Explore all the previous studies we have interpreted and highlighted over the years.
January 2025
Retrospective evaluation of the incidence and outcome of neutropenia in dogs with acute hemorrhagic diarrhea syndrome (2017-2022): 54 cases
JVECC
In this UK referral population of dogs with AHDS, 28/54 dogs were documented neutropenic on presentation or during hospitalisation. Of these 28, 20 survived and 8 were non-survivors. Of the 26 dogs that were non-neutropenic, 25 survived and one was a non-survivor.
Retrospective evaluation of dexamethasone for treatment of suspected critical illness-related corticosteroid insufficiency in dogs with septic shock (2017–2022): 60 cases
JVECC
Although used clinically, reported in low numbers, suggested in the surviving sepsis guidelines (https://journals.lww.com/ccmjournal/fulltext/2021/11000/surviving_sepsis_campaign__international.21.aspx) in people and we have many anecdotes of the benefits of glucocorticoids (and mineralocorticoid activity in hydrocortisone) in vasopressor-resistant septic dogs…the evidence of their benefit and how (or if!) to try to diagnose critical illness-related corticosteroid insufficiency is harder to come by.
This study reports 60 dogs with vasopressor-resistant septic shock, and described those treated with dexamethasone (not hydrocort) or no glucocorticoids at all. Finding no difference in time to weaning of vasopressors or outcome may be truisms but as the authors discuss – non-matched groups (eg. sicker patients in the dex group and different adjunctive treatments), lack of mineralocorticoid provision and type II error are also feasible in explaining the lack of difference.
Retrospective evaluation of autotransfusion using a cell saver device versus allotransfusion in the perioperative management of acute hemoperitoneum in 43 dogs (2017–2021)
Frontiers in Veterinary Science – Veterinary Emergency and Critical Care Medicine. Open access
Of the 47 dogs with haemoabdomen of splenic aetiology being managed surgically in this study, 11 were managed with autotransfusion alone, with similar survival times on follow up to those receiving allotransfusion or no transfusion. The autotransfusions were performed by intraoperative collection in this study. Out if interest, an alternative approach is also to harvest the blood pre-surgically by abdominocentesis (eg. using a centesis catheter or percutaneously placed drain).
Implementation of a standard perioperative protocol reduces postoperative respiratory distress events in dogs undergoing surgical correction of brachycephalic obstructive airway syndrome
JAVMA
This study retrospectively describes the frequency of post-operative respiratory distress events in dogs undergong BOAS surgery before and after implementation of a protocol for their peri-operative management. The frequency of post-op respiratory distress was lower in the post-protocol group. The frequencies with which regurgitation and aspiration were documented were similar across both groups, however. We don’t know what the perfect recipe is yet, but Table 3 provides an easy to gauge summary of what has been implemented at this hospital over time.
Clinical characteristics associated with cervical hydrated nucleus pulposus extrusion in dogs
JVIM. Open access.
This is a useful evidence base to inform generation of your differential diagnoses list in dogs presenting with cervical myelopathy. The study describes the presentation of dogs with cervical neurolocalisations, divided according to diagnosis: hydrated nucleus pulposus extrusion (HNPE), intervertebral disk extrusion (IVDE), fibrocartilaginous embolism (FCE), cervical spondylomyelopathy (CSM) and neoplasia.
The focus was on dogs with hydrated nucleus pulposus extrusion (HNPE), documenting that while dogs with HNPE are often non- or minimally painful, over a third did have pain scores of 2/3. Compare this to dogs with FCE of which over 90% were non- or minimally painful, and dogs with IVDE in which over 70% were moderately painful.
Dogs with HNPE also tended to be older (median 10 years, IQR 8-12) without evidence of lateralisation compared to dogs with FCE (median 5.5 years, IQR 3.7-8, 77% lateralising).
The reason I discuss those two acute differentials in particular, is that FCE is a non-surgical condition, and HNPE is also often considered non-surgical. So, in cost-restrictive settings, converting to conservative management and physiotherapy without the end diagnoses where those diagnoses are likely, is completely reasonable.
Figures 2 and 3, and table 3 present a lot of the data very clearly.
Abdominal fluid score as a predictor of transfusion needs and outcome in cats following trauma
JVECC
In this study of over 2000 cats from the VetCOT registry, the presence of abdominal effusion was associated with a requirement for transfusion, in that 16% of those with free peritoneal fluid required a transfusion compared to just 4% of those without effusion. Free fluid was not associated with a higher need for surgery in these cats.
Comparison of removal of intestinal foreign bodies using orogastric retrieval techniques versus gastrotomies in dogs and cats
JSAP
This is the latest description on an interesting theme:
In the last few years there have been two studies describing the intraoperative use of endoscopy (gastroscopy) to retrieve foreign bodies that can be moved orally into the stomach at surgery or, for example, to retrieve gastric foreign bodies where initial endoscopic retrieval is unsuccessful and you convert to laparotomy, thus avoiding the enterotomy. (Surgical removal of intestinal foreign bodies using a laparotomy-assisted endoscopic approach in dogs and cats and comparison with enterotomy https://onlinelibrary.wiley.com/doi/10.1111/jsap.13550 and Laparotomy-assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats – https://onlinelibrary.wiley.com/doi/10.1111/vsu.14126)
This most recent study skips the visualisation component. They report using endoscopic grabbers (without the scope) or gastric tubes and manual manipulation to assist gastric FB retrieval via the mouth in animals with small intestinal foreign bodies that can be localised to the stomach.
A little tour and some cool lightbulb moments, for me anyway.
(Though reassuring that dehiscence rates post gastrotomy are very low anyway:
Dehiscence rate and associated risk factors after gastrotomy for removal of foreign material in dogs and cats
JAVMA
Two CPR based studies for you here:
An exploratory study on the effect of rescuer team size on basic and advanced life support technical skills in a high-fidelity simulation of canine cardiopulmonary arrest
JVECC
Effect of blindfolding the lead resuscitator on frequency of closed-loop communication during veterinary cardio-pulmonary resuscitation training: a randomized, controlled pilot study
Frontiers in Veterinary Science – Veterinary Emergency and Critical Care Medicine. Open access
and one cytology based one too:
Observer reliability in counting erythrocyte ghost cells and impact of short-term storage of canine and feline blood samples.
The Veterinary Journal. Open access
In this study, blood smears were made from EDTA anticoagulated blood at 0, 2 and 24 hours (blood from cases with IMHA was not used in this study). There were significantly more ghost cells identifiable in the smears made at 24 hours.
Can you discriminate between a true ghost cell and a ‘smudged erythrocyte’?! See Fig 1.
Can’t beat a fresh blood smear. In my opinion anyway.
December 2024
Therapy with clopidogrel or rivaroxaban has equivalent impacts on recurrence of thromboembolism and survival in cats following cardiogenic thromboembolism: the SUPERCAT study
JAVMA. Open access
This has been an eagerly awaited study! 45 cats were prospectively enrolled after cardiogenic thromboembolism and randomised to receive monotherapy with clopidogrel (18.75mg/cat) or rivaroxaban (2.5mg/cat). Most (27/45) cats had had bilateral hindlimb thrombi, 9 were unilateral pelvic and 7 unilateral thoracic limb. Frequencies of ATE recurrence were similar in both groups: 7/19 cats receiving clopidogrel and 10/26 cats receiving rivaroxaban, after medians of 663 and 513 days, respectively. Quality of life was also tracked and displayed over time in these cats in figure 2.
Recalling that clopidogrel alone offers an advantage over aspirin in such cats, and if we take as given that rivaroxaban performs similarly to clopidogrel…then the scene is set for exploring if there is a benefit to dual therapy, which seems to be increasingly prescribed.
Window entrapment trauma in cats: clinical, neurological and clinicopathological findings and outcome (70 cases)
JFMS. Open access
A new word for you here, don’t say I never give you anything: Kippfenster syndrome (google search Kippfenster syndrome here).
In the UK I only really know to expect a bilateral femoral neuropathy (with frog-legged stance) in animals trapped over the horizontal plane of a window. The cats in this study have been trapped in a vertical plane (look at the google images, sorry!) for up to 12 hours. Rectal hypothermia was very common on examination. Only 5 of 70 cats had a normal gait; most being somewhere from ambulatory paraparetic to paraplegic. Half had normal femoral pulses but half were reduced or absent. CK was elevated in all cats in which it was measured, usually more than 30-fold. Most cats did well, with severely affected cats (eg. no femoral pulses, no tail sensation) having poor outcomes.
Tremors in cats: 105 cases (2004-2023)
The Veterinary Journal. Open access
In this referral population of 105 cats with tremors reported, the most common aetiologies were degenerative encephalopathies, FIP, congenital portosystemic shunting (all three of these broadly tending to be chronic and progressive in presentation) and intoxications.
Feline dystocia and kitten mortality up to 12 weeks in pedigree cats
Journal of feline medicine and surgery. Open access
This study retrospectively captured data directly from breeders (448 of them) of pedigree cats about 853 litters in 2019. Veterinary assistance was required for 127/853 (14%) litters. Kitten mortality up to 12 weeks ranged from 7.1% to 23.4% in Cornish Rex and Bengals, respectively. Higher queen age was associated with lower kitten mortality and reduced odds of requiring a caesarean section.
Evaluation of bile acids and bilirubin in serum and abdominal fluid in dogs with abdominal effusion
JSAP
This is an interesting study challenging the often-proposed diagnostic criterium of an abdominal fluid to serum bilirubin ratio of more than 2 for biliary tract rupture. That ratio, however, is not substantiated in the literature. In this small study including 7 biliary tract rupture cases (some based on ultrasound, some on surgical findings), abdominal effusion bile acids seemed to perform better than bilirubin.
I’m interested in the haemoabdomen patients of this study, and this is actually on my study ‘to-do’ list! I have definitely seen haemoabdomen cases that have been complicated by documentation of a high bilirubin on a peritoneal fluid sample. Haemorrhagic effusion due to hepatic rupture (eg. in a trauma case) should (presumably?) contain more bilirubin (or bile acids!?) than serum. Whether that is due to rupture of a bile duct per se, or any number of bile canaliculi within a parenchymal laceration is perhaps the question…
What does biliary tract rupture even mean…?! 😉
Having previously highlighted an update article on hypoadrenocorticism in cats (Hypoadrenocorticism in cats: a 40-year update https://journals.sagepub.com/doi/10.1177/1098612X241248381), this study describes a more recent collection of 41 cases:
Clinical findings, treatment, and outcomes in cats with naturally occurring hypoadrenocorticism: 41 cases
JVIM. Open access
36/41 cats were classified as hyponatremic or hyperkalemic or both, while 5 were neither. Median age was 5.7 years and the median length of clinical signs was approximately 3 weeks. Plenty more details for future reference are contained within!
Also flagging this for your attention now, though I’m certain it will be covered in more detail in the Neurology e-mail from Abbe…
Comorbidities, long-term outcome and poststroke epilepsy associated with ischemic stroke – A multicenter observational study of 125 dogs
JVIM. Open access
The search for sepsis biomarkers: A tale of promises, pitfalls and potential
Critical Care Medicine
This foreword is a good read. It’s a relief, in some ways, to hear that in people no biomarkers have yet “supplanted our useful but imperfect friends: C-reactive protein, procalcitonin, white cell count and standard microbiological culture” (!) (not that procalcitonin applies to us in veterinary medicine) when trying to rapidly identify infection. I enjoyed the more specific uses of biomarkers that are discussed – eg. in predicting future deterioration or suitability for specific or alternative treatments – reaching beyond ‘infection yes/no’.
November 2024
Assessment of change in end-tidal CO2 after fluid challenge as a marker of fluid responsiveness as measured by the aortic velocity time integral in healthy anesthetized mechanically ventilated dogs.
JVECC
These results are perhaps hard to directly translate for a couple of reasons and, as the authors state, different clinical contexts would be interesting to explore but I enjoyed the concept because it relates to a couple of situations in which we clinically do use ETCO2. For example as a surrogate for cardiac output during CPR, and what we see in our mechanically ventilated patients sometimes. In an animal with a big CO2 mismatch between venous (PvCO2) or arterial (PaCO2) and ETCO2 (end-tidal being much lower), sometimes this is related to perfusion (as well as related to overdistension – both situations increase alveolar dead space and potentiate “dead space ventilation”). When perfusion to the lungs is improved, eg. with volume resuscitation, CO2 delivery to the lungs is improved, ETCO2 increases, and the mismatch is reduced. The same happens in ROSC.
Significance of incidentally identified bullae and blebs on thoracic computed tomography and prevalence of subsequent pneumothorax in dogs
Veterinary Surgery
Pulmonary bullae and blebs (PBBs) are air-filled lesions in the lung parenchyma often implicated in spontaneous pneumothorax in dogs. However, the significance of these findings when documented incidentally is unclear. In this retrospective study, thoracic CT scans that had been performed in dogs for reasons unrelated to pneumothorax or severe pulmonary disease were retrospectively reviewed. 2178 CT scans were reviewed and PBBs were identified incidentally in 30 (1.4%) of the studies. Over a median follow-up period of 1,255 days, none of these dogs developed spontaneous pneumothorax. (One dog did die suddenly from an unknown cause, so spontaneous pneumothorax could not be ruled out). Based on these findings and in these timeframes, the risk of SP in dogs with incidentally identified PBBs appears minimal. We should remain mindful of the theoretical risk of spontaneous pneumothorax in these cases without further follow up.
The prevalence of murmurs and gallop sounds in anemic cats
JVECC
In retrospectively identified populations of cats presenting to an emergency room or requiring a blood transfusion, where those with known heart disease were excluded, 56/185 anaemic cats had a heart murmur, compared to 11/102 non-anaemic cats, and 25/185 anaemic cats had a gallop sound reported, compared to 4/102 non-anaemic cats. The proportion of cats with murmurs was highest in those with a PCV of less than 15%. Amongst those cats with a gallop sound documented were cats without echocardiographic evidence of cardiomyopathy. Knowing more about these cats will be very interesting…
Urinary Cystatin B as a marker of acute kidney injury in cats
The Veterinary Journal. Open access
Cystatin B is an intracellular protein but can be detected in urine and used as a biomarker following kidney cell damage. This study included 76 cats: 38 with acute kidney injury (AKI) (as defined using IRIS guidelines – 2, 4, 9, 13 and 10 cats with IRIS AKI grades I, II, III, IV and V, respectively), 17 with chronic kidney disease (CKD) (2, 6, 8 and 1 cats in stages 1, 2, 3 and 4, respectively), 9 cats with urethral obstruction and 12 control cats. Cats within AKI and CKD groups had higher median urine cystatin B compared to controls (1052, 112 and 22 ng/mL, respectively), and urine cystatin B was higher in the AKI group than the CKD group. When divided by outcome, cats surviving 30 days had a median of 584ng/ml, compared to 1572 ng/mL in non-survivors.
Utilization of peripheral glucose and lactate differences in the diagnosis of feline arterial thromboembolism: a multi-center study.
Frontiers in Veterinary Science – Veterinary Emergency and Critical Care Medicine. Open access
This study prospectively measured glucose and lactate in the affected limbs of 18 cats with confirmed arterial thromboembolism, and used them to create differentials between affected and unaffected limbs (Difference = affected – unaffected). Amongst cats with ATE, the median lactate from an affected limb was 11.5 mmol/L (range 5.2–17 mmol/L) and the median difference between that and an unaffected limb was 7.2 mmol/L (range 0.3–14.8 mmol/L). The median blood glucose in an affected limb was 108 mg/dL (6 mmol/L) and the median blood glucose in an unaffected limb was 250 mg/dL (14mmol/L). Optimal cut-offs for lactate and glucose differentials to diagnose ATE when were reported as 2.2 mmol/L and 41 mg/dL (2.2mmol/L), respectively. Hindlimb – forelimb differentials were used in a control population of cats presenting to the ER for these analyses.
Evaluation of the Trauma-Associated Severe Hemorrhage score as a predictor of transfusion in traumatized dogs
JVECC
A small study but interesting for trauma enthusiasts – this study calculated and compared a trauma-associated hemorrhage score (TASH score) between 2 groups of dogs presenting post trauma: those receiving a blood transfusion (12 dogs) and those that did not receive a transfusion (12 dogs). Those receiving a transfusion had higher TASH scores (10.2 ± 2.0) compared with dogs that did not (5.2 ± 1.1). Animal trauma triage (ATT) scores were also reported: mean ATT score was higher in dogs that received a blood transfusion (5.2 ± 0.78) than those that did not (2.0 ± 0.5).
In the last month there have been a number of commentaries on the changing landscape of statistics in veterinary literature. Set aside some time to indulge your stats curiosities (!) and have a look at the following articles…
P values and confidence intervals, with examples of how to use them:
Reporting and interpreting statistical results in veterinary medicine: Calling for change
JVIM. Open access
Consideration of levels of evidence and common methodology flaws:
Evidence-based veterinary medicine-potential, practice, and pitfalls
JVIM. Open access
…and how P values can be over-interpreted:
The perilous P value
JAVMA. Free access
October 2024
Feline blood donation: Description and adverse reactions from 29201 donation events between 2019 and 2023
JVIM. Open access
This study retrospectively reviewed 29 201 cat blood donation events over the course of 4 years, inspecting for adverse reactions in particular. Adverse reactions were divided into those occurring at the time of or within 2 hours of the donation, or in the following 5 days. The median volume of blood donated was 9.3ml/kg and the majority of cats were sedated for the donation. The most frequent acute adverse reactions were labelled cardiorespiratory (including hypotension, requirement for fluids or tachypnoea); these were documented in 22/29 201 donations events. The most frequent reactions described within the 5 day follow up period were altered behaviour or lethargy, reported after 18/29 201 donations and 16/29 201 donations respectively, and all of these spontaneously recovered. Vomiting or reduced appetite were reported after 10/29 201 donation events.
Prevalence of acute kidney injury and outcome in cats treated as inpatients versus outpatients following lily exposure.
JAVMA. Free access
This study retrospectively described cats with suspected or known lily exposure within the previous 48 hours, where hospital records included at least two creatinine results. 112 cats were described; 96 treated as inpatient and 16 being treated as outpatients. Acute kidney injury was reported in a total of 52/112 cats, with 20 of those being a maximum of grade I (non-azotaemic) AKI. A maximum of grade II AKI was documented in 31 cats. There was no difference in frequency of AKI between inpatient and outpatient treated groups. Two outpatient cats were euthanased, where grade II AKI had been documented, and this created the difference in outcome between the two groups.
Neosporosis in 21 adult dogs, 2010-2023
JVIM. Open access.
A little Neospora tour here prompted by this study – it’s uncommon but on a surprising number of differential diagnoses lists 😉
We used to say/be taught neosporosis in young dogs causes a paraparesis and rigid extension, and that in older dogs cerebellar signs predominate. A study in a UK population of dogs earlier this year documented that in 41cases, most actually had a multifocal presentation
(Insights into the clinical presentation, diagnostics and outcome in dogs presenting with neurological signs secondary to infection with Neospora caninum: 41 cases (2014-2023)) meaning it can definitely be a differential in a dog with suspected meningioencephalitis of unknown aetiology, or meningoencephalomyelitis of unknown aetiology.
This current study documented variable localisations including neuromuscular and multifocal intracranial in adult dogs with neosporosis.
Then, this article gives an overview of diagnostics, because often multimodal testing will be necessary to diagnose: A multimodal approach to diagnosis of neuromuscular neosporosis in dogs.
…and, considering that it is a differential for dogs with suspected MUA; in another recent study, significantly higher AST and CK values helped discriminate these conditions:
Two studies on vena cava assessment by ultrasound in opposite disease states:
Assessment of hemodynamic parameters and caudal vena cava-to-aorta ratio pre- and post- pericardiocentesis in dogs with cardiac tamponade.
JSAP
This is a physiology-centric description of the haemodynamic picture of dogs with pericardial effusion, including documentation of the caudal vena cava to aorta ratio, pre- and post pericardiocentesis. The study documented a median CVC:Ao ratio of 1.72 pre-pericardiocentesis (consistently above a previously reported reference interval for this variable, obtained just caudal to the left kidney and in transverse, of 0.93-1.32), reducing to a median of 1.1 post-pericardiocentesis.
Point of care ultrasound measurement of paralumbar caudal vena cava diameter and caudal vena cava to aortic ratio in hypovolemic dogs.
Frontiers in Veterinary Science – Veterinary ECC Medicine. Open access
This adds important information too, because in states of marked hypovolaemia here, while the CVC and aorta were readily documented smaller, their ratio was preserved. Includes a nice discussion on how cardiac output and blood pressure are complex functions of plenty more than volume status.
Comparison of the pharmacokinetic and pharmacodynamics of apixaban and rivaroxaban in dogs.
JVIM. Open access
Anti-Xa bioactivity was well correlated with apixaban and rivaroxaban plasma concentrations, peaking after 3-5 days, though variation within and between dogs was documented during the 7 days of treatment. Evidence of rebound hypercoagulability was not documented in these healthy dogs on abrupt withdrawal of apixaban and rivaroxaban.
Association of time to start of enteral nutrition and outcome in cats with hepatic lipidosis.
JVIM. Open access.
This study explored 48 cats with a working diagnosis of hepatic lipidosis, where moderate to severe lipid deposition affecting >50% of hepatocytes had been documented by cytology also. Non-survivors tended to have higher ALP activity, were older, and had ascites more frequently than survivors.
Longer preoperative fluid resuscitation decreased anesthetic fluid interventions in 297 dogs undergoing surgery for gastrointestinal foreign body obstruction.
JAVMA. Open access.
This study retrospectively evaluated 297 dogs undergoing surgical retrieval of gastrointestinal foreign bodies. Mean duration of clinical signs was over 2 days in these dogs, and aside from vomiting/inappetence, diarrhoea was reported in 16% of dogs. The authors were particularly interested in associations between fluid therapy use and the level of interventions required or gastrointestinal integrity/complications, but hard findings were not documented. When there was a short period of fluid resuscitation pre-operatively, dogs were more likely to receive more fluid and fluid boluses under anaesthesia. Increased pre-operative fluid bolus volumes were associated with colloid use under anaesthesia. When higher fluid ates were used pre-operatively, dogs were less likely to receive fluid bolus therapy under anaesthesia.
Case report: use of pleural dialysis as an alternate means of renal replacement therapy in three cats
Frontiers in Veterinary Science – Veterinary ECC Medicine. Open access
As the authors say “Additional prospective research is needed to understand the benefit of pleural dialysis over peritoneal dialysis in a similar patient population.” But the concept and description is very interesting.
Then, with your GP and shelter hats on:
Doxycycline with or without famciclovir for infectious ophthalmic and respiratory disease: a prospective, randomized, masked, placebo-controlled trial in 373 kittens.
JFMS. Open access.
Perioperative anaesthetic complications in healthy cats undergoing anaesthesia for neutering in first opinion practice.
JFMS. Open access.
September 2024
A prospective multicenter observational study assessing risk factors for acute blood transfusion reactions in dogs.
JVIM. Open access
This large prospective multicentre study tracked 1542 allogenic transfusions (predominantly pRBCs, whole blood and plasma products, but also including platelet and albumin products) to 858 dogs in the US, UK and Australia.
Some takehomes:
- Transfusion reactions occurred in 8.9% of pRBC transfusions, with the most common reactions being febrile nonhemolytic transfusion reactions (in 4%), acute hemolytic transfusion reactions (in 2.3%) and allergic reactions (mainly cutaneous and vomiting, in 2.2%).
- No anaphylactic reactions were documented.
- The age of the pRBC unit was positively associated with the odds of developing a transfusion reaction.
- Leukoreduction of pRBCs was not associated with reduced odds of a transfusion reaction.
- The most frequent justification for use of plasma was colloidal and volume support.
It might be problematic to know that older units generate more reactions (eg. when trying to allocate units), but if at all possible to tailor donations to requirements then this is likely the way to address that difficulty.
Placement, management and complications associated with peripheral intravenous catheter use in UK small animal practice.
JSAP. Open access
This multicentre, prospective, observational study captured data on 382 peripheral intravenous catheters, documenting that the most common complication was limb swelling and/or suspected phlebitis and that factors associated with increased odds of a complication included there being more than one attempt at catheter insertion and having more than one catheter placed during hospitalisation. There is huge scope for protocolising and minimising morbidity attributable to such an overlooked intervention.
Evaluation of early and systematic ultrasound examination to determine postoperative dehiscence after small intestinal surgery (114 cases in dogs and cats).
JAVMA. Open access.
This group has been building experience of routine post-operative ultrasonography of enterotomy and enterectomy sites, developing criteria that might prove useful in early documentation of dehiscence. Overt discontinuity and intramural gas traversing the surgical site were detected in this and one study from last year (Ultrasonographic assessment of early leakage in intestinal sutures in dogs) though we don’t yet have the acuity on when these changes occur, if they reliably precede clinical deterioration, and if so, by how long.
Clinical course and radiographic resolution of pneumonia in dogs treated with a shorter versus longer course of antimicrobials: a randomized, double-masked, placebo-controlled study
JAVMA
More prospectively documented evidence here, including a placebo-controlled component, that clinical signs are usually the earliest markers of pneumonia resolution (with reference to radiographic findings), with no apparent differences in these outcomes when shorter or longer courses of antimicrobials are used. No relapses were reported.
Tranexamic acid stops hyperfibrinolysis in dogs with hemorrhagic shock: a randomized, controlled clinical trial
JAVMA
In this study of dogs with traumatic haemorrhagic shock or spontaneous haemoabdomen (hepatosplenic origin) and evidence of hyperfibrinolysis (based on rTEG or tPA-stressed rTEG LY30%), the hyperfibrinolysis tended to resolve irrespective of treatment with tranexamic acid or saline (though a more “complete” resolution was documented in the TXA group). No blood product or survival advantage was detected, though larger studies would be required to confirm that finding.
Seeking simplicity, navigating complexity: How veterinarians select an antimicrobial drug, dose and duration for companion animals.
JVIM. Open access.
This is a small study but the themes identified are still important indicators. A survey of 22 Australian vets was conducted, which included asking for treatment recommendations in two case scenarios. The spectrum of choice and duration of prescription is demonstrated in Figure 1. There are multiple facets to driving reduction in antimicrobial prescription and treatment duration, but within “education” there is a lot of scope for peer-to-peer influence – If we can normalise those discussions anyway…See how you get on..!
We can probably help (more- and less-experienced) colleagues with the confidence to limit prescription and duration too – that perceived ‘safety net’ is commonly referred to. Again, see how you get on. Also see what you can do to dispel the concept of ‘finishing the course’…
Hypoadrenocorticism in cats: a 40-year update
JFMS. Open access
I’ve only ever seen (not even treated) this once in my career. Nonetheless fascinating. One day…
Though it does remind me of a particularly interesting case that developed acute adrenocortical insufficiency resulting from adrenal infection and haemorrhage (Waterhouse–Friderichsen syndrome in a cat with Klebsiella spp. Infection)
Comparing the effects of various fluid resuscitative strategies on Glycocalyx damage in a canine hemorrhage model
The Veterinary Journal.
Here is an in-depth appraisal of the effect of haemorrhagic shock and subsequent resuscitation on biomarkers possibly linked to endothelial glycocalyx damage.
Serum hyaluronan was the only marker to increase during hemorrhage, increasing further post-resuscitation and often remaining elevated after 2 weeks. VE-cadherin increased post-resuscitation also. Serum syndecan-1 and heparan sulphate tended to decrease during hemorrhage and resuscitation in this study.
Hyaluronan has also been documented high in the serum of populations of dogs with mitral valve disease and hypercoagulability (Circulating hyaluronan as a marker of endothelial glycocalyx damage in dogs with myxomatous mitral valve disease and dogs in a hypercoagulable state) and in the plasma of dogs with sepsis (Biomarkers of endothelial activation and inflammation in dogs with organ dysfunction secondary to sepsis – Dogs with sepsis had higher plasma VEGF, hyaluronan, and PAI-1 concentrations compared to healthy dogs).
You can read more about this topic in this narrative review from 2021 (The Effects of Resuscitative Fluid Therapy on the Endothelial Surface Layer) and in this (Large-volume crystalloid fluid is associated with increased hyaluronan shedding and inflammation in a canine hemorrhagic shock model)
Manual carbon hemoperfusion for the treatment of meloxicam toxicity in a cat and suspected ibuprofen toxicity in a dog.
Frontiers in Veterinary Science – Veterinary Emergency and Critical Care Medicine. Open access.
This is an article after my own heart. The DIY approach to extracorporeal therapy!
August 2024
Plasma concentration of thrombopoietin in dogs with immune thrombocytopenia
JVIM. Open access
In people with immune thrombocytopenia, thrombopoietin (the main regulator of platelet production) is unexpectedly low; it appears that while platelet destruction is the most overt cause of the thrombocytopenia, reduced thrombopoiesis also has a role. This group developed an ELISA for canine thrombopoietin, and documented similar findings in dogs with ITP, in that plasma thrombopoietin in dogs with ITP was usually within the derived reference interval for normal dogs. The reason this is important is that it would be very useful to know the dynamics of thrombopoietin in dogs with ITP, whether treatment with thrombopoietin receptor agonists could be of benefit (as they are in people) and whether thrombopoietin concentration could be useful to determine the aetiologies of thrombocytopenia in dogs.
If you want to read further on this topic, obviously read the article but I can also suggest this review article Immune thrombocytopenia (ITP): Pathophysiology update and diagnostic dilemmas and the ACVIM consensus statement on the diagnosis of immune thrombocytopenia in dogs and cats.
Ultrasonographic liver nodules are more often benign lesions in dogs with hemoperitoneum secondary to splenic tumor rupture
JAVMA. Open access
In this study of 99 dogs being surgically managed for spontaneous haemoabdomen of splenic origin (and with no evidence of metastatic disease on thoracic radiography), the rate and type of malignancies was in line with many previous studies. When specifically considering ultrasound findings, 20 dogs had liver lesions (defined as any discrete and measurable mass or nodule) identified during pre-operative ultrasound. Of those 20, 16 had a liver biopsy collected, 13 of which revealed benign changes. Of the same 20, 17 animals had benign splenic disease recorded. To quote the authors directly, it’s important to note that “the presence of these lesions does not unequivocally imply liver metastasis.”
