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Abstract

OBJECTIVE

To determine the rate of survival to hospital discharge and identify indicators associated with poor outcomes among female dogs (bitches) with pyometra treated with ovariohysterectomy (OHE) in a nonspecialized setting.

ANIMALS

405 bitches diagnosed with pyometra at the American Society for the Prevention of Cruelty to Animals Animal Hospital from January 1, 2017, to February 8, 2019.

PROCEDURES

For this retrospective study, medical records were searched and data collected including patient history, clinical signs, serum biochemical analyses results, and outcome (survival to hospital discharge, length of hospital stay, and uterine rupture). Logistic regression models were used to assess multivariable associations and identify potential predictive variables.

RESULTS

The rate of survival to hospital discharge for bitches with pyometra treated with OHE was 97% (394/405); 44% (174/394) stayed in the hospital ≥ 2 nights, and 3% (11/390) had a ruptured uterus. Bitches with a high BUN concentration or heart murmur had greater odds of death after OHE; however, the model had low predictive power. Those with uterine rupture, inappetence, high concentrations of BUN or serum creatinine, low PCV, or dehydration had greater odds of hospitalization ≥ 2 nights. There were no significant predictors of uterine rupture.

CLINICAL RELEVANCE

The rate of survival to hospital discharge was high for bitches with pyometra treated with OHE in a nonspecialized setting; therefore, general practitioners could expect similar outcomes. With this important procedure widely available in general practices, more pets can receive treatment for this life-threatening disease.

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To describe findings, determine the rate of survival to hospital discharge, and identify prognostic indicators of poor outcomes for female cats (queens) with pyometra treated with ovariohysterectomy (OHE) in a nonspecialized setting.

ANIMALS

134 queens with pyometra diagnosed between January 1, 2017, and December 31, 2019.

PROCEDURES

The medical records were retrospectively searched and data including patient history, clinical signs, blood work results, and outcome (survival to hospital discharge, length of hospitalization, and uterine rupture) were collected from medical records. Logistic regression models were used to assess potential predictors of outcomes.

RESULTS

Dehydration (69% [83/121]) and absolute neutrophilia (83% [52/63]) were commonly reported. The rate of survival to hospital discharge was 100% (126/126; 95% CI, 97% to 100%) for queens treated with OHE; 33% (41/126) were hospitalized ≥ 2 nights, and 4% (5/120) had uterine rupture. Queens with abnormal serum ionized calcium concentration or signs of depressed mentation had greater odds (OR of 4.64 and 2.26, respectively) of ≥ 2 nights’ hospitalization. Queens with high rectal temperature, closed pyometra, or heart murmur had greater odds (OR of 35.66, 17.37, or 16.06, respectively) of uterine rupture.

CLINICAL RELEVANCE

Our findings indicated that OHE for pyometra in queens was highly successful even when performed in a nonspecialty hospital with high-quality basic supportive care, and we believe most general practitioners who offer OHE could expect to see similar outcomes. With more general-practice veterinarians comfortable treating pyometra in their clinics, OHE for pyometra will be available to more pets, ultimately saving more lives.

Open access
in Journal of the American Veterinary Medical Association

Welcome to the second JAVMA special supplement. We are excited to present to you a collection of ground-breaking articles with a reproductive medicine focus.

Small Animals

Veterinary teams today deal with higher caseloads and often-reduced referral care availability. Improvements in efficiency, triage, and schedule management can help with these challenges. But how exactly could this be done?

In this supplement, Rigdon-Brestle et al 1 provide evidence that the ovarian pedicle tie is a safe and efficient surgical technique for ovariohysterectomy in anatomically normal cats, independent of surgeon experience.

A group of articles by McCobb et al 2

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To describe uterine prolapse, predispositions, and outcomes in mares treated between 1988 and 2019.

ANIMALS

24 mares with uterine prolapse.

PROCEDURES

Clinical records were retrospectively reviewed, and follow-up information was gathered. The Mann-Whitney U test and Fisher exact test were used to analyze results for history and outcome variables for potential association with mare survival to hospital discharge. The χ2 test was used to compare breed distribution.

