Journal of Veterinary Internal Medicine最新文献

Background: In hospitalized foals, limited data are available on the utility of sequential measurement of SAA concentrations and the value of these data in a clinical setting.

Hypothesis/objectives: To determine serum amyloid A (SAA) concentrations in ill neonatal foals at multiple timepoints during hospitalization, and to evaluate a potential association with systemic inflammatory response syndrome (SIRS) status, blood culture (BC) result, and survival.

Animals: Hospitalized ill foals (n = 90, ≤ 14 days).

Methods: In this retrospective study, foals were classified based on SIRS criteria: "SIRS" or "NonSIRS," BC results, and survival. Serum amyloid A concentrations on admission (ADM), day 1 (D1) and day 2 (D2) were compared within and between groups, using nonparametric tests. Results are presented as median (IQR) (effect size; 95% CI).

Results: Serum amyloid A concentrations were higher in SIRS than in NonSIRS foals both on ADM (401 mg/L (99; 855) vs 67 mg/L (23; 685), [ES 129, 95% CI, 15-385]), and on D1 (836 mg/L (616; 1240) vs 212 mg/L (69; 890), [ES 501, 95% CI, 121-724]). On D2, but not on ADM, foals with a positive BC had higher SAA (1244 mg/L (757; 2004)) than BC negative foals (153 mg/L (57; 695), [ES 1002; 95% CI, 282-1418]). On D1, but not on ADM, SAA was higher in non-survivors (729 mg/L (469; 1347) than in survivors (323 mg/L (75; 889), [ES 373; 95% CI, 28-651]).

Conclusions and clinical importance: Serum amyloid A measurements on D1 and D2 of hospitalization likely reflect both the severity of disease and response to initial treatment. Repeated SAA measurements during hospitalization can aid clinicians in determining severity of disease and can be useful as a prognosticator in ill neonatal foals.

Background: Hypercalcemia associated with granulomatous disease in dogs can present a diagnostic challenge.

Hypothesis/objectives: Excessive endogenous, extrarenal calcitriol production is a potential mechanism of ionized hypercalcemia in dogs with granulomatous skin conditions.

Animals: Hypercalcemic client-owned dogs (n = 7) with chronic skin disease seen in general and specialty practices with calcium profiles submitted to a university veterinary diagnostic laboratory by the attending clinician.

Methods: Descriptive case series reporting clinical presentation, laboratory findings, treatment, and outcome of 7 hypercalcemic dogs with dermatopathies of varying etiology.

Results: Panniculitis was confirmed histologically in 5 dogs (idiopathic, n = 4; presumed bacterial, n = 1). The other 2 dogs had severe generalized demodicosis (n = 1) and demodectic/sarcoptic mange with superficial and deep pyoderma (n = 1). Initial testing showed clinically relevant parathyroid-independent ionized hypercalcemia, undetectable parathyroid hormone-related protein concentration, and 25-hydroxyvitamin D concentration close to or below the lower reference limit in all dogs. Calcitriol concentration was above reference interval in 6 dogs at initial testing, and near the upper reference limit in 1 dog 29 days after presentation. In all cases, normalization of calcium and vitamin D homeostasis paralleled clinical improvement with appropriate therapy for the underlying skin condition.

Conclusions and clinical importance: Ionized hypercalcemia apparently mediated by excessive extrarenal calcitriol production can be seen in dogs with granulomatous skin disease. Calcitriol measurement should be included with other calcium-related testing in the workup of unexplained hypercalcemia with concurrent chronic skin disease.

Asthma is one of the most common respiratory diseases in cats and humans. Cats are the only domestic species that develop a syndrome similar to asthma in humans, characterized by type I hypersensitivity and consequent narrowing of the airways. Because of the chronic nature of the condition and the adverse effects of long-term corticosteroid use, exploring new therapeutic strategies is crucial for improving the health and well-being of affected cats. We present a novel therapeutic approach using IM mesenchymal stromal cells (MSCs), a delivery route not previously reported for asthma in any species. A 7-year-old cat with asthma had severe clinical signs, including coughing, apathy, vomiting, and dependence on corticosteroids and bronchodilators. The cat received 3 IM injections of 1 × 106 MSCs per kg body weight at 30-day intervals. The cat experienced lasting clinical improvement. No adverse effects were observed, and corticosteroids and bronchodilators were successfully discontinued without subsequent asthma attacks during 2-years of follow-up. Anti-emalso etics were withdrawn without recurrence of frequent vomiting, and the animal's appetite improved sufficiently to achieve a 0.6 kg weight gain. In addition, a quality-of-life questionnaire indicated substantial improvement in vitality and comfort (P < .05). This case highlights the potential of IM MSCs as an alternative treatment for asthma in cats, offering a safe and potentially effective option for minimizing corticosteroid dependence. Additional studies are warranted to confirm the therapeutic benefits and broader applicability of MSCs.

