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History

A 6-year-old sexually intact male Yorkshire Terrier was evaluated because of a nonproductive cough and dyspnea of 10 days' duration. The dog had been treated with amoxicillin-clavulanic acid and betamethasone without apparent improvement. Three days before evaluation, the dog became anorectic and had signs of depression. On physical examination, the dog had labored breathing and was tachypneic. Abnormalities detected on CBC and microscopic examination of a blood smear included a stress leukogram (leukocytosis, mature neutrophilia, and lymphopenia), poikilocytosis, and activated monocytes. The serum glucose concentration was 65.7 mg/dL (reference range, 80 to 120 mg/dL). Radiographs of the thorax were

Restricted access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To investigate serum calcium-phosphorus concentration product (sCaPP) as a predictor of mortality rate in dogs with chronic kidney disease (CKD).

Design—Retrospective case-control study.

Animals—31 dogs with definitive CKD and 35 apparently healthy dogs.

Procedures—All dogs had been referred for nephrological consultation between December 2008 and December 2010. Dogs with CKD had stable disease for ≥ 3 months. On the basis of glomerular filtration rate < 60 mL/min/m2, 13 of the 35 apparently healthy dogs were subsequently classified as having early CKD. Disease stage among dogs was determined on the basis of plasma creatinine concentration as follows: stage 1, < 123.7 μmol/L (n = 13), stage 2, 123.7 to 176.8 μmol/L (7); stage 3, 185.6 to 442 μmol/L (13); or stage 4, > 442 μmol/L (11). For each dog, serum concentrations of ionized and total calcium and phosphorus were evaluated once; the latter 2 variables were used to determine sCaPP.

Results—The sCaPP differed significantly between the 22 healthy dogs and dogs with stage 3 or stage 4 CKD. The proportion of dogs with sCaPP > 70 mg2/dL2 increased with stage of disease. Mortality rate among the 24 dogs with sCaPP > 70 mg2/dL2 was higher than that among the 42 dogs with sCaPP ≤ 70 mg2/dL2. Dogs with sCaPP > 70 mg2/dL2 had a comparatively lower survival rate, and risk of death was 4.2 times as high as risk for dogs with sCaPP ≤ 70 mg2/dL2.

Conclusions and Clinical Relevance—For dogs with CKD, sCaPP > 70 mg2/dL2 appeared to be a negative prognostic indicator, which was not influenced by the concomitant serum concentrations of phosphorus and total or ionized calcium.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To report abdominal ultrasonography (AUS) findings in dogs with clinical signs of acute pancreatitis (AP) during the first 2 days of hospitalization and to compare AUS findings with severity of disease and mortality rate.

ANIMALS

37 client-owned dogs with clinical signs of AP.

PROCEDURES

Dogs suspected of having AP with complete medical records, AUS examinations performed throughout the first 2 days of hospitalization, and available frozen surplus serum samples for quantitative measurement of canine pancreatic lipase (cPL) concentrations at hospital admission met the criteria for study inclusion. Dogs were grouped as AUS+ or AUS− on the basis of positive or negative findings for AP on AUS, respectively. Abdominal ultra-sonography findings of AP were stratified (as mild, moderate, or severe) by use of an AUS severity index, and a canine acute pancreatitis severity score was calculated.

RESULTS

24 of 37 (64.8%) dogs had AUS findings of AP at hospital admission, whereas 10 had positive findings for AP on AUS within 2 days of hospitalization. Three (8%) dogs were AUS− but had serum cPL concentrations > 400 µg/L (ie, values considered diagnostic for AP). On the AUS severity index, 5 of 34 (14.7%) AUS+ dogs had mild findings, 18 (52.9%) AUS+ dogs had moderate findings, and 11 (32.4%) AUS+ dogs had severe findings. Severe findings were associated with a higher risk of death than mild and moderate findings. A significant association was found between canine acute pancreatitis severity scores and mortality rates.

CONCLUSIONS AND CLINICAL RELEVANCE

For dogs with clinical signs of AP, repeated AUS examinations during hospitalization should be performed, severe findings on the AUS severity index may indicate an increased risk of death, and serum cPL concentrations may increase earlier than findings on AUS of AP.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate pulsed-wave Doppler spectral parameters as a method for distinguishing between neoplastic and inflammatory peripheral lymphadenopathy in dogs.

Sample Population—40 superficial lymph nodes from 33 dogs with peripheral lymphadenopathy.

