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Abstract

OBJECTIVE

To provide a video tutorial detailing how to perform “blind” and ultrasound-guided abdominocentesis for diagnostic and therapeutic guidance, and to provide a brief demonstration of intra-abdominal pressure measurement (IAP).

ANIMALS

Any cat or dog with suspicion of free abdominal effusion or patients requiring measurement of IAP.

METHODS

Abdominocentesis should be performed when there is high suspicion for peritoneal effusion based on physical exam and/or diagnostic imaging. The 4-quadrant tap uses 20-gauge or larger needles placed blindly in ≥ 1 of the 4 quadrants of the abdomen to collect abdominal fluid. In contrast, ultrasound allows visualization of fluid in the abdomen prior to percutaneous insertion of a needle and syringe to collect fluid. Regardless of collection technique, fluid should have immediate cytologic analysis and later can be submitted for biochemical parameters, additional cellular analysis by a pathologist, and culture and sensitivity (in rare cases if indicated). Intravesicular bladder pressure measurement using a manometer–urinary catheter system approximates the IAP when there is concern for organ hypoperfusion and compartment syndrome.

RESULTS

Abdominocentesis can be performed with and without the use of ultrasound guidance. Intravesicular bladder pressure measurement is used to diagnose and trend IAP values before and after treatments are performed.

CLINICAL RELEVANCE

Abdominocentesis is a simple and safe technique that all small animal clinicians should be comfortable performing. Effusion sampling can guide further diagnostics and treatments. Measurement of IAP is simple and requires no specialized equipment.

Open access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To compare 4 techniques for determination of total protein concentrations in peritoneal and pleural effusions from dogs.

Sample Population—23 peritoneal and 12 pleural fluid samples from 35 dogs with various abnormalities.

Procedure—Samples were collected into tubes containing EDTA, centrifuged, and stored at −20 C until total protein concentrations were assessed. Protein concentration in each sample was determined by use of urine test strips, refractometry, and Bradford and biuret techniques. Accuracy of each method was determined, using dilutions of human control sera.

Results—There was good correlation among results of all quantitative procedures. Results of the biuret technique were more accurate than results of the Bradford assay. Refractometry underestimated protein concentration in samples with < 20 g of protein/L. Results of urine test strips correctly classified effusion samples into 2 groups on the basis of total protein concentrations less than or greater than 20 g/L.

Conclusions and Clinical Relevance—Results of any of these 4 techniques can be used to rapidly and efficiently differentiate peritoneal and pleural fluid from dogs into transudates and exudates on the basis of total protein concentration less than or greater than 20 g/L, respectively. (Am J Vet Res 2001;62:294-296)

Full access
in American Journal of Veterinary Research

SUMMARY

The antebrachiocarpal and tarsocrural joints of 10 adult horses were randomly assigned to 1 of 4 groups. Groups were formulated and were treated as follows: group 1, control (arthrocentesis only); group 2, buffered lactated Ringer solution; group 3, 10% dimethyl sulfoxide (dmso; w/v) in lactated Ringer solution; and group 4, 30% dmso (w/v) in lactated Ringer solution. Joints were lavaged once with the respective solution. Prior to lavage and on days 1, 4, and 8 after lavage, all horses were evaluated for lameness and joint effusion; synovial fluid total and differential wbc counts, synovial fluid total protein concentration, and mucin clot quality were determined. Horses were euthanatized on day 8, and joints were evaluated grossly, histologically, and histochemically.

Significant difference was not observed in effect of lactated Ringer solution, 10% dmso, and 30% dmso on any measured variable. At 24 hours after treatment, significant (P < 0.05) difference in synovial fluid wbc numbers and total protein concentration was detected between control and treated joints. Eighty percent of lavaged joints had effusion 24 hours after treatment, compared with 30% of control joints.

Gross, histopathologic, or histochemical differences were not detected between treated and control joints. Results of the study indicate that buffered lactated Ringer, 10% dmso, and 30% dmso solutions induce similar inflammatory changes in articular structures and significantly greater inflammatory reaction than does arthrocentesis alone.

Free access
in American Journal of Veterinary Research

Summary

Case records of 37 cats with chylothorax examined at 2 institutions were retrospectively evaluated. Dyspnea and coughing were the most common abnormalities noticed by the owners, and most cats were dyspneic on initial examination. There was no statistically significant difference in the gender distribution of cats studied when compared with reference populations; however, purebred cats appeared to be overrepresented in the study population. Four of the cats had unilateral pleural effusion (2 left side, 2 right side) and 9 cats had effusions that were primarily, but not exclusively, on the right side. Surgery was performed on 20 cats. Fifteen cats underwent thoracic duct or cisterna chyli ligation; 20% had complete resolution of pleural fluid. There was no significant difference in the survival rate of cats that underwent thoracic duct ligation and those that were treated by other means. Six cats had mesenteric lymphangiography performed; 2 cats had normal results, and the remainder had various degrees of thoracic lymphangiectasia. Two cats in which pleuroperitoneal shunts were placed and 2 of 3 cats that underwent pleurodesis were euthanatized or died after surgery.

Free access
in Journal of the American Veterinary Medical Association

dorsoventral view. Scalloping of the ventral lung margins is also present, and overlying pleural effusion obscures the caudal vena cava. Most likely differential diagnoses for the severe increase in size of the cardiac silhouette include pericardial effusion

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine clinical and laboratory findings associated with protein-losing enteropathy, hypomagnesemia, and hypocalcemia in Yorkshire Terriers.

Design—Retrospective study.

Animals—5 purebred or crossbred Yorkshire Terriers with protein-losing enteropathy, hypomagnesemia, and hypocalcemia.

Procedure—Medical records were reviewed for dogs with protein-losing enteropathy, hypomagnesemia, and hypocalcemia.

Results—Of 8 dogs with these signs, 5 had Yorkshire Terrier breeding. Common findings were diarrhea, abdominal effusion, leukocytosis, neutrophilia, hypocalcemia (ionized calcium), hypomagnesemia, hypoproteinemia, hypoalbuminemia, hypocholesterolemia, and increased serum activity of aspartate aminotransferase.

Conclusions and Clinical Relevance—Yorkshire Terriers are at increased risk for development of protein-losing enteropathy with hypomagnesemia and decreased ionized calcium concentration. Hypomagnesemia and hypocalcemia may have a related pathogenesis involving intestinal loss, malabsorption, and abnormalities of vitamin D and parathyroid hormone metabolism. Serum electrolyte replacement may be required to avoid neurologic and metabolic problems. (J Am Vet Med Assoc 2000;217: 703–706)

Full access
in Journal of the American Veterinary Medical Association

Summary

Records of 6 horses with pericarditis were reviewed. Septic pericarditis was suspected in all horses, based on historic and clinical findings. In horses 1, 2, and 4, cytologic examination of the pericardial effusion revealed acute inflammation with severe neutrophil degeneration. In horses 3 and 5, cytologic examination of pericardial fluid revealed subacute inflammation with degenerated neutrophils, and in horse 6, chronic active inflammation, with well preserved neutrophils. In horses 1 and 3, bacteria were identified on cytologic examination of pericardial fluid. Results of microbiologic cultures of pericardial fluid were positive in horse 3. All horses were treated with broad-spectrum antibiotics. An indwelling pericardial catheter was used to lavage and directly administer antibiotics into the pericardial sac. Horses 1, 4, 5, and 6 survived, horse 2 died of unrelated causes, and horse 3 was euthanatized at the owner's request. Surviving horses returned to athletic performance.

Free access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To establish an immortalized cell line and transplantable xenograft of feline bronchioloalveolar lung carcinoma (BAC).

Sample Population—Pleural effusion from a 12-yearold Persian male cat with BAC.

Procedure—Tumor cells from the pleural effusion were grown in monolayer cell culture and injected into severe combined immunodeficient (SCID) mice to establish an immortalized cell line as well as a transplantable xenograft.

