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

Objective: To retrospectively evaluate the use and adverse effects of oral azithromycin prescribed in guinea pigs and chinchilla patients.

Methods: The medical record database of a veterinary teaching hospital was searched from 2009 to 2025 for records of guinea pigs or chinchillas that were prescribed oral azithromycin. Data reviewed included age, weight, indicated use, azithromycin dose, treatment duration, follow-up, and potential adverse effects within 4 weeks of administration.

Results: 101 guinea pigs and 30 chinchillas were included in this study. The most common indications for treatment were otitis media in guinea pigs and dental disease in chinchillas. The median azithromycin dose was 30 mg/kg, PO, every 24 hours, in both species. Minor adverse effects occurred in 10% of guinea pigs with follow-up information available (6 of 58), with hyporexia being reported in all 6 cases. In addition, in 3 of these cases, diarrhea and weight loss were reported. One guinea pig (1 of 58) developed severe adverse effects (typhlitis) during their third course of azithromycin and was euthanized. There were no documented adverse effects of azithromycin prescribed in chinchillas within 4 weeks of administration.

Conclusions: In guinea pigs prescribed oral azithromycin, 10% (6 of 58) had minor adverse effects, while 1 guinea pig (1 of 58) developed severe adverse effects and was euthanized during their third course of azithromycin. There were no documented adverse effects of oral azithromycin prescribed to chinchillas.

Clinical relevance: Based on this retrospective study, orally administered azithromycin appears suitable for clinical use in guinea pigs and chinchillas.

Objective: To describe the surgical techniques for ureteroneocystostomy in cats with benign ureteral obstruction, evaluate and compare the clinical outcomes of various techniques, and conduct meta-analyses using previously reported modalities.

Methods: Medical records of cats that underwent ureteroneocystostomy for benign ureteral obstruction between 2018 and 2024 were reviewed. Retrieved data (4 ureteroneocystostomy techniques, complications, and survivals) were analyzed. Random-effect meta-analyses with a logit transformation were conducted using previous studies on implant placement (subcutaneous ureteral bypass or ureteral stents) and traditional surgery (ureterotomy or ureteroneocystostomy).

Results: Overall, 220 ureters in 189 cats were treated with ureteroneocystostomy. Overall outcomes for all techniques were a perioperative mortality rate of 0.5% (95% CI, 0.0% to 1.6%), uroabdomen rate of 1.1% (95% CI, 0.3% to 4.0%), reobstruction rate of 8.5% (95% CI, 4.5% to 12.4%), and urinary tract infection rate of 13.2% (95% CI, 8.3% to 18.1%). These rates were lower than or similar to those in previous implant and traditional surgery studies. The 12-month survival rate was 89.4% (95% CI, 85.0% to 93.8%). Cats classified as International Renal Interest Society chronic kidney disease stage ≥ III at 1 month postoperatively had significantly shorter survival times than lower stages. Extravesicular, 2-layer, side-to-side ureteroneocystostomy with tension-relieving techniques reduced reobstruction risk compared with the other types of ureteroneocystostomy.

Conclusions: Tailored ureteroneocystostomy and tension-relieving techniques can result in favorable long-term outcomes and low complication rates, similar to or better than those in previous implant and traditional surgery studies.

Clinical relevance: Ureteroneocystostomy is a primary surgical treatment for feline benign ureteral obstruction, particularly when combined with tension-relieving techniques and temporary ureteral catheterization.

Objective: To evaluate survival outcomes, complication rates, and prognostic factors for dogs and cats with urothelial carcinoma (UC) treated with partial cystectomy.

Methods: Medical records of client-owned dogs and cats with UC treated with partial cystectomy between January 2010 and December 2024 were retrospectively reviewed. Data regarding signalment, tumor and surgical characteristics, adjuvant therapy, and outcomes were collected. Disease-free interval and median survival time (MST) were estimated via the Kaplan-Meier method. Prognostic factors were identified with log-rank tests and Cox proportional hazards modeling.

