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

Objective: To compare the clinical decision-support performance of 2 large language models (LLMs), ChatGPT-5 and ChatGPT-5 Thinking, with that of experienced clinicians and novices in veterinary theriogenology.

Methods: 15 standardized obstetric and gynecologic scenarios were independently evaluated by 2 expert clinicians, 2 novice veterinarians, and both LLMs under matched, cold-start conditions. Responses were assessed with a 5-point global quality score by a blinded expert panel.

Results: ChatGPT-5 Thinking achieved the highest overall quality ratings, followed by ChatGPT-5 and the expert clinicians. Novice veterinarians received the lowest scores. Responses generated by LLM were generally more consistent and complete than those of human readers.

Conclusions: Within the constraints of a simulated scenario design, LLMs, particularly ChatGPT-5 Thinking, provided clinically appropriate guidance that exceeded novice performance and approached that of expert clinicians. These findings support the potential role of LLMs as adjunct decision-support tools in time-sensitive obstetric and gynecologic cases.

Clinical relevance: LLMs may assist clinicians and trainees in managing reproductive emergencies by offering rapid, structured, guideline-aligned recommendations. Further evaluation in real clinical settings is warranted.

Objective: To compare the signalment of dogs with dilated cardiomyopathy (DCM) eating hydrolyzed and nonhydrolyzed protein diets, and to characterize clinical data and echocardiographic indices of dogs with DCM eating hydrolyzed protein diets.

Methods: Medical records of dogs diagnosed with DCM between May 2018 and October 2023 were retrospectively reviewed. Clinical data were compared between dogs eating hydrolyzed and nonhydrolyzed protein diets. For the latter group, presence of arrhythmias or congestive heart failure, whether diet was changed, and echocardiographic measurements were recorded.

Results: From 2,222 dogs diagnosed with DCM, 2,105 dogs met the study's inclusion criteria. Twenty-eight of 2,105 dogs (1.3%) were eating hydrolyzed protein diets. The most common breeds were pit bull-type breed (n = 6), English Bulldog (4), and Doberman Pinscher (4). Seventeen of 28 dogs (60.7%) had arrhythmias, and 17 of 28 dogs (60.7%) had congestive heart failure. There were no significant differences in age, sex, or body weight between the 2 diet groups. Five of 28 dogs eating hydrolyzed protein diets had follow-up echocardiograms and changed diet. In these 5 dogs, there was a significant reduction in left atrial-to-aortic ratio (from median 1.24 to 1.09; effect size, 0.64) and normalized left ventricular internal dimension at end systole (from median 1.41 to 1.25; effect size, 0.64) at the follow-up examination.

Conclusions: In a large population of dogs with DCM, 1.3% were eating hydrolyzed protein diets prior to diagnosis; only a small number had follow-up echocardiograms.

Clinical relevance: The role of hydrolyzed protein diets in DCM is unclear but warrants further investigation.

Objective: To describe ocular abnormalities of pet and sanctuary-housed domestic pigs presented to an academic veterinary hospital.

Methods: Electronic medical records at the Cornell University Hospital for Animals were searched for pigs having undergone a complete ophthalmic examination by a Diplomate of the American College of Veterinary Ophthalmologists between 2011 and 2024. Signalment, examination findings, diagnoses, and treatments were reviewed.

Results: 36 domestic pigs of a variety of breeds were represented, including Vietnamese pot-bellied (22 of 36), American Miniature (4 of 36), Yorkshire (2 of 36), Berkshire (1 of 36), mixed breed (2 of 36), and unknown breeds (5 of 36). Most ocular abnormalities were adnexal with the following abnormalities diagnosed: excessive periocular fat ("fat blindness"; 8 of 36), corneal ulceration (8 of 36), blepharitis/periocular dermatitis (7 of 36), conjunctivitis (7 of 36), entropion (3 of 36), and eyelid neoplasia (melanoma; 1 of 36). Cataracts were diagnosed in 2 (3 eyes) of 36 pigs.

Conclusions: A wide range of ocular disease impacted pet and sanctuary-housed pigs. Vision-threatening ophthalmic disease appeared to be rare, aside from functional blindness associated with excessive periocular fat.

Clinical relevance: This study provided veterinarians with new information on the ophthalmic diseases that affect pigs as well as approaches to treatment.

