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

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.

Objective: To evaluate plasma C-reactive protein (CRP) concentrations in dogs with eosinophilic meningoencephalitis (EME) and dogs with steroid-responsive meningitis-arteritis (SRMA) and compare clinical features of the 2 groups.

Methods: Medical records from 2 referral hospitals in Australia of client-owned dogs diagnosed with EME and SRMA between February 1, 2020, and April 30, 2025, were reviewed. Data collected included breed, age, sex, weight, comorbidities, physical examination findings, plasma CRP measurements, CSF analysis, hematology results, and final diagnosis for EME patients.

Results: 15 dogs with EME and 35 dogs with SRMA were included in the study. Dogs diagnosed with EME had significantly lower plasma CRP values compared to dogs with SRMA. The mean CRP concentration was 7.45 mg/L (95% CI, 5.21 to 10.66 mg/L) for the EME group and 112.0 mg/L (95% CI, 96.3 to 130.9 mg/L) for the SRMA group. None of the dogs in the EME group had a significant elevation in plasma CRP of over 30 mg/L. Dogs with EME were generally younger than those with SRMA, with lower rectal temperature and fewer comorbidities on presentation. The leukogram profiles between the 2 groups were markedly different, and peripheral eosinophilia was not a consistent finding in patients with EME.

Conclusions: Plasma CRP showed good diagnostic potential for differentiating between EME and SRMA in dogs, especially when interpreted alongside demographic and other clinicopathological features.

Clinical relevance: This information may assist clinicians in clinical reasoning when presented with young dogs showing similar neurological signs.

Objective: To evaluate the effectiveness of bupivacaine liposomal injectable suspension (BLIS), administered as a peri-incisional eyelid block, in reducing postoperative pain when compared to saline placebo in dogs undergoing enucleation.

Methods: Client-owned dogs undergoing enucleation were enrolled from April 2021 until January 2023 and randomly assigned to receive either BLIS or saline. Dogs were premedicated with hydromorphone and acepromazine, induced with propofol, and maintained with isoflurane. Following subconjunctival enucleation and immediately prior to incision closure, a peri-incisional injection with BLIS or saline was administered into the subcutaneous eyelid tissues. Pain scoring and algometry of the incision were conducted preoperatively by a masked observer and at 0, 1, 2, 4, 8, 24, 36, 48, and 72 hours postoperatively. Oral meloxicam was administered after the 8-hour time point. Rescue analgesia was given if a pain score ≥ 3 in any category or ≥ 10 total was recorded.

Results: 30 dogs completed the study (n = 15 in each treatment group). Dogs receiving BLIS had a significantly lower odds (OR, 0.14) of need for rescue and significantly lower odds (OR, 0.38) of having a higher pain score across the study. Administration of BLIS did not significantly impact mechanical threshold testing results.

Conclusions: Treatment with BLIS reduced the need for rescue analgesia, and these dogs were more likely to have lower pain scores.

Clinical relevance: BLIS may be useful as part of a multimodal pain management plan in dogs undergoing enucleation when administered as a peri-incisional eyelid block.

Objective: To compare the effectiveness of active versus passive QR code distribution on the frequency of veterinary client visits to a website containing disaster preparedness resources.

Methods: A prospective trial was conducted in a veterinary clinical setting from May 27 through July 3, 2025, comparing client engagement with web-based disaster preparedness resources; a website QR code was distributed actively (handed to clients) versus passively (posted in the clinic). Website engagement was tracked with the use of a web-analytics platform, and group differences were assessed with descriptive statistics, χ2 tests, and risk ratios with 95% CIs.

Results: Clients were 5.3 times more likely to click the QR code when it was actively distributed (95% CI, 1.88 to 14.96; χ2 = 11.6).

Conclusions: Actively handing out resources was more effective at encouraging clients to engage with the material than passively making these flyers available for clients to pick up on their own.

Clinical relevance: Veterinary teams can use existing resources and brief client interactions to support the development of disaster preparedness planning that includes pets.

Objective: To demonstrate the proper technique for performing a systematic oral examination in dogs and to explain the clinical significance of oral health assessment in veterinary practice.

Animals: Client-owned dogs of various breeds, ages, and sizes presented for routine wellness examinations or oral health evaluations.

Methods: This instructional video outlines a step-by-step approach to conducting a conscious canine oral examination, including patient positioning, safe handling techniques, and systematic inspection of oral structures such as the lips, gingiva, teeth, tongue, palate, and oropharynx. The video also highlights normal anatomical features and common pathologies, such as periodontal disease, fractured teeth, and others. Footage was recorded in a clinical setting with a cooperative canine patient and voice-over narration for educational clarity.

Results: Viewers are provided with a practical visual guide to improve their ability to identify oral abnormalities and perform comprehensive oral assessments. Emphasis is placed on recognizing early signs of disease and understanding the limitations of conscious oral examinations compared to those performed under anesthesia.

Clinical relevance: Routine oral examinations are a critical component of canine health assessments. The conscious oral examination informs treatment planning for a complete oral health assessment under general anesthesia. Early detection of oral disease can lead to timely intervention, improve quality of life, and prevent systemic complications. This video aims to enhance clinical confidence and promote best practices among veterinary professionals and students by reinforcing the "why" and "how" of the canine oral examination.