BACKGROUND:Renal dysfunction in cardiac disease is attributed to both reduced cardiac output and venous congestion; however, relative contributions of these mechanisms are difficult to evaluate clinically. HYPOTHESIS/OBJECTIVES:Renal microvascular perfusion assessed by Superb Microvascular Imaging (SMI) would be associated with indices of cardiac output and venous congestion in dogs with cardiac disease. ANIMALS:Forty-three client-owned dogs were enrolled: 15 healthy dogs (Control), 21 dogs with cardiac disease but without right-sided heart failure (non-RHF), and 7 dogs with signs of right-sided heart failure (RHF). METHODS:Prospective cross-sectional observational study. SMI images were obtained from renal cortex, and mean SMI signal intensity (SMI-SI) was calculated as an index of renal perfusion. The left ventricular outflow tract velocity-time integral (LVOT-VTI) was used as an index of cardiac output, while caudal vena cava short-to-long axis ratio at minimal inspiratory diameter (CVC SD/LD) was used to indicate venous congestion. RESULTS:Median SMI-SI was 41.3 (95% CI, 39.1-43.8) in Control, 21.6 (95% CI: 19.4-23.9) in non-RHF, and 18.6 (95% CI, 16.4-21.0) in RHF. Both cardiac disease groups had lower values than Control (P < .001). SMI-SI was negatively correlated with CVC SD/LD (ρ = -0.59, P < .001) and positively correlated with LVOT-VTI (ρ = 0.43, P = .007). In full multivariable analysis, only CVC SD/LD was independently associated with SMI-SI (P = .001). CONCLUSIONS AND CLINICAL IMPORTANCE:SMI detects reduced renal microvascular perfusion in dogs with cardiac disease, which is associated with venous congestion rather than cardiac output.
BACKGROUND:Total calcium concentration (tCa) poorly reflects ionized hypocalcemia across species, and multiple factors influence ionized calcium concentration (iCa2+). These relationships have not been evaluated in Assaf ewes. HYPOTHESIS/OBJECTIVES:Assess the diagnostic accuracy of tCa for detecting hypocalcemia and identify factors associated with iCa2+ during pre- and post-lambing periods. ANIMALS:A total of 105 clinically healthy multiparous Assaf ewes from a commercial flock. METHODS:Prospective observational study. Venous blood samples were collected during pre- and post-lambing periods. Blood gas-electrolytes (pH, pCO₂, pO₂, HCO₃-, TCO₂, Na+, K+, iCa2+) and biochemical analyses (total protein, albumin, tCa, magnesium, phosphorus, β-hydroxybutyrate [BHB], glucose, alkaline phosphatase) were performed. Discriminatory performance of tCa was evaluated using area under the receiver operating characteristic curve (AUC) analysis. Variables associated with iCa2+ were assessed using multiple linear regression. RESULTS:During the pre-lambing period, tCa showed moderate diagnostic performance (AUC, 0.73; 95% CI, 0.57-0.87; sensitivity, 67%; specificity, 80%) at a cutoff of ≤ 2.42 mmol/L, whereas performance was poor for the post-lambing period (AUC, 0.59; 95% CI, 0.47-0.70; sensitivity, 97%; specificity, 31%) at ≤ 2.77 mmol/L. In multiple regression, tCa, BHB, pCO₂, and pO₂ were associated with iCa2+ during pre-lambing (adjusted R2 = 0.27, P < .001), whereas tCa, BHB, phosphorus, albumin, and Na+ were associated with the post-lambing period (adjusted R2 = 0.25, P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE:iCa2+ varied by production stage and was influenced by several physiologic variables. Direct measurement of iCa2+ should be prioritized to improve the accuracy of hypocalcemia assessment in Assaf ewes.
BACKGROUND:Bexagliflozin and velagliflozin are currently the only sodium-glucose cotransporter 2 inhibitors approved by the United States Food and Drug Administration (FDA) for treating diabetes in cats. There are limited real-world safety reports on their associated adverse events (AEs). HYPOTHESIS/OBJECTIVES:To analyze AEs associated with bexagliflozin and velagliflozin using real-world data from the FDA Animal Drug Adverse Events (ADAE) database. ANIMALS:None. METHODS:AE reports submitted for cats receiving bexagliflozin and velagliflozin. Data were obtained from the ADAE database up to the second quarter of 2025. Disproportionality analysis was conducted employing four algorithms: the reporting odds ratio (ROR), proportional reporting ratio, Bayesian confidence propagation neural network, and multi-item gamma Poisson shrinker. RESULTS:Of the 34 187 AE reports for cats, 2876 were related to bexagliflozin and 2776 to velagliflozin. AEs associated with bexagliflozin spanned 22 system organ classes (SOCs), with stronger signals observed for weight fluctuation, glucosuria, and diabetic ketoacidosis. Velagliflozin-related AEs occurred in 19 SOCs, with higher RORs for ketonuria, hypochloremia, and acid-base disorders. Bexagliflozin was associated with stronger signals for DKA and ketosis, whereas velagliflozin showed stronger signals for ketonuria and hypochloremia. Velagliflozin-related AEs occurred earlier (median onset: 5 vs. 9 days), resolved more quickly (median duration: 8 vs. 14 days). CONCLUSIONS AND CLINICAL IMPORTANCE:This study provides a comprehensive safety profile of bexagliflozin and velagliflozin for diabetes in cats. These findings support veterinarians in implementing differentiated risk monitoring and individualized therapeutic decisions in the management of diabetes in cats.
BACKGROUND:The adrenocorticotropic hormone (ACTH) stimulation test is the gold standard test for diagnosing hypoadrenocorticism. However, basal cortisol is recommended for screening but fails to consider the effect of analytical variation and previous glucocorticoid therapy on test performance and additional information that a stimulation test could provide. HYPOTHESIS/OBJECTIVES:To investigate the effect of varied cut-offs and previous glucocorticoid therapy on the diagnostic performance of basal cortisol and whether ACTH stimulation test results impart additional prognostic information. ANIMALS:Fifty-five and 927 hospitalized dogs with and without hypoadrenocorticism, respectively. METHODS:Retrospective case record analysis of dogs undergoing ACTH stimulation testing. Cortisol concentrations were compared between glucocorticoid-exposed (GS, n = 198) and non-exposed (NGS, n = 729) groups. RESULTS:Basal cortisol concentrations ≤ 2.0 μg/dL were significantly (P < .0001) more common in the GS (n = 91, 46.0%) than in the NGS group (n = 226, 31.0%). False-positive flat-line ACTH stimulation test results occurred in 11 (1.2%) dogs. Basal cortisol ≤ 2.0 μg/dL demonstrated imperfect diagnostic sensitivity (98.2%; 95% CI, 90.3%-100%) and poor specificity (65.8%; 95% CI, 62.7%-68.9%). Increasing the cut-off from 2.0 to 2.4, 2.7, or 3.1 μg/dL improved diagnostic sensitivity at the expense of specificity. In the NGS group, basal > 7.0 μg/dL, post-ACTH > 15.6 μg/dL, and delta < 5.3 μg/dL cortisol concentrations were associated with increased risk of not surviving to discharge. CONCLUSIONS AND CLINICAL IMPORTANCE:Higher basal cortisol concentration cut-offs (>2 μg/dL) maximize test sensitivity to the detriment of specificity. Adrenocorticotropic hormone stimulation test results rule out hypoadrenocorticism in the majority of dogs and can provide prognostic information.