Clinical features and outcome of dogs and cats with gastrointestinal pneumatosis: 30 cases (2010-2021)
JVECC
Another great radiographic finding here (diffuse intramural gas within the GI tract), but we don’t necessarily know how to interpret it, and there’s a potential for it to be over-interpreted. At one stage it would have been considered consistent with bowel ischaemia or necrosis, mandating aggressive (often surgical) management. This group make the point that it is a diagnostic imaging finding, not a clinical diagnosis, and describe the cases from their hospital with intestinal pneumatosis. The cases were very varied with common underlying diagnoses in these animals being GDV (at least three of which in theatre did have necrosis described), AHDS and GI ulceration, or having had recent abdominal surgery. 13 medically treated animals survived. The bacterial and mechanical theories as to how pneumatosis develops are discussed.
Moderate IV Fluid Resuscitation Is Associated With Decreased Sepsis Mortality
Critical Care Medicine. Open access.
I include this article not least because it demonstrates a principle quite ingrained in ECC – that in which we often do/deliver/administer/prescribe (delete as appropriate) as much as is necessary, but as little as possible – but because the opening paragraph gives a very concise summary of fluid prescription practices over the decades, and reasons for those changes, in people.
Two articles here on the topic of acute (haemorrhagic) diarrhoea…
Comparing treatment effects on dogs with acute hemorrhagic diarrhea syndrome: fecal microbiota transplantation, symptomatic therapy, or antibiotic treatment
JAVMA. Open access
…and guidelines recommending reserving antimicrobials for severely affected animals ie. clinically septic or failing to respond appropriately to standard stabilisation efforts and daily reassessment of such a prescription:
European Network for Optimization of Veterinary Antimicrobial Therapy (ENOVAT) guidelines for antimicrobial use in canine acute diarrhoea
The Veterinary Journal. Open access
plus some related evidence bases in cats…
Rational use of gastroprotectants in cats: An evidence-based approach
JFMS. Open access
For a tour of research likely to come out in the next year or two – do take a few minutes to explore these abstracts, presented at the 2024 ACVIM forum in June of this year. I’ve signposted a few you might find interesting within:
Retrospective evaluation of complications associated with ultrasound guided percutaneous renal biopsy in dogs.
Transmucosal glucagon rapidly increases blood glucose concentration in healthy cats.
Autologous oral fecal microbiota transplantation and microbiome recovery after antibiotic treatment, a randomized controlled trial.
Management of acute diarrhea in dogs: A questionnaire of united states veterinarians.
2024 ACVIM Forum Research Abstract Program.
JVIM. Open access
Abdominal ultrasound has inconsistent agreement with subsequent surgery or necropsy findings in dogs and cats with septic peritonitis
JAVMA
You diagnose an animal with septic peritonitis. Is there merit in performing abdominal ultrasonography?…possibly not…(Obviously multiple factors to consider here, such as whether your staff and facilities are equipped to deal with whatever you do find, and whether the animal has had a recent entorotomy/ectomy…)
This group documented that the origin of the septic peritonitis was much more readily identified ultrasonographically when of gastrointestinal origin, but identifying the sources of non-GI septic peritonitis was understandably difficult in these animals. Also bare in mind these ultrasound studies were performed by specialists and specialists-in-training.
Feline acute patient physiologic and laboratory evaluation scores and other prognostic factors in cats with first-time diabetic ketoacidosis
JVIM. Open access
I include this because I have an interest in APPLE scores and DKA, but actually specifically because it could be useful to dissect and learn from if you are wanting to familiarise yourself with common statistical tests.
July 2024
Recovery of ambulation in small, nonbrachycephalic dogs after conservative management of acute thoracolumbar disk extrusion.
JVIM. Open access
This study included dogs that were non-ambulatory due to suspected or confirmed thoracolumbar disc extrusion, which were unable to pursue surgical management as would usually be recommended, and committed them to conservative management.
49/51 deep pain perception positive animals recovered ambulation. Of 21 deep pain perception negative dogs, 5 were euthanised prior to initial investigations, leaving 16 undergoing conservative management. Of these, 10 regained ambulation after a median of 25 days, 4 remained deep pain perception negative and 2 developed progressive myelomalacia. All deep pain perception negative dogs that recovered ambulation were urinary continent and without ongoing pain.
Take home – even if you are presented with a deep pain perception negative dachshund with minimal finances, if nursing at home is an option and owners are recognising that myelomalacia could still develop, then ongoing conservative management should absolutely be discussed. (It remains to be seen if there is an even stronger case to pursue conservative management…)
Linear and discrete foreign body small intestinal obstruction outcomes, complication risk factors, and single incision red rubber catheter technique success in cats.
Vet Surgery
This study identified 169 cats that had had surgical management of small intestinal foreign bodies. Those with linear foreign bodies were significantly younger than those with discrete foreign bodies (median 2 vs 4 years). A red rubber catheter technique was often used to retrieve linear foreign bodies. 164 cats survived to discharge and dehiscence rates were very low, which seems to be the case in previous literature on cats with GI foreign bodies too. In dogs you will readily find surgical site dehiscence rates of >10%.
High-flow nasal cannula oxygen therapy in seven cats with respiratory failure
JFMS. Open access
This is the largest description of HFNOT in cats to date. A range of diseases were represented (CHF, pneumonia, ARDS…) but the interfaces were well tolerated; where sedation was used, it was predominantly butorphanol. HFNOT was initiated with median flow rates of 1.5 l/kg/min (range 1.5–2.3) and a median FiO2 of 0.95 (range 0.4–1.0). Photos are included of both Vapotherm and Airvo 2 system interfaces.
Ultrasound is an accurate imaging modality for diagnosing hip luxation in dogs presenting with hind limb lameness
JAVMA. Open access
The techniques and skillsets documented in this study are great to read about. I am not proposing that radiographs shouldn’t be the default, but increasing availability of ultrasound means that musculoskeletal ultrasound is getting more exposure, and some of you may be keen to upskill in it.
Evaluation of fluid responsiveness using liver compression in dogs with experimentally induced hypovolemia.
AJVR. Open access
This experimental study explores the concept that external liver compression might augment preload, and enable assessment of fluid responsiveness to that effect. In a state of marked hypovolaemia, stroke volume and mean arterial blood pressure were significantly improved with this intervention. Pressure was applied for 1 minute with a pressure of 12 to 13 N per 42 cm2, which is the same as a pressure of 22 mmHg.
Open-chest cardiopulmonary resuscitation through a transdiaphragmatic approach in dogs: a cadaveric study to describe the surgical approach and manipulations
AJVR. Open access.
This is exactly as it sounds, complete with photos. I think it’s important to think about this, with specific scenarios in mind (eg. being in theatre with an animal already, or if an animal crashes with a diaphragmatic rupture…) I include here also an excerpt from the advanced life support article from the recent RECOVER guidelines (https://onlinelibrary.wiley.com/doi/10.1111/vec.13389)
“We recommend OCCPR in dogs and cats with abdominal organs or substantial accumulations of fluid or air in the pleural or pericardial spaces (strong recommendation, expert opinion).
We recommend direct cardiac massage in dogs and cats undergoing abdominal or thoracic surgery (strong recommendation, low quality of evidence).
We suggest OCCPR in dogs and cats with penetrating thoracic trauma or rib fractures at or near the chest compression point (weak recommendation, very low quality of evidence).
In medium- and large-breed round-chested and wide-chested dogs in which OCCPR is feasible and clients are amenable to the procedure, we recommend that CCCPR be started immediately and OCCPR be started as soon as possible (strong recommendation, low quality of evidence).
We suggest attempting OCCPR in cats and small dogs (<15 kg) only if they have pleural or pericardial disease, if they have penetrating thoracic trauma, if they are undergoing abdominal or thoracic surgery, or if CCCPR appears to be inadequate (weak recommendation, expert opinion).
We recommend discussing the pros and cons of OCCPR in any dog at risk of CPA when obtaining a “CPR code” at the time of hospitalization if OCCPR is offered by the practice and is indicated (strong recommendation, expert opinion).”
Intravenous fluid therapy compared to no treatment following blood donation in cats: a randomised controlled trial
JSAP. Open access.
Just as is practiced in people and dogs – it seems that we probably don’t need to be providing fluids post blood donation to our cats (consciously donating medians of 9.7-9.9ml/kg in this study). Glad we are learning more about the donors and the donation process.
A review of renal tubular acidosis
JVECC
When one of your previous renal lecturers tells you “I don’t even really understand RTA” it gives you (gave me) an enormous sense of relief…This article is very helpful to “un-muddy” the waters though, if you enjoy blood gases and renal physiology and want to commit some time to indulge.
Then one final study, on the topic of challenging the status quo, and even more physiology…
Beneficial Effect of Calcium Treatment for Hyperkalemia Is Not Due to “Membrane Stabilization”
Critical Care Medicine
June 2024
A newsletter spearheaded by the new RECOVER (https://recoverinitiative.org/) guidelines for CPR in dogs and cats. Every article is open access.
Some key points from the updated treatment recommendations, including highlighted knowledge gaps:
Target an ETCO2 of >18mmHg
Perform chest compressions to 25% depth (rather than 33%–50%) when patient is in dorsal recumbency.
When to discontinue CPR because of suspected return of spontaneous circulation: if confirmed by both ETCO2 increase and consistent pulse that is distinct from compressions – yes. If capnography data is not available – continue the 2 min cycle.
Standard dose (0.01mg/kg) not high dose (0.1mg/kg) epinephrine is recommended in all settings.
If atropine is to be used – deliver it early and do not repeat.
Knowledge gaps
How best to use invasive blood pressures in dogs and cats undergoing CPR.
The optimal timing of open chest CPR attempts.
Actual evidence on respiratory rates during CPR
Plenty more details are available in each of four areas in separate articles:
-Why recommendations exist for wide chested dogs, keel chested dogs and round chested dogs, and why even extremely short interruptions to compressions can be so deleterious.
-How new recommendations were derived on monitoring animals at risk of CPA; why an end tidal CO2 of 18mmHg is recommended as a target to reach with CPR optimisation; why a diastolic blood pressure of >30mmHg is the target (should there be an arterial catheter in place ;-)); why potassium monitoring is recommending intra-arrest and whether ionised calcium should be monitored and supplemented (yes if <0.8mmol/L).
