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  • Author or Editor: Gabrielle Monteith x
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Abstract

Objective—To determine whether the number, volume, or age of transfused packed RBC units; volume of other blood products; or pretransfusion PCV was a risk factor for transfusion-associated complications or nonsurvival in dogs.

Design—Retrospective case series.

Animals—211 client-owned dogs receiving stored packed RBC transfusions.

Procedures—Information collected or calculated from the medical record of each dog included the total number, volume, and dose of packed RBC units; mean age of packed RBC units; number of packed RBC units > 14 days old; age of oldest packed RBC unit; volume and dose of other blood products used; pretransfusion PCV; acute patient physiologic and laboratory evaluation score; transfusion-associated complications; and outcome.

Results—The dose (mL/kg) of other blood products transfused was a risk factor for transfusion-associated complications (OR, 1.03; 95% confidence interval [CI], 1.01 to 1.05). The pretransfusion PCV (OR, 1.13; 95% CI, 1.06 to 1.21) and dose of packed RBCs administered (OR, 1.04; 95% CI, 1.02 to 1.07) were risk factors for nonsurvival. Age of transfused packed RBC units was not identified as a risk factor for transfusion-associated complications or nonsurvival, but the study was statistically underpowered to detect this finding.

Conclusions and Clinical Relevance—Administration of larger doses of other non–packed RBC blood products was a risk factor for transfusion-associated complications, and a higher pretransfusion PCV and larger dose of packed RBCs administered were risk factors for nonsurvival. Prospective randomized studies are needed to determine whether conservative transfusion strategies will reduce transfusion-associated complications and improve outcome in dogs.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the effects of indwelling nasogastric intubation on the gastric emptying rate of liquid in horses.

Animals—6 healthy horses.

Procedures—Horses were assigned to treatment and control groups in a prospective randomized crossover study with a washout period of at least 4 weeks between trials. Acetaminophen (20 mg/kg) diluted in 1 L of distilled water was administered via nasogastric tube at time points of 0, 12, 30, 48, and 72 hours to evaluate the liquid-phase gastric emptying rate. In control horses, nasogastric tubes were removed after administration of acetaminophen. In horses receiving treatment, the tube was left indwelling and maintained for 72 hours. A 10-mL sample of blood was collected from a jugular vein immediately before and 20, 40, 60, 80, 100, 120, and 180 minutes after acetaminophen administration. Serum acetaminophen concentrations were measured by use of a colorimetric method.

Results—Peak serum acetaminophen concentration was significantly higher in the control group (38.11 μg/mL) than in the treatment group (29.09 μg/mL), and the time required to reach peak serum acetaminophen concentration was significantly shorter in the control group (22.79 minutes) than in the treatment group (35.95 minutes).

Conclusions and Clinical Relevance—Results indicated that indwelling nasogastric intubation has a delaying effect on the gastric emptying rate of liquids. Veterinarians should consider the potential for delayed gastric emptying when placing and maintaining an indwelling nasogastric tube for an extended period of time after surgery. Repeated nasogastric intubation may be better than maintenance of an indwelling tube in horses with ileus.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To describe the clinical use of regional limb perfusion with antimicrobials (A-RLP), complications, and outcome in a large series of patients.

Design—Retrospective case series.

Animals—174 horses.

Procedures—Medical records of horses treated with A-RLP between 1999 and 2009 were reviewed. Signalment, primary complaint, horse use, etiology, duration of clinical signs, previous treatment, structures involved, concurrent conditions, A-RLP characteristics, additional treatments, complications, and outcome were recorded. At long-term follow-up, 2 outcomes were investigated: survival rate and return to previous use at the same or higher level. Univariate and multivariate logistic regression analyses were conducted.

Results—Group 1 (96 horses) included septic synovitis. Group 2 (50 horses) included extrasynovial lacerations (23 horses) and fresh, minimally contaminated intrasynovial lacerations without evidence of established synovial infection (27 horses). Group 3 (28 horses) included miscellaneous other conditions. Only minor complications were reported in 12.26% of horses that received IV (n = 155) and 33% of horses that received intraosseous (27) A-RLP. Horses with septic synovitis had a lower survival rate (53.43%) than did horses with lacerations (91.89%). Within group 2, no significant differences in short- or long-term outcomes were found between horses with extrasynovial and fresh, minimally contaminated intrasynovial lacerations. For the horses returning to previous use, 80% of horses with septic synovitis and 72.72% of horses with lacerations were performing at the same or higher level at the time of follow-up.

Conclusions and Clinical Relevance—The results of the present study indicated that A-RLP is a safe technique with minimal adverse effects. The IV route presented fewer complications than intraosseous injection. Horses with infection of synovial structures had a lower survival rate than did those with acute, minimally contaminated intrasynovial lacerations. The latter had a similar prognosis for horses with extrasynovial lacerations treated with A-RLP.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the efficacy and toxic effects of epirubicin for the adjuvant treatment of dogs with splenic hemangiosarcoma and identify prognostic factors.

Design—Retrospective case series.

Animals—59 client-owned dogs that underwent splenectomy for splenic hemangiosarcoma treated with or without epirubicin.

