Journal of Small Animal Practice最新文献

Objectives: To describe the computed tomography appearance of gastropexy sites and report their anatomical and suspected functional abnormalities.

Materials and methods: Medical records of dogs with prior gastropexy undergoing abdominal computed tomography between December 2010 and June 2021 were reviewed from two veterinary hospitals. Dogs were categorised into two groups based on gastric anatomic distortion: anatomic (10) or non-anatomic (12).

Results: A total of 22 dogs were included, with time since gastropexy ranging from 16 to 1552 days (median: 311 days). Computed tomography findings showed a median attenuation of 38.5 HU (range: 6 to 57) of the gastropexy site, as well as focal slight thickening of the gastric wall and adjacent muscle in all dogs. Neovascularisation at the gastropexy site was found in approximately 65% of the animals, while marked gastric dilatation was noted in 32%, and a gravel sign was observed in 73%. The anatomic group had broader pedicles and a greater distance from the xiphisternum and midline compared to the non-anatomic group. Median gastric angles were significantly smaller in the gastropexy groups (Anatomic: 85.5°; Non-anatomic: 52°) compared to a control group (132°).

Clinical significance: The current study identified specific computed tomography imaging features of gastropexy sites contributing to a better understanding of the range of appearance and degree of detected anatomic distortion following gastropexy. It also identified signs of suspected gastric functional abnormalities in all gastropexy patients regardless of the degree of anatomic distortion.

A two-and-a-half-year-old female neutered Maine Coon cat was presented for investigation of urinary incontinence to an academic referral hospital. An ultrasound of the abdomen performed at the referring veterinarian showed a distended ureter with no clear ureterovesical junction visible. The cat was referred for further investigations and treatment. Ultrasound, cystoscopy and computed tomography urography were performed. A duplication of the right kidney with a separate and ectopic duplicated ureter, joining the right dorsolateral aspect of the urethra, was diagnosed. A normal ureter was closely associated with the ectopic ureter and entered the bladder at the level of the trigone. The left kidney and ureter were normal in appearance. The ectopic ureter was ligated before entering the urethra and neoureterocystostomy of the dilated ectopic ureter was performed without complications. Incontinence resolved following surgery, and the patient showed no clinically apparent complications 5 months post-surgery.

Objective: To describe the coagulation status of dogs with immune-mediated polyarthritis.

Materials and methods: Hospital records at a single referral centre were retrospectively reviewed for dogs diagnosed with immune-mediated polyarthritis. Cases were classified as hypercoagulable, normocoagulable, hypocoagulable, or hypercoagulable and hypocoagulable according to the results of viscoelastic testing performed at the time of diagnosis. Other data including signalment, body weight, age at diagnosis, haematological and biochemical laboratory findings, number of joints sampled and synovial fluid analysis, and short-term outcome were recorded. Breed predisposition was defined through comparison to the hospital population and odds ratio calculation.

Results: Thirty-eight dogs were included with a median age of diagnosis of 4 years (range 9 months to 10 years). One dog (2.6%) was classified as hypercoagulable, 32 (84.2%) were classified as normocoagulable, four (10.5%) were classified as hypocoagulable and one dog (2.6%) had changes associated with both hypercoagulability and hypocoagulability.

Clinical significance: In contrast to other systemic inflammatory disorders, immune-mediated polyarthritis was not commonly associated with either hypo- or hypercoagulability in this cohort of dogs.

Objectives: To retrospectively evaluate plasma amylase concentrations in client-owned guinea pigs (Cavia porcellus) and determine a possible association with mortality.

Materials and methods: Medical records of guinea pigs that had a biochemistry panel from four institutions were retrospectively reviewed. Guinea pigs were excluded from the study if plasma amylase concentrations were not measured or there was no follow-up 30 days after the initial biochemistry panel.

Results: Two hundred seventy-eight guinea pigs were included. Odds of mortality were not linearly associated with increasing amylase concentrations, but higher mortality was seen with markedly elevated plasma amylase (1910 to 3985 U/L; 65.2% death). After multivariable adjustment, guinea pigs with markedly elevated plasma amylase concentrations were seven times more likely to die within 30 days compared to those with a concentration within the reference interval (1339 to 1573 U/L) (aOR: 7.98; adj. 95% CI: 3.29 to 19.35). In addition, BUN concentration higher than 62 mg/dL had a 29.97 times greater odds of 30-day mortality than those with a BUN concentration lower than 62 mg/dL (aOR: 29.97, adj. 95% CI: 3.78 to 237.65). The AUC of the ROC curve of amylase concentrations to predict 30-day mortality was 72.7% (95% CI: 65% to 79.9%).

