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

Objective: The objectives were to (1) compare the impact of preoperative fluid resuscitation on anesthetic parameters and interventions and (2) assess the impact of preoperative resuscitation duration on the integrity of intestinal tissue and postoperative complications in dogs with gastrointestinal foreign body obstruction.

Methods: Medical records from 1 academic hospital were reviewed for 297 client-owned dogs that underwent gastrointestinal foreign body obstruction surgery between May 2017 and August 2022. Data collected included the following: signalment, preoperative fluid resuscitation, surgical findings, anesthetic parameters and interventions, postoperative complications, and timing of the first meal. Variables for preoperative length of fluid resuscitation (hours), total preoperative fluid bolus (mL/kg), and preoperative fluid rate (mL/kg/d) were changed to categorical variables. Associations between anesthetic interventions, postoperative outcomes, preoperative fluid resuscitation length, and total fluid bolus were assessed with ordered logistic regression.

Results: Shorter preoperative fluid resuscitation length was associated with higher anesthetic fluid rates (P = .033) and fluid boluses performed (P = .023). Increased total volume of preoperative fluid boluses was associated with anesthetic synthetic colloid use (P = .028). There was insufficient evidence to claim an association between the impact of preoperative fluid resuscitation length and intestinal wall compromise (perforation, P = .912; enterectomy performed, P = .711).

Conclusions: Shorter preoperative fluid resuscitation was associated with increased anesthetic fluid interventions but not the need for more complex surgeries.

Clinical relevance: Longer fluid resuscitation periods are associated with fewer anesthetic interventions in dogs.

Objective: To evaluate the sedation quality of an IM injection of a commercially available medetomidine-vatinoxan combination (ZEN) in healthy goats and sheep and discern species differences in cardiopulmonary parameters.

Methods: 10 apparently healthy adult university-owned research Black Bengal-crossbreed goats and 10 adult Gulf Coast native and Katahdin sheep were enrolled in this prospective experimental study from June 27 to July 27, 2023. All animals were sedated on 1 occasion with 0.06 mL of ZEN/kg, IM (0.03 mg of medetomidine/kg and 0.6 mg of vatinoxan hydrochloride/kg). Cardiopulmonary variables including heart rate, arterial blood pressure, and arterial blood gas parameters were recorded along with sedation depth and duration. Any animals still sedated after 150 minutes received 0.01 mg of atipamezole/kg.

Results: The mean ± SD of the total sedation time for sheep and goats was 102.80 ± 10.90 minutes and 133.50 ± 32.63 minutes, respectively. Profound reliable sedation was achieved in all but 1 animal. Hypoxemia was observed in sheep and goats (11 of 20 animals total). Hypotension was seen in 3 of 10 goats.

Conclusions: In sheep and goats, ZEN at 0.06 mL/kg, IM, caused profound sedation. Total sedation time was significantly longer in goats than in sheep.

Clinical relevance: In the presence of oxygen supplementation, ZEN at 0.06 mL/kg, IM, may be an acceptable sedation choice for apparently healthy Gulf Coast native and Katahdin sheep, but not goats; however, preexisting hypokalemia or pulmonary disease are contraindications for the use of ZEN in sheep.

Objective: To determine clinical outcome, treatment costs, and hospitalization duration in horses treated for keratomycosis and identify ophthalmic examination and diagnostic results associated with these outcomes.

Methods: This was a retrospective study of 126 equine keratomycosis cases between 2004 and 2020 with fungal infection confirmed on cytology, culture, and/or histopathology and a minimum of 1-month follow-up. Details of the ophthalmic examination, diagnostic test results, and treatment and cost outcomes were recorded. Outcomes of interest were analyzed by treatment type. The relationship of patient and diagnostic test variables to the outcomes of interest was determined via logistic and linear regression models.

Results: Globe retention and positive visual outcome occurred in 82.5% and 78.9% of medically and 88.4% and 85.5% of surgically treated cases, respectively. While not statistically significant, there were more positive clinical outcomes with surgery; in recent years, the globe and vision were preserved in 94.7% of cases following penetrating keratoplasty. The choice to pursue surgery was related to lesion depth. Medical treatment was associated with statistically shorter hospitalization times and lower total and hospitalization invoices compared to all surgical treatments. Diagnosis of stromal abscess was associated with higher total invoice and longer hospitalization times compared to ulcerative keratomycosis, although clinical outcomes were similar.

