The American College of Veterinary Internal Medicine (ACVIM) Forum and the Journal of Veterinary Internal Medicine (JVIM) are not responsible for the content or dosage recommendations in the abstracts. The abstracts are not peer reviewed before publication. The opinions expressed in the abstracts are those of the author(s) and may not represent the views or position of the ACVIM. The authors are solely responsible for the content of the abstracts.
{"title":"2024 ACVIM Forum Research Report Program","authors":"","doi":"10.1111/jvim.17177","DOIUrl":"10.1111/jvim.17177","url":null,"abstract":"<p>The American College of Veterinary Internal Medicine (ACVIM) Forum and the Journal of Veterinary Internal Medicine (JVIM) are not responsible for the content or dosage recommendations in the abstracts. The abstracts are not peer reviewed before publication. The opinions expressed in the abstracts are those of the author(s) and may not represent the views or position of the ACVIM. The authors are solely responsible for the content of the abstracts.</p><p><b>2024 ACVIM Forum</b></p><p><b>June 5–October 31, 2024</b></p><p><b>Research Report Program</b></p><p><b>Index of Abstracts</b></p>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gilad Segev, Hilla Chen, Jonathan D. Dear, Beatriz Martínez López, Jully Pires, David J. Klumpp, Anthony J. Schaeffer, Jodi L. Westropp
Background
Recurrent bacterial cystitis, often referred to as recurrent urinary tract infection (UTI), can be difficult to manage and alternative treatments are needed.
Hypothesis/Objective
Intravesicular administration of asymptomatic bacteriuria (ASB) E. coli 212 will not be inferior to antimicrobial treatment for the management of recurrent UTI in dogs.
Animals
Thirty-four dogs with >1 UTI in the 12 months before presentation.
Methods
All dogs were deemed normal otherwise based on absence of abnormalities on physical examination, CBC, serum biochemical panel, and abdominal ultrasonography. Dogs were randomized to 1 of 2 treatment groups: Group 1 antimicrobials for 7 days or group 2 intravesicular administration of ASB E. coli 212. Owners were provided a voiding questionnaire regarding their dogs' clinical signs, which was completed daily for 14 days to assess clinical cure. Dogs were examined on days 7 and 14 to assess clinical cure, and urine specimens were submitted for urinalysis and bacterial culture.
Results
Clinical cure rates for ASB E. coli 212–treated dogs were not inferior to 7 days of antimicrobial treatment with a 12% margin of difference to determine non-inferiority. No significant difference was found between the treatment groups on days 7 and 14 in the proportion of dogs achieving ≥50% or ≥75% reduction in their clinical score compared with baseline.
Conclusions and Clinical Importance
These data suggest that intravesicular administration of ASB E. coli 212 is not inferior to antimicrobials for the treatment of recurrent UTI in dogs. This biotherapeutic agent could help alleviate the need for antimicrobials for some dogs with recurrent UTI, improving antimicrobial stewardship.
{"title":"Evaluation of the efficacy of a live Escherichia coli biotherapeutic product (asymptomatic bacteriuria E. coli 212)","authors":"Gilad Segev, Hilla Chen, Jonathan D. Dear, Beatriz Martínez López, Jully Pires, David J. Klumpp, Anthony J. Schaeffer, Jodi L. Westropp","doi":"10.1111/jvim.17167","DOIUrl":"10.1111/jvim.17167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recurrent bacterial cystitis, often referred to as recurrent urinary tract infection (UTI), can be difficult to manage and alternative treatments are needed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis/Objective</h3>\u0000 \u0000 <p>Intravesicular administration of asymptomatic bacteriuria (ASB) <i>E. coli</i> 212 will not be inferior to antimicrobial treatment for the management of recurrent UTI in dogs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Thirty-four dogs with >1 UTI in the 12 months before presentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All dogs were deemed normal otherwise based on absence of abnormalities on physical examination, CBC, serum biochemical panel, and abdominal ultrasonography. Dogs were randomized to 1 of 2 treatment groups: Group 1 antimicrobials for 7 days or group 2 intravesicular administration of ASB <i>E. coli</i> 212. Owners were provided a voiding questionnaire regarding their dogs' clinical signs, which was completed daily for 14 days to assess clinical cure. Dogs were examined on days 7 and 14 to assess clinical cure, and urine specimens were submitted for urinalysis and bacterial culture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clinical cure rates for ASB <i>E. coli</i> 212–treated dogs were not inferior to 7 days of antimicrobial treatment with a 12% margin of difference to determine non-inferiority. No significant difference was found between the treatment groups on days 7 and 14 in the proportion of dogs achieving ≥50% or ≥75% reduction in their clinical score compared with baseline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Importance</h3>\u0000 \u0000 <p>These data suggest that intravesicular administration of ASB <i>E. coli</i> 212 is not inferior to antimicrobials for the treatment of recurrent UTI in dogs. This biotherapeutic agent could help alleviate the need for antimicrobials for some dogs with recurrent UTI, improving antimicrobial stewardship.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diego E. Gomez, Ahmed Kamr, William F. Gilsenan, Teresa A. Burns, M. C. Mudge, Laura D. Hostnik, Ramiro E. Toribio
Background
Endothelial glycocalyx (EG) degradation occurs in septic humans and EG products can be used as biomarkers of endothelial injury. Information about EG biomarkers and their association with disease severity is lacking in hospitalized foals.
