OBJECTIVE To determine whether urolithiasis is associated with chronic kidney disease (CKD) in cats.
DESIGN Retrospective case-control study.
ANIMALS 126 cats (59 and 67 with and without urolithiasis, respectively).
PROCEDURES Medical records from June 2006 to July 2013 were searched to identify cats that underwent abdominal or focal urinary tract ultrasonography and for which serum creatinine concentration and urine specific gravity data were obtained ≤ 14 days before or after the examination. In cats with (urolithiasis group) and without (control group) urolithiasis, the presence of CKD was determined according to International Renal Interest Society guidelines. Information recorded included signalment, body weight, serum creatinine concentration, and urine specific gravity; when present, the location and number of uroliths were noted. Differences between groups and associations between group and categorical variables were analyzed statistically.
RESULTS Age, weight, sex, and breed did not differ between groups. The prevalence of CKD was significantly higher in cats with urolithiasis than in the control group. Among cats with urolithiasis, there was a negative association between CKD and presence of cystoliths. There was no association between urolithiasis and the stage of CKD or between presence of CKD and location of nephroliths in the kidney.
CONCLUSIONS AND CLINICAL RELEVANCE Results confirmed a positive association between urolithiasis and CKD in the feline population studied and suggested that cats with urolithiasis should be evaluated for CKD. Further research is warranted to assess the nature of the relationship between CKD and urolithiasis in cats.
Objective—To determine variations in cytologic counts of bronchoalveolar lavage (BAL) fluid attributable to month of collection, first and second aliquots, and left and right lung sites in horses with recurrent airway obstruction (RAO).
Animals—5 horses with RAO and 5 healthy horses without respiratory tract disease.
Procedures—Horses were housed in a stable for 5 months prior to and throughout the study. Bronchoalveolar lavage fluid was collected from the right and left lung of each horse 3 times at monthly intervals (February, March, and April). Each BAL fluid collection was performed by use of 2 incremental instillations of 250 mL of isotonic saline (0.9% NaCl) solution in the same bronchial site. Analysis of BAL fluid included volume of BAL fluid recovered, a CBC, and differential cytologic counts.
Results—Volume of BAL fluid recovered and cytologic counts did not differ in horses with RAO across time or between right and left lungs, except for the number of mast cells. Horses with RAO had significantly lower volumes of BAL fluid recovered, significantly lower percentages of macrophages and lymphocytes, and significantly higher percentages of neutrophils than did healthy horses. Despite individual variation, all horses with RAO had > 25% neutrophils throughout the study period.
Conclusions and Clinical Relevance—Despite variation among horses, BAL fluid cytologic counts were repeatable over short and long periods and samples can be used for longitudinal studies as a diagnostic tool of pulmonary inflammation in horses with RAO.
Objective—To systematically review the scientific literature to identify, assess the quality of, and determine outcomes of studies conducted to evaluate the use of pheromones for treatment of undesirable behavior in cats and dogs.
Study Population—Reports of prospective studies published from January 1998 through December 2008.
Procedures—The MEDLINE and CAB Abstracts databases were searched with the following key terms: dog OR dogs OR canine OR cat OR cats OR feline AND pheromone OR synthetic pheromone OR facial pheromone OR appeasing pheromone. A date limit was set from 1998 through 2008. Identified reports for dogs (n = 7) and cats (7) were systematically reviewed.
Results—Studies provided insufficient evidence of the effectiveness of feline facial pheromone for management of idiopathic cystitis or calming cats during catheterization and lack of support for reducing stress in hospitalized cats. Only 1 study yielded sufficient evidence that dog-appeasing pheromone reduces fear or anxiety in dogs during training. Six studies yielded insufficient evidence of the effectiveness of dog-appeasing pheromone for treatment of noise phobia (2 reports), travel-related problems, fear or anxiety in the veterinary clinic, and stress- and fear-related behavior in shelter dogs as well as vocalizing and house soiling in recently adopted puppies.
Conclusions and Clinical Relevance—11 of the 14 reports reviewed provided insufficient evidence and 1 provided lack of support for effectiveness of pheromones for the treatment of undesirable behavior in cats and dogs.
Objective—To evaluate the effects of continuous oral administration of phenylbutazone on serum and synovial fluid biomarkers of skeletal matrix metabolism in horses.
Animals—11 adult female horses without clinical or radiographic evidence of joint disease.
Procedures—Horses were randomly assigned to control or treatment groups. Phenylbutazone was administered orally twice daily at a dose of 4.4 mg/kg for 3 days to the treatment group and subsequently at a dose of 2.2 mg/kg for 7 days. Serum and radiocarpal synovial fluid samples were obtained at baseline and thereafter at regular intervals for 4 weeks. Biomarkers of cartilage aggrecan synthesis (chondroitin sulfate 846) and type II collagen synthesis (procollagen type II C-propeptide) and degradation (collagen type II cleavage) were assayed. Biomarkers of bone synthesis (osteocalcin) and resorption (C-terminal telopeptide of type I collagen) were also measured.