BACKGROUND:Paroxysmal dyskinesia (PxD) has not been characterized in Dachshunds. HYPOTHESIS/OBJECTIVES:Describe the phenotype, treatment, and outcome of PxD in Dachshunds. ANIMALS:Sixty-two Dachshunds with presumptive PxD. METHODS:Observational, retrospective, multicenter study of dogs diagnosed with PxD between 2017 and 2025, with prospective information using an owner questionnaire. RESULTS:Median age at presentation was 3.2 years (range, 1-11 years). Episodes were characterized by shifting (55/62; 88.7%), single (4/62; 6.5%) limb or cervical dystonia (28/62; 45.2%), tremors (25/62; 40.3%), dystonic head tremors (15/62; 35.5%), truncal sway (20/62, 32.3%), kyphosis (17/62; 27.4%), and ataxia (15/62, 24.2%) or head sway (12/62, 19.4%). Shifting limb dystonia was exhibited in all (19/55; 34.5%), pelvic (7/55; 12.7%), or thoracic (1/55; 1.8 %) limbs. Ptyalism (25/62; 40.3%), vomiting (23/62; 37.1%), or lip smacking (25/62; 40.3%) were common. All dogs were diagnosed with presumptive idiopathic paroxysmal non-kinesigenic dyskinesia. Most common treatments were gluten-free diet (42/62; 67.7%), levetiracetam (9/62; 14.5%), phenobarbital (5/62; 8.1%), or no treatment (18/62; 29%). Follow-up was available for 49 of 62 (79%) dogs with a median follow-up of 543 days (range, 5-2903 days). Twenty-six of 49 (53%) dogs had a decrease, 19 of 49 (38.8%) had no change and 4 of 49 (8.2%) had an increase in the frequency or intensity of episodes. CONCLUSIONS AND CLINICAL IMPORTANCE:Paroxysmal dyskinesia occurs in young Dachshunds. Shifting limb dystonia is a common feature, and it can affect the pelvic limbs exclusively, mimicking spinal cord disease. Most dogs experienced a decrease in numbers of events regardless of treatment.
A 7-month-old intact male Cavalier King Charles Spaniel was presented for persistent glucosuria despite normoglycemia, failure to thrive, chronic diarrhea, and cerebellar ataxia. Fanconi syndrome was diagnosed, but the neurologic abnormalities were not fully explained. As a consequence of the early onset Fanconi syndrome, a hereditary process was suspected. Whole genome sequencing identified a private hemizygous SINE-like insertion into the ATP7A gene, at the end of intron 13, near the start of exon 14. In humans, variants in ATP7A are associated with Menkes disease, a disorder of copper metabolism associated with a spectrum of clinical signs including progressive neurodegeneration and connective tissue abnormalities. Clinically affected dogs with variants in ATP7A have not been reported previously. Although this case appears to represent a mild phenotypic presentation of Menkes-like disease, it raises the possibility that copper disorders aside from copper-associated hepatitis might exist in dogs. Further genetic screening and phenotypic characterization of rare genetic variants associated with copper metabolism would be beneficial to expand our knowledge of copper disorders in dogs and allow potential early intervention and modeling for metabolic diseases in humans.
BACKGROUND:Subcutaneous ureteral bypass (SUB) can be an effective treatment for ureteral obstruction in cats, but SUB explantation is little documented. HYPOTHESIS/OBJECTIVES:Describe reasons for SUB explantation, outcomes, and owner experiences. We hypothesized that explantation would be effective in managing common SUB-related complications. ANIMALS:Twenty-one cats (31 SUBs) that underwent 29 explantations. METHODS:Retrospective case-series of cats undergoing explantation between 2015 and 2023 with medical record review and 20 owners emailed for follow-up. Results are median (range). RESULTS:Explantation was performed 1.8 years (0.2-4.1 years) after placement because of positive urine culture (PUC; 15/21), SUB obstruction (8/21), sterile cystitis (4/21), and suspected SUB failure (2/21). Twenty-six out of 31 ureters had documented patency. Seventeen cats had all implants removed (9 unilateral, 8 bilateral). Two underwent unilateral explantation and ipsilateral ureteronephrectomy. Two with bilateral SUBs underwent unilateral explantation. Follow-up after explantation was 596 days (3-2310 days). Four cats had ureteral re-obstruction (1 after partial obstruction at explantation), 10 did not re-obstruct and the remainder were undetermined. Seven cats died at 614 days (405-2200 days), 11 were lost to follow-up at 135 days (19-1774 days) after explantation, and 3 remained alive. Four deaths were renal related (2/4 re-obstructions). Nine of 15 cats explanted due to PUC had a negative postoperative urine culture. Three of 15 cats had clinical signs related to PUC postoperatively. Questionnaire response was 9 of 20, and 8 of 9 owners would consider explantation if in the same situation again. CONCLUSIONS AND CLINICAL IMPORTANCE:For SUB cats with complications, explantation is a viable option. A small proportion of cats had clinical signs of PUC, or ureteral re-obstruction postoperatively.
