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

Objective: To highlight clinical and clinicopathologic differences between kittens with feline infectious peritonitis-associated uveitis (FIP-AU) versus those with an otherwise similar feline undifferentiated resolving uveitis (FURU).

Methods: Clinical and clinicopathologic data were compared between 22 kittens with FURU and 8 with necropsy-confirmed FIP-AU examined between January 1, 1985, and December 31, 2022.

Results: Sex, lifestyle, seasonality, household cat numbers and systemic signs were similar in both groups. Feline undifferentiated resolving uveitis occurred predominantly in domestic-breed kittens from shelters, whereas FIP-AU was more frequent in purebred or stray cats. Duration of ocular signs before presentation was 1 to 2 weeks for FURU versus > 2 months for FIP-AU. Feline undifferentiated resolving uveitis was more commonly associated with episcleral hyperemia while FIP-AU was more commonly associated with corneal edema, dyscoria, rubeosis iridis, iridal congestion/thickening, posterior synechia, or keratic precipitates. Corneal edema and chemosis were more severe in FIP-AU. No eyes with FURU had fundic abnormalities whereas 6 of 11 eyes with FIP-AU had chorioretinitis. All kittens with FIP-AU presented bilaterally whereas 5 of 15 kittens in which FURU was ultimately bilateral, initially presented unilaterally. Hyperproteinemia, hyperglobulinemia, and hyperbilirubinemia occurred only with FIP-AU. Neither likelihood of a positive coronavirus titer nor titer magnitude differed between groups.

Conclusions: Kittens can develop bilateral fibrinous uveitis with keratic precipitates, systemic signs of illness, and serum coronavirus antibodies which resolves without sequelae following empirical treatment. Syndromic assessment-including careful fundic examination-can help differentiate FURU from FIP-AU and should precede antiviral therapy.

Clinical relevance: Resolution of uveitis during antiviral treatment does not confirm FIP. Comprehensive diagnostic evaluation is essential to avoid misdiagnosis and inappropriate treatment.

Canine osteoarthritis (OA) is a major contributor to chronic pain, mobility loss, and premature euthanasia. Although multimodal care is standard, many dogs experience incomplete relief, adverse events, or limited access to care. Radiosynoviorthesis (RSO) is a targeted IA therapy that delivers localized radiation to inflamed synovial tissue, reducing synovial effusion and alleviating joint pain. While various RSO agents have been used for over 70 years in human medicine to manage inflammatory joint disease, tin-117m (Sn-117m) is the first RSO agent adapted for veterinary use and approved for the treatment of canine OA. Sn-117m is a radionuclide emitting low-energy conversion electrons with minimal tissue penetration and, unlike systemic radiotherapeutics, Sn-117m remains confined within the joint capsule and does not form radioactive metabolites. This containment minimizes environmental contamination and limits caregiver exposure. This narrative review synthesized current evidence on the clinical use of Sn-117m RSO in dogs, addressing therapeutic efficacy and effectiveness, safety, and caregiver radiation exposure. Sn-117m offers a minimally invasive alternative to fill this treatment gap. Following a single injection for OA, prospective clinical trials report sustained improvements in objective gait analysis and caregiver-reported pain scores with benefits lasting up to 12 months. Modeled and measured radiation exposures for caregivers remain below US Nuclear Regulatory Commission limits, allowing outpatient use without isolation. This review evaluated existing data, highlighted regulatory and implementation considerations, and identified areas of potential further research. Long-term outcome tracking and expanded joint-specific data could help refine the use of RSO in human and veterinary medicine.

Objective: To test the efficacy of a novel hemostatic agent to control high-pressure, high-flow hemorrhage in a large animal model.

Methods: A randomized controlled trial was performed with 18 Holstein calves from January 2023 through January 2024. Following calf randomization, a single carotid arteriotomy incision (3 to 5 mm) was made. In the treatment group, a novel hemostatic hydrogel (TRAUMAGEL) was immediately applied at the site of hemorrhage followed by direct pressure with gauze pads. Calves in the control group received hemorrhage control with direct pressure with gauze pads only. The pads were removed and the arteriotomy site observed at 3, 9, and 19 minutes. Time to hemostasis and severity of any continued hemorrhage were compared.

Results: Calves treated with TRAUMAGEL (n = 9) had decreased time to hemostasis and less severe hemorrhage compared with control animals (9; median time to hemostasis, 170 vs 1,134 seconds).

Conclusions: Application of TRAUMAGEL followed by direct pressure decreased time to hemostasis and severity of hemorrhage compared to direct pressure alone.

