Explore all the previous studies we have interpreted and highlighted over the years.
| Retrospective evaluation of risk factors for worsening renal function after angiotensin-converting enzyme inhibitor treatment in dogs JVIM. Open access. https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.17252 ACE inhibitors are used in the management of congestive heart failure, hypertension and protein-losing nephropathies in cats and dogs. Glomerular filtration rate may decline following initiation of treatment due to decreased glomerular hydrostatic pressure. Prior literature suggests clinically relevant increases of serum creatinine are uncommon after starting these drugs, and drug datasheets tend to suggest pre-existing azotaemia may be a risk factor for this event. This study included 120 dogs receiving enalapril and 36 dogs receiving benazepril. Creatinine increases (>26 umol/L / >0.3 mg/dL) occurred in 17% of dogs with 30 days after starting ACE inhibitor treatment, with most dogs remaining non-azotaemic, but 5 dogs had creatinine increases > 88 umol/L / 1 mg/dL. Concurrent administration of furosemide and pre-existing azotaemia were independent predictors of worsening azotaemia in their multivariable regression model, and so patients with these risk factors may warrant closer monitoring when ACE inhibitor drugs are prescribed. Association of time to start of enteral nutrition and outcome in cats with hepatic lipidosis JVIM. Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.17200 Hepatic lipidosis (HL) is a clinical condition which occurs due to progressive hepatic lipid accumulation which causes liver dysfunction. Providing appropriate nutrition is the mainstay of treatment, but the optimal time to initiation nutrition has been debatable, possibly due to factors such as electrolyte, blood pressure and hydration derangements affecting time to starting nutrition. This study described 48 cats diagnosed with HL, with 42 having a feeding tube in situ. Those cats which had a nasogastric tube were fed at a median of 5 hours after presentation, whilst those with an oesophagostomy tube placed were fed at a median of 18 hours post-admission. Somewhat surprising to me, those cats that started nutrition >12hours post-admission had shorter hospitalisation times and 38% of cats did not survive to 3 months. Less surprisingly, those cats with ascites and were older had increased hazard of death within 3 months of initial presentation. Perceptions, practices and preferences of veterinarians and veterinary nurses in the UK on consent for cardiopulmonary resuscitation in pets JSAP https://onlinelibrary.wiley.com/doi/10.1111/jsap.13778 I chose to highlight this study because nearly half of the data came from primary care practice, and obtaining information from primary care practice will help studies be relevant to most small animal veterinarians. This study obtained data regarding cardiopulmonary resuscitation (CPR) using an electronic questionnaire advertised on a Facebook group and a corporate veterinary group. There were 290 completed questionnaires from UK veterinary professionals. Some findings I found interesting included only 35% of respondents definitely discussed CPR on their admission/procedure consent forms. Common barriers to CPR discussions with owners were ‘emotion’ such as fear of upsetting owners, as well as potential ‘loss of confidence/blame’ being reported by 6% of respondents, and a lack of time by 19%. Effective communication is such an important part of working as a veterinary professional, and there seems to be room for improved education regarding CPR, how to undertaken owner discussions, and also how to habituate owners to these types of discussions when their pets are hospitalised or undergoing procedures. Urinary Cystatin B as a marker of acute kidney injury in cats The Vet Journal. Open access https://www.sciencedirect.com/science/article/pii/S1090023324002016 Cystatins are protease inhibitors, and cystatin B is typically found intracellularly but can be detected in urine following kidney cell damage. This study included 38 cats with acute kidney injury (AKI) (as defined using IRIS guidelines), 17 cats 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 statistically 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. A urine cystatin B of 180 ng/mL identified the AKI group with a sensitivity of 76% and specificity of 71%. Urine cystatin B concentrations predicted survival in AKI; cats surviving 30 days had a median of 584ng/ml, compared to 1572 ng/mL in non-survivors. Therefore, when the aetiology of azotaemia is uncertain then cystatin B may help determine the likelihood of AKI and likelihood of survival from AKI. Video capsule endoscopy findings in dogs with chronic enteropathy and in healthy dogs. JVIM. Open access. https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.17168 A lot of nice information was presented in this study describing capsule ALICAM endoscopy in 15 dogs with and 15 dogs without chronic enteropathy (CE). All dogs with CE had undergone at least one elimination diet trial (of at least 4 weeks) without improvement of their gastrointestinal clinical signs, were not receiving steroids and had undergone routine investigations to identify any extra-gastrointestinal causes of the clinical signs. According to CCECAI scores, dogs in the CE group had mild (n=4), moderate (n=9), severe or very severe (n=2) disease. Across all dogs, the gastric capsular transit times ranged from 23 to 110 minutes, and small intestinal capsular transit times ranged from 90 to 168 minutes. There were no significant differences in transit times or mucosal surface changes between groups, and gastric bleeding erosions and dilated lacteals were seen in roughly half of the control group. I feel this study highlights the importance of needing the whole history of a patient to understand their gastrointestinal condition. There are no short cuts. We cannot solely rely on imaging findings of non-mass lesions within the gastrointestinal tract to help to understand their condition. Feline acute patient physiologic and laboratory evaluation scores and other prognostic factors in cats with first-time diabetic ketoacidosis. JVIM. Open access. https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.17151 Sickness severity scores may be used to predict survival from ill health, and the APPLEfast score has been associated with survival following polytrauma in cats. This retrospective study included 68 cats that were hospitalised for treatment of diabetic ketoacidosis (DKA). Thirty cats had received insulin treatment prior to diagnosis of DKA and none had received SGLT2i treatment. 30/68 cats did not survive to discharge, with median time to euthanasia being 2 days (range 1 – 13 days). Of the 38 surviving cats, 7 later experienced another DKA event. Mean APPLEfast scores were higher in cats that were euthanised compared to survivors, and an APPLEfast score threshold of 24.5 had a sensitivity and specificity for the prediction of euthanasia of 0.60 and 0.76, respectively. Higher blood glucose within the first 24 hours of hospitalisation was also a predictor of euthanasia. I thought this was a very interesting study, I did not expect that 42% of cats would be euthanised and would like to see a prospective study assessing these criteria with outcome as 55 cats were excluded due to incomplete APPLE scores. Diagnostic yield of percutaneous, ultrasound-guided, fine needle aspirates of the gastrointestinal wall: a retrospective analysis of 152 samples. JSAP. Open access https://onlinelibrary.wiley.com/doi/10.1111/jsap.13759 Can we get a diagnosis of a gastrointestinal lesion with percutaneous fine needle aspirates? This retrospective study examined cytology reports from the database at the authors’ institution, from cases that had FNAs of the gastrointestinal tract performed. There were 152 samples included, of which 58% were considered ‘successful’. The presence of a gastrointestinal mass lesion or increasing number of slides submitted were associated with increased odds of a successful FNA. Diagnostic accuracy of FNAs were determined by comparing cytological diagnosis with histological diagnosis, which was available for 17 cases and was considered poor, but it is noteworthy that 7/8 of the discrepancies derive from 7 samples which were considered inflammatory from FNAs but neoplastic from biopsies, and clinical concern regarding a neoplastic process would have likely led clinicians to recommend biopsies in these cases. So in answer to the original question: possibly. The effect of prophylactic tranexamic acid on the incidence of postoperative hemorrhage in greyhounds The Veterinary Journal. https://www.sciencedirect.com/science/article/pii/S1090023324001655 This retrospective study aimed to describe whether the frequency of post-operative haemorrhage was different between greyhounds that received prophylactic TXA and those that did not. A total of 30 greyhounds underwent 58 surgical interventions in referral and first opinion veterinary institutes. Haemorrhage was defined as active bleeding, a haematoma or bruising between the surgery and 10 to 14 days post-operative assessment. TXA was administered peri-operatively for 21/58 surgeries. Post-operative haemorrhage occurred in 11/21 in the TXA group and 7/37 in the control group. More cases received TXA in the referral setting compared to first opinion and the average time of hospitalisation was longer in the TXA group, which might be because these surgeries were more complex. This study did not document a benefit from routine perioperative TXA administration to greyhounds, but as is the theme in this group of articles, a prospective study is required. Chris versis AI Internal Medicine Newsletter: Usefulness of serum amyloid A for the diagnosis of pyelonephritis in cats: A prospective evaluation JVIM.Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.17082 Chris This study caught my eye because our hospital now routinely measures SAA on the feline biochemistry panel. Cats eligible for inclusion had clinical signs of a urinary tract disease, and pyelonephritis was diagnosed (based on positive culture via pyelocentesis) or presumed (based on three of these factors being present: azotaemia, positive urine culture, increased rectal temperature or pyelectasia). Excluded cats included those with an overt inflammatory, infectious or neoplastic disease (I assume outside the urinary tract). Those with confirmed or presumed pyelonephritis had significantly higher SAA than those who did not. Cats where pyelonephritis was excluded based on negative bacterial culture of urine from a pyelocentesis sample (an inference here being this is a 100% sensitive test) but had pyelectasia and/or ureteral dilatation (19 cats), all had SAA within reference interval and of these, 14 had ureteric obstruction. So SAA may be a useful test to differentiate between cats with and without pyelonephritis as long as they do not have concurrent non-urinary tract inflammatory, infectious or neoplastic disease. If you want to explore more literature regarding pyelonephritis then have a look at http://www.iris-kidney.com/education/pyelonephritis.html AI: This study investigated the usefulness of serum amyloid A (SAA) as a diagnostic marker for bacterial pyelonephritis in cats. The study found that cats with pyelonephritis had significantly higher SAA concentrations compared to cats without pyelonephritis. SAA measurement could be used as a diagnostic tool to rule out pyelonephritis in cats with low suspicion of the disease, but increased SAA concentration is not specific to pyelonephritis. The study also highlighted the need for an easily accessible and accurate diagnostic tool for pyelonephritis in cats. Total thyroxine, triiodothyronine, and thyrotropin concentrations during acute nonthyroidal illness and recovery in dogs JVIM.Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.17059 Chris This two year prospective study enrolled 19 dogs with acute illness who then underwent physical examination, routine blood testing, had their APPLEfast scores calculated and had total T4, total T3 and TSH measured at day 0, discharge and then 3, 7, 14 and 21 days after discharge and underwent TSH stimulation testing at day 21 after discharge to determine their thyroid function status. As previously reported, total T3 was not a clinically useful parameter to measure. Only 3/19 dogs had total T4 below reference interval at admission, none of which had increased TSH concentration. There was a negative correlation between total T4 and APPLEfast at admission, with the mean APPLEfast score being 19 (S.D 4.9). The effect of illness on thyroid blood test results in this cohort of dogs was mild, possibly because this cohort of dogs had lower APPLEfast scores compared to other studies. AI Dogs with acute illness may have low levels of total thyroxine (tT4) and total triiodothyronine (tT3), but these levels normalise during the recovery phase. Thyrotropin (TSH) concentrations may be elevated during the recovery phase, but hypothyroidism is unlikely. Overall, acute illness can interfere with thyroid function assessment in dogs for up to 21 days during the recovery period, but it does not lead to a false diagnosis of hypothyroidism when both tT4 and TSH are assessed. Diagnostic findings in sinonasal aspergillosis in dogs in the United Kingdom: 475 cases (2011-2021) JSAP.Open access https://onlinelibrary.wiley.com/doi/full/10.1111/jsap.13736 Chris This descriptive, retrospective multicentre study enrolled 475 dogs that had a diagnosis of sinonasal aspergilloses. The diagnosis was based on compatible clinical signs, nasal turbinate destruction and/or sinus involvement and either fungal plaques visualised or a positive ancillary test. Ancillary tests were defined as consistent histopathological or cytological findings, positive fungal culture or fungal PCR, and were performed in 319/419 dogs in which fungal plaques were observed. Male dogs were more commonly diagnosed than females, and dogs were generally middle aged and dolichocephalic. Nasal pain and nasal planum ulceration or depigmentation was present in only 40% of cases. The sensitivity of the ancillary tests was generally poor. My take home, ancillary tests play a minor role in the diagnosis of this condition. AI The study aimed to assess the sensitivity of four diagnostic tests for sinonasal aspergillosis in dogs: cytology, histopathology, culture, and PCR. The researchers looked at data from 23 referral centers in the United Kingdom and compared the performance of the tests in 475 dogs. They found that the sensitivity of all four tests was lower than previously reported. The study suggests that diagnosis should be based on a combination of tests, including clinical signs, imaging findings, and visual inspection, rather than relying on any one test. Blood fibroblast growth factor 23 concentration in cats with and without chronic kidney disease: a scoping review JFMS.Open access https://journals.sagepub.com/doi/10.1177/1098612X241234984 Chris FGF-23 measurement is now commercially available and can be used as part of a decision-making process to determine if a cat with phosphate within the IRIS target interval would benefit from phosphate restriction. The manuscript gives an overview of FGF-23 physiology and appraises the literature (17 studies) published up to December 2022 regarding the use of FGF-23 in cats. The manuscript reviews and compares the 17 studies, and summises FGF-23 is typically lowest in healthy cats, increases with IRIS stage, but with a wide variability and overlap between stages and healthy cats. FGF-23 is positively correlated with serum phosphorus in several but not all studies, and can decrease when a renal diet is fed, is positively correlated with ionised calcium concentrations and negatively correlated with total magnesium. FGF-23 appears to be an independent predictor of CKD progression in cats > IRIS stage I. The manuscript concludes more data is required, particularly prospective studies enrolling cats with IRIS stage I CKD to develop robust guidance on how to clinically utilise FGF-23 data in this cohort. AI This manuscript explores the potential of Fibroblast Growth Factor 23 (FGF-23) as a diagnostic tool for CKD in cats. FGF-23 is a hormone known to regulate phosphate levels and is linked to CKD in humans. There is disruption of calcium, phosphate, and vitamin D metabolism in CKD and FGF-23 levels, rise in human CKD patients and could offer similar insights in cats. The review acknowledges the existing research gap in veterinary medicine and emphasizes the need for further studies to determine the utility of FGF-23 as a diagnostic marker for feline CKD and its role in disease management. Clinicopathological findings, treatment, and outcome in 60 cats with gastrointestinal eosinophilic sclerosing fibroplasia JVIM. Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16992 I always struggle with the name of this condition, which is feline gastrointestinal eosinophilic sclerosing fibroplasia. This is an inflammatory disorder which typically presents as an abdominal mass lesion, gastrointestinal signs and weight loss in middle-aged cats. This multicentre retrospective study describes the clinical signs, diagnostic findings and outcome of 60 cats diagnosed with this condition. The most common mass lesion locations were gastric and small intestinal, and 15% of cases had more than one mass. Intralesional bacteria were seen in 32% of cases via mass histopathology. Almost all cats received corticosteroids, 72% received antibiotics and 37% were fed a selected protein or hydrolysed diet. No specific factor was associated with survival, and only 7/60 cats had died by the time of writing so median survival times could not be described. Hepatic abscessation in dogs: A multicenter study of 56 cases (2010–2019). JVECC https://onlinelibrary.wiley.com/doi/10.1111/vec.13340 Hepatic abscessation is a rare condition, which I’ve personally seen more in dogs with diabetes than other conditions. This multicentre retrospective study defined hepatic abscesses to be cystic lesions seen on ultrasound, surgery or necropsy which were diagnosed as being septic. The median age of dogs was 11 years, and clinical signs were generally non-specific such as lethargy and vomiting. Pyrexia was common but inconsistent in these dogs. Abdominal ultrasonography (performed in 48 dogs) identified the abscesses in 37 of these, 18 of which had multifocal abscesses. Of 47 dogs that had histopathology performed, 10 had hepatic neoplasia associated with the hepatic abscess. Various different bacteria were cultured from the hepatic lesions, and culture results of peritoneal fluid (if present) were consistent with that of the abscess in 6/10 cases. Treatment was pursued in 49 dogs; 41 dogs underwent surgical management and 8 dogs were treated medically only. 35/41 dogs survived to discharge following surgery, 32 of which were discharged with an antibiotic prescription. The presence of multiple abscesses was the only factor that was negatively associated with survival using multivariate analysis. Effect of hospitalisation on the rate of surgical site infection in dogs with Penrose drains JSAP https://onlinelibrary.wiley.com/doi/10.1111/jsap.13678 This study caught my eye because I initially thought those dogs hospitalised with a drain in place would be more likely to develop a surgical site infection than if managed at home; the counter argument being that the care of the drain may be less effective at home. This retrospective study from a single centre included two predominant groups – cases that were discharged within 24 hours after drain placement with the drain in place (group A containing 136 dogs), and those that were discharged only after the drain was removed (group B containing 50 dogs). Most drains were placed to aid the healing of a traumatic wound repair or following mass resection. Nearly 90% of dogs were prescribed antibiotics, with those cases in group B being more likely to receive antibiotics. There were 35 wounds that became infected, 16% of group A and 18% of group B but group B had a greater proportion of dogs with infected / contaminated wounds at the time of surgery. The overall complication rate was 41% with no difference between groups. The data suggests dogs can be effectively managed at home but whatever decisions lead to a Penrose drain being placed, it is worth being mindful these wounds tend to have a high complication rate. The effect of ε-aminocaproic acid on blood product requirement, outcome and thromboelastography parameters in severely thrombocytopenic dogs JVIM. Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16977 Last year a study describing 10 dogs (6 control, 4 case) diagnosed with primary immune mediated thrombocytopenia reported no identified benefit from the administration of 20mg/kg tranexamic acid. Aminocaproic acid is another antifibrinolytic drug used in veterinary medicine. This study included 28 prospectively enrolled dogs with severe thrombocytopenia treated with aminocaproic acid (although 6 did not complete the study) and used a retrospective historical control population. There was no difference in the number of blood transfusions administered between groups, no difference between number of bleeding events, and no difference in time to discharge. Changes on thromboelastography pre- and post-aminocaproic acid suggested increased clot strength following treatment without observable clinical benefit. ACVIM consensus statement on diagnosis and management of urinary incontinence in dogs JVIM. Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16975 This consensus statement begins with a review of the anatomy and physiology of the lower urinary tract and urination, followed by classification of urinary incontinence (disorders of storage and disorders of voiding). Within each classification an extensive differential list is provided as well as a diagnostic approach to dogs with urinary incontinence (Figure 4 is good overview). There are numerous flow charts and tables with a practical viewpoint on the diagnosis and treatment of both storage and voiding disorders. This is a very useful reference to refer to and well worth a read. C-reactive protein concentration has limited value in the diagnosis of meningoencephalitis of unknown origin in dogs. JAVMA. Open access https://avmajournals.avma.org/view/journals/javma/aop/javma.23.11.0606/javma.23.11.0606.xml I am very much applying my own bias with this one. CRP is an acute phase protein which is used as a marker of inflammation and has been reported to be increased in numerous inflammatory conditions, including meningoencephalitis of unknown origin (MUO). This single centre prospective study enrolled dogs for just over 3 years and included dogs with a diagnosis of MUO (group A, 30 dogs) or steroid responsive meningitis arteritis (group B, 15 dogs), and healthy dogs (group C, 15 dogs). CRP was measured in plasma and CSF (CSF was only available for group A and B). Plasma CRP was increased in 30% of group A (range 0.1 – 102 mg/L), 100% of group B (range 42 – 278 mg/L) and 0% of group C (to convert mg/L to nmol/L, multiple by 9.5). CSF CRP was detectable in 10% of dogs in dogs with MUO (all of which had increased blood CRP) and in 60% of dogs with SRMA. There was a significant difference in the length of clinical signs between dogs with MUO and an increased CRP, and those with CRP within reference interval (median 47.5 versus 8.5 days). The area under the ROC curve to determine the predictive value of CRP for survival at 6 months for group A was 0.6, consistent with poor predictive value. My take home message from this study is CRP appears to be not clinically useful for patients with MUO. Histopathologic diagnosis and patient characteristics in cats with small intestinal obstructions secondary to trichobezoars JFMS. Open access. https://journals.sagepub.com/doi/full/10.1177/1098612X231196231?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org As my own cat had a large trichobezoar when he had a significant gastrointestinal flare up when he was younger, this article caught my eye. This study assessed full thickness intestinal biopsies that had been obtained at the time of enterotomy for trichobezoar removal. There were 100 biopsies from 44 cats assessed. The majority of the population were medium to long-haired cat breeds (37/44). Small cell lymphoma was diagnosed in 10 cats. Of these, 4/10 were domestic short haired cats and 6/10 were domestic medium or long haired cats, raising the possibility that short haired cats presenting with a trichobezoar may be more likely to have small cell lymphoma. Response and survival of dogs with proteinuria (UPC <2.0) treated with angiotensin converting enzyme inhibitors JVIM. Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16864?af=R Proteinuria management using ACE inhibitors has been common place, although this may change now the updated 2023 IRIS CKD guidelines recommend an angiotensin receptor blocker as first line drug therapy. This retrospective study assessed UPC over time in 85 dogs that had a UPC >2 and were being treated with benazepril or enalapril. There were 35 responders (UPC decreased by 50% or became <0.5). There was no difference in whether dogs were fed a renal diet or had omega-3 fatty supplementation between groups. Factors associated with decreased survival at 12 months were being a ‘non-responder’ to treatment, azotaemia at baseline and hypoalbuminaemia at baseline. Fuzapladib in a randomized controlled multicenter masked study in dogs with presumptive acute onset pancreatitis JVIM. Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16897 Fuzapladib is a leukocyte function-associated antigen type-1 (LFA-1) activation inhibitor which prevents neutrophil extravasation and therefore was hypothesised to decrease the severity of acute neutrophilic pancreatitis. This multicentre prospective study enrolled dogs with presumptive acute pancreatitis and randomly assigned 16 dogs to treatment with 0.4 mg/kg of fuzapladib IV once daily for 3 consecutive days and 19 dogs to the placebo group. Response was determined using a modified clinical activity index (MCAI) and the canine acute pancreatitis clinical severity index (CAPCSI). The mean decrease of the MCAI score was greater in the treatment group although the mean total score was not different at the end point, and neither were CRP or cPLI. 2023 Updated ACVIM consensus statement on leptospirosis in dogs JVIM.Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16903 This updated consensus presents numerous recommendations and is certainly worth a read for any veterinarian managing cats and dogs. A selection of recommendations are as follows: “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…to optimize sensitivity of nucleic acid amplification tests (NAATs), specimens should be collected before administration of antibiotics (also, both blood and urine should be submitted)…because the DNA of pathogenic leptospires can be found in the urine of up to 20% of apparently healthy dogs, a positive NAAT test on urine must be interpreted in conjunction with clinical signs and the results of other diagnostic tests…dogs with leptospirosis should be treated with doxycycline at a dosage of 5 mg/kg q12h PO for 2 weeks” Biological variation of urinary protein : creatinine ratio and urine specific gravity in cats JVIM. Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16881?af=R UPC is a key component of the monitoring of CKD in cats, as proteinuria is negatively associated with survival. This prospective study serially assessed the UPC of healthy cats; they were assessed at day 0, 14 and 56 (total of 80 cats) whilst a subset of 15 cats were assessed weekly for 6 weeks and then on two consecutive days. At enrolment, 62 had UPC <0.2 (non-proteinuric group), 15 had UPC 0.2 to 0.4 (borderline proteinuric group) and 3 had UPC >0.4 (proteinuric group). All 3 proteinuric cats were either non-proteinuric or borderline proteinuric after 2 months. Of the 62 cats which were initially non-proteinuric, 58/62 were non-proteinuric at all 3 timepoints and 4/62 became borderline proteinuric. Of the 15 cats in the borderline proteinuric group at enrolment, 10/15 cats were borderline proteinuric at all three time points, 4/15 cats became non-proteinuric and 1/15 became proteinuric. The mean difference of UPC (between highest and lowest) in the weekly assessed group was 0.1, whilst the median difference on consecutive days was 0.03. An increase of UPC of >82% was determined to be clinically relevant and not likely related to physiological variation. Risk factors influencing death prior to discharge in 302 dogs undergoing unilateral adrenalectomy for treatment of primary adrenal gland tumours Veterinary and Comparative Oncology. Open access https://onlinelibrary.wiley.com/doi/10.1111/vco.12931 We couldn’t get through a VetLit update without an endocrine update. This multicentre retrospective descriptive study from the USA and Canada describes the outcome of 107 dogs with pheochromocytoma, and 189 dogs with cortical tumours (105 adenoma and 84 adenocarcinoma) of which 99 had hypercortisolaemia. Factors associated with overall mortality were post-operative pancreatitis or pneumonia and undergoing ureteronephrectomy. Performing a caval venotomy was not associated with survival. Pre-treatment with phenoxybenzamine for patients with a pheochromocytoma was not associated with survival. External validation of a United Kingdom primary-care Cushing’s prediction tool in a population of referred Dutch dogs JVIM. Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16848 A previously validated tool which utilises signalment, clinical signs and routine laboratory test results had good predictive performance (AUROC = 0.78) to diagnose Cushing’s syndrome in a UK cohort of dogs. This same tool was utilised to classify a cohort of dogs in a Dutch referral clinic. The tool over-estimated the probability of a dog having Cushing’s syndrome, and results highlight the requirement for external validation of such tools before implementation in populations of dogs which differ from those used for tool development. Efficacy of an elemental diet in achieving clinical remission in dogs with chronic enteropathy JVIM.Open access https://onlinelibrary.wiley.com/doi/10.1111/jvim.16846 Elemental diets differ from hydrolysed diets as proteins are presented as amino acids rather than polypeptides. These diets may be suitable to manage dogs with chronic enteropathies, including those that have previously failed to respond to hydrolysed diet trials. The study enrolled 23 dogs that had a diagnosis of chronic enteropathy without moderate to severe hypoalbuminaemia. Dogs were initially fed the diet exclusively for two weeks, and those who were stable or improving were enrolled for a further six weeks. Only one dog was removed due to not eating the study diet. 15 of 22 dogs (68%) eating the diet were considered to be responding by two weeks. The overall clinical response rate was considered to be 70% by eight weeks (16/23). These results are similar to other studies describing the use of hydrolysed diets to manage chronic enteropathy in dogs. 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 https://onlinelibrary.wiley.com/doi/full/10.1111/jsap.13661 Ureteral obstruction can result in a variety of clinical signs from being almost incidental to a cause of abdominal pain, anorexia and documented acute kidney injury. Identification of an obstruction allows early intervention to be offered. This study assessed azotaemic cats (median creatinine 889 umol/L /[10ng/dL]) that had undergone point of care ultrasound as well as formal ultrasound, dividing them into obstructed vs non obstructed groups. Renal pelvic dilatation was identified in 76% of cats in the obstructed group compared to 6% of cats in the non obstructed group on point of care ultrasound. Other factors associated with obstruction included hypercalcaemia and hypokalaemia. Oligo/anuria was more common in non-obstructed cats. Clinical assessment of a point-of-care assay to determine protective vaccinal antibody titers to canine viral diseases The Veterinary Journal. Open access https://www.sciencedirect.com/science/article/pii/S1090023323000680?via%3Dihub Vaccine antibody titers can be used to aid the decision-making process for repeat vaccination. A point of care (POC) assessment of these titers is desirable to reduce the cost of testing to owners and reduce time for results/allow same day results which could reduce the number of visits to the veterinary practice. Ninety-two healthy dogs due to be vaccinated were enrolled and their antibody titers against canine distemper virus (CDV), canine parvovirus (CPV) and canine adenovirus (CAV) were measured using a semi-quantitative assay and compared to reference standard assays. The sensitivities and specificities of identification of protective antibodies using the POC test if there was a result of ‘high positive’ for CDV were 51% and 100%, for CPV were 76% and 100%, and for CAV were 60% and 100%. These tests may aid vaccine decision making for CPV and CAV when using high positive results, but were less useful for CDV decision making. Evaluation of red blood cell distribution width, neutrophil-to-lymphocyte ratio, and other hematologic parameters in canine acute pancreatitis JVECC https://onlinelibrary.wiley.com/doi/10.1111/vec.13325 This retrospective study included 118 hospitalised dogs with a diagnosis of acute pancreatitis using the inclusion criteria of having two or more of lethargy, anorexia, vomiting, or abdominal pain (sudden in onset), and a cPL of >400 ug/L. Canine acute pancreatitis severity scores were calculated. The overall mortality was 37%. A higher neutrophil to lymphocyte ratio was associated with increased likelihood of nonsurvival (odds ratio 1.1). The study adds to the literature of prognostic factors in acute pancreatitis such as presence of SIRS, coagulation disorders, hypocalcaemia, azotaemia, and the use of the CAPS score. Retrospective comparison of modified percutaneous cystolithotomy (PCCLm) and traditional open cystotomy (OC) in dogs: 218 cases (2010–2019) Veterinary Surgery. https://onlinelibrary.wiley.com/doi/abs/10.1111/vsu.13869 A percutaneous cystolithotomy (PCCLm), aka minimally invasive cystotomy, is a technique which utilises a smaller abdominal incision than traditional open cystotomy (OC), and whereby trocar-cannulae are introduced into the urinary bladder to allow endoscopy to be performed to assess the proximal urethra and retrieve cytoliths +/- obtain urinary bladder biopsies. This study compared outcomes of 87 dogs following OC and 131 dogs following PCCLm. There was a lower incidence of short-term lower urinary tract signs in the PCCLm group (7% versus 18%) and a longer time to requiring a second cystotomy (24 versus 12 months). There was an equivalent percentage of dogs in each group that were taken immediately back to surgery due to persistence of cystoliths following the initial procedure (7% PCCLm and 8% OC). Where available, a PCCLm may be a desirable alternative to OC to reduce post-operative lower urinary tract signs. Thirty-two cats with effusive or non-effusive feline infectious peritonitis treated with a combination of remdesivir and GS-441524 https://onlinelibrary.wiley.com/doi/10.1111/jvim.16804?af=R JVIM. Open access. This retrospective study reports the outcomes of cats treated for FIP. The most common breeds were British short hair, Siberian and Ragdolls. Twenty five cats presented with effusive and seven presented with non-effusive disease, six had ocular involvement and five had neurological signs. Nearly all cats received injectable remdesivir initially and 24 cats were later transitioned to GS-441524. A clinical improvement