Procedures—Medical records were examined for signalment, clinical signs, diagnostic and surgical findings, and postoperative outcome. For dogs treated with epirubicin, dose numbers, intervals, and reductions and type and severity of toxic effects were recorded. Dogs were allotted to 2 groups: splenectomy alone and splenectomy with adjuvant epirubicin treatment.

Results—18 dogs received epirubicin (30 mg/m2) every 3 weeks for up to 4 to 6 treatments. Forty-one dogs were treated with splenectomy alone. The overall median survival time was significantly longer in dogs treated with splenectomy and epirubicin (144 days), compared with splenectomy alone (86 days). Median survival time for dogs with stage I disease (345 days) was significantly longer than for dogs with either stage II (93 days) or III disease (68 days). Seven of 18 dogs treated with epirubicin were hospitalized for signs of adverse gastrointestinal effects. Inappetence, long duration of clinical signs, thrombocytopenia, neutrophilia, and high mitotic rate were negative prognostic factors.

Conclusions and Clinical Relevance—Epirubicin may be as efficacious as adjuvant doxorubicin-based protocols, but may result in a higher incidence of adverse gastrointestinal effects. Epirubicin should be considered as an alternative to doxorubicin in dogs with preexisting cardiac disease, as clinical epirubicin cardiotoxicity was not diagnosed in treated dogs.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To compare outcomes and survival times for dogs with cervical spondylomyelopathy (CSM; wobbler syndrome) treated medically or surgically.

Design—Retrospective case series.

Animals—104 dogs.

Procedures—Medical records of dogs were included if the diagnosis of CSM had been made on the basis of results of diagnostic imaging and follow-up information (minimum, 6 months) was available. Ordinal logistic regression was used to compare outcomes and the product-limit method was used to compare survival times between dogs treated surgically and dogs treated medically.

Results—37 dogs were treated surgically, and 67 were treated medically. Owners reported that 30 (81%) dogs treated surgically were improved, 1 (3%) was unchanged, and 6 (16%) were worse and that 36 (54%) dogs treated medically were improved, 18 (27%) were unchanged, and 13 (19%) were worse. Outcome was not significantly different between groups. Information on survival time was available for 33 dogs treated surgically and 43 dogs treated medically. Forty of the 76 (53%) dogs were euthanized because of CSM. Median and mean survival times were 36 and 48 months, respectively, for dogs treated medically and 36 and 46.5 months, respectively, for dogs treated surgically. Survival times did not differ significantly between groups.

Conclusions and Clinical Relevance—In the present study, neither outcome nor survival time was significantly different between dogs with CSM treated medically and dogs treated surgically, suggesting that medical treatment is a viable and valuable option for management of dogs with CSM.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To compare perioperative characteristics of dogs with cystic calculi treated via open versus laparoscopic-assisted cystotomy (LAC).

DESIGN Retrospective case series.

ANIMALS 89 client-owned dogs that underwent open cystotomy (n = 39) or LAC (50).

PROCEDURES Medical records of dogs that underwent cystotomy between 2011 and 2015 were reviewed. History, signalment, surgery date, results of physical examination, results of preoperative diagnostic testing, details of surgical treatment, duration of surgery, perioperative complications, treatment costs, and duration of hospitalization were recorded.

RESULTS 5 of 50 (10%) dogs required conversion from LAC to open cystotomy (OC). There was no significant difference between the LAC (1/50) and OC (2/39) groups with regard to percentage of patients with incomplete removal of calculi. Duration of surgery was not significantly different between the LAC (median, 80 min; range, 35 to 145 min) and OC (median, 70 min; range, 45 to 120 min) groups. Postoperative duration of hospitalization was significantly shorter for dogs that underwent LAC (median, 24 hours; range, 12 to 48 hours) versus OC (median, 26 hours; range, 12 to 63 hours). Surgical and total procedural costs were significantly higher for patients undergoing LAC.

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that LAC may be an acceptable minimally invasive technique for treatment of cystic calculi in dogs. Surgery times were similar to those for dogs undergoing OC; however, surgical and total procedural costs were higher. Further investigation is suggested to determine which patients may benefit from LAC versus traditional OC.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To establish the reference ranges for motor evoked potential (MEP) latency and amplitude in clinically normal Doberman Pinschers, compare the MEPs of Doberman Pinschers with and without clinical signs of cervical spondylomyelopathy (CSM; wobbler syndrome), and determine whether MEP data correlate with neurologic or magnetic resonance imaging (MRI) findings.

Animals—16 clinically normal and 16 CSM-affected Doberman Pinschers.

Procedures—Dogs were classified according to their neurologic deficits. After sedation with acepromazine and hydromorphone, transcranial magnetic MEPs were assessed in each dog; latencies and amplitudes were recorded from the extensor carpi radialis and cranial tibial muscles. Magnetic resonance imaging was performed to evaluate the presence and severity of spinal cord compression.