RESULTS

Age was known in 23 mares (median, 11.1 years). For 15 mares with exact known parity, the median parity was 3 births (range, 1 to 13 births). For 22 mares, the maiden status was known (7 [32%] maiden; 15 [68%] multiparous). Breed distribution differed significantly between mares with uterine prolapse and all mares treated at the Veterinary Medical Teaching Hospital. Arabians were overrepresented in the uterine prolapse group (7/24 [29%]), compared with all mares treated (4,174/44,474 [9%]). Uterine prolapse occurred within 2 hours after parturition for 10 of 11 mares with known foaling times, after dystocia for 7 mares, and after abortion for 4 mares. Seventeen of 23 (74%) mares survived to hospital discharge. Acute hemorrhage was the most frequent cause of death. There were no correlations between mare survival to hospital discharge and mare parity or age, foal sex, retained fetal membranes, sepsis, or maiden status. Colts were overrepresented in foals with a known sex (12/17).

CLINICAL RELEVANCE

Results indicated a breed predisposition to uterine prolapse, with Arabian mares overrepresented among affected mares. No characteristics correlated with mare survival to hospital discharge.

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine the most common indications for cranial surgery and identify risk factors associated with the occurrence of complications and death in the perioperative period following cranial surgery.

ANIMALS

150 dogs and 15 cats.

PROCEDURES

For this multi-institutional retrospective case series, medical records of dogs and cats that underwent cranial surgery at any of the 4 participating institutions between 1995 and 2016 were reviewed. Variables were evaluated included species, sex, age, neurolocalization, history of preoperative seizures, surgical approach, histological results, perioperative complications, and outcome. Logistic regression analysis was performed to assess for risk factors for complications.

RESULTS

The most common neurolocalization was the forebrain (110/165 [66.7%]), with 94 (57.0%) animals having had seizures preoperatively. The rostrotentorial (116/165 [70.3%]) and caudotentorial (32/165 [19.4%]) surgical approaches were most commonly reported. The most common indication was the treatment of meningioma (75/142 [52.8%]). Complications arose in 58 of the 165 (35.2%) cases within 24 hours and in 86 (52.1%) cases 1 to 10 days postoperatively. Perioperative complications included hypotension (38/165 [23.0%]) and anemia (27/165 [16.4%]). During the postoperative period, the most common complications were neurologic deficits, seizures, postoperative anemia, and aspiration pneumonia. The mortality rate with death or euthanasia perioperatively or ≤ 10 days postoperatively was 14.5% (24/165). Long-term complications occurred in 65 of the 165 (39.4%) animals, with seizures and neurologic deficits being the most common.

CLINICAL RELEVANCE

Cranial surgery was performed most commonly for the removal of neoplastic lesions in dogs and cats, and most complications were not life-threatening.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To evaluate the urine cortisol-to-creatinine ratio (UCCR) for the diagnosis of hypoadrenocorticism (HA) in dogs and to determine whether the method of urine cortisol measurement affects results. 

ANIMALS

41 dogs with naturally occurring HA and 107 dogs with nonadrenal illness.

PROCEDURES

Urine samples were prospectively collected from dogs undergoing testing for HA. Urine cortisol concentrations were measured at a veterinary diagnostic laboratory using either a radioimmunoassay (RIA) or a chemiluminescent immunoassay (CLIA). Receiver operating characteristic (ROC) curves were constructed to assess UCCR performance by both methods for HA diagnosis. Sensitivities, specificities, accuracies, and predictive values were calculated for various cutpoints.

RESULTS

The areas under the ROC curves for UCCR diagnosis of HA were 0.99 (95% CI, 0.98 to 1.00) and 1.00 (95% CI, 1.00 to 1.00) when urine cortisol was determined by RIA and CLIA, respectively. An RIA UCCR of ≤ 2 was 97.2% sensitive, 93.6% specific, and 94.7% accurate for HA diagnosis, whereas a CLIA UCCR of ≤ 10 was 100% sensitive, specific, and accurate. An RIA UCCR > 4 and a CLIA UCCR of > 10 had negative predictive values of 100%.

