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

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.

Objective: To measure the prevalence of antibiotic use in dogs and cats, identify the most common antibiotic drugs prescribed, and determine the most common indications for use.

Methods: Point-prevalence survey methodology was used to collect antibiotic prescribing data for cats and dogs from 1 practice day in 2021 at nonacademic primary care and referral practices in the US.

Results: 52 practices participated, comprising records for 2,599 dogs and cats. Antibiotics were prescribed to 29.2% of animals, including 24.6% prescribed antibiotics for systemic and 6.3% for topical administration. The most common systemically administered antibiotics prescribed were aminopenicillins with beta-lactamase inhibitors (29.7%), imidazoles (16.4%), first-generation cephalosporins (15.9%), and third-generation cephalosporins (12.5%). Of the 810 clinical conditions associated with antibiotic prescriptions, the majority were skin (17.0%), gastrointestinal (15.9%), surgical (12.5%), otic (8.6%), ocular (8.5%), urinary (7.8%), and respiratory (7.3%). Dogs, inpatients, and animals presenting to referral practices were more likely to receive an antibiotic prescription. For the 478 dogs and cats prescribed an antibiotic intended to treat infection, 13.4% had bacterial culture and susceptibility testing.

Conclusions: This study highlights areas for targeted antimicrobial stewardship efforts, including the limited use of bacterial culture and susceptibility testing, the frequent prescribing of third-generation cephalosporins and imidazoles, and the common use of prophylactic antibiotics for clean surgical procedures.

Clinical relevance: Measurement of antibiotic use in companion animals is critical to focus antibiotic use guideline development, highlight the need for outcomes-based research, and identify barriers to engage in antimicrobial stewardship efforts.

Objective: The aim of this study was to report the outcome and prognosis of canine patients treated medically or surgically for rectal plasmacytomas and to identify factors associated with recurrence, mortality, or progression to multiple myeloma.

Methods: The databases of 7 referral hospitals were reviewed. The Kaplan-Meier method and Cox proportional hazards analysis were used to determine the association of a range of variables with recurrence and progression-free interval for the surgically treated patients.

Results: 20 dogs were included. Nineteen cases were treated surgically, and 1 case was treated conservatively (analgesia and monitoring). Metastatic lesions were detected in 2 of 20 dogs (10%). Four of 19 dogs (21%) treated surgically developed postoperative complications, 1 major (1 of 19 [5.2%]) and 3 minor (3 of 19 [15.8%]). Tumor recurrence was identified in 6 of 19 dogs (31.5%). The 1-, 2-, and 3-year survival rates were 95%, 72%, and 66%, respectively. None of the variables tested were associated with occurrence of complications. Increased distance from the anus, incomplete surgical margins, and decreasing surgeon experience were associated with an increased risk of recurrence. No progression to multiple myeloma was seen in any of the cases.

Conclusions: Surgical treatment of rectal plasmacytomas is associated with a low major complication rate and long survival. Metastasis and recurrence rates are significantly higher than previously reported.

Clinical relevance: Conservative surgery leads to long-term survival, but recurrence is common. Future studies should focus on the benefits of adjuvant treatments.