Javma-journal of The American Veterinary Medical Association最新文献

Objective: To evaluate plasma and synovial fluid amikacin concentrations following cephalic or saphenous IV regional limb perfusion (IVRLP) with a dosing protocol of 25 mg of amikacin/kg, divided into 16.7 mg/kg systemically and 8.3 mg/kg regionally. We hypothesized that plasma amikacin concentrations observed at 30 minutes after systemic administration would exceed a therapeutic target of 53 μg/mL and that synovial fluid concentrations would exceed a therapeutic target of 80 μg/mL.

Methods: Over a 5-month period (spring/summer of 2023), 8 healthy neonatal foals were administered each protocol at least 48 hours apart. Synovial fluid was obtained 30 minutes after IVRLP. The systemic amikacin dose was administered at the time of tourniquet release (30 minutes), and plasma samples were obtained over a 24-hour period.

Results: The observed synovial fluid and plasma amikacin concentrations were not different between protocols, so a single least square means estimate was predicted for each sample type, at each time point. The amikacin concentration estimate in synovial fluid was 238.5 μg/mL (95% CI, 146.1 to 330.9) 30 minutes after IVRLP and in plasma was 66.3 μg/mL (95% CI, 57.5 to 75.1) 30 minutes after administration of the systemic dose. Some foals did not reach the synovial fluid therapeutic target in all joints studied.

Conclusions: These results support our hypotheses and suggest that administering amikacin systemically and via IVRLP as described can achieve therapeutic plasma and synovial fluid concentrations in neonatal foals.

Clinical relevance: Concurrent systemic and IVRLP administration of amikacin as described can be clinically effective in the treatment of sepsis with concurrent septic arthritis in neonatal foals.

The American College of Veterinary Radiology (ACVR) and the European College of Veterinary Diagnostic Imaging (ECVDI) recognize the transformative potential of AI in veterinary diagnostic imaging and radiation oncology. This position statement outlines the guiding principles for the ethical development and integration of AI technologies to ensure patient safety and clinical effectiveness. Artificial intelligence systems must adhere to good machine learning practices, emphasizing transparency, error reporting, and the involvement of clinical experts throughout development. These tools should also include robust mechanisms for secure patient data handling and postimplementation monitoring. The position highlights the critical importance of maintaining a veterinarian in the loop, preferably a board-certified radiologist or radiation oncologist, to interpret AI outputs and safeguard diagnostic quality. Currently, no commercially available AI products for veterinary diagnostic imaging meet the required standards for transparency, validation, or safety. The ACVR and ECVDI advocate for rigorous peer-reviewed research, unbiased third-party evaluations, and interdisciplinary collaboration to establish evidence-based benchmarks for AI applications. Additionally, the statement calls for enhanced education on AI for veterinary professionals, from foundational training in curricula to continuing education for practitioners. Veterinarians are encouraged to disclose AI usage to pet owners and provide alternative diagnostic options as needed. Regulatory bodies should establish guidelines to prevent misuse and protect the profession and patients. The ACVR and ECVDI stress the need for a cautious, informed approach to AI adoption, ensuring these technologies augment, rather than compromise, veterinary care.

Objective: To survey the commonality of needle-changing practices among veterinarians and measure whether 1 or 2 passages through a vaccine vial septum affects needle sharpness.

Methods: An anonymous online survey of needle-changing behaviors by veterinary professionals was conducted from April to May 2023. Subsequently, a blinded randomized controlled bench trial assessed the impact of septum passage on needle sharpness between June and August 2023 at Midwestern University. Veterinary hypodermic needles of 3 brands and 4 gauges were tested after passing through a septum 0, 1, or 2 times. The primary outcome was the peak penetration force (PF) required to puncture standardized material. Secondary analysis involved visual examination of needles with the use of an optical 3-D surface roughness measurement instrument.

Results: Of 482 survey respondents, 76% routinely changed needles due to concerns about dulling. Experimental results showed a minor increase in PF after 1 (9%) and 2 (18%) septum passages. Needle gauge and brand impacted PF more than septum passage, with differences of 6% to 58% and 9% to 10%, respectively. Visual inspection revealed a 40% incidence of gross defects after 1 passage and 52% after 2 passages, with PF through the vial septum being the strongest damage predictor.

Conclusions: While septum passage slightly increased the PF, brand and gauge had a more substantial impact.

Clinical relevance: This study suggests that changing needles may not be necessary for maintaining sharpness if proper technique is used, potentially reducing the risk of needlestick injuries and medical waste.