-Why standard rather than high dose epinephrine is recommended, when lidocaine or amiodarone might be indicated, why fluids aren’t indicated (assuming normovolaemia) and the use of calcium in the setting of hyperkalaemia.
Methodology of the process
-How the evidence bases are collated, how studies are graded, and how the >200 contributors worked together.
A few other articles for your interest 🙂
Laparotomy-assisted endoscopic removal of gastrointestinal foreign bodies: Evaluation of this technique and postoperative recovery in dogs and cats
Veterinary Surgery. Open access.
Do we always need to perform an enterotomy if endoscopic retrieval has failed, or it is not deemed possible in the first instance, and you proceed to ex lap…? These groups are hard to compare but the concept is an interesting one. It follows an article on the same topic from last year: Surgical removal of intestinal foreign bodies using a laparotomy-assisted endoscopic approach in dogs and cats and comparison with enterotomy https://onlinelibrary.wiley.com/doi/10.1111/jsap.13550
Clinical features, treatment, and outcome of juvenile dogs with meningoencephalitis of unknown etiology
JVIM. Open access.
Although meningoencephalitis of unknown etiology (MUE) is often considered a disease of young-middle aged dogs (at least 6 months), this group specifically explored the ‘younger’ dogs developing MUE (<1 year) and found 3 dogs less than 16 weeks of age. Long term outcomes were poor in these animals.
Prospective randomized trial comparing relapse rates in dogs with steroid-responsive meningitis-arteritis treated with a 6-week or 6-month prednisolone protocol
JVIM. Open access
I do appreciate studies that challenge the status quo. While this won’t be the final say on this matter, with relatively small sample sizes and short term follow up, there was at least a good proportion of dogs responding similarly well with 6-week courses of prednisolone in these dogs.
Causes and consequences of feline haemothorax: A retrospective case series https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.4338
Vet Record. Open access.
Haemothorax in cats is uncommon, mostly arising due to trauma. Spontaneous haemothorax in cats is even less common, as supported by these authors finding only four cases of non traumatic haemothorax in their records.
Cats don’t often get the headlines like dogs, so I have included some previous literature on haemoperitoneum in cats also for your perusal.
Spontaneous hemoperitoneum in cats: 65 cases (1994–2006)
Twelve autologous blood transfusions in eight cats with haemoperitoneum
Something for some of your more stable patients 🙂
Comparison of grapiprant and meloxicam for management of postoperative joint pain in dogs: A randomized, double-blinded, prospective clinical trial
JVIM. Open access.
And for keeping up to speed with recent movements in the management of diabetes in cats:
Efficacy and safety of once daily oral administration of sodium-glucose cotransporter-2 inhibitor velagliflozin compared with twice daily insulin injection in diabetic cats
JVIM. Open access
May 2024
ACVIM consensus statement on the diagnosis of immune thrombocytopenia in dogs and cats.
JVIM. Open access.
Great to see this in print! It includes diagnostic algorithms to navigate the tricky cases that, for example, may have a component of consumptive thrombocytopenia (one for dogs and one for cats). It provides all the evidence to support decision making where multiple additional indices exist (eg plateletcrit, bone marrow examination) but the platelet count alone and clinical picture may suffice, and summaries of evidence in infectious and drug-induced ITP populations (amongst others).
ACVIM consensus statement on the treatment of immune thrombocytopenia in dogs and cats
JVIM. Open access
Similarly, a very helpful article I’d really encourage you to read. This distils the evidence behind, for example, vincristine, human intravenous immunoglobulin, and additional immunosupressive drug use into very accessible recommendations. Very broadly, these might be reserved for the sicker cases with clinically relevant bleeding (vinc and hIVIg), and to augment tapering of glucocorticoids, where there is a lack of initial response to glucocorticoids, or in animals with severe bleeding requiring multiple transfusions (2nd immunosuppressive). Definitions of treatment responses are also included.
Retrospective evaluation of traumatic pneumomediastinum in dogs and cats (2005–2022): 52 cases
JVECC
I think these might be my favourite radiographs. This study reports that of 52 animals with traumatic pneumomediastinum, approximately 70% had subcutaneous emphysema appreciated, and approximately 70% had pneumothorax appreciated. Thoracocentesis was often performed but specific management of the cause of pneumomediastinum itself was rarely required.
This following study reports pneumomediastinum too, but in animals in which it was considered an incidental finding, in sighthounds, and without pneumothorax:
Spontaneous pulmonary interstitial emphysema, pneumomediastinum and cervical subcutaneous emphysema secondary to the Macklin effect in dogs with no clinical signs: 12 cases
The Veterinary Journal.
Clinical features and outcomes of dogs with attempted medical management for discrete gastrointestinal foreign material: 68 cases (2018-2023)
JAVMA
This topic really interests me, and my approach has evolved with the number of grey hairs on my head (I will much more readily consider conservative (medical) management in the first instance). The decision to monitor versus take to surgery is not an exact science (perhaps most pertinently involving the length of clinical signs, the physical examination of the dog, and the presence or extent of any evidence of obstruction on diagnostic imaging) but it’s great to see some more evidence emerging. This group managed to identify their cases that had undergone conservative management when gastrointestinal foreign bodies were identified. The median length of medical management was 17 hours in those in which it was successful. The median length of medical management in those that ultimately failed this approach was also 17 hours. Gastrointestinal distension was tracked and deemed to have resolved in all those managed successfully, and a greater proportion of cases failed medical management as the duration of clinical signs increased (though this could always reflect case selection).
The other important point about this study is not having reported p values, the reader is free to explore raw data and confidence intervals.
Retrospective evaluation of the prevalence and risk factors associated with red blood cell transfusions in cats with urethral obstruction (2009-2019): 575 cases
JVECC
This study documented the PCV and RBC transfusion requirements in 622 occurrences of UO across 4 university teaching hospitals. 1% of cats had a PCV of less than 20% on presentation, 8% had a PCV of 20-30% on presentation and 2% received a transfusion in total. Those being transfused were complicated, with repeat obstructions, long catheterisation lengths and perineal urethrostomies being performed in most.
Standard tests of haemostasis do not predict elevated thromboelastographic maximum amplitude, an index of hypercoagulability, in sick dogs.
JSAP. Open access
This study grouped dogs into hypercoagulable or normocoagulable states by thromboelastographic maximum amplitude alone, and explored standard tests of haemostasis amongst these groups. There were no correlations identified between TEG variables and PT or aPTT, suggesting that they cannot be used to gauge hypercoagulability (according to TEG MA) in such populations.
Neuropathic pain in cats: Mechanisms and multimodal management
JFMS. Open access
A nice review if you have had any challenging cases of cats with suspected neuropathic pain.
April 2024
Usefulness of serum amyloid A for the diagnosis of pyelonephritis in cats: A prospective evaluation
JVIM. Open access
As we get used to increased availability of serum amyloid A as an inflammatory biomarker in cats, an interesting finding for me in these cases is the comparison between high SAA in cats with pyelonephritis, and the much lower SAA in cats with ureteric obstructions and AKI of unknown origin (where pyelonephritis has been excluded), because discerning such cases from eachother can sometimes be difficult.
Comparison of hematologic variables between dogs with congenital intrahepatic and extrahepatic portosystemic shunts
JVIM. Open access.
In this study of dogs diagnosed with intra and extrahepatic portosystemic shunts, those with intrahepatic shunts exhibited more gastrointestinal signs and were more frequently anaemic (characterised as microcytic and hypochromic).
What is the best treatment for hypotension in healthy dogs during anaesthesia maintained with isoflurane?
Australian Veterinary Journal. Open access.
A useful appraisal and commentary here on an often-overlooked dogma…
Thromboelastometry for assessment of hemostasis and disease severity in 42 dogs with naturally-occurring heatstroke.
JVIM. Open access
Very interesting to see the hypocoagulability in these dogs, especially non-survivors, and changes over time too.
Retrospective evaluation of the respiratory rate–oxygenation index to predict the outcome of high-flow nasal cannula oxygen therapy in dogs (2018–2021): 81 cases
JVECC
This study explored the use of the respiratory rate-oxygenation index (ROX, defined as (SpO2/FiO2)/respiratory rate) amongst other variables to predict failure of high flow nasal oxygen therapy in dogs. A higher ROX is better. ROX and the SpO2/FiO2 ratio were significantly different between groups at most timepoints. These could be useful objective measures of response to treatment and expectations.
Corticosteroid monotherapy versus combined cytarabine continuous rate infusion and corticosteroid therapy in dogs with meningoencephalitis of unknown origin: A blinded, randomized, controlled trial.
JVIM. Open access
In the short term there appeared to be no difference in outcome between those receiving corticosteroids alone and those receiving corticosteroids and cytarabine.
Detection of Anaplasma phagocytophilum in an inflammatory pericardial effusion of a dog
JVIM. Open access.
Just because I enjoy pericardial effusions, infectious diseases, and cytology 🙂 Low chance of me diagnosing this in the UK, but some anaplasmosis factoids in these articles, perhaps more relevant for those of you that are UK based.
Anaplasma phagocytophilum is present in Ixodes ticks throughout the UK, maybe moreso in sheep farming areas (https://www.sciencedirect.com/science/article/pii/S1877959X2200070X?pes=vo) though it is rarely reported to cause clinical disease. When it does, it tends to cause non-specific lethargy, pyrexia and thrombocytopenia.
Several different co-infections within Ixodes ticks are feasible, but co-infection with Anaplasma spp and Borrelia spp is well reported. (https://bvajournals.onlinelibrary.wiley.com/doi/full/10.1002/vetr.12)
Utility of immature platelet fraction in the Sysmex XN-1000V for the differential diagnosis of central and peripheral thrombocytopenia in dogs and cats
JVIM. Open access.
This study describes a relatively novel parameter available on a specific haematology analyser, the immature platelet fraction, and its use in discriminating central from peripheral aetiologies of thrombocytopenia in dogs and cats. This readout is analogous to a reticulocyte count as evidence of erythropoiesis; an elevation reflecting thrombopoiesis, suggesting a peripheral aetiology of a thrombocytopenia. It would be interesting to see how it performs in a different patient population but appears to hold promise from these results.
2024 guidelines for the vaccination of dogs and cats – compiled by the Vaccination Guidelines Group (VGG) of the World Small Animal Veterinary Association (WSAVA)
JSAP. Free access
I can’t do this justice, so just a notification that this resource exists and is free to access.
