions regarding adverse effects of medication (29.0%), residual clinical signs (35.8%), and confinement instructions (36.8%) had the lowest RPAs at the first time point. The age of clients (P = .008) negatively influenced RPAs, with clients older than 50 years having lower RPA.

CONCLUSIONS AND CLINICAL IMPORTANCE

Clients can only partially reproduce information provided at discharge. Only clients' increasing age influenced recall of information. Instructions deemed to be important should be specifically stressed during discharge.

Effect of Bacillus subtilis and Bacillus coagulans spores on induced allergic contact dermatitis in dogs

BACKGROUND

Probiotic strains have the potential to modulate immune responses, reduce intestinal inflammation, normalize intestinal mucosal function and decrease allergic reactions.

OBJECTIVE

This study aimed to investigate the effect of oral probiotic supplements containing Bacillus subtilis and Bacillus coagulans spores on clinical symptoms, haematological factors and immune responses to allergic contact dermatitis in dogs induced by dinitrochlorobenzene (DNCB).

METHODS

DNCB was injected subcutaneously into the scapular region of 20 healthy adult dogs of both sexes, divided into four groups, to induce experimental allergic contact dermatitis. Dogs in Group 1 received food without probiotics or medication. Oral prednisolone was administered to Group 2 for 30 days at a dosage of 0.25 mg/kg every other day. The dogs in Group 3 were treated with a combination of oral prednisolone and probiotics. The dogs in Group 4 were fed daily with a mixture of 109 B. subtilis and B. coagulans bacteria for 30 days. The immune system responses and related gene expression were analysed in the treated animals.

RESULTS

The administration of probiotics for 30 days resulted in a reduction in clinical symptoms and duration of wound repair. The probiotics treatment also significantly increased the serum bactericidal effects against Staphylococcus aureus and Escherichia coli. It enhanced both the classic and alternative activity of the complement, as well as lysozyme activity. Additionally, the probiotics led to higher total immunoglobulin levels and significant reductions in anti-trypsin and C-reactive protein levels. Furthermore, the expression of IgE, induction of interferon-gamma and IL-4 genes were also reduced.

CONCLUSIONS

According to the results, B. subtilis and B. coagulans can be further investigated as a viable alternative to corticosteroids in treating allergic contact dermatitis in dogs.

A novel acrylic orthodontic device for treatment of linguoverted mandibular canine teeth in small dogs

Linguoverted mandibular canine teeth (LMC) is a common malocclusion in dogs. Several inclined bite-plane techniques using acrylic resin have been introduced to correct LMC in dogs. Although these techniques have suggested modifications to overcome shortcomings, there are still limitations; e.g., high technical sensitivity, as the viscous acrylic resin must still be fabricated in the oral cavity. The authors developed a novel method for small-breed dogs that uses a doughy acrylic resin form to achieve an easy intraoral design and extraoral fabrication. Eight small-breed dogs were presented to evaluate and treat malocclusion causing palatal trauma. First, a Class-1 malocclusion with linguoversion of the mandibular canine teeth (6 dogs with unilateral LMC and 2 dogs with bilateral) was diagnosed based on oral examination. Dogs were treated with the new method using a doughy acrylic resin form for 6 to 7 wk and had posttreatment follow-up 1 y after the procedure. All treated canine teeth were in correct positions 1 y after the appliances were removed. Key clinical message: The authors believe that the new method using a doughy acrylic resin form could be a good alternative for veterinarians to use when treating LMC.

Caudoventral hip luxation in 160 dogs (2003-2023): A multicenter retrospective case series

OBJECTIVE

To describe patient characteristics, etiology, treatment outcomes and complications of caudoventral hip luxation (CvHL) in a large cohort of dogs and investigate factors associated with nonsurgical treatment outcomes.

STUDY DESIGN

Multicenter retrospective case series.

ANIMAL POPULATION

A total of 160 client-owned dogs (170 limbs).

METHODS

Medical records from 2003 to 2023 were reviewed for signalment, history, treatment outcomes and complications. Logistic regression was performed to investigate factors associated with nonsurgical treatment outcome.

RESULTS

Low-trauma accidents accounted for 82.9% of cases. Over-represented breeds included poodles (38.1%) and poodle crosses (11.3%). On a per-treatment basis, success rates of closed reduction alone, closed reduction/Ehmer sling, closed reduction/hobbles were 9.1%, 15.2% and 48.8%, respectively. When accounting for repeated attempts using closed reduction alone, Ehmer sling, or hobbles, eventual success rate increased to 10.3%, 18.5% and 61.8%, respectively. Success rate for toggle rod stabilization was 88.2%. Complication rate of hobbles was 31.9% versus 60.6% for Ehmer slings. Use of hobbles (OR:7.62, p = .001, CI:2.23-26.05), treatment by specialist surgeons (OR:2.68, p = .047, CI: 1.01-7.08) and increasing age (OR:1.15, p < .005, CI: 1.08-1.23) were associated with successful nonsurgical treatments.

CONCLUSION

Low-trauma etiology, and poodles and their crosses were over-represented in cases of CvHL. Success rate of nonsurgical treatments was lower than previously reported. Hobbles were 7.6 times more likely to be successful when compared to dogs treated without hobbles and remains a viable noninvasive first-line treatment.

CLINICAL SIGNIFICANCE/IMPACT

Hobbles are recommended as a low-morbidity first-line treatment for CvHL. An Ehmer sling is not recommended. Toggle rod stabilization is an effective surgical treatment for CvHL.

Precision Medicine in Veterinary Science

Precision medicine focuses on the clinical management of the individual patient, not on population-based findings. Successes from human precision medicine inform veterinary oncology. Early evidence of success for canines shows how precision medicine can be integrated into practice. Decreasing genomic profiling costs will allow increased utilization and subsequent improvement of knowledge base from which to make better informed decisions. Utility of precision medicine in canine oncology will only increase for improved cancer characterization, enhanced therapy selection, and overall more successful management of canine cancer. As such, practitioners are called to interpret and leverage precision medicine reports for their patients.

Pulsed shortwave electromagnetic field therapy increases quality of life in canines with symptoms of osteoarthritics

BACKGROUND

Joint stiffness, lameness and reduced activity levels are common inflammatory responses observed in canines and have significant impact on quality of life (QOL). The symptoms are often ascribed to osteoarthritis (OA), for which the standard treatment is systemic anti-inflammatories, but pharmacologic intervention can have significant short-term and long-term side effects.

OBJECTIVES

Test the efficacy of a Food and Drug Administration (FDA)-cleared pulsed shortwave therapy (PSWT) device as a means to modulate vagus nerve activity and initiate a systemic anti-inflammatory response to determine its ability to improve functionality and the QOL of canines with inflammatory symptoms commonly associated with OA.

METHODS

A randomized, double-blinded, placebo-controlled 14-day study of 60 dogs with a presumptive prior diagnosis of OA in at least one limb joint. Two outcomes assessing changes in the dog's QOL and functionality were measured: subjectively determined changes in eight behaviours associated with discomfort and objectively determined changes in passive range of motion (PROM). The device was secured near the cervico-thoracic region of the dog's spine. PROM measures were taken at baseline and at the end of study. Behavioural measures were taken daily.

RESULTS

Forty-nine animals completed the study. No negative side effects were reported. Average subjective discomfort scores for the treatment group (N = 26) were reduced from 3.74 to 2.10 (44%), compared to no improvement in the placebo group (N = 23) over the study period (p = 0.0001). Average PROM scores increased by 5.51 (4.59-6.23) degrees relative to the placebo group (p < 0.01). Ninety-six per cent of the treatment group showed either increased PROM or improved behavioural changes or both, compared to 4% for the placebo group (p < 0.01). Most changes occurred within the first 8 days of treatment.

