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

Objective: To learn the knowledge, attitudes, and practices of veterinarians and technicians in Kansas regarding the occupational risk of tularemia, personal protection, patient diagnosis and management, zoonotic risk communication, and public health reporting.

Methods: Kansas veterinarians and technicians serving cats and dogs completed an online survey between June and September 2024.

Results: The survey was completed by 109 veterinarians and 19 technicians. Forty-three percent (47 of 109) of veterinarians reported diagnosing tularemia in cats and 13% (14 of 109) in dogs. Seven percent (8 of 109) of veterinarians reported having had tularemia. When performing procedures with a high risk of exposure, such as lancing abscesses in tularemia suspects, glove use was 100% but additional personal protective equipment was inconsistent, including eye protection (81 of 116 [70%]) and surgical face mask (69 of 116 [59%]). Antibody titer and PCR were common diagnostics, but 42% (26 of 62) of veterinarians reported never submitting a confirmatory test, with owner finances being the primary hurdle. Veterinarians and technicians have inconsistent knowledge about reporting regulations, but 91% (58 of 64) discuss tularemia's public health risk with pet owners.

Conclusions: Veterinarians are not only diagnosing tularemia in their patients but also contracting the disease themselves. Education should be targeted toward diagnostics, protection, and reporting.

Clinical relevance: Veterinary personnel play an essential One Health role in the prevention and control of tularemia in Kansas through environmental tick and wildlife management, diagnosis and treatment of sick pets, and education about transmission and protection precautions for people. Designating tularemia as reportable in animals would allow determination of disease trends and more rapid public health follow-up.

Objective: To describe the development of neurologic signs progressing to seizures in 2 dogs and 1 cat with unoperated single congenital portosystemic shunts (CPSSs) after general anesthesia for non-shunt-related surgery and no intraoperative shunt manipulation.

Animals: 2 dogs (dog 1 [a 5-year-old 7.1-kg castrated male Bichon Frise] and dog 2 [a 10-year-old 7.3-kg castrated male Bichon Frise]) and 1 cat (cat 1 [a 2-year-old 3.8-kg castrated male Ragdoll]).

Clinical presentation: Medical records from the University College Dublin Veterinary Hospital and Royal Veterinary College Queen Mother Animal Hospital were searched for dogs and cats with unoperated CPSSs that developed neurologic signs progressing to seizures after general anesthesia for non-shunt-related surgery between January 1, 2015, and June 31, 2024.

Results: 3 animals were identified. Dogs 1 and 2 both underwent cholecystectomy, whereas cat 1 underwent jejunal enterectomy. None had known preoperative seizures, although both dogs had experienced prolonged anesthetic recovery after previous surgery and the cat had a 3-day history of ataxia, walking into walls, and generalized weakness. All 3 animals developed severe neurologic signs including seizures within 48 hours postoperatively. Both dogs were euthanized before hospital discharge: dog 1 for suspected aspiration pneumonia coupled with severe neurologic signs and dog 2 for refractory neurologic signs. Cat 1 survived to hospital discharge and underwent 2 subsequent CPSS attenuation surgeries.

Clinical relevance: Postanesthetic neurologic signs can occur in animals with CPSSs without intraoperative shunt manipulation. This possible complication should be discussed with owners of animals with unoperated CPSSs that require general anesthesia for non-shunt-related surgery.

Objective: To assess pet owners' trust in veterinarians and the connection between pet owners' trust and sources of vaccine information, as well as the association with vaccination status.

Methods: A national survey was administered to 2,853 dog and 1,977 cat owners focused on vaccine behavior. Survey data were analyzed with weighted Poisson (number of sources), logit (veterinarians as primary sources), least-squares (information seeking), and linear probability (vaccination status) models.

Results: Overall, 62.9% of dog and 61.2% of cat owners were classified as trusting their veterinarians. On average, dog owners consulted 2.50 sources about vaccine information; cat owners consulted 2.27 sources. Veterinarians were the most common primary sources of information for 85.4% of dog owners with high levels of trust, but only 62.6% of dog owners with lower levels. This was the case for 83.8% and 56.3% of cat owners. Trust in veterinarians was not associated with the number of sources consulted, but those with higher levels of trust were more likely to list veterinarians as their primary sources. Those with higher levels of trusts were also more likely to seek out information on vaccines. Trust and certain types of information sources like the internet were associated with vaccination status.