Determination of clopidogrel effect in cats using point-of-care Plateletworks ADP and shipped samples for PFA-200 analysis in a clinical practice setting
JFMS. Open access.
Some more potential here with regards external laboratory platelet function testing.
March 2024
International Renal Interest Society best practice consensus guidelines for the diagnosis and management of acute kidney injury in cats and dogs.
The Veterinary Journal. Open access.
Far too many for me to cover here, but just a couple of points from this new consensus statement, with possibly the most overlooked one first:
“Forced diuresis with high fluid rates beyond optimization of kidney perfusion does not improve outcomes but rather increases the risk of volume overload and is associated with severe clinical consequences such as hypertension and interstitial edema, further negatively impacting kidney function (i.e. congestive nephropathy)”
“failure to identify a ureterolith and lack of or only minimal pyelectasia does not preclude an obstructive disease process”
The crucial concept of fluid balance is discussed at multiple points throughout.
Then for those with dialysis hats or simply an interest:
International renal interest society best practice consensus guidelines for intermittent hemodialysis in dogs and cats
The Veterinary Journal. Open access.
Haemodialysis for certain toxicants is considered most effective if the molecular weight of the toxicant is less than 15,000 Da, the degree of protein binding is <80%, and the volume of distribution (Vd) is <2 L/kg.
Tolerable ultrafiltration rates are discussed, as well as heparinisation protocols too.
Prognosis in meningoencephalitis of unknown origin in dogs: Risk factors associated with survival, clinical relapse, and long-term disability
JVIM. Open access
In this UK population of dogs with MUO: Neurolocalisation was most often multifocal in nature, with proprioceptive deficits, ataxia and obtundation being the most frequent findings on neurological examination. Survival to discharge was 82% and half of these then relapsed after a median of 7 months. Incomplete resolution of clinical signs was associated with relapse. 63.5% were still alive at 6 months; being a pug, being paretic and having seizures were associated with non-survival at 6 months.
Caudoventral hip luxation in 160 dogs (2003-2023): A multicenter retrospective case series
Veterinary Surgery
Dog hips luxate craniodorsally in most cases. In this population of dogs with caudoventral hip luxations case variables were explored and factors were interrogated for associations with non-surgical treatment success. Most occurred during low level trauma, poodles and poodle crosses accounted for nearly half the cases, and the success rate of closed reduction was highest when hobbles were used. Of note: Ehmer slings are not indicated in the management of caudoventral luxations, only craniodorsal (if you choose to use at all).
Assessment of hemostasis in hyperthyroid and euthyroid cats using two viscoelastic assays and platelet aggregometry
JVIM. Open access
This study compared VCM and ROTEM variables between groups, broadly documenting higher indices of maximal clot amplitude and firmness, and shorter time to clot formation in hyperthyroid cats compared to controls. Previous literature has documented higher fibrinogen concentrations in hyperthyroid cats, and other mild evidence of hypercoagulability compared to controls. These may be subtle findings and are perhaps unlikely to modify treatment of hyperthyroidism in isolation, but in managing hyperthyroid cats with ischaemic disease and in interpreting haemostatic data in hyperthyroid cats with comorbidities, this has its place.
To finish…
We are, perhaps quite rightfully, encountering more questions and scenarios involving CPR techniques in species other than cats and dogs. So, feast your eyes on this 🙂
A proof-of-concept study evaluating cardiac compression techniques for cardiopulmonary resuscitation in laying hens (Gallus gallus)
JVECC
February 2024
Defining sepsis in small animals
JVECC. Open access.
To keep track of an impressive veterinary sepsis movement, start here. This article provides a tour of sepsis in people and animals, including the evolution of current definitions. It details plans for veterinary sepsis definitions, evidence-based guidelines and a case registry to bolster future research efforts.
A retrospective study of hydrocortisone continuous rate infusion compared with administration of dexamethasone boluses in dogs with adrenal crisis
JVIM. Open access
The normal caveats apply for retrospective data, but some reassuring results here, whatever your approach is! There were no differences in any outcome measure between those dogs getting a dose of dexamethasone (median of 0.15mg/kg) and those receiving a hydrocortisone CRI.
Clinical outcome of idiopathic juvenile ventricular arrhythmias in 25 dogs
Journal of Veterinary Cardiology.
This case series describes 25 young dogs (less than 2 years) with no underlying cause identified for ventricular arrhythmias (11 had ventricular tachycardia). The arrhythmias were documented incidentally, with no associated clinical signs. A median survival time of approximately 9 years post diagnosis was reported.
Control line failure in Angiostrongylus vasorum point-of-care serology test in dogs with angiostrongylosis due to suspected hook effect.
JSAP. Open access.
This study describes 6 dogs with angiostrongylosis, in which the A. vasorum lateral flow test control line failed to declare in the presence of positive test lines. Seemingly, this might happen when the antigenic load is very high, and dilution of the sample was reported to resolve the issue in these cases, generating a valid control line with positive test line. So where the index of suspicion is high, consider this if the LFT is invalid.
(Also includes a very cool video of convergence-retraction nystagmus, that localises to the dorsal midbrain https://onlinelibrary.wiley.com/doi/10.1111/jvim.13966)
Retrospective evaluation of 22 dogs with leptospirosis treated with extracorporeal renal replacement therapies (2018-2021)
JVIM. Open access.
There are several findings to report depending on your interests here. The median maximum creatinine was 9.8mg/dL (866umol/L) in these dogs. 16 of 22 dogs survived to discharge, 12 were alive at 6 months, and 8 were still alive after several years. There were a total of 68 treatments; 10 were emergently terminated due to events such as arrhythmias, and there were three incidences of circuit clotting. The majority of dogs were systemically anticoagulated with heparin.
Evaluation of B-lines with 2 point-of-care lung ultrasound protocols in cats with radiographically normal lungs
JVECC
We used to say about 12% of cats (and dogs) had an occasional B-line in either hemithorax, but if you do have a tendency to image more surface area (compared to four classical sites), that number will increase. Maybe even towards 50%…
Co-existence of a fluid responsive state and venous congestion signals in critically ill patients: a multicenter observational proof-of-concept study.
Critical Care. Open access
This study highlights at least one tenet of critical care (in my opinion!) – to use as much as necessary but as little as possible, all wrapped up in the concept of fluid tolerance, not just fluid responsiveness. (Another unfortunate tenet being just how much we don’t know, specifically with regards gauging fluid tolerance early, and accurately gauging congestion). Do have a read 🙂
January 2024
A prospective cohort study to identify clinical diagnostic and prognostic markers of primary immune thrombocytopenia in dogs.
JVIM. Open access
This prospective study looked for markers to suggest primary over secondary ITP, and also for markers associated with outcome and transfusion. Primary ITP cases tended to have lower platelet counts, lower d-dimer concentrations and less or less-detectable platelet membrane antigens CD61 and CD9. A low haematocrit and high BUN were associated with non-survival in primary ITP.
Early administration of canine parvovirus monoclonal antibody prevented mortality after experimental challenge
JAVMA. Open access
This is very good journal club material. This may well be a useful intervention, and be proved so in future studies, but it’s important to recognise what these data actually support. In this study 28 dogs were inoculated with parvovirus, 21 were then treated with the monoclonal antibody as soon as they begun shedding the virus (4 days later, when 17 of 28 had abnormal faeces and 11 of 28 were vomiting), and the other 7 were simply monitored without any interventions.
How this performs against or in conjunction with standard treatment, or how it performs in animals presenting later in the disease course, has not been interrogated in this study.
Comparison of timing of relapse in dogs with nonassociative immune-mediated hemolytic anemia, thrombocytopenia or polyarthritis.
JVIM. Open access
This retrospective study in UK populations documented relapse rates of 41%, 18% and 23% for IMPA, IMHA and ITP, respectively. IMPA tended to relapse earlier (within the first year) than in IMHA and ITP cases. Median durations of prednisolone treatment were 5, 5 and 6 months for dogs with IMPA, IMHA and ITP, respectively.
2024 Focused update: Guidelines on use of corticosteroids in sepsis, acute respiratory distress syndrome and community acquired pneumonia
Critical Care Medicine. Free to access.
I can imagine a situation in which veterinary medicine goes full circle in our relationship with steroids, and settles somewhere near these guidelines too! They do find their way into treatment of, for example, pneumonia, sepsis and ARDS in dogs, but often just based on clinician preference.
Arterial thromboembolism in a cat with transient myocardial thickening
Journal of Veterinary Cardiology. Open access
Good to know – I definitely haven’t noted this situation before, and reminds us of a study on TMT that we covered recently.
Scientific writing and editorial policies and procedures of the Journal of Veterinary Internal Medicine
JVIM. Open access.
Like it or loath being told it, most of this is both true and reasonable. Most importantly, it might help improve our scientific writing and comes from authors that have the authority to say it. It is possible for a published study to be worth very little due to a lack of clarity or focus. Somebody clever once wrote that rather than being simply ‘possible to understand’ we should strive to be ‘impossible to misunderstand’. I don’t write perfectly by any stretch, and you can attest to this, but remembering that helps to improve with every draft.
Difficult catheterization and previous urethral obstruction are associated with lower urinary tract tears in cats with urethral obstruction
JAVMA
A small but hypothesis generating study, which I like because it touches upon a topic that is essentially unexplored – that catheterisation technique and urethral ‘handling’ may be important variables in the quest to limit complications and re-obstruction.
Assessment of the likelihood of hypothyroidism in dogs diagnosed with and treated for hypothyroidism at primary care practices: 102 cases (2016-2021).
JVIM. Open access
Less ECC, but I liked the questions being asked in this study – an interesting idea, a novel format, and clinically useful output.
December 2023
Surgical treatment of canine urethral prolapse via urethropexy or resection and anastomosis
JSAP
Although not a classical emergency, these often find their way into many an emergency room (!) mainly due to bleeding. Median duration of clinical signs was 3 days in these dogs with urethral prolapse, with English bulldogs making up the majority of cases. Only 9/79 dogs had an anaemia documented, with a median PCV of 24% in those dogs. Recurrence was relatively common (39%) in animals undergoing urethropexy compared to 11% in those undergoing resection/anastomosis in this study. Maybe there’s a future in combination techniques…
Evaluation of the clinical outcome of hypercalcemia of malignancy and concurrent azotaemia in dogs with lymphoma
JVIM. Open access.
