In This Issue—February 15, 2013

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JAVMA News

AVMA Group Health & Life Insurance Trust medical coverage will end after 2013 because the program's underwriter is leaving the association health insurance market ahead of new regulations. The Department of Education continued recognition of the AVMA Council on Education and gave it one year to make program changes.

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Letter to the Editor

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What Is Your Diagnosis?

article image

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Pathology in Practice

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commentary

Reactive versus empathic listening

Communication is a vital component of providing effective patient care, and listening skills are of paramount importance to effective communication. However, learning how to listen and when to listen is not enough. We must also want to listen.

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reference point

Current therapeutic approaches to equine protozoal myeloencephalitis

Therapeutic approaches to equine protozoal myeloencephalitis are evolving. The ideal therapeutic agents for treatment of EPM would be effective when administered orally, have a high efficacy against Sarcocystis neurona, and be minimally toxic to horses.

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A thoracoscopic pericardial window procedure versus subtotal pericardectomy via thoracotomy for treatment of pericardial effusion in dogs

In dogs with idiopathic pericardial effusion, subtotal pericardectomy via thoracotomy has been associated with an excellent prognosis. An alternative procedure, thoracoscopic creation of a pericardial window, has been advocated, but in a study involving 58 dogs with pericardial effusion, disease-free interval and median survival time were significantly shorter for dogs with idiopathic pericardial effusion that underwent the thoracoscopic pericardial window procedure than for those that underwent subtotal pericardectomy via thoracotomy. In contrast, for dogs with neoplastic pericardial effusion, DFI and MST were not significantly different between the two surgical techniques.

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Transitional cell carcinoma of the abdominal wall in dogs

In dogs, transitional cell carcinoma of the abdominal wall is typically thought to be a result of seeding of the abdominal wall during surgical evaluation or treatment of urinary tract TCC. However, limited information on the biological behavior and causes of abdominal wall TCC is available. A review of medical records of 24 dogs with TCC of the urinary tract that also had histologic confirmation of abdominal wall TCC found that none of 18 dogs that received anticancer drugs had remission once abdominal wall TCC was clinically detected, and median survival time was 57 days. Results emphasize that percutaneous sampling of urinary tract TCCs should be avoided.

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Preoperative factors associated with postoperative hypocalcemia in dogs with primary hyperparathyroidism that underwent parathyroidectomy

Surgical resection of affected parathyroid gland tissue is a common treatment for dogs with primary hyperparathyroidism. Severe hypocalcemia is a potential complication of this procedure, and methods for identifying dogs likely to develop postoperative hypocalcemia would be clinically useful. In a review of medical records for 62 dogs that underwent parathyroidectomy for treatment of primary hyperparathyroidism, age, body weight, serum calcium-phosphorus concentration product, serum parathyroid hormone concentration, and BUN concentration were found, by means of multiple linear regression, to be associated with postoperative serum calcium concentration.

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Anticoagulant rodenticide screening in dogs

Anticoagulant rodenticide screening is a valuable tool for confirming the diagnosis of anticoagulant rodenticide intoxication in cases when ingestion was not witnessed. However, serum anticoagulant rodenticide concentrations are not correlated with severity of clinical signs or with degree of prolongation of coagulation times, according to a review of medical records for 123 dogs that underwent screening. In the study, 75 of 123 (60.9%) dogs tested positive for anticoagulant rodenticide intoxication. The most common conditions diagnosed in the 48 dogs with negative screening test results included neoplasia (n = 15), immune-mediated disease (7), and gastrointestinal bleeding (5).

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Diagnosis and treatment of an insulinoma in a guinea pig

Hyperinsulinemia with concurrent hypoglycemia were identified in a 5-year-old guinea pig examined because of lethargy, weight loss, and episodic neurologic signs, and a presumptive diagnosis of an insulinoma was made. Administration of diazoxide at a dosage of 5 mg/kg (2.3 mg/lb), PO, every 12 hours, was begun, but because of persistent hypoglycemia, the diazoxide dosage was gradually increased to 25 mg/kg (11.4 mg/lb), PO, every 12 hours, which resulted in euglycemia. Three weeks after the initial diazoxide dosage increase, the animal died, and a pancreatic beta-cell tumor (insulinoma) was identified histologically.

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Pregnancy and foaling rates after reduction of twin pregnancy via transvaginal ultrasound-guided aspiration in mares

Advanced twin pregnancies in mares typically result in abortion, stillbirth, or the delivery of weak foals, and various methods of twin pregnancy reduction have been used. Manual crushing of one embryonic vesicle is the preferred technique, but the success rate is limited in mares beyond day 30 of gestation. In a study involving 44 mares pregnant with twins that were examined between day 25 and day 62 of gestation, transvaginal ultrasound-guided aspiration was found to be effective for reduction of the twin pregnancy, with best results achieved before gestational day 43. Twenty of 41 (49%) mares delivered live singleton foals.

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Effects of postanesthetic sedation with romifidine or xylazine on quality of recovery from isoflurane anesthesia in horses

In horses, postanesthetic sedation with α2-adrenoceptor agonists prolongs recovery time but improves the quality of recovery from isoflurane or sevoflurane anesthesia. However, which agonist and what dose should be used to best improve recovery have not been established. In a randomized controlled trial involving 101 healthy adult horses anesthetized with isoflurane for 1 to 4 hours, postanesthetic IV administration of romifidine at a dose of 20 μg/kg (9.1 μg/lb) was associated with an improved recovery score, compared with administration of romifidine at a lower dose (10 μg/kg [4.5 μg/lb]) or administration of xylazine at a dose of 100 or 200 μg/kg (45 or 91 μg/lb).

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Oleander toxicosis in equids

Oleander intoxication should be considered in the differential diagnosis for equids with colic in geographic areas where oleander is found, especially when azotemia or cardiac arrhythmias are detