Objective—To describe clinical signs, treatment, and outcome of aortic thrombosis in dogs.
Design—Retrospective case series.
Animals—31 dogs with aortic thrombosis.
Procedures—Records were retrospectively reviewed and data collected regarding signalment, historical signs, physical examination findings, laboratory testing, definitive diagnosis, and presence of concurrent disease.
Results—The records of 31 dogs with clinical or postmortem diagnosis of aortic thrombosis were reviewed. Onset of clinical signs was acute in 14 (45%) dogs, chronic in 15 (48%), and not documented in 2 (6%). Femoral pulses were subjectively weak in 6 (19%) dogs and absent in 17 (55%). Frequent laboratory abnormalities included high BUN concentration (n = 13), creatinine concentration (6), creatine kinase activity (10), and D-dimer concentration (10) and proteinuria with a urine protein–to–creatinine concentration ratio > 0.5 (12). Concurrent conditions included neoplasia (n = 6), recent administration of corticosteroids (6), and renal (8) or cardiac (6) disease. Median survival time was significantly longer for dogs with chronic onset of disease (30 days; range, 0 to 959 days) than for those with acute onset of clinical signs (1.5 days; range, 0 to 120 days).
Conclusions and Clinical Relevance—Results suggested that aortic thrombosis is a rare condition in dogs and accounted for only 0.0005% of hospital admissions during the study period. The clinical signs for dogs with aortic thrombosis differed from those seen in feline patients with aortic thromboembolism. Median survival time was significantly longer for dogs with chronic disease than for dogs with acute disease. Despite treatment, outcomes were typically poor, although protracted periods of survival were achieved in some dogs.
Objective—To characterize clinical and pathological features of implant-associated neoplasms in dogs.
Design—Retrospective case-control study.
Animals—16 dogs with implant-associated neoplasia and 32 control dogs with osteosarcoma without implants.
Procedures—Medical records of dogs with tumors associated with metallic implants (cases) treated between 1983 and 2013 were reviewed. Two dogs with naturally occurring osteosarcoma (controls) were matched to each case on the basis of tumor location, age, and sex.
Results—Median time from implant placement to diagnosis of neoplasia was 5.5 years (range, 9 months to 10 years). Pelvic limbs were most frequently affected, including the tibia (8/16) and femur (5/16), with 1 neoplasm involving both the femur and pelvis. Implant-associated tumors most commonly affected the diaphysis (15/16), with osteosarcomas significantly more likely to involve the long bone diaphysis in case dogs than in control dogs with naturally occurring osteosarcomas. Osteosarcoma was the most common tumor, accounting for 13 of 16 implant-associated tumors. For 7 of these osteosarcoma cases, review of histopathology results enabled subclassification into osteoblastic nonproductive (n = 3), chondroblastic (2), osteoblastic productive (1), and fibroblastic (1) groups. Three case dogs had a diagnosis of histiocytic sarcoma, fibrosarcoma, and spindle cell sarcoma.
Conclusions and Clinical Relevance—Results of this study highlighted important anatomic differences between spontaneous and implant-associated neoplasia in dogs. (J Am Vet Med Assoc 2015;247:778–785)
OBJECTIVE To evaluate tramadol for treatment of signs of pain and impaired mobility in geriatric cats with osteoarthritis.
DESIGN Randomized controlled crossover trial.
ANIMALS 24 client-owned geriatric (≥ 10 years old) cats with osteoarthritis.
PROCEDURES Otherwise healthy cats with owner-identified mobility impairment and clinical and radiographic evidence of osteoarthritis involving at least 1 appendicular joint were enrolled in the study. Cats were treated with tramadol orally at dosages of 0 (placebo), 1, 2, and 4 mg/kg (0, 0.45, 0.9, and 1.8 mg/lb) twice a day for 5 days, with a 2-day (weekend) washout period between treatments. Mobility was assessed with a collar-mounted activity monitor system, and impairments in activity were assessed with a client-completed questionnaire.