CONCLUSIONS

PSWT applied at the level of the cervico-thoracic spine to target the vagus nerve may have the potential to improve QOL in dogs manifesting behaviours commonly associated with OA.

Ventricular bigeminy associated with myocardial ischemia in a dog with a colonic torsion: a case report

BACKGROUND

Ventricular bigeminy due to myocardial ischemia has been reported in humans as well as in canine patients with obstructive gastrointestinal diseases. This is the first case report of ventricular bigeminy in a dog with a colonic torsion that resolved after fluid resuscitation and restoration of myocardial perfusion.

CASE PRESENTATION

An 11-year-old, male neutered mixed breed dog presented with a one day history of vomiting, tenesmus, and lethargy. Physical examination identified an irregular heart rhythm and intermittent pulse deficits. A ventricular arrhythmia represented by ventricular premature complexes (VPCs) organized in bigeminy, was appreciated on a 3-lead electrocardiogram (ECG) with a single lead (II) view. Abdominal radiographs confirmed a colonic torsion. Prior to anesthetic induction, ventricular bigeminy was non responsive to fentanyl or lidocaine. The patient was anesthetized and intravascular volume deficit was identified by dampened plethysmographic wave amplitude (plethysomographic variability), audible softening of the Doppler sound, and more pronounced pulse deficits. Fluid resuscitation was achieved with a combination of intravenous crystalloid and colloid fluid therapy comprising 7.2% hypertonic saline and 6% hetastarch. The patient's cardiac rhythm converted to normal sinus after fluid resuscitation. The colonic torsion was surgically corrected. The patient recovered well from anesthesia and was ultimately discharged from the hospital 5 days later.

CONCLUSIONS

The present case report highlights that myocardial ischemia can lead to ventricular arrythmias, such as ventricular bigeminy. This is the first documented case of ventricular bigeminy in the canine patient with a colonic torsion. Assessment of patient volume status and appropriate fluid resuscitation along with continuous electrocardiogram (ECG) monitoring are vital to patient stability under general anesthesia.

Successful management of pulmonary edema secondary to accidental electrocution in a young dog

BACKGROUND

Human records describe pulmonary edema as a life-threatening complication of electric shock. Successful management requires prompt recognition and intensive care. However, in companion animals, electrocutions are rarely reported, even though domestic environments are full of electrical devices and there is always the possibility of accidental injury. Therefore, it is important for veterinarians to know more about this condition in order to achieve successful patient outcomes.

CASE PRESENTATION

A 3-month-old male Labrador Retriever was presented with a history of transient loss of consciousness after chewing on a household electrical cord. On admission, the puppy showed an orthopneic position with moderate respiratory distress. Supplemental oxygen via nasal catheter was provided, but the patient showed marked worsening of respiratory status. Point-of-care ultrasound exams suggested neurogenic pulmonary edema due to electrical shock close to the central nervous system and increased B-lines without evidence of cardiac abnormalities. Mechanical ventilation of the patient was initiated using volume-controlled mode with a tidal volume of 9 to 15 ml/kg until reaching an end-tidal carbon dioxide ≤ 40 mm Hg, followed by a stepwise lung-recruitment maneuver in pressure-controlled mode with increases of the peak inspiratory pressure (15 to 20 cm H2O) and positive end-expiratory pressure (3 to 10 cm H2O) for 30 min, and return to volume-controlled mode with a tidal volume of 15 ml/kg until reaching a peripheral oxygen saturation ≥ 96%. Weaning from the ventilator was achieved in six hours, and the patient was discharged two days after admission without neurological or respiratory deficits.

CONCLUSIONS

We present a rather unusual case of a neurogenic pulmonary edema subsequent to accidental electrocution in a dog. Timely diagnosis by ultrasound and mechanical ventilation settings are described. Our case highlights that pulmonary edema should be considered a potentially life-threatening complication of electrical shock in small animal emergency and critical care medicine.

Oxidative stress in dogs with chronic inflammatory enteropathy treated with allogeneic mesenchymal stem cells

The search for new biomarkers in patients with chronic inflammatory enteropathy (CIE) is ongoing in the human and veterinary medicine fields. Oxidative stress biomarkers (malondialdehyde [MDA], reduced glutathione [GSH], and albumin) have been studied in humans with chronic enteropathies, but among them, only albumin has been studied in dogs with CIE. Moreover, the effect of mesenchymal stem cell (MSCs) treatment with or without prednisone on these parameters has never been studied in dogs with CIE. These parameters were compared between healthy dogs (n = 12) and dogs with CIE, and before and 1, 3, 6, and 12 months after the treatment with MSCs alone (n = 9) or together with prednisone (n = 11). The relationship between the Canine Inflammatory Bowel Disease Activity Index (CIBDAI) and oxidative stress was evaluated. Albumin was the only parameter that significantly differed between dogs with CIE and healthy dogs (p = 0,037). Differences were observed only in albumin values after combined treatment with MSCs and prednisone. No differences were observed in MDA and GSH after treatment with MSCs with or without prednisone. Albumin could help stage canine CIE, as well as its prognosis, as has already been demonstrated, although it is essential to evaluate this parameter for its antioxidant capacity, and therefore it could be a good biomarker of oxidative stress in this pathology. However, the treatment with MSCs seems unable to modify any of the analyzed oxidative stress parameters.

Heterogeneity of mesenchymal stem cells as a limiting factor in their clinical application to inflammatory bowel disease in dogs and cats

Inflammatory bowel disease (IBD) is a major subtype of chronic enteropathies in dogs and cats. Conventional drugs such as immunomodulatory medicines as glucocorticoids and/or other anti-inflammatory are mainly applied for treatment. However, these drugs are not always effective to maintain remission from IBD and are limited by unacceptable side effects. Hence, more effective and safe therapeutic options need to be developed. Mesenchymal stem cells (MSCs) are multipotent stem cells with a self-renewal capacity, and have immunomodulatory, anti-inflammatory, anti-fibrotic, and tissue repair properties. Therefore, the application of MSCs as an alternative therapy for IBD has great potential in veterinary medicine. The efficacy of adipose tissue-derived MSC (ADSC) therapy for IBD in dogs and cats has been reported, including numerous studies in animal models. However, treatment outcomes in clinical trials of human IBD patients have not been consistent with preclinical studies. MSC-based therapy for various diseases has received widespread attention, but various problems in such therapy remain, among which no consensus has been reached on the preparation and treatment procedures for MSCs, and cellular heterogeneity of MSCs may be an issue. This review describes the current status of ADSC therapy for canine and feline IBD and summarizes the cellular heterogeneity of canine ADSCs, to highlight the necessity for further reduction or elimination of MSCs heterogeneity and standardization of MSC-based therapies.

Basic triage in dogs and cats: Part III

Background

Emergency cases can be presented at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases, even if the ultimate goal is to refer the animal to another facility.

Objective and procedure

The third and final part of this 3-part review article series discusses arrhythmias typical in emergency cases and the approach to animals that are presented with an inability to stand up and walk normally. A stepwise method to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated.

Results

Recognizing and knowing how to treat tachy- and bradyarrhythmias is important in stabilizing a dog's or cat's condition. Understanding how to differentiate the various reasons that a dog or cat is unable to stand on its own allows a veterinarian to both treat and communicate outcome expectations for those animals.

Conclusion and clinical relevance

Do not refer emergent cases before basic stabilization is completed. Many emergency cases can either be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps have occurred.

Efficacy of therapeutic plasma exchange in a case of severe, generalised canine pemphigus foliaceus

Successful treatment of pemphigus foliaceus (PF) often requires a multimodal therapeutic approach. The dog described herein underwent four therapeutic plasma exchange treatments for severe, refractory PF, resulting in a 50% reduction of lesional body surface area. This treatment option should be considered for the management of canine PF.