Objectives
Measure serum syndecan-1 (SDC-1), heparan sulfate (HS), angiopoietin-2 (ANG-2), aldosterone (ALD), and plasma atrial natriuretic peptide (ANP) concentrations and to determine their association with disease severity and death in hospitalized foals.
Animals
Ninety foals ≤3 days old.
Methods
Prospective, multicenter, longitudinal study. Foals were categorized into hospitalized (n = 74; 55 septic; 19 sick nonseptic) and 16 healthy foals. Serum ([SDC-1], [HS], [ANG-2], [ALD]) and plasma (ANP) were measured over 72 hours using immunoassays.
Results
Serum ([SDC-1], [HS], [ANG-2], [ALD]) and plasma (ANP) were significantly higher in hospitalized and septic than healthy foals (P < .05). Serum (ANG-2) and plasma (ANP) were significantly higher in hospitalized nonsurvivors than in survivors (P < .05). On admission, hospitalized foals with serum (HS) > 58.7 ng/mL had higher odds of nonsurvival (odds ratio [OR] = 6.1; 95% confidence interval [CI] = 1.02-36.7). Plasma (ANP) >11.5 pg/mL was associated with the likelihood of nonsurvival in hospitalized foals (OR = 7.2; 95% CI = 1.4-37.4; P < .05). Septic foals with serum (ANG-2) >1018 pg/mL on admission had higher odds of nonsurvival (OR = 6.5; 95% CI =1.2-36.6; P < .05).
Conclusion and Clinical Importance
Critical illness in newborn foals is associated with EG degradation and injury, and these biomarkers are related to the severity of disease on admission and the outcome of sick foals.
{"title":"Endothelial glycocalyx degradation in critically ill foals","authors":"Diego E. Gomez, Ahmed Kamr, William F. Gilsenan, Teresa A. Burns, M. C. Mudge, Laura D. Hostnik, Ramiro E. Toribio","doi":"10.1111/jvim.17196","DOIUrl":"10.1111/jvim.17196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Endothelial glycocalyx (EG) degradation occurs in septic humans and EG products can be used as biomarkers of endothelial injury. Information about EG biomarkers and their association with disease severity is lacking in hospitalized foals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Measure serum syndecan-1 (SDC-1), heparan sulfate (HS), angiopoietin-2 (ANG-2), aldosterone (ALD), and plasma atrial natriuretic peptide (ANP) concentrations and to determine their association with disease severity and death in hospitalized foals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Ninety foals ≤3 days old.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective, multicenter, longitudinal study. Foals were categorized into hospitalized (n = 74; 55 septic; 19 sick nonseptic) and 16 healthy foals. Serum ([SDC-1], [HS], [ANG-2], [ALD]) and plasma (ANP) were measured over 72 hours using immunoassays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Serum ([SDC-1], [HS], [ANG-2], [ALD]) and plasma (ANP) were significantly higher in hospitalized and septic than healthy foals (<i>P</i> < .05). Serum (ANG-2) and plasma (ANP) were significantly higher in hospitalized nonsurvivors than in survivors (<i>P</i> < .05). On admission, hospitalized foals with serum (HS) > 58.7 ng/mL had higher odds of nonsurvival (odds ratio [OR] = 6.1; 95% confidence interval [CI] = 1.02-36.7). Plasma (ANP) >11.5 pg/mL was associated with the likelihood of nonsurvival in hospitalized foals (OR = 7.2; 95% CI = 1.4-37.4; <i>P</i> < .05). Septic foals with serum (ANG-2) >1018 pg/mL on admission had higher odds of nonsurvival (OR = 6.5; 95% CI =1.2-36.6; <i>P</i> < .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion and Clinical Importance</h3>\u0000 \u0000 <p>Critical illness in newborn foals is associated with EG degradation and injury, and these biomarkers are related to the severity of disease on admission and the outcome of sick foals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chee-Hoon Chang, Jonathan Lidbury, Jan S. Suchodolski, Joerg M. Steiner
Background
No prospective study has evaluated the efficacy of oral supplementation with cobalamin in hypocobalaminemic cats.
