Journal of Veterinary Internal Medicine最新文献

Background: Assessment of left ventricular (LV) function using conventional echocardiographic methods is difficult in mitral regurgitation (MR) owing to altered hemodynamic loading conditions. Newer methods such as speckle-tracking echocardiography (STE) provide assessment of LV strain (St) and strain rates (SR).

Hypotheses: Global St and SR are 1) decreased in dogs with clinical signs of congestive heart failure (CHF) due to myxomatous mitral valve disease (MMVD) compared with clinically healthy dogs, and are 2) associated with conventional echocardiographic indices of MMVD severity.

Animals: The study subjects were 93 privately owned dogs with different MMVD severities.

Methods: Prospectively recruited dogs were grouped according to MMVD severity based on echocardiographic evaluation of MR and presence of clinical signs. Global radial and longitudinal St, SR, and indices of LV dyssynchrony were assessed.

Results: On group-wise comparisons, dogs with CHF had increased global longitudinal St, global longitudinal and radial SR in systole (SRs), and early diastole (SRe) compared with dogs with no or minimal MR (all P < .04). On multiple regression analyses, these global STE variables increased with degree of MR, but associations with left atrial-to-aortic root ratio (LA/Ao) were best described by second-order polynomial equations. Thus, curvilinear relationships were found for LA/Ao and longitudinal St, SRs, and SRe (all P < .002) and radial St and SRe (all P < .001).

Conclusions and clinical importance: Assessed by STE, LV function appeared to be augmented in moderate-to-severe disease. However, at CHF stages with greatly enlarged atria, a decrease to levels comparable to dogs with no or minimal MR was observed.

Paratuberculosis (Johne's disease) is a widespread and costly disease. This consensus statement will summarize recommendations regarding diagnosis, control, and treatment of Johne's disease in cattle and other species. Each section of recommendations is followed by a statement that subjectively characterizes the strength of the supporting evidence. The role played by Mycobacterium avium subsp. paratuberculosis (MAP) in the pathogenesis has been a matter of controversy for many years. This statement concludes with an assessment of the evidence in favor of MAP as a potential zoonotic pathogen.

Background: Copper-associated hepatitis is an inherited disease in the Labrador Retriever. Apart from genetic factors, dietary intake of copper and zinc are suspected to play a role in the pathogenesis.

Objectives: To investigate whether dietary copper and zinc levels of commercially available dry diets are associated with hepatic copper and zinc concentrations in Labrador Retrievers.

Animals: Fifty-five Labrador Retrievers that were fed a single brand and type of commercial dry food for at least 1 year. Of these, 44 dogs were family members of Labrador Retrievers with copper-associated hepatitis.

Methods: Liver biopsies, blood samples, and diet samples were obtained. Liver specimens were scored histologically and copper and zinc concentrations were quantified. Dietary concentrations of copper and zinc were measured. The association between dietary intake of copper and zinc and hepatic copper and zinc concentrations was investigated by linear regression analysis.

Results: High dietary copper and low dietary zinc levels were significantly associated with high hepatic copper levels. No association between dietary intake and hepatic zinc was present.

Conclusions and clinical relevance: Dietary copper and zinc at current levels in commercially available dry dog food can influence hepatic copper and can be a risk factor for the development of copper-associated hepatitis in Labrador Retrievers with a genetic susceptibility to copper.

Background: Correct interpretation of blood pressure (BP) and heart rate (HR) recordings is important in a clinical environment, but little is known about effects of stress on BP and HR responses of dogs to different clinical settings.

Objective: To investigate BP and HR responses in different clinical settings in dogs of 3 breeds, and to relate findings to urinary catecholamine concentrations measured by ELISA assays previously validated for use in human plasma and urine, after validation for use in dogs.

Animals: Client-owned healthy dogs; 41 Labrador Retrievers, 33 Cavalier King Charles Spaniels (CKCS), and 15 Dachshunds.

Methods: Prospective observational study. BP and HR were measured in 4 clinical settings with or without veterinarian and owner present. Urine samples were taken before and after examination. ELISA assays were validated for canine urine, and epinephrine/creatinine and norepinephrine/creatinine ratios were analyzed.

Results: BP and HR were higher when measured by veterinarian alone than when owner was present (P < .020). Urinary catecholamine/creatinine ratios were higher after examination, compared with before, in all dogs (P < .0001). Labrador Retrievers had lower diastolic BP than Dachshunds in 2 settings (P ≤ .041), lower HR than CKCSs in 3 settings (all P < .0001), and lower catecholamine/creatinine ratios after examination than both other breeds (P ≤ .035). The in-house validation showed mean spiked recovery of 96.5% for epinephrine and 83.8% for norepinephrine.

Conclusions and clinical importance: BP and HR responses were related to breed as well as clinical setting. Breed differences were detected in urinary catecholamine/creatinine ratios. Further studies on breed differences are warranted.

