Journal of Veterinary Internal Medicine最新文献

Background: Neutrophil gelatinase-associated lipocalin (NGAL) is an accurate marker of septic cavitary effusions in people.

Hypothesis/objectives: To evaluate the utility of serum and effusion NGAL concentrations in differentiating septic effusions from effusions caused by other etiologies in dogs.

Animals: Fifty dogs with pleural or peritoneal effusion.

Methods: Ten dogs were prospectively enrolled into each of 5 groups based on effusion etiology: hypoalbuminemia, increased hydrostatic pressure, neoplastic, inflammatory, and septic. Concentrations of NGAL were measured in both serum and effusion.

Results: While median serum NGAL concentrations did not significantly differ between dogs with hypoalbuminemia (24.8 ng/mL, range 5.0-110.0 ng/mL), increased hydrostatic pressure (13.2 ng/mL, range 5.8-46.9 ng/mL), abdominal neoplasia (13.8 ng/mL, range 3.2-27.3 ng/mL), inflammatory (15.8 ng/mL, 5.6-36.6 ng/mL), or septic causes (19.2 ng/mL, range 7.2-64.8 ng/mL) of effusion (P = .272), median effusion NGAL concentrations were significantly higher in the septic group (194.4 ng/mL, range 120.0-1471.1ng/mL) than in the hypoalbuminemic (10.7 ng/mL, range 4.1-27.8 ng/mL, P < .001), hydrostatic (22.7 ng/mL, range 11.3-56.7 ng/mL, P < .001), neoplastic (65 ng/mL, range 15.7-215.3 ng/mL, P < .001), or inflammatory (45 ng/mL, range 33.8-195 ng/mL, P < .001) groups.

Conclusions and clinical importance: Concentrations of NGAL in effusions were significantly higher in septic effusions than in effusions of other etiologies. These findings suggest that effusion NGAL concentrations could be a helpful marker in the identification of cases with septic effusion.

Background: Splenic hemangiosarcoma (SHSA) is an aggressive neoplasm of dogs characterized by high metastatic rate and short survival time. Although staging and treatment are well established prognostic factors, the implication of specific metastatic sites remains unclear.

Hypothesis/objectives: Describe the frequency and distribution of metastatic site at diagnosis in dogs with SHSA and evaluate the potential prognostic role of different metastatic locations.

Animals: Sixty-six dogs with histologically confirmed SHSA.

Methods: Retrospective, multicenter, descriptive study of dogs with SHSA treated by splenectomy. Data collected included demographics, clinical stage, and site of metastasis at diagnosis and at death, staging procedures, histopathology results, treatment protocols, and outcome. Survival analysis was conducted using Kaplan-Meier and Cox proportional hazards models.

Results: At diagnosis, three dogs were stage I (5%), 35 stage II (53%), and 28 stage III (42%). Overall median tumor-specific survival (TSS) was 132 days. Stage III disease and hepatic metastases were associated with significantly decreased survival (P < .001). Dogs with liver metastasis that received anthracycline-based chemotherapy had longer survival compared with dogs that received metronomic therapy (255 vs 65 days, P = .02). Muscular and pulmonary metastases did not correlate with worse outcomes.

Conclusions and clinical importance: Stage and treatment were confirmed as prognostic factors, with patients in stage III and patients having received surgery alone having a worse prognosis. Although current staging classifies all metastatic disease as stage III, metastatic site may have variable impact on survival and should be considered when devising treatment strategy.

Background: No consensus exists regarding the monitoring and therapeutic approach to adrenal tumors (ATs) discovered incidentally by diagnostic imaging, when standard endocrine testing yields negative results.

Hypothesis/objectives: To evaluate tissue concentrations of adrenocortical steroids in hormonally silent adrenocortical tumors (SATs) in dogs.

Animals: Fourteen dogs with SATs (12 unilateral, 2 bilateral), 11 dogs with cortisol-secreting adrenocortical tumors (cs-ACTs) and 10 healthy dogs.