Objectives
To investigate the efficacy of oral or SC supplementation with cyanocobalamin in normalizing serum cobalamin and methylmalonic acid (MMA) concentrations in hypocobalaminemic cats with chronic gastrointestinal disease (CGID) or exocrine pancreatic insufficiency (EPI).
Animals
Forty-eight client-owned hypocobalaminemic (<290 ng/L) cats with normal or abnormally high serum MMA concentrations.
Methods
This study was conducted based on the prospective randomized clinical trial method. Cats with CGID or EPI were randomly assigned to 2 groups that received either oral or SC supplementation with cobalamin (250 μg/cat) for 12 and 10 weeks, respectively, in addition to other medical and dietary interventions. Each cat was evaluated 3 times (baseline, 6-week postsupplementation, and 1-week postcompletion) by measuring serum cobalamin and MMA concentrations.
Results
In cats with CGID or EPI, cobalamin concentrations were normalized in all cats that received either oral or SC supplementation (mean 100% [95% CI: 80.6%-100%] in both groups in cats with CGID and 100% [67.6%-100%] in both groups in cats with EPI). Among 37 cats with elevated MMA concentrations at baseline (21 cats with CGID and 16 cats with EPI), MMA concentrations were normalized in most cats with CGID (70% in oral and 82% in SC group) or EPI (88% in both groups).
Conclusions and Clinical Importance
In hypocobalaminemic cats with CGID or EPI, in conjunction with other medical and dietary interventions, both oral and SC supplementation are effective at normalizing serum cobalamin and MMA concentrations.
{"title":"Effect of oral or subcutaneous administration of cyanocobalamin in hypocobalaminemic cats with chronic gastrointestinal disease or exocrine pancreatic insufficiency","authors":"Chee-Hoon Chang, Jonathan Lidbury, Jan S. Suchodolski, Joerg M. Steiner","doi":"10.1111/jvim.17195","DOIUrl":"10.1111/jvim.17195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>No prospective study has evaluated the efficacy of oral supplementation with cobalamin in hypocobalaminemic cats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the efficacy of oral or SC supplementation with cyanocobalamin in normalizing serum cobalamin and methylmalonic acid (MMA) concentrations in hypocobalaminemic cats with chronic gastrointestinal disease (CGID) or exocrine pancreatic insufficiency (EPI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Forty-eight client-owned hypocobalaminemic (<290 ng/L) cats with normal or abnormally high serum MMA concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted based on the prospective randomized clinical trial method. Cats with CGID or EPI were randomly assigned to 2 groups that received either oral or SC supplementation with cobalamin (250 μg/cat) for 12 and 10 weeks, respectively, in addition to other medical and dietary interventions. Each cat was evaluated 3 times (baseline, 6-week postsupplementation, and 1-week postcompletion) by measuring serum cobalamin and MMA concentrations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In cats with CGID or EPI, cobalamin concentrations were normalized in all cats that received either oral or SC supplementation (mean 100% [95% CI: 80.6%-100%] in both groups in cats with CGID and 100% [67.6%-100%] in both groups in cats with EPI). Among 37 cats with elevated MMA concentrations at baseline (21 cats with CGID and 16 cats with EPI), MMA concentrations were normalized in most cats with CGID (70% in oral and 82% in SC group) or EPI (88% in both groups).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Importance</h3>\u0000 \u0000 <p>In hypocobalaminemic cats with CGID or EPI, in conjunction with other medical and dietary interventions, both oral and SC supplementation are effective at normalizing serum cobalamin and MMA concentrations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jillian Bell, Sharanne L. Radial, Rosemary S. Cuming, Gareth Trope, Kristopher J. Hughes
Background
Diarrhea in foals can be associated with disruption of the intestinal microbiota (dysbiosis). Effective management of intestinal dysbiosis in foals has not been demonstrated.