Procedures—3 Doppler spectral tracings were recorded from each node. Spectral Doppler analysis including assessment of the resistive index, peak systolic velocity-to-end diastolic velocity (S:D) ratio, diastolic notch velocity-to-peak systolic velocity (N:S) ratio, and end diastolic velocity-to-diastolic notch velocity ratio was performed for each tracing. Several calculation methods were used to determine the Doppler indices for each lymph node. After the ultrasonographic examination, fine needle aspirates or excisional biopsy specimens of the examined lymph nodes were obtained, and lymphadenopathy was classified as either inflammatory or neoplastic (lymphomatous or metastatic) via cytologic or histologic examination. Results of Doppler analysis were compared with cytologic or histopathologic findings.

Results—The Doppler index with the highest diagnostic accuracy was the S:D ratio calculated from the first recorded tracing; a cutoff value of 3.22 yielded sensitivity of 91%, specificity of 100%, and negative predictive value of 89% for detection of neoplasia. Overall diagnostic accuracy was 95%. At a sensitivity of 100%, the most accurate index was the N:S ratio calculated from the first recorded tracing; a cutoff value of 0.45 yielded specificity of 67%, positive predictive value of 81%, and overall diagnostic accuracy of 86.5%.

Conclusions and Clinical Relevance—Results suggested that noninvasive Doppler spectral analysis may be useful in the diagnosis of neoplastic versus inflammatory peripheral lymphadenopathy in dogs.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To prospectively evaluate the clinical and prognostic importance of duodenal endoscopic and histologic findings, including duodenal mucosal counts of forkhead box P3-positive regulatory T cells (Foxp3+ Tregs), in dogs with immunosuppressant-responsive enteropathy (IRE).

ANIMALS

57 client-owned dogs with IRE.

PROCEDURES

The canine chronic enteropathy clinical activity index (CCECAI) was used to assess each dog when IRE was diagnosed (T0) and 1, 3, 6, and 12 months later. Dogs were grouped on the basis of clinical response (responder group vs nonresponder group) and 12-month long-term outcome (responded to treatment and did not relapse [good outcome group] vs did not respond to treatment or had relapsed [bad outcome group]). At T0, dogs underwent gastrointestinal endoscopy and endoscopic biopsy, with results for variables of duodenal endoscopic and histologic evaluations scored and compared across groups.

RESULTS

At T0, the overall median CCECAI score was 7; CCECAI score was not associated with clinical response or relapse. Dogs had significantly greater odds of being in the bad outcome group (vs the good outcome group) if they had a histologic score of 3 (OR, 3.5; 95% CI, 1.09 to 11.3). No differences in the counts of Foxp3+ Tregs were detected between groups.

CONCLUSIONS AND CLINICAL RELEVANCE

In dogs with IRE, results indicated that evaluation of Foxp3+ Tregs did not have prognostic value, whereas a duodenal histologic score of 3 could be a negative prognostic factor for response and relapse, and higher severity scores for intraepithelial lymphocytes and lamina propria lymphocytes and plasma cells in duodenal biopsy samples may be negatively associated with response.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

To evaluate ultrasound-guided placement of an anchor wire (AW) or injection of methylene blue (MB) to aid in the intraoperative localization of peripheral lymph nodes in dogs and cats.

ANIMALS

125 dogs and 10 cats with a total of 171 lymphadenectomies.

PROCEDURES

Medical records of dogs and cats that underwent peripheral lymphadenectomies with or without (N) the AW or MB localization technique were reviewed. Data retrieved included clinical, surgical, and histologic findings. The proportions of successful lymphadenectomies, lymph node characteristics, and complications among the 3 groups were analyzed.

RESULTS

143 (84%) lymph nodes were successfully excised. Lymphadenectomy success was significantly affected by the localization technique, with 94% for group AW, 87% for group MB, and 72% for group N. Lymph node size was smaller in groups AW and MB, compared with group N. Duration of lymphadenectomy was shorter in group AW, compared with groups MB and N, and in group MB, compared with group N. Intra- (7%) and postoperative (10%) complications and final diagnosis did not significantly differ among groups.

CONCLUSIONS AND CLINICAL RELEVANCE

Both lymph node localization techniques were highly successful and reduced surgery time, compared with unassisted lymphadenectomy. Specifically, these techniques were effective for localization of normal-sized and nonpalpable lymph nodes and were efficient and practical options for peripheral lymphadenectomies, particularly for those that were small or nonpalpable.

Open access
in Journal of the American Veterinary Medical Association