Clinical and pathological findings in five dogs with nodular histiocytic iritis in the United Kingdom: A case series

PURPOSE

The aim of this study was to describe the clinical presentation, histopathology, management, and outcome of nodular histiocytic iritis, an intraocular variant of nodular granulomatous episcleritis (NGE).

METHODS

A retrospective review of the medical records of five dogs with intraocular NGE-type inflammation as diagnosed by histopathology.

RESULTS

Four Border Collies and one crossbreed dog, aged 1.5-3.4 years (mean age 2.38 years). The clinical presentation was an extensive, raised, pale iris lesion of variable location. All cases were unilateral. The physical examination was normal. Complete blood count/serum biochemistry (n = 1) and thoracic radiography (n = 1) were normal. Ocular ultrasound (n = 2) was normal apart from increased iris thickness. Enucleation (n = 4) or excisional biopsy (iridectomy, n = 1) was performed because of suspected neoplasia. Following enucleation, the remaining, contralateral eye did not develop additional lesions (9 days-3.7 years follow-up). There was no recurrence following sector iridectomy with 5 months topical 1% prednisolone acetate (3.9 years follow-up). The histopathologic findings in all five cases indicated a focal histiocytic and lymphoplasmacytic anterior uveitis (iritis), similar to that seen in cases of NGE.

CONCLUSION

Nodular histiocytic iritis presents as unilateral iris thickening in isolation and young Collies appear to be predisposed. The histopathological findings are similar to NGE. Although the clinical presentation resembles intraocular neoplasia, an inflammatory process should be considered, which may be amenable to medical management. Definitive diagnosis may be obtained by iris sampling.

Use of an intraoral scanner to evaluate orthodontic treatment for dental malocclusion in a dog

OBJECTIVE

In human dental practice, intraoral scanners (IOSs) are increasingly used to evaluate the oral cavity. However, there have been no reports concerning evaluation of the canine oral cavity using IOSs in veterinary dentistry. In this case, optical impressions obtained with an IOS were used for 3-D evaluation of the orthodontic treatment outcome. Additionally, few reports have addressed the optimal orthodontic force for canine teeth. Therefore, this case explored whether sufficient tooth movement into the extraction site could be achieved with a lighter orthodontic force than previously reported.

ANIMAL

An 8-month-old spayed female dog.

CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES

A retained right maxillary third deciduous incisor (503) caused distoversion of the right maxillary third permanent incisor (103), leading to dental malocclusion that involved contact between 103 and the right mandibular canine teeth.

TREATMENT AND OUTCOME

All retained deciduous teeth were extracted. Mesial tipping movement of 103 into the extraction site of 503 was achieved with light orthodontic force using an elastomeric chain. An IOS was used to construct 3-D optical impression data from oral stone models taken before and after treatment, and tooth movement was evaluated. The results showed that 103 had sufficient tipping movement and no anchorage loss; comfortable occlusion was achieved. In addition to crown length extension, labioversion and mesioversion of maxillary incisors (other than 103) were observed.

CLINICAL RELEVANCE

Detailed intraoral evaluation with optical impressions was beneficial in the orthodontic treatment of a dog. Light orthodontic force may be sufficient for movement into the extraction site.

A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs

BACKGROUND

Primary immune thrombocytopenia (pITP) in dogs presents a diagnostic challenge, and clinical markers of severity are lacking.

OBJECTIVES

Identify clinicopathologic features that differentiate pITP from secondary ITP (sITP) and markers related to bleeding severity, transfusion, and survival of dogs with pITP.

ANIMALS

Ninety-eight thrombocytopenic dogs (58 pITP and 40 sITP).

METHODS

Client-owned dogs with platelet counts <50 000/μL were enrolled in a prospective, multi-institution cohort study. History and treatment information, through a maximum of 7 days, was recorded on standard data forms. Bleeding severity was scored daily using a bleeding assessment tool (DOGiBAT). At-admission blood samples were collected for CBC, biochemistry, C-reactive protein concentration, and coagulation panels, and to measure platelet surface-associated immunoglobulin G (PSAIg) and expression of platelet membrane proteins and phospholipids. Dogs with evidence of coincident disease were classified as sITP.

RESULTS

No definitive pITP diagnostic test was found. However, pITP cases were characterized by lower platelet counts, D dimer concentrations, and platelet membrane protein expression than sITP cases. Differentiation between pITP and sITP was further enhanced using logistic regression modeling combining patient sex, coagulation profile, platelet count, D dimer, and PSAIg. A second model of pITP severity indicated that low hematocrit and high BUN concentration were associated with non-survival. Low hematocrit at admission, but not platelet count or DOGiBAT score, was associated with transfusion.

CONCLUSIONS AND CLINICAL IMPORTANCE

Pending validation studies, models constructed from at-admission clinicopathologic findings may improve differentiation of pITP from sITP and identify the most severe pITP cases at the time of presentation.

The use of a kaolin-based hemostatic dressing to attenuate bleeding in dogs: A series of 4 cases

OBJECTIVE

To describe the use of a synthetic hemostatic dressing, QuikClot Combat Gauze (QCG), in dogs with bleeding wounds.

CASE SERIES SUMMARY

Two dogs presented with bleeding traumatic wounds, and QCG was used to achieve hemostasis during stabilization of these dogs. In the other 2 dogs, QCG was used to help attenuate bleeding associated with a surgical procedure.

NEW OR UNIQUE INFORMATION PROVIDED

While hemostatic dressings have been widely studied and used in human medicine, there is minimal information on the use and efficacy of these hemostatic dressings in veterinary medicine. This case series describes the use of QCG in dogs with hemorrhaging wounds. QCG could be a valuable resource in veterinary emergency and critical care settings.

Basic triage in dogs and cats: Part II

Background

Emergency cases can be presented at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases, even if cases are ultimately referred to another facility.

Objective and procedure

The second part of this 3-part review article series discusses animals that collapse at home as well as dogs and cats with bleeding. A stepwise approach to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated.

Results

Having a robust and methodical approach to animals that collapse is important for many emergency cases, as the causes and treatment methods vary. Bleeding can lead to acute death if left untreated and knowing the steps to stop bleeding is important for patient stabilization.

Conclusion and clinical relevance

Do not refer emergent cases before completing basic stabilization. Many emergency cases do not require emergent referral and can be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps have occurred.

Medical management of pneumoperitoneum, gastric pneumatosis, and hepatic venous gas secondary to 3% hydrogen peroxide toxicity in a dog

OBJECTIVE

To describe the medical management and outcome of a dog suffering severe hydrogen peroxide toxicity.

CASE SUMMARY

A 3-year-old neutered female Bichon Frise was presented to an emergency and referral practice after ingestion of 10-20 mL/kg 3% hydrogen peroxide. On presentation, the dog was obtunded, was tachypneic, and had severe gastric tympany. Abdominal radiographs revealed pneumoperitoneum, gastric pneumatosis, and hepatic venous gas. The dog was managed conservatively with supportive care and oxygen therapy. Repeat radiographs 6 hours later showed complete resolution of all gas inclusions. While hospitalized, the dog developed severe hematemesis, and abdominal ultrasound revealed severe gastric wall thickening. Subsequent endoscopy confirmed severe gastric mucosal necrosis without evidence of deeper ulceration and relatively mild petechiation of the esophagus. The dog was ultimately discharged after 5 days of hospitalization and continued to do well at home. Recheck ultrasound 5 weeks postdischarge showed normal gastric wall appearance.

NEW OR UNIQUE INFORMATION PROVIDED

To the authors' knowledge, this is the first reported case of pneumoperitoneum secondary to hydrogen peroxide toxicity and the first description of the clinical course of severe toxicity in dogs.

