Journal of the American Animal Hospital Association最新文献

Vaccination is a cornerstone of canine preventive healthcare and one of the most cost-effective ways of maintaining a dog's health, longevity, and quality of life. Canine vaccination also serves a public health function by forming a barrier against several zoonotic diseases affecting dogs and humans. Canine vaccines are broadly categorized as containing core and noncore immunizing antigens, with administration recommendations based on assessment of individual patient risk factors. The guidelines include a comprehensive table listing canine core and noncore vaccines and a recommended vaccination and revaccination schedule for each vaccine. The guidelines explain the relevance of different vaccine formulations, including those containing modified-live virus, inactivated, and recombinant immunizing agents. Factors that potentially affect vaccine efficacy are addressed, including the patient's prevaccination immune status and vaccine duration of immunity. Because animal shelters are one of the most challenging environments for prevention and control of infectious diseases, the guidelines also provide recommendations for vaccination of dogs presented at or housed in animal shelters, including the appropriate response to an infectious disease outbreak in the shelter setting. The guidelines explain how practitioners can interpret a patient's serological status, including maternally derived antibody titers, as indicators of immune status and suitability for vaccination. Other topics covered include factors associated with postvaccination adverse events, vaccine storage and handling to preserve product efficacy, interpreting product labeling to ensure proper vaccine use, and using client education and healthcare team training to raise awareness of the importance of vaccinations.

Community care is a creative way of thinking about health care that mobilizes resources within a community and consists of four core principles: recognition of the urgency of access-to-care for the veterinary profession, collaboration within community networks, family-centered health care, and redefining the gold standard of care. The AAHA Community Care Guidelines for Small Animal Practice offer strategies to help busy veterinary practitioners increase access to care within their practice and community by optimizing collaborative networks. While these guidelines do not claim to provide exhaustive solutions to access-to-care issues, they propose a starting point from which private practices can explore and implement workable solutions for their community and their practice. Broadening the scope of care to reach all people with pets requires multimodal, collaborative, and creative solutions both within and outside of the veterinary profession. These solutions can begin with greater communication and collaboration between private veterinary practices and nonprofit veterinary practices, with the goal of keeping pets in their homes with their loving families as much as reasonably possible.

An approximately 3 yr old female Chihuahua was presented for evaluation of polyuria and polydipsia noted by the owner after adoption. Serum biochemistry and urinalysis revealed hyponatremia, hypochloremia, hypo-osmolality, and normal fractional excretion of sodium. Serum antidiuretic hormone concentration was 5.54 pg/mL and serum copeptin concentration was 135.40 pg/mL. The antidiuretic hormone value was above the reported range for healthy dogs and was considered inappropriate in light of serum osmolality. Idiopathic syndrome of inappropriate antidiuretic hormone secretion was considered the most likely diagnosis after excluding other potential causes, such as diuretic use, renal disease, adrenal disease, and thyroid dysfunction. The dog remains clinically well 2 yr after diagnosis without specific treatment other than minimal dietary salt supplementation. This case is unique because of the absence of systemic or neurologic signs, good long-term outcome without treatment, and use of novel diagnostic testing.

Most urinary bladder (UB) tumors are malignant, and transitional cell carcinoma (TCC) is the most common neoplasm affecting the UB in dogs. Sorafenib may be a potential therapeutic agent for canine TCC. A 12 yr old spayed female Maltese dog weighing 3.6 kg and with a history of hematuria was referred for a suspected UB tumor. Abdominal ultrasonography revealed a UB mass attached to the cranioventral wall. The remaining abdominal examinations, including that of the lymph nodes, were unremarkable. Ultrasound-guided traumatic catheterization of the UB mass was performed, and the cytological evaluation of the UB mass indicated TCC. Excision was performed by partial cystectomy, and histopathology confirmed TCC, although the tumor had infiltrated the surgical margins. A chemosensitivity assay was conducted using tissue from the excised tumor. Sorafenib tosylate, a tyrosine kinase inhibitor, showed the greatest effect in the chemosensitivity assay. Therefore, adjuvant chemotherapy with sorafenib tosylate and piroxicam was administered postoperatively. The dog lived without any clinical signs, including hematuria or tumor relapse, for more than 2 yr after the surgery. This is the first report of successful long-term management of TCC with sorafenib tosylate in a dog.

Training and maintaining a service dog requires extensive time and financial resources. The emotional bond between service dogs and their handlers poses unique challenges when dogs develop behavioral issues. We present a case of an otherwise healthy adult service dog exhibiting acute environmental fears, hindering her job performance. The dog's fear responses escalated in various settings, including school and home environments. Diagnostic evaluation ruled out medical pathology, leading to a diagnosis of nonsocial environmental fear and generalized anxiety. A multimodal treatment approach involving environmental management, antidepressant medication (fluoxetine), and behavior modification was implemented. Desensitization and counterconditioning protocols targeted specific triggers, such as shiny floors and elevators. Eight weeks after treatment initiation, the dog showed improvement, enabling a modified behavior treatment plan to be implemented as she gradually returned to work with reduced fear responses. Follow-up revealed sustained progress with additional dosage adjustment of fluoxetine.