Clinical relevance: TRAUMAGEL may be valuable in large animals for traumatic injury or during surgery for controlling hemorrhage that is accessible to hydrogel application and direct pressure.

Objective: Evaluate the feasibility of measuring plasma concentrations of 4 endothelial glycocalyx components and their correlation to patient and treatment characteristics in canine trauma patients.

Methods: This was an observational study of dogs presenting to a university-based emergency department between August 2021 and March 2022 within 2 hours of traumatic injury and healthy, age-matched controls. We obtained EDTA plasma at arrival and 3, 6, and 24 hours later. Degree of injury was classified based on Animal Trauma Triage score (mild, 0 to 3; moderate, 4 to 6; and severe, ≥ 7). Data collected included signalment, modified Glasgow Coma Scale score, interventions, diagnostic results, and patient outcomes. Plasma concentrations of syndecan-1, hyaluronan, heparan sulfate, and vascular endothelial-cadherin (cadherin-5) were determined via ELISA.

Results: 19 canine trauma patients and 16 age-matched controls were enrolled. Hyaluronan was significantly lower at arrival versus 24 hours later and demonstrated a significant increase over all time points. There was a significant negative correlation between heparan sulfate and lactate. Vascular endothelial cadherin was significantly higher in penetrating trauma than blunt trauma at arrival and 6 hours later.

Conclusions: Measurement of the 4 markers of endothelial glycocalyx damage in canine trauma patients was generally feasible, and further study may determine clinical application.

Clinical relevance: This was the first evaluation of these glycocalyx biomarkers in canine trauma patients. Additional studies evaluating these and other glycocalyx biomarkers longitudinally are needed to determine the effect of injury and fluid resuscitation on the glycocalyx and outcome in canine trauma patients.

Objective: To describe exposure characteristics and clinical signs of companion animals following incidental exposure to kratom.

Methods: Cases were identified from the American Society for the Prevention of Cruelty to Animals Animal Poison Control Center electronic database between February 2014 and December 2024. Geographic, exposure details and clinical variables were collected.

Results: From 2014 to 2024, there were 139 animals (128 dogs, 9 cats, 1 pig, and 1 rabbit) that had incidental exposure to kratom. Oral ingestion was the primary route of exposure. Doses when available ranged from 1.2 mg/kg to 4,775 mg/kg (median 203.5 mg/kg). The most common clinical signs seen in dogs were lethargy/weakness/sedation, followed by vocalization and hypersalivation/lip licking. In cats, lethargy, mydriasis, and vocalization were the most reported clinical signs. The outcomes were unknown for most animals.

Conclusions: Incidental kratom exposure in companion animals may occur predominantly through ingestion with clinical signs in dogs consisting of lethargy, vocalization, and hypersalivation, while in cats, lethargy, mydriasis, and vocalization are most common. Because most cases had unknown outcomes, the long-term prognosis is unclear.

Clinical relevance: Veterinarians should consider kratom exposure in the differential for nonspecific lethargy, vocalization, or nausea, especially in states where kratom is legal.

Background: Porcine epidemic diarrhea virus (PEDV) is a highly contagious enteric coronavirus that has caused severe economic losses in the swine industry worldwide. The virus spreads rapidly through fecal-oral transmission and contaminated fomites. Despite extensive research on vaccines, biosecurity, and inactivation strategies, PEDV remains endemic in the US. This systematic review evaluated the key epidemiological factors relevant to the feasibility of regional or national PEDV eradication.

Methods: A systematic review of peer-reviewed literature published since 1990 was conducted with PubMed and similar bibliographic databases. Studies were selected based on their relevance to PEDV transmission, biosecurity interventions, and disease-control measures, including vaccination, antivirals, epidemiological modelling, and inactivation methods; studies of other porcine coronaviruses were excluded. A narrative summary of the included studies was developed to describe current knowledge and identify gaps.

Results: Across 412 included studies, risk factors such as shedding duration, transportation-related contamination, and feed transmission were identified, all complicating eradication efforts. Epidemiological modelling indicated that localized control can reduce outbreaks, but national-level eradication remains difficult. Biosecurity and disinfection aid control, yet transportation networks remain a weak point in PEDV containment.

Clinical relevance: National PEDV eradication may not be feasible, but improved biosecurity, feed decontamination, and surveillance can reduce transmission and losses. Vaccines can help control disease but do not provide complete immunity, and other complementary control strategies are required for an industry-level control program. Future research should focus on improving biosecurity compliance, information-sharing during outbreaks, and epidemiological modelling to understand the role of vaccines during an eradication program.

Objective: To explore the causes and short-term outcomes of unplanned recurrent exploratory celiotomies in dogs.

