OBJECTIVE To use variable-number tandem-repeat (VNTR) analysis to determine the infecting serovar and strain for leptospiral DNA isolated from canine urine samples confirmed through PCR testing to contain pathogenic leptospires and to evaluate the sensitivity and specificity of microscopic agglutination testing (MAT) for identifying the infecting serogroup.
DESIGN Diagnostic survey and test evaluation.
SAMPLE Leptospiral DNA isolated from urine samples from 98 dogs confirmed through PCR testing to have pathogenic leptospires in their urine.
PROCEDURES VNTR analysis of DNA isolates was performed to identify the infecting leptospiral serovar and strain by use of primer pairs for the loci 4, 7, 10, and Lb5. Eighteen pathogenic and 2 saprophytic leptospiral serovars were used as reference strains for VNTR analysis. Results of MAT were compared with those of the PCR assay and VNTR analysis to determine the sensitivity and specificity of MAT for diagnosing leptospirosis and identifying the infecting serovar at various reciprocal titers.
RESULTS VNTR analysis identified Leptospira kirschneri serovar Grippotyphosa strain DF as the most common infecting serovar in dogs (78/98 [80%]). Thirteen unique VNTR patterns could not be identified by comparison with the Leptospira reference strains used. The MAT had a maximum sensitivity of 41% and a specificity of 100% for identifying Grippotyphosa as the infecting serogroup.
CONCLUSIONS AND CLINICAL RELEVANCE Findings confirmed the importance of Leptospira serovar Grippotyphosa among dogs in the United States. Serologic testing had poor sensitivity for identifying the infecting serogroup, and conclusions about emerging serogroups should be cautiously interpreted when serologic data are reported.
Objective—To describe clinical, laboratory, and surgical findings in dogs with confirmed gallbladder rupture and in which serum total bilirubin concentration was within reference limits.
Design—Retrospective case series.
Procedures—Medical records were searched to identify dogs with gallbladder rupture that underwent treatment at the Kansas State University Veterinary Health Center from November 2007 through November 2013. Dogs were included if they had undergone abdominal ultrasonography, serum total bilirubin concentration was ≤ 0.4 mg/dL, and abdominal exploratory surgery confirmed the presence of gallbladder upture.
Results—An exploratory celotomy was performed in all dogs because of ultrasonographic findings of mild to marked abdominal effusion and either an unidentifiable gallbladder (n = 1 dog) or a distended gallbladder with a suspected gallbladder mucocele (4 dogs). Serum total bilirubin concentration was within reference limits (median, 0.2 mg/dL; range, 0.1 to 0.4 mg/dL; reference range, 0.1 to 0.4 mg/dL) in all dogs before surgery. In 1 dog, bile acids concentrations in serum and in peritoneal fluid were compared and the results (48 μmol/L and 1,070 μmol/L, respectively) were supportive of the diagnosis of gallbladder rupture.
Conclusions and Clinical Relevance—Results indicated that even when serum total bilirubin concentration is within reference limits, gallbladder rupture should be considered in dogs with acute signs of abdominal pain when a mucocele is suspected on abdominal imaging and free abdominal fluid is present. Results suggested that a comparison of serum to peritoneal fluid bile acids concentrations may provide additional support for a diagnosis of gallbladder rupture.
Objective—To evaluate the use of a polymerase
chain reaction (PCR) assay on urine samples for diagnosis
of leptospirosis in dogs.
Design—Prospective case study.
Animals—132 dogs with clinical signs suggestive of
leptospirosis and 13 healthy dogs.
Procedure—PCR testing was performed on urine
samples to detect leptospiral DNA; results were compared
with results of conventional criteria for the diagnosis
Results—Leptospirosis was diagnosed in 8 dogs via
established criteria; all these dogs had positive results
of PCR assay, including 1 dog with positive results
before seroconversion developed. A positive PCR
assay result was also obtained in 16 dogs that did not
have a confirmed diagnosis of leptospirosis. In the 8
dogs that had a confirmed diagnosis of leptospirosis,
serovars pomona (n = 3 dogs), grippotyphosa (2),
canicola (2), and bratislava (1) were identified serologically.
The remaining 121 dogs all had a diagnosis
other than leptospirosis or were healthy. For PCR
testing on urine, sensitivity was 100%, specificity
was 88.3%, positive predictive value was 33%, and
negative predictive value was 100%.
Conclusions and Clinical Relevance—Positive PCR
test results prior to seroconversion may have value in
establishing an early diagnosis. Positive results in
dogs that had signs consistent with leptospirosis
despite failing to meet established criteria for leptospirosis
raise questions regarding the sensitivity of
serologic testing in diagnosis of leptospirosis.
Serovars pomona, grippotyphosa, and canicola were
most common. (J Am Vet Med Assoc 2003;222:1224–1229)
Infection by Histoplasma organisms most commonly results in disseminated systemic infection in cats. Relapse during therapy with itraconazole and fluconazole has been reported. The aim of this study was to report the clinical response, duration of therapy, side effects, and outcome in cats with histoplasmosis that were treated with voriconazole.
6 client-owned cats.
Medical records were reviewed of cats with confirmed histoplasmosis that presented to the Kansas State University Veterinary Health Center and received voriconazole therapy (n = 6 cats).
4 cats were switched to voriconazole from fluconazole (n = 2), itraconazole (1), or both (1), and 2 cats received voriconazole as initial therapy. Median starting dosage was 3.51 mg/kg PO every 72 hours. Two cats required a change in dosing interval from every 72 hours to every 96 hours due to hyporexia (n = 2) and an elevated ALT (1). Remission was documented in all 6 cats with a median time to a negative urine antigen of 256 days (range, 94 to 494 days).
