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

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.

Objective: To compare the analgesic efficacy and cardiovascular and respiratory effects of lumbosacral epidural (EP) and ultrasound-guided lateral quadratus lumborum (QL) block with 1% lidocaine in dogs undergoing elective ovariohysterectomy (OVH).

Methods: Following an experimental, prospective study design, dogs presented for OVH at the Veterinary Teaching Hospital of the Universidad Nacional del Centro de la Provincia de Buenos Aires during 2024 to 2025 were randomly assigned to receive either an EP injection of 1% lidocaine (0.4 mL/kg) or a bilateral QL block with the same formulation and dose per site (n = 12 each group). All dogs were premedicated with dexmedetomidine and meloxicam, anesthetized with propofol, and maintained with sevoflurane under spontaneous ventilation. Intraoperative analgesic requirements, physiological variables, and postoperative pain scores were evaluated for 6 hours after extubation.

Results: 24 healthy, female mixed-breed dogs (mean age, 1.65 years [SD, 0.8 years]; mean weight, 17.45 kg [SD, 6 kg]) were included in the study. A total of 23 dogs completed the study; 1 QL case was excluded due to block failure. No evidence of differences was observed between groups in heart rate, blood pressure, or respiratory parameters. The number of fentanyl boluses did not differ between groups. Postoperative pain scores were similarly low in both groups, with no need for rescue analgesia.

Conclusions: EP and QL blocks with 1% lidocaine provided comparable anesthetic stability and postoperative analgesia in dogs premedicated with dexmedetomidine and meloxicam undergoing OVH.

Clinical relevance: EP and QL blocks with 1% lidocaine provided similar anesthetic and analgesic effects, with the EP technique requiring less equipment and patient manipulation.

Objective: To investigate the link between preoperative anemia and perioperative complications in cats undergoing general anesthesia for subcutaneous ureteral bypass (SUB) and examine whether preoperative anemia is associated with poor outcome.

Methods: This retrospective study used data records of cats presenting to the Queen Mother Hospital for Animals requiring SUB system implantation. Anemia was defined as a PCV < 25%. Signalment, blood samples, perioperative data, and short-term outcomes were compared between anemic and nonanemic groups.

Results: 196 cats were included; 28.6% (n = 56) presented anemic. Anemic patients were more likely to be hypotensive perioperatively compared with nonanemic patients. Nonanemic cases were significantly more likely to demonstrate a greater reduction in creatinine following SUB placement (median, 73.0% reduction vs anemic cases, 56.6%; OR, 0.4146; 95% CI, 0.1835% to 0.8929%). Patients presenting with anemia were significantly older than patients presenting without anemia (95% CI, -2.411% to -0.2965%). There was no significant difference in survival to discharge (OR, 0.7106; 95% CI, 0.2421% to 2.033%) or 30-day survival between anemic and nonanemic groups (OR, 0.5798; 95% CI, 0.2446% to 1.396%).

Conclusions: Anemic cats presenting with ureteric obstruction are at an increased risk of perioperative hypotension and less likely to have a reduction in creatinine at discharge. There was no difference in survival between groups.

Clinical relevance: Anemia occurs commonly in cats with ureteric obstructions and is a preoperative factor shown to require careful management during the peri- and postoperative periods, increasing complications and reducing the normalization of creatinine.

Objective: To determine whether replacing needles after vial septum puncture affects canine response to vaccination and whether injectors can distinguish between replaced and nonreplaced needles.

Methods: In this randomized, double-blinded, controlled crossover trial conducted at the Midwestern University College of Veterinary Medicine vaccine clinics between June and August of 2024, 75 client-owned dogs received both rabies and distemper, hepatitis, parainfluenza, and parvovirus vaccines, one with a replaced needle and one with the original needle used to draw up the vaccine. Heart rate (HR) was recorded continuously, reaction to needle insertion was scored on a 5-point scale by 2 blinded observers, and injectors guessed which syringe had the replaced needle. The outcomes of HR change between baseline and maximum after insertion and mean reaction rating were analyzed with linear mixed-effects models and injector guess with a 1-sample test of proportions.

