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

Objective: To evaluate the prevalence of acute kidney injury (AKI) in dogs with gastric dilatation and volvulus (GDV), identify risk factors associated with AKI diagnosed at presentation or that developed in hospital, and evaluate the association between AKI and selected nonrenal risk factors and mortality before discharge.

Methods: Medical records of 106 dogs that underwent surgical correction of GDV between January 2013 and September 2023 were retrospectively reviewed. Dogs were categorized as presenting with or developing AKI in hospital, according to International Renal Interest Society criteria. Univariate and multivariate logistic regression were used to evaluate the association between selected risk factors and AKI or mortality.

Results: In total, 20 of 106 dogs (18.9%) had AKI, with 18 of 106 dogs (17.0%) presenting with it. Sixteen dogs (15.1%) did not survive to discharge, of which 8 and 9 had AKI on presentation and at any time point, respectively. Dogs with AKI on presentation (OR, 7.90) or at any time point (OR, 9.23) had greater odds of not surviving to discharge. On multivariate analysis, preoperative lactate (OR, 1.13 for every 0.5 mmol/L higher) was significantly associated with presenting with AKI, and lowest mean arterial blood pressure during anesthesia (OR, 0.42 for every 10 mm Hg higher) and hetastarch infusion (OR, 4.00) were significantly associated with mortality.

Conclusions: AKI, lowest mean arterial blood pressure during anesthesia, and hetastarch administration were associated with mortality in dogs with GDV.

Clinical relevance: Careful assessment of kidney function is recommended in dogs with GDV, as concurrent AKI is common and associated with outcome.

Canine atopic dermatitis (cAD) provides opportunities to study spectrum of care (SOC) because it is a common, chronic, nonfatal disease often requiring owner-performed multimodal therapy. Canine atopic dermatitis's lifelong nature allows for investigation into SOC factors including financial limitations, client and patient compliance, owner and patient quality of life, and access to veterinarians. Literature addressing financial burden and compliance for cAD treatment is extremely limited. Research on quality of life of patients and owners with cAD has improved our understanding of owner perspectives. This article highlights SOC veterinary and medical research shaping cAD care and encourageds further investigation of this topic.

Objective: To compare the nature and frequency of complications between French Bulldogs (FBDs) and Miniature Dachshunds (MDs) with thoracolumbar or lumbar intervertebral disk extrusion (IVDE).

Methods: This retrospective, single-center study included dogs diagnosed with thoracolumbar or lumbar IVDE between January 1, 2019, and December 31, 2023, with complete medical records. Dogs with a confirmed history of previous IVDE were excluded. Perioperative complications, length of hospitalization, and total cost of care were documented and compared between the 2 breeds.

Results: A total of 379 patients (211 FBDs, 168 MDs) were included in the study. Complications occurred in 50.2% (106 of 211) of FBDs and 13.1% (22 of 168) of MDs. Diarrhea was the most common complication for both breeds. Regurgitation and urinary tract infection commonly occurred in FBDs. Brachycephalic obstructive airway syndrome was only recorded in FBDs. Progressive myelomalacia was diagnosed in 3 FBDs and 4 MDs postoperatively. Corneal ulceration, surgical site infection, seroma, and aspiration pneumonia were rare complications reported in FBDs only. The median length of hospitalization was 5 days for both breeds. The median total cost of care was higher for FBDs.

Conclusions: Significant differences were found in the types and frequency of complications between FBDs and MDs.

Clinical relevance: This study highlighted both shared and breed-specific perioperative complications in 2 popular breeds commonly affected by IVDE and the related differences in cost of care. These findings support the importance of breed-specific preoperative counseling and perioperative planning, particularly for FBDs, in which more complications and higher costs were found.

Objective: To evaluate the immediate influence of iopromide, a nonionic iodinated contrast medium for IV use, on urinalysis in dogs undergoing CT scanning, including urine specific gravity (USG), urine dipstick parameters, urinary sediment, and urinary protein-to-creatinine ratio (UPCR).

Methods: This prospective, 1-group pretest, post-test experimental study included 30 client-owned dogs undergoing CT between May 1 and July 31, 2024. Cystocentesis samples were collected immediately before and within 30 minutes after IV iodinated contrast medium (IVIC) administration and analyzed by the same laboratory.

Results: Following IVIC administration, median USG increased significantly from 1.046 (95% CI, 1.032 to 1.052) to 1.058 (95% CI, 1.044 to 1.068) and median urine pH increased significantly from 6.25 (range, 5 to 9) to 7 (range, 5 to 9). No significant changes were observed in other urine dipstick parameters, urinary sediment, or UPCR after IVIC administration.