Background: Diabetes mellitus (DM) management primarily focuses on improvement in blood glucose concentrations and clinical signs. A tool to assess the psychological and social impact of DM and its treatment on quality of life (QoL) previously has only been validated for feline DM.

Hypothesis/objectives: To validate a diabetic pet and owner-centered individualized measure of impact of DM (DIAQoL-pet) for diabetic dogs and their owners. ANIMALS/SUBJECTS: A total of 101 owners of insulin-treated diabetic dogs were recruited to complete the DIAQoL-pet.

Methods: Discussions and pilot surveys with clinicians and owners of diabetic pets led to the design of 29 specific DM-associated QoL questions. Each item was scored according to impact frequency and perceived importance. An Item-Weighted-Impact-Score (IWIS) for each item was calculated, as was an Average-Weighted-Impact-Score (AWIS) by averaging all IWISs. Principal component analysis and Cronbach's α calculation assessed the measure's reliability.

Results: The DIAQoL-pet showed high reliability (Communalities ≥0.5; Cronbach's α 0.85). The AWIS was -2.74 ± 1.7 (mean ± SD). Areas reported as most negatively impacting QoL included: "worry" (IWIS ± SD: -5.92 ± 4.3), "difficulties leaving dog with friends or family" (-5.68 ± 5.1), "worry vision" (-5.58 ± 4.6), "boarding difficulties" (-5.18 ± 5.2), "worry hypoglycemia" (-4.95 ± 4.3), "social life" (-4.82 ± 4.4), "costs" (-4.11 ± 4.7), and "future care"(-4.07 ± 4.6). Eighty-four percent of owners reported negative impact of DM on QoL.

Conclusions and clinical importance: The DIAQoL-pet proved robust when used by owners of insulin-treated diabetic dogs and identified specific areas most negatively impacting dogs' and their owners' QoL. This tool could be used as an additional assessment parameter in clinical and research settings.

Background: Increases of adrenal hormone concentrations other than cortisol have been reported in dogs with hyperadrenocorticism (HAC).

Hypothesis/objectives: Measuring noncortisol adrenal hormone concentrations will help identify HAC in dogs. The objective was to determine plasma cortisol, androstenedione, estradiol, progesterone, testosterone, and 17-hydroxyprogesterone concentrations during ACTH stimulation testing of dogs with clinical signs of HAC to ascertain their utility in diagnosis of the disease.

Animals: Ninety dogs with clinical findings consistent with HAC had ACTH stimulation tests performed. Results from 29 dogs were excluded from analysis because diagnoses were inconclusive for a variety of reasons. Results from 32 dogs with HAC and 29 dogs with disease other than HAC were analyzed.

Methods: Prospective observational study. Concentrations of adrenocortical hormones were determined before and 1 hour after injecting 5 μg/kg ACTH IM. Diagnoses were determined by response to therapy, histopathology or both.

Results: Post-ACTH cortisol (P < .001), progesterone (P = .001), and 17-hydroxyprogesterone (P < .001) concentrations were associated with a diagnosis of HAC. Sensitivity and specificity, respectively, for diagnosing HAC for post-ACTH cortisol were 84 and 59%, progesterone 88 and 55%, and 17-hydroxyprogesterone 91 and 59%, and for post-ACTH cortisol, progesterone and 17-hydroxyprogesterone combined were 88 and 55%. Of 5 dogs with HAC and normal post-ACTH cortisol concentrations, 5 had increased progesterone and 4 had increased 17-hydroxyprogesterone.

Conclusions and clinical importance: Serum progesterone and 17-hydroxyprogesterone concentrations were useful to diagnose HAC in this study, but were not more sensitive or specific than cortisol concentration.

Background: The diagnosis of encephalitis is usually presumptive based on MRI, cerebrospinal fluid analysis, or both. A definitive diagnosis based on histopathology, however, is required for optimizing treatment strategies.

Objective: To investigate the diagnostic yield and adverse effects of minimally invasive brain biopsies in dogs with encephalitis.

Animals: Seventeen dogs with suspected encephalitis, based on MR imaging and cerebrospinal fluid analysis.

Methods: Retrospective study. Minimally invasive, free-hand brain biopsy specimens were taken from forebrain lesions through a 4-mm burr hole using a Sedan side-cutting needle. Routine histopathological examination was performed. The adverse effects were assessed by MRI evaluations after biopsy procedure (12/17) and by sequential neurological examinations.

Results: The overall diagnostic yield with regard to a specific type of encephalitis was 82%. Encephalitis was evident in an additional 12%, but a specific disease could not be determined. There were no deaths caused by the biopsy procedure itself, but the indirect case fatality rate was 6%. Morbidity was 29%, including stupor, seizures, tetraparesis, hemiparesis, ataxia, and loss of conscious proprioception. All these signs resolved within 3-14 days.

Conclusions and clinical importance: Minimally invasive brain biopsy in dogs with suspected encephalitis leads to a definite diagnosis in the majority of dogs, allowing for a specific treatment. The advantages of a definite diagnosis outweigh potential case fatality rate and temporary neurological deficits.