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

Objective: Borzoi reportedly experience sudden death. The objective of this study was to report ECG intervals, amplitudes, and frequency of ECG abnormalities in clinically healthy Borzoi.

Methods: 98 clinically healthy Borzoi were prospectively recruited and underwent echocardiogram, ECG, and cardiac troponin I testing between October 2020 and December 2022. Standard ECG measurements were obtained. Early repolarization notches and slurs were recorded.

Results: Of 82 Borzoi with a structurally normal echocardiogram, ventricular arrhythmias were documented in 8 (10%) dogs, all of which had normal cardiac troponin I concentrations. Median P wave duration was 55 milliseconds (range, 45 to 70 milliseconds). Median PR interval was 125 milliseconds (range, 80 to 175 milliseconds). Thirty-one (38%) Borzoi had first-degree atrioventricular block (PR interval > 130 milliseconds). Median QRS duration was 65 milliseconds (range, 48 to 90 milliseconds). Median QT interval was 235 milliseconds (range, 185 to 275 milliseconds). Twenty-nine (35%) and 15 (18%) of 82 Borzoi had QT intervals > 240 or > 250 milliseconds, respectively. Sixty-seven of 82 (82%) Borzoi had early repolarization notches or slurs. Seventeen of 82 (21%) Borzoi had an abnormality of the ST segment, most commonly convexity/doming. Convexity of the ST segment was intermittent (n = 9) or persistent (4).

Conclusions: Ventricular arrhythmias, early repolarization, prolonged QT intervals, and ST segment abnormalities are not infrequent in clinically healthy Borzoi. P, PR, and QRS durations are commonly prolonged compared to general canine reference intervals.

Clinical relevance: Future study into heritable channelopathies in Borzoi is warranted given the frequency of ventricular arrhythmias, repolarization abnormalities, and sudden death in the breed. Breed-specific ECG reference intervals are needed.

Objective: To determine whether urea nitrogen and creatinine levels differ in lacrimal fluid (LF) and serum (SER) in nonazotemic (control) and azotemic dogs and whether there is an agreement between LF and SER.

Methods: A prospective observational study was performed at the Auburn University Small Animal Teaching Hospital between May 2023 and March 2024. Forty control and 38 azotemic dogs were enrolled. Twenty microliters of LF per eye was collected with microcapillary tubes, and 3 mL of blood was drawn. Bland-Altman plot and intraclass correlation coefficient (ICC) were used to evaluate the agreement between LF and SER.

Results: There was good agreement between LF and SER levels of urea nitrogen in the control group (Bland-Altman plot mean bias of -0.8108 ± 2.407 mg/dL; ICC of 0.874 [95% CI, 0.773 to 0.934]) and the azotemic group (Bland-Altman plot mean bias of -9.681 ± 23.89 mg/dL; ICC of 0.82 [95% CI, 0.658 to 0.906]). There was poor agreement between LF and SER concentrations for creatinine in the control and azotemic groups, with only 26 dogs with creatinine detectable in LF.

Conclusions: Lacrimal fluid and SER concentrations of urea nitrogen showed good agreement in both the control and azotemic groups, whereas poor agreement was found for creatinine in both groups.

Clinical relevance: Measurement of urea nitrogen in LF may provide an alternative to blood for diagnosing uremia. However, additional research is necessary before substituting LF for SER.

Objective: To describe and evaluate the use of preoperative percutaneous ultrasound-guided anchor wire placement to aid intraoperative localization of superficial foreign bodies and abscesses in dogs.

Animals: 11 dogs.

Clinical presentation: In a retrospective observational study, the medical records of dogs that underwent surgical exploration of superficial abscesses, guided by anchor wire, between 2018 and 2023 were reviewed for clinical and histopathological findings and complications. Owners or veterinarians were contacted to collect long-term follow-up information.

Results: 11 dogs were included. Superficial swelling was the most common clinical presentation. Computed tomography and ultrasound revealed an abscess cavity and suspected foreign body in 9 dogs and an abscess cavity without evidence of a foreign body in 2 dogs. Anchor wires were placed in close proximity to the foreign body or inside the abscess. All documented foreign bodies were successfully located and retrieved. Two dogs suffered minor postoperative complications. No major intra- or postoperative complications were documented. One dog displayed recurrence of clinical signs, but no further surgical management was required.