Diagnosis and treatment of urolithiasis in a Toy Poodle dog

Background

Urolithiasis in dogs is a disorder of the urinary tract caused by the development of crystals. These crystals are composed of minerals such as phosphates, oxalates, urates, cystine, carbonates, and silica. It can be fatal if the diagnosis and treatment are inaccurate. This report aims to report a case of urolithiasis in a Toy Poodle dog.

Case Description

A 2-year-old male Toy Poodle dog weighing 4.2 kg with black hair, and having trouble urinating was presented to Prof. Soeparwi Animal Hospital, Universitas Gadjah Mada, Indonesia. The dog is examined physically and, in the laboratory, diagnosed and continued with operative therapy. The history and physical examination revealed that the dog had been experiencing hematuria, stranguria, and oliguria for 2 months, with the last few days accompanied by decreased appetite. The dog exhibited decreased skin turgor, a capillary refill time (CRT) of less than 2 seconds, signs of pain and distress during urination, and palpation of distended urinary vesicles. Ultrasound scans revealed uroliths in the urinary vesica, which were identified by an acoustic shadow. Blood tests indicated a decrease in hematocrit and erythrocytes along with an increase in leukocytes. Urolithiasis was diagnosed in the case dog based on anamnesis, physical examination, hematological examination, and ultrasonography. Subsequently, a cystotomy was performed, and uroliths located in urinary vesicles were removed. The dog received ceftriaxone injections at 15 mg/kg body weight and vitamin B-complex injections at a concentration of 10 mg/kg body weight for 5 days. Four days post-surgery, the case dog was able to successfully urinate and pass clean urine.

Conclusion

The Toy Poodle dog was diagnosed with silica urolithiasis in the urinary vesicles and the urolith is quite large. Cystotomy was performed to remove the urolith. Postoperative care were included the administration of antibiotics and vitamins to facilitate the healing process. The condition of the Poodle toy dog improved.

Retrospective evaluation of 22 dogs with leptospirosis treated with extracorporeal renal replacement therapies (2018-2021)

BACKGROUND

Outcomes of dogs with acute kidney injury secondary to leptospirosis (AKI-L) treated using renal replacement therapies (RRT) are poorly characterized.

HYPOTHESIS/OBJECTIVES

Describe survival to discharge, short (≤30 days) and long-term (≥6 months) outcomes of AKI-L dogs receiving RRT and determine if there is a significant difference in maximum blood urea nitrogen (maxBUN), maximum creatinine (maxCr), maximum bilirubin (maxBili) and the number of body systems affected between survivors and non-survivors.

ANIMALS

Twenty-two client-owned dogs with AKI-L receiving RRT.

METHODS

Retrospective medical record review of dogs with AKI-L that received RRT between 2018 and 2021.

RESULTS

Sixteen of 22 (73%) dogs survived to discharge. Of the survivors, 13 (81%) were alive >30 days from discharge and 12 (75%) were alive at 6 months from discharge. Factors significantly higher in non-survivors included number of body systems affected (survivors: 1 (19%), 2 (50%), 3 (25%) and 4 (6%) vs non-survivors: 3 (33.3%), and 4 (66.7%); P = .01) and median maxBili (survivors: 1.9 mg/dL; range, 0.1-41.6 vs non-survivors: 21.0 mg/dL; range, 12.3-38.9; P = .02). There was no significant difference in median maxBUN (survivors: 153.0 mg/dL; range, 67-257 vs non-survivors: 185.5 mg/dL; range, 102-218; P = .44) and median maxCr (survivors: 9.8 mg/dL; range, 6.2-15.9 vs non-survivors: 9.8 mg/dL; range, 8.4-13.5; P = .69) between survivors and non-survivors.

CONCLUSIONS AND CLINICAL IMPORTANCE

Regardless of azotemia severity, dogs with AKI-L receiving RRT have a good survival rate to discharge. The number of body systems affected and hyperbilirubinemia might be associated with worse outcomes.

Successful treatment of a severe 5-hydroxytrytophan intoxication using carbon hemoperfusion, hemodiafiltration, and mechanical ventilation in a dog

OBJECTIVE

To describe the successful use of carbon hemoperfusion and hemodiafiltration in combination with mechanical ventilation (MV) to treat a severe intoxication of 5-hydroxytryptophan (5-HTP) in a dog.

CASE SUMMARY

A dog ingested a minimum of 550 mg/kg of extended-release 5-HTP, resulting in serotonin syndrome that progressed to a comatose state and severe hypoventilation requiring MV. Extracorporeal carbon hemoperfusion coupled with hemodiafiltration was performed to remove 5-HTP from this patient. A carbon hemoperfusion cartridge was placed in series upstream in the extracorporeal circuit from the hemodialyzer. A total of 46.5 L of blood (4.89 L/kg) was processed during a 4.85-hour treatment. Serial plasma samples were obtained at 0, 60, 90, and 150 minutes during the session and 14 hours after the session. These samples were later analyzed for 5-HTP and serotonin concentrations. The extraction ratio of 5-HTP was 93.6%-98.9% through the carbon filter. The dog was weaned from MV within 8 hours after extracorporeal therapy and, after a full recovery, was successfully discharged.

NEW OR UNIQUE INFORMATION PROVIDED

Despite an extensive review of the available literature, this appears to be the first reported case of using a carbon hemoperfusion, hemodiafiltration, and MV to treat severe serotonin syndrome secondary to 5-HTP intoxication in a dog. The combination of carbon hemoperfusion and hemodiafiltration can significantly reduce plasma 5-HTP concentrations after acute intoxication and may serve to decrease morbidity and mortality in patients with severe intoxication.

ACVIM consensus statement on diagnosis and management of urinary incontinence in dogs

Urinary incontinence (UI) is a disorder of micturition that can occur in dogs of any age, sex, and breed depending on the underlying cause and time of onset. Diagnosis and treatment for various causes of UI in dogs have been described by multiple comprehensive single author review articles, but large prospective clinical trials comparing treatment outcomes in veterinary medicine are lacking. The objectives of this consensus statement therefore are to provide guidelines on both recommended diagnostic testing and treatment for various causes of UI in dogs. Specifically, pathophysiology directly related to the canine urinary system will be reviewed and diagnostic and therapeutic challenges will be addressed. A panel of 12 experts in the field (8 small animal internists [L. Adams, J. Bartges, A. Berent, J. Byron, J. Foster, A. Kendall, S. Vaden, J. Westropp], 2 neurologists [J. Coates, N. Olby], 1 radiologist [G. Oetelaar], and 1 surgeon [C. Adin]) was formed to assess and summarize evidence in the peer-reviewed literature and to complement it with consensus recommendations using the Delphi method. Some statements were not voted on by all panelists. This consensus statement aims to provide guidance for management of both male and female dogs with underlying storage or voiding disorders resulting in UI.

Assessment of owner perceptions of caregiver burden, veterinarian-client relationship and satisfaction with the provider in canine pruritus: An experimental vignette study

BACKGROUND

Complicated treatments for skin disease are linked to owner-caregiver burden and poorer perception of the veterinarian-client relationship, regardless of disease severity.

HYPOTHESES/OBJECTIVES

Using experimental vignettes, we explored the impact on owner perception of the interaction of treatment complexity and skin disease outcomes. We hypothesised that: (i) vignette conditions involving injection therapy would result in lower burden, better veterinary-client relationship and greater satisfaction relative to multimodal therapy conditions; (ii) the vignette condition of injection therapy with a completely effective outcome would be superior to all other conditions; (iii) ineffective vignette conditions would be inferior to all other conditions; and (iv) the vignette condition injection with a mostly effective outcome would be similar or superior to the multimodal therapy with a completely effective outcome condition.

