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Objectives: To evaluate the potential association between signalment, history and physical examination findings and elevated renal and hepatic blood values before non‐steroidal anti‐inflammatory drug administration in dogs. Secondary objectives were to investigate clinicopathologic differences between dogs that were and were not prescribed a non‐steroidal anti‐inflammatory drug. Materials and Methods: Medical records of 81 dogs that underwent renal and hepatic blood value screening before drug administration via a non‐steroidal anti‐inflammatory drug blood panel were reviewed retrospectively. Patient signalment, history and physical examination findings were recorded. Results: Six (7%) dogs had an elevated blood urea nitrogen, 2 (2%) dogs had an elevated creatinine, 24 (30%) dogs had an elevated alanine aminotransferase, 29 (36%) had an elevated aspartate aminotransferase and 14 (17%) had an elevated alkaline phosphatase. Forty‐five (56%) dogs had an elevation in at least 1 renal or hepatic blood value. Dogs less than 8 years of age and with a longer duration of clinical signs were less likely to have an elevated renal or hepatic blood value. Dogs with elevated hepatic blood values were less likely to be prescribed a non‐steroidal anti‐inflammatory drug; however, this was not true for elevated renal parameters alone. Clinical Significance: The results of this preliminary study suggest that blood value screening before non‐steroidal anti‐inflammatory drug administration may be important for dogs greater than 8 years of age. Hepatic enzyme elevations may play a greater role in clinical decision making in comparison to renal parameters. [ABSTRACT FROM AUTHOR]

Background: There are conflicting reports of plasma lipoprotein lipid content in dogs with diabetes mellitus (DM). Objectives: To determine lipoprotein lipid content of plasma of dogs with DM by spectrophotometry and ultracentrifugation; to compare lipoprotein lipid content in diabetic and healthy dogs; and to quantify apolipoprotein B‐100 (ApoB) in dogs with DM. Animals: 22 dogs with DM and 9 healthy dogs. Methods: Cross‐sectional study. Triglyceride (TG), total cholesterol (TC), and high‐density lipoprotein cholesterol (HDL‐C) concentrations were measured by spectrophotometry. Very low‐density lipoprotein cholesterol (VLDL‐C) and low‐density lipoprotein cholesterol (LDL‐C) concentrations were calculated after ultracentrifugation. Non‐HDL‐C cholesterol was calculated by subtracting HDL‐C from TC. ApoB was quantified by ELISA. The Mann‐Whitney test was used for comparison of median lipoprotein concentrations, and Spearman's correlation was used to assess associations between ApoB and lipoprotein fractions. Results: All values are reported in mg/dL. Median TG (122), TC (343.5), HDL‐C, (200), VLDL‐C, (27) LDL‐C (68), non‐HDL‐C (114), and ApoB (320) were significantly higher in dogs with DM, compared to healthy dogs (57, 197, 168, 12, 16, 31, and 258, respectively, P‐values 0.0079, <0.001, 0.029, 0.011, <0.001, <0.001, 0.025, respectively). A significant association was found between ApoB and LDL‐C (Spearman's rho = 0.41, P = 0.022) and between ApoB and non‐HDL‐C (Spearman's rho = 0.40, P = 0.027). Conclusions and Clinical Importance: Dyslipidemia of dogs with DM is characterized by pronounced increases in LDL‐C and non‐HDL‐C concentrations, although all lipoprotein fractions are significantly increased. Knowledge of specific lipoprotein fraction alterations in dogs with DM can enhance treatment options for diabetic dyslipidemia in dogs. [ABSTRACT FROM AUTHOR]

Background: Platelet cryopreservation allows long-term storage and immediate availability of transfusion products. Hypothesis: The addition of a preparation inhibiting platelet activation (Thrombosol, in 2% dimethyl sulfoxide [DMSO]) will enhance in vitro function and prolong in vivo survival of cryopreserved platelets compared with those preserved in 6% DMSO. Animals: Thirty-three research dogs. Methods: Prospective study. Eleven fresh canine apheresis platelet concentrates (PCs) were each split into 3 units: fresh and cryopreserved in 6% DMSO or Thrombosol. Platelet analysis, performed 1–10 weeks postfreezing, included in vitro functional testing and in vivo survival assessed by administration of biotinylated platelets. Results: Platelet aggregation was diminished in cryopreserved PC. Cryopreserved platelets could be activated, as based on mean thrombin-stimulated P-selectin expression (6% DMSO, 23.0%; Thrombosol, 18.4%), although to a lesser extent than fresh PC (49.1%) ( P < .0001). The mean maximum in vivo platelet recovery for fresh PC was 80.3%, significantly greater than recovery for 6% DMSO (49.2%) and Thrombosol PC (43.7%) ( P≤ .001). The half-life (days) of fresh PC (3.8 ± 0.4) was significantly ( P < .002) greater than that of 6% DMSO (1.9 ± 1.0) and Thrombosol (2.4 ± 1.1) PC, with no difference ( P= .3) between cryopreserved PC. Conclusions and Clinical Importance: Cryopreservation of canine platelets using Thrombosol did not provide any advantage over preservation using 6% DMSO. Cryopreserved platelets can be activated in vitro and provide therapeutic benefit when fresh platelets are unavailable. Further studies are needed to assess their in vivo hemostatic function. [ABSTRACT FROM AUTHOR]

Background: Feline visceral hemangiosarcoma (HSA) is an uncommon tumor, and the clinical progression and outcome are rarely reported. Hypothesis: The prognosis of feline visceral HSA is poor because of severe clinical signs, anemia, and a high rate of metastasis. Animals: The medical records of 26 client-owned cats with visceral HSA were reviewed. Methods: Multi-institutional retrospective study. Results: The most common historical findings and clinical signs included lethargy, anorexia, respiratory difficulty, collapse, and vocalizing. Eighty-two percent of cats were anemic, and aspartate transaminase was increased in 53% of the study population. Metastatic lung disease was noted in 33% of affected cats. In 75% of the cats, abdominal ultrasonography identified a specific location of HSA. However, ultrasound identification of all multifocal lesions was successful only in 3/9 cats (33%). Tumor location was identified in the following organs: liver (35%), small intestine (31%), large intestine (31%), abdominal lymph node (31%), mesentery (27%), spleen (23%), lung (19%), omentum (12%), brain (8%), pancreas (8%), and diaphragm (8%). Multifocal HSA was noted in 77% of cats. Three cats received adjuvant chemotherapy (doxorubicin). Seventy-one percent of euthanized cats were euthanized within 1 day of diagnosis. The median survival time of the remaining cats (n = 6) was 77 days (range, 23–296 days). Conclusion and Clinical Importance: Feline visceral HSA is most often multifocal at the time of diagnosis. The prognosis appears poor, and the number of cats receiving chemotherapy is low. [ABSTRACT FROM AUTHOR]

The article discusses research on clinical outcomes in cats suffering from spontaneous haemoperitoneum conducted by W. T. N. Culp et al., published in the 2010 issue of the "Journal of the American Veterinary Medical Association."

Objective: To determine the frequency of abnormal findings on digital rectal examination (DRE) performed during physical examinations at a tertiary referral veterinary hospital, to establish what abnormal findings are most common and whether they impact diagnostic and treatment plans, and to assess whether patient signalment or admitting service influences the frequency of abnormalities., Animals: Client-owned dogs (n = 440)., Methods: Veterinarians performed DREs on dogs as part of a physical examination. Patient signalment and DRE findings were recorded in a standardized survey. Findings were deemed normal or abnormal and described. Whether the findings changed the diagnostic or treatment plan was also recorded., Results: Abnormalities were detected on DRE in 160 of 440 (36%) dogs. Changes to the diagnostic plan occurred in 41 of 160 (26%) cases when an abnormality was found. Changes to the treatment plan occurred in 20 of 160 (12.5%) cases when an abnormality was found. Age (P = .2), sex (P = .9), and breed (P = 1) did not significantly influence the frequency of abnormal findings. Abnormal findings were significantly more common in dogs presenting to the emergency service than elective services (P = .005)., Clinical Relevance: Among dogs presenting to a tertiary veterinary hospital, abnormalities found on DRE are common and change the diagnostic plan in 1 out of 4 dogs and treatment plan in 1 out of 8 dogs. This study supports the continued practice of DREs in dogs, especially in emergency settings, regardless of signalment.

Objective: To determine if an association between ionized magnesium (iMg) and total magnesium (tMg) exists in healthy and hospitalized dogs admitted through an emergency service and to assess the associations between iMg and tMg with total protein, albumin, ionized calcium, and total calcium., Design: Prospective cohort study., Setting: Veterinary teaching hospital., Animals: Sixty-nine dogs were enrolled. The healthy control group (group 1) included 24 dogs, and the hospitalized group (group 2) included 45 dogs., Interventions: None., Measurements and Main Results: For both groups, signalment, a venous blood gas, and serum biochemistry were obtained. In addition, the presumptive diagnosis was recorded for group 2. Blood was obtained prior to any therapeutic interventions. Group 1 tMg was within the reference interval (RI), and the values for iMg were used to provide a healthy group range (HGR) of 0.44-0.50 mmol/L. Group 2 tMg was within the RI, but iMg was below the calculated HGR range (group 2 median iMg = 0.4 mmol/L; range = 0.27-0.70). There was a significant positive correlation between iMg and tMg in each group (group 1: r = 0.6713, P = 0.0003; group 2: r = 0.5312, P = 0.0002). Ionized Mg and tMg were not significantly associated with any of the other evaluated variables in either group., Conclusions: Ionized Mg and tMg were significantly associated in both healthy and hospitalized dogs, but the relationship was weaker in the hospitalized dogs compared with the healthy population. For hospitalized dogs, the relationship was weak enough to question the validity of using iMg and tMg interchangeably to track magnesium status., (© Veterinary Emergency and Critical Care Society 2023.)

Acute hemorrhage in small animals results from traumatic and non-traumatic causes. This review seeks to describe current understanding of the resuscitation of the acutely hemorrhaging small animal (dog and cat) veterinary patient through evaluation of pre-clinical canine models of hemorrhage and resuscitation, clinical research in dogs and cats, and selected extrapolation from human medicine. The physiologic dose and response to whole blood loss in the canine patient is repeatable both in anesthetized and awake animals and is primarily characterized clinically by increased heart rate, decreased systolic blood pressure, and increased shock index and biochemically by increased lactate and lower base excess. Previously, initial resuscitation in these patients included immediate volume support with crystalloid and/or colloid, regardless of total volume, with a target to replace lost vascular volume and bring blood pressure back to normal. Newer research now supports prioritizing hemorrhage control in conjunction with judicious crystalloid administration followed by early consideration for administration of platelets, plasma and red blood during the resuscitation phase. This approach minimizes blood loss, ameliorates coagulopathy, restores oxygen delivery and correct changes in the glycocalyx. There are many hurdles in the application of this approach in clinical veterinary medicine including the speed with which the bleeding source is controlled and the rapid availability of blood component therapy. Recommendations regarding the clinical approach to volume resuscitation in the acutely hemorrhaging veterinary patient are made based on the canine pre-clinical, veterinary clinical and human literature reviewed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Hall and Drobatz.)

Background: Viscoelastic coagulation devices are a useful adjunct to the evaluation of hemostasis in veterinary patients. VCM Vet is a point-of-care device that is simple in operation and could be used to diagnose and trend hemostatic abnormalities in sick patients. VCM Vet does not use activators., Objectives: We aimed to establish reference intervals (RIs) for VCM Vet in a healthy adult canine population and concurrently perform thromboelastographic (TEG) analysis on these samples with and without tissue factor (TF) activation for RI comparisons., Methods: Duplicate VCM Vet tests were performed immediately upon sample collection. Two concurrent TEG tests were performed on the remaining blood, one citrated, untreated (CU), and one activated with TF at a 1:3600 dilution., Results: Fifty-two dogs were enrolled in the study. The following RIs were generated for VCM Vet machine 1 and 2, respectively: clot time (CT) (seconds) 163-480 and 172-457; clot formation time (CFT) (seconds) 104-288 and 94-252, α-angle (degrees) 41-65 and 44-66, and maximum clot firmness (MCF) (no units) 27-43 and 30-46. Moderate to good correlations were observed between the two machines with Lin's concordance correlation coefficients of 0.51-0.9 and a P < 0.002. TEG RIs were similar to previously reported values., Conclusions: VCM Vet RIs were generated. Each VCM Vet device should have a unique RI established due to inter-device variability. Direct correlations of VCM Vet values with TEG parameters were not performed due to the narrow range of the normal values and the need to evaluate patients with a wide range of hemostatic abnormalities., (© 2020 American Society for Veterinary Clinical Pathology.)

A restrospective study was performed to evaluate the efficacy of and complications among Jackson-Pratt (JP) drains placed as thoracostomy drains, traditional trocar type (TRO) thoracostomy drains, and guidewire (GW)-inserted thoracostomy drains that were placed in open fashion during thoracotomy. Medical records of 65 canine and feline patients who underwent thoracic surgery were evaluated. Dogs and cats who underwent thoracotomy and had a chest drain placed intraoperatively were included. Data retrieved from medical records included signalment, body weight, diagnosis, surgical approach, surgical procedure, type of thoracostomy drain, postoperative analgesia, duration of thoracostomy drain, and postoperative complications. The incidence of complications and number of medications used in pain protocols were compared among types of thoracostomy drains. JP (n = 31), TRO (n = 25), and GW (n = 9) thoracostomy drains were placed in 65 patients. Ten minor (15.3%) and four major (6.2%) complications occurred. Cases with JP thoracostomy drains were significantly less likely to have complications (2 minor, 1 major) than cases with TRO thoracostomy drains (8 minor, 3 major, P = .009). There were no differences in the number of major complications when comparing all three drains individually ( P = .350). JP drains and GW drains can be considered as an alternative to traditional TRO thoracostomy drains.

Background: Prophylactic gastropexy has been promoted as a means of preventing gastric volvulus during gastric dilatation and volvulus (GDV) syndrome. Little is known about the impact of gastropexy on gastrointestinal transit time., Hypothesis: Laparoscopic-assisted gastropexy (LAG) will not alter gastrointestinal transit times when comparing gastric (GET), small and large bowel (SLBTT), and whole gut transit times (TTT) before and after surgery., Animals: 10 healthy client-owned large-breed dogs., Methods: Prospective clinical trial. Before surgery, all dogs underwent physical examination and diagnostic evaluation to ensure normal health status. Dogs were fed a prescription diet for 6 weeks before determination of gastrointestinal transit with a wireless motility capsule. LAG was then performed, and dogs were fed the diet for 6 additional weeks. Measurement of transit times was repeated 6 weeks after surgery., Results: Ten dogs of various breeds at-risk for GDV were enrolled. No complications were encountered associated with surgery or capsule administration. There were no significant differences in GET 429 [306-1,370] versus 541 [326-1,298] (P = 0.80), SLBTT 1,243 [841-3,070] versus 1,540 [756-2,623] (P = 0.72), or TTT 1,971 [1,205-3,469] versus 1,792 [1,234-3,343] minutes (median, range) (P = 0.65) before and after LAG., Conclusions and Clinical Importance: An effect of LAG on gastrointestinal transit time was not identified, and wireless motility capsule can be safely administered in dogs after LAG., (Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Background: Acute kidney injury (AKI) is a common problem in small-animal patients and carries a guarded prognosis with substantial morbidity and mortality, particularly in oligoanuric dogs. Fenoldopam, a selective dopamine agonist, has been shown to increase urine output in healthy dogs and cats; however, the mechanism of action is unknown., Hypothesis/objectives: To evaluate the effect of fenoldopam infusion on glomerular filtration rate (GFR) and fractional excretion of sodium (FeNa) in healthy dogs., Animals: Ten healthy, privately owned dogs., Methods: Randomized, crossover design with negative control. Ten healthy dogs were given fenoldopam diluted in 5% dextrose (D5W) as a continuous IV infusion of 0.8 μg/kg/min for 5 hours and a control infusion of D5W alone, 7 days apart. Glomerular filtration rate was measured by exogenous iohexol clearance, beginning 1 hour after the start of the fenoldopam infusion. Fractional excretion of sodium (FeNa) was measured before and after the infusion. Glomerular filtration rate and change in FeNa were compared between treatment days., Results: Fenoldopam infusion resulted in a significantly increased (P = .0166) GFR (median GFR, 3.33 mL/min/kg) in healthy dogs compared with D5W infusion (median GFR, 2.71 mL/kg/min). Fenoldopam also resulted in a significantly increased (P = .0148) FeNa (mean change, 0.106), whereas infusion of D5W alone did not (mean change, 0.016)., Conclusions and Clinical Importance: In healthy dogs, fenoldopam significantly increased GFR and FeNa compared with infusion of D5W alone. No adverse effects were seen., (Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Background: β-hydroxybutyrate (BOHB) concentrations have not been quantified in dogs with acute pancreatitis (AP)., Objective: The aim of this study was to investigate BOHB concentrations in dogs with AP., Animals: A total of 154 client-owned dogs without DM., Methods: Prospective clinical study. Dogs were enrolled into 1 of 3 groups: AP, sick without an AP diagnosis, or fasted. Dogs were diagnosed with AP (44) if they had vomiting or anorexia, and either ultrasonographic findings consistent with AP or increased pancreatic lipase. Sick dogs without AP (68) had vomiting or anorexia but a diagnosis of AP was either not suspected or was excluded based on ultrasonographic findings or a normal pancreatic lipase. Dogs without anorexia or vomiting that were fasted for over 10 hours for a procedure were also enrolled (42). BOHB was measured on whole blood with a portable ketone meter. The Kruskal-Wallis test was performed to compare BOHB in the 3 groups. Pair-wise comparisons were performed using the Mann-Whitney test and Bonferroni corrected P-values are reported., Results: Median BOHB concentration was significantly higher in dogs with AP (0.3 mmol/L, range 0-2.9 mmol/L) compared to sick dogs without AP (0.20 mmol/L, range 0-0.9 mmol/L, P = .007) and fasted dogs (0.1 mmol/L, range 0-0.4 mmol/L, P = .0001). Median BOHB concentration was significantly higher in sick dogs without AP compared to fasted dogs (P = .0002)., Conclusions and Clinical Importance: In dogs without DM, BOHB is significantly higher in dogs with AP compared to other dogs. The diagnostic utility of this finding remains to be investigated., (Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Background: There are no clear treatment guidelines for dogs with clinically well-regulated hyperadrenocorticism in which serum cortisol concentrations before and after an ACTH stimulation test performed 3-6 hours after trilostane administration are < 2.0 μg/dL., Objective: To determine if serum cortisol concentrations measured before (Pre1) and after (Post1) ACTH stimulation at 3-6 hours after trilostane administration are significantly lower than cortisol concentrations measured before (Pre2) and after (Post2) ACTH stimulation 9-12 hours after trilostane administration, in a specific population of dogs with clinically well-regulated hyperadrenocorticism and Pre1 and Post1 <2 μg/dL., Animals: Thirteen client-owned dogs with clinically well-regulated hyperadrenocorticism and Pre1 and Post1 serum cortisol concentrations <2.0 μg/dL 3-6 hours after trilostane administration., Methods: Prospective study. Dogs had a second ACTH stimulation test performed 9-12 hours after trilostane administration, on the same day of the first ACTH stimulation test. Cortisol concentrations before and after ACTH stimulation were compared using a paired t-test., Results: Cortisol concentrations before (1.4 ± 0.3 μg/dL) and after the first stimulation (1.5 ± 0.3 μg/dL, mean ± SD) were significantly lower than cortisol concentration before the second stimulation (3.3 ± 1.6 μg/dL, P = .0012 each). Cortisol concentration before the first stimulation was also significantly lower than cortisol concentration after the second stimulation (5.3 ± 2.4 μg/dL, P = .0001)., Conclusions and Clinical Importance: In dogs with clinically well-regulated, trilostane-treated, hyperadrenocorticism, and cortisol concentrations <2 μg/dL before and after the first stimulation, a second ACTH stimulation test performed 9-12 hours after treatment can result in higher cortisol concentrations that could support continued trilostane treatment., (Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Objective: To generate reference ranges for echocardiographic variables in clinically normal adult chimpanzees (Pan troglodytes)., Design: Retrospective cohort study., Animals: 88 clinically normal adult chimpanzees., Procedures: Echocardiographic data obtained between 2002 and 2011 from chimpanzees at the Alamogordo Primate Facility were reviewed (263 echocardiograms obtained from 158 individuals). Data from clinically normal individuals (33 females and 55 males) were analyzed. Basic cardiac parameters measured in all individuals included aortic root diameter and left atrial diameter in the short and long axis during diastole. Left ventricular measurements included left ventricular internal diameter in systole and diastole and diastolic septal and posterior wall thickness. The E point to septal separation was also measured. Spectral Doppler measurements included the peak flow velocity of the pulmonary artery and aorta and diastolic transmitral flow. The presence of arrhythmias was also noted., Results: Standard echocardiographic findings for a large group of adult female and male chimpanzees were obtained. Female and male chimpanzees were grouped by age in 10-year blocks, and echocardiographic findings were analyzed statistically by 10-year block. In male chimpanzees, cardiac arrhythmias were noted to increase with age., Conclusions and Clinical Relevance: Cardiovascular disease is an important cause of morbidity and death in captive chimpanzees; however, basic echocardiographic measurements from a large cohort of clinically normal animals have not previously been reported. The number of animals in the present study was insufficient to generate reference ranges; however, data from a large cohort of clinically normal animals are presented. This information will be useful for veterinarians working in clinical and research settings with this species.

Canine hemangiosarcoma (HSA) is a highly malignant tumor for which standard chemotherapy has done little to substantially improve survival. Cyclooxygenase-2 (Cox-2) plays a role in the formation, growth, and metastasis of tumors and inhibitors have demonstrated therapeutic benefit with certain canine cancers. In this prospective study, 21 dogs received adjuvant therapy combining the selective Cox-2 inhibitor deracoxib with doxorubicin, following splenectomy for HSA. The combination was well-tolerated with only low-grade gastrointestinal and hematologic toxicities noted. An overall median survival of 150 days (range; 21 to 1506 days) was noted. Although there was no significant difference in survival based upon stage of disease, dogs with stage III HSA (n = 11) had a median survival of 149 days, which appears to be longer than previously reported. Further studies are warranted to evaluate the potential benefit of Cox-2 inhibitors in the treatment of canine HSA.

In human beings, diabetes mellitus (DM) and diabetic ketoacidosis (DKA) are recognized as proinflammatory states and dysregulation of cytokines has been linked to some potentially fatal complications. Cytokine profiles of dogs with DM or DKA have not been reported. The objectives of this study were to compare cytokine and hormone concentrations in dogs with DKA before and after resolution of ketoacidosis, to compare these concentrations before treatment of DKA to those measured in dogs with uncomplicated DM and healthy dogs, and to compare concentrations in dogs with uncomplicated DM to those measured in healthy dogs. 27 dogs were included in this prospective clinical study. 18 dogs had naturally-occurring disease (9 DKA and 9 DM) and 9 dogs were healthy. Serum GMCSF, IL-2, IL-4, IL-6, IL-7, CXCL8, IL-10, IL-15, IL-18, IFNγ, IP-10, TNFα, Monocyte Chemoattractant Protein-1 (MCP-1), Keratinocyte Chemoattractant (KC), glucagon, leptin, adiponectin, and resistin were assayed using Milliplex MAP Canine kits.(2)(,)(3) IL-18, resistin, and GMCSF concentrations were significantly higher in dogs with DKA before treatment compared to after resolution of ketoacidosis. CXCL8, MCP-1, KC, and resistin were significantly higher in DKA dogs compared to healthy controls, and KC was also significantly higher in DKA compared to DM dogs. Additionally, CXCL8 and MCP-1 were significantly higher in dogs with DM compared to healthy controls. Significant differences were not detected in concentrations of the other measured analytes, including glucagon. It is concluded that IL-18, resistin, GMCSF, and KC may be involved in the pathogenesis of canine DKA, and their importance in this pathogenesis may be as great as that of glucagon. Dysregulation of CXCL8 and MCP-1 may be involved in the pathogenesis of DM in dogs., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Background: Abnormal sodium to potassium (Na:K) ratios can raise suspicion for hypoadrenocorticism (HA). Although dogs with HA usually have normal leukograms, their white blood cell counts may be useful in screening for HA., Objectives: To examine the utility of combining the Na:K ratio with white blood cell counts to screen for HA in hospitalized dogs requiring fluid treatment administered i.v.., Animals: Fifty-three dogs with confirmed HA and 110 sick dogs confirmed not to have HA., Methods: Retrospective, case-control study. Dogs were included if they were hospitalized and administered fluids i.v., had a complete blood count and measurement of serum Na and K concentrations. HA was diagnosed using an ACTH stimulation test, or ruled out by measurement of basal serum cortisol concentration., Results: The receiver operating characteristic (ROC) curve for the lymphocyte count was not significantly different from the ROC curve of the Na:K ratio (P = .55). The ROC curve for the model combining the Na:K ratio and lymphocyte count was superior for identifying dogs with HA compared to the Na:K ratio (P = .02) or lymphocyte count (P = .005) alone. At the 100% sensitivity cutoff, lymphocyte count was more specific for detection of HA than Na:K (P < .001)., Conclusions and Clinical Importance: A combination of the Na:K ratio and lymphocyte count provides a better screening test for HA compared to the Na:K ratio or lymphocyte count alone. At 100% sensitivity, the lymphocyte count is a more specific test for HA than the Na:K., (Copyright © 2011 by the American College of Veterinary Internal Medicine.)

Hypovolemia and hypoperfusion are common life-threatening problems in animals presented to the emergency veterinarian. Assessment of physical findings and rapid recognition and treatment of abnormal tissue perfusion are crucial in optimizing outcome. The clinician should be familiar with the disease being treated and the types of fluids that are available. Development of a fluid therapy plan to correct life-threatening abnormalities and patient monitoring during treatment play an important role in patient outcome.

Aims: To examine the clinical signs, laboratory and radiographic findings, surgical technique, ureterolith composition, and post-operative outcomes in dogs managed surgically for ureterolithiasis to determine whether surgical removal of ureteroliths in dogs resulted in a positive clinical outcome., Methods: The medical record database of a university veterinary hospital in Pennsylvania, USA, was searched for dogs that underwent surgery to remove obstructive ureteral calculi between 1990 and 2003. Records were reviewed for signalment, clinical history and examination findings, radiographic and laboratory test results, surgical technique, and ureterolith analysis. Follow-up information was obtained from telephone interviews with owners or referring veterinarians, or by reviewing the medical record of subsequent hospital visits., Results: Sixteen dogs were included in this study; ten were neutered females, two intact females and four castrated males. Abdominal radiography revealed ureteral calculi in 14/16 dogs, renal calculi in 8/16, cystic calculi in 8/16, urethral calculi in 1/16, renomegaly in 6/16 and renal mineralisation in 5/16. Ureterolith type included struvite in six dogs, calcium oxalate in five, calcium phosphate in one, and a mix of struvite, calcium phosphate and calcium oxalate in another. Compared to dogs with non-struvite ureteroliths, those with struvite ureteroliths had a higher pre-operative white blood cell (WBC) count (25.6, SD 7 vs 17.6, SD 6 x 103 cells/mul; p=0.046), and were more likely to have a purulent discharge from the ureteral incision noted at the time of surgery (p=0.015). Following discharge, 14/16 dogs were re-evaluated. Median survival time was 904 days (range 2-1,876). Two dogs required additional surgery on the urinary tract. Four dogs died or were euthanised because of azotaemia and clinical signs related to the urinary system or non-specific signs of illness (vomiting, lethargy) at 8, 90, 333 and 904 days post-operatively., Conclusions: Surgical management of ureteroliths was successful and resulted in good long-term survival in the majority of dogs examined in this small study population. Similar proportions of calcium oxalate and struvite ureteroliths were identified., Clinical Relevance: The use of the ureteral surgery may increase as the frequency of diagnosis of ureteroliths in dogs increases.

Fifty-seven cases of feline pemphigus foliaceus were identified from biopsy specimens submitted to University of Pennsylvania School of Veterinary Medicine's Laboratory of Pathology and Toxicology by veterinary dermatologists from 1991 to 2002. Age at onset ranged from less than 1 year to 17 years; median 5 years. Eighty per cent of cats were reported to have been pruritic. At the time of biopsy, the distribution of lesions varied, but included some combination of face/head, paws, dorsum or ventrum and consisted of crusts, erosions, scale and alopecia. The histological features of 208 biopsy specimens were reviewed and included the following. Acantholytic cells were found in large numbers in both intact and degenerating pustules in most cases. Mast cells were found in the dermal infiltrate more often than reported previously. Seventeen cases were receiving corticosteroids at the time of biopsy; reducing the percentage of diagnostic biopsies per case. Forty-four cases were followed for 1-54 months (median 9 months). Triamcinolone was more successful at inducing remission without significant adverse effects than prednisone or prednisone in combination with chlorambucil. Only 4/44 cats died from their disease or therapy during the study period.

Objective: To determine ultrasonographic findings in cats with clinical, gross pathologic, and histologic evidence of acute pancreatic necrosis., Design: Retrospective study., Animals: 20 cats., Procedure: Ultrasound reports and permanent ultrasonographic images were reviewed, and ultrasonographic findings were recorded. Thoracic and abdominal radiographs were also reviewed, when available. Anatomic localization of pancreatic necrosis was determined from the gross pathology report; duration and severity of pancreatic necrosis were determined by reviewing histologic specimens. The presence of concurrent disease was recorded from the final pathology report., Results: The pancreas was considered ultrasonographically normal in 10 cats and was not observed in 3. Ultrasonographic findings were considered compatible with pancreatitis in the remaining 7 cats. Gross pathologic findings indicated that pancreatitis was multifocal in all 7 of these cats; histologically, pancreatitis was acute or subacute in 5 and associated with severe or moderate necrosis in 6. In the remaining 13 cats, gross pathologic findings indicated that pancreatitis was multifocal (n = 8) or focal (2), or gross pathologic findings were normal (3). Histologically, pancreatitis was peracute or acute in 11 of these 13 cats and associated with severe or moderate necrosis in 8. Thoracic and abdominal radiographic findings were nonspecific., Conclusions and Clinical Relevance: Results of ultrasonography were consistent with a diagnosis of pancreatitis in only 7 of 20 cats with acute pancreatic necrosis in the present study. This suggests that new diagnostic criteria must be established if abdominal ultrasonography is to be an effective tool in the diagnosis of pancreatitis in cats.

Objective: To compare results of surgical versus nonsurgical treatment of spontaneous pneumothorax in dogs., Design: Retrospective study., Animals: 64 dogs with pneumothorax without any history of antecedent trauma., Procedure: Information on signalment, thoracic radiographic findings, treatment, histologic findings, and outcome was obtained from the medical records. Signalment of affected dogs was compared with signalment of a control population of 260 dogs examined by the emergency service for reasons other than pneumothorax during the study period., Results: Siberian Huskies were overrepresented in the case population, compared with the control population of dogs examined by the emergency service for other reasons. Twenty-eight dogs were treated without surgery (ie, thoracocentesis or tube thoracostomy with or without cage rest), and 36 were treated with surgery. Information regarding final outcome was available for 33 dogs treated with surgery (median follow-up time, 485 days) and 15 dogs treated without surgery (median follow-up time, 366 days). Dogs that underwent surgery had significantly lower recurrence (1/30) and mortality (4/33) rates, compared with dogs treated without surgery (6/12 and 8/15, respectively). A definitive diagnosis was obtained for 38 dogs, including 34 of 36 dogs undergoing surgery; 26 had bullous emphysema and 4 had neoplasia. Two dogs developed spontaneous pneumothorax secondary to migration of plant foreign bodies., Conclusions and Clinical Relevance: Results suggest that recurrence and mortality rates for dogs with spontaneous pneumothorax managed surgically were significantly lower than rates for dogs managed by nonsurgical means alone. Early surgical intervention is recommended for definitive diagnosis and treatment of dogs with spontaneous pneumothorax.

A retrospective study was performed on eight dogs, one cat, and one ferret with ruptured ureters secondary to blunt trauma. The most common physical examination findings were abdominal distension/discomfort (in five of 10 animals) and gross hematuria (in five of six animals). Multiple organ injury was also common (in seven of 10 animals). Loss of retroperitoneal and peritoneal detail was the most common radiographic finding (in four of six animals). Ureteronephrectomy was the most common surgical procedure (performed in five out of seven procedures). Three of the five cases discharged were available for follow-up and have had no evidence of associated problems.

Objective: To determine the incidence and prognostic significance of low plasma ionized calcium concentration in cats with clinical signs of acute pancreatitis (AP)., Design: Retrospective study., Animals: 46 cats with AP and 92 control cats with nonpancreatic diseases., Procedure: Medical records were reviewed, and results of clinicopathologic testing, including plasma ionized and total calcium concentrations, acid-base values, and electrolyte concentrations, were recorded. Cats with AP were grouped on the basis of outcome (survived vs died or were euthanatized), and plasma ionized calcium concentrations, acid-base values, and electrolyte concentrations were compared between groups., Results: Serum total calcium concentration was low in 19 (41%) cats with AP, and plasma ionized calcium concentration was low in 28 (61%). Cats with AP had a significantly lower median plasma ionized calcium concentration (1.07 mmol/L) than did control cats (1.12 mmol/L). Nineteen (41%) cats with AP died or were euthanatized; these cats had a significantly lower median plasma ionized calcium concentration (1.00 mmol/L) than did cats that survived (1.12 mmol/L). Ten of the 13 cats with AP that had plasma ionized calcium concentrations < or = 1.00 mmol/L died or were euthanatized., Conclusions and Clinical Relevance: Results suggest that low plasma ionized calcium concentration is common in cats with AP and is associated with a poorer outcome. A grave prognosis and aggressive medical treatment are warranted for cats with AP that have a plasma ionized calcium concentration < or = 1.00 mmol/L.

Alpha-mannosidosis is a disease caused by the deficient activity of alpha-mannosidase, a lysosomal hydrolase involved in the degradation of glycoproteins. The disease is characterized by the accumulation of mannose-rich oligosaccharides within lysosomes. The purpose of this study was to characterize the peripheral nervous system (PNS) and central nervous system (CNS) myelin abnormalities in cats from a breeding colony with a uniform mutation in the gene encoding alpha-mannosidase. Three affected cats and 3 normal cats from 2 litters were examined weekly from 4 to 18 wk of age. Progressively worsening neurological signs developed in affected cats that included tremors, loss of balance, and nystagmus. In the PNS, affected cats showed slow motor nerve conduction velocity and increased F-wave latency. Single nerve fiber teasing revealed significant demyelination/remyelination in affected cats. Mean G-ratios of nerves showed a significant increase in affected cats compared to normal cats. Magnetic resonance imaging of the CNS revealed diffuse white matter signal abnormalities throughout the brain of affected cats. Quantitative magnetization transfer imaging showed a 8%-16% decrease in the magnetization transfer ratio in brain white matter of affected cats compared to normal cats, consistent with myelin abnormalities. Histology confirmed myelin loss throughout the cerebrum and cerebellum. Thus, histology, electrodiagnostic testing, and magnetic resonance imaging identified significant myelination abnormalities in both the PNS and CNS that have not been described previously in alpha-mannosidosis.

Objective: To determine whether hyperglycemia is associated with head trauma in dogs and cats and whether the degree of hyperglycemia corresponds to severity of neurologic injury or outcome., Design: Retrospective study., Animals: 52 dogs and 70 cats with head trauma and 122 age- and species-matched control dogs and cats., Procedure: Severity of head trauma was classified as mild, moderate, or severe. Blood glucose concentrations recorded within 1 hour after admission were compared between case and control animals and among groups when case animals were grouped on the basis of severity of head trauma or outcome., Results: Blood glucose concentration was significantly associated with severity of head trauma in dogs and cats and was significantly higher in dogs and cats with head trauma than in the control animals. However, blood glucose concentration was not associated with outcome., Conclusions and Clinical Relevance: Results suggest that dogs and cats with head trauma may have hyperglycemia and that degree of hyperglycemia was associated with severity of head trauma. However, degree of hyperglycemia was not associated with outcome for dogs and cats with head trauma. Because hyperglycemia can potentiate neurologic injury, iatrogenic hyperglycemia should be avoided in patients with head trauma.

An 11-year-old 3.0-kg (6.6-lb) neutered male Persian was referred for renal transplantation. Serum total calcium concentration was slightly high prior to surgery, but the week after surgery, total and ionized calcium concentrations were extremely high, and a small mass was palpable on the right side of the trachea at the level of the thyroid and parathyroid glands. Exploratory surgery of the ventral aspect of the neck was performed, and a right external parathyroid mass was removed. One hour after surgery, the serum ionized calcium concentration was within reference limits, and the serum calcium concentration remained normal for the next 14 months without any specific treatment. The gross and histologic appearance of the mass, combined with the rapid decrease in serum calcium concentration following its removal, confirmed that the mass was a functional parathyroid adenoma. Although a common postoperative complication in people, hypercalcemia following renal transplantation appears to be a rare complication in cats. Surgery should be considered if the condition is a result of a parathyroid adenoma.

Objective: To compare clinical characteristics and laboratory findings of dogs with eclampsia with those of dogs without eclampsia., Design: Retrospective study., Animals: 31 dogs with eclampsia (affected) and 31 with dystocia (controls)., Procedure: Information on signalment, type of diet, reproductive history, litter size, time from whelping to eclampsia, body weight, clinical signs, results of physical examination and hematologic and biochemical analyses, response to calcium supplementation, and recurrence was obtained from the medical records of all dogs with eclampsia evaluated between 1995 and 1998 and compared with information from medical records of 31 of 102 dogs with dystocia evaluated during the same period., Results: Dogs with eclampsia weighed less, had a smaller body weight-to-litter size ratio, higher rectal temperature and heart and respiratory rates, and lower plasma total solids concentration than control dogs. Ionized calcium concentration was < or = 0.8 mmol/L for all but 1 of the affected dogs; median concentration for the affected dogs was significantly less than that for control dogs. Six (19%) dogs did not manifest typical clinical signs associated with eclampsia. Twelve (39%) dogs with eclampsia had previous litters; none had a history of eclampsia. Affected dogs were discharged from the hospital within hours after admission, but 3 dogs returned 1 to 3 weeks later because of recurrence of eclampsia., Conclusions and Clinical Relevance: Eclampsia develops primarily in small-breed dogs with large litters. Plasma ionized calcium concentrations > 0.8 mmol/L in dogs with clinical signs typical of hypocalcemia may indicate that other causes of clinical signs should be considered. In addition, some dogs with eclampsia may have low ionized calcium concentrations and not manifest typical clinical signs.

The initial management and stabilization of the emergency surgical patient is challenging. A consistent systematic evaluation of the four major body systems, determination of the underlying cause, and aggressive stabilization before surgery can optimize the outcome.

Objective: To review clinical findings and clinical course for cats exposed to smoke in residential fires and to determine clinical variables that may have prognostic importance., Design: Retrospective study., Animals: 22 cats admitted to our veterinary teaching hospital between 1986 and 1997 with a history of smoke exposure during a residential fire., Procedure: Medical records were reviewed for history, clinical signs, physical examination findings, changes in respiratory tract signs, initial hematologic analysis, treatment, results of thoracic radiography, and outcome., Results: Fifteen of 22 (68%) cats were categorized in the uncomplicated group, 5 (23%) in the complicated group, and 2 (9%) were discharged after a short period because of financial considerations. Twenty (91%) cats survived, but 2 (9%) were euthanatized because of severe respiratory compromise or neurologic changes. Predominant thoracic radiographic changes were diffuse interstitial pattern (6 cats) and focal alveolar pattern (5). The majority (8/13) of cats that were stable or had improved by the day after admission had an uncomplicated clinical course while hospitalized, whereas cats that were worse on the day after admission tended to have a complicated clinical course., Conclusions and Clinical Relevance: Cats that survive a residential fire and are admitted to a hospital have a good chance to be discharged. Cats that do not have signs of respiratory tract dysfunction at admission probably will not develop severe respiratory complications. For cats with signs of respiratory dysfunction at admission, better prognostic information will be determined by monitoring progression of the respiratory condition on the day after admission.