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

Objective: To estimate the time until reliable echocardiography in healthy dogs by evaluating differences in measured echocardiographic variables in dogs before sedation, during sedation with dexmedetomidine, and after reversal with atipamezole.

Methods: 13 dogs were prospectively enrolled. Two-dimensional echocardiographic measurements on left atrial and ventricular dimensions and ventricular systolic function were obtained at each time point. Dogs underwent IV sedation with 10 µg/kg of dexmedetomidine and 0.2 mg/kg of butorphanol, and dexmedetomidine was reversed with atipamezole IM. Echocardiography was performed before sedation, during sedation, and 30 to 60 minutes, 2 hours, and 6 hours after reversal. Data were analyzed with a Bayesian multivariate hierarchical model.

Results: There were effects of sedation on the mean values of all echocardiographic variables. These effects varied among dogs, with most dogs expected to remain within normal reference ranges during and after sedation for all variables except ejection fraction and fractional shortening. The effects of sedation on ejection fraction and fractional shortening were widespread and persistent, such that 88% and 79% of dogs, respectively, were expected to measure outside the normal ranges during sedation. After reversal with atipamezole, this proportion declined, with approximately 9% of dogs estimated outside the normal reference ranges after 6 hours.

Conclusions: Effects of dexmedetomidine on echocardiographic measurements were detected 6 hours after reversal with atipamezole. Accurate cardiac assessment in dogs sedated with this drug is not likely to be possible on the same day as sedation.

Clinical relevance: Dogs sedated with this protocol and that have echocardiography performed within 6 hours following reversal should have results interpreted with caution.

Objective: To evaluate the malignancy status of additional masses in dogs with a primary liver mass. The hypothesis was that the malignancy status of the primary liver mass would not be related to the malignancy status of the biopsied additional mass.

Methods: This retrospective study evaluated canines receiving a liver lobectomy for a primary liver tumor with concurrent biopsy of an additional liver mass and subsequent histopathologic diagnoses from January 1, 2019, to May 15, 2025, at a single institution.

Results: 40 dogs were identified. All 22 benign primary masses had benign additional masses. Sixteen malignant primary masses had benign additional masses, and 2 malignant primary masses had malignant additional masses. The second mass was benign in 38 of 40 dogs (95%).

Conclusions: In dogs with multiple liver masses, a malignant primary liver mass did not correlate with a malignant secondary mass. Dogs with a primary liver mass that was excised were not found to have a significant incidence of the additional mass representing metastasis.

Clinical relevance: Benign additional liver masses frequently occur in dogs with primary liver masses. Additional masses should not be overinterpreted as a strong indicator of metastatic disease when discussing the results of staging diagnostics with clients, as most dogs have an excellent prognosis with liver lobectomy.

Objective: To characterize the clinical features, management, and short- and long-term outcomes of dogs experiencing insulin-induced hypoglycemic seizures (IIHS).

Methods: Dogs with documented blood glucose concentrations < 80 mg/dL (4.4 mmol/L) within 12 hours of insulin administration were retrospectively identified from 14 private practice emergency and specialty hospitals in the US (January 2017 to January 2025). Dogs were classified as having IIHS or insulin-induced hypoglycemia (IIH) without seizures. Data collected included signalment, insulin type and dose, blood glucose concentration at presentation, time to glucose correction, seizure characteristics, antiepileptic drug (AED) use, length of hospitalization, and survival to discharge. Associations between clinical variables and seizure occurrence were assessed with logistic regression.

Results: 49 dogs met the inclusion criteria: 34 with and 15 without seizure activity. Body weight showed a curvilinear association with seizure occurrence, with higher odds at low (< 10-kg) and high (> 25-kg) weights (body weight: OR, 0.26; 95% CI, 0.07 to 0.97; body weight2: OR, 1.41; 95% CI, 1.04 to 1.93). Antiepileptic drugs were used in 7 of 34 dogs (20.6%); 3 required long-term management. Multiple seizures were associated with AED use. No significant differences were found in insulin type, amount administered, or time to glucose correction between groups.