Hypothesis/Objectives
Fecal microbiota transplantation (FMT) in foals with diarrhea influences the intestinal microbiota and improves clinical and clinicopathological outcomes.
Animals
Twenty-five foals <6 months of age with diarrhea and systemic inflammatory response syndrome at 3 veterinary hospitals.
Methods
A prospective randomized placebo-controlled cohort study. Foals in the FMT group (n = 19) or control group (n = 9) received FMT or electrolyte solution once daily for 3 days. Fecal samples were obtained on Day 0 (D0), D1, D2, D3, and D7. Within group and between group data analyses were performed for clinical, clinicopathological, and microbiota variables.
Results
Treatment had no effect on survival (FMT 79%; control 100%, P = .3) or resolution of diarrhea (FMT 68%; control 55%, P = .4). On D3, the white blood cell count of the FMT group was lower than the control group (D3 FMT group median 6.4 g/L [5-8.3 g/L]; D3 control group median 14.3 g/L [6.7-18.9 g/L] P = .04). Heart rate reduced over time in the FMT group (D0 median 80 bpm [60-150 bpm]; D2 median 70 bpm [52-110 bpm] [P = .005]; and D3 median 64, [54-102 bpm] [P < .001]). Phylum Verrucomicrobiota, genus Akkermansia, and family Prevotellaceae were enriched in the FMT group on D1 (linear discriminate analysis > 4).
Conclusions and Clinical Importance
In foals with diarrhea, FMT appears safe and can be associated with some clinical and microbiota changes suggestive of beneficial effect.
{"title":"Effects of fecal microbiota transplantation on clinical outcomes and fecal microbiota of foals with diarrhea","authors":"Jillian Bell, Sharanne L. Radial, Rosemary S. Cuming, Gareth Trope, Kristopher J. Hughes","doi":"10.1111/jvim.17185","DOIUrl":"10.1111/jvim.17185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diarrhea in foals can be associated with disruption of the intestinal microbiota (dysbiosis). Effective management of intestinal dysbiosis in foals has not been demonstrated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Hypothesis/Objectives</h3>\u0000 \u0000 <p>Fecal microbiota transplantation (FMT) in foals with diarrhea influences the intestinal microbiota and improves clinical and clinicopathological outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Twenty-five foals <6 months of age with diarrhea and systemic inflammatory response syndrome at 3 veterinary hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective randomized placebo-controlled cohort study. Foals in the FMT group (n = 19) or control group (n = 9) received FMT or electrolyte solution once daily for 3 days. Fecal samples were obtained on Day 0 (D0), D1, D2, D3, and D7. Within group and between group data analyses were performed for clinical, clinicopathological, and microbiota variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Treatment had no effect on survival (FMT 79%; control 100%, <i>P</i> = .3) or resolution of diarrhea (FMT 68%; control 55%, <i>P</i> = .4). On D3, the white blood cell count of the FMT group was lower than the control group (D3 FMT group median 6.4 g/L [5-8.3 g/L]; D3 control group median 14.3 g/L [6.7-18.9 g/L] <i>P</i> = .04). Heart rate reduced over time in the FMT group (D0 median 80 bpm [60-150 bpm]; D2 median 70 bpm [52-110 bpm] [<i>P</i> = .005]; and D3 median 64, [54-102 bpm] [<i>P</i> < .001]). Phylum Verrucomicrobiota, genus <i>Akkermansia</i>, and family <i>Prevotellaceae</i> were enriched in the FMT group on D1 (linear discriminate analysis > 4).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Importance</h3>\u0000 \u0000 <p>In foals with diarrhea, FMT appears safe and can be associated with some clinical and microbiota changes suggestive of beneficial effect.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeremy H. Rose, Colin J. Driver, Lorna Arrol, Thomas J. A. Cardy, Joana Tabanez, Anna Tauro, Ricardo Fernandes, Imogen Schofield, Sophie Adamantos, Nicolas Granger, Thomas R. Harcourt-Brown
We thank you for your considered comments.
We believe we have been transparent in our methodology and the limitations of the study, particularly relating to the sample size and therefore certainty of the results.