PARTICIPANTS

Three hundred and nine owners of pruritic dogs recruited from a general veterinary practice, pet-related podcast, or social media dog allergy group.

MATERIALS AND METHODS

Participants were presented with six counterbalanced online vignettes representing three levels of treatment effectiveness (Completely Effective, Mostly Effective, Ineffective) and two treatment regimens (Multimodal, Injection). Measurements of participant perceptions of caregiver burden, veterinarian-client relationship and satisfaction were recorded.

RESULTS

Injection with perfect outcome was superior to other conditions (p < 0.001). Conditions with poor effectiveness were inferior (p < 0.001). Comparison of Injection with a mostly effective outcome to Multimodal treatment with perfect outcome yielded small-to-medium effects of preference for the latter in veterinarian-client relationship and satisfaction (p < 0.01); no difference was observed for caregiver burden. When good effectiveness was assured, injection was preferred (p < 0.001).

CONCLUSIONS AND CLINICAL RELEVANCE

Owners preferred a Completely Effective outcome and were prepared to select the Injection regimen or Multimodal therapy to achieve this; Injection was preferred when effectiveness was assured.

Synthesis of surgeon and rehabilitation therapist treatment methods of bicipital tenosynovitis in dogs allows development of an initial consensus therapeutic protocol

OBJECTIVE

To compare the therapeutic approach of surgical specialists, sports medicine and rehabilitation specialists, and veterinarians with rehabilitation certification when treating bicipital tendon disease or tenosynovitis in dogs and to combine this information with existing research to develop a treatment algorithm that provides a framework for treating bicipital tenosynovitis.

SAMPLE

223 respondents to an internet survey of board-certified veterinary surgeons, board-certified sports medicine and rehabilitation therapists, and veterinarians with rehabilitation certification.

METHODS

The survey was promoted via multiple listservs, specialist college newsletters, and private relevant social media sites. Answers were compiled and submitted for statistical analysis.

RESULTS

Compared to rehabilitation therapists (RTh), surgeons placed less value on the stabilizing function of the biceps tendon and its role in preventing other shoulder morbidities. Similarly, compared to RTh, surgeons were more inclined to select surgery as the primary therapeutic approach and attributed a less optimistic prognosis to conservative therapy outcomes. There were multiple differences between surgeons and RTh in executing a conservative therapy program, with RTh more likely to recommend therapeutic exercise, extracorporeal shockwave, regenerative medicine, therapeutic ultrasound, exercise restriction, photobiomodulation, and pulsed electromagnetic field therapy. RTh were less likely to prescribe NSAIDS or inject corticosteroids. Despite the above noted differences, there were also multiple areas of agreement.

CLINICAL RELEVANCE

Consensus agreement, combined with existing research, was used to create a treatment algorithm suggesting how to best address multiple manifestations of bicipital tendinopathy. Such guidelines can be considered to direct therapeutic strategies for this common condition.

Basic triage in dogs and cats: Part I

Background

Emergency cases can present at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases even if they ultimately aim to refer the patient to another facility.

Objectives and procedures

The first part of this 3-part review article series covers respiratory distress and seizures. A stepwise approach to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated.

Results

Having a strong methodical approach to animals in respiratory distress optimizes treatment. Similarly, achieving cessation of seizures, along with having a good understanding of the causes of seizures, allows for patient stabilization.

Conclusion and clinical relevance

Do NOT refer emergent cases before completing basic stabilization. Many emergency cases do not require emergent referral and can be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps are completed.

[Overview of canine eosinophilic lung and bronchial diseases]

In dogs with chronic cough eosinophilic lung disease (ELD) may be present, especially in young dogs. A breed predisposition has been described in Alaskan Malamutes and Siberian Huskies. Chronic cough is the most common clinical sign. Other symptoms include nasal discharge, sneezing, poly- or dyspnea and exercise intolerance. The exact pathogenesis is unknown. Type 1 hypersensitivity reaction is suspected. Eosinophilic lung diseases may be classified into different groups (eosinophilic bronchitis, eosinophilic bronchopneumopathy and eosinophilic granuloma). Diagnostic work-up includes hematology, imaging, bronchoscopy and cytologic examination of bronchoalveolar lavage fluid. A wide spectrum is present in terms of the expression and severity of the changes. The current reported treatment is systemic or inhaled glucocorticoids, or a combination of both.Most patients respond well to therapy. Relapses after treatment discontinuation are common.

Preliminary evaluation of the impact of periodontal treatment on markers of glycaemic control in dogs with diabetes mellitus: A prospective, clinical case series

BACKGROUND

Periodontal disease (PD) can adversely affect glycaemic control in humans. However, it is unknown if a similar association exists in dogs.

METHODS

Ten client-owned dogs with poorly regulated diabetes mellitus (DM) and PD were prospectively enrolled. A complete blood count, serum biochemistry, urinalysis and measurement of C-reactive protein, interleukin-6 (IL-6), tumour necrosis factor-α, haemoglobin A1c (HbA1c) and fructosamine concentrations were performed before periodontal treatment (PT) and monthly thereafter for 3 months. A periodontal disease severity score (PDSS) was determined during PT. The effects of time post-PT and PDSS on markers of inflammation and glycaemic control were determined by generalised estimating equation analysis.

RESULTS

HbA1c (mean; 95% confidence interval [CI]) decreased 3 months post-PT (32.1 mmol/mol; 21.1-43.1 mmol/mol vs. 44.3 mmol/mol; 36.4-52.0; p = 0.003). PDSS at enrolment was significantly (p = 0.031) positively associated with HbA1c concentration. Due to a significant (p < 0.001) interaction between PDSS and time post-PT in the analysis of fructosamine, dogs with low (1-3) PDSS and high (7-9) PDSS were analysed separately. Fructosamine (mean; 95% CI) significantly decreased 1 month post-PT (570 μmol/L; 457-684 μmol/L vs. 624 μmol/L; 499-748; p = 0.001) in the high PDSS group but not in the low PDSS group. Fructosamine concentration upon enrolment and PDSS were correlated (r = 0.73, p = 0.017). IL-6 concentration significantly decreased 3 months post-PT (9.9 pg/mL; 8.5-11.3 pg/mL vs. 11.2 pg/mL; 9.7-12.7; p = 0.002).

LIMITATIONS

Limitations of the study included the small number of dogs, the lack of a control group and the inability to assess PDSS during follow-ups.

CONCLUSIONS

These findings support a potential detrimental interaction between PD and DM. The apparent beneficial effect of PT on markers of glycaemic control was most conspicuous in dogs with more severe PD.

Current evidence for non-pharmaceutical, non-surgical treatments of canine osteoarthritis

Osteoarthritis is a progressive degenerative disease process that affects a significant proportion of the canine population, impacting these animals' quality of life. Currently, there is no cure and treatment consists of managing the clinical signs of pain and reduced mobility. There are many treatments for canine osteoarthritis and in this review we discuss the evidence base behind non-pharmaceutical, non-surgical treatments of this disease. These treatments include weight management, nutraceuticals, acupuncture, physiotherapies such as therapeutic exercise, hydrotherapy as well as other therapeutic modalities including photobiomodulation therapy, electromagnetic field therapy and others.

Inflammation and Behavior Changes in Dogs and Cats

Sickness is a normal response to infections or stress triggered by proinflammatory cytokines that drive local and systemic inflammatory responses. Proinflammatory cytokines act on the brain causing the so called "sickness behavior,"which is thought to improve recovery but can become maladaptive in the long term. Chronic inflammation characterizes many diseases and there is some evidence that dogs and cats experience age-associated increases in inflammation, a condition named "inflammaging." A complex and multifactorial relationship exists between these inflammatory mechanisms, pain, and psychological illness that may complicate veterinary diagnosis and affect the outcome.