Methods: Medical records from a tertiary veterinary teaching hospital (June 2014 to June 2024) were reviewed. Dogs were included if they underwent 2 exploratory celiotomies within 14 days, the second being unplanned. Data included signalment, comorbidities, surgical indications, complications, and survival to discharge. Cases were categorized by type of initial surgery and indication for secondary surgery.

Results: Of 50 dogs, 58% had an initial gastrointestinal (GI) surgery and 42% had an initial non-GI surgery. Leading indications for a second surgery included septic peritonitis (50%; 95% CI, 35.5% to 64.5%), incisional complications (18%; 95% CI, 8.6% to 31.4%), and hemorrhage (14%; 95% CI, 5.8% to 26.7%). Septic peritonitis was significantly more common following initial GI surgery, while hemorrhage and miscellaneous causes were more prevalent following non-GI surgery. Survival to hospital discharge was 66% (95% CI, 51.2% to 78.8%) and did not differ significantly by initial surgery type. Hemorrhage was the leading cause of death, accounting for 71.4% (95% CI, 29.0% to 96.3%) of all deaths, with significantly higher mortality than all other causes combined. After adjusting for initial surgery type, hemorrhage remained associated with decrease survival (adjusted OR, 0.13; 95% CI, 0.02 to 0.73).

Conclusions: Septic peritonitis was the leading surgical complication following GI surgery; hemorrhage and miscellaneous complications were more prevalent following non-GI surgeries. Hemorrhagic complications were linked to a lower survival to hospital discharge.

Clinical relevance: Findings supported condition-specific prognostication to guide clinical decision-making and client communication in dogs undergoing unplanned repeat celiotomy.

Objective: To evaluate the literacy level of online resources for management and recovery after cranial cruciate ligament rupture (CCLR) in dogs.

Methods: This was a cross-sectional observational study evaluating the readability and suitability of online information sources describing CCLR management and recovery. Websites were queried on June 25, 2025. Websites lacking relevance or limited to videos, graphics, tables, blogs, or discussions were excluded. The first 15 online sources describing CCLR management and describing CCLR recovery were analyzed using the Flesch Reading Ease score and the Flesch-Kincaid Grade Level score. Scores were compared with those recommended by the American Medical Association to ensure understanding of medical communications by a broad segment of the US population (sixth-grade reading level).

Results: For CCLR management, the mean ± SD (95% CI) reading ease score was 47.1 ± 5.6 (-∞ to 49.7) and was < 80 (Cohen d effect size = -5.66), and the mean grade level score was 10.7 ± 1.2 (10.1 to ∞) and was > 6 (d = 3.67). For CCLR recovery instructions, the mean reading ease score was 49.1 ± 9.5 (-∞ to 53.6) and was < 80 (d = -3.15), and the mean grade level score was 10.0 ± 1.7 (9.2 to ∞) was > the sixth grade (d = 2.31).

Conclusions: Online information about the CCLR management and recovery is written at a level unlikely to be understood by a broad segment of the US population.

Clinical relevance: Veterinarians should simplify wording of medical communications related to CCLR management.

Canine cognitive dysfunction syndrome (CCDS) is diagnosed with increasing frequency, yet standardized diagnostic guidelines are lacking. The CCDS Working Group, an international group combining experts in the field and primary care veterinarians, proposes a definition of the syndrome and practical diagnostic criteria designed to aid clinicians and researchers alike. Canine cognitive dysfunction syndrome is defined as a chronic, progressive, age-associated neurodegenerative syndrome, characterized by cognitive and behavioral changes that affect daily life to varying degrees. These changes affect the behavioral domains of disorientation, social interaction, sleep disruption, house soiling, learning and memory, activity changes, and anxiety (DISHAA). We propose 3 severity stages. In mild CCDS, signs are subtle and of low frequency or severity, with preserved function. With progression, behavioral changes become more apparent and impactful, requiring management adjustments. In severe CCDS, debilitating deficits are overt, significantly impairing basic functions and necessitating comprehensive support. Two diagnostic levels are proposed. Level 1 is based on consistent history of progressive DISHAA signs, identification of alternate causes through physical, orthopedic, and neurologic examination and laboratory work; either normal neurologic examination or evidence of symmetrical, diffuse forebrain dysfunction; and persistence of signs following management of relevant comorbidities. Level 2 includes a brain MRI showing cortical atrophy with CSF cell counts within normal limits. Definitive postmortem histopathological confirmation rests on cortical atrophy, amyloid deposition, myelin loss, neuroinflammation, and amyloid angiopathy. Future priorities include the development of blood biomarkers and cognitive testing batteries for routine clinical settings, both of which will refine diagnostic accuracy and therapeutic monitoring.