Objective: To assess heart rate variability (HRV) as a marker of autonomic nervous system disruption and its role in disease progression in dogs with Chagas disease (CD), and to evaluate arrhythmias and conduction abnormalities in symptomatic and asymptomatic groups.

Methods: A prospective observational study was conducted on dogs treated at a small animal hospital in central Texas from August to December 2023. Ambulatory 24-hour Holter monitoring was conducted to assess HRV metrics (proportion of pairs of successive NN intervals differing by > 50 milliseconds and root mean square of the successive differences), arrhythmias, and conduction abnormalities. Heart rate variability parameters were categorized as high, normal, or low. Dogs were classified as symptomatic or asymptomatic on the basis of clinical presentation, and comparisons of HRV and ECG findings between groups were performed.

Results: 112 client-owned dogs with confirmed Trypanosoma cruzi infection were included. Of the 112 dogs, 46 (41.1%) were symptomatic and 66 (58.9%) were asymptomatic. Heart rate variability disruptions were observed in 63% of dogs, underscoring early and widespread autonomic dysregulation in T cruzi infection. Symptomatic dogs had more arrhythmias (1.54 vs 1.02) and a higher prevalence of second-degree atrioventricular blocks (0.19 vs 0.03), but HRV abnormalities were similar between groups.

Conclusions: Heart rate variability abnormalities were prominent across all dogs with CD, regardless of symptoms, suggesting their utility as early markers of autonomic and cardiac dysfunction. These findings highlight HRV's potential for monitoring disease progression, particularly in asymptomatic dogs, supporting its inclusion in routine assessments for T cruzi infections.

Clinical relevance: Heart rate variability analysis may enhance early detection and management of CD, an emerging One Health issue, by addressing underdiagnosed autonomic and cardiac dysfunction in dogs.

The past 20 years have observed the emergence of an enigmatic and deadly disease in dogs referred to as gallbladder mucocele formation. The disease has been the subject of over 100 PubMed-indexed publications, yet only a single review of the topic has been published approximately 10 years ago. The aim of the current review was to provide a practical overview of the current literature of and, in some cases, the authors' experience in the diagnosis and management of gallbladder mucocele formation in dogs. Key takeaways were that gallbladder mucocele formation is caused by secretion of abnormal mucus by the gallbladder epithelium and has a predilection for older, small-sized purebred dogs. These dogs are often concurrently diagnosed with hypothyroidism, hyperadrenocorticism, hyperlipidemia, and proteinuria. Diagnosis is reliant on ultrasonographic features demonstrating the presence of non-gravity-dependent mucus that is adherent to the walls of the gallbladder and encroaching into the lumen. The definitive treatment for mucocele formation is cholecystectomy, which carries a significant short-term mortality but good long-term prognosis.

Objective: To quantify the behavior problems and prescription of psychoactive medications in dogs seen at primary care veterinary hospitals.

Methods: Medical records of canine patients in a nationwide network of primary care veterinary hospitals in the US obtained between January 1, 2010, and December 31, 2020, were retrospectively analyzed. Information retrieved included prescription of clomipramine, fluoxetine, or trazodone; patient signalment; and common behavior problem labels (aggression, separation anxiety, and fear or anxiety unrelated to separation anxiety). Associations between behavior problem labels and drug prescriptions were assessed with Pearson χ2 tests.

Results: A total of 32,468,046 canine medical records were retrieved. The overall prescription percentage was 0.03% for clomipramine, 0.02% for fluoxetine, and 1.33% for trazodone during the study period. Prescription of trazodone started in 2013, with a sharp increase after 2015. The frequency of behavior problem labels increased 10-fold from 1.0% in 2010 to 10.2% in 2020, with an overall frequency of 5%. Among dogs with behavior problem labels, 0.15% were prescribed clomipramine, 0.14% were prescribed fluoxetine, and 8.4% were prescribed trazodone. Notably, about 70% of dogs receiving psychoactive drugs had no associated behavior problem labels used in the study.

Conclusions: Frequencies of behavior problem labels and prescriptions in primary care settings were both low, with notable variations among psychoactive drugs. Furthermore, about 70% of cases prescribed psychoactive medications lacked target behavior problem labels.

Clinical relevance: These findings highlight a critical need to bridge the knowledge gap between identifying behavior problems and effectively addressing them in behavioral practice within primary care veterinary settings.