Results: 45 dogs (60%) provided complete HR data. Change in HR for replaced as compared to nonreplaced needles was not different (β = -0.8; 95% CI, -12 to 10). Heart rate was higher for rabies administered second (β = 23; 95% CI, 7 to 40). Reaction scores did not differ (β = -0.05; 95% CI, -0.24 to 0.14). Injectors identified replaced needles 46% of the time (95% CI, 34 to 58), which was not better than chance.

Conclusions: Needle replacement did not improve patient comfort, and injectors were unable to perceive a difference between replaced and nonreplaced needles.

Clinical relevance: Injecting dogs with the same needle used for drawing up vaccines is clinically acceptable. Replacement provides no measurable patient benefit while adding risk, waste, and cost.

Objective: To investigate clinical features and potential risk factors in dogs surgically treated for pyothorax.

Methods: Medical records from 41 private referral hospitals were retrospectively searched for dogs that underwent thoracic surgery and had pyothorax diagnosed via cytologic or microbiologic review of pleural fluid samples. Data regarding signalment, clinical factors, perioperative complications, and outcomes were collected. Univariable logistic regressions were used to estimate ORs and test for the effects of risk factors on postoperative hospitalization duration, major complications, and survival to discharge. Log-likelihood P values and ORs with profile-likelihood OR confidence limits were reported.

Results: 157 client-owned dogs were included. A total of 140 dogs (89%) survived to discharge. Neither duration of signs (OR, 0.98; 95% CI, 0.95 to 102) nor preoperative hospitalization (OR, 0.85; 95% CI, 0.66 to 1.13) was associated with survival. Of the 157 dogs, 67 (43%) were noted to have complications requiring additional therapy. Abscessation was associated with shorter postoperative hospitalization duration compared to any other pyothorax etiology. Increased age (OR, 0.81; 95% CI, 0.69 to 0.95), hyperglobulinemia (OR, 0.54; 95% CI, 0.32 to 0.89), and increasing leukocyte count (OR, 0.92; 95% CI, 0.88 to 0.96) were associated with decreased odds of survival.

Conclusions: Survival outcomes following thoracic surgery were good despite a high complication rate. Chronicity of disease prior to surgery for pyothorax may not have affected outcomes.

Clinical relevance: Risk factors associated with outcomes of canine pyothorax may guide treatment decisions for clinicians and clients. Careful case selection is indicated to determine which patients may benefit most from surgical intervention.

Objective: To evaluate survival outcomes in dogs undergoing mechanical ventilation (MV) when accounting for ventilation duration and euthanasia context, and to determine survival rates in patients ventilated ≥ 24 hours.

Methods: In this retrospective observational study, records were reviewed from dogs undergoing all-cause MV at 3 academic referral hospitals and 2 private specialty hospitals between March 2019 and January 2025. Data collected included underlying diagnosis, indication for MV, ventilation duration, and outcome. Indications were categorized as increased work of breathing, severe hypoxemia (Pao2 < 60 mm Hg or peripheral oxygen saturation of hemoglobin as measured by pulse oximetry < 90% despite supplemental oxygen), or hypoventilation (Paco2 ≥ 60 mm Hg). Ventilation duration was classified as < 24 hours or ≥ 24 hours, and reasons for euthanasia were recorded when available.

Results: Of 258 dogs, 85 (32.9%) survived to discharge, 105 (40.7%) were euthanized, and 68 (26.4%) died. Survival was 52.3% for dogs ventilated ≥ 24 hours compared to 13.3% for those ventilated < 24 hours. Overall, 64.7% of euthanasias occurred within 24 hours and 28.6% were financially driven. Median ventilation duration among survivors was 48 hours (range, 24 to 356 hours).

Conclusions: This multi-institutional study demonstrates improved survival outcome with a 52% survival to discharge for patients ventilated ≥ 24 hours compared to patients ventilated < 24 hours. These findings suggest that once a patient surpasses the initial 24-hour period on MV, prognosis stabilizes at approximately 50:50, aligning more closely with human ICU survival rates.

Clinical relevance: These findings support MV as a viable therapeutic option in veterinary critical care, and updated survival statistics provide a basis for prognostic discussions and treatment decisions.