Journal of Veterinary Internal Medicine最新文献

Background: Sarcoids are locally invasive skin tumors in equids, associated with bovine papillomavirus.

Hypothesis/objectives: Address potential applications of cannabidiol (CBD) in veterinary medicine. We evaluated the response of equine sarcoid cells to CBD in vitro, focusing on viability, invasiveness, and matrix remodeling.

Animals: Three primary sarcoid cell lines.

Methods: Cells were treated with CBD (20, 6.75, 2.25, 0.75 μM) and incubated for 6, 24, 48, 72 hours. Cell viability, cytotoxicity, and apoptosis were assessed using the ApoTox-Glo Assay. Based on these results, further analyses were performed for selected conditions only, including the assessment of cell invasiveness using the ECMatrix™ Cell Invasion Assay and the quantification of matrix metalloproteinase (MMP)-1, -2, and -9 in the culture medium by ELISA.

Results: Treatment with CBD affected cell viability, cytotoxicity, and apoptosis. At 48 hours, apoptosis (measured as caspase 3/7 activity) reached 49.5% and further increased to 75% at 72 hours. Marked cytotoxicity (>96%) and decreased viability were observed at 72 hours. Cannabidiol also significantly decreased MMP-1 concentration by 48.9% at 24 hours and MMP-2 concentrations by 84% at 6 hours. Concentrations of MMP-9 also decreased by 37.2% and 45.3% at 6 and 48 hours, respectively, after treatment with 20 μM. Despite observed decreases in cell invasiveness ranging from 34% to 59% after 24 hours, these changes were not significant.

Conclusions and clinical importance: Our findings support further investigation of CBD's role in extracellular matrix modulation in sarcoid tumors.

Background: The endocrine response to snake envenomation in dogs remains unexplored.

Hypothesis/objectives: To compare the endocrine response in dogs envenomated by snouted cobra (Naja annulifera) and African puffadder (Bitis arietans) with healthy control dogs, to evaluate the change over time of specific hormones, and to investigate the correlation of these changes with C-reactive protein (CRP).

Animals: This study included 17 client-owned dogs naturally envenomed by either a snouted cobra (N annulifera) (n = 9) or a puffadder (B arietans) (n = 8). Two control groups (n = 10 and n = 12) consisted of client-owned dogs in good health.

Methods: In this prospective longitudinal observational study, serum samples were collected at admission, and at 12, 24, and 36 h after envenomation. At each time point, the serum total thyroxine (TT4), thyrotropin, total cortisol, and CRP concentrations were measured.

Results: The median serum TT4 concentrations of all the cases were significantly lower than those of controls at all time points (P < .05). The cases had a median (Q1-Q3) serum TT4 of 20.8 nmol/L (15.2-25) at admission, and 7.71 (6.4-19.7), 11.50 (6.4-18.5), and 12.3 (6.4-16.6) nmol/L at 12, 24, and 36 h after envenomation, respectively. The puffadder and neurological cobra subgroup TT4 remained significantly suppressed until 36 h after envenomation and had nadirs of 9.15 (6.4-14.65) and 6.4 (6.1-7.45) nmol/L, respectively. The non-neurological cobra subgroup had a nadir of 14.6 (9.4-21.45) nmol/L and recovered within 24 h. Serum TT4 concentration was negatively correlated with CRP (P < .05, ρ = -0.326). The total serum cortisol concentration in the neurological cobra subgroup at admission was 483.0 (153-549) nmol/L.

Conclusions and clinical importance: Puffadder and snouted cobra envenomation are associated with profound suppression of serum TT4 concentrations, correlated with systemic inflammatory activation as measured by serum CRP concentrations.

Background: Tethered cord syndrome (TCS) results from tension on the conus medullaris (CM), causing pain, bladder or bowel dysfunction, and lower limb neurologic deficits in humans. It is underrecognized in dogs; diagnosis is difficult and depends on improvement after surgery.

Hypothesis/objectives: Describe clinical signs, advanced imaging results, surgical procedures, and outcomes of dogs with TCS. Develop objective measurements of CM and dural sac (DS) movement on dynamic magnetic resonance imaging (MRI) in dogs that benefitted from TCS surgery.