Conclusions: Our study suggests that IV iopromide transiently alters USG and pH in dogs, whereas other urinalysis parameters remain unaffected. Clinicians can rely on most urinalysis parameters, particularly proteinuria and sediment, to guide immediate clinical decisions.

Clinical relevance: These findings provide practical guidance for accurate interpretation of urinalysis in dogs undergoing CT with contrast media. If USG or pH are critical for patient management, urinalysis should be performed before or on a different day than contrast administration.

Pancreatitis is the most frequently diagnosed disorder of the exocrine pancreas in dogs, yet its etiology remains poorly understood. Early and frequently cited studies suggest an association between high dietary fat and onset of pancreatitis, leading to the long-standing recommendation to restrict dietary fat in affected dogs. However, these studies are limited by the use of experimental models, small sample sizes, variable diagnostic methods, failure to isolate fat-specific effects, and the use of diets that do not reflect current formulations. Anecdote also suggests that dogs can relapse or have persistently elevated pancreatic lipase concentrations despite strict adherence to a low- or ultralow-fat diet, indicating that fat restriction may not be the key to prevention of pancreatitis in all cases. In recent years, a small but growing body of work has revisited the relationship between dietary fat and pancreatitis. These studies have generally failed to confirm a consistent or straightforward association between dietary fat content and disease onset. This narrative review summarized the current literature on the role of dietary fat in canine pancreatitis, identified knowledge gaps, and outlined priorities for future research to advance our knowledge of this clinically important condition.

Objective: To characterize the clinical and histologic features of a novel polyostotic osteoproliferative disease in lovebirds (Agapornis spp).

Animals: Records from select avian clinical and/or pathology diagnostic services in France, Australia, and Italy (2017 to 2024) and the US (1984 to 2024) were searched for clinical and pathological data from lovebirds with polyostotic osseous proliferations. Solitary lesions and suspect cases unconfirmed by imaging or postmortem examination were excluded. When available, fixed lesions were recut for independent histopathological re-examination by 5 veterinary pathologists to confirm consistency of diagnosis. Survival was assessed with a Kaplan-Meier curve.

Clinical presentation: 22 cases from Australia, France, and Italy met the inclusion criteria, including 14 females, 5 males, and 3 of unknown sex. The median age at diagnosis was 3.5 years (range, 2 to 9 years). Apart from occasional palpation of osseous masses on physical examination, clinical signs were nonspecific and highly variable, corresponding with lesion location.

Results: Imaging revealed several expansile lesions (with the sternum, skull, and vertebrae most often affected), while hematology and biochemistry were generally nonspecific. Lesions were confirmed to be the same disease process in all histologically examined cases and showed extensive woven bone proliferation, disrupting the normal medullary and cortical architecture of affected bones. Prognosis was guarded, with a mean survival time of 68 days. The condition was termed polyostotic osteopetrosis syndrome. The cause is unknown, although an inherited disorder is suspected.

Clinical relevance: Findings will assist clinicians in diagnosis and management of polyostotic osteopetrosis syndrome and provide foundations for further research.

Objective: To describe the demographics and treatment outcomes of horses definitively diagnosed with epithelial or stromal immune-mediated keratitis (IMMK) by use of in vivo confocal microscopy (IVCM) and/or histopathology.

Methods: Medical records of horses presented to the Cornell University Equine Hospital definitively diagnosed with epithelial or stromal IMMK with IVCM and/or histopathology between 2020 and 2024 were reviewed. Patient signalment, affected eye(s), diagnostics, treatments, and outcomes were assessed.

Results: 22 horses met the inclusion criteria. The mean age was 16.9 years (SD, ± 7.3 years). There were significantly more geldings (n = 16) than mares (6). Nineteen horses were unilaterally affected (11 right eyes and 8 left eyes) and 3 bilaterally affected. Twenty horses underwent IVCM, of which 8 had histopathology following superficial keratectomy with agreement in diagnosis. Two horses had corneal histopathology without IVCM. All horses were initially managed medically. Seven horses subsequently underwent episcleral cyclosporine implantation, of which 2 were controlled at last follow-up (median, 532 days). Standing superficial keratectomy was performed in 10 horses, with IMMK controlled in 9 of 10 horses at last follow-up (median, 692 days). Recurrence was documented in 1 horse 12 months after keratectomy.

Conclusions: IVCM allowed for a rapid noninvasive diagnosis of equine IMMK that correlated with histopathology. Standing superficial keratectomy was an effective diagnostic and therapeutic option for equine IMMK.

Clinical relevance: Standing superficial keratectomy was an effective diagnostic and treatment for equine IMMK that provided long-term control of disease and minimized the need for long-term daily medications.