Background: Post-cystoscopy dysuria is thought to be common in dogs. Limited information is available in veterinary medicine regarding strategies to prevent or mitigate post-cystoscopy dysuria.

Hypothesis/objectives: Determine the efficacy of intraurethrally administered lidocaine jelly in combination with current standard-of-care pain control (eg, epidural anesthesia, nonsteroidal anti-inflammatory drugs) for prevention of post-cystoscopy dysuria.

Animals: Fifty-one client-owned dogs presented for cystoscopy or other cystoscopically guided interventions.

Methods: Randomized, placebo-controlled, double-blinded, and clinical study. All dogs undergoing cystoscopy for common indications were considered for enrollment during the study period with owner permission. Dysuria scores were compared between groups on days 0-7.

Results: Twenty-six dogs were included in the lidocaine group and 25 in the placebo group. No significant difference was found in the frequency of postprocedure dysuria between groups. Twenty percent of all dogs exhibited dysuria on day 1 after cystoscopy, but decreased to 11% by day 5 (P < .001).

Conclusions and clinical importance: Intraurethral administration of lidocaine jelly might not be necessary to decrease the frequency and duration of postprocedural dysuria. Dysuria resolved in most patients undergoing cystoscopy by day 4. This information might be helpful for owner education and preparation of dogs for cystoscopic procedures.

Background: Infrared thermography (IRT) is a noninvasive imaging technique increasingly applied in medical fields, including breast cancer detection.

Hypothesis/objectives: To evaluate the diagnostic accuracy of IRT in assessing the biological behavior and progression of canine mammary tumors (CMTs) and to investigate associations with routine prognostic factors.

Animals: Eighty-one female companion dogs were enrolled, including 17 healthy controls and 64 dogs with 80 mammary tumors (MTs), which were categorized as benign (n = 9), low-grade malignant (n = 30), or moderate- to high-grade malignant (n = 41).

Methods: This prospective comparative cohort study qualitatively and quantitatively evaluated thermographic images by analyzing the distribution of white pixels (WPs), red pixels (RPs), and yellow pixels (YPs) based on surface temperature. Thermal symmetry, vascular patterns, and necrotic areas were assessed, as well as their correlation with tumor malignancy and survival.

Results: Control dogs showed symmetrical mammary thermal patterns, whereas MT dogs exhibited asymmetries associated with vascularization and necrosis. Benign tumors had a higher WP distribution, whereas high-grade malignancies showed a significantly increased RP distribution. An RP threshold of 16.9% differentiated tumors by aggressiveness. Dogs with >16.9% RPs had shorter survival (P = .004). RP distribution correlated with the malignancy grade (P = .003).

Conclusions and clinical importance: IRT identified thermal patterns linked to tumor aggressiveness and survival in dogs with CMTs, indicating that it is a valuable, noninvasive tool for initial evaluation, surgical planning, and prognostic assessment in CMT.

A 7-year-old Pomeranian with a history of patent ductus arteriosus (PDA) was presented with acute hindlimb paralysis. Hindlimb aortic thrombosis (ATh) was suspected, and spontaneous PDA thrombus was incidentally identified on echocardiography and computed tomography (CT). Concurrent protein-losing nephropathy was identified as the underlying condition contributing to the hypercoagulable state. Low-dose antithrombotic therapy was initiated to minimize the risk of abrupt PDA recanalization, which could result in cardiovascular compromise. Despite treatment, distal ATh progressed, resulting in renal infarction, acute kidney injury, and death. This report describes a rare case of spontaneous PDA closure without surgical or interventional treatment. Thrombotic PDA occlusion should be considered in hypercoagulable dogs with a history of PDA and no audible murmurs. Echocardiography and arterial-phase CT can help in establishing a diagnosis. This case highlights the importance of close monitoring and individualized treatment in dogs with PDA and prothrombotic risk factors.

A 7-year-old spayed female mixed-breed dog was diagnosed with acute pancreatitis and received supportive care for 2 weeks, after which the dog developed diabetes mellitus (DM). Insulin therapy was initiated (insulin glargine 300 U/ml) at 0.2 U/kg subcutaneously (SQ) every 12 hours with no dose adjustments required. After 2 months, insulin therapy was discontinued because of a suspected hypoglycemic episode and persistently normal interstitial glucose concentrations. Nineteen months after diagnosis, the dog remained euglycemic with normal hemoglobin A1c, consistent with diabetic remission. Diabetic remission is rare in dogs and is reported only in the context of insulin-resistance caused by excess progesterone or glucocorticoids and in a single case report with no obvious cause of insulin-resistance. The case reported here demonstrates that even in pancreatitis-related DM, remission is possible in a dog.

Background: In people, electrocardiography (ECG) is recommended for screening of hypertrophic cardiomyopathy (HCM). Data for assessing the ability of ECG to screen HCM in apparently healthy cats is scarce.

Hypothesis/objectives: Determine whether ECG variables on a 6-lead ECG can identify subclinical HCM in cats.

