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Objective To describe clinically significant thromboembolism as the result of idiopathic hypereosinophilic syndrome (HES) in a dog. Case Summary A 3-year-old neutered female Boxer was evaluated for 2-week history of progressive respiratory difficulty and hemoptysis. A brief thoracic ultrasound performed shortly after presentation identified a presumed thrombus within the left atrium. Initial blood work revealed a marked eosinophilia 6.8 × 109/L (6.8 × 103/μL; reference interval, 0.1–2.1 × 109/L [0.1–2.1 × 103/μL]) and evidence of organ dysfunction. Within 24 hours of admission the patient developed acute paraparesis with absent femoral pulses and was euthanized. Necropsy findings included marked infiltration of multiple organs with large numbers of histologically normal eosinophils and numerous thrombi including a large aortic thrombus. This combination of findings resulted in a final diagnosis of HES with associated thromboembolism. New or Unique Information Provided Thromboembolism occurs relatively commonly in people with HES. While there are a few case reports of HES in the veterinary literature, this is the first to describe thromboembolism as a manifestation of this disease in a canine patient.

Objective To describe an entire litter of kittens with severe hyperlipidemia and subsequent successful, low-cost treatment that included high protein enteral support and parasite control. Previous case studies of similarly affected kittens have focused on a genetic etiology and on advanced interventions. The role of negative energy balance and additional factors influencing hyperlipidemia, as well as treatment and prognosis are discussed. Case Summary Three of 6 kittens died or were euthanized due to severe clinical signs attributable to multiorgan failure associated with subacute hyperlipidemia. The remaining 3 kittens, although subclinical, were found to have similar biochemical abnormalities, including severe anemia and hypertriglyceridemia. Flea treatment and weaning with assisted enteral support prevented the worsening of clinical signs and returned biochemical parameters to within reference intervals. Unique Information Provided Transient hyperlipidemia in kittens has been previously reported and successfully treated with administration of oxygen, blood transfusion, and diet change; these treatment recommendations may not always be financially feasible, resulting in euthanasia of affected kittens. In contrast, this report describes a successful, low-cost, outpatient approach of flea control, weaning, and introduction of a high protein enteral diet. It also highlights the importance of screening and treating seemingly unaffected littermates, provides new, previously unreported biochemical and histopathology findings, and proposes that negative energy balance is a significant factor in the development of transient hyperlipidemia in kittens.

Objective – To report the surgical repair, case management, and outcome of a dog with sepsis and severe intraabdominal trauma secondary to a penetrating stick injury. Case or Series Summary – A 1.5-year-old, spayed female, mixed-breed dog was presented to the emergency service after incurring a small laceration on the medial aspect of the left pelvic limb while running in the woods. The wound was surgically explored and a primary closure achieved. The patient was discharged the same day with oral antimicrobial therapy. The following morning the dog was represented to the emergency service for acute vomiting. Abdominal radiographs were performed and demonstrated loss of serosal detail and pneumoperitoneum. An emergency celiotomy was performed and revealed distal colonic perforation, left ureteral laceration, and lacerations of the left common iliac vein. Ureteronephrectomy, as well as primary closure of the distal colonic perforation and left common iliac vein lacerations, were performed. The patient recovered and was ultimately discharged from the hospital 5 days later. Follow-up 1 year later revealed no significant physical exam or biochemical abnormalities. New or Unique Information Provided – A seemingly benign penetrating stick injury initially deemed to be superficial in nature was later demonstrated to have resulted in sepsis following severe intraabdominal trauma that included lacerations of the distal colon, left ureter, and left common iliac vein in a dog. Successful surgical management and intensive care led to a full recovery without any residual impairment noted a year later.

Objective – To determine the incidence rate and prognostic significance of ionized hypocalcemia (iHCa) among septic dogs. Design – Retrospective study Setting – Veterinary teaching hospital Animals – Fifty-eight septic dogs that were presented to Cornell University Hospital for Animals between January 2006 and December 2007. Procedure – Cases were diagnosed with sepsis if they exhibited 2 or more criteria of the systemic inflammatory response syndrome with a concurrent documented infectious focus. Cases were excluded if diagnosed with a concurrent illness reportedly associated with calcium derangements. Lowest, mean, and highest blood ionized calcium concentrations were recorded and statistically analyzed for an association with morbidity, as measured by duration of hospitalization and number of blood product transfusions, and outcome. In addition, the incidence rate of iHCa was recorded. Results – Of the 58 cases included in this study, iHCa was documented in 4 of 6 (67%) patients that died, 5 of 19 (26%) euthanized patients and 5 of 33 (15%) patients that survived to discharge, with an overall incidence of 24%. Dogs that died during hospitalization had more severe iHCa than patients that were discharged or euthanized as well as significantly lower mean ionized calcium concentrations than patients who were discharged. Severity of iHCa was also associated with a longer duration of hospitalization. The highest ionized calcium concentration was not associated with outcome. Conclusion and Clinical Relevance – This study is the first to document the incidence of iHCa among septic dogs. Because both low mean ionized calcium and the lowest documented ionized calcium concentration are associated with poor outcome, it is likely that both the severity and duration of hypocalcemia are important in these patients. Further prospective studies investigating the prognostic significance, etiology and treatment of iHCa among septic veterinary patients are needed to better understand its role in sepsis.

To describe clinically significant thromboembolism as the result of idiopathic hypereosinophilic syndrome (HES) in a dog.A 3-year-old neutered female Boxer was evaluated for 2-week history of progressive respiratory difficulty and hemoptysis. A brief thoracic ultrasound performed shortly after presentation identified a presumed thrombus within the left atrium. Initial blood work revealed a marked eosinophilia 6.8 × 10Thromboembolism occurs relatively commonly in people with HES. While there are a few case reports of HES in the veterinary literature, this is the first to describe thromboembolism as a manifestation of this disease in a canine patient.

Objective: To report a case of pyothorax in a critically ill canine neonat. Case Summary: A12-day old, female boxer puppy was presented for lethargy, fever and respiratory distress. Pleural ceffusion was apparent on thoracic radiography. Thoracentesis and subsequent cytology and bacteriologic culture of the Pleural effusion, confirmed a diagnosis of pyothorax. Clinical management of pyothorax in critically ill 12-day- old puppy is decribed New or Unique information provided: Pyothorax can occur in the caine neonate.J Vet Emerg crit care 2001;11(2): 147–152)

High-fidelity human patient simulators have been used for decades in medical education to provide opportunities for students to practice technical skills, diagnostic and therapeutic planning, and communication skills in a safe environment. A high-fidelity canine patient simulator (CPS) was developed using components from a human patient simulator and a low-fidelity foam core canine mannequin. Ninety-six veterinary students participated in cardiopulmonary arrest scenarios in groups of three to five students. Afterwards, participants were asked to complete an anonymous online survey describing their experiences. A total of 70 students (73%) completed the survey. All of the students (100%) felt that the simulator session expanded their cardiopulmonary resuscitation (CPR) knowledge base, and 97% responded that their skills and abilities had improved. Students also expressed positive opinions about the CPS, with 89% agreeing or strongly agreeing that the CPS was realistic and 73% agreeing or strongly agreeing that the scenarios generated emotions similar to real clinical situations. Most participants (98.5%) agreed or strongly agreed that the simulator was an engaging learning experience. Students commonly commented that the simulations allowed them to practice communication and teamwork skills and were more effective than paper-based, problem-oriented learning opportunities and lecture. Students also commented that they wanted more opportunities to participate in simulation exercises. These results suggest that high-fidelity veterinary simulation is an engaging educational methodology that addresses some limitations of other forms of problem-based learning. More studies are needed to quantitatively determine the effectiveness of this novel veterinary educational technology in comparison with more traditional approaches.

The purpose of this study was to determine the effect of different amounts of dietary fat on colonic cell proliferation and fecal bile acid concentrations. Thirty-nine male Sprague-Dawley rats were randomly assigned to three diets (13 rats per diet) containing 5, 10 and 20 g butter/100 g diet. Diets were fed for 3 wk. As fat intake increased, total fecal fat excretion remained constant. When dietary fat was decreased from 20 to 10 g/100 g diet, total fecal bile acid concentrations tended to increase 14.5%. However, a further reduction to 5 g butter/100 g diet significantly decreased fecal total bile acid concentration by 48% from the concentration in feces of rats fed 10 g butter/100 g diet. The concentration of deoxycholate (considered a highly promotive bile acid) was not reduced unless the amount of fat in the diet was reduced to 5 g/100 g. Labeling index was used as an intermediate marker for colon carcinogenesis. For deoxycholate, a decrease of fat intake to 5 g/100 g diet decreased the cecal labeling index relative to those of rats fed 10 or 20 g butter/100 g diet. These data indicate that decreasing the dietary fat from 20 to 10 g/100 g does not decrease fecal bile acid concentration or colonic cell proliferation, but some effects are seen in rats fed 5 g butter/100 g diet.

To describe the pathologic consequences of parenteral nutrition (PN) extravasation into the mediastinum of a cat.An 8-year-old domestic short hair cat with persistent vomiting and anorexia was initiated on PN for nutritional support. PN was being administered at a rate of 12.9 mL/h when inadvertent jugular catheter migration resulted in thrombophlebitis and cellulitis and 40-80 mL of PN extravasated into the SC and mediastinal tissues. The cat was euthanized 36 hours after the extravasation of PN due to poor prognosis related to the gastric complications associated with a presumed primary gastrinoma. Grossly there was excessive mediastinal lymphatic drainage and pronounced edema in the cervical SC and mediastinal tissue. Histopathologic examination of the PN-extravasated area revealed a severe mixed inflammatory reaction, represented by a severe neutrophilic and mild histiocytic infiltrate with lymphoplasmacytic perivascular cuffing. No bacterial agents were observed or cultured from this area.This is the first case report of a foreign body-type reaction due to extravasation of PN (extravasation injury) in a cat. Extravasation of PN is not without pathologic consequence, and can result in a severe inflammatory reaction in affected tissues.

To report the surgical repair, case management, and outcome of a dog with sepsis and severe intraabdominal trauma secondary to a penetrating stick injury.A 1.5-year-old, spayed female, mixed-breed dog was presented to the emergency service after incurring a small laceration on the medial aspect of the left pelvic limb while running in the woods. The wound was surgically explored and a primary closure achieved. The patient was discharged the same day with oral antimicrobial therapy. The following morning the dog was represented to the emergency service for acute vomiting. Abdominal radiographs were performed and demonstrated loss of serosal detail and pneumoperitoneum. An emergency celiotomy was performed and revealed distal colonic perforation, left ureteral laceration, and lacerations of the left common iliac vein. Ureteronephrectomy, as well as primary closure of the distal colonic perforation and left common iliac vein lacerations, were performed. The patient recovered and was ultimately discharged from the hospital 5 days later. Follow-up 1 year later revealed no significant physical exam or biochemical abnormalities.A seemingly benign penetrating stick injury initially deemed to be superficial in nature was later demonstrated to have resulted in sepsis following severe intraabdominal trauma that included lacerations of the distal colon, left ureter, and left common iliac vein in a dog. Successful surgical management and intensive care led to a full recovery without any residual impairment noted a year later.

To determine the incidence rate and prognostic significance of ionized hypocalcemia (iHCa) among septic dogs.Retrospective study.Veterinary teaching hospital.Fifty-eight septic dogs that were presented to Cornell University Hospital for Animals between January 2006 and December 2007.Cases were diagnosed with sepsis if they exhibited 2 or more criteria of the systemic inflammatory response syndrome with a concurrent documented infectious focus. Cases were excluded if diagnosed with a concurrent illness reportedly associated with calcium derangements. Lowest, mean, and highest blood ionized calcium concentrations were recorded and statistically analyzed for an association with morbidity, as measured by duration of hospitalization and number of blood product transfusions, and outcome. In addition, the incidence rate of iHCa was recorded.Of the 58 cases included in this study, iHCa was documented in 4 of 6 (67%) patients that died, 5 of 19 (26%) euthanized patients and 5 of 33 (15%) patients that survived to discharge, with an overall incidence of 24%. Dogs that died during hospitalization had more severe iHCa than patients that were discharged or euthanized as well as significantly lower mean ionized calcium concentrations than patients who were discharged. Severity of iHCa was also associated with a longer duration of hospitalization. The highest ionized calcium concentration was not associated with outcome.This study is the first to document the incidence of iHCa among septic dogs. Because both low mean ionized calcium and the lowest documented ionized calcium concentration are associated with poor outcome, it is likely that both the severity and duration of hypocalcemia are important in these patients. Further prospective studies investigating the prognostic significance, etiology and treatment of iHCa among septic veterinary patients are needed to better understand its role in sepsis.

The mechanism by which calcium may protect against colon carcinogenesis was studied in rats fed three levels of calcium (0.5, 1.0 and 1.5 g/100 g diet) and a high butter diet (20 g/100 g). Results were compared with values obtained using a low butter diet (5 g/100 g) supplemented with 0.5 g Ca/100 g diet. Concentration and relative proportions of individual fecal bile acids were determined by gas chromatography, and in vivo colonic cell proliferation was assessed using [3H]thymidine. Total fecal output and total fecal lipids increased as dietary calcium increased. When calcium supplementation remained at 0.5%, raising the level of fat in the diet increased the fecal concentrations of deoxycholate, omega-muricholate and total bile acids. However, when the level of fat supplementation remained constant at 20 g/100 g diet, but dietary calcium was 1.0 or 1.5 g/100 g, the concentration of these bile acids returned to the level found in feces of rats fed the low fat diet. Despite the significant decrease in the concentrations of certain fecal bile acids with increasing calcium supplementation, these differences were not reflected in substantive changes in epithelial cytokinetics. These data show that in rats fed high butter diets, 1.0% calcium is sufficient to lower total bile acid concentration and the concentrations of certain individual bile acids to those found in feces of rats fed low fat diets. Despite the significant effects of calcium on bile acid concentrations, minimal effects were observed on indices of colonic cell proliferation.