Clinical significance: While the exact pathophysiology of changes in plasma amylase concentrations in guinea pigs is unknown, this enzyme has clinical significance, considering that markedly elevated plasma amylase concentrations were associated with a higher risk of mortality. The actual prognostic capacity of the enzyme alone is limited and should be evaluated as part of a full clinical picture.

Objectives: The objective of this study was to confirm the accuracy of a new portable beta prototype glucometer device for monitoring blood glucose levels in dogs.

Materials and methods: One hundred and three client-owned dogs with dysglycemia or normoglycemia were enrolled. A 3 mL whole blood sample was collected from a peripheral vein from each dog and divided into four aliquots. Blood glucose was measured from three of the aliquots on the beta prototype glucometer in triplicate. The remaining aliquot was used to measure packed cell volume, total solids, and blood glucose via a reference laboratory chemistry analyzer. Accuracy was assessed in accordance with the International Organization for Standardization guidelines.

Results: The analytical performance of the beta prototype met the International Organization for Standardization accuracy requirements, with 95.1% of measurements falling within the International Organization for Standardization accuracy threshold as well as 100% of measurements being within zones A and B of the consensus error grid. Within the full range of glucose concentrations (20 to 750 mg/dL) the mean difference between the AT3 and reference lab analyzer was 2.53 mg/dL (95% limit of agreement: -45.27 to 50.34).

Clinical significance: The beta prototype glucometer device had a strong correlation with the reference laboratory standard and can be used confidently in clinical patients for the accurate monitoring of blood glucose levels in dogs.

Objectives: Locoregional anaesthesia of the dorsal cranium (scalp blocks) are used for craniotomy in people. The technique is described in dogs and appears efficacious. The aim was to describe its application in cats undergoing craniotomy.

Materials and methods: All cats presenting to two referral centres between January 2022 and December 2023 for craniotomy, which received a scalp block, were considered for inclusion in this retrospective study. Cases were excluded if full peri-operative records were missing. Details of all anaesthetic and analgesic agents administered, the locoregional blocks performed, physiological responses to specific surgical time points and intraoperative complications were taken from anaesthetic records. Post-operative management, complications and pain assessments were taken from treatment sheets and electronic health records.

Results: Records of seven cats that underwent craniotomy and received a scalp block were identified. Surgery was for the removal of intracranial meningioma in all cats. Scalp blocks were performed using anatomical landmarks based on the technique described in dogs using a mixture of bupivacaine and dexmedetomidine. All scalp blocks were performed within 5 minutes. One cat received no intra-operative analgesia beyond the scalp block. The other cats received methadone between 0.1 and 0.3 mg/kg. The time from recovery until the first dose of post-operative pain relief ranged from 435 to 1440 minutes, with one cat receiving no post-operative opioids at all.

Clinical significance: Scalp blocks appear a simple and potentially highly effective locoregional anaesthetic technique in cats undergoing craniotomy. Analgesia provided by the block appeared to last well into the post-operative period and warrants further investigation.

Objectives: The aims of this study were to evaluate the response rate, time to progression (TTP) and survival times of dogs with high-risk adrenal gland tumours (ATs) treated with toceranib phosphate, in both macroscopic and microscopic setting, and to report the adverse event (AE) profiles.

Materials and methods: Medical records of dogs diagnosed with a high-risk adrenocortical carcinoma (ACC) or phaeochromocytoma (PCC), treated with toceranib, were retrospectively reviewed. High-risk ATs were defined as inoperable and/or metastatic ATs or cortical tumours with high Utrecht score. Endpoints were response rate, TTP and overall progression-free survival time (PFST). Adverse events were reported according to VCOG-CTCAE.

Results: Sixteen dogs were included: 10 diagnosed with PCC and six with ACC. All dogs with ACC received adjuvant toceranib due to a high Utrecht score or metastatic disease, while all dogs with PCC were treated with toceranib in the macroscopic setting. A clinical benefit was detected in 80% of dogs with PCC: four achieved stable disease for a median TTP of 176.5 days, and two achieved partial response for 182 and >100 days, respectively. Median PFST for dogs with PCC was 112 days. Among dogs with ACC, 3 (50%) progressed and were euthanized after 237, 364 and 273 days; the remaining 3 (50%) dogs were alive and disease free 382, 508 and 583 days after starting toceranib. Overall, toceranib was well-tolerated.

Clinical significance: Toceranib may offer clinical benefit and improve outcome in dogs with high-risk ATs in both the macroscopic and microscopic disease setting.

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.