Conclusions: Most pet owners trust their veterinarian, but a substantial minority do not. This has important implications for vaccination behavior. Efforts should be made to increase levels of trust.

Clinical relevance: Trust in veterinarians can serve as an important resource to increase vaccinations.

Objective: This study assessed the safety and tolerability of concurrent intra-articular (IA) injection of 2.5% polyacrylamide hydrogel (2.5% iPAAG) and betamethasone sodium phosphate and betamethasone acetate esters (BME) in the metacarpophalangeal joints (MCPJs) of healthy horses.

Methods: 10 healthy therapeutic riding horses were enrolled in this open-label safety study from August 1 to September 14, 2023. Inclusion criteria required normal physical examinations, insulin level, hematology, biochemistry, soundness at all gaits, and negative forelimb flexion tests. Screening occurred from days -14 to -0. Each horse received a single IA injection of 1 mL of 2.5% iPAAG and 1 mL of BME (6 mg/mL) into the right MCPJ on day 0. Posttreatment veterinary assessments (days 0, 1, 2, 3, 7, 14, and 30) included physical examinations, joint-specific evaluations (skin temperature, fetlock circumference at the level of the MCPJ), soundness assessments, and adverse event monitoring. Caretaker observation diaries (days 0 through 30) were also reviewed.

Results: No adverse events occurred, and all horses remained clinically sound. Joint circumference remained stable without evidence of effusion. Transient increases in skin temperature on days 2, 3, 7, and 14 correlated with ambient temperature changes, returning to baseline by day 30. Caretaker observations supported clinical findings.

Conclusions: Concurrent IA administration of 2.5% iPAAG and BME was safe and well tolerated in the right MCPJ of healthy horses, with no evidence of local or systemic adverse effects.

Clinical relevance: This therapy combines BME's short-term anti-inflammatory effects with 2.5% iPAAG's long-term synovial integration, warranting further evaluation in diseased joints.

Objective: To report cases of aural hematoma (AH) in 7 dogs and 3 cats treated with polycaprolactone (PCL) splint application.

Animals: 7 dogs and 3 cats.

Clinical presentation: 4 dogs and 2 cats presented with generalized AH, whereas 3 dogs and 1 cat presented with localized AH. All cases were investigated between December 2022 and June 2024. The hematoma area was measured to allow appropriate sizing of the PCL splint material. The surgery involved aspirating the hematoma and applying PCL splints to the auricle with sutures.

Results: The mean time of PCL splint application was 16.3 ± 4.6 days for all animals. Clinical signs were resolved in 5 dogs and 3 cats (8 of 10 AHs [80%]). Complications occurred in 3 cases. Two dogs (2 of 10 AHs [20%]) experienced recurrence at 7 and 10 days, which was suspected to be associated with the premature removal of the PCL splints; new PCL splints were applied to these dogs, and no recurrence of AH was observed upon their removal at 21 and 23 days. One dog exhibited localized wrinkling of the auricle. There were no other cases of recurrent AH during the long-term follow-up period of > 6 months.

Clinical relevance: The PCL splint application is safe and efficacious for treating AH in dogs and cats, whether localized or generalized, initial or recurrent. This simple surgical procedure minimizes iatrogenic skin trauma, and this approach may represent a valid alternative to other available treatments.

Objective: To determine the prevalence of vitamin E deficiency in horses at admission and at the time of discharge. The hypothesis was that vitamin E concentrations would decrease during hospitalization.

Methods: A prospective cohort study was performed of client-owned horses admitted as patients or companions through the emergency service at a tertiary referral center. Exclusion criteria included vitamin E supplementation. Whole blood was collected into an additive-free tube at the time of admission for all horses and at discharge if the horse was hospitalized for a minimum of 5 days. Serum vitamin E concentration was obtained with high-performance liquid chromatography. Data were analyzed with mixed-effects linear regression and the Spearman rank correlation for confounding factors.