In 29 dogs with lymphoma, hypercalcaemia and azotaemia (grade II IRIS AKI and above, median 248umol/L or 2.8mg/dL), all dogs had a resolution of the hypercalcaemia within the first few weeks of treatment, and 23/29 had a resolution of the azotaemia (12/29 resolved within the first few weeks). If azotaemia did not resolve, it improved over the course of several months.
Abdominal ultrasonographic findings of cats with feline infectious peritonitis: an update
JFMS. Open access.
As we are increasingly having to (able to?) ‘diagnose’ or treat FIP without extensive investigations, these may prove useful. Aside from effusions, lymphadenomegaly, GI and hepatic changes were common. Sampling tends to be reported as ‘pyogranulomatous’ or neutrophilic/macrophagic inflammation.
Factors associated with thrombotic disease in dogs with renal proteinuria: A retrospective of 150 cases
JVIM. Open access.
In this retrospective, case-controlled study of dogs with renal proteinuria (UPC >2) in the UK, 50 dogs with thrombosis were identified and compared to dogs without thrombosis. Cavalier King Charles Spaniels and sighthounds were over-represented, AKI was more common in the thrombosis group, and serum albumin was lower also. Serum albumin was lower in the dogs with venous thombi compared to those with arterial thrombi.
Respiratory compromise in French bulldogs presented with intervertebral disc extrusion
Vet Record. Open access.
Just a nod to the frequency with which BOAS manifests in French bulldogs with intervertebral disc disease. Approximately a fifth of dogs at these referral centres required management of respiratory distress, having presented primarily for intervertebral disc disease.
Efficacy of antimicrobial and nutraceutical treatment for canine acute diarrhoea: A systematic review and meta-analysis for European Network for Optimization of Antimicrobial Therapy (ENOVAT) guidelines
The Veterinary Journal. Open access
Can you get the conclusions from this…?
Intravenous loss of over-the-wire catheter guidewires in 13 horses
JVIM. Open access.
I can’t imagine I’ll include many articles with horse in the title, but this was a good opportunity to stir the pot…
A relatively untapped area in veterinary medicine here, but plenty of scope for modifications along this theme, I am sure:
Modification in ICU Design May Affect Delirium and Circadian Melatonin: A Proof of Concept Pilot Study
Critical Care Medicine. Open access.
November 2023
Evaluation of hemostatic derangements associated with canine anaphylaxis and the relationship to syndrome severity
JVECC. Open access
Some anaphylaxis pathophys here. A hypocoagulable state (identified by viscoelastic testing and PT/aPTT prolongation in the most affected dogs) was documented in this study in the first 6 hours. Platelet counts were also lower in the most affected dogs, but could that even implicate the platelets…?
This doesn’t mean we need to intervene differently, but some more pieces of the puzzle. We don’t exactly know why some dogs with anaphylaxis develop haemoabdomen; it’s likely multifactorial.
Establishment of a reference interval for thiamine concentrations in healthy dogs and evaluation of the prevalence of absolute thiamine deficiency in critically ill dogs with and without sepsis using high-performance liquid chromatography
JVECC
Sepsis and thiamine deficiency has been a hot topic recently, and septic dogs had lower thiamine pyrophosphate than healthy control dogs in this study, with approximately a quarter being lower than the generated reference interval.
Prevalence of nonconvulsive seizures and nonconvulsive status epilepticus in dogs and cats with a history of cluster seizures: A retrospective study
JVIM. Open access
Very interesting work on this poorly characterised scenario. Could this be something we should be looking for in those animals with decreased levels of consciousness after a convulsive seizure…
You may or may not have read of the FIP outbreak in Cyprus: (https://www.biorxiv.org/content/10.1101/2023.11.08.566182v2.full.pdf+html); especially noteworthy as direct transmission appears to be a feature. Either way, it has been documented in the UK in an imported cat, which is being treated and isolated. In case any further reminders were needed to note travel history…
FCoV-23 causing FIP in a cat imported to the UK from Cyprus
Vet Record
Outcome prediction in dogs admitted through the emergency room: Accuracy of staff prediction and comparison with an illness severity stratification system for hospitalized dogs
JVECC. Open access
Turns out gut instinct isn’t so far off the mark! Though when these predictions were wrong, it was usually due to being too pessimistic…Something to consider during client comms…
Thyroid function tests during nonthyroidal illness syndrome and recovery in acutely ill dogs
JVIM. Open access
In this prospective observational study, sick hospitalised dogs with low total T4 had their thyroid axis monitored to determine by when a nonthyroidal illness syndrome (NTIS) resolves.
The short answer was that total T4 was usually normal again by day 5-6, but definitely by 2-4 weeks post illness.
Some personal study fodder here: 😉
A review of the pharmacology and clinical applications of levetiracetam in dogs and cats
JVECC. Open access
October 2023
Retrospective evaluation of the clinical course and outcome of zinc toxicosis due to metallic foreign bodies in dogs (2005–2021): 55 cases
JVECC
A handy reminder here. I haven’t seen one in a few years now, but the blood smear can be beautiful! Lethargy and gastrointestinal signs were the most common presenting complaints, and anaemia and acute liver injury were the most common clinicopathological findings.
Transient myocardial thickening: a retrospective analysis on etiological, clinical, laboratory, therapeutic and outcome findings in 27 cats.
Journal of Veterinary Cardiology. Open access
There is very little published on these cats, but it’s an extremely important differential that underlines the importance of complete clinical history-taking and follow up. These cats have a reversible cause of structural heart disease, often a congestive heart failure phenotype, sometimes apparently triggered by certain events (eg surgery/anaesthesia).
Tolerability of naso-esophageal feeding tubes in dogs and cats at home: Retrospective review
JVIM. Open access
Often wondered about this…never actually done it. A very intriguing read.
Association between clinical history in the radiographic request and diagnostic accuracy of thorax radiographs in dogs: A retrospective case-control study
JVIM. Open access
This study highlights the importance of accurate clinical history and signalment in improving the yield from radiographic studies. Not really reasonable to expect the most useful output without the necessary input. The principle can be applied across the board though eg. case discussions, handovers, rounds, advice, etc.
Long-term outcome of epileptic dogs treated with implantable vagus nerve stimulation.
JVIM. Open access
Vagal nerve stimulation is an area I have a particular interest in, so am excited to include this article. Experimentally and holistically, there are numerous feasible indications for such technologies, (harnessing the so-called cholinergic anti-inflammatory pathway being just one important example). Clinically deploying and fine-tuning might take a few more years…
2023 Updated ACVIM consensus statement on leptospirosis in dogs
JVIM. Open access
Some snippets from this updated consensus:
“Leptospirosis should be considered in cats with AKI, ≥1 additional clinicopathologic findings suggestive of a systemic infection, and no other explanation for their clinical signs”
“leptospirosis should not be ruled out based on a single negative test”
“an interval of 7 to 14 days is recommended between acute and convalescent phase samples to identify seroconversion”
ACVIM consensus statement on the management of status epilepticus and cluster seizures in dogs and cats.
JVIM. Open access
Similarly useful update here. Includes a discussion on the uses of ketamine, dexmedetomidine and propofol for controlling seizure activity once routine anti-seizure medications have been used without sufficient response.
September 2023
Eosinophilic cavitary effusions in cats: 48 cases (2010-2020)
Veterinary Clinical Pathology. Open access.
Although neoplasia, particularly lymphoma, may move towards the top of the list when you document an eosinophilic effusion in a cat, cardiac and purely inflammatory diseases were common causes in this study…
Head tilt as a clinical sign of cervical spinal or paraspinal disease in 15 dogs (2000-2021)
JSAP. Open access
While most classically associated with vestibular disease, the head tilt in these dogs was documented in association with cervical lesions. Dogs often had spinal pain with or without tetraparesis.
Abstracts from the International Veterinary Emergency and Critical Care Symposium, the European Veterinary Emergency and Critical Care Annual Congress, and the ACVECC VetCOT Veterinary Trauma & Critical Care Conference 2023
JVECC.
Three conferences worth of abstracts here! Topics include POCUS findings in dogs with PTE, carboxyhemoglobin in immune-mediated hemolytic anemia, hypotonic “maintenance” fluids, how tachypnoea affects FiO2 during oxygen supplementation, arterial blood gases at altitude and plenty more.
The assessment of haematologic and serum chemistry parameters in canine pyometra: a systematic review and meta-analysis
JSAP
Diagnosing pyometra might not be the difficult bit, but explaining away the biochemistry profile and recalling what is ‘normal’ in these dogs may be useful in certain cases. For example, a consistent mild elevation in ALP activity was observed, with inconsistent mild ALT changes, and the expected moderate hypoalbuminaemia (mean 23.7 g/L).
Evaluation of leukocyte depletion of packed red blood cell units and impact on clinically observed transfusion reactions.
Frontiers in Veterinary Science. Veterinary emergency and critical care medicine. Open access.
Albeit retrospective, this is not the first study to suggest leukoreduction alone has no significant clinical effect, including with regards limiting the incidence of febrile non-haemolytic transfusion reactions. Other evidence is also presented and discussed.
Once-a-day oral treatment with phenobarbital in cats with presumptive idiopathic epilepsy
JFMS. Open access.
Satisfactory seizure control was achieved in the cats described in this study, despite often “subtherapeutic” serum phenobarbital concentrations. Food for thought.
A retrospective evaluation of phenobarbital-induced hematologic changes in 69 cats
Veterinary Clinical Pathology. Open access.
While on the topic, despite the frequency with which we use phenobarbital, we actually know relatively little about adverse effects and specifically the blood dyscrasias often mentioned. In this study the most common cytopenia was neutropenia (median 2.45 × 109/L, range 0.06–3.66). Cytopenias were mostly mild, occurring in the first few months of treatment, and not associated with clinical signs, being detected during routine monitoring.
Retrospective study and outcome of 307 cats with feline infectious peritonitis treated with legally sourced veterinary compounded preparations of remdesivir and GS-441524 (2020-2022)
JFMS. Open access.
We did look at a couple of smaller FIP studies recently, but this includes 307 cats. It includes an extensive breakdown of how these cats presented, treatment responses, timeframes of clinical improvement and follow up. 71% were effusive, most of which were solely abdominal. 84% of cats had a complete response to treatment. Approximately 11% were considered to have had a relapse.