occurred within five days in 28 cats, and 26/28 cats survived to complete the 84 day treatment. During treatment, increases in ALT activity were common and albumin globulin ratios gradually improved over the 12 weeks. Assessment of glucocorticoid and antibiotic exposure as risk factors for diabetes mellitus in selected dog breeds attending UK primary‐care clinics https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.2785 Vet Record. Open access. The incidence of diabetes mellitus in dogs appears to be increasing and environmental factors may account for some of this increase, including those which affect the intestinal microbiome. This study utilised VetCompass data from 2016-2017 which identified 1808 dogs with diabetes and used 565 incident cases with over 2000 controls. Exposure to glucocorticoids (systemic) in the 6 weeks prior to diagnosis occurred in 9% of cases and 2.7% of controls (p <0.001, 4 x odds of diabetes) and dogs with one unique antibiotic treatment had decreased odds of diabetes compared to those who had no antibiotic treatment. Postoperative complications and antibiotic use in dogs with pyometra: a retrospective review of 140 cases (2019) https://actavetscand.biomedcentral.com/articles/10.1186/s13028-023-00670-5 Acta Veterinaria Scandinavica. Open access. This study describes the complications following pyometra surgery within 30 days of the procedure and whether national antibiotic guidance was adhered to. Dogs were grouped according to their antibiotic treatment pre-surgery (group A, no treatment, 90 dogs; group B, treated with antibiotics prior to or during surgery, 50 dogs). Antibiotic adherence occurred in 90% of cases. Group B had higher ASA scores. Complications were reported in 27 cases (most often a surgical site infection), with more occurring in group A (all 10 cases of infection occurred in group A). 71 cases received no antibiotics and did not develop surgical site infections. Three dogs, all in group A, died or were euthanised. Severe complications were uncommon in both groups. Retrospective review of diphenhydramine vs diphenhydramine plus glucocorticoid for the treatment of allergic reaction in cats https://journals.sagepub.com/doi/10.1177/1098612X231173521 JFMS. Open access Anti-histamines and glucocorticoids downregulate the inflammatory response and are commonly prescribed for patients exhibiting signs of an allergic reaction, although glucocorticoids may take several hours to take effect. This retrospective study described the outcome of 73 cats receiving treatment for a presumed allergic reaction; 44 were treated with diphenhydramine only and 29 with diphenhydramine and dexamethasone. Follow up was available for 40 cats, with all being reported to survive the event. Persistent signs following discharge were reported in 7% of the anti-histamine only group and 17% of the combination treatment group, and this difference was not significantly different. Very similar findings are already reported in dogs: https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.13054 Clinical features, comparative imaging findings, treatment, and outcome in dogs with discospondylitis: A multi-institutional retrospective study https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.16785 JVIM. Open access. This study describes 386 dogs diagnosed with discospondylitis whose ages ranged from 2 months to 15 years (median 7 years). There were almost twice as many males than females, and over-represented breeds were generally medium to large breeds. Most dogs presented with non-specific signs with two thirds being painful and only one third presented with paresis. The most common localisations were T3-L3 and L4-S3. Only 27% of blood and 28% of urine cultures were positive. Staphylococcus spp accounted for 61% and 39% of positive blood and urine cultures, respectively. Intervertebral cultures were performed in 16% of cases. Most dogs were treated medically with antibiotic administration courses administered for a median of 16 weeks. Human intravenous immunoglobulin use for hematological immune-mediated disease in dogs https://avmajournals.avma.org/view/journals/javma/261/7/javma.23.01.0043.xml JAVMA. Open access. Human intravenous immunoglobulin (hIVIG) has immunomodulatory effects including downregulation of phagocytosis. This retrospective study included 16 dogs treated with hIVIG at 0.5mg/kg with either a diagnosis of immune-mediated haemolytic anaemia (6) or immune-mediated thrombocytopenia (10) between 2006-2022, and a control group that had not received hIVIG. The median number of blood transfusions in the hIVIG group was 4.5 versus 0 in the control group. In the hIVIG group, 5/16 died whilst 7/36 in the control group died. Whether hIVIG transfusion can reduce the blood transfusion requirement of the the cases receiving it remains to be seen by way of a prospective study. ACVIM consensus statement guidelines on diagnosing and distinguishing low-grade neoplastic from inflammatory lymphocytic chronic enteropathies in cats. Journal of Veterinary Internal Medicine.Open access The differentiation of lymphoplasmacytic enteritis from low grade intestinal T-cell lymphoma is challenging, and as treatment strategies may differ when managing each condition then robust diagnostic criteria are needed. This consensus aims to unify terminology, and presents the similar risk factors, presenting clinical signs and diagnostic test findings of these conditions. The utility of routine histology, and role of immunohistochemistry and T cell clonality analysis is also presented. Despite appropriate application of diagnostic tests and intestinal tissue analysis, differentiation of inflammation only versus low grade T-cell lymphoma may not be possible in all cases. Safety and effectiveness of the sodium-glucose cotransporter inhibitor bexagliflozin in cats newly diagnosed with diabetes mellitus Journal of Veterinary Internal Medicine. Open access Sodium-glucose cotransport 2 (SGLT2) inhibitors are a new class of medication for the treatment of diabetes mellitus in cats (not dogs). The mechanism of action is to inhibit reuptake of glucose in the proximal tubule of the kidney. This multicentre study evaluated newly diagnosed client owned diabetic cats treated using bexagliflozin administered as a one daily oral tablet. Treatment success was defined as a mean blood glucose <14 mmol/l or fructosamine <358 umol/l by day 56 and improvement of a clinical sign of diabetes. 84% and 87% of cats were deemed to have experienced treatment success and experienced an improvement in quality of life, respectively. Gastrointestinal upsets were the most commonly reported adverse events, but were generally considered to be non-serious while 8 cats experienced serious adverse events, with 3 confirmed and 1 suspected diabetic ketoacidosis. There were no symptomatic hypoglycaemic events. Evaluation of haem dipstick pad, urine protein, urine pH and urine protein:creatinine ratio results as a marker of bacteriuria in dogs and cats with inactive urine sediment Journal of Small Animal Practice. Open access The haem pad on a dipstick undergoes a colour change when exposed to peroxidase like activity. False positive results may occur when the pad is exposed to bacterial peroxidases. This study aimed to determine if false positive haem pad results were consistent with bacteriuria when urine sediment analysis was inactive. For dogs and cats a positive haem result was consistent with an increased odds of bacteriuria. In dogs, a haem result of greater than or equal to 4+ had a sensitivity of 39% and specificity of 82% to detect bacteriuria, and there was no haem result cut off which was considered accurate enough for use as a screening tool. The utility of a positive haem result on a dipstick from urine with an inactive sediment appears to be low. Retrospective evaluation of noncardiogenic pulmonary edema in dogs and cats (2000–2021): 31 cases Journal of Veterinary Emergency and Critical Care This retrospective study described 30 dogs and 1 cat presenting to the emergency service of a single centre. The most common cause of non-cardiogenic pulmonary oedema was upper airway obstruction. A mixed interstitial to alveolar pattern was described in 53% of dogs, and the changes were diffuse and caudodorsal in equal proportions. Almost all animals received oxygen therapy, for a median duration of 24 hours, and 6 dogs required mechanical ventilation. Of the 30 dogs, 8 died or were euthanised because of their condition, of these four had undergone mechanical ventilation. The cat did not require hospitalisation or treatment. The effect of flushing of the common bile duct on hepatobiliary markers and short-term outcomes in dogs undergoing cholecystectomy for the management of gall bladder mucocele: A randomized controlled prospective study Veterinary Surgery. Open access Gall bladder mucoceles may be managed surgically or medically. If a surgical approach is undertaken then cholecystectomy is performed +/- flushing of the common bile duct. This flushing may increase the risk of post-operative complications. This prospective study enrolled 32 dogs who were randomised to either undergo cholecystectomy only or cholecystectomy + common bile flushing, with one dog later being excluded from the flush group due a diagnosis of hepatic lymphoma. Two dogs in each group had gall bladder rupture identified during surgery. Three dogs died (one in flush, two in non-flush group), with 2/3 dogs having gall bladder rupture. Post-operative complications were common (58%), and there was no difference between groups nor difference of biochemical parameter change between groups. There was no apparent benefit nor detrimental effect from undergoing flushing. Resolution, recurrence, and chyle redistribution after thoracic duct ligation with or without pericardiectomy in dogs with naturally occurring idiopathic chylothorax Journal of American Veterinary Medical Association This study aimed to determine if documentation of constrictive pericardial pathology (CPP) (diagnosed via cardiac catheterisation when right atrial pressure was greater than 6mmHg) aided identification of those dogs who would benefit from pericardiectomy when thoracic duct ligation is performed to manage chylothorax. Twenty six dogs were enrolled; 17 without CPP undergoing thoracic duct ligation only and 9 dogs with CPP undergoing thoracic duct ligation plus pericardiectomy. Resolution of chylothorax occurred in 94% of the non-CPP and 88% of the CPP group. Fatal ventricular fibrillation occurred in one dog undergoing pericardiectomy. As surgical time and anaesthesia times were longer in patients undergoing pericardiectomy, and this procedure is associated with some risk, then the authors suggest this procedure might not be routinely indicated in dogs without CPP. Effect of laboratory and sample storage factors on urinary protein:creatinine ratios and clinical decision making in cats JVIM.Open access Urine samples from 60 cats were analysed to determine interlaboratory variation of UPC measurement. There was good correlation between laboratories for actual UPC measurement which resulted in moderate agreement between laboratories when applying IRIS sub-staging for UPC. The UPC was stable for 7 days at room temperature. The study highlights the importance of using the same laboratory when IRIS sub-staging cats using UPC. Clinicopathological and gastrointestinal effects of administration of prednisone, prednisone with omeprazole or prednisone with probiotics: a double blind randomized trial JVIM.Open access. In this study, six research dogs were enrolled into each group and received treatments for 28 days. The dose of prednisone was 2mg/kg q24h p/o, of probiotics was 1.2 to 22.5 billion CFU/kg q24h p/o and of omeprazole was 1mg/kg q12h p/o. All treatments were given with food. Upper gastrointestinal endoscopy was performed on days 0, 14 and 28. Mucosal lesions increased in dogs receiving prednisone, and those dogs receiving prednisolone and omeprazole had a lower mucosal lesion score than the other prednisone treated groups, suggesting omeprazole may have a beneficial effect by reducing mucosal damage when treatment with prednisolone at 2mg/kg q24h p/o is prescribed, but diarrhoea occurred most frequently in this group. Successful management of pelvic urethral strictures with balloon dilation in 3 cats. JVECC. Two of the cats developed stricture related to lower urinary tract disease and the other after perineal urethrostomy for a suspected congenitally narrow urethra. The catheters were 3.5F with 20 x 6 mm balloons, and following the procedure an indwelling urinary catheter was placed (length of stay of catheter varied for each patient). The procedure was successful in terms of dilating the affected urethra, although one cat required a perineal urethrostomy due to urethral orifice stricture formation and one cat developed urinary tract infections likely related to the indwelling catheter. The technique described provides a method to manage intra-pelvic urethral strictures. Epidemiology and risk factors for mammary tumours in female cats JSAP. Open access This study assessed electronic patient record data of cats presenting to UK primary care practices in 2016. There were 270 cases, equating to an incidence of 0.1%. Median age was 12 years (IQR 8.5-14) and 67% were neutered but the timing of neutering was not available for review in most cases. Besides weight loss and appetite loss, the most common clinical findings associated with the mammary masses were ulceration, a firm mass and discharge. Median survival time of the 56% of cases which died during the study period was 19 months. Neuter status was not associated with risk of mammary tumour but as the timing of neutering was not available then the association with neutering could not be fully evaluated. Antibiotic therapy in dogs and cats in general practice in the United Kingdom before referral JSAP. I somewhat apologise for promoting a study I was involved in, but I really think the data is useful. Of the 917 cases assessed in this study, just over half of patients had been prescribed antibiotics for the condition they were referred for, with 71% not adhering to local (BSAVA and SAMSoc Protect / Protect Me) guidance. Bacterial culture testing had been performed in only 9% of cases which were prescribed antibiotics and cats were more likely to have received a third generation cephalosporin than dogs, with 33% of cats being prescribed cefovecin. Nitroimidazoles (i.e. metronidazole) were the commonly prescribed antibiotics for gastrointestinal disorders in dogs. This data highlights the need for more targeted antibiotic prescribing behaviours. An investigation into an outbreak of pancytopenia in cats in the United Kingdom JVIM. Open access. There was an outbreak of cats presenting with severe bi- or pancytopenia to UK practices in 2021, which peaked in the summer and had resolved by the beginning of 2022. The study reports the outcome of 580 of these cats. Bone marrow examination was performed in 56 cats, with generalised hypoplasia in 36, aplasia in 18 and hyperplasia in 2 cats. The mortality rate was 63%. The dietary history was available for 554 cats; three brands were commonly fed to the cats and were subsequently withdrawn from the market in June 2021. 93% of the cats were fed one of these diets before the food recall. Food analysis identified higher concentrations of trichothecene mycotoxins than recommended guidance, and as some of these mycotoxins are hematotoxic, this suggests contaminated foodstuffs were the source of this outbreak. Risk factors for upper urinary tract uroliths and ureteral obstruction in cats under referral veterinary care in the United Kingdom. JVIM.Open access Cats with upper urinary tract obstruction are commonly referred, and in this study accounted for 4.6% of all cat referrals. Obstructive upper urinary tract conditions were more commonly diagnosed in female cats, in cats > four years of age and in certain breeds. As female cats tended to weigh less than males, then a size effect may explain the different odds between sexes. Having bilateral upper urinary tract uroliths was identified as a risk factor for obstructive disease. Upper urinary tract uroliths in cats <8 yrs should be monitored for possible future obstruction events. Retrospective analysis of immunosuppressive and anti-thrombotic protocols in non-associative immune mediated hemolytic anemia in dogs JVIM.Open access. The benefits of second line immunosuppressives or ideal thromboprophylactic drugs for the treatment of IMHA are not clear. This two centre retrospective study included data from 242 dogs diagnosed with non-associative IMHA. Combination immunosuppression therapy was not associated with shorter period of stabilisation of IMHA but was with a reduced rate of relapse. Dogs treated with either unfractionated heparin or enoxaparin alone had a higher rate of thrombus events (either confirmed or suspected) compared to combination treatments targeting primary and secondary haemostasis. There are many considerations in interpreting these results, but multi-modal management of dogs with IMHA seems to be beneficial. Prevalence of gastroesophageal reflux in dogs undergoing MRI for a thoracolumbar vertebral column pathology JSAP.Open access Gastrointestinal reflux can result in a multitude of consequences and seems to occur frequently in dogs under general anaesthesia. Two hundred and seventy five dogs undergoing thoracolumbar MRI were included, and 51% demonstrated evidence of reflux on MRI of the oesophagus. Unsurprisingly for a UK population, French bulldogs and dachshunds were the most common breeds. The incidence of reflux was high and awareness may aid minimising the extent or consequences of reflux if interventions are applied to manage this condition. Cardiopulmonary resuscitation outcomes of dogs and cats at a veterinary teaching hospital before and after publication of the