Conclusions: IIHS are common in diabetic dogs; however, long-term neurologic sequelae and the need for ongoing AEDs are uncommon.

Clinical relevance: Future studies are warranted to better identify patients at increased risk for long-term neurologic complications and to establish criteria for initiating AEDs. Additionally, research evaluating IIHS associated with other insulin preparations (eg, detemir, glargine) is needed.

Objective: To develop a machine learning (ML) model to identify fiducial points on canine ECGs to localize right-sided accessory pathways as posterior or anterior during ventricular preexcitation (VPE).

Methods: ECG recordings with VPE and documented accessory pathway locations were preprocessed for a 1-dimensional U-net algorithm. A web-based platform (https://setpsi.com/AccessoryPathways/) was created. Training used approximately 70% of pooled beats from 16 of 27 dogs. Testing used approximately 30% of pooled beats from 11 of 27 dogs to assess accurate diagnosis of posterior versus anterior accessory pathways. Vectorcardiograms and mean electrical axis (MEA) were calculated to validate the ML model. Fiducial boundary correctness and beat identification accuracy were assessed with receiver operator characteristic curves and reported as area under the curve (AUC; 95% CI). A Mann-Whitney test was used to compare MEA methods (median; IQR).

Results: The ML algorithm was trained on 3,405 beats and tested on 1,984 beats. The model identified fiducial points P wave to delta wave (AUC, 0.957; 95% CI, 0.957 to 0.958) and delta wave/QRS (AUC, 0.965; 95% CI, 0.964 to 0.966), classified individual beats as posterior (AUC, 0.917; 95% CI, 0.915 to 0.920) and anterior (AUC, 0.948; 95% CI, 0.947 to 0.949), and determined pathway location in 82% (9 of 11) of test dogs. Vectorcardiograms of posterior pathways showed oval or elliptical loops with superior leftward vectors, while anterior pathways displayed complex figure-eight loops with inferior leftward vectors. The MEA differed (P < .01) between posterior (-23.7°; IQR, 39.5°) and anterior (61.1°; IQR, 9.8°) pathways. Both methods validated the ML model.

Conclusions: The ML model accurately localized accessory pathways in canine VPE.

Clinical relevance: ML will advance the ability to accurately diagnose VPE.

Objective: To report the outcome of total lung lobectomy with self-ligating loop in cats.

Animals: This was a retrospective case series of cats that underwent total lung lobectomy with self-ligating loop between January 2020 and February 2025. Data regarding signalment, history, physical examination, diagnostics, surgical approach, lung lobe affected, hospitalization length, intraoperative/postoperative complications, and short- and long-term outcomes were analyzed.

Clinical presentation: 13 cats were included: 9 domestic shorthair, 2 domestic longhair, 1 Maine Coon, and 1 Burmese. Clinical signs included respiratory distress (4 of 13), lethargy (4 of 13), cough (3 of 13), hyporexia (3 of 13), dyspnea (2 of 13), vomiting (2 of 13), and pyrexia (1 of 13). Six cats suffered from more than 1 clinical sign.

Results: A total of 14 lung lobectomies were performed via either right (n = 2) or left (5) intercostal thoracotomy, median sternotomy (4), or video-assisted thoracic surgery (2). No major intraoperative complications occurred. Temporary hypoxemia was recorded during a video-assisted thoracic surgery procedure in 1 case and resolved with thoracic lift. Eleven cats survived hospital discharge. Minor postoperative complications (wound inflammation, vomiting, hyperthermia) occurred in 3 cats, while major postoperative complications (pleural effusion, intrathoracic infection) occurred in 3 cats. No revision surgery was necessary in any case. Three cats underwent humane euthanasia due to a sudden deterioration secondary to the underlying disease in the immediate postoperative period (catastrophic complication). On long-term follow-up, 7 cats were alive and no long-term complications related to the lobectomy were reported.

Clinical relevance: Lung lobectomy with self-ligating loop provides a safe technique for total lung lobectomy and can be considered as an alternative when thoracic stapler is not available in cats.