Methods: Observational study. Diagnosis of SAT was based on finding an AT on diagnostic imaging, negative endocrine function tests, and histopathological and immunohistochemical confirmation. Adrenocortical steroid tissue concentrations were measured by liquid chromatography with tandem mass spectrometry and compared between SATs, cs-ACTs, and normal adrenals (NAs).

Results: Hormonally silent adrenocortical tumors exhibited higher median tissue cortisol (3.62 ng/mg, range 0.05-18.1) and 21-deoxycortisol (0.08 ng/mg, range 0.00-0.44) concentrations than NAs (cortisol 0.38 ng/mg, range 0.01-1.90; 21-deoxycortisol 0.01 ng/mg, range 0.00-0.03; P = .04 and P = .001, respectively), and these concentrations were not significantly different between SATs and cs-ACTs. Furthermore, SATs' median tissue concentrations of mineralocorticoid precursors corticosterone (2.15 ng/mg, range 0.01-14.1) and 18-OH-corticosterone (0.70 ng/mg, range 0.00-4.89) were higher than in NAs (respectively 0.19 ng/mg [range 0.14-0.54] and 0.05 ng/mg [range 0.01-0.33]; both P = .01) and not different when compared to cs-ACTs.

Conclusions and clinical importance: This study on tissue metabolomics in ATs in dogs demonstrates comparable tissue concentrations of specific glucocorticoids and mineralocorticoids in SATs and cs-ACTs. This implies that some SATs are not hormonally silent, prompting further studies on diagnostics, treatment, and monitoring recommendations.

Background: Degenerative myelopathy (DM) is a progressive neurodegenerative disease in dogs associated with a superoxide dismutase 1 (SOD1) gene mutation, resulting in SOD1 protein aggregation within neurons and astrocytes. Targeting SOD1 expression represents a viable therapeutic strategy.

Hypothesis/objectives: Assess the safety and potential efficacy of SOD1 silencing by intrathecal administration of a U1 Adaptor oligonucleotide targeting canine SOD1 (U1cSOD1) in healthy and DM-diseased dogs.

Animals: Seven purpose-bred healthy adult dogs, 1 dog with stage III DM and 4 dogs with Stage I DM.

Methods: Healthy dogs and the stage III DM dog received a single intrathecal dose of U1cSOD1 or a vehicle and were euthanized 5 or 30 days later. Four stage I DM-affected dogs received monthly intrathecal injections of U1cSOD1 for up to 10 months. Physical and neurologic examinations, blood tests, cerebrospinal fluid analysis, as well as pharmacokinetic, pharmacodynamic, and histopathologic analyses were performed in all dogs.

Results: In dogs receiving U1cSOD1, spinal cord SOD1 RNA expression near the injection site was decreased to a median of 37% of normal (range, 21%-79%). Dogs tolerated the procedure and test agent well, exhibiting no adverse effects clinically or histopathologically. Two of 34 injections were aborted because of high intrathecal pressure.

Conclusions and clinical importance: Monthly intrathecal injections of U1cSOD1 in DM-affected dogs are safe and decrease spinal cord SOD1 expression by >50% but an alternative administration route would be preferred. This first test of U1 Adaptor technology in dogs with a naturally occurring disease shows potential for therapeutic intervention in a fatal disease without a current cure.

A 2-year-old Border Collie presented with watery diarrhea and weight loss. Laboratory testing disclosed hypoproteinemia and abdominal imaging identified striations suggestive of intestinal lymphangiectasia and a polycystic mass contiguous with the pancreas. Clinical signs were transiently ameliorated by using prednisolone at an anti-inflammatory dosage, but hypoproteinemia recurred accompanied by ascites within 1 month. Exploratory laparotomy identified pancreatic cysts and extensive inflammation of the duodenum and jejunum, and biopsy samples were taken for histopathology. The pancreatic cyst was lined by lymphatic vessels with no atypia and surrounding collagen fibers, highly suggestive of pancreatic lymphangioma. Histopathology of jejunal biopsy samples disclosed lipogranulomatous lymphangitis and lymphangiectasia. After the laparotomy, the dog was treated with prednisolone at a physiologic dosage and a low-fat diet, and remained asymptomatic for 1 year.