Results: A total of 12.7% of horses were deficient at admission, including 16.5% of adults and 5.5% of foals (< 3 months old). Of horses hospitalized for a minimum of 5 days, 6.7% were deficient at the time of discharge, including 0% of foals and 10% of adults. Duration of hospitalization had no significant effect on vitamin E concentration when all patients were considered.

Conclusions: Vitamin E deficiency is prevalent in horses. Horses admitted to the hospital do not require vitamin E supplementation to maintain adequate concentrations.

Clinical relevance: Approximately 1 in 6 horses presented to the emergency service were deficient in vitamin E. Vitamin E concentrations should be measured routinely in horses and supplemented if indicated by the presence of deficiency or the patient's underlying disease pathophysiology.

Objective: To determine whether a standardized perioperative protocol for patients undergoing brachycephalic obstructive airway syndrome (BOAS) surgery reduces the incidence of regurgitation, aspiration pneumonia, and respiratory distress in the postoperative period.

Methods: The records of client-owned dogs referred to the Texas A&M University Small Animal Teaching Hospital for surgical correction of BOAS over 4 years (February 2019 to June 2023) were retrospectively reviewed. A perioperative protocol for patients undergoing surgical correction of BOAS was implemented in June 2021, which included preoperative cisapride and antacid administration, minimizing opioid use, and a slow recovery with nebulization of hypertonic saline. Patient factors, perioperative treatments administered, and complications identified in hospital were recorded and compared between pre- and postprotocol groups.

Results: The pre- and postprotocol groups included 42 and 47 dogs, respectively. A significant reduction in postoperative respiratory distress events was identified after protocol implementation (postprotocol, n = 6 [12.77%]; preprotocol, 15 [35.71%]). Postoperative regurgitation (preprotocol, n = 15 [35.71%]; postprotocol, 23 [48.94%]) and aspiration pneumonia events (preprotocol, 4 [9.52%]; postprotocol, 3 [6.38%]) did not differ significantly between groups. More dogs enrolled after protocol implementation experienced historical regurgitation prior to BOAS surgery (postprotocol, n = 31 [65.96%]; preprotocol, 18 [42.86%]).

Conclusions: Standardized protocol implementation reduced postoperative respiratory distress events, but not postoperative regurgitation nor aspiration pneumonia events, in patients undergoing BOAS surgery at our institution. Prospective studies are required to further assess these findings.

Clinical relevance: Veterinarians performing surgery in BOAS patients should consider implementation of a protocol to proactively minimize complications in the postoperative period.

Objective: This study aimed to compare the effects of intranasal (IN) and IM administration of medetomidine on cardiac size and sedation variables in cats.

Methods: This study included 14 male tabby cats, aged 1 to 3 years, with American Society of Anesthesiologists status of 1 to 2. The cats were randomly assigned to 2 groups (IN and IM; n = 7 cats/group) and received 0.08 mg/kg of medetomidine. Radiographic and anesthesia parameters were recorded at multiple time points.

Results: No significant differences were observed between the groups in terms of cardiac size, except for the ventrodorsal cardiothoracic ratio, which showed a significant increase from baseline at several time points. Heart rate, respiratory rate, rectal temperature, and systolic and diastolic blood pressure showed no significant intergroup differences. Peripheral arterial oxygen saturation was significantly lower in the IM group (90 [85 to 93]) compared to the IN group (95 [92 to 100). The onset of clinical sedation was significantly faster in the IM group (3.85 ± 1.21 minutes) than in the IN group (9.85 ± 4.98 minutes). Lateral recumbency was achieved significantly earlier in the IM group (7.28 ± 1.79 minutes) compared to the IN group (12.42 ± 4.79 minutes).

Conclusions: Both IN and IM administration of medetomidine in cats resulted in increased ventrodorsal cardiothoracic ratios compared to baseline, with no significant differences between groups for this parameter.

Clinical relevance: Both IN and IM administration of medetomidine were well tolerated and effective for sedation in cats, with comparable safety profiles.