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  • Author or Editor: Laura J. Crews x
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Abstract

Objective—To identify radiographic patterns in dogs with pulmonary blastomycosis and radiographic factors associated with outcome.

Design—Retrospective case series.

Animals—125 dogs with pulmonary blastomycosis.

Procedures—Medical records were reviewed, and for each lung lobe, the primary radiographic pattern and percentage of lobar involvement at the time of initial examination were recorded.

Results—79 dogs survived, 38 died, and 8 were euthanized without treatment. The initial radiographic pattern was variable and not significantly associated with outcome. Mean half-time for radiographic resolution of pulmonary infiltrates was 41.4 days for all patterns except masses, for which mean half-time to resolution was 90.8 days. Transient radiographic worsening was seen in 20 of 87 (23%) dogs but was not associated with a poor prognosis. Pulmonary bullae were seen in 20 (16%) dogs, most often in association with an alveolar pattern. Accuracy of using percentage of right caudal lung lobe involvement (≤ 20% vs > 20%) to predict outcome was 74.4%; accuracy of using number of affected lobes (< 4 vs ≥ 4) to predict outcome was 65.8%.

Conclusions and Clinical Relevance—Results suggested that a nonuniform distribution of pulmonary infiltrates was equally as likely as a diffuse nodular interstitial pattern in dogs with pulmonary blastomycosis. On the basis of half-time for resolution of pulmonary infiltrates, follow-up radiography should be performed no more often than every 4 to 6 weeks in clinically stable patients. Transient radiographic worsening that occurred during the initial weeks of treatment was not associated with a poorer prognosis.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To compare results of the most common diagnostic tests for pulmonary blastomycosis in dogs, identify factors associated with outcome, and determine response to various antifungal treatment protocols.

Design—Retrospective case series.

Animals—125 dogs with pulmonary blastomycosis.

Procedures—Medical records were reviewed, and information was obtained regarding diagnostic methods, results of routine laboratory testing, and radiographic response to antifungal treatment.

Results—79 dogs survived, 38 died, and 8 were euthanized. Transthoracic fine-needle aspiration and transtracheal lavage were the most common diagnostic methods. Results of an agar gel immunodiffusion test for antibodies against Blastomyces dermatitidis were negative in 12 of 24 (50%) dogs. Only 3 of 94 (3.2%) dogs in which cytologic or histologic examination or bacterial culture of pulmonary samples were performed had any evidence of concurrent bacterial infection. The half-time for radiographic resolution of pulmonary infiltrates did not vary significantly with antifungal treatment, and use of a loading dosage of itraconazole was not associated with significant improvements in outcome or time to disease resolution. Dogs that died had a higher number of band neutrophils at initial examination, compared with those that survived.

Conclusions and Clinical Relevance—Results suggested that the agar gel immunodiffusion test should not be used as the sole diagnostic test for pulmonary blastomycosis in dogs, that concurrent bacterial pneumonia was uncommon in dogs with pulmonary blastomycosis, and that the rate with which pulmonary infiltrates resolved did not vary significantly among antifungal treatments.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To identify clinical, laboratory, and ultrasonographic characteristics associated with gallbladder disease and rupture in dogs.

Design—Retrospective case series.

Animals—45 client-owned dogs.

Procedures—Medical records of dogs with histologically confirmed gallbladder disease that had ultrasonographic evaluation were reviewed. Signalment, history, clinical signs, laboratory values, bacteriologic culture of bile, gallbladder status at surgery or necropsy (intact vs ruptured), histopathologic findings, radiographic findings, ultrasonographic findings, and outcome were analyzed.

Results—The most common ultrasonographic findings were echogenic peritoneal fluid, thickened or laminated gallbladder wall, and echogenic reaction in the gallbladder fossa. Eighteen of 45 (40%) dogs had gallbladder rupture. Rupture was associated with histologic evidence of gallbladder necrosis, decreased serosal detail radiographically, and pericholecystic echogenic reaction, pericholecystic echogenic fluid, and generalized echogenic abdominal effusion ultrasonographically. Twenty-one of 45 (47%) dogs had mucocele, and 9 (43%) of those had gallbladder rupture. Eleven of 40 dogs had positive results of bacteriologic culture, and 5 of those had gallbladder rupture. Only 2 dogs had concurrent positive results of bacterial bile culture and gallbladder mucocele. Survival rate was 86% and not significantly related to presurgical bile leakage, positive results of bacterial culture, or mucocele.

Conclusions and Clinical Relevance—Ultrasonographic findings of pericholecystic reaction, localized or generalized echogenic peritoneal fluid, or decreased radiographic peritoneal detail should raise the index of suspicion for gallbladder rupture. Mucocele or bacterial gallbladder infection was the most common concurrent finding in dogs with gallbladder rupture.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine blood ionized calcium (iCa) and serum total calcium (tCa) concentrations in dogs with blastomycosis and to evaluate whether serum tCa concentration, albumin-adjusted serum calcium concentration (AdjCa-Alb), and total protein–adjusted serum calcium concentration (AdjCa-TP) accurately predict iCa status.

Design—Retrospective case series.

Animals—38 client-owned dogs with a cytologic diagnosis of blastomycosis.

Procedures—Dogs were classified as hypocalcemic, normocalcemic, or hypercalcemic on the basis of blood iCa concentration, serum tCa concentration, AdjCa-Alb, and AdjCa-TP; classification on the basis of serum tCa concentration, AdjCa-Alb, and AdjCa-TP was compared with blood iCa concentration.

Results—Except for 2 hypercalcemic dogs, all dogs had blood iCa concentrations within the reference interval. Use of serum tCa concentration overestimated hypocalcemia in 57.9% (22/38) of dogs and underestimated hypercalcemia in 1 dog. Use of AdjCa-Alb correctly reclassified all dogs as normocalcemic that were classified as hypocalcemic on the basis of serum tCa concentration, but failed to predict hypercalcemia in 1 dog. Use of AdjCa-TP correctly reclassified all but 2 dogs as normocalcemic that were classified as hypocalcemic on the basis of serum tCa concentration, and failed to predict hypercalcemia in 1 dog. No correlation was found between blood iCa concentration and serum concentrations of tCa, total protein, and albumin; AdjCa-Alb; or AdjCa-TP.

Conclusions and Clinical Relevance—High blood iCa concentration was uncommon in dogs with blastomycosis. Hypoalbuminemia contributed to a low serum tCa concentration despite a blood iCa concentration within reference limits. The use of serum tCa concentration, AdjCa-Alb, and AdjCa-TP may fail to identify a small number of dogs with high blood iCa concentrations.

Full access
in Journal of the American Veterinary Medical Association