RESULTS 17 cats completed the study; 7 cats were withdrawn. There was a significant increase in activity with the 2-mg/kg dosage of tramadol, compared with activity when cats received the placebo. Significantly more owners (11/18) considered their cats to have improved with the 2-mg/kg treatment, compared with all other dosages (6/19 to 8/21). Most owners (17/20 [85%]) considered their cat's global quality of life to have improved during the study. Adverse events, predominantly euphoria, dysphoria, sedation, decreased appetite, and diarrhea, were significantly more frequent with the 4-mg/kg (8/19) and 2-mg/kg (6/18) treatments but not with the 1-mg/kg (2/21) treatment, compared with frequency of adverse events with the placebo (0/21).
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested a beneficial effect of twice-daily oral administration of tramadol at a dosage of 2 mg/kg in geriatric cats with osteoarthritis. Adverse events were dose dependent, and caution should be exercised in cats that have concurrent disease or are receiving other drugs that may produce adverse gastrointestinal effects.
Case Description—A 1.5-year-old spayed female Bernese Mountain Dog was examined for a 6-month history of intermittent vomiting, regurgitation, wheezing, and coughing. Initially, a diagnosis of gastroesophageal reflux disease with secondary aspiration pneumonitis was made but clinical signs did not resolve with treatment.
Clinical Findings—Thoracic and cervical radiography and CT revealed a sessile, irregularly marginated soft tissue opacity at the level of the fourth rib. Results of a CBC, serum biochemical analysis, and urinalysis were within reference limits. Results of abdominal ultrasonography were normal.
Treatment and Outcome—Tracheoscopy revealed a firm, irregularly marginated mass apparently originating from the ventral aspect of the trachea, occluding approximately one-half of the tracheal lumen, and located 2 cm cranial to the carina. Cytologic and histopathologic examination of fine-needle aspirate and biopsy samples suggested a benign etiology; therefore, endoscopic minimally invasive laser and electrocautery resection of the mass was scheduled. A total IV anesthetic protocol was administered with an oxygen-air mixture used to decrease the risk of fire during tracheal surgery. The mass was successfully resected, and histopathologic examination confirmed a diagnosis of osteochondroma. Clinical signs resolved, and at follow-up 32 months later, no regrowth of the mass was evident.
Clinical Relevance—Tracheoscopy-guided electrocautery and surgical diode laser resection was successful in removing an obstructive tracheal mass that was not resectable by means of a conventional open surgical approach. Minimally invasive procedures may decrease morbidity and mortality and improve outcome in appropriately selected small animal patients.
PROCEDURES Cats received gabapentin (10 mg/kg [4.5 mg/lb]) or placebo treatment, PO, every 12 hours for 2 weeks, followed by the alternate treatment (with no washout period). Activity was assessed with a collar-mounted accelerometer. A client-specific outcome measure (CSOM) questionnaire was used weekly to collect owner assessments of 3 selected activities in which their cats had impaired mobility; QOL ratings (worse, the same, or improved) following crossover to each treatment and for the overall study period were collected at the end of the investigation. Activity counts, CSOM and QOL data, and deterioration in impaired activities (ie, decrease of ≥ 2 points in CSOM scores) associated with treatment crossover were assessed statistically. Adverse events were recorded.
RESULTS Gabapentin administration was associated with significantly lower mean daily activity counts (48,333 vs 39,038 counts/d) and significantly greater odds (approx 3-fold change) of CSOM ratings indicating improvement in impaired activities, compared with results for the placebo treatment. A greater proportion of cats had deterioration in impaired activities after the crossover from gabapentin to placebo than when the opposite occurred, but the proportion of cats with worsened QOL did not differ between sequences. Adverse events were noted for 10 cats (9 that completed the study) during gabapentin treatment (sedation, ataxia, weakness, and muscle tremors) and 1 cat during placebo treatment (lethargy).
CONCLUSIONS AND CLINICAL RELEVANCE Gabapentin treatment was associated with improvement in owner-identified impaired activities of osteoarthritic cats. Activity levels were lower than those during placebo treatment, and sedation was the most common adverse effect.
Objective—To describe clinical features of oral and maxillofacial osteomas in cats.
Design—Retrospective case series.
Animals—7 cats with oral or maxillofacial osteoma or both.
Procedures—Medical records were reviewed for information on signalment, history, clinical signs, physical examination findings, diagnostic imaging findings, results of serum biochemical analyses and histologic testing, surgical procedures performed, and perioperative complications. Outcome was determined on the basis of follow-up telephone interviews of owners.
Results—Cats ranged from 1 to 23 years of age. Clinical signs were observed in 5 cats and were attributed to the presence of the mass. Diagnostic imaging (radiography and computed tomography) and histologic examination confirmed the diagnosis of osteoma. Three cats were euthanatized; 1 cat was treated by mandibulectomy, 1 was treated by maxillectomy, and 2 were treated by debulking. At the time of follow-up at least 1 year after surgery, all 4 treated cats were alive, with owners reporting an acceptable quality of life.
Conclusions and Clinical Relevance—Osteoma of the oral and maxillofacial regions is an uncommon tumor in cats. Most cats are examined during an advanced stage of the disease, when treatment options may be limited. Although osteoma is a benign tumor, the recommendation is to perform a clinical evaluation, diagnostic imaging, biopsy, and treatment early in the disease process, when less invasive surgical approaches may be feasible.
Objective—To compare effectiveness and complications associated with peribulbar and retrobulbar anesthesia with bupivacaine in cats.
Animals—6 healthy adult cats.
Procedures—Cats were sedated with dexmedetomidine and received a peribulbar injection of 0.5% bupivacaine (1.5 mL), iopamidol (0.5 mL), and saline (0.9% NaCl) solution (1 mL) or retrobulbar injection of 0.5% bupivacaine (0.75 mL) and iopamidol (0.25 mL) in a crossover study with ≥ 2 weeks between treatments. The contralateral eye was the control. Injectate distribution was evaluated with CT. After atipamezole administration, periocular and corneal sensations, intraocular pressure (IOP), and ocular reflexes and appearance were evaluated for 24 hours.
Results—All peribulbar and 3 of 6 retrobulbar injections resulted in CT evidence of intraconal injectate. Corneal sensation and periocular skin sensation were absent or significantly reduced relative to that for control eyes for 3 hours after peribulbar injection. Mean ± SD IOP immediately after injection was significantly higher for eyes with peribulbar injections (33 ± 12 mm Hg) than for control eyes or eyes with retrobulbar injections (both 14 ± 4 mm Hg) but 10 minutes later decreased to 18 ± 3 mm Hg. Exophthalmos, chemosis, and ptosis were evident in most injected eyes, and irritation was evident in 3 of 6 peribulbar-injected and 1 of 6 retrobulbar-injected eyes. All conditions resolved within 14 hours.
Conclusions and Clinical Relevance—Peribulbar injection resulted in intraconal deposition of bupivicaine in a higher percentage of cats than did retrobulbar injection and induced notable anesthesia relative to that for the control eye; however, IOP increased temporarily.
To evaluate the use of transrectal ultrasonography (TRUS) for the assessment of prostatic tumors in dogs and to compare results for TRUS with results for other imaging modalities.
10 client-owned male dogs.
Client-owned dogs identified with prostatic carcinoma were enrolled. Fluoroscopy, transabdominal ultrasonography (TAUS), TRUS, and MRI were performed on all dogs. Tumor measurements, urethral penetration (identification of abnormal tissue within the urethral lumen), and tumor extension into the urinary tract were recorded for all imaging modalities. Agreement between results for MRI (considered the criterion-referenced standard) and results for other modalities were compared.