Animals: One hundred twelve cats were enrolled, 61 normal and 51 with subclinical HCM.

Methods: Single-center, cross-sectional study. Cats with normal hearts (end-diastolic left ventricular wall thickness [LVWTd] ≤ 5.0 mm) and cats with subclinical HCM (LVWTd ≥ 6.0 mm) were prospectively enrolled. Blinded assessment of the following ECG variables was performed: P wave amplitude and duration, PQ interval duration, amplitude of Q, R, and S waves, QRS duration, dispersion and mean electrical axis, R-to-peak time, T wave amplitude and duration, T/R ratio, T peak-to-end time (Tpte), Tpte/QT, RT concordance, QT interval (absolute and corrected for heart rate), presence of ST segment elevation (STE)/depression, and J wave.

Results: On multivariable analysis, a higher R wave amplitude (odds ratio [OR], 20.12; 95% confidence interval [CI], 2.4-227.5) and presence of STE ($ge$0.04 mV; OR, 8.3; 95% CI, 2.9-27.4) were the only variables independently associated with HCM after adjusting for body weight (area under the curve, 0.86; 95% CI, 0.78-0.93). An R wave amplitude > 0.26 mV as a sole screening test for HCM had 65% sensitivity and 62% specificity to detect HCM.

Conclusions and clinical importance: Our results suggest that a 6-lead ECG is a poor screening tool to detect subclinical HCM in cats.

Background: Cerebellar diseases in dogs cause diverse neurologic signs depending on the affected region. Although functional topographic maps linking cerebellar areas to motor, behavioral, and vestibular functions have been established in humans, such mapping is poorly characterized in veterinary medicine.

Hypothesis/objectives: Evaluate how specific clinical signs in dogs correspond to cerebellar lesion locations and contribute to differential diagnoses.

Animals: One hundred two client-owned dogs from 4 referral centers in Spain and the United Kingdom.

Methods: Multicenter retrospective study including dogs diagnosed with cerebellar disease that underwent neurologic examination and magnetic resonance imaging of the head.

Results: Rostral cerebellar lobe lesions were significantly associated with motor abnormalities: the rostral culmen with cerebellar ataxia (OR, 5.76) and the lobulus centralis with decerebellate rigidity (OR, 5.68). Caudal lobe involvement (folium and tuber vermis) was linked to abnormal behavior (OR, 4.12). Deep white matter lesions involving the interpositus nucleus were associated with head tilt (OR, 6.48), nystagmus (OR, 3.76), vestibular ataxia (OR, 4.01), and delayed postural reactions (OR, 4.83).Vascular disease was significantly associated with brachycephalic breeds (P = .02), comorbidities (P < .001), non-ambulation (P = .01), and paresis (P = .01). Neoplasia was significantly linked to incoordination (P = .02), head tilt (P < .01), and abnormal behavior (P < .001). Inflammatory or infectious diseases commonly presented with pain (P = .02) and tremors (P < .001).

Conclusion and clinical importance: Our findings suggest 3 region-related cerebellar syndromes in dogs, motor (rostral lobe), behavioral (caudal lobe), and vestibular (deep white matter), which parallel cerebellar syndromes described in humans. Additionally, the specific clinical presentation may indicate a particular differential diagnosis.

Background: Acute tumor lysis syndrome (ATLS) is caused by the rapid breakdown of tumor cells, leading to electrolyte imbalances and renal dysfunction. The risk of ATLS is particularly high in lymphoma, and therefore it is crucial to consider this risk when initiating chemotherapy. However, risk factors associated with ATLS in dogs remain largely unexplored.

Hypothesis/objectives: Identify potential risk factors for ATLS in dogs with multicentric lymphoma.

Animals: A retrospective analysis was conducted on 24 dogs diagnosed with B-cell high-grade multicentric lymphoma that received chemotherapy.

Methods: Blood samples were collected before treatment and on days 3, 5, and 8 after treatment. Serum concentrations of uric acid, potassium, phosphorus, calcium, and creatinine were measured based on the Cairo-Bishop Criteria to classify cases as laboratory tumor lysis syndrome (LTLS) or clinical tumor lysis syndrome (CTLS). Clinical variables, including signalment, clinical signs, comorbidities, stage, chemotherapy agents, hematologic and biochemical findings, chemotherapy response, and clinical outcomes were compared between two groups: normal and LTLS/CTLS.

Results: Of 24 dogs, LTLS occurred in 5 (20.8%), whereas CTLS occurred in 2 (8.3%). The development of LTLS/CTLS was strongly associated with the initial administration of L-asparaginase, presence of chronic kidney disease (CKD), weight loss, and metabolic acidosis. However, no significant differences were observed between the normal and LTLS/CTLS groups regarding signalment, clinical signs, stage, CBC abnormality, and clinical outcomes.

Conclusions and clinical importance: Evaluating the four risk factors at the initiation of chemotherapy may help establish personalized prevention strategies for ATLS in dogs with multicentric lymphoma.