Animals: Twelve client-owned dogs that underwent TCS surgery with follow-up.

Methods: Retrospective study. Diagnosis was based on clinical signs and MRI or computed tomography (CT). The MRI measurements were performed retrospectively in extension and flexion.

Results: Median age at presentation was 52 months (range, 1-12 years). All the dogs had lumbar pain and transient paresthesias such as biting at their hindquarters, sitting urgently or looking at their hindquarters. Dynamic imaging identified minimal craniocaudal movement of the DS and CM between flexion and extension. The mean movement of the CM and DS was 0 mm (range, -1.79 to -2.6 mm), and 0.93 mm (range, -1.4 to -2.9 mm), respectively. All the dogs had a taut external or internal filum terminale, extradural adhesions, or both, which were transected during surgery. All the dogs showed improvement at short-term and long-term follow-up.

Conclusions and clinical importance: Dogs with unexplained lumbar pain and transient paresthesias should be evaluated using dynamic MRI. If minimal movement of the DS or CM is noted, surgical detethering is indicated.

Background: Insulin response to a meal is crucial for metabolic health in cats, influencing the risk of metabolic disorders.

Hypothesis/objectives: Investigate dietary macronutrient compositions on fasted and post-prandial insulin and glucose responses, and lipid profiles, in lean and obese cats.

Animals: Nine lean and 9 obese, male neutered colony cats.

Methods: Cats were fed 3 extruded dry diets: low protein (LP: 28% protein, 40% fat, and 32% nitrogen-free extract [NFE]), low fat (LF: 40% protein, 30% fat, and 30% NFE), and low carbohydrate (LC: 36% protein, 41% fat, and 23% NFE) for 28 days using a 3 × 3 Latin square design. Fasted and post-prandial blood samples were collected to measure serum insulin and whole blood glucose concentrations, and fasted samples were analyzed for serum cholesterol, triacylglycerol (TAG), nonesterified fatty acid (NEFA), very low-density lipoprotein (VLDL), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c) concentrations at the end of each period.

Results: No differences were found in serum insulin, glucose, cholesterol, NEFA, TAG, HDL-c, LDL-c, or VLDL concentrations between lean and obese cats (P > .05) suggesting dyslipidemia was not present in the obese cats. The LP diet resulted in lower post-prandial insulin concentrations compared with the LC and LF diets (P = .01) which was attributed to lower protein intake with the LP diet. As expected, the LF diet led to lower fasted serum cholesterol and LDL-c concentrations compared with the LP and LC diets (P < .001).

Conclusions and clinical importance: These findings document the metabolic flexibility of cats and suggest that dietary macronutrient composition, particularly protein content, plays an important role in modulating insulin responses in adult, otherwise healthy, cats.

Background: Our program was initiated to manage an unexpected increase in carbapenem-resistant Enterobacterales (CRE) contamination identified during routine environmental surveillance in the small animal intensive care unit (ICU) at The Ohio State University Veterinary Medical Center (VMC). Addressing CRE, an urgent public health threat, was critical to protect patients and veterinary personnel.

Hypothesis/objectives: Design an active surveillance program to guide infection control and prevention (ICP) measures and successfully manage CRE in the VMC environment.

Methods: The VMC's environmental surveillance program has conducted monthly surveillance since 2018 to identify pathogens, including CRE. In response to increased CRE contamination in September 2023, a CRE Response Plan Working Group developed and implemented a plan to control contamination and prevent disease transmission. Interventions included enhanced surveillance, strengthened ICP measures, updated CRE protocols, improved cleaning and disinfection, hand hygiene audits and education, ICP training, and a unified communication strategy.

Results: Weekly environmental surveillance identified 4 repeatedly CRE-contaminated surfaces: the covered outdoor run, the emergency room and ICU hallway floors, and the ICU medication preparation counter and CUBEX machine. One patient with a clinical CRE infection was managed without any further identified transmission. By January 2024, repeated CRE contamination was no longer detected in the VMC. Screening ICU patients for CRE fecal colonization identified a 1.9% prevalence.