Voriconazole therapy in 6 cats with histoplasmosis yielded mild side effects and a favorable outcome. Reported dosages provide a feasible alternative to daily dosing for owners of feline patients.
Objective—To identify erythrocyte-bound immunoglobulin (Ig) isotypes in dogs with primary immune-mediated hemolytic anemia (IMHA).
Design—Retrospective case series.
Animals—54 dogs with IMHA.
Procedures—Medical records of dogs with IMHA diagnosed between January 2001 and April 2010 were examined. Immunoglobulin isotype (tested via direct immunofluorescence by flow cytometry to identify erythrocyte-bound Ig), Hct, serum bilirubin concentration, presence of autoagglutination, degree of spherocytosis, duration of hospitalization, and 90-day outcome were recorded.
Results—The Hct on admission was significantly lower in dogs with IgG and IgM isotypes bound to erythrocytes, compared with dogs with a single Ig isotype, and the degree of spherocytosis was greater in dogs with IgG and IgM bound to erythrocytes, compared with dogs that only had IgM. Dogs with only IgM were not more likely to have autoagglutination, compared with dogs that only had IgG on the erythrocyte surface. Although Ig isotype was not associated with survival time, initial serum total bilirubin concentration was higher in nonsurvivors.
Conclusions and Clinical Relevance—Results suggested that dogs with IMHA with ≥ 2 Ig isotypes bound to erythrocytes, particularly IgG and IgM, are likely to have a more severe degree of anemia, spherocytosis, and autoagglutination.
Objective—To determine signalment, history, clinical
findings, results of autonomic function testing and
other antemortem diagnostic tests, and pathologic
findings in dogs with dysautonomia.
Animals—65 dogs with dysautonomia.
Procedure—Case records of 68 dogs with a diagnosis
of dysautonomia were reviewed; inclusion criteria
included histologic confirmation of dysautonomia or
clinical signs and results of pharmacologic testing
consistent with dysautonomia.
Results—65 dogs fulfilled all criteria for dysautonomia.
Dogs from rural environments were overrepresented,
and cases of dysautonomia were reported for
every month, although the highest number of cases
was reported in February and March. Vomiting was
the most common clinical sign, followed by diarrhea,
signs of anorexia and depression, weight loss, and
dysuria. The most common physical examination finding
was decreased or absent anal tone, followed by
absent pupillary light reflexes and elevated nictitating
membrane. Results of pharmacologic te sting were
consistent with dysautonomia, although no single
test was 100% sensitive. Histologic lesions consistent
with dysautonomia were found in the autonomic
ganglia, brainstem nuclei, and ventral horns of the
Conclusions and Clinical Relevance—Dysautonomia
is an endemic disease in Kansas, and a high
index of suspicion of the disease can be made by
combining clinical signs, physical examination findings,
and results of pharmacologic testing. (J Am Vet
Med Assoc 2002;220:633–639)
Objective—To determine serum antinuclear antibody (ANA) titers in dogs with systemic lupus erythematosus (SLE) and in dogs with related clinical and clinicopathologic findings.
Design—Retrospective case series.
Procedures—Information that was evaluated included signalment, clinical signs, results of routine laboratory testing, ANA titer, and diagnosis.
Results—The most common clinical signs were arthralgia, myalgia, and stiffness (n = 41 [34.2%]); the most common clinicopathologic abnormality was thrombocytopenia (30 [25%]). Serum ANA titer was < 160 (seronegative) in 89 dogs (74.2%), 160 in 14 dogs (11.7%), 320 in 5dogs (4.2%), and ≥ 640 in 12 dogs (10%). Immune-mediated disease was confirmed in 40 dogs, 18 of which fulfilled the criteria for a definitive or probable diagnosis of SLE. Only 1 of 47 dogs with no major signs compatible with SLE had immune-mediated disease, compared with 26 of 57 dogs with 1 major sign and 13 of 16 dogs with ≥ 2 major signs.
Conclusions and Clinical Relevance—Results suggested that measurement of ANA titer was not a useful diagnostic test in dogs without any major clinical or clinicopathologic abnormalities suggestive of SLE. In contrast, there was a good chance that results of the ANA assay would be positive and that the dog would be found to have immune-mediated disease if at least 2 major signs were evident. Findings suggest that it would be reasonable to limit the use of the ANA assay to those dogs that have at least 1 major sign compatible with a diagnosis of SLE.
Objective—To describe echocardiographic findings in dogs with dysautonomia.
Design—Prospective case series.
Animals—20 dogs with dysautonomia (13 confirmed during necropsy and 7 with results of antemortem testing [tear production, pilocarpine response test, atropine response test, and ID histamine response] supportive of the diagnosis).
Procedures—Dogs with dysautonomia were evaluated by use of echocardiography, and M-mode measurements were obtained on all dogs. A dobutamine response test was performed on 1 dog, starting at a rate of 1 μg/kg/min and doubling the rate every 15 minutes until fractional shortening (FS) increased to > 2 times the baseline value.
Results—Evidence of systolic dysfunction was detected in 17 of 20 dogs with dysautonomia, as determined on the basis of FS (median, 17.9%; range, 4.0% to 31.1%). Left ventricular internal dimension during diastole or left ventricular internal dimension during systole was enlarged in 4 of 20 and 14 of 20 dogs, respectively. Enlargement of the left atrium or aorta was identified in 3 of 15 and 1 of 15 dogs in which it was measured, respectively. Administration of dobutamine at a rate of 4 μg/kg/min resulted in dramatic improvement in FS (increase from 4% to 17%) in the 1 dog tested.
Conclusions and Clinical Relevance—Results suggested that echocardiographic evidence of diminished systolic function was common in dogs with dysautonomia. Whether the diminished function was a result of sympathetic denervation or myocardial hibernation was unclear, although myocardial hibernation was more likely.