We credit our readers with the ability to draw their own conclusions on the statistical and clinical relevance of the work based on the study design. We believe this prospective, randomized, multicenter trial offers real-world findings that suggest a possibility that shorter prednisolone courses may be effective in treating SRMA, but agree this is not conclusive. As such, we used the word “could” in our statement, “both a ‘long’ 6-month or ‘short’ 6-week prednisolone protocol could be considered to treat SRMA cases.” It is possible neither prednisolone protocol used in our study is optimal because of the limited evidence on this topic to date. Hopefully this will be one of many studies to allow veterinary surgeons to optimize the medication and duration of the treatment to improve the quality of life for SRMA dogs.
We appreciate there may be a wider discussion concerning the utilization of P-values in veterinary clinical research and appreciate your perspective on this matter. However, beyond noting this, we feel it is not for us to comment further.
{"title":"Response to letter regarding “Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol”","authors":"Jeremy H. Rose, Colin J. Driver, Lorna Arrol, Thomas J. A. Cardy, Joana Tabanez, Anna Tauro, Ricardo Fernandes, Imogen Schofield, Sophie Adamantos, Nicolas Granger, Thomas R. Harcourt-Brown","doi":"10.1111/jvim.17189","DOIUrl":"10.1111/jvim.17189","url":null,"abstract":"<p>We thank you for your considered comments.</p><p>We believe we have been transparent in our methodology and the limitations of the study, particularly relating to the sample size and therefore certainty of the results.</p><p>We credit our readers with the ability to draw their own conclusions on the statistical and clinical relevance of the work based on the study design. We believe this prospective, randomized, multicenter trial offers real-world findings that suggest a possibility that shorter prednisolone courses may be effective in treating SRMA, but agree this is not conclusive. As such, we used the word “could” in our statement, “both a ‘long’ 6-month or ‘short’ 6-week prednisolone protocol could be considered to treat SRMA cases.” It is possible neither prednisolone protocol used in our study is optimal because of the limited evidence on this topic to date. Hopefully this will be one of many studies to allow veterinary surgeons to optimize the medication and duration of the treatment to improve the quality of life for SRMA dogs.</p><p>We appreciate there may be a wider discussion concerning the utilization of <i>P</i>-values in veterinary clinical research and appreciate your perspective on this matter. However, beyond noting this, we feel it is not for us to comment further.</p><p>Regards,</p>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vanessa Franzen, Nina Alexandra Gruber, Sven Klußmann, Angelika Schoster, Anna May
Background
Trigeminal-mediated headshaking is a neuropathic facial pain condition in horses. No treatment has been entirely successful. Repetitive transcranial magnetic stimulation (rTMS) is used in human medicine as a treatment for various neuropathic pain conditions, and good results have been achieved in cases of trigeminal neuralgia.
Objectives
Apply rTMS to horses with trigeminal-mediated headshaking (TMHS) and to evaluate tolerability, application of the setting, and success rate.
Animals
Seventeen horses with nonseasonal signs of TMHS.
Methods
Other underlying causes of headshaking were ruled out. The rTMS was performed under standing sedation on 5 consecutive days applying 3 sets of 500 stimulations each, with a stimulation strength of 5 Hz. Horses were evaluated on Day 1 (t0) and Day 5 (t1) of the treatment and 2 (t2) and 4 weeks (t3) afterwards using a special scoring system.
Results
The rTMS was well tolerated. Headshaking signs during exercise were decreased by 70% (Day 5; t1). Four weeks after rTMS, signs were still decreased (mean reduction of 50%) during exercise. Improvement of mean resting and exercise scores was significant (P < .05) and effect sizes between pretreatment and all time points after treatment (t1, t2, t3) were large (>±0.8).
Conclusions and Clinical Importance
Repetitive transcranial magnetic stimulation may be a promising treatment for neuropathic pain and headshaking in affected horses. Pain-free periods after treatment differ individually, and repeated treatment may be necessary. More studies should be performed to determine ideal settings for horses.