Results—No significant differences were found between control and treatment groups or temporally for the biomarkers chondroitin sulfate 846, procollagen type II C-propeptide, collagen type II cleavage, and C-terminal telopeptide of type I collagen in serum or synovial fluid. A significant increase in osteocalcin concentration occurred in synovial fluid during treatment in the treated group. No treatment effect was detected for serum osteocalcin concentration.
Conclusions and Clinical Relevance—Results suggested that continuous phenylbutazone administration at recommended doses altered some biomarkers in healthy equine joints after short periods of administration. Increased osteocalcin concentration may indicate an undetermined anabolic effect of phenylbutazone administration on periarticular bone or transient induction of osteogenesis in articular chondrocytes or a mesenchymal subpopulation of synoviocytes.
Procedures—In each bird, a standardized osteotomy of 1 femur was performed and the fracture was immobilized with an intramedullary pin. Degree of postoperative pain was evaluated 6 times/d for 4 days by use of 3 methods: an electronic perch for assessment of weight-bearing load differential of the pelvic limbs, 4 numeric rating pain scales for assessment of pain (all of which involved the observer in the same room as the bird), and analysis of video-recorded (observer absent) partial ethograms for bird activity and posture. Measurements obtained were compared with data collected before the surgery to evaluate the ability of these methods to detect pain.
Results—The weight-bearing load differential was a sensitive, specific, reliable, and indirect measure of fracture-associated pain in the model used. Two of 4 tested pain scales (fractured limb position and subjective evaluation of degree of pain) were sensitive and specific for detecting pain and were reliable in a research setting. Interobserver reliability of the 4 pain scales was excellent. Partial ethograms were sensitive for identifying pain-associated behavior in pigeons, particularly during the first 2 days after surgery.
Conclusions and Clinical Relevance—The fracture pain model was reliable and reproducible and may be useful for experimental studies involving postsurgical pain in pigeons. Weight-bearing load differential was the most sensitive and specific means of determining degree of pain in pigeons during the first 4 days after hind limb fracture induction.
Objective—To evaluate the usefulness of Doppler-derived peak flow velocity through the left ventricular outflow tract (LVOT Vmax) and effective orifice area indexed to body surface area (EOAi) in puppies to predict development of subaortic stenosis (SAS) in the same dogs as adults.
Procedures—Cardiac auscultation and echocardiography were performed on 2- to 6-month-old puppies, then repeated at 12 to 18 months. Subaortic stenosis was diagnosed when LVOT Vmax was ≥ 2.3 m/s in adult dogs with left basilar systolic murmurs.
Results—All puppies with EOAi < 1.46 cm2/m2 had SAS as adults. All adults with EOAi < 1.29 cm2/m2 had SAS. An LVOT Vmax > 2.3 m/s in puppyhood was 63% sensitive and 100% specific for SAS in adulthood. In puppies, LVOT Vmax was more strongly associated with a future diagnosis of SAS (area under the curve [AUC], 0.89) than was EOAi (AUC, 0.80). In puppies, the combination of LVOT Vmax and EOAi yielded slightly higher sensitivity (69%) and specificity (100%) for adult SAS than did LVOT Vmax alone. In unaffected and affected dogs, LVOT Vmax increased significantly from puppyhood to adulthood but EOAi did not.
Conclusions and Clinical Relevance—In Golden Retriever puppies, LVOT Vmax > 2.3 m/s and EOAi < 1.46 cm2/m2 were both associated with a diagnosis of SAS at adulthood. The combination of these 2 criteria may result in higher sensitivity for SAS screening. Unlike LVOT Vmax, EOAi did not change during growth in either unaffected Golden Retrievers or those with SAS.
Objective—To ultrasonographically quantify experimentally induced effusion of the distal interphalangeal (DIP) joint of horses and compare results with those obtained with palpation.
Sample—8 forelimbs from equine cadavers and forelimbs of 5 mares.
Procedures—Preliminary ex vivo experiments were performed to validate the methods. Then, the DIP joints of the forelimbs of standing horses were serially distended with saline (0.9% NaCl) solution (1, 4, and 10 mL) by injection through an intra-articular catheter. Two ultrasonographers measured distension of the dorsal recess of the DIP joint, and 2 surgeons, who were not aware of the volume injected, graded joint effusion by palpation.
Results—Intraobserver and interobserver repeatability was excellent for ultrasonographic measurements. Interobserver agreement for use of palpation to detect joint distension was moderate (κ = 0.45). There was an overall increase in the palpation distension grade with an increase in injected volume. Sensitivity for detection with palpation of larger volumes (4 and 10 mL) was high (92% and 100%, respectively). However, sensitivity was lower (57%) for detection with palpation of minimal distension (1 mL).
Conclusions and Clinical Relevance—Although palpation provided a reliable clinical assessment of DIP joint effusion for volumes of 4 to 10 mL, ultrasonographic measurements were easy to obtain, more accurate, and able to detect smaller amounts of distension. This may be clinically relevant for the assessment of effusion of the DIP joint that can arise in horses with early osteoarthritis or infectious arthritis with concomitant soft tissue swelling that precludes accurate assessment with palpation.
