Journal of Small Animal Practice最新文献

Objectives: Thromboelastography (TEG) using the TEG 6s, a point-of-care viscoelastic assay, was prospectively evaluated in dogs with chronic enteropathy (CE). Additionally, the study determined whether disease activity, assessed using the Canine Chronic Enteropathy Clinical Activity Index (CCECAI), correlated with TEG 6s parameters.

Materials and methods: A CCECAI score and TEG using the TEG 6s (Haemonetics®) was performed on 19 dogs with CE. In a separate study, TEG using the TEG 6s was performed on 40 healthy adult dogs, which served as the control group. For statistical analysis, normally distributed data were analysed using the two-sample t-test. Non-Gaussian data were analysed using the Wilcoxon rank sum test. Correlations between TEG 6s parameters and the CCECAI scores were assessed using the Pearson test for data with Gaussian distribution and the Spearman test for data with non-Gaussian distribution.

Results: Dogs with CE had significantly shortened mean clot kinetics, prolonged mean reaction time (R) and increased alpha angle (angle), maximum amplitude (MA) and RapidTEG™ MA compared to healthy dogs. Dogs with CE had a significant median increase in Functional Fibrinogen MA compared to healthy dogs. The CCECAI moderately positively correlated with angle.

Clinical significance: With the exception of prolonged R, dogs with CE have several TEG 6s alterations suggestive of hypercoagulability.

Objectives: The primary objective of this study was to evaluate viscoelastic profiles in heartworm antigen-positive versus antigen-negative dogs using a point-of-care viscoelastic device. A secondary objective was to compare intraoperative bleeding and surgical duration between these same groups.

Materials and methods: Dogs presented for elective surgical gonadectomy were screened for the presence of heartworm antigen using a commercial antigen detection test. Viscoelastic testing was performed in equal numbers of asymptomatic heartworm antigen-positive and -negative dogs. Viscoelastic data recorded included Clot Time, Clot Formation Time, α-angle, Maximum Clot Formation, Amplitude at 10 minutes (A10), Amplitude at 20 minutes (A20), Lysis Index at 30 minutes (LI30) and Lysis Index at 45 minutes (LI45). Other data included intraoperative blood loss via the gravimetric technique and surgical time (incision to closure).

Results: A total of 60 dogs (30 heartworm antigen-negative and 30 heartworm antigen-positive) were enrolled in the study. There were no significant differences between Clot Time, Clot Formation Time, α-angle, LI30 and LI45 between heartworm antigen-positive and -negative dogs; however, Maximum Clot Formation, A10 and A20 were higher in heartworm antigen-positive dogs. All viscoelastic results were within previously published normal reference ranges. No significant differences in surgical gonadectomy duration or intraoperative blood loss were observed between groups for male or female dogs.

Clinical significance: Apparently healthy heartworm antigen-positive dogs were relatively hypercoagulable as defined by viscoelastic testing compared to heartworm antigen-negative dogs. There was no apparent additional risk of bleeding in dogs with subclinical heartworm infection.

A spayed female Miniature dachshund presented with a large mediastinal mass. During thymectomy, the left phrenic nerve, which was encircled by the neoplastic tissue, was resected en bloc with the tumour and the right phrenic nerve was damaged by thermal coagulation from electrosurgery. Postoperatively, the dog exhibited significant respiratory distress and paradoxical respiratory movement. Bilateral diaphragmatic paralysis was confirmed on inspiratory radiographs, and lack of structural abnormalities on thoracic computed tomography was noted. The dog collapsed 5 days postoperatively from respiratory fatigue. Thus, salvage surgery and tensioning diaphragmoplasty were performed. Briefly, The diaphragm was partially resected, primarily closed and reinforced with a polypropylene mesh sutured on the abdominal surface. Thereafter, the dog's condition improved significantly. The dog did not present with respiratory issues until she died of urothelial carcinoma on day 375. In conclusion, this surgical technique can be considered to re-establish the function of the diaphragm.