Collecting clean-caught voided urine samples is minimally invasive, but contamination occurs when urine passes through the nonsterile urethra and external genitalia. Discarding the initial urine stream may reduce these contaminants. This study hypothesized that using a midstream urine collection device would decrease bacterial and cellular contamination as compared with cleanly caught voided urine. This descriptive cross-sectional study collected urine from dogs using standard clean-caught (SCC), midstream collection device (MCD), and cystocentesis (CYS) techniques. Urinalysis and aerobic urine culture characteristics were recorded with each characteristic's prevalence described using percentages and 95% confidence intervals for each mode of collection. Positive urine culture prevalence did not differ between SCC and MCD (adjusted P value = .099); however, CYS had a lower prevalence compared with SCC and MCD (adjusted P values of <.001 [CYS versus SCC] and 0.009 [CYS versus MCD]). For other variables, there was no difference in prevalence when comparing SCC with MCD. There was no identified advantage to collecting urine using an MCD as compared with the SCC technique. Either option is a suitable alternative when CYS is not practical; however, clinicians need to interpret results cautiously because bacterial contamination is more common as compared with CYS.

Pancarpal arthrodesis was performed in 21 dogs, using orthogonal (cranial/dorsal and medial) plates without postoperative rigid external coaptation. Short-term and long-term outcomes, arthrodesis progression, and complications were assessed using a retrospective review of case records and radiographs. Three of 21 (14.2%) dogs required a revision surgery: 2 had total implant explantation and 1 had a screw removed. Other complications were managed successfully medically. One of 21 (4.8%) dogs had confirmed deep surgical site infection requiring implant removal, and 4 of 21 (19%) had suspected (not confirmed on microbiology) superficial surgical site infections that resolved with medical management. Long-term outcomes were assessed via owner questionnaire (Canine Brief Pain Inventory) and were available for nine dogs at a mean of 26.78 mo after surgery. The mean score for the first part (assessment of pain) was 7.83/40, which is classified as no pain to mild pain. The mean score for the second part (assessment of function) was 12.67/60, which is classified as very good. The last part (overall impression) was defined as excellent in four dogs (44.44%), very good in one dog (11.11%), and good in the other four dogs (44.44%). This retrospective study documents a suitable technique for pancarpal arthrodesis in dogs with carpal injuries.

An 8 mo old spayed female mixed-breed dog was presented for pale mucous membranes. The dog was diagnosed with intravascular immune-mediated hemolytic anemia (IMHA) and was started on medical management including corticosteroids, thromboprophylaxis, a packed red blood cell transfusion, and IV immunoglobulin. The dog developed severe hyperbilirubinemia (total bilirubin 48.1 mg/dL) and was referred for centrifugal plasmapheresis. Before treatment, the dog was stuporous to comatose, had intermittent opisthotonos, forelimb extension, and an absent menace consistent with acute bilirubin encephalopathy (ABE). The dog underwent a previously reported protocol of three therapeutic plasma exchange (TPE) treatments 24 hr apart. Moderate improvement was noted in her neurological status, although autoagglutination and hemolysis persisted, and the protocol was deemed inadequate. A fourth TPE treatment was performed on day 6. The following morning, the dog was autoagglutination negative. Her neurological status gradually improved, and she was discharged from the hospital on day 12. The dog remains neurologically normal and continues to do well at home on monotherapy with mycophenolate. Continued plasmapheresis treatments should be offered as a treatment option for severe cases of IMHA in the face of persistent disease, because TPE is able to provide ongoing support and stabilization, particularly in the face of ABE.

Salmonella is a rod-shaped gram-negative bacterium of the family Enterobacteriaceae, commonly present in the gastrointestinal tract in humans and animals. Salmonella-associated bacteriuria and prostatitis are rare but have been reported in humans, predominantly older patients with underlying diseases, including urinary tract obstructions, diabetes mellitus, and compromised immunity. In dogs, Salmonella bacteriuria and prostatitis have only been described in patients on immunosuppressive medications. This study reports the case of a 7 yr old male Pit bull terrier mix with Salmonella prostatitis. The patient had a 3 day history of lethargy and anorexia. He was fed a commercial diet and had no previous medical or medication history. On physical examination, he had caudal abdominal pain and a firm, enlarged, painful prostate. Ultrasound revealed marked prostatomegaly with multifocal echogenic fluid-filled cavitations and regional peritonitis. Urine and prostatic fluid culture grew Salmonella (>100,000 colony-forming units/mL) using standard culture methods. Treatment with enrofloxacin was initiated for 8 wk. Repeat urine and prostatic cultures after cessation of antibiotics were negative, and serial fecal cultures were Salmonella negative. This case report is, to the best of our knowledge, the first to describe Salmonella prostatitis and bacteriuria in an immunocompetent dog who was not fed a raw diet.

Immune-mediated hemolytic anemia (IMHA) is defined as an immune-mediated destruction of erythrocytes. Relapses are recognized, but risk factors are poorly defined. We hypothesized that a lower packed cell volume (PCV) on presentation, more transfusions during hospitalization, or a higher total bilirubin would be associated with an increased risk of relapse. IMHA was defined as a PCV less than 30% at diagnosis with two of the following identified: spherocytes, positive Coombs test, elevated total bilirubin, hemoglobinemia, or positive slide agglutination. This was a retrospective study evaluating 163 dogs between January 2005 and December 2019 from one specialty hospital. There were 13 relapses. The probability (95% confidence interval [CI]) of relapse by 3 and 12 mo was 0.05 (0.02-0.13) and 0.11 (0.06-0.22). The probability (95% CI) of relapse by 12 mo in patients who required two or more transfusions was 0.20 (0.09-0.42) compared with 0.07 (0.02-0.19) in patients who did not (P = .191). A lower PCV at diagnosis was not associated with an increased risk of relapse (hazard ratio [95% CI] 0.95 [0.86-1.04], P = .238). A higher total bilirubin was associated with a significantly increased risk of relapse (P = .003). With each increase of 1 mg/dL of total bilirubin, there was a 0.17 (95% CI 0.06-0.28) increase in the probability of relapse. These patients would likely need closer monitoring.