Conclusions and clinical importance: Active environmental surveillance enabled early detection of increased CRE contamination which guided ICP measures, decreasing the risk of CRE transmission. We provide a framework for responding to nosocomial threats in veterinary hospital settings.

Background: MicroRNAs (miRNAs) are non-coding RNAs involved in cancer-related biological processes. To date, no studies have determined that liquid biopsy using miRNA can specifically identify dogs with cancer from a mixed population of dogs with and without non-malignant diseases.

Hypothesis/objectives: To assess the utility of a diagnostic model that differentiates dogs with cancer from a combined group of healthy dogs and dogs with non-malignant diseases, using miRNA profiles obtained by next-generation sequencing (NGS) and analyzed using machine learning.

Animals: A total of 574 dogs were enrolled in the study: 168 with cancer, 138 with non-malignant diseases, and 268 healthy controls.

Methods: Plasma samples from all dogs were analyzed by NGS to generate comprehensive miRNA profiles. Models were developed using DataRobot, based on the 50 most highly expressed miRNAs. The optimal model was selected based on area under the curve (AUC) results obtained using 5-fold cross-validation.

Results: The miRNA-based model accurately distinguished dogs with cancer from those without cancer, achieving an AUC of 0.907, with both sensitivity and specificity of 0.85.

Conclusions and clinical importance: A model integrating NGS-derived miRNA profiles with machine learning can serve as a diagnostic approach for cancer detection in dogs. Such a model can distinguish dogs with cancer from both healthy dogs and those with non-malignant disease. These findings suggest that such a model could be used as a screening test for dogs with cancer in veterinary practice.

Background: Treatment of naturally occurring Cushing's syndrome includes surgery or medical management but there is little information on how primary care veterinarians (PCVs) select and monitor such treatment.

Hypothesis/objectives: Determine how PCVs from selected European countries treat and monitor Cushing's syndrome in dogs.

Methods: Cross-sectional survey study assessing treatment and monitoring protocols used by PCVs when managing dogs with Cushing's syndrome.

Results: A total of 2178 responses from 9 European countries were included. Overall, 1694 (77.8%) respondents attempted to differentiate functional adrenal tumor (FAT) from pituitary-dependent hypercortisolism (PDH). Adrenalectomy and hypophysectomy were recommended in 67.8% and 30.5% dogs with FAT and PDH, respectively. When surgery was not considered, 23.9% of respondents did not always suggest medical management. Of those recommending medical treatment, 1895/2163 (87.6%) respondents used trilostane either once (60.7%) or twice (39.3%) daily. Time to first follow-up was < 10, 10-14, and 15-30 days for 6.1%, 59.8%, and 31.1% of respondents, respectively. Long-term follow-up was every 3-4 (41.7%) or 5-6 months (37.9%). Monitoring is performed using ACTH stimulation test (54.6%), pre-pill plasma cortisol concentration (18.4%), and both pre- and post-pill plasma cortisol concentration (13.3%).

Conclusions and clinical importance: Approximately one-third of PCVs do not recommend adrenalectomy for FAT and two-thirds do not recommend hypophysectomy in PDH. Despite demonstrated benefits of medical treatment, one-quarter of respondents do not always recommend it, which may adversely affect life expectancy and quality of life. Treatment and monitoring protocols vary among PCVs. These results suggest that further education of PCVs about management of Cushing's syndrome in dogs may be warranted.

Background: The surgical efficacy of mitral valve repair (MVR) in dogs with advanced myxomatous mitral valve disease (MMVD) and atrial fibrillation (AF) remains unclear.

Hypothesis/objectives: To explore risk factors for the persistence of AF and to evaluate survival after MVR.

Animals: Twenty-eight dogs with preoperative AF selected from a cohort of 2733 dogs with MMVD that underwent MVR between January 2015 and April 2024.

Methods: This retrospective study evaluated whether AF persisted at 30 days postoperatively. Risk factors for postoperative persistent atrial fibrillation (pAF) were assessed using preoperative variables. Survival was analyzed using landmark analysis over 2 postoperative intervals: 0-30 days and 30-1000 days.