A 4-year-old, male neutered rabbit presented for chronic, antibiotics non-responsive upper respiratory disease. Computed tomography revealed sinusitis and nasopharyngeal stenosis resulting in upper airway obstruction. Deep nasal culture grew Pasteurella multocida. Airway fluoroscopy, performed with the rabbit conscious in a standing position, confirmed the location of the obstruction and subtle open mouth breathing. Pharyngoscopy further confirmed epiglottic displacement. In addition to antimicrobial therapy, three fluoroscopic balloon dilation procedures were performed to address the nasopharyngeal stenosis. Clinical signs improved during treatment course, and epiglottic displacement was resolved at the time of the third procedure. The rabbit was healthy 18 months after the last procedure. Nasopharyngeal stenosis should be considered a differential diagnosis for upper respiratory signs in rabbits. This rabbit was likely able to breathe through the oral cavity due to chronic epiglottic displacement secondary to the upper airway obstruction. Fluoroscopic-assisted balloon dilation was successful to treat this condition.

Objectives: To report clinical presentation, short-term outcome and complications of tracheal resection and anastomosis in dogs and cats.

Materials and methods: Clinical records of pets treated with tracheal resection and anastomosis in seven UK-based veterinary referral centres were retrospectively reviewed (2009 to 2022).

Results: Twenty client-owned pets (eight dogs; 12 cats) were included. Clinical signs comprised dyspnoea (n = 15), stridor (n = 5), subcutaneous emphysema (n = 3), pneumothorax and pneumomediastinum (n = 1), coughing (n = 3), regurgitation (n = 1) and exercise intolerance (n = 1). Indication for surgery was traumatic tracheal rupture (n = 5), tracheal avulsion (n = 7), neoplasia (n = 5) and stenosis (n = 3). Complications occurred in 15 patients (75%). Non-anastomotic complications occurred in nine patients and consisted of cough (n = 5), self-resolving laryngeal paralysis (n = 1), surgical site infection (n = 1) and septic shock (n = 2). Anastomotic complications occurred in seven patients and consisted of anastomotic dehiscence (n = 1), tracheal stenosis (n = 4) and fatal respiratory failure (n = 2). Revision surgery was performed in two dogs due to anastomotic dehiscence and stenosis, and tracheal stenting was performed in one cat due to stenosis. Sixteen patients survived to hospital discharge and 14 survived to latest follow-up (median: 119 days; range: 14 to 1744). Outcome was scored as excellent in five, good in seven, fair in two and poor in six patients.

Clinical significance: Tracheal resection and anastomosis is the surgical technique of choice to reconstruct tracheal defects. Although more than half of the patients recovered well, high morbidity and mortality rates were documented. This may be due to the severe comorbidities affecting most tracheal resection and anastomosis patients, as well as the client's decision against further treatment when facing serious post-operative complications.

Objectives: The objectives of this study were to describe the outcome and prognostic factors in dogs diagnosed with primary and secondary immune thrombocytopenia (ITP).

Materials and methods: Medical records of dogs diagnosed with primary and secondary ITP in a referral hospital in Ireland were retrospectively evaluated. Short- and long-term survivals were analysed using Cox proportional-hazards regression models.

Results: Medical records from 49 dogs were included. Primary and secondary ITP were diagnosed in 81.25% and 18.75% of dogs, respectively. The survival rate was 69% at 2 weeks (95% confidence interval [CI]: 0.54 to 0.80), 63% at 3 months (95% CI: 0.48 to 0.75) and 51% at 2 years (95% CI: 0.37 to 0.65). The overall median survival time was 985 days (primary ITP only: 1084 days; secondary ITP only: 225 days). Dogs surviving 30 days post-diagnosis had a median long-term survival time of 10 years. A lower haematocrit was negatively associated with survival [hazard ratio (HR) 0.96, 95% CI: 0.92 to 0.99]. Neutrophilia (HR: 0.44, 95% CI: 0.20 to 0.96) was associated with a 66% decreased risk of death. Band neutrophilia was associated with shorter hospitalisation (regression coefficient -3.56, 95% CI: -5.70 to -1.42). Presence of petechiae and ecchymoses (regression coefficient 2.41, 95% CI: 0.41 to 4.42), and the use of a second-line immunosuppressive agent (SLI) (regression coefficient 2.11, 95% CI: 0.11 to 4.12) were significantly associated with longer hospitalisation but not with survival.