BACKGROUND:Causes for idiopathic acute hemorrhagic diarrhea syndrome (AHDS) in dogs remain uncertain. Recent discoveries suggest a role for enterotoxin-producing Clostridium perfringens, but the triggers for toxin production and AHDS onset are unknown. Meteorological factors have not been examined as a possible AHDS trigger. HYPOTHESIS/OBJECTIVES:Retrospective case-control study aiming to examine the effects of weather conditions and weather changes on the prevalence of idiopathic AHDS. ANIMALS:Dogs (n = 412) presented with acute gastrointestinal (GI) clinical signs between January 2016 and January 2021 at a tertiary veterinary care center. METHODS:Dogs were stratified into 3 groups: idiopathic AHDS, acute gastroenteritis, and other causes for acute GI signs. This categorization was based on the combination of patient history, physical examination, and further diagnostic evaluation (eg, laboratory and imaging diagnostics). Meteorological data were extracted for each dog based on the geocodes of their primary location and were analyzed for associations with AHDS presentations by building a random forest model and calculating odds ratios. RESULTS:Increased wind speeds and shortwave radiation exposure, lower temperatures and sunlight intensity, and dry weather were linked to increased idiopathic AHDS presentations in dogs in the investigated geographical region. CONCLUSIONS AND CLINICAL IMPORTANCE:Our explorative study provides an outlook for prospective investigations to further evaluate potential effects of meteorological factors on the gut-brain-microbiome axis and their role in the development of idiopathic AHDS. In addition to shedding more light on pathogenetic mechanisms of an idiopathic condition, understanding these environmental and weather-related effects could be important in predicting and managing this condition.
BACKGROUND:Assessment of trigeminal nerve (TN) function in horses with trigeminal-mediated headshaking (TMHS) using trigeminocervical reflex (TCR) and quantitative sensory testing (QST) has not been investigated. HYPOTHESIS/OBJECTIVES:Horses with TMHS show lower TCR and QST thresholds than controls. A subset shows left-to-right differences. ANIMALS:Privately owned horses with TMHS (n = 12) and secondary headshaking (sHS; n = 4), from a referral hospital. Headshaking-free controls (n = 14), from the hospital's teaching herd or privately owned. METHODS:Prospective case-control-study. In unsedated horses, TCR was assessed using an automated threshold-tracking device via infraorbital nerve stimulation with concurrent splenic muscle electromyography. QST included evaluation of mechanical nociceptive, tactile sensory, and thermal nociceptive thresholds, assessed bilaterally at 2 sites. Group comparisons used t-tests or Mann-Whitney U tests. Univariate logistic regression assessed TCR and QST as predictors of TMHS. RESULTS:Horses with TMHS had significantly lower TCR thresholds than controls (0.82 ± 0.22 mA vs. 1.16 ± 0.30 mA, Hedges' g = 1.24, 95% CI, 0.41-2.06, t = -3.31, P = .003), and logistic regression predicting TMHS showed good performance (R2 of 0.73, area under the curve of 0.83). No significant left-to-right differences were identified. In sHS horses, lower thresholds were observed on the affected side. QST revealed no significant differences between groups. CONCLUSIONS AND CLINICAL IMPORTANCE:Lower TCR thresholds support altered TN function in TMHS. TCR might be a useful adjunct diagnostic tool, whereas QST did not identify affected horses, reflecting heterogeneous somatosensory phenotypes or limited sensitivity of the QST protocol.