2023 AAFP/IAAHPC feline hospice and palliative care guidelines
JFMS. Open access.
A concept we are increasingly aware of in our discipline; there may be some useful resources here, including communication techniques when approaching palliation.
August 2023
Acid-base and electrolyte evaluation in dogs with upper GI obstruction: 115 dogs (2015-2021)
JSAP
We always talk about the (hypochloraemic) metabolic alkalosis in animals with gastrointestinal obstructions, but how common is it in reality? One previous study documented it in 45% of dogs with GI obstruction. The most common finding in this study of 115 dogs with upper GI obstruction was…normal blood gases. Some form of metabolic alkalosis was documented in 25% of dogs. (I’d love to know the positive predictive value of this abnormality for obstruction in vomiting English Bull Terriers 😉)
Comparison of 4 point-of-care techniques to detect correct positioning of nasogastric tubes in dogs (2020-2021)
JVECC
With a bit of practice you’ll find a feeding tube by cervical ultrasonography – this study suggesting the technique performs well compared to other often considered techniques to evaluate correct placement. The awkward truth remains that feeding tubes have been placed tracheally, in conscious dogs, without eliciting a cough, so please do your best to confirm placement by some means, and that radiography still wins.
Retrospective evaluation of indications, transfusion protocols, and acute transfusion reactions associated with the administration of lyophilized canine albumin: 53 cases (2009–2020)
JVECC. Open access
Of 53 dogs receiving lyophilized canine albumin in this study, 12 displayed evidence of a transfusion reaction when TRACS criteria were retrospectively employed. The reactions were predominantly transfusion associated dyspnoea and febrile non haemolytic transfusion reactions.
Evaluation of bacterial growth, effects on albumin, and coagulation factors in canine fresh frozen plasma administered as continuous rate infusion exposed to room temperature for 12 hours.
JVECC
There was no decrease over time in factors V, VII, VIII, IX or albumin, nor any positive cultures when plasma was kept at room temperature for 12 hours in this ex vivo study.
A very useful review article here, hopefully you will be able to secure access:
Preventing Cardiogenic Thromboembolism in Cats Literature Gaps, Rational Recommendations, and Future Therapies.
Vet Clinics: Small Animal Practice
A prospective evaluation of the prevalence of thromboemboli and associated hemostatic dysfunction in dogs with carcinoma or sarcoma.
JVIM. Open access
This study sheds light on the spectrum of disease that is DIC, perhaps more specifically, non-overt DIC. High D-dimer concentrations were common in dogs with carcinoma or sarcoma, including when microthrombi were present.
The utility of clinicopathological findings and point-of-care ultrasound in increasing the index of suspicion of ureteral obstruction in azotaemic cats presenting to the emergency room.
JSAP. Open access
It’s reasonable to include a gross renal assessment during point of care ultrasound in azotaemic cats – finding gross evidence of renal pelvic dilation may expedite investigations or the diagnosis of ureteral obstruction. Ionised calcium was also higher in obstructed cats.
Clinical characterisation and long-term survival of paediatric and juvenile lymphoma in cats: 33 cases (2008-2022)
JSAP. Open access
On a similar topic: low numbers but I was still intrigued to see 5 cats with renal lymphoma (all with bilateral renomegaly and retroperitoneal effusion as ultrasonographic findings) had reasonable long term outcomes in this retrospective study.
…and while this isn’t published, it is very interesting data on uroliths comprised of GS-441524…
July 2023
Two studies documenting the impressive responses that can now be expected in cats with FIP:
JVIM. Open access.
In this study of 32 cats, 25 presented with effusive and 7 presented with non-effusive disease. 6 had ocular involvement and 5 had neurological signs. Four cats were euthanised within the first few days of treatment, a clinical improvement occurred within five days in 28 cats, and 26/28 cats survived to complete the 12 week treatment. Nearly all cats received injectable remdesivir initially and 24 cats were later transitioned to oral GS-441524. During treatment, increases in ALT activity were common and albumin globulin ratios gradually improved over the 12 weeks. Four cats appeared to relapse.
JVIM. Open access.
25/28 cats survived the first 12 weeks of treatment in this study, with 2 dying and 1 being euthanised in the first 2 days. Treatment protocols evolved to incorporate oral GS-441524 when it became available. Three cats developed relapse.
JVECC
In line with attempts to create scoring systems (HeLP score, malignancy calculator) for malignancy in dogs with spontaneous haemoabdomen and splenic masses, it’s not possible to predict with certainty the malignancy (or perhaps more importantly, the benignancy?) in these dogs using abdominal CT alone.
JVECC.
In this retrospective study, of 537 animals which had been managed surgically or endoscopically for gastrointestinal foreign bodies, 200 received an antiemetic prior to the definitive treatment, and 337 did not. Amongst those receiving an antiemetic, time to definitive treatment was a median of 3.2 days, versus a median of 1.6 days in the animals that did not receive an antiemetic.
(A prospective audit of maropitant use in practice would probably yield some interesting findings Eg. frequency with which animals require no further follow up, frequency with which a foreign body passes through etc (!)).
JAVMA. Open access
Maybe we’ll have very different treatment options for cats with HCM in years to come…!
JFMS. Open access
Latest data on xenotransfusions in cats here: The most common transfusion reaction in the cats receiving xenotransfusions being a delayed haemolytic transfusion reaction, occurring in a third of cats. Interesting to see how different centres decide which cases to use these in.
Thrombocytosis in 158 cats (2011–2018)
JFMS. Open access.
Similar to the findings in dogs (Thrombocytosis in 715 Dogs (2011–2015)), cats with thrombocytosis were often diagnosed with neoplasia, endocrine disease and inflammatory disease in this study.
And this just for its pure ingenuity, having previously made my own from a desk fan.
Veterinary Clinical Pathology. Open access.
June 2023
Clinical presentation, diagnosis, treatment and outcome in 8 dogs and 2 cats with global hypoxic-ischaemic brain injury (2010 – 2022)
JVIM. Open access.
In animals sustaining in-hospital global hypoxic-ischaemic events (likely CPA), good neurological outcomes were achieved in 6/8 despite significant deficits during recovery. Improvements in mentation and ambulation tended to be documented within the first 48-72 hours post injury. In animals surviving such events, the aftercare and nursing is of crucial importance. Do watch the case videos attached to this article.
(RECOVER guidelines – Post cardiac arrest care https://onlinelibrary.wiley.com/doi/10.1111/j.1476-4431.2012.00754.x).
Clinical features, comparative imaging findings, treatment and outcome in dogs with discospondylitis: A multi-institutional retrospective study.
JVIM. Open access.
Pain and paraparesis were the most common clinical findings with a T3-L3 neurolocalisation accounting for 40% of cases in this large, retrospective study. Males were over-represented and pyrexia was infrequently documented.
Owner-assisted recovery and early discharge after surgical treatment in dogs with brachycephalic obstructive airway syndrome.
JSAP.
A very interesting approach to consider in this retrospective study. Owners were involved immediately on recovery in these dogs managed electively for their BOAS. Perhaps it could be especially valuable if it were also associated with lesser demands on clinical staff, or had a role in emergently managed cases. Food for thought…
A double-blinded randomized placebo-controlled non-inferiority trial protocol for postoperative infections associated with canine pyometra.
BMC Veterinary Research. Open access
Even just to know this study will happen is great to read!
If you want to catch up on some human nutritional guidelines for inspiration, this (open access) narrative review makes for excellent reading.
How to avoid harm with feeding critically ill patients: a synthesis of viewpoints of a basic scientist, dietician and intensivist.
Critical Care. Open access
Or if you are feeling more philosophical…this piece discusses the growing number of journals with less savoury aims. Some emerging journals are less reputable than they may claim.
Predatory journals – a cautionary tale for veterinary authors.
JAVMA. Open access
The full version of this article will be available very shortly; hyaluronan and vascular endothelial growth appearing to evidence the extent of endothelial interruption during systemic diseases like sepsis.
Biomarkers of endothelial activation and inflammation in dogs with organ dysfunction secondary to sepsis.
Frontiers in Veterinary Science – Veterinary ECC Medicine. Open access
May 2023
A feline model of spontaneously occurring autoimmune limbic encephalitis
The Veterinary Journal. Open access.
Evidence is growing for autoimmune encephalitis as a cause of seizures in cats (and specifically with LGI-1 autoantibodies); this study describes 32 cases. Partial cluster seizures with orofacial involvement was common, as were behavioural changes and unprovoked aggression.
If you encounter cases and have residual samples, do consider submitting for testing here: https://www.rvc.ac.uk/research/feline-encephalitis/testing
High flow nasal oxygen therapy is proving both very useful and popular in a number of settings, so this review may be of use/interest to many of you.
Clinical review of high-flow nasal oxygen therapy in human and veterinary patients.
Frontiers in Veterinary Science – Veterinary Emergency and Critical Care Medicine. Open access.
Serum cobalamin and methylmalonic acid concentrations in juvenile dogs with parvoviral enteritis or other acute enteropathies
JVIM. Open access
Cobalamin (vitamin B12) is cofactor for the conversion of -methylmalonyl-CoA to succinyl-CoA. Methylmalonic acid accumulates when a cellular deficiency of cobalamin exists. This group measured serum cobalamin in young healthy dogs and in young dogs with acute enteropathies including parvoviral enteritis. Cobalamin was lower in affected dogs but infrequently below reference interval. Serum methylmalonic acid was also measured as a marker of cellular cobalamin availability, and there was no difference between study groups.
Echocardiographic caudal vena cava measurements in healthy cats and in cats with congestive heart failure and non-cardiac causes of cavitary effusions
Journal of Veterinary Cardiology
There isn’t a huge amount of data on caudal vena cava measurement/monitoring in cats. This study documents larger diameter venae cavae in congested cats, with lower collapsibility indices also. Bare in mind these were performed by trained cardiologists! Cats were in right lateral recumbency.
The forgotten electrolyte!
Total serum and ionized magnesium concentrations in healthy and hospitalized dogs.
JVECC
Retrospective study of feline tracheal mass lesions
JFMS. Open access.
Lymphoma was the most common diagnosis in this retrospective study.