{"title":"Effect of repetitive transcranial magnetic stimulation on trigeminal-mediated headshaking in 17 horses","authors":"Vanessa Franzen, Nina Alexandra Gruber, Sven Klußmann, Angelika Schoster, Anna May","doi":"10.1111/jvim.17194","DOIUrl":"10.1111/jvim.17194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trigeminal-mediated headshaking is a neuropathic facial pain condition in horses. No treatment has been entirely successful. Repetitive transcranial magnetic stimulation (rTMS) is used in human medicine as a treatment for various neuropathic pain conditions, and good results have been achieved in cases of trigeminal neuralgia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Apply rTMS to horses with trigeminal-mediated headshaking (TMHS) and to evaluate tolerability, application of the setting, and success rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Animals</h3>\u0000 \u0000 <p>Seventeen horses with nonseasonal signs of TMHS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Other underlying causes of headshaking were ruled out. The rTMS was performed under standing sedation on 5 consecutive days applying 3 sets of 500 stimulations each, with a stimulation strength of 5 Hz. Horses were evaluated on Day 1 (t0) and Day 5 (t1) of the treatment and 2 (t2) and 4 weeks (t3) afterwards using a special scoring system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The rTMS was well tolerated. Headshaking signs during exercise were decreased by 70% (Day 5; t1). Four weeks after rTMS, signs were still decreased (mean reduction of 50%) during exercise. Improvement of mean resting and exercise scores was significant (<i>P</i> < .05) and effect sizes between pretreatment and all time points after treatment (t1, t2, t3) were large (>±0.8).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions and Clinical Importance</h3>\u0000 \u0000 <p>Repetitive transcranial magnetic stimulation may be a promising treatment for neuropathic pain and headshaking in affected horses. Pain-free periods after treatment differ individually, and repeated treatment may be necessary. More studies should be performed to determine ideal settings for horses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Milda Baltrimaite, Clodagh Kearney, Anne O'Brien, Michael Duggan, Benoît Cuq
A 10-year-old Irish Sport Horse gelding developed complications from a general anesthesia resulting in sling support and recurrent urinary catheterization. The horse subsequently presented signs of dysuria and pollakiuria, was diagnosed with sabulous cystitis, and developed a urethral stricture from the repeated catheterizations, which was confirmed on urethroscopy. Clinical signs persisted despite conservative management with topical corticosteroids and urethral bougienage with balloon dilators. An image-guided approach was used to treat the stricture with a custom-made polydioxanone stent placed in the urethra after which the horse was able to void normally and fully empty his bladder. Repeat urethroscopy and ultrasonography 6 months after the procedure showed the stent to have completely reabsorbed with urethra remaining patent. Nineten months after the procedure, the owner reports the horse remaining at his intended level of athletic performance with no dysuria.
{"title":"Treatment of a urethral stricture by image-guided placement of a custom-made absorbable stent in a standing, sedated horse","authors":"Milda Baltrimaite, Clodagh Kearney, Anne O'Brien, Michael Duggan, Benoît Cuq","doi":"10.1111/jvim.17181","DOIUrl":"10.1111/jvim.17181","url":null,"abstract":"<p>A 10-year-old Irish Sport Horse gelding developed complications from a general anesthesia resulting in sling support and recurrent urinary catheterization. The horse subsequently presented signs of dysuria and pollakiuria, was diagnosed with sabulous cystitis, and developed a urethral stricture from the repeated catheterizations, which was confirmed on urethroscopy. Clinical signs persisted despite conservative management with topical corticosteroids and urethral bougienage with balloon dilators. An image-guided approach was used to treat the stricture with a custom-made polydioxanone stent placed in the urethra after which the horse was able to void normally and fully empty his bladder. Repeat urethroscopy and ultrasonography 6 months after the procedure showed the stent to have completely reabsorbed with urethra remaining patent. Nineten months after the procedure, the owner reports the horse remaining at his intended level of athletic performance with no dysuria.</p>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p>I read with interest the article “Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol.”