Results: 30 animals were included (20 dogs, 10 cats). Overall MST for 27 patients was 512 days and disease-free interval was 255 days. Mean survival time was 498 days for dogs and 730 days for cats. Complete surgical margins were associated with longer MST on univariate analysis. On multivariate analysis, complete surgical margins (hazard ratio, 0.27) and adjuvant chemotherapy (hazard ratio, 0.24) were independent positive prognostic factors. Postoperative complications occurred in 16 of 30 patients (53%). Local recurrence was documented in 12 patients (40%) and distant metastasis in 5 patients (17%).

Conclusions: Partial cystectomy, as part of a multimodal treatment plan including adjuvant medical therapy, can be associated with prolonged survival in select dogs and cats with nontrigonal UC. The achievement of complete surgical margins is a critical predictor of outcome.

Clinical relevance: The procedure carries a substantial risk of complications and eventual disease progression, underscoring the importance of careful case selection and comprehensive client counseling regarding the palliative intent of therapy.

Objective: The Dog Aging Project (DAP) launched the validated owner-facing End of Life Survey (EOLS) to better understand companion dog death.

Methods: Participating owners whose dogs died between December 26, 2019, and March 24, 2021, were surveyed. Responses were reported descriptively. Student t and χ2 tests were utilized to assess differences in dog demographics among response-variable groups.

Results: Owners whose dogs died within the study period (n = 793) were invited to complete the EOLS. Response rate was 85.7% (n = 655 respondents; 29 invitees with unexpired response windows). After respondents lacking baseline DAP survey data (n = 9) were excluded, 646 EOLS responses were analyzed. Mean age at death was 13.0 ± 3.0 years. Most dogs (536 of 646 [83.0%]) experienced euthanasia rather than unassisted death, with most instances of euthanasia performed in a veterinary clinic (411 of 536 [76.7%]) or the owner's home (122 of 536 [22.8%]). Ninety-five of 646 dogs (14.7%) died without any veterinary involvement. The most common owner-perceived causes of death (CoDs) were cancer (192 of 646 [29.7%]), "old age" (190 of 646 [29.4%]), and organ system diseases (144 of 646 [22.3%]). Perimortem quality of life (QoL) was negatively associated with age at death. The most common reason for euthanasia was pain and/or suffering (260 of 536 [48.5%]), followed by poor QoL (133 of 536 [24.8%]).

Conclusions: Owner-perceived CoD varies among dogs of different ages. Owners' perceptions about canine pain and suffering, QoL, and old age influence euthanasia decisions. Future analyses will heighten veterinary professionals' understanding of these perceptions.

Clinical relevance: Understanding end-of-life factors that are important to dog owners enables veterinarians to thoughtfully educate clients and optimally care for and support aging dogs and their families.

Objective: To describe veterinary clients' view of the Value Matrix (VM) as a tool to aid veterinarian-client decision-making.

Methods: A cross-sectional online questionnaire was available between April 15 and May 15, 2025. Recruitment involved snowball sampling via social media pages with pet-owner audiences. Demographic information was collected. Participants were presented with a video demonstrating a communication tool, the VM, being used in a simulated interaction between a veterinarian and client. Participants were asked to evaluate various functions of the VM in aiding veterinarian-client decision-making and to rate its utility in various clinical contexts.

Results: In total, 204 respondents were included in the final analyses. Most participants owned more than 1 pet, were financially stable, and did not report issues with accessing or adhering to veterinary care recommendations. Participants rated the VM highly in terms of its overall utility for supporting veterinarian-client decision-making (median score, 9 out of 10). Most participants agreed or strongly agreed that the VM would improve their understanding of available options, help them understand benefits and financial costs associated with care options, and help them make informed decisions. Participants indicated the VM would be most useful for decisions involving quality of life or chronic illness or to consult with other decision-makers after an appointment.