Objective: To compare short- and long-term clinical outcomes in dogs with extrahepatic biliary duct obstruction (EHBO) managed medically, with endoscopic retrograde cholangiography (ERC)-assisted biliary stenting, or with surgical biliary decompression.

Methods: Medical records from 28 client-owned dogs diagnosed with EHBO and treated at a single veterinary referral center between 2012 and 2019 were reviewed retrospectively as part of an observational study. Inclusion criteria included common bile duct dilation (> 3 mm) and clinicopathologic evidence of biliary obstruction. Dogs were grouped based on treatment modality: medical management, ERC (ERC-assisted biliary stenting), or surgery. Outcomes included survival to discharge, median survival time, and complications.

Results: 28 dogs were included: 10 medically managed, 12 treated with ERC-assisted biliary stenting, and 6 treated surgically. Survival to discharge was 100% (medical), 92% (ERC), and 33% (surgical). Median survival time was not reached in medical or ERC groups; the surgical group had a median survival time of 4 days. Endoscopic retrograde cholangiography achieved technical success in 86% of cases and had a lower complication rate than surgery. Most dogs managed medically experienced spontaneous resolution of EHBO with supportive care. Pancreatitis as the cause of EHBO was associated with not surviving to discharge.

Conclusions: Medical management and ERC-assisted biliary stenting were associated with improved short- and long-term survival rates and fewer complications compared to surgical intervention. Surgical intervention was associated with the highest mortality and complication rates.

Clinical relevance: ERC-assisted biliary stenting and medical management may provide safer alternatives for similar etiologies to surgery for dogs with EHBO, particularly in facilities with interventional endoscopic capabilities. In many cases, supportive care alone may lead to spontaneous resolution of EHBO.

Objective: To evaluate functional outcome and owner satisfaction of chondrodysplastic dog breeds undergoing full limb amputation.

Methods: Medical records from 4 academic institutions were reviewed for chondrodysplastic dog breeds that underwent limb amputation from March 2015 to April 2024. Data collected included signalment, reason for amputation, day of return to ambulation with or without assistance, and comorbidities. Owner satisfaction was investigated via a nonvalidated questionnaire. Continuous data were analyzed for normal distribution and expressed as means if normally distributed and medians if nonnormally distributed. Categorial data were reported as frequencies, and comparisons between groups were performed with the Fisher exact test.

Results: At the time of discharge, 19 of 28 dogs (68%) were walking unassisted, 8 of 28 (29%) were walking with assistance, and 1 of 28 (4%) was unable to walk. Eighty-seven percent (13 of 15) of dogs that underwent a thoracic limb amputation were able to ambulate without assistance at the time of discharge, while only 46% (6 of 13) of dogs in the pelvic limb group were able to do so. Over the course of the postoperative period, 25 of 28 dogs (89%) were independently ambulatory. Overall, 18 of 28 owners (64%) completed the satisfaction questionnaire, and 13 of 18 (72%) were very satisfied with the outcome.

Conclusions: The majority of chondrodysplastic dog breeds did well following amputation and achieved the ability to ambulate independently. Furthermore, dog owners reported high levels of satisfaction following this procedure.

Clinical relevance: This information may help dog owners make informed decisions when considering a limb amputation for a chondrodysplastic dog.

Objective: To demonstrate how to perform a venipuncture technique in small mammals using the proximal jugular vein, which may be useful when working with zoological companion and laboratory animals.

Animals: Proximal jugular venipuncture can be performed in a variety of small mammal species.

Methods: Heavy sedation or anesthesia is required. The patient is placed in dorsal recumbency and the skin disinfected. A small-gauge needle (typically, a 27-gauge needle or smaller is sufficient) on a 1- to 3-mL syringe is inserted 90° to the skin immediately cranial to where the clavicle inserts onto the manubrium. In species with small clavicles (eg, guinea pigs), the needle is inserted where the first rib connects to the manubrium. The needle is inserted to a depth of approximately 1 cm and slowly retracted with negative pressure. When a flash of blood appears in the hub, the needle is maintained at that depth by stabilizing the barrel. If the blood flow stops, the needle is gently inserted or retracted until it resumes. Pressure is held at the site after needle retraction.

Results: Proximal jugular venipuncture is performed with the immobilized patient in dorsal recumbency and utilizes palpable landmarks. Holding the needle at the successful depth by stabilizing the syringe barrel is key for blood collection, and it is important to hold pressure at the site after collection to prevent hematoma formation.