A Review of Pet Food Recalls from 2003 Through 2022

This is a review of U.S. Food and Drug Administration (FDA) recalls of products that are for dogs and cats which took place from 2003 through 2022. It includes recalls for pet foods (food, treats, and chews), ingredients, supplements (vitamins and minerals), and drugs. There were 3,691 recalls during this period: 51% were Class I, 35% were Class II, and 14% were Class III. Food items and ingredients accounted for the majority or 68%, drugs for 27%, and supplements (vitamins and minerals) accounted for 5% of these recalls. Recalls that could be associated with dogs only accounted for 42%, with cats only 18%, and with multiple species 40%. The primary reasons for the recalls were biological contamination at 35%, chemical contamination at 32%, and cGMP violations at 8%. Almost 25% of the total recalls in the past 20 years were due to a melamine incident in 2007/2008 (73% of those were Class I). Salmonella recalls for the 20 years accounted for 23% of the total recalls (94 % of those were Class I). Although the recalls for vitamins and minerals accounted for only 5.6% percent of the total, 70% of those were Class I and 30% Class II. Pet food is a complex part of the processed food industry, and the processing of pet food is subject to at least 40 different federal regulations. To avoid recalls and be successful, pet food manufacturers need a robust food safety culture to meet all of these requirements to produce a safe product. In contrast, the melamine contamination (an adulteration event) in 2007/2008 which resulted in animal deaths and recalls is a prime example of the need for an effective and robust supplier approval program in order to avoid fraudulent suppliers in the future.

The Use of Diets in the Diagnosis and Treatment of Common Gastrointestinal Diseases in Dogs and Cats

The nutritional health of dogs and cats is important to pet owners around the world. Nutrition is inextricably linked to the health of the gastrointestinal system and vice versa. Gastrointestinal signs, such as vomiting, diarrhea, anorexia, or weight loss, are one of the most common reasons that dog and cat owners make non-routine appointments with veterinarians. Those patients are evaluated systematically to identify and/or rule out the causes of the symptoms. Some causes of chronic diarrhea are within the gastrointestinal tract while others are secondary to pathogenic factors outside the digestive system. Some useful biomarkers of chronic intestinal disease (enteropathy) exist in serum and feces. After determination that the clinical signs are due to primary gastrointestinal disease and that there is no parasitism, specific diets are used for at least two weeks. There are several types of diets for pets with chronic enteropathies. There are limited ingredient diets and hydrolyzed protein diets with reduced levels of allergens. There are also highly digestible and fiber-enhanced diets. Some diets contain probiotics and/or prebiotics. If symptoms do not improve and the patient is stable, a diet from a different class may be tried. For chronic enteropathies, the prognosis is generally good for symptom resolution or at least improvement. However, if interventions with novel diets do not ameliorate the symptoms of chronic enteropathy, then antibiotic, anti-inflammatory, or immunosuppressant therapy or further, more invasive diagnostics such as taking an intestinal biopsy, may be indicated. Pancreatitis is a common gastrointestinal disease in dogs and cats and patients may present with mild to severe disease. Many patients with mild to moderate disease can be successfully treated with early supportive care, including feeding a low-fat diet. A novel pharmaceutical, fuzapladib (Panoquell-CA1) looks very promising for treating more severe forms of acute pancreatitis in dogs. Maintenance on a low-fat diet may prevent pancreatitis in at-risk dogs. Future advances in medicine will allow pet owners and veterinarians to use dietary management to maximize the health of their dogs and cats.

Retrospective evaluation of admission total plasma protein as a predictor of red blood cell transfusion requirement in dogs diagnosed with traumatic and nontraumatic hemoabdomen: 90 dogs (2009-2019)

OBJECTIVE

To evaluate the association of admission total plasma protein (TPP) and the administration of red blood cell transfusions in dogs with diagnosed hemoabdomen. To secondarily evaluate additional point-of-care parameters associated with red blood cell transfusion administration.

DESIGN

Retrospective study between 2009 and 2019.

SETTING

University veterinary teaching hospital.

ANIMALS

Ninety dogs admitted to a university veterinary teaching hospital after a diagnosis of traumatic or nontraumatic hemoabdomen (NTH).

MEASUREMENTS AND MAIN RESULTS

Medical records were retrospectively reviewed; signalment, point-of-care diagnostics, and transfusion administration information was recorded. A total of 47 dogs (traumatic hemoabdomen 11/26; NTH 36/64) received packed red blood cell transfusions. For each 1 g/dL unit decrease in TPP, dogs had an increased odds ratio (OR) of 2.14 (95% confidence interval [CI]: 1.44-3.40, P < 0.001) of receiving a red blood cell transfusion. Dogs diagnosed with NTH were more likely to receive a red blood cell transfusion than dogs with a traumatic hemoabdomen (OR: 2.78, 95% CI: 1.11-7.141, P = 0.03). Lower PCV values (OR: 1.08, 95% CI: 1.04-1.12, P < 0.001), bicarbonate values (OR: 1.3, 95% CI: 1.09-1.56, P = 0.003), and base excess (OR: 1.27, 95% CI: 1.1-1.49, P = 0.003) were associated with a higher likelihood of red blood cell transfusion. Additionally, higher lactate (OR: 1.35, 95% CI: 1.16-1.63, P < 0.001) and Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast scores (OR: 1.10, 95% CI: 1.04-1.17, P < 0.001) were associated with increased red blood cell transfusion administration.

CONCLUSIONS

Low admission TPP, independent of low PCV, was associated with red blood cell transfusions regardless of underlying cause. For each 1 g/dL unit decrease in TPP on presentation, dogs were approximately 2 times more likely to receive a red blood cell transfusion during hospitalization. Other factors that were associated with increased transfusion administration included presenting PCV, PCV/TPP ratio, bicarbonate, base excess, lactate, and APPLEfast scores.

Comparison of mortality of brachycephalic dogs undergoing partial staphylectomy using conventional incisional, carbon dioxide laser, or bipolar vessel sealing device

OBJECTIVE

To compare mortality of dogs undergoing partial staphylectomy using conventional incisional, carbon dioxide (CO2 ) laser, and bipolar vessel sealing device (BVSD) techniques for the treatment of brachycephalic obstructive airway syndrome (BOAS).

STUDY DESIGN

Retrospective multicenter cohort study.

ANIMALS

A total of 606 client-owned English bulldogs, French bulldogs, and pugs.

METHODS

Medical records from 2011 to 2021 were reviewed for signalment, history, surgical technique, length of hospitalization, and complications. Multivariate statistical analysis was performed to compare odds of mortality between the three techniques of staphylectomy.

RESULTS

The overall mortality rate was 24/606 (4.0%). Of those 24 dogs, staphylectomy was performed with BVSD technique in 13 cases, with CO2 laser in nine, and using conventional incisional technique in two. Nine dogs were graded II or III laryngeal collapse, 14 were graded I, and one was unknown. BVSD technique was associated with mortality prior to discharge compared to the other two techniques (OR = 6.0, 95% CI: 1.3-28.4, p = .023). No differences were detected between conventional incisional and CO2 laser techniques. Concurrent higher grade (stage II or III) laryngeal collapse was independently associated with mortality prior to discharge (OR = 4.6, 95% CI: 1.8-11.8, p = .002).

CONCLUSION

The use of BVSD and grade of laryngeal collapse were associated with a higher risk of perioperative mortality.

CLINICAL SIGNIFICANCE

Clinical studies using a randomized trial design should be conducted to further determine the putative influence of surgical instrumentation in the perioperative mortality rate following multilevel surgery in dogs with BOAS.