Clinical significance: A lower haematocrit was the only variable associated with a worse prognosis in dogs diagnosed with ITP. Dogs with confirmed secondary ITP had an overall shorter median survival time. Dogs surviving over 30 days had an excellent prognosis.

Objectives: The aim of this prospective study was to assess the association between methylene blue staining pattern and the presence of histologic nodal metastasis in dogs with low-grade mast cell tumour in low-resource settings for the efficient diagnosis of lymphatic spread.

Methods: Dogs with a single, cytologically low-grade mast cell tumour and no documented distant metastases were prospectively included and underwent surgery. Along with primary mast cell tumour removal, intraoperative sentinel lymph node mapping with peritumoral mast cell tumour injection and regional lymph node excision, regardless of whether blue dye was visible in the lymph node, were performed. Association between the lymph nodes with dye uptake (stained) and their metastatic status was evaluated.

Results: Twenty-five dogs were enrolled, and at least one stained lymph node was identified in 22 (88%) of them. A total of 49 lymphocentres were surgically inspected, and a total of 53 lymph nodes were removed. Twenty-nine (54.7%) lymph nodes were stained, and 24 (45.3%) were unstained. Among the 29 stained lymph nodes, there were seven (24.1%) HN0, seven (24.1%) HN1, seven (24.1%) HN2 and eight (27.7%) HN3. Among the 24 unstained lymph nodes, 17 (70.8%) were HN0 and seven (29.2%) were HN1. No complications related to methylene blue injection were recorded.

Clinical significance: Peritumoral methylene blue injection is a cost-effective alternative technique for detecting sentinel lymph node for dogs with mast cell tumours, particularly in economically constrained settings. All metastatic lymph nodes (HN2/HN3) were stained, and all unstained lymph nodes were non-metastatic (HN0/HN1).

Primary uterine lymphoma is an extremely rare disease. An 11-year-old spayed female domestic short-haired cat presented with a 3-month history of mucopurulent vaginal discharge, lethargy, acute vomiting and constipation. Physical examination revealed vulvar swelling, purulent discharge and a mass in the mid-caudal abdomen. A CT scan identified a large uterine mass, displacing the colon dorsally and the urethra ventrally. A hysterectomy was performed. Histology and immunohistochemistry confirmed a T-cell uterine transmural medium to large cell lymphoma. One-month post-surgery, an abdominal ultrasound showed thickening of the jejunal loops, enlarged lymph nodes and nodular peritoneal lesions at the surgical site. Cytology raised suspicion of large granular lymphocyte lymphoma, confirmed by anti-Granzyme B immunohistochemistry on the uterine tissue specimen. The final diagnosis was primary uterine large granular lymphocyte lymphoma, marking the first reported case in small animal oncology.

Objectives: To describe the clinical presentation and clinicopathological findings of dogs with nodular splenic lesions composed of heterogeneous cell components associated with systemic inflammation and to provide information on the outcome after surgical resection.

Materials and methods: Medical records were searched for dogs with histologically and immunohistochemically characterised nodular splenic lesions with mixed stromal, histiocytic and lymphoid cells and the presence of systemic inflammatory markers at the time of diagnosis.

Results: Four dogs were included, of which three had an undifferentiated splenic stromal sarcoma and one had a splenic leiomyosarcoma. Fever and abdominal pain were reported in three and four cases, respectively. All dogs showed hyperglobulinaemia and marked changes in the serum protein electrophoresis profile. C-reactive protein and fibrinogen concentrations were both increased in three cases. These abnormalities completely resolved after splenectomy. Moreover, two dogs had concomitant glomerular disease and one dog had liver amyloidosis. Three dogs were still alive and asymptomatic 1, 6 and 9 months after surgery. One dog died 16 months after the initial presentation due to complications related to progressive renal failure.

Clinical significance: Based on this report, nodular splenic lesions with heterogeneous cell components may directly be associated with a pro-inflammatory state and should be considered as part of the differential diagnosis of fever and hyperglobulinaemia in dogs. Furthermore, early recognition and treatment of these lesions could reduce the risk of systemic complications potentially associated with amyloid deposit and organ failure.