Clinical relevance: Preoperative percutaneous placement of an anchor wire via ultrasound guidance was successful in aiding intraoperative localization of nonpalpable abscesses and retrieval of foreign bodies. This technique may decrease surgical time, minimize the surgical approach required, and increase the likelihood of successful localization.

Objective: To assess the perioperative analgesic effects of bilateral ultrasound (US)-guided quadratus lumborum block (QLB) using low-volume (LV) or high-volume (HV) bupivacaine, compared to a control group, in cats undergoing ovariectomy.

Animals: 48 healthy female cats.

Methods: Cats were sedated with IM dexmedetomidine (5 µg/kg), ketamine (1 mg/kg), and methadone (0.2 mg/kg) followed by IV propofol induction and isoflurane maintenance. Cats were randomly assigned to 3 groups of 16 patients each: QLB-LV group (0.3 mL/kg/side), QLB-HV group (0.5 mL/kg/side), and control group (no QLB). Bilateral, in-plane, US-guided QLB was performed with lateral approach at the L2 transverse process with bupivacaine 0.2%. Physiological variables were recorded intraoperatively by a masked investigator. If intraoperative nociception occurred, fentanyl (1 µg/kg) was administered IV. Rescue postoperative analgesia (buprenorphine, 0.2 mg/kg) was administered in case of a Feline Grimace Scale score ≥ 4 after a 4-hour evaluation period.

Results: In the control group, heart rate (HR) was higher than the QLB-LV group during the first ovarian manipulation (P < .001) and higher than the QLB-HV group during both ovarian manipulations (P < .001 and P = .006). The need for intraoperative rescue analgesia and postoperative pain scores were significantly higher in the QLB-LV (P = .005 and P = .047) and control (P < .001 and P < .001) groups compared to the QLB-HV group. Buprenorphine was administered once in the control group. No clinical signs of bupivacaine toxicity or QLB complications were observed.

Clinical relevance: Bilateral US-guided QLB-HV may effectively provide perioperative analgesia in feline patients undergoing ovariectomy.

Objective: To describe the treatment of subcutaneous lipomas in the horse.

Animals: 3 horses.

Clinical presentation: The horses were aged 1 to 2 years old, with lipoma of the abdomen, prepuce, and tarsus.

Results: All cases had surgical removal of the masses under general anesthesia. Recurrence of an invasive abdominal lipoma occurred in case 1 at the exit site of a passive drain. The recurrence was treated unsuccessfully with injectable cisplatin, and a second revision surgery with the use of an active drain resulted in resolution. In case 2, complete resection of an encapsulated lipoma of the lateral prepuce was successful with no recurrence. In case 3, incomplete resection of a tarsal lipoma resulted in a sound horse, with no further growth. Histopathologic analysis revealed that all masses were composed of well-differentiated adipocytes with no evidence of malignancy.

Clinical relevance: Subcutaneous lipomas are relatively rare and affect horses primarily ≤ 2 years of age. They are benign, although their presence can be deleterious due to invasion of local structures or the impact on normal locomotion. The margins of invasive tumors are difficult to identify due to their integration with normal tissue. Incomplete removal may allow for mass recurrence. Active suctions drains are beneficial if dead space is a concern.

Objective: The objective of this demonstration was to describe and simulate a surgical technique for removing subepiglottic cysts in horses via an oral approach under endoscopic guidance using a cadaver model for simulation and clinical data. The technique aims to provide a minimally invasive method for the removal of these cysts.

Animals: 2 clinical case images from the Washington State University Teaching Hospital were used in the video. In a third horse euthanized for reasons unrelated to the study, the procedure was simulated after the head was frozen and transected transversally.

Methods: Files from 2 horses were reviewed, and the relevant parts were selected. The horse head was set on a stand, and a simulated cyst was implanted under the mucosa, made of the fingertip from a glove filled with carboxymethyl cellulose gel, and sutured. The procedure was performed by one of the authors (CAR) and recorded. A bronchoesophageal grasping forceps and cautery snare were used to simulate a clinical situation in dorsal recumbency.

Results: The cyst was successfully removed as in the real procedure, and the demonstration was recorded for educational use. The review of the videos shows that the simulated procedure is also achievable in a real clinical environment.

Clinical relevance: This technique provides a minimally invasive method for the removal of subepiglottic cysts in horses. The demonstration of this procedure is crucial for the training of surgeons, as it allows the visualization of the procedure in a controlled setting, free from the complications of real clinical situations.