Conclusions: The VM was viewed positively by participating veterinary clients, offering it as a potential tool to aid decision-making in veterinary practice.

Clinical relevance: The VM can be considered a communication tool to aid veterinarian-client decision-making during clinical interactions.

Objective: To describe the proposed mechanism of action of shock wave therapy and discuss treatment considerations and guidelines for use in equine and canine practice.

Animals: Client-owned animals with owner consent.

Methods: Shock wave therapy is proposed to stimulate healing by generating forces that cause cells to undergo microtrauma and release anti-inflammatory cytokines and growth factors into the treated tissues. While the 4 types of shock wave therapies are discussed, electrohydraulic and piezoelectric are described in detail, as they are most utilized in veterinary medicine for the treatment of tendon and ligament injuries, osteoarthritis, and nonunion fractures. The dose that is applied per patient is relative to the selected settings of depth, energy level, and number of pulses delivered. It is important to recognize that the highest energy deposition and greatest biological effects are seen at anatomic regions of differing tissue types such as bone and soft tissue interfaces; thus, shock wave is particularly useful at areas of enthesopathy.

Results: Because of the mechanism of action, the use of anti-inflammatory medications and/or cryotherapy around shock wave treatment times should be avoided. Additionally, because of the potent analgesic effects of shock wave for the first 48 hours after treatment, rest is recommended to prevent any further damage to the tissues. Competition rules surrounding the use of shock wave must also be followed and discussed with owners.

Clinical relevance: Shock wave therapy is an accessible and useful modality for the treatment of tendon and ligament injuries, osteoarthritis, and nonunion fractures.

Veterinary service-learning programs can address gaps in access to care while fostering ethical, culturally responsive education. This paper examines 2 long-standing initiatives at the University of Calgary Faculty of Veterinary Medicine, the Northern Community Health Rotation, and the Equine Service-Learning Initiative, which center Indigenous partner communities through sustained, reciprocal engagement and how they relate to principles of veterinary community engagement. Program evaluations demonstrate improved animal health outcomes and transformative, culturally responsive student learning.

Objective: In 2024, Cornell University's Maddie's Shelter Medicine Program, in collaboration with the College of Veterinary Medicine and the local society for the prevention of cruelty to animals (SPCA), launched a service-learning, high-volume trap-neuter-(vaccinate)-return (TNR) initiative at the request of local neighborhood residents to address a chronic community cat crisis and provide needed surgical opportunities for veterinary students. This mixed-methods study investigated the short-term impacts of the project on student surgical experiences, shelter metrics, and community perceptions of human and feline well-being.

Methods: Through observational and prospective quantitative and qualitative methods, we analyzed changes in student surgical opportunity, shelter cat metrics, and caregiver experiences before and after the 2024 project.

Results: During 2024, 147 cats underwent TNR and 48 participating students increased their on-site surgical volume by approximately 3 procedures. Qualitative feedback revealed gains in confidence and perception of professional readiness. Shelter data showed a moderate impact compared to other TNR studies; benefits included a significant reduction in unweaned kittens and a 3-fold reduction in euthanasia from the target community (OR, 3.89; 95% CI, 1.55 to 9.8). A small increase in intake from this neighborhood after intervention reflected better alignment between community needs (fewer) and access to shelter services (more). The largest impact of the project was in the community. Residents reported profound improvements in cat welfare, kitten births, and mortality. They also reported reduced fighting, injuries, and property damage and renewed trust in the local society for the prevention of cruelty to animals.

Conclusions: This mixed-methods study demonstrated that a collaborative, service-learning, large-scale TNR intervention generated meaningful benefits for the target community, the local shelter, cats, and veterinary students.

Clinical relevance: A collaborative, community-engaged, service-learning TNR model could provide sufficient surgical capacity to simultaneously expand surgical training and rapidly stabilize free-roaming cat populations in resource-limited communities.