CLINICAL RELEVANCE

The UCCR was an accurate diagnostic test for HA in this study population, although equivocal results are possible. Case characteristics, method of cortisol measurement, and laboratory-specific cutpoints must be considered when interpreting results.

Restricted access
in Journal of the American Veterinary Medical Association
IN SHORT

Photo by Nathan Latil/NCSU

AAHA UPDATES GUIDELINES ON PAIN MANAGEMENT IN DOGS AND CATS

The latest guidelines on pain management in dogs and cats from the American Animal Hospital Association separate out recommendations for cats and dogs while continuing to promote a team approach to pain management that involves the pet owner as well as the practice team.

The 2022 AAHA Pain Management Guidelines for Dogs and Cats appeared in the March/April edition of the Journal of the American Animal Hospital Association. The American Association of Feline Practitioners endorsed the document and planned to publish the guidelines in

Restricted access
in Journal of the American Veterinary Medical Association

We’re coming back—live and on location! After holding virtual-only conventions for the past two years due to the COVID-19 pandemic, this year’s AVMA Convention takes on added significance, as it will be our first in-person convention since 2019. You will have the opportunity to reunite with your veterinary colleagues, and the reunion we’re planning is something you won’t forget.

The 2022 AVMA Convention, being held from July 29 – August 2 in Philadelphia, will have something for everyone.

Our keynote speaker will be Dr. Bertice Berry, a sociologist, best-selling author, lecturer, storyteller, and humorist who will discuss the power and

Restricted access
in Journal of the American Veterinary Medical Association
The role of carbohydrates in feline diets

In the Timely Topics in Nutrition review article “Evidence does not support the controversy regarding carbohydrates in feline diets,” 1 the authors suggest that, for healthy cats, an upper limit of 50% of calories coming from carbohydrates in their diets is acceptable. But they also state that low-carbohydrate diets can help diabetic cats and achieve remission. 1 How are we to know that a cat is diabetic until it has been fed a high-carbohydrate, diabetogenic diet, to which, admittedly, many cats adapt. But they can develop other health consequences, which these

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To evaluate neurological tests and expected results in inland bearded dragons (Pogona vitticeps) and generate recommendations for bearded dragon–specific neurological examination.

ANIMALS

26 healthy adult inland bearded dragons.

PROCEDURES

A complete neurological examination utilizing tests described in both mammals and reptiles was performed on each lizard, and test feasibility and outcome were recorded.

RESULTS

Tests with poor feasibility included oculocardiac reflex (successfully completed in 62% [16/26] of animals) and voluntary ambulation and swallowing by use of a food item (0% [0/26] of animals). Tests with outcomes considered abnormal in mammals but attributable to normal bearded dragon behavior included head position (head tilt present in 12% [3/26]) and head movement (head bob present in 4% [1/26]). Many tests had absent or inconsistent outcomes, including menace response (present in 19% [5/26]), proprioceptive positioning (present in 4% [1/26] in the thoracic limbs and 0% [0/26] in the pelvic limbs), vent reflex (present in 27% [7/26]), and myotatic reflexes (biceps present in 8% [2/26]; patellar, gastrocnemius, and triceps present in 0% [0/26]). Extensor postural thrust was absent in all successfully tested animals, but a novel reflex termed the caudal thoracic extensor reflex was noted instead in all observed animals (100% [21/21]).

CLINICAL RELEVANCE

Tests with poor feasibility or inconsistent outcomes should have low priority or be excluded from neurological examinations of inland bearded dragons. Normal behaviors should be considered for head position and movement. A bearded dragon–specific neurological examination protocol derived from these findings is described and recommended in order to decrease stress and improve neurolocalization.

Restricted access
in Journal of the American Veterinary Medical Association