OBJECTIVE To evaluate interobserver agreement for features used in presumptive diagnosis of acute noncompressive nucleus pulposus extrusion (ANNPE) or ischemic myelopathy by MRI, compare findings on postcontrast T1-weighted (T1W) MRI sequences with fat saturation (FS) for the 2 conditions, and determine whether length and directional patterns of hyperintensity of the intramedullary spinal cord on T2-weighted (T2W) fast spin echo (FSE) MRI sequences differ between dogs with these diseases.
DESIGN Retrospective, observational study.
ANIMALS 20 dogs with clinical signs compatible with ANNPE (n = 14) or ischemic myelopathy (6).
PROCEDURES 3 observers evaluated MRI data (including T2W FSE, T2W single-shot FSE, and T1W FS sequences) for dogs with a presumptive diagnosis of ischemic myelopathy or ANNPE. Interobserver agreement for variables of interest including presumptive diagnosis was assessed by κ statistic calculations. Associations between diagnosis and variables of interest were assessed with Fisher exact or Cochran-Mantel-Haenszel tests.
RESULTS Perfect interobserver agreement (κ = 1 for all comparisons) was found for the presumptive diagnosis of ischemic myelopathy versus ANNPE. Meningeal enhancement on postcontrast T1W FS MRI images and nonlongitudinal directional pattern of intramedullary hyperintensity on T2W FSE images were significantly associated with a diagnosis of ANNPE. Greater length of intramedullary hyperintensity was significantly associated with a diagnosis of ischemic myelopathy.
CONCLUSIONS AND CLINICAL RELEVANCE Directional pattern and length of intramedullary hyperintensity on T2W FSE MRI images and enhancement patterns in postcontrast T1W FS sequences may provide important contributions to the criteria currently used in the presumptive diagnosis of ischemic myelopathy versus ANNPE.
Objective—To assess the variability in vertebral heart score (VHS) measurement induced by cardiac and respiratory cycles in dogs.
Design—Prospective observational study.
Animals—14 healthy Beagles.
Procedures—Dogs underwent fluoroscopic examination by 4 observers, and VHS was measured at end-tidal inspiration and end-tidal expiration during end systole and end diastole in left and right lateral recumbency. Mean VHS was compared within and among cardiac and respiratory phases and recumbency type, and correlation between VHS and heart rate was investigated. Interobserver variability was assessed.
Results—Mean VHS for each combination of respiratory and cardiac cycle was larger on images obtained in right lateral versus left lateral recumbency. The greatest differences were observed between VHS measured in the diastolic inspiratory phase (mean ± SD, 10.59 ± 0.49 vertebral units [VU] and 10.35 ± 0.50 VU for right and left lateral recumbency, respectively) and the systolic expiratory phase (10.11 ± 0.37 VU and 9.92 ± 0.50 VU for right and left lateral recumbency, respectively). The combination of respiratory and cardiac cycles induced a maximal difference in VHS of up to 0.97 VU and 1.11 VU in the inspiratory and expiratory phases, respectively. Heart rate was not correlated with the difference between VHS in systolic and diastolic phases.
Conclusions and Clinical Relevance—Clinicians should be aware of the potential influence of these factors when assessing VHS in dogs; in addition to allowing optimal pulmonary assessment, consistently taking radiographs at end-inspiratory tidal volume may help to limit VHS variability attributable to the respiratory cycle. Further research is needed to assess the effects of cardiac and respiratory phases on VHS in dogs with cardiac or respiratory disease.
OBJECTIVE To evaluate agreement between observers with different training and experience for assessment of postoperative pain and sedation in cats by use of a dynamic and interactive visual analog scale (DIVAS) and for assessment of postoperative pain in the same cats with a multidimensional composite pain scale (MCPS).
PROCEDURES Cats received 1 of 3 preoperative treatments: bupivacaine, IP; meloxicam, SC with saline (0.9% NaCl) solution, IP, (positive control); or saline solution only, IP (negative control). All cats received premedication with buprenorphine prior to general anesthesia. An experienced observer (observer 1; male; native language, Spanish) used scales in English, and an inexperienced observer (observer 2; female; native language, French) used scales in French to assess signs of sedation and pain. Rescue analgesia was administered according to MCPS scoring by observer 1. Mean pain and sedation scores per treatment and time point, proportions of cats in each group with MCPS scores necessitating rescue analgesia, and mean MCPS scores assigned at the time of rescue analgesia were compared between observers. Agreement was assessed by intraclass correlation coefficient determination. Percentage disagreement between observers on the need for rescue analgesia was calculated.
RESULTS Interobserver agreements for pain scores were good, and that for sedation scores was fair. On the basis of observer 1's MCPS scores, a greater proportion of cats in the negative control group received rescue analgesia than in the bupivacaine or positive control groups. Scores from observer 2 indicated a greater proportion of cats in the negative control group than in the positive control group required rescue analgesia but identified no significant difference between the negative control and bupivacaine groups for this variable. Overall, disagreement regarding need for rescue analgesia was identified for 22 of 360 (6.1%) paired observations.
CONCLUSIONS AND CLINICAL RELEVANCE Interobserver differences in assessing pain can lead to different conclusions regarding treatment effectiveness.