Results—Significant differences in cranial tibial muscle MEP latencies and amplitudes were detected between clinically normal and CSM-affected dogs. No differences in the extensor carpi radialis MEP were detected between groups. There was a significant correlation (r = 0.776) between the cranial tibial muscle MEP latencies and neurologic findings. Significant correlations were also found between MRI findings and the cranial tibial muscle MEP latencies (r = 0.757) and amplitudes (r = −0.453).

Conclusions and Clinical Relevance—Results provided a reference range for MEPs in clinically normal Doberman Pinschers and indicated that cranial tibial muscle MEP latencies correlated well with both MRI and neurologic findings. Because of the high correlation between cranial tibial muscle MEP data and neurologic and MRI findings, MEP assessment could be considered as a screening tool in the management of dogs with spinal cord disease.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To use quantitative ultrasonography to evaluate the association between the speed of sound (SOS) at 9 sites in the third metacarpal bone (MCIII) of racing Thoroughbreds with workload accumulation and the effect that MCIII failure has on this association.

Animals—Sixty-two 2- and 3-year-old Thoroughbreds in racing condition.

Procedures—Cumulative work index (CWI) was used to calculate total workload (CWItotal) and also 3 independent CWIs for the various gaits (ie, trot [CWItrot], gallop [CWIgallop], and race [CWIrace]) used during training and racing. Speed of sound was monitored in horses during the 2007 racing season and compared with the CWIs via regression analysis. Sex, age, limb, and MCIII failure were included as covariates in the model.

Results—SOS was significantly associated with CWItotal at 8 sites and with independent CWIs of the various gaits at all 9 sites. Progression of SOS in MCIIIs with workload differed significantly in horses with clinical signs of metacarpal bone failure, compared with results for horses with clinically normal MCIIIs, in 1 site by use of CWItotal and in 5 sites by use of the independent CWIs for the various gaits.

Conclusions and Clinical Relevance—These results indicated that SOS in the MCIII of racing Thoroughbreds followed a constant pattern of progression as workload accumulated. With the development of more precise quantitative ultrasonography devices, SOS corrected for amount of activity may be used to identify horses at risk of bone failure.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate use of transcranial magnetic motor evoked potentials for assessment of the functional integrity of the cervical spinal cord in largebreed dogs with cervical spinal cord disease.

Design—Randomized, controlled, masked study.

Animals—10 healthy large-breed control dogs and 25 large-breed dogs with cervical spinal cord diseases.

Procedure—Affected dogs were allocated to 3 groups on the basis of neurologic status: signs of neck pain alone, ambulatory with ataxia in all limbs, or nonambulatory. Transcranial magnetic stimulation was performed on each dog with the same standard technique. Motor evoked potentials (MEP) were recorded from electrodes inserted in the tibialis cranialis muscle. Following the procedure, each dog was anesthetized and cervical radiography, CSF analysis, and cervical myelography were performed. The MEP latencies and amplitudes were correlated with neurologic status of the dogs after correction for neuronal path length.

Results—Mean MEP latencies and amplitudes were significantly different between control dogs and dogs in each of the 3 neurologic categories, but were not significantly different among dogs in the 3 neurologic categories. A linear association was evident between MEP latencies and amplitudes and severity of neurologic deficits; the more severe the neurologic deficits, the more prolonged the latencies and the more decreased the amplitudes.

Conclusions and Clinical Relevance—Transcranial magnetic MEP are useful to assess severity of cervical spinal cord disease in large-breed dogs. Impairment of the functional integrity of the cervical spinal cord was found even in dogs with neck pain alone. (J Am Vet Med Assoc 2002;221:60–64)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To compare electroencephalography (EEG) artifact associated with use of the subdermal wire electrode (SWE), gold cup electrode (GCE), and subdermal needle electrode (SNE) over an 8-hour period in sedated and awake dogs.

Animals—6 healthy dogs.

Procedures—8 EEG channels were recorded during 20-minute video-EEG recording sessions (intermittently at 0.5, 2, 4, 6, and 8 hours) with and without chlorpromazine sedation. Nonphysiologic artifacts were identified. Duration of artifact was summed for each channel. Number of unaffected channels (NUC) was determined.

Results—NUC was significantly affected by electrode type and sedation over time; median for SWE (2.80 channels; 95% confidence interval [CI], 0.84 to 5.70 channels) was significantly different from medians for GCE (7.87 channels; 95% CI, 7.44 to 7.94 channels) and SNE (7.60 channels; 95% CI, 6.61 to 7.89 channels). After 4 hours, NUC decreased in awake dogs, regardless of electrode type. In awake dogs, duration of artifact differed significantly between SWE and GCE or SNE; medians at 8 hours were 61.55 seconds (95% CI, 21.81 to 173.65 seconds), 1.33 seconds (95% CI, 0.47 to 3.75 seconds), and 21.01 seconds (95% CI, 6.85 to 64.42 seconds), respectively.

Conclusions and Clinical Relevance—The SWE had a significant duration of artifact during recording periods > 2 hours, compared with results for the GCE and SNE, in awake dogs. The GCE, SNE, and sedation resulted in significantly more channels unaffected by artifact. For longer recordings, caution should be exercised in selecting EEG electrodes and sedation state, although differences among electrodes may not be clinically relevant.

Full access
in American Journal of Veterinary Research