RECOVER guidelines JSAP. Open access I do like an audit-reaudit type project. The RECOVER guidelines have been widely accepted in the veterinary community and provide a structured approach to CPR. Another study identified improved return of spontaneous circulation following implementation of the guidelines without improved survival to discharge. In this study, There were 81 cases assessed pre-implementation of RECOVER between 2010 and 2012 and 190 post between 2018 and 2020. There was no statistical difference in survival pre- and post-implementation of the guidelines, and as more cases experienced arrest out of hours post-implementation and a greater percentage of cases were discharged after arrest after implementation, then it is likely the guidelines have had a positive impact despite lack of significance in this institute. Does preappointment gabapentin affect neurological examination findings? A prospective, randomized and blinded study in healthy cats. JFMS.Open access Gabapentin seems to be increasingly prescribed for cats to decrease their stress during transport to, and assessment during, veterinary examinations. In this study cats underwent neurological examination without medication and following administration of gabapentin (median dose 29mg/kg, examination two hours after administration). Following gabapentin, cats were more likely to exhibit proprioceptive ataxia and numerous postural reactions were decreased compared to pre-treatment, but cranial nerve and spinal reflex evaluations were unaffected. Knowledge of medications given before assessment is important when interpreting neurological examination findings. Clinical and epidemiologic features of SARS-CoV-2 in dogs and cats compiled through national surveillance in the United States JAVMA During the SARS-CoV-2 pandemic there has been much concern regarding the risk and severity of infection in companion animals. Through both passive (owner bringing pet to clinic) and active (known exposures or compatible clinical signs actively pursued) surveillance, 109 cats and 95 dogs were confirmed as positive for the virus in the United States via serological or genomic testing. The source of infection in most cases was the owner. Seventy two percentage of cats and dogs identified by passive surveillance exhibited clinical signs compared to 27% by active, with respiratory signs being the most common. If one cat/dog in a multi-animal household was positive, there was a 25% another cat/dog in the household would be positive). I cannot present all the data here but the full article is a very interesting read. Owner preference for insulin delivery device and glycaemic control in diabetic dogs. JSAP Insulin pens have been proven to be more accurate than needle and syringe when administering low volumes of insulin, and people with diabetes report a preference for insulin pens. In this cross over study, owners preferred the VetPen when trained to use this before using needle and syringe, whilst owners using needle and syringes first had no preference. Glycaemic control was similar across insulin administration devices. Owners can be presented with both administration options and choose which suits them best. Neutering is not associated with early-onset urethral obstruction in cats JFMS. Free access. The literature regarding neuter status and age of neutering on the risk of urethral obstruction is conflicting. There were 84 male cats included: 24 intact, 24 neutered <7 months and 36 neutered >7 months in this study. Entire cats presenting with urethral obstruction were younger than pre-or post-pubertal cats (3.6 vs 5.7 vs 5.4 yrs). Although overall risk of neutered status was not presented, the age of intact cats presented suggested neutering does not increase the risk of urethral obstruction at an earlier age. Short-term postprandial changes in select serum biochemistry analytes in healthy adult cats JFMS. Free access. Although a 12 hour fast prior to blood sampling for serum biochemistry analysis is commonly recommended in cats, post-prandial analyte changes are poorly described. This study enrolled nine purpose-bred three year old domestic short hair cats, and repeat serum biochemistry analyses were performed at two hourly intervals after feeding. Several analytes changed after feeding including BUN, which increased to a peak at 6 hours and phosphorous peaking at 2 hours but most analytes remained within normal limits, or perturbations were unlikely to affect clinical practice. Radiographic features of cardiogenic pulmonary oedema in cats with left-sided cardiac disease: 71 cases JFMS. Free access. In this retrospective study, the distribution of cardiogenic pulmonary was described in 46 cats with hypertrophic cardiomyopathy, 13 cats with restrictive cardiomyopathy, and 12 cats with other cardiac disease. Using thoracic radiographs, subjective cardiomegaly was identified in 69/71 cats and left atrial enlargement in 57/71 cats. Only one cat presented with purely an alveolar lung pattern, while 41 and 27 had an interstitial or mixed interstitial-alveolar pattern, respectively. This study highlights the combination of cardiomegaly with interstitial lung patterns as suggestive of congestive heart failure in cats. Progression of lipase activity and pancreatic lipase immunoreactivity in dogs hospitalized for acute pancreatitis and correlation with clinical features. JVIM. Open access. This retrospective study included 39 dogs that were hospitalised to manage acute pancreatitis (<7 days), with the diagnosis based on consistent clinical signs and increased DGGR-lipase activity. There was a strong correlation between cPL concentration and DGGR-lipase activities, and a rapid decline of both parameters within 3 days of hospitalisation in most dogs. Both DGGR-lipase and cPLI moderately correlated with triglyceride concentration. Two different smartwatches exhibit high accuracy in evaluating heart rate and peripheral oxygen saturation in cats when compared with the electrocardiography and transmittance pulse oximetry JAVMA Ten young male cats undergoing castration were enrolled to determine the agreement between smartwatches (Garmin Fenix 5X plus and Apple Watch 6) and a multiparameter monitor in measuring heart rate and Sp02. Watches were attached around the proximal tibia. Both watches achieved low levels of bias in measuring heart rate and SpO2. Both devices had a high failure rate for Sp02 readings, however. Both devices were considered accurate for heart rate and Sp02 readings but the high failure rate in SpO2 monitoring may limit their utility. Incidence of relapse of inflammatory protein-losing enteropathy in dogs and associated risk factors JVIM. Open access Dogs diagnosed with inflammatory protein-losing enteropathy (iPLE) tend to have a poor prognosis and information regarding relapse of those initially achieving remission is lacking. This study described 75 dogs with iPLE. 33 dogs did not achieve remission. 42 dogs achieved remission; 23 achieved sustained remission and 19 dogs relapsed a median of 209 days after diagnosis. 56% of dogs ultimately died within 2 years due to iPLE. The only significant risk factor identified between sustained remission and relapsing remission groups was dietary compliance, with poorer dietary compliance in the relapsing group. This study highlights the importance of encouraging owners to maintain dietary recommendation compliance. Incidence and type of peripheral intravenous catheter complications documented in hospitalised dogs JSAP. Open access Complications associated with peripheral intravenous catheters (PIVCs) are common. This prospective study assessed the complications associated with PIVCs placed in dogs in intermediate and critical care units at Colorado State University Veterinary Teaching Hospital. All PIVCs were in situ for >24hrs and must have had intravenous fluid therapy administered through them. 412 PIVCs were assessed in 396 dogs, and a PIVC complication was recorded in 20%. Phlebitis was the most common complication in critical care whilst line breakage was most common in intermediate care wards. Multi-centre studies will be necessary to determine if centre-specific operating procedures influence PIVC complication rates… The diagnostic utility of hypophosphatemia for differentiating generalized tonic-clonic seizures from syncope in dogs: A case control study The Veterinary Journal A combination of CK and serum phosphate aids differentiation of seizure versus transient loss of consciousness due to other causes in people. This study retrospectively reviewed serum biochemistry, including electrolytes, of dogs with seizures or syncope and where blood tests were performed within 3 hours of the event. Those with azotaemia or <1yr were excluded. There were 87 dogs with seizures and 26 with syncope. CK activity was increased and hypophosphatemia documented in 53% and 32% of dogs with seizure, respectively. Serum phosphate was remeasured within 24 hours and had normalised in all dogs. No dogs with syncope had CK elevations, and serum phosphate was not lower than 0.97mmol/L in any dog from the syncope group. Serum phosphorous of <0.97 mmol/l was 100% specific and 44% sensitive for differentiating seizure from syncope. Therefore, serum phosphate and creatinine kinase activity may aid differentiation of syncope and seizure in dogs >1yr of age. The sample should be assessed for haemolysis as this may artificially increase phosphate concentrations. 