Conclusions: Overall positive clinical outcomes were achieved despite the severity of the disease in many cases, highlighting the need for appropriate treatment selection based on clinical presentation.

Clinical relevance: Expanding knowledge of clinical decision-making, treatment options, and associated clinical and financial outcomes may further improve outcomes for equine keratomycosis patients.

Objective: Determine the prevalence, types, and geographical distribution of oral tumors in dogs in Switzerland to provide insights into demographics, tumor characteristics, and trends.

Methods: The medical and pathology records of dogs diagnosed with oral tumors from 2012 to 2022 were sourced from diagnostic laboratories in Switzerland. The focus was on histopathologically confirmed oral neoplasms. Inflammatory, viral, and cystic lesions were excluded. Geographic trends were analyzed by use of postal addresses, revealing local distributions.

Results: Of the 948 reports, 773 cases fulfilled the study's criteria. Benign tumors constituted 63% (487 of 773), with peripheral odontogenic fibroma being the most common (77.8% [379 of 487]). Among the malignant tumors, malignant melanoma was the most frequent (38.1% [109 of 286]), followed by squamous cell carcinoma (21% [60 of 286]) and fibrosarcoma (8% [23 of 286]). The locations of tumors varied, with a higher prevalence of malignant melanoma on the lips. Histopathologic findings indicated ulceration and necrosis were more common in malignant tumors. Significant differences were noted in the mitotic index between benign and malignant groups. No tumor predisposition was noted for any breed. Oral tumors were prevalent in older dogs (median age, 9.4 years).

Conclusions: The findings highlighted the predominance of benign tumors in dogs in Switzerland, with specific histopathologic features distinguishing benign from malignant cases.

Clinical relevance: Understanding the prevalence, types, and geographic distribution of oral tumors based on the representation in dogs in Switzerland may aid in early detection, appropriate diagnostic workup, and informed treatment planning for oral tumors in dogs.

Objective: To report the incidence and characteristics of gastrointestinal ulceration lesions in dogs receiving an NSAID and/or corticosteroid.

Animals: 33 dogs.

Clinical presentation: Medical records of dogs with gastrointestinal ulceration receiving NSAIDs and/or corticosteroids within 30 days of diagnosis between January 2012 and July 2022 at multiple referral institutions were reviewed. Diagnosis was confirmed via endoscopy, surgery, or necropsy. Clinical data were collected from the medical record, including the dose and reason for administration of NSAIDs or steroids.

Results: Dogs received a single NSAID (n = 22, most commonly carprofen [9], meloxicam [4], and deracoxib [3]), 2 NSAIDs (5), a single steroid (5: prednisolone [2], prednisone [2], or dexamethasone SP [1]), or an NSAID and steroid (1). Eleven dogs receiving a single cyclooxygenase (COX)-2-sparing NSAID at an appropriate dose had ulcerations. All dogs receiving 2 NSAIDs concurrently experienced full-thickness perforation (5 of 5). The most common ulcer locations were duodenum (n = 18) and pylorus (11). Abdominal ultrasound correctly identified the site of ulceration in 5 of 24 dogs.

Clinical relevance: Dogs receiving COX-2 sparing NSAIDs at recommended doses are at risk of severe GI ulceration. Carprofen was the most common NSAID resulting in ulceration; however, it is one of the most prescribed NSAIDs. Adding another NSAID and steroid could increase this risk. Careful monitoring is crucial for dogs on NSAIDs, regardless of duration.

Objective: To describe the clinical, laboratory and ultrasonographic findings, treatment, and outcome of cattle with small intestinal incarceration (SII) through internal and external hernias.

Methods: The medical records of 85 cattle with SII admitted between January 1, 1987, and December 31, 2019, were retrospectively reviewed. The long-term outcome was determined 2 years after discharge.