BACKGROUND:Proteinuria is reported in 68%-71% of dogs with spontaneous hypercortisolism (HC). The long-term effect of trilostane on HC-associated proteinuria remains poorly documented. HYPOTHESIS/OBJECTIVES:To evaluate the efficacy of trilostane on proteinuria in dogs with HC and identify potential clinical, anamnestic, and analytical differences between responders and nonresponders. METHODS:Retrospective longitudinal cohort study including dogs with proteinuric HC treated exclusively with trilostane. Clinical history and laboratory data at diagnosis (T0) were retrieved. When available, urine protein-to-creatinine ratio (UPC), disease clinical score (DCS), blood pressure (BP), and daily trilostane dosage (TD) were recorded at 30, 90, 180, and 365 days (T30, T90, T180, and T365) after treatment initiation. Dogs achieving a ≥ 50% UPC reduction or a final UPC < 0.5 were defined as "responders." RESULTS:One hundred sixty dogs met inclusion criteria: 89% had pituitary-dependent HC and 10% adrenal-dependent HC. At diagnosis, 64% were proteinuric. A significant UPC reduction over time occurred (P = .0005; F(4,153.9) = 5.26), with statistically significant decreases at T90 (P = .020; difference, 1.093; 95% CI, 0.115-2.071), T180 (P = .031; difference, 1.122; 95% CI, 0.064-2.181), and T365 (P = .002; difference, 1.599; 95% CI, 0.436-2.761) compared to baseline. At the last follow-up, 76 dogs were evaluable; 48% were responders and had lower median DCS, BP, and TD (P = .029, P = .025, and P = .048, respectively) than nonresponders. CONCLUSIONS AND CLINICAL IMPORTANCE:Trilostane induces a significant and sustained reduction in proteinuria in some dogs with spontaneous HC, evident from 3 months of treatment. Responders exhibit better control of hypertension and clinical signs despite lower TD. Nonresponders account for 52% of proteinuric dogs.
BACKGROUND:Being a life-threatening syndrome, rapid detection of sepsis in critically ill dogs is mandatory. HYPOTHESIS/OBJECTIVES:Determine risk factors associated with sepsis in critically ill dogs and evaluate diseases and scoring systems associated with sepsis or mortality. ANIMALS:One hundred thirty critically ill dogs. METHODS:Prospective single-center cohort study. Logistic regression and classification and regression tree (CART) analysis were performed to assess clinical and laboratory variables as risk factors for sepsis. Diagnostic and prognostic performance of available scoring systems was evaluated. RESULTS:Sepsis was confirmed in 29 of 130 critically ill dogs (22.3%), and 18 died, with a short-term mortality rate of 62.1%. Pneumonia (odds ratio [OR] = 4.8; 95% confidence interval [CI] = 1.8-13.1; P = .002) and acute kidney injury (AKI; OR = 7.4; 95% CI = 2.2-25.1; P = .001) were associated with sepsis. Multivariable logistic regression identified dyspnea (OR = 6.5; 95% CI = 1.6-26.0; P = .01), respiratory rate (≥38 per minute; OR = 3.9; 95% CI = 1.1-13.1; P = .03), and alanine aminotransferase activity (≥109.5 U/L; OR = 3.8; 95% CI = 1.1-12.8; P = .03) as risk factors for sepsis. When combined, these factors yielded a sensitivity of 35.0% and specificity of 92.8%. The CART analysis identified body weight, tachypnea, hypotension, hyperchloremia, hyperlactatemia, and hyponatremia as risk factors for sepsis (sensitivity, 58.6%; specificity, 97.0%). The APPLE FAST score (OR = 2.9; 95% CI = 1.2-7.1; P = .02) was associated with sepsis. The APPLE FAST score (OR = 3.2; 95% CI = 1.4-7.2; P = .01) was the strongest predictor of mortality. CONCLUSIONS AND CLINICAL IMPORTANCE:Pneumonia and AKI were associated with sepsis. Identified risk factors may guide veterinarians in the rapid recognition of sepsis. The APPLE FAST score was associated with sepsis and mortality and may support diagnostic and therapeutic decision-making for critically ill dogs with sepsis.
A 9-year-old neutered male Toy Poodle was diagnosed with true gastrogastric intussusception based on clinical signs, imaging studies, and endoscopic findings. The dog presented with vomiting, hematochezia, and decreased activity. Abdominal ultrasonography identified edematous thickening of the gastric wall and invagination of the gastric fundus into the gastric body. The diagnosis was confirmed by computed tomography (CT). Endoscopic examination clearly identified the intussuscepted portion of the gastric fundus, which was successfully reduced without surgery using insufflation. Histopathologic analysis of gastrointestinal biopsy samples identified chronic gastritis, enteritis, and colitis. After the procedure, the dog remained free of recurrence through day 216. This case emphasizes the value of early ultrasonographic diagnosis and successful endoscopic reduction in the management of true gastrogastric intussusception.