Background: B-cell lymphoma in dogs is a common hematopoietic malignancy, often treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-based chemotherapy, but long-term outcomes remain suboptimal. Although CD20 targeting has improved outcomes in humans with non-Hodgkin's lymphoma, it remains challenging in dogs because of the lack of effective anti-CD20 antibodies.

Hypothesis/objectives: We aimed to assess the safety, efficacy, and B-cell depletion kinetics of a novel afucosylated chimeric anti-canine anti-CD20 antibody (4E1-7-B_f) combined with CHOP chemotherapy in dogs with untreated B-cell lymphoma.

Animals: Thirteen client-owned dogs with high-grade B-cell lymphoma.

Methods: In this open-label, single-arm, single-center clinical trial, dogs received 4E1-7-B_f with CHOP chemotherapy. Treatment response was assessed using the Veterinary Cooperative Oncology Group criteria, whereas progression-free survival (PFS), overall survival (OS), and adverse events (AEs), and peripheral B-cell kinetics were evaluated.

Results: All 13 dogs achieved complete response (CR), with a median time to CR of 3 weeks. The median PFS and OS were 340 (95% confidence interval [CI], 87-417) and 458 (95% CI, 196-not estimable) days, respectively. The 1- and 2-year survival rates were 69.2% and 38.9%, respectively. Most AEs were mild to moderate. B-cell depletion lasted for > 200 days in most dogs, with some remaining B-cells deficient for over 300 days.

Conclusions and clinical importance: The combination of 4E1-7-B_f with CHOP chemotherapy showed promising efficacy and prolonged B-cell depletion. Although direct comparisons cannot be made because of the single-arm design, the results suggest a potential benefit over historical CHOP data. Additional randomized controlled trials are needed to confirm these findings.

We describe a Cockapoo with a subarachnoid diverticulum (Type III), at the level of L6-7. Magnetic resonance imaging identified a circumferential dilatation of the dural sac, extending from the cranial endplate of L6 to the midbody of L7, containing T2-weighted hyperintense and T1-weighted hypointense material that suppressed on fluid-attenuated inversion recovery sequences, consistent with cerebrospinal fluid. An exploratory dorsal laminectomy confirmed a subarachnoid diverticulum (Type III), and a durotomy was performed. After surgical decompression, full clinical resolution was observed. This case had a clinical presentation that mimicked an intervertebral disc extrusion.

Background: Myopathies caused by genetic abnormalities are increasingly recognized in veterinary medicine.

Hypothesis/objectives: Clinically and genetically characterize a novel creatine deficiency disorder (CDD) myopathy in a family of mixed breed dogs.

Animals: Three siblings from the same litter were evaluated and genetically tested, including 2 dogs that were clinically affected and one dog clinically normal. All dogs were client owned.

Methods: Case series describing clinical, imaging, electrodiagnostic, histopathologic investigations, and response to treatment. Whole genome sequencing and bioinformatics were performed to identify a causative variant followed by Sanger sequencing to confirm the suspected variant in related dogs.

Results: Clinical signs included megaesophagus with generalized muscle atrophy in both affected dogs. One dog showed exercise intolerance. Computed tomography (CT) scan revealed bilateral and symmetrical diffuse hypoattenuating muscle lesions. Electromyography was characterized by nonspecific abnormal spontaneous activity in electrodiagnostically affected muscles. Type 2 fiber atrophy and excessive intramyofiber lipid droplets in type 1 muscle fibers were the predominant findings in histopathology. Both affected dogs were homozygous for a unique GATM p.R414C (NP_001274013.1) missense variant, while the unaffected sibling did not have this variant. All clinical signs improved after 3 days of creatine (800-1500 mg/kg/day) and L-carnitine (80-150 mg/kg) supplementation and remained stable at the time of writing 4 months after diagnosis.

