Journal of the American Animal Hospital Association最新文献

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.

A 5 yr old female spayed pit bull terrier mix was evaluated for development of multiple dermal nodules over the previous 2 wk with concurrent weight loss and lethargy. A definitive diagnosis of cutaneous epitheliotropic T-cell lymphoma was obtained through histopathology and immunohistochemistry. Treatment was initiated with 32.9 mg/m2 (1.2 mg/kg) of oral verdinexor twice per week, according to label guidance. One week after treatment initiation, clinical remission was noted with complete resolution of the cutaneous nodules. The dog has continued twice-weekly treatments without any interruption and remains in complete remission 17 mo following initiation of verdinexor therapy. This case provides evidence for the utility of verdinexor in the treatment of canine cutaneous epitheliotropic T-cell lymphoma.

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.

The literature regarding surgical repair of urethral prolapse in dogs is limited and associated with a high recurrence rate. We hypothesized that combined resection and anastomosis (R&A) with urethropexy would be associated with less recurrence of urethral prolapse compared with R&A alone. Medical records of dogs managed surgically for urethral prolapse were reviewed (2013-2023) from three tertiary care hospitals. Inclusion criteria included complete medical records, including surgery reports, short-term postoperative complications, and longer-term follow-up. Forty-six male dogs successfully met the inclusion criteria (16 castrated; 30 intact). Brachycephalic breeds were overrepresented (37/46, 80%). Surgical repair by R&A alone (n = 27), urethropexy alone (n = 6), or a combined R&A and urethropexy (n = 13) was performed. Recurrence rates for these techniques were 13/27 (48%), 2/6 (33%), and 1/13 (8%), respectively. The recurrence rate of urethral prolapse treated by a combined R&A and urethropexy was significantly lower (P < .05) than R&A alone, despite more dogs being overweight and less surgeon experience (each P < .05). Interestingly, dogs neutered before initial diagnosis may be more likely to have postoperative recurrence. Considering general anesthesia risks, an initial combination procedure for urethral prolapse may help prevent recurrence.

A 1 yr old female Chihuahua was presented for traumatic skull injury. Computed tomography revealed brain herniation through the bregmatic fontanelle. The hernia was manually reduced, and the defect was repaired using a polypropylene mesh. To the authors' knowledge, this is the first reported case of brain herniation through the bregmatic fontanelle in a dog.

Smoke contains a mixture of harmful gases, chemicals, and superheated particles. Inhalation of smoke causes generalized hypoxia and airway inflammation due to impaired oxygen transport and utilization, as well as thermal and chemical injury in the airways. Generally, treatment is supportive with oxygen therapy and airway management, including chest physiotherapy, bronchodilators, and nebulization. Immediate oxygen therapy is mandatory for all suspected smoke inhalation patients and should not be delayed pending diagnostic test results or due to "normal" oxygen saturation readings that can be falsely elevated in carbon monoxide intoxication. Smoke inhalation patients with mild clinical signs who respond well to initial stabilization generally have a favorable prognosis. However, patients with severe signs or progression despite initial stabilization may require more advanced or intensive care.

A 7 yr old castrated male domestic shorthair presented for assessment of a chronic left head tilt, losses of balance, and positional nystagmus. A computed tomographic scan of the head revealed several fragments of a metallic foreign body in the left tympanic cavity. The foreign material was removed under endoscopic assistance through a minimally invasive ventral bulla osteotomy. No complications were noted during the immediate postoperative period. Follow-up 5 mo after surgery revealed complete resolution of the neurological signs with no evidence of recurrence. Foreign bodies associated with middle ear infection have not been previously reported in the cat. They should now be included in the differential diagnosis of vestibular disease. Endoscopic-assisted foreign body removal in the middle ear seems to be a safe and efficient way to retrieve small foreign bodies in bullae in cats.

A 7 yr old female French bulldog exhibited recurrent purulent vulvar discharge following an episode of pyometra treated by ovariohysterectomy. The diagnosis of ureteral duplication was established through a combination of ultrasonography, computed tomography scanning, and cystoscopy/vaginoscopy. Despite initial medical intervention, the dog's clinical condition did not improve. Consequently, surgical treatment was pursued to remove the duplicated ureter while preserving the integrity of the urinary tract. Resection of the duplicated ureter was performed from the kidney to the bladder, and the blind ends left in place in the kidney and in the bladder wall were omentalized. Histopathological analysis confirmed the presence of the duplicated ureter. Postoperatively, the dog made a full recovery with no complications or urinary tract dysfunction. Long-term follow-up (11 mo) revealed complete resolution of all clinical signs. Ureteral duplication should be included in the differential diagnosis of vulvar purulent discharge in dogs. Removal of the abnormal ureter resulted in complete resolution of the clinical signs. This case underscores the importance of individualized treatment plans for ureteral duplications in dogs and the potential for successful surgical treatment in selected cases.