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Abstract

OBJECTIVE

To determine the prognostic value of lactate concentration measurements at admission in cattle with long-bone fractures.

ANIMALS

43 cattle with long-bone fractures between July 2016 and Dec 2018.

PROCEDURES

In this prospective cohort study, lactate concentration was measured in systemic venous blood and locally in capillary blood sampled from the fractured and contralateral limbs of cattle and assessed for outcome prediction. The cutoff value was determined by maximizing the Youden index from receiver-operating characteristic curves. Multivariable logistic regression was employed to verify whether higher lactate concentrations compared with the cutoff value were an independent risk factor for poor outcomes at 30 days or 3 years after admission.

RESULTS

Poor outcome was associated with higher capillary lactate concentration in the fractured limb (P < .001) and greater difference with systemic blood (P = .005). A cutoff value of lactate difference ≥ 2.4 mmol/L (sensitivity = 0.80; specificity = 0.965) between capillary lactate in the fractured limb and systemic blood was the best predictor of death ≤ 30 days after admission (P < .001). Multivariable analysis revealed that this cutoff value was an independent risk factor for 30-day and 3-year outcomes (P < .001).

CLINICAL RELEVANCE

Admission blood lactate concentration difference ≥ 2.4 mmol/L between the fractured limb and systemic blood was a robust and independent predictor of outcome for cattle of the present report. Lactate metabolism is locally impaired in fractured limbs of nonsurviving or at higher complication risk cattle, which may help identify patients at high risk for poor outcomes.

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

Abstract

OBJECTIVE

To provide a postmortem description of anatomic variations and changes of the lumbosacroiliac region in horses. The authors hypothesized that lesion severity would increase with age and body weight and correlate to anatomic variations.

SAMPLES

Lumbosacroiliac vertebral specimens from 38 horses (mean age, 16 years; range, 5 to 30 years) that died or were euthanized for reasons unrelated to the study between November 2019 and October 2021.

PROCEDURES

The lumbosacroiliac region of the vertebral column was removed from each cadaver. After dissection, disarticulation, and boiling, the anatomic specimens were examined for anatomic variations and osseous changes of the articular process joints (APJs), intertransverse joints (ITJs), and sacroiliac joints (SIJs). The lengths of L6-S1 intertransverse articular surfaces were measured and their ratios calculated. Descriptive statistics were obtained, and the χ2 test was used to assess differences in anatomic variations and abnormal changes of the APJs, ITJs, and SIJs.

RESULTS

The most common anatomic variation was a sacrum-like shape of the transverse processes of L6 (29/38 [76%]) and converging orientation of dorsal spinous process of L6 (33/38 [87%]). The highest prevalence of bony changes was detected at L5-L6 (right, 34/38 [89%]; left, 33/38 [87%]) and L6-S1 APJs (right, 38/38 [100%]; left, 37/38 [97%]) and at SIJs (right, 32/38 [86%]; left, 31/38 [82%]). The shape of L6 transverse processes differed between breed (P = .01) and was associated with presence of L4-L5 ITJs (P < .01).

CLINICAL RELEVANCE

Age and sex were associated with changes of the sacral dorsal spinous processes, ITJs, and APJs. The clinical significance of these findings could not be confirmed based on the study limitations.

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

Abstract

OBJECTIVE

To evaluate whether intraoperative detection of rising levels of blood glucose could improve the completeness of resection of insulin-secreting tumor tissue and whether this improves long-term outcomes.

ANIMALS

11 client-owned dogs diagnosed with insulinoma.

PROCEDURES

Retrospective review of medical records of dogs undergoing partial pancreatectomy as treatment for insulinoma. A blood glucose reading was obtained at induction, following removal of the pancreatic mass and/or after each suspected metastatic lesion until blood glucose had normalized. Disease-free interval and survival time were measures of outcome.