Conclusions and clinical importance: This is a report of CDD in dogs characterized by a glycine amidinotransferase (GATM) variant, which showed a good short-term outcome with supplementation with creatine and L-carnitine.

Background: Various echocardiographic views are used to assess left ventricular wall thickness (LVWT), but whether these measurements are interchangeable remains unclear.

Hypothesis/objectives: To assess agreement of LVWT measurements between different echocardiographic views and techniques in cats.

Animals: Four hundred eight cats: 292 with maximal LVWT (MaxLVWTd) < 6 mm and 116 with MaxLVWTd ≥6 mm.

Methods: Cross-sectional study. Echocardiograms performed and measured by a single observer. Septal and free wall LVWT were measured using 2-dimensional (2D) right parasternal long-axis (RPLA) 4- and 5-chamber views, 2D short-axis (RPSA), and M-mode RPSA views. Bland-Altman analysis assessed agreement between views.

Results: Septal thickness (4.6 mm [range, 2.9-9.5] vs 4.2 mm [range, 2.8-9.2], P < .0001) and free wall thickness (4.6 mm [range, 3.0-11.1] vs. 4.1 mm [range, 2.4-12.3]; P < .0001) were significantly greater in 2D RPLA than 2D RPSA. Agreement between 2D RPLA and 2D RPSA showed wide limits of agreement (LoA) and heteroscedasticity for septal and free wall measurements. Between 2D RPSA and M-mode RPSA, a small bias was noted for septal thickness (-0.04 mm, 95%, -0.12 to 0.04 mm), but LoA remained wide (-1.1 to 1.1 mm). Agreement between 4- and 5-chamber 2D RPLA showed small biases (septum: -0.09 mm, 95% CI -0.14 to -0.04 mm; free wall: -0.03 mm, 95% CI -0.09 to 0.02), with wide LoA (septum: -0.8 to 0.7 mm; free wall: -0.9 to 0.8 mm).

Conclusions and clinical importance: LVWT measurements vary significantly across echocardiographic views and are not interchangeable. Standardized measurement protocols are needed to improve consistency in cardiac phenotyping.

Background: Intrapulmonary arteriovenous anastomoses (IPAVAs) are physiological pulmonary right-to-left shunts reported in both humans and dogs but their clinical relevance remains uncertain.

Hypothesis/objectives: Intrapulmonary arteriovenous anastomoses frequently are present in healthy dogs at rest and oxygen therapy will decrease IPAVA flow. We aimed to determine the prevalence of IPAVAs in clinically healthy dogs and to assess the effect of oxygen supplementation on shunt flow.

Animals: Fifty-three client-owned dogs undergoing routine cardiac screening at the Jeonbuk National University Animal Medical Center.

Methods: Prospective study. Clinically healthy dogs underwent agitated saline contrast echocardiography to detect IPAVAs at rest. The IPAVAs were identified by delayed microbubble appearance in the left ventricle (≥3 cardiac cycles after right ventricular opacification). Dogs with confirmed IPAVAs received oxygen therapy (FiO₂ = 0.4) for 5 min, and bubble scores were compared before and after oxygen supplementation.

Results: Of the 53 clinically healthy dogs, IPAVAs were observed in 24 (45.3%). Among 20 IPAVA-positive dogs that received oxygen therapy, bubble scores significantly decreased (P < .01), with complete resolution of shunting in 8 dogs.

Conclusions and clinical importance: Intrapulmonary arteriovenous anastomoses are common in clinically healthy dogs and may cause delayed left ventricular microbubble appearance during saline contrast echocardiography, potentially mimicking intracardiac right-to-left shunts. Oxygen supplementation significantly decreased IPAVA flow, suggesting that these physiological shunts may be dynamically regulated by inspired oxygen levels.