Clinical relevance: Proximal jugular venipuncture is an option for collecting diagnostically useful volumes of blood in several small mammal species and provides palpable landmarks for needle placement while avoiding the need to utilize small peripheral veins or needle insertion into the thoracic cavity (eg, cranial vena cava venipuncture).

Objective: To describe the clinical features of urinary tract infections in pet rabbits, identify the bacterial species involved and their antimicrobial susceptibility profiles, and investigate risk factors.

Methods: In this retrospective multicentric observational study, data were retrieved from the medical records of 3 veterinary centers located in the Greater Paris region, France, between 2009 and 2025. Inclusion criteria consisted of all rabbits presented for consultation in which a urine culture had been carried out. Signalment and clinical data were analyzed for statistical associations with urine culture results (positive vs negative). Antimicrobial susceptibility profiles were retrieved.

Results: 79 rabbits underwent urine bacterial culture. Overall, 34.2% (27 of 79) of rabbits had a positive urine culture, of which 59.3% (16 of 27) were female and 84.6% (22 of 26) had urinary sludge, 9.1% (2 of 22) urolithiasis, 33.3% (8 of 24) consistent ultrasonographic signs of pyelonephritis, and 71.4% (15 of 21) bacteria on urine microscopic examination. Most urine samples were collected by cystocentesis (94.8% [73 of 77]). The presence of bacteria on urine microscopic examination was the only statistically significant parameter associated with urinary tract infection, with a sensitivity of 71% (95% CI, 60% to 82%) and specificity of 90% (95% CI, 82% to 98%) when compared to culture results. In 74.1% (20 of 27) of cases, a single species of bacteria was isolated, with a total of 36 different isolates. The most common bacteria were Escherichia coli (27.8% [10 of 36]), Enterococcus faecalis (19.4% [7 of 36]), and Staphylococcus spp (11.1% [4 of 36]). Resistance was reported for azithromycin (66.2% [15 of 20]), penicillin (57.9% [13 of 19]), sulfonamides-trimethoprim (31.4% [11 of 35]), enrofloxacin (17.9% [5 of 28]), and ceftiofur (17.1% [6 of 35]). Overall, 52.8% (19 of 36) of bacteria were multidrug resistant.

Conclusions: Frequent resistance to empirically used antibiotics was observed. As no risk factors could be identified, larger-scale studies are needed.

Clinical relevance: Bacterial isolation is common, and urine culture should be encouraged to adjust therapy in accordance with antimicrobial stewardship practices.

Objective: To compare blood parameters from samples collected by venipuncture versus a push-pull technique from a peripheral IV catheter (PIVC).

Methods: This prospective nonrandomized clinical study included dogs that required hospitalization with IV fluid therapy. Dogs were prospectively enrolled if they met the study criteria and owner consent was obtained. To be included, dogs had to weigh ≥ 10 kg and require hospitalization with IV fluid therapy. Exclusion criteria included confirmed or suspected coagulopathy or clinically relevant anemia (Hct < 0.30 L/L) or thrombocytopenia (platelet concentration < 100 X 109/L). At the time of hospitalization, paired blood samples were collected via venous venipuncture and with the use of a push-pull technique with a freshly placed 20-gauge, 1.1 X 30-mm PIVC. Blood samples were submitted for CBC and biochemistry profiles. Samples were again collected after a minimum of 24 hours of hospitalization, with IV fluids and medications administered through the PIVC.

Results: 70 dogs were included, with 33 completing both time points. The venipuncture and PIVC methods had an overall positive correlation at both the T0 and T24 time points. Statistically significant, but not clinically relevant, differences were noted for several parameters. Leukogram indices were more likely to have discordant results. Despite observed differences, all blood indices with PIVC collection fell well within acceptable variation for clinical decision-making.

Conclusions: This push-pull PIVC sampling protocol is an effective and clinically appropriate method of blood collection in hospitalized dogs.

Clinical relevance: This protocol may be used to reduce venipuncture in hospitalized dogs.

Porcine reproductive and respiratory syndrome virus negatively impacts pig health and well-being, the mental health and emotional well-being of animal caretakers, and producer economics. In response, a vision of "A World Without PRRS" has been cast, calling for elimination of porcine reproductive and respiratory syndrome virus from the US swine herd. This Viewpoint provided an opinion regarding the road map to success and identified essential tactics.