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

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.

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.