Fluorescent bead-based multiplex assays (multiplex assays) for serological detection of antibodies in patient samples have been used in veterinary diagnostics for a little over a decade. These quantitative assays offer several advantages compared to classical serological assays, like a lower limit of detection, less background, and a broader linear quantification range, all of which improve test accuracy. The simultaneous multiplex analysis of a patient's serological response to several specific antigens also improves the diagnostic result interpretation. This influences treatment and management decisions and often allows for a quantitative follow-up as treatment response evaluation. In this review article, we discuss examples of 3 diagnostic multiplex assays for antibody detection in veterinary patients: the Lyme Multiplex assay, the Canine Brucella Multiplex assay, and the Equine Herpesvirus Type-1 Risk Evaluation assay. In addition, multiplex assays for immune response markers, like soluble cytokines, chemokines, or other inflammatory proteins, have recently become available. Currently, these assays are mainly used as clinical research tools to broadly evaluate immune activation and/or inflammation during a variety of infectious and noninfectious diseases. Quantitative cytokine and inflammatory marker multiplex assays have the potential to identify sensitive immune biomarkers for maintaining health and performance in veterinary animals.

Objective: To clinically and histopathologically characterize the laryngeal mass commonly referred to as vocal fold granuloma in brachycephalic dogs and to evaluate treatment responses and follow-up outcomes.

Animals: 13 brachycephalic dogs were included (8 French Bulldogs, 2 Bulldogs, 1 Pug, 1 Boston Terrier, and 1 Cavalier King Charles Spaniel).

Clinical presentation: Brachycephalic dogs diagnosed with a vocal fold mass during endoscopic laryngeal examination were retrospectively included.

Results: 11 dogs were referred for consultation of brachycephalic obstructive airway syndrome (BOAS). All dogs exhibited clinical signs of upper respiratory obstruction, and 7 had gastrointestinal symptoms. Twelve dogs underwent surgical resection of vocal fold masses with BOAS surgery. Histopathological evaluation revealed exophytic granulation tissue associated with ulceration and inflammation, as well as varying degrees of mucosal hyperplasia. Postoperative treatment included glucocorticoids and antibiotics. One dog with unilateral laryngeal paresis experienced a recurrence of clinical signs 6 months postoperatively and required a second surgical resection. The median follow-up duration for all 13 dogs was 499 days (range, 95 to 1,708 days). No further recurrence was observed during the follow-up period.

Clinical relevance: Laryngeal masses in various brachycephalic breeds, referred to as vocal fold granulomas, consisted of granulation tissue rather than true granulomas. Surgical intervention, including conventional BOAS surgery and excision of granulation tissue, combined with anti-inflammatory treatment appeared essential for establishing a diagnosis and addressing underlying causes.

Objective: To compare the use of intraoperative urethrocystoscopy with postoperative retrograde positive-contrast urethrocystography in male dogs undergoing open cystotomy for urolithiasis and evaluate the efficacy of urethrocystoscopy as an alternative for assessing complete urolith removal.

Methods: This retrospective matched case-control study included 54 male dogs that underwent open cystotomy for urolithiasis between January 2018 and July 2024. Intraoperative urethrocystoscopy was performed in 18 dogs (case group), while postoperative contrast urethrocystography was used in 36 dogs (control group). Completeness of urolith removal and time durations for the 2 techniques were compared.

Results: Both intraoperative urethrocystoscopy and postoperative contrast urethrocystography confirmed complete urolith removal in all dogs. However, 1 control dog presented 50 days postoperatively with a urethral obstruction caused by a retained urolith missed during postoperative imaging. Intraoperative urethrocystoscopy was faster (median, 5.5 minutes; range, 3 to 19 minutes) compared to postoperative imaging (median, 25 minutes; range, 10 to 55 minutes). Intraoperative urethrocystoscopy detected a residual urolith along the urethra in 1 dog, avoiding the need for urethrotomy. No postoperative urethral obstructions occurred in the case group during the follow-up period (median, 374 days; range, 67 to 1,664 days).

Conclusions: Intraoperative urethrocystoscopy was a safe, efficient, and reliable method for confirming complete urolith removal in male dogs undergoing open cystotomy. This technique reduced anesthesia time, avoided additional surgical procedures, and enhanced visualization of the urinary tract.

Clinical relevance: Intraoperative urethrocystoscopy offered a practical and efficient alternative to postoperative contrast imaging for assessing complete urolith removal in male dogs undergoing cystotomy, reducing anesthesia time and potentially decreasing the risk of retained uroliths. Appropriate equipment and training are required to safely perform this technique and minimize the risk of complications.