<span><sup>1</sup></span> I am concerned that the article contains substantial misinterpretations of statistical evidence, which undermine the reliability of the authors' conclusions.</p><p>Unfortunately, the phrase “no significant difference” may be deeply misleading unless it is correctly interpreted, under the unintuitive logic of frequentist hypothesis tests, and has led the authors to a mistake; it may be true that the interventions are practically exchangeable, but that conclusion cannot be reached from “not significant.” The <i>P</i>-value resulting from frequentist hypothesis tests represents an approximation of the probability that data more extreme than the data at hand would be observed, if the test hypothesis was true; where “probability” represents the frequency in a hypothetical series of identical repeated trials, and the test hypothesis is some statistical model including its parameters.<span><sup>2</sup></span></p><p>The <i>P</i>-value is calculated under the assumption that the test hypothesis (whatever it is) is true, so never indicates support for the test hypothesis, which would involve circular reasoning. Though the “evidential” meaning of <i>P</i>-values is contested and generally dubious,<span><sup>3</sup></span> in simple terms the <i>P</i>-value can be considered a summary of the evidence provided by the data to <i>refute</i> the test hypothesis,<span><sup>4</sup></span> or equivalently, an expression of how surprising it would be to observe data at least as extreme as these, if the test hypothesis was in fact true.<span><sup>2</sup></span> Though a small <i>P</i>-value may suggest (charitably) that some aspect of the test hypothesis is untrue, the usage advocated by Fisher, a large <i>P</i>-value does not support that it is true, because it says nothing about other test hypotheses (in this case, difference between interventions) with which the data may be compatible. It is, therefore, incorrect to conclude anything substantive from a large <i>P</i>-value. Unfortunately, the incorrect interpretation that a large <i>P</i>-value indicates that an effect or association is absent appears common in clinical trials reporting.<span><sup>5</sup></span></p><p>An emphasis on confidence intervals may mitigate some of the limitations of reasoning based on hypothesis tests, even if their exact meaning is unintuitive. This is a popular view,<span><sup>6</sup></span> and is generally encouraged by relevant reporting guidelines. Considering the authors' estimate of the relative incidence risk (which they express as odds ratio) of at least one relapse, which they state as 1.40 (95% CI: 0.40, 4.96, <i>P</i> = 0.60), the confidence interval represents, in simple terms, the set of values of the parameter of interest (test hypotheses) with which
我饶有兴趣地阅读了《比较类固醇反应性脑膜炎-动脉炎患犬接受 6 周或 6 个月泼尼松龙方案治疗后的复发率的前瞻性随机试验》1 一文，我担心的是，该文对统计证据进行了大量曲解，从而削弱了作者结论的可靠性。不幸的是，根据频繁假设检验的非直觉逻辑，除非正确解释，否则 "无显著差异 "这一短语可能会严重误导读者，并导致作者犯了一个错误；干预措施实际上可以交换可能是真的，但这一结论不能从 "无显著差异 "中得出。频繁假设检验得出的 P 值代表的是，如果检验假设为真，那么观察到比当前数据更极端数据的概率的近似值；其中 "概率 "代表的是假设的一系列相同重复试验中的频率，而检验假设则是某种统计模型，包括其参数2 。虽然 P 值的 "证据 "意义存在争议，而且一般都值得怀疑3 ，但简单地说，P 值可以被视为数据提供的反驳检验假设的证据的总结4 ，或者说，如果检验假设确实成立，那么观察到至少与这些数据一样极端的数据会是多么令人惊讶2。虽然小的 P 值可以（善意地）表明检验假设的某些方面是不真实的，但按照费雪所主张的用法，大的 P 值并不支持检验假设是真实的，因为它对数据可能与之相符的其他检验假设（在本例中为干预之间的差异）只字未提。因此，从大 P 值得出任何实质性结论都是不正确的。不幸的是，临床试验报告中经常出现这样的错误解释，即大 P 值表明不存在效应或关联。5 强调置信区间可以减轻基于假设检验推理的一些局限性，即使其确切含义并不直观。这是一种流行的观点6 ，也是相关报告指南所普遍鼓励的。考虑到作者估计的至少一次复发的相对发病风险（以几率比表示）为 1.40（95% CI：0.40, 4.96，P = 0.60），简单地说，置信区间代表了与数据合理一致的一组相关参数值（检验假设）；从某种意义上说，是手头数据无法排除的参数值。虽然我自认不擅长评估神经病学中的干预效果大小，但从表面价值来看，这个区间还是相当宽的；数据显示，每 6 周一次的干预可使复发几率降低约 2.5（1/0.40），或使复发几率增加约 5 倍。这项研究为支持每 6 周一次的干预措施提供了多大程度的证据，这在很大程度上取决于对提名不确定区间内所有效应的背景解释，而作者并没有提供这种解释。8 在大多数情况下，我认为兽医临床研究人员最好将 "显著性"、P 值阈值及相关概念完全搁置一边，将注意力集中在估计值及其不确定性上。
{"title":"Letter regarding “Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol”","authors":"Andrew Woodward","doi":"10.1111/jvim.17188","DOIUrl":"10.1111/jvim.17188","url":null,"abstract":"<p>I read with interest the article “Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol.”<span><sup>1</sup></span> I am concerned that the article contains substantial misinterpretations of statistical evidence, which undermine the reliability of the authors' conclusions.</p><p>Unfortunately, the phrase “no significant difference” may be deeply misleading unless it is correctly interpreted, under the unintuitive logic of frequentist hypothesis tests, and has led the authors to a mistake; it may be true that the interventions are practically exchangeable, but that conclusion cannot be reached from “not significant.” The <i>P</i>-value resulting from frequentist hypothesis tests represents an approximation of the probability that data more extreme than the data at hand would be observed, if the test hypothesis was true; where “probability” represents the frequency in a hypothetical series of identical repeated trials, and the test hypothesis is some statistical model including its parameters.