BACKGROUND:Early detection of tumors might prolong the survival of dogs. Kynurenine 3-monooxygenase (KMO) and Ki-67 are tumor biomarkers, but few studies have described the clinical value of KMO and Ki-67 in veterinary medicine. HYPOTHESIS/OBJECTIVES:This study aims to compare the activity of KMO and the concentration of Ki-67 between healthy dogs and dogs with neoplasms. ANIMALS:A total of 162 dogs with different types of tumors were included. Forty-six tumor-free individuals were included as the control group. METHODS:This is a case-control study. Dogs with neoplasms, confirmed through medical record review, were recruited. The primary outcomes were the plasma concentrations of KMO and Ki-67, along with their diagnostic efficacy. RESULTS:Expression levels of KMO were significantly higher in dogs with neoplasms (median, 2.02 ng/mL; IQR, 1.03-3.65) than in tumor-free individuals (median, 0.69 ng/mL; IQR, 0.23-1.18; P < .0001). The values of Ki-67 were higher in dogs with neoplasms (median, 4.28 ng/mL; IQR, 3.75-4.84) than in the control group (median, 3.80 ng/mL; IQR, 3.31-4.43; P < .05). No significant correlation was found between KMO and Ki-67 concentrations (R2 = 0.003, P = .48) in the tested samples and 50.6% (82/162) of dogs exhibited inconsistent results. The area under the ROC curve for KMO and Ki-67 were 0.837 and 0.644. CONCLUSIONS AND CLINICAL IMPORTANCE:This study presents that KMO is an effective biomarker and Ki-67 is an adjunctive marker. While lacking standalone diagnostic utility, Ki-67 reflects systemic tumor biology and complements biomarkers such as KMO.
BACKGROUND:Spontaneous subperiosteal vertebral hemorrhages (SSVHs) are rarely documented in veterinary literature, with only a few cases reported in dogs. HYPOTHESIS/OBJECTIVES:Describe the clinical presentation, imaging findings, and outcome of presumptive cervical SSVHs in dogs and perform a prospective cadaveric study describing the morphology of lesions. ANIMALS:Nine greyhounds presented with acute onset of cervical myelopathy. METHODS:Multicenter descriptive study. The databases were searched for dogs that underwent magnetic resonance imaging (MRI), computed tomography (CT), or both of cervical vertebral column with SSVH as the main or differential diagnosis. RESULTS:Nine middle-aged greyhounds met the inclusion criteria. On MRI, all lesions were at third cervical vertebra or fourth cervical vertebra or both vertebral bodies. Most were bilateral, symmetrical, and ventrolaterally located, causing spinal cord compression. Lesions showed homogeneous T2W hyperintense and T1W isointense to hyperintense signal relative to gray matter; they were non-contrast-enhancing and exhibited a peripheral rim of susceptibility artifact on T2*W images. On CT images, extradural lesions were homogeneously hyperattenuating (60-80 Hounsfield Units). All dogs had an acute onset of clinical signs and were treated medically. Clinical improvement was observed in all cases, and all nonambulatory dogs became ambulatory within 9 days. Clinical signs did not recur during the follow-up period (median, 254 days; range, 5-1217 days). CONCLUSIONS AND CLINICAL IMPORTANCE:Spontaneous subperiosteal vertebral hemorrhage should be included in the differential diagnosis of acute onset cervical myelopathy in greyhounds. Imaging characteristics can aid in differentiating subperiosteal hemorrhage from other extramedullary or extradural lesions. The prognosis is excellent despite the severity of neurologic impairment at presentation.