Results—Both the primary lung carcinoma, the derived cell line, and the transplantable xenograft had evidence of a type-II pneumocyte origin expressing lamellar bodies ultrastructurally and thyroid transcription factor-1 and surfactant immunocytochemically. All 3 also expressed nuclear p53 immunoreactivity. A metaphase spread of the cell line (SPARKY) probed with fluorescein-labeled genomic feline DNA gave evidence of its feline origin. Flow cytometric studies indicated aneuploidy with a DNA index of 1.6. An R-banded karyotype revealed a modal number of 66 including the feline Y chromosome. The cell line had a doubling time of 16 hours. The xenograft (SPARKY-X) reached a diameter of 1 cm in 3 weeks in SCID mice. Deoxyribonucleic acid fingerprint analysis revealed that SPARKY and SPARKY-X were novel and strongly matched each other, except for the murine component found in SPARKY-X. Interestingly, SPARKY-X manifested the characteristic lepidic growth pattern of pulmonic BAC.

Conclusions—Both the cell line and xenograft retained their autochthonous BAC phenotype, making them useful for the subsequent dissection of molecular abnormalities in feline BAC and in vitro screening of chemotherapeutic agents. (Am J Vet Res 2002; 63:1745–1753)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate the temporal pattern of prostaglandin (PG) E2 concentrations in synovial fluid after transection of the cranial cruciate ligament (CCL) in dogs and to correlate PGE2 concentrations with ground reaction forces and subjective clinical variables for lameness or pain.

Animals—19 purpose-bred adult male Walker Hounds.

Procedure—Force plate measurements, subjective clinical analysis of pain or lameness, and samples of synovial fluid were obtained before (baseline) and at various time points after arthroscopic transection of the right CCL. Concentrations of PGE2 were measured in synovial fluid samples, and the PGE2 concentrations were correlated with ground reaction forces and clinical variables.

Results—The PGE2 concentration increased significantly above the baseline value throughout the entire study, peaking 14 days after transection. Peak vertical force and vertical impulse significantly decreased by day 14 after transection, followed by an increase over time without returning to baseline values. All clinical variables (eg, lameness, degree of weight bearing, joint extension, cumulative pain score, effusion score, and total protein content of synovial fluid, except for WBC count in synovial fluid) increased significantly above baseline values. Significant negative correlations were detected between PGE2 concentrations and peak vertical force (r, –0.5720) and vertical impulse (r, –0.4618), and significant positive correlations were detected between PGE2 concentrations and the subjective lameness score (r, 0.5016) and effusion score (r, 0.6817).

Conclusions and Clinical Relevance—Assessment of the acute inflammatory process by measurement of PGE2 concentrations in synovial fluid may be correlated with the amount of pain or lameness in dogs. (Am J Vet Res 2004;65:1269–1275)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine clinical features and outcome associated with use of a hemoglobin-based oxygen-carrying (HBOC) solution in cats.

Design—Retrospective study.

Animals—72 cats.

Procedure—Medical records of cats that received an HBOC solution were reviewed.

Results—The most common clinical signs and physical examination findings prior to infusion of the HBOC solution were associated with anemia; vomiting, neurologic signs, and respiratory abnormalities were also detected. The HBOC solution was given as a supportive measure in treatment of anemia in 70 cats, most often because compatible blood was not readily available. There were 80 separate HBOC solution infusion events (mean dose, 14.6 ml/kg [6.6 mg/lb]; mean rate of infusion, 4.8 ml/kg [2.2 ml/lb] per hour). Improvements in 37 of 43 of the more closely monitored cats included increased rectal temperature, blood hemoglobin concentration, blood pressure, appetite, and activity. Adverse events in 44 cats included pulmonary edema (n = 8), pleural effusion (21), mucous membrane discoloration (21), pigmenturia (11), vomiting (4), and neurologic abnormalities (4). Twenty-three cats were discharged from the hospital, and 49 cats died or were euthanatized. Necropsy examination of 23 cats did not reveal evidence of renal or hepatic toxicosis associated with HBOC administration.

Conclusions and Clinical Relevance—Although administration of an HBOC solution may provide temporary support to anemic cats, the development of pulmonary edema or pleural effusion potentially associated with rapid infusion rate and large volume of infusion of the HBOC solution should be investigated further before use of the solution can be recommended in cats. (J Am Vet Med Assoc 2002;221:96–102)

Full access
in Journal of the American Veterinary Medical Association