<span><sup>2</sup></span></p><p>The <i>P</i>-value is calculated under the assumption that the test hypothesis (whatever it is) is true, so never indicates support for the test hypothesis, which would involve circular reasoning. Though the “evidential” meaning of <i>P</i>-values is contested and generally dubious,<span><sup>3</sup></span> in simple terms the <i>P</i>-value can be considered a summary of the evidence provided by the data to <i>refute</i> the test hypothesis,<span><sup>4</sup></span> or equivalently, an expression of how surprising it would be to observe data at least as extreme as these, if the test hypothesis was in fact true.<span><sup>2</sup></span> Though a small <i>P</i>-value may suggest (charitably) that some aspect of the test hypothesis is untrue, the usage advocated by Fisher, a large <i>P</i>-value does not support that it is true, because it says nothing about other test hypotheses (in this case, difference between interventions) with which the data may be compatible. It is, therefore, incorrect to conclude anything substantive from a large <i>P</i>-value. Unfortunately, the incorrect interpretation that a large <i>P</i>-value indicates that an effect or association is absent appears common in clinical trials reporting.<span><sup>5</sup></span></p><p>An emphasis on confidence intervals may mitigate some of the limitations of reasoning based on hypothesis tests, even if their exact meaning is unintuitive. This is a popular view,<span><sup>6</sup></span> and is generally encouraged by relevant reporting guidelines. Considering the authors' estimate of the relative incidence risk (which they express as odds ratio) of at least one relapse, which they state as 1.40 (95% CI: 0.40, 4.96, <i>P</i> = 0.60), the confidence interval represents, in simple terms, the set of values of the parameter of interest (test hypotheses) with which ","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Courtney P. Korff, Sophie Nelissen, Amy B. Todd-Donato, Andrew D. Miller, Emma Davies
An 8-year-old female spayed German shepherd dog was presented for evaluation of a 1-week history of right thoracic limb monoparesis. Magnetic resonance imaging (MRI) identified an intraparenchymal, T2 hypointense and T1 isointense, strongly heterogeneously contrast-enhancing mass with moderate internal susceptibility artifact on T2* images at the level of the cranial extent of the C5 vertebral body. Euthanasia was elected after a rapid neurologic decline in the 24 hours after MRI. Necropsy and histopathology identified an intraparenchymal hemangiosarcoma arising from a hemangioma in the cervical spinal cord, with no evidence of neoplastic disease in any other examined organs. The spectrum of vasoproliferative disorders in the central nervous system in veterinary species has been codified recently, but hemangiosarcoma is considered metastatic to the central nervous system. Herein we describe the clinical, imaging, and histologic findings in a dog with a novel primary location of hemangiosarcoma in the cervical spinal cord.
{"title":"Malignant transformation of an intraparenchymal hemangioma in the cervical spinal cord of a German shepherd dog","authors":"Courtney P. Korff, Sophie Nelissen, Amy B. Todd-Donato, Andrew D. Miller, Emma Davies","doi":"10.1111/jvim.17190","DOIUrl":"10.1111/jvim.17190","url":null,"abstract":"<p>An 8-year-old female spayed German shepherd dog was presented for evaluation of a 1-week history of right thoracic limb monoparesis. Magnetic resonance imaging (MRI) identified an intraparenchymal, T2 hypointense and T1 isointense, strongly heterogeneously contrast-enhancing mass with moderate internal susceptibility artifact on T2* images at the level of the cranial extent of the C5 vertebral body. Euthanasia was elected after a rapid neurologic decline in the 24 hours after MRI. Necropsy and histopathology identified an intraparenchymal hemangiosarcoma arising from a hemangioma in the cervical spinal cord, with no evidence of neoplastic disease in any other examined organs. The spectrum of vasoproliferative disorders in the central nervous system in veterinary species has been codified recently, but hemangiosarcoma is considered metastatic to the central nervous system. Herein we describe the clinical, imaging, and histologic findings in a dog with a novel primary location of hemangiosarcoma in the cervical spinal cord.</p>","PeriodicalId":49958,"journal":{"name":"Journal of Veterinary Internal Medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvim.17190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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