Results: 85 cattle had herniation of the small intestine through congenital or acquired openings in mesentery or omentum (internal herniation; n = 60) or the abdominal wall (external herniation; 25). The most common findings were little or no feces in the rectum (77 of 85 [90.6%]), reduced or absent intestinal motility (76 of 85 [89.4%]), and hypocalcemia (36 of 44 [81.8%]). Thirteen (15.3%) cattle died or were euthanized without surgery. Of the remaining 72 (84.7%) cattle that underwent surgery, 42 survived the procedure. Overall, 52 of 85 cattle (61.2%; 95% CI, 50% to 72%) did not survive to hospital discharge and 33 (38.8%; 95% CI, 28% to 50%) were discharged alive. Of these, 11 (33.3%; 6 with and 5 without hernias closed completely) were still productive in their respective herds 2 years later.

Conclusions: The diagnosis of an incarcerated external hernia is usually straightforward, whereas internal SII necessitates laparotomy or postmortem examination for a definitive diagnosis.

Clinical relevance: Internal herniation should be part of the differential diagnosis in cattle with signs of ileus. Immediate surgical treatment is paramount in cattle with SII.

Objective: To evaluate the precision of urinary dipstick (UD) to assess protein and glucose concentrations in canine CSF samples compared to the standard methods.

Methods: Cerebrospinal fluid protein and glucose were measured in 22 samples from dogs with neurological diseases affecting the CNS using UD and biochemistry (pyrogallol red and glucose oxidase reaction, respectively). Results were converted into scores to allow comparison between methods. The proportion of divergence between methods and its CI were calculated. The sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and accuracy (Ac) of UD were determined for 2 cutoff levels of CSF protein (15 and 30 mg/dL) and glucose (40 and 100 mg/dL).

Results: The proportion of divergence between methods was 64% (95% CI, 44% to 84%) for CSF protein (representing 14 of 22 erroneous samples), of which 92.9% (13 of 14) had a UD score lower than biochemistry. For CSF glucose, 73% (16 of 22 erroneous samples; 95% CI, 54% to 91%) had divergence between methods, of which 87.5% (14 of 16) had a UD score higher than biochemistry. Urinary dipstick had better results when the cutoff level was 15 mg/dL for protein (Se, 78.9%; Sp, 66.7%; PPV, 93.7%; NPV, 33.3%; Ac, 77.3%) and 40 mg/dL for glucose (Se, 89.5%; Sp, 33.3%; PPV, 89.5%; NPV, 33.3%; Ac, 81.8%) concentrations.

Conclusions: Urinary dipstick was unreliable in estimating canine CSF protein and glucose concentrations.

Clinical relevance: The UD underestimated protein and overestimated glucose levels in the canine CSF, which could have a significant diagnostic impact and should discourage its use as a bedside test.

Objective: To report quantitative PCR (qPCR) detection of Echinococcus multilocularis DNA in fecal samples from 26 dogs in the US and Canada.

Animals: 26 dogs with fecal samples submitted for parasite screening by qPCR.

Clinical presentation: Dog signalment, presenting concern, preventive care, and outcomes were obtained from the primary veterinarian via email or telephone, where available.

Results: Echinococcus multilocularis was detected in 26 of 2,333,797 dog fecal samples by reference laboratory fecal qPCR surveillance between March 2022 and July 2024. Seventeen E multilocularis-detected samples were sequenced as European haplotypes (E3/E4). Taenia-type eggs were identified by zinc sulfate centrifugal flotation in 8 of 17 samples (47%). Dogs were from the US (n = 16) and Canada (10). Ten dogs had gastrointestinal signs (diarrhea) reported on initial presentation. Clinical history revealed that some dogs were receiving a monthly antiparasitic preventive in the 6-month period prior to sampling (n = 10) and had regular wildlife (rodent) exposure (13). Twenty-five dogs were subsequently confirmed to have received treatment with praziquantel for detected E multilocularis, and 25 of these dogs were qPCR negative 3 to 5 weeks after treatment.

Clinical relevance: Veterinary awareness of endemic risk regions for E multilocularis and its emergence in novel areas (Colorado, Nevada, Wyoming, Montana, Illinois, Washington, Idaho, Kansas, and Oregon) are key for One Health. Dogs can serve as sentinels for Echinococcus tapeworm risk, and detection of E multilocularis tapeworms in dogs through routine qPCR fecal screening can alert clinicians to zoonotic concern and common environmental exposure risk.