Retrospective evaluation and review of approaches for nonspecific lameness in dogs presented to an emergency service (2013-2014): 134 cases

OBJECTIVE

This retrospective study aimed to characterize and evaluate the emergency approach, diagnosis, management, treatment, and follow-up of nonspecific canine lameness cases.

DESIGN

Retrospective case series from September 25, 2013 to September 25, 2014.

SETTING

The study was conducted at an urban university teaching hospital.

ANIMALS

A consecutive sample of dogs presenting to the emergency service with nonspecific lameness in the designated timeframe was used to identify 134 cases. Owners were contacted to participate in the follow-up survey; dogs that died prior to data collection were excluded from the survey. Medical records were reviewed for lameness localization, etiology of lameness, diagnostics obtained, medications prescribed, and owner recommendations.

INTERVENTIONS

Based on review of the medical records, the lameness localization, presumptive source of lameness (joint, soft tissue, neurological, or bone), diagnostics obtained, medications prescribed, and owner recommendations were recorded. Survey data included duration of lameness, perceived response to treatment, and activity level.

MEASUREMENTS AND MAIN RESULTS

Definitive diagnoses were not assigned in 88.8% of lameness cases. A presumptive diagnosis of soft tissue injury was assigned in 45.3% of cases. Single limb lameness was more prevalent than multiple limb lameness. Owners whose dogs were treated with medication were significantly more likely to report that the lameness resolved (P = 0.049). Dogs with injury localized to ≥1 of the joints were significantly less likely to have resolution of lameness (P = 0.037). Treatment recommendations were predominantly pain control and activity restriction.

CONCLUSIONS

Nonspecific lameness represents approximately 4% of canine urban emergency cases. Highlighting the points of clinical care considerations in understanding the etiology of lameness in dogs represents an opportunity for improved patient care and growth in emergency referral and follow-up.

Canine amniotic membrane-derived mesenchymal stem cells ameliorate atopic dermatitis through regeneration and immunomodulation

Mesenchymal stem cells (MSCs) are a promising tool for treating immune disorders. However, the immunomodulatory effects of canine MSCs compared with other commercialized biologics for treating immune disorders have not been well studied. In this study we investigated the characteristics and immunomodulatory effects of canine amnion membrane (cAM)-MSCs. We examined gene expression of immune modulation and T lymphocytes from activated canine peripheral blood mononuclear cell (PBMC) proliferation. As a result, we confirmed that cAM-MSCs upregulated immune modulation genes (TGF-β1, IDO1 and PTGES2) and suppressed the proliferation capacity of T cells. Moreover, we confirmed the therapeutic effect of cAM-MSCs compared with oclacitinib (OCL), the most commonly used Janus kinase (JAK) inhibitor, as a treatment for canine atopic dermatitis (AD) using a mouse AD model. As a result, we confirmed that cAM-MSCs with PBS treatment groups (passage 4, 6 and 8) compared with PBS only (PBS) though scores of dermatologic signs, tissue pathologic changes and inflammatory cytokines were significantly reduced. In particular, cAM-MSCs were more effective than OCL in the recovery of wound dysfunction, regulation of mast cell activity and expression level of immune modulation protein. Interestingly, subcutaneous injection of cAM-MSCs induced weight recovery, but oral administration of oclacitinib induced weight loss as a side effect. In conclusion, this study suggests that cAM-MSCs can be developed as a safe canine treatment for atopic dermatitis without side effects through effective regeneration and immunomodulation.

Day one core competencies in veterinary dentistry

This article describes the core competencies recommended for inclusion in the veterinary curriculum for all veterinary graduates based on the American Association of Veterinary Medical Colleges Competency-Based Veterinary Education document. General practice companion animal veterinarians are frequently presented with patients having dental, oral, or maxillofacial pathology, and veterinary graduates will be relied upon for recommendations for the maintenance of oral health, including the prevention of periodontal disease, identification of endodontic disease, and knowledge of developmental defects. These recommendations should be made for all veterinary patients starting at a young age. These core competencies can apply to many companion species, but mainly are focused on the dog and cat. Because periodontal disease is the most common abnormality observed in dogs and cats, the first key step is taking a few seconds during examination of every patient of any age presented for any reason to examine the oral cavity. Although dental, oral, and maxillofacial pathology is often diagnosed after imaging and evaluation under anesthesia, the first step is observation of dentition and gingivae during the conscious exam to assess periodontal health status. The physical exam of the oral cavity may reveal oral behavior (eg, observation of uncomplicated crown fractures due to chewing on hard objects), which will permit recommendations for enhanced prevention by daily oral hygiene or professional treatment. There are now many involved dental and surgical treatments available, some of which require specialist-level instrumentation and expertise. General practitioners should be able to competently perform the following immediately upon graduation from veterinary school: For patients for whom the owner's reason for the veterinary visit is not dental, oral, or maxillofacial disease, obtain a brief (1 or 2 questions) history of the oral health of the patient. On lifting the lip of every patient, recognize presence or absence of accumulated dental plaque or calculus on the crowns of the teeth, presence or absence of gingival inflammation or ulceration, and presence or absence of other dental, oral, and maxillofacial pathology. On anesthetized patients that have dental, oral, and maxillofacial pathology for which professional treatment is indicated, be able to obtain and interpret appropriately positioned and exposed dental radiographs. When the presence of dental, oral, and maxillofacial pathology is recognized, determine whether each tooth present in the mouth does or does not require professional treatment beyond dental subgingival and supragingival scaling and polishing. List the indications for tooth extraction, know indications for potential oral/dental treatments beyond subgingival and supragingival scaling and polishing or extraction, and determine whether the professional treatment that may be indicated, such as root canal treatment or mass resection of oral tissues, requires referral for specialist-level expertise and instrumentation. Complete a thorough periodontal evaluation and therapy with periodontal probing, including professional subgingival and supragingival ultrasonic scaling with polishing under anesthesia. Demonstrate the ability to extract teeth indicated for extraction, using gentle and appropriate techniques that will risk minimal injury to the jaws and oral soft tissues and reduce postoperative patient pain. Provide appropriate postoperative care, including recognition of when postoperative analgesia and possibly antibiotic administration are indicated.

Improving access to advanced veterinary care for rescued cats and dogs

OBJECTIVES

The objectives of this study were as follows: (1) to describe the AMC to the Rescue (AMCTTR) funding criteria and the application process; (2) to describe the distribution of species cared for through the program, the medical conditions treated in cats compared with those treated in dogs and the cost of that care; and (3) to define the successes and challenges of the program.

METHODS

The AMCTTR database was reviewed for applications submitted between 1 January 2020 and 31 December 2022. Data collected included the following: the date of application; rescue organization seeking financial support; species; age of pet at time of application; expenditures funded by AMCTTR; and the method by which the rescue organization learned about AMCTTR. The animals in the AMCTTR database were sorted into two groups: those accepted for funding and those that did not meet funding criteria. The Animal Medical Center (AMC) medical record system was searched for the total number of individual animals, species and age seen at AMC during the study period.

RESULTS

In total, 267 applications were reviewed and 190 applications from 134 cats, 52 dogs and four rabbits were accepted for advanced veterinary care funded by AMCTTR. Over the 3-year study period, US$612,564 were awarded and over half of those funds were awarded to cats. The average expenditure per animal during this time period was US$3224. The most common referrals to AMCTTR were made to ophthalmology, surgery and dentistry.

CONCLUSIONS AND RELEVANCE

The needs of cats differed from dogs in that feline applications were most commonly submitted for ophthalmology or dentistry. Expenditures per cat were less than per dog because dogs were referred for more expensive orthopedic surgery. The need for advanced veterinary care for rescue animals is enormous, especially for cats. Programs that subsidize advanced veterinary care increase access to that care.