Median body weight of the 10 dogs was 26.3 kg (range, 9.4 to 49.5 kg). No complications were encountered during or after TRUS. Significant moderate to good agreements (intraclass correlation coefficients, 0.60 to 0.86) among TAUS, TRUS, fluoroscopy, and MRI were identified for tumor length and height. Assessments of urethral penetration and tumor extension into the bladder with TRUS did not differ significantly from those made with MRI and were superior in terms of absolute agreement with MRI when compared with those for TAUS.
CONCLUSIONS AND CLINICAL RELEVANCE
TRUS was successfully and safely used to evaluate prostatic carcinoma in dogs. There was moderate to good agreement with MRI results for tumor height and length measurements, and TRUS was found to be superior to TAUS for some assessments. Transrectal ultrasonography can be considered an adjunctive imaging modality for the performance of prostatic interventional procedures or assessment of response to treatment.
OBJECTIVE To evaluate the outcome for cats with benign ureteral obstructions treated by means of ureteral stenting and to compare the outcome for these cats with outcome for a historical cohort of cats treated by means of ureterotomy only.
DESIGN Prospective study with historical cohort.
ANIMALS 62 client-owned cats with benign ureteral obstructions, including 26 cats treated with ureteral stenting and 36 cats previously treated with ureterotomy.
PROCEDURES Data were recorded prospectively (ureteral stent cases) or collected retrospectively from the medical records (ureterotomy cases), and results were compared.
RESULTS Cats treated with ureteral stents had significantly greater decreases in BUN and serum creatinine concentrations 1 day after surgery and at hospital discharge, compared with values for cats that underwent ureterotomy. Six cats in the ureteral stent group developed abdominal effusion after surgery, and cats in this group were significantly more likely to develop abdominal effusion when a ureterotomy was performed than when it was not. Cats that developed abdominal effusion after surgery were significantly less likely to survive to hospital discharge. Cats that underwent ureteral stenting were significantly more likely to have resolution of azotemia prior to hospital discharge than were cats that underwent ureterotomy alone.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that cats with benign ureteral obstructions treated with ureteral stenting were more likely to have resolution of azotemia prior to hospital discharge, compared with cats undergoing ureterotomy alone. Results of ureteral stenting were encouraging, but further investigation is warranted.
To determine whether ultrasonographic features in dogs with protein-losing nephropathy (PLN) were associated with renal biopsy findings and compare corticomedullary ratios between dogs with PLN versus non-renal disease.
71 dogs with PLN and 33 dogs without renal disease.
Medical records and archived ultrasonographic images for dogs with PLN that underwent renal biopsy between 2008 and 2018 were reviewed. Corticomedullary ratios were measured.
In dogs with PLN, median serum creatinine and BUN concentrations and urine-protein-to-creatinine-ratio prior to renal biopsy were 3.4 mg/dL (interquartile range [IQR], 1.2 to 5.3 mg/dL), 80 mg/dL (IQR, 28 to 105 mg/dL), and 11.4 (IQR, 6.4 to 18.3), respectively. Histologic abnormalities within the tubulointerstitial space were associated with cortical echogenicity. Gastric wall thickness > 5 mm was associated with a histologic diagnosis of acute glomerular disease. Dogs with immune complex–mediated glomerular disease were more likely to have abnormal gastric mural architecture. Other ultrasonographic features of the kidneys, liver, and stomach and the presence of ascites did not help to differentiate immune complex–mediated from non-immune complex–mediated glomerular disease, acute from chronic disease, or amyloid from non-amyloid disease or distinguish whether tubulointerstitial disease was present or absent. Median left corticomedullary ratio for 66 dogs with PLN (1.2) was significantly higher than that for the 33 dogs without renal disease (1.0).
Ultrasonographic features were poorly associated with specific pathological disorders in dogs with PLN. In this study, the corticomedullary ratio was higher in dogs with PLN, indicating the presence of cortical thickening, but the clinical relevance is unknown.