BACKGROUND:Renal disease in cattle is often suspected based on urinalysis and blood biochemical analysis, but prognostic biomarkers for survival are lacking. HYPOTHESIS/OBJECTIVES:Identify blood and urine biomarkers predicting mortality or discharge in azotemic cattle. ANIMALS:Thirty-four azotemic adult cattle referred to the Clinic for Cattle of the National Veterinary School of Toulouse. METHODS:In our prospective cohort study, renal disease was suspected based on clinical signs and azotemia (plasma creatinine concentration > 228 μmol/L and urea concentration > 5 mmol/L) and confirmed by urinalysis or ultrasonography. When death or euthanasia occurred, confirmation was obtained by gross and histologic examination. To construct a decision tree for short-term prognosis, additional biochemical and cytological biomarkers were measured in urine and blood samples collected at hospitalization. Outcomes were defined as favorable (discharge) or unfavorable (death). Correlation analyses, univariate and multivariate statistics, receiver operating characteristic curves, and decision tree modeling were performed. RESULTS:Thirteen cattle survived and 21 died or were euthanized. Mortality was associated with higher plasma symmetric dimethylarginine (SDMA), creatinine, and urea concentrations, as well as hypocalcemia, hypochloremia, and lower hematocrit. Creatinine, SDMA, chloride, and albumin were the most consistent predictors of outcome. A decision tree combining creatinine and SDMA achieved 87.5% accuracy. Animals with plasma creatinine concentration < 605 μmol/L and SDMA < 33 μg/dL had the highest probability of survival. CONCLUSIONS AND CLINICAL IMPORTANCE:Plasma creatinine, urea, SDMA, chloride, and albumin concentrations are promising short-term prognostic biomarkers in azotemic cattle. Combined SDMA and creatinine assessment may assist clinical decision-making.
Radiation-induced peripheral neuropathy (RIPN) is a well-known late adverse effect of radiotherapy (RT) in humans, but to date, is not reported in companion animals. An 11-year-old spayed female beagle was presented for evaluation regarding a progressive left sciatic neuropathy. The dog had received stereotactic RT (20 Gy) following excision of a grade 2 soft tissue sarcoma over the proximo-caudal aspect of the left thigh approximately 19 months prior to the onset of signs. Computed tomography and magnetic resonance imaging of the left sciatic nerve was consistent with RIPN, and histopathology of the sciatic nerve supported severe nerve fiber loss. No improvement was observed with an anti-inflammatory course of corticosteroids, and the affected limb was subsequently amputated.
A 2-day-old Miniature Horse filly presented with severe clinical and clinicopathologic findings consistent with neonatal sepsis, failure of transfer of passive immunity, and aspiration pneumonia. The filly initially was treated with broad spectrum antimicrobials, hemodynamic support, and hyperimmune plasma. Because of a lack of improvement within the first 24 h, extracorporeal blood purification and cytokine removal were implemented. The foal underwent hemoperfusion (HP) using a polymer-based device (VetResQ). Reported notable changes during and after treatment included improved physical examination variables, increased total white blood cell count, and decreased cytokine and chemokine concentrations. However, progressive thrombocytopenia (secondary to sepsis or HP), increased hemolysis index, and hyperbilirubinemia also were observed after the procedure. The treatment was well tolerated. Ultimately, the foal was euthanized approximately 48 h post-procedure because of development of multiple sites of septic polyarthritis and associated financial constraints. Polymer-based HP has not previously been used to treat septic neonatal foals.
BACKGROUND:Right-sided heart disease (RHD) affects gastrointestinal function and hemostasis. HYPOTHESIS/OBJECTIVES:Dogs with progressively severe RHD have impaired gastrointestinal function and altered hemostasis. ANIMALS:Eighteen client-owned dogs with RHD; group 1: 6 dogs without hepatic venous congestion, group 2: 6 dogs with hepatic venous congestion but no ascites, and group 3: 6 dogs with ascites. METHODS:Prospective, cross-sectional, exploratory study. Dogs underwent routine blood, urine, and fecal testing, measures of gastrointestinal health, coagulation testing, C-reactive protein (CRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and comprehensive echocardiography. RESULTS:Right atrial area higher from groups 1 to 3 (1.34 ± 0.66, 2.48 ± 1.33, 3.1 ± 0.93 cm2/kg0.71; P = .02). NT-proBNP (median; range) higher across group 1 (821; 493-3016 pmol/L), group 2 (1694; 1125-8117 pmol/L), and group 3 (5165; 3492-10 000 pmol/L) (P = .006). Measures of gastrointestinal dysfunction including serum methylmalonic acid (group 1 = 857.5 ± 322.6; group 2 = 1031.1 ± 222.5; and group 3 = 1460.5 ± 516.3 nmol/L; P = .037) and intestinal fatty acid binding protein (group 1 median = 9.3, range = 5.6-11.5; group 2 = 10.1, 8.0-20.4; and group 3 = 13.8, 10.3-17.5 ng/mL) were worse in more severely affected dogs (P = .032). Hyperfibrinolysis was observed with worsening RHD (none in group 1, 2 in group 2, and 3 in group 3). Activated partial thromboplastin time was higher with disease severity. No difference was detected among groups in cobalamin, folate, or CRP (all P > .05). CONCLUSIONS AND CLINICAL IMPORTANCE:Clinicians should be aware of derangements within the gut-heart axis and coagulation system when managing dogs with RHD.
BACKGROUND:Risk of some diseases of cats increases with age, including chronic kidney disease (CKD) and hyperthyroidism, but clinical signs can be dismissed by caregivers as age-related changes. HYPOTHESIS/OBJECTIVES:Quantify the prevalence of disease and other major clinical findings in older cats. ANIMALS:Data from cats (≥8 years old) that underwent routine health screening at 2 United Kingdom (UK)-based primary care veterinary clinics over a 52-month period (October 2, 2018 to February 14, 2023) were analyzed. METHODS:At screening visits, history, physical examination, and blood tests for plasma biochemistry with or without plasma total thyroxine concentration were performed. When possible, systolic blood pressure measurement (97.1% of cases; Doppler method) and urinalysis (41.3% of cases; 98.2% by cystocentesis; and bacterial culture if indicated based on sediment examination) were performed. RESULTS:A total of 549 cats were screened with a median age of 13.5 (IQR: 11.3-15.8) years old. Diagnoses of hyperthyroidism, azotemic CKD, and hypertension were made in 89/464 (19.2%; 95% CI, 15.9%-23.0%), 62/542 (11.4%; 95% CI, 9.0%-14.4%), and 37/524 (7.1%; 95% CI, 5.2%-9.6%) of cats, respectively. Severe dental disease was present in 32/522 (6.1%; 95% CI, 4.4%-8.5%) and bacteriuria was identified in 22/227 (9.7%; 95% CI, 6.5%-14.2%) of urine samples. Other diagnoses included suspected neoplasia (8 cats), diabetes mellitus (8 cats), and suspected primary gastrointestinal disease (4 cats). CONCLUSIONS AND CLINICAL IMPORTANCE:Routine medical health screening in older cats is useful in detecting diseases, many of which would benefit from prompt veterinary intervention. These results can assist veterinarians in explaining the value of health screening to cat caregivers.
BACKGROUND:Single measurements of serum amyloid A (SAA) concentration at hospital admission has limited sensitivity for predicting sepsis and death. HYPOTHESIS/OBJECTIVES:To determine whether differences in SAA during the first 2 days of hospitalization could predict sepsis and death in critically ill foals. ANIMALS:One hundred twenty-seven critically ill neonatal foals, <14 days of age. METHODS:Prospective cohort study. SAA was measured at hospital admission and on day 2 of hospitalization using a validated point-of-care test. Logistic regression was conducted to evaluate the predictive value of individual SAA measurements for diagnosing sepsis and assess whether change in SAA during 48 h could predict sepsis or death. Cox survival analysis assessed the association between SAA concentration and death. RESULTS:Serum amyloid A (SAA) concentrations were measured on day 0 (n = 127) and day 2 (n = 97) of hospitalization. On admission and day 2, SAA was not significantly associated with death (P = .20 and P = .08), but was significantly associated with neutropenia (OR 1.001; 95% CI, 1.001-1.1002; P ≤ .001), blood culture positivity (OR 1.001; 95% CI, 1.0-1.1001; P = .002), or both (OR 1.002; 95% CI, 1.001-1.1003; P ≤ .001), with optimal cut-offs of 419 μg/mL on day 0, with moderate sensitivity and specificity (80% and 81%, respectively). Changes between day 0 and day 2 were not predictive for death (P = .49), neutropenia (P = .36), blood culture positivity (P = .41) or both (P = .17). CONCLUSIONS AND CLINICAL IMPORTANCE:In this cohort, SAA only had moderate ability to rule in or rule out sepsis or predict death. Repeated measurements after 48 h did not improve accuracy, suggesting that SAA should not be used as a standalone test.