Insulation break of the ventricular lead in a dog with a pacemaker

A 10-year-old female spayed mixed breed dog that had a transvenous pacemaker implanted four years prior was presented for the evaluation of episodes of transient loss of consciousness without any history of trauma that were unresponsive to anticonvulsant therapies. Intermittent failure to capture coupled with low impedance and high capture threshold were noted upon interrogation of the pacemaker. Radiography and fluoroscopy demonstrated a possible break in the insulation of the lead. After the placement of another transvenous pacemaker, the dog had no additional syncopal episodes, and anticonvulsants were tapered off. The dog developed an implant infection from the newly placed pacemaker, which prompted the removal of the infected pacemaker and the implantation of an epicardial pacemaker. However, the epicardial lead dislodged seven days after placement, and the dog was euthanized. During necropsy, the first transvenous lead was removed, and the insulation break was visually confirmed. Although an insulation break is a rare delayed complication of pacemaker implantation, this report shows how the diagnosis, suspected by typical interrogation findings, can be aided by radiographic and fluoroscopic investigations.

Canine Oral Lymphoma: A Review and 3 Case Studies

Canine oral lymphoma is an infrequently diagnosed malignancy in dogs and reports in the literature are lacking. Most cases are due to epitheliotropic lymphoma, in which lesions are often multifocal and involve the skin as well as the oral cavity. Epitheliotropic lymphoma is an uncommon form of lymphoma that is characterized by neoplastic T-lymphocyte tropism for epithelial tissues. However, not all cases of oral lymphoma are due to epitheliotropic lymphoma, and B-cell disease is also possible. This article describes very different cases of oral lymphoma in dogs including the history at presentation, examination and radiographic findings, treatments, and outcomes. The cases highlight the variability in signalment, examination findings, and clinical courses that are found with oral lymphoma.

Successful treatment of acute respiratory failure following hypertensive crisis in a dog with presumed pheochromocytoma or paraganglioma

Background

Acute respiratory failure has been reported as one of the manifestations of hypertensive crisis in pheochromocytoma in human medicine. In dogs, no reports have been described as acute respiratory failure following hypertensive crisis. Here, we report the clinical presentation, course, and treatment of acute respiratory failure following the hypertensive crisis in a dog with presumed pheochromocytoma or paraganglioma.

Case Description

A 12-year-old neutered male toy poodle was referred for the diagnostic evaluation of a right adrenal gland mass. The dog suddenly exhibited severe dyspnea with abnormal hypertension (systolic blood pressure >200 mmHg) 15 minutes after recovery from the anesthesia for the computed tomography (CT) examination. Pulmonary CT and ultrasonography findings suggested acute onset of severe pulmonary edema. Pulmonary edema was treated with mechanical ventilation (pressure-support ventilation with continuous positive airway pressure) and negative fluid balance after the administration of furosemide. Weaning from mechanical ventilation was successful 24 hours after the onset of respiratory failure. Finally, the dog was discharged 3 days after weaning from ventilation without complications.

Conclusion

This report outlines a case of acute respiratory failure following a hypertensive crisis requiring mechanical ventilatory management in a dog. The onset and progression of pulmonary edema were extremely rapid. However, improvement in pulmonary edema was also rapid. Hemodynamic stability, in addition to prompt diagnosis and aggressive therapeutic intervention, including mechanical ventilation, may have contributed to the good prognosis of pulmonary edema following hypertensive crisis in a dog, which we attribute to a catecholamine storm.

A case series of urinary bladder rhabdomyosarcoma in seven dogs

Background

Juvenile urinary bladder rhabdomyosarcoma (ubRMS) is a known entity; however, literature regarding its clinical behavior and endoscopic features is scarce. The aim of this study was to describe clinical and endoscopic features, and outcomes of ubRMS in dogs.

Case Description

Dogs undergoing transurethral endoscopy and with a histological diagnosis of ubRMS were retrospectively collected. Seven dogs with a median age of 18 months (range 6-32 months) were included in this retrospective, multicenter, and descriptive study. Median tumor size was 58 mm (range 30-65 mm), and tumor location was bladder neck in three cases, trigone in two cases, and bladder body in two cases. Two dogs had monolateral ureteral obstruction. Two dogs presented with regional lymphadenopathy and one dog had lung lesions suggestive of metastatic disease. A grape-like mass was reported in four cases and solid in two, with variable consistency (two friables, two firms, and two not reported). Tumor treatments included surgery in three cases, surgery, and adjuvant doxorubicin in one case, and palliative therapy in three cases. The overall median survival time (ST) was 45 days. STs were shorter (range 20-45 days) for dogs treated with palliative care than for dogs treated with curative-intent treatment (range 70-120 days).

Conclusion

ubRMS should be considered as a differential diagnosis in young dogs presenting with bladder masses. In this study, ubRMS confirmed its aggressive clinical behavior. Surgery and chemotherapy seem to increase STs but the prognosis remains poor.

A novel two-catheter method for urethral catheterization improves success rates of urethral catheterization in female dogs and cats weighing less than ten kilograms

OBJECTIVE

To compare the success rates for urethral catheterization in clinical patients using the traditional and 2-catheter techniques when placed by personnel of all experience levels.

ANIMALS

38 female cats and dogs weighing less than 10 kg were prospectively enrolled.

METHODS

Enrolled animals were randomized to have a urethral catheter placed by the traditional technique or the 2-catheter method under sedation or general anesthesia. Any qualified hospital personnel of any experience level were allowed to place the catheter. If after 5 minutes the animal was not successfully catheterized, the alternate method was performed. The previous experience of the catheter placer, animal signalment, animal condition that necessitated catheter placement, time to successful placement, and which technique was successful was recorded.

RESULTS

The 2-catheter technique was more successful than the traditional method (60.5% and 34.2%, respectively) for urethral catheterization when used by a variety of hospital personnel. The 2-catheter technique was successful in 63.3% of dogs and 66.6% of cats, while the traditional method was successful in 36.6% of dogs and 33.3% of cats. Eight of 9 (88.9%) novice catheter placers that placed their first urinary catheter in this study succeeded with the 2-catheter technique and only 1 was successful with the traditional method.

CLINICAL RELEVANCE

The 2-catheter technique has a higher rate of success for placement of female urinary catheters in small patients that are unable to have concurrent digital palpation. This technique may also be helpful in the inexperienced catheter placer population to aid in guidance into the urethral papilla.

An atypical presentation of anticoagulant rodenticide toxicosis in a dog

A 5-month-old intact female Australian shepherd dog was referred to our clinic for neurologic signs including ataxia, a head tilt, and altered mentation following consumption of an unidentified rodenticide several days prior to developing clinical signs. A provisional diagnosis of bromethalin toxicosis had been made, given the neurologic signs seen and the general increased use of bromethalin-containing rodenticide products. However, on physical examination, the dog was noted to have scleral hemorrhage and bleeding at the venipuncture sites, which was inconsistent with bromethalin toxicosis. Coagulation testing was supportive of anticoagulant rodenticide toxicosis and the rodenticide was later identified as the first-generation anticoagulant rodenticide diphacinone. The neurologic signs seen were attributed to a coagulopathy causing multifocal hemorrhage into the central nervous system. Neurologic signs rapidly resolved following treatment with a frozen plasma transfusion and vitamin K1. This atypical presentation of an anticoagulant rodenticide toxicosis highlights the need for accurate product identification, if available, and thorough patient examination and laboratory testing. An atypical presentation of anticoagulant rodenticide toxicosis should be considered when neurologic signs are present with clinical bleeding, especially if the type of rodenticide is unknown, or even if it was not thought to have an anticoagulant as the active ingredient. Key clinical message: Given the change in commercially available rodenticide products, this case highlights the need for accurate product identification in cases of suspected toxicosis, and the variable clinical signs that can be seen following anticoagulant rodenticide toxicosis.