RESULTS

A positive increase in blood glucose was detected in all cases, with a mean rise of 6.35 ± 4.5 mmol/L. Mean follow-up was 611 days, mean disease-free interval was 382 days, and median survival time was 762 days. Tumor stage was not associated with outcome. Three cases underwent a second surgery (metastasectomy), achieving further prolongation of disease-free survival.

CLINICAL RELEVANCE

A sustained increase in intraoperative blood glucose provided the surgeon with confidence of more complete resection of insulinoma tissue and resulted in improved outcomes in all cases included in this study. Subsequent metastasectomy of recurrent insulinoma lesions also provided good outcomes. Intraoperative monitoring of blood glucose during surgical treatment of insulinoma resulted in the surgeon continuing to explore and resect abnormal tissue until an increase of glycemia was observed. This was shown to provide the surgeon with more confidence of resection of all active insulinoma tissue and improved clinical outcomes.

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To describe the clinical findings and outcomes of Australian cats and dogs with CNS cryptococcosis.

ANIMALS

19 cats and 31 dogs with CNS cryptococcosis diagnosed between 2000 and 2020.

PROCEDURES

A case series and cohort study were performed using the same 50 animals. Both studies were multi-institutional and both retrospective and prospective. Disease features were compared between cats and dogs, and associations between putative risk factors and survival time (ST) were assessed.

RESULTS

Dogs were younger at initial presentation than cats and had lower latex cryptococcal antigen agglutination titers. Extraneurologic signs were common and frequently involved sinonasal and contiguous tissues. Neuroanatomic localization was predominantly forebrain, central vestibular (including cerebellum), multifocal, or diffuse. CSF analysis predominantly showed pleocytosis, with eosinophilic inflammation common in dogs. Seventy-eight percent (39/50) of patients received antifungal treatment. Median STs (from presentation) in treated patients were 1,678 days for cats and 679 days for dogs. Abnormal mentation at presentation (in dogs) and CSF collection (in cats) were associated with shorter STs. In treated dogs, those that received glucocorticoids prior to diagnosis, or single rather than multiple antifungal agents, had shorter STs.

CLINICAL RELEVANCE

The prognosis for feline and canine CNS cryptococcosis is guarded, yet long STs are possible with appropriate treatment. Presence of subtle upper respiratory tract signs may suggest cryptococcosis in patients with neurologic signs, while the absence of neurologic signs does not preclude CNS involvement.

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

Abstract

OBJECTIVE

To determine the feasibility of endoscopic application of fibrin glue for the treatment of experimentally induced postintubation tracheal laceration (PITL) in feline cadavers. The secondary objective was to determine the optimal technique for application of the fibrin glue.

ANIMALS

20 feline cadavers (n = 10 fresh and 10 frozen).

PROCEDURES

An experimentally induced tracheal rupture was created via overinflation of an endotracheal tube cuff. After endoscopic identification of the tracheal tear, fibrin glue was instilled into the tracheal defect in either a bridging or filling fashion. Following the procedure, the airway of each cat was examined and leak tested. Length of tear, volume of glue applied, procedural time, and glue efficacy were recorded.

RESULTS

Experimentally induced tracheal lacerations were full thickness with a mean length of 3.27 ± 0.96 cm. A complete seal was attained in 6 of the 9 fresh cadavers when filling the defect with fibrin glue. In the remaining 3 fresh cadavers, air leakage was restricted to the dorsal mediastinum. Bridging the defect with fibrin glue did not attain a seal in fresh or frozen cadavers. The median volume of glue used to fill defects in fresh cadavers was 0.5 mL (range, 0.4 to 2 mL). Procedural time for the application of fibrin glue was 10.5 ± 4.1 minutes for bridging the defect and 7.8 ± 1.5 minutes for filling the defect.

CLINICAL RELEVANCE

Endoscopic application of fibrin glue may be a feasible method of treatment for PITL in cats.

Open access
in American Journal of Veterinary Research