10 points for anybody replying with a mechanism for the hypophosphataemia… 😉 Diagnostic effectiveness of stress biomarkers in cats with feline interstitial and bacterial cystitis Veterinary Clinical Pathology Feline idiopathic cystitis (FIC) events are commonly associated with psychological stressors. Plasma biomarkers of stress have been previously assessed in cats with FIC, with increased norepinephrine being documented whilst cortisol was not. This study aimed to measure hormones associated with stress in urine from cats with FIC, bacterial cystitis and from healthy controls. There were 12 cats in each group. There was no statistical difference in serum serotonin, cortisol or dopamine, nor urine dopamine or cortisol between groups. Urine serotonin was higher in cats with FIC and bacterial cystitis compared to controls. Patient history appeared to be more informative than hormone testing in these patients. It is also noteworthy that there were numerous exclusion criteria applied to this study, including commonly prescribed medications for lower urinary tract disease of cats. Treatment strategies for hyperkalemia secondary to urethral obstruction in 50 male cats: 2002-2017 JFMS. Open access Insulin and dextrose administration is commonly recommended to manage hyperkalaemia. This study documented the development of hypoglycaemia within 12 hours in 15/31 cats administered dextrose and insulin, with the median dextrose:insulin ratio being 2g:1unit (median insulin dose was 0.17 units/kg). This highlights the need to monitor glucose regularly after administration of insulin to hyperkalaemic patients and that no one size fits all ratio of dextrose to insulin seems to exist. A quiet place: The impact of the word “quiet” on clinical workload World Journal of Otorhinolaryngology. Open access We all know that you shouldn’t whisper Candyman three times into a mirror or say the ‘quiet’ word when on shift, otherwise bad things will happen. This study enrolled second and third year residents doing nightshifts. At 5pm at the beginning of their shift, the residents were randomised to say either ‘today will be a good night’ or ‘today will be a quiet night’. Workload was assessed by calculating total number of urgent and non-urgent appointments. There were 40 nights per group. There was no difference of workload between ‘good night’ and ‘quiet night’ groups, although residents reported being more busy on ‘quiet night’. Characterization of clinicopathologic and abdominal ultrasound findings in dogs with glucocorticoid deficient hypoadrenocorticism JVIM (open access) This study describes dogs with eunatraemic eukalaemic hypoadrenocorticism (previously called ‘atypical’ and referred to as glucocorticoid deficient hypoadrenocorticism in the study). Aldosterone was not measured. There were 29 cases and 594 control dogs for comparison. The most common presenting signs in case dogs were gastrointestinal, and 6 had weight loss. The model for differentiating cases from controls included serum albumin, cholesterol and lymphocyte count, all of which were lower in the cases, and globulin, which was higher in the cases. The width of the adrenal glands was different between groups, with an optimal cut off being <0.43cm for the right and <0.39cm for the left adrenal. The clinical findings in these dogs are similar to those in dogs with hypoadrenocorticism and the typical electrolyte derangements. Read more… Outcome of chronic inflammatory enteropathy in cats: 65 cases (2011-2021) JSAP (open access) The goal of the study was to describe the outcome of cats with chronic inflammatory enteropathy with a minimum follow-up time of 6 months unless already euthanised / had died. A secondary goal was to describe variables associated with survival. Cases with suspected small cell lymphoma were excluded. Diet change only was the most common treatment, prescribed in 37/65 cats, 18 received a combination of diet change and immunosuppression, whilst immunosuppression alone was prescribed for 4 cats. The outcome of 54 cats was known and 25/54 achieved remission. Of the 29 cats not achieving remission, 20 were euthanised at a median time of 130 days. No clinicopathological or histological findings were associated with survival. Read more… Description and outcome of dogs with primary immune-mediated polyarthritis: 73 cases (2012-2017). JSAP The most frequent clinical signs were lameness/stiffness (90%) and joint pain (78%) and only 58% had pyrexia. Dogs were typically young to middle aged, and breeds considered predisposed were the cockerpoo, whippet, Cairn terrier, Hungarian vizsla, miniature schnauzer and cocker spaniel. All dogs received glucocorticoid immunosuppression, 19 received a second immunosuppressive agent from initiation of treatment, while 27 received a second immunosuppressive later in their treatment after a median of 36 days. Disease relapse occurred in 35/73 dogs, the majority (31) while still receiving immunosuppressive treatments, with relapse occurring between 20 and 480 days. Long-term successful management with subsequent weaning of immunosuppressives occurred in 46/73 dogs; with 20/54 steroid only, 12/27 steroids plus subsequent second line agents and 14/19 multi-model therapy from initiation treated dogs achieving this ‘cure’. Read more… Ultrasonographic intestinal muscularis thickening in dogs with histologically confirmed inflammatory bowel disease: 13 cases (2010-2021) Veterinary Radiology and Ultrasound The significance of muscularis wall thickening in dogs presenting with gastrointestinal signs is not well described. The inclusion criteria required the muscularis to submucosa ratio to be >1.0 and intestinal biopsies, either full thickness or endoscopic, to be available for review. In the two samples with full thickness biopsies, no cause for the muscularis thickening was identified, and of the 11 remaining endoscopic biopsies, 4 had mild, 4 moderate and 3 marked lymphoplasmacytic and sometimes eosinophilic and neutrophilic inflammation. A limitation of the study was that the muscularis layer itself could only be assessed in two cases, and eight cases had jejunal muscularis thickening without jejunal biopsies to review. Read more… ATP7A, ATP7B, and RETN genotypes in Labrador Retrievers with and without copper-associated hepatopathy JAVMA ATP7A and ATP7B are transmembrane copper transporters. ATP7A protein is involved in copper transportation from enterocytes to the portal circulation, and ATP7B is involved in biliary excretion of copper. RETN, otherwise known as resistin, is an adipokine but levels are increased in humans with chronic liver injury and in dogs with acute pancreatitis. RETN was recently identified as a possible modifier of copper handling in Labrador dogs with a missense variant (p.Leu7Phe) being associated with decreased liver copper levels. The frequency of the known copper-associated variants of these three genes were compared between three groups of Labradors; cases (45 dogs), intermediate phenotype dogs (16 dogs) and controls (29 dogs). The ATP7B variant (ATP7B:c4358G>A) was more common in the cases (30%) than controls (13%), all 3 dogs who were homozygous for the ATP7B variant were in the case group, and dogs who had a heterozygous variant were 3 times more likely to be a case than in the other groups. However, around half of cases did not have an ATP7B variant, and as heterozygous mutations were identified in cases and controls, then clinician decision making should not be made using genotyping of ATP7B alone. Read more… Evaluation of the validity of the double two-thirds rule for diagnosing hemangiosarcoma in dogs with nontraumatic hemoperitoneum due to a ruptured splenic mass: a systematic review. JAVMA A common rule of thumb for dogs with haemoperitoneum and splenic masses is that 2/3rds of the masses are malignant, of which 2/3rds are haemangiosarcoma. The study undertook a publication review as per the “Preferred Reporting Items for Systemic Reviews and Meta-Analysis” guidelines. Fourteen previous publications, 12 retrospective and 2 prospective, on the topic were included following review. This resulted in data from 1150 dogs being analysed, with 73% having a splenic malignancy and 87% of the malignancies being haemangiosarcoma. More prospective studies are needed on the topic to decrease the bias associated with retrospective studies, which accounted for 1087/1150 dogs in the study population. We are missing a lot of data from dogs that don’t make it beyond initial consult! Read more… |