Results: Four dogs died within the first 30 days. Ten dogs were assigned to the pAF group, whereas 14 dogs that returned to sinus rhythm (SR) comprised the SR group. During the initial 30-day postoperative period, the survival probability at 30 days was 86% (95% confidence interval [CI], 74-100). Body weight (per 1.0 kg; risk ratio, 1.07; 95% CI, 1.01-1.12) and preoperative fractional shortening (per 1.0%; risk ratio, 0.95; 95% CI, 0.90-0.99) were predictive of postoperative pAF at 30 days. From 30 to 1000 days, the survival probability at 1000 days was 45% (95% CI, 20-100) in the pAF group and 90% (95% CI, 73-100) in the SR group (P = .030).

Conclusions and clinical importance: Greater body weight and systolic dysfunction might be associated with postoperative pAF, which might negatively affect long-term survival after MVR.

Background: Keratoconjunctivitis sicca (KCS) is a common and important eye disease of dogs and has been associated with the administration of trimethoprim sulfonamide (TMS).

Hypothesis/objectives: Determine the prevalence of KCS after TMS treatment at a population level and describe risk factors for KCS development.

Animals: Dogs evaluated in general veterinary practice in Australia with records in VetCompass Australia between 2012 and 2022.

Methods: Natural language processing was used to detect dogs treated with TMS and to detect dogs that subsequently developed KCS. Cox proportional hazards modeling was performed to investigate risk factors such as drug dose, duration of treatment, and patient level characteristics (breed, age, sex).

Results: A total of 2243 dogs were treated with TMS during the study period. Four definitive cases of KCS and an additional 35 cases of possible KCS were detected (prevalence 1.8%; 95% confidence interval [CI], 1.3-2.5%). Median duration of TMS treatment was 10 days for both cases (interquartile range [IQR], 7-17 days) and non-cases (IQR, 7-15 days). Median doses were 32 and 33 mg/kg/day for cases and non-cases, respectively. Trimethoprim sulfonamide dose and duration of treatment were not associated with KCS. Some breeds were over-represented and older dogs were more likely to be affected (hazard ratio [HR], 1.076; 95% CI, 1.005-1.152; P = .04).

Conclusions and clinical importance: Keratoconjunctivitis sicca is rare in dogs treated with TMS.

Background: Subclinical bacteriuria (SB) and pyuria (SP) are recognized in companion animals, yet their prevalence and comorbidities in those without signs of lower urinary tract disease (LUTD) remain underexplored.

Hypothesis/objectives: Determine SB and SP prevalence, identify associations, and compare species differences.

Animals: Two hundred eighty-seven cats and 533 dogs without LUTD signs.

Methods: Prospective cross-sectional study with retrospective analysis of medical records.

Results: Subclinical bacteriuria prevalence was 6.67% in cats and 9.81% in dogs. Subclinical pyuria was rarer in cats (1.05%) than in dogs (2.88%). Concurrent SB and SP occurred in 0.3% of cats and 2.5% of dogs (P = .0275), highlighting species-specific patterns. Higher urinary white blood cell levels were associated with higher urine bacterial levels (P < .001). In cats, key multivariable logistic regression associations increasing the composite outcome variable (SP, SB, or SP and SB) odds included previous diagnoses of lower urinary tract infection (LUTI; odds ratio [OR] 5.6 [95% confidence limit or 95CL 2-15.6), diabetes mellitus (OR 6.5 [95CL 1.4-30.3]), hyperthyroidism (OR 9.6 [95CL 1.2-77]), and current diagnosis of acute kidney injury (AKI; OR 7.5 [95CL 2.1-27]); in dogs, a previous diagnosis of AKI (OR 9.9 [95CL 1.3-76.9]), and current diagnoses of AKI (OR 9.9 [95CL 2.3-43.5]) and LUTI (OR 23.3 [95CL 12.5-43.5]). Machine learning revealed additional associations, including hypercortisolism in dogs.

Conclusions and clinical importance: These findings underscore distinct risk profiles between species, suggesting tailored diagnostic approaches in veterinary practice. The rarity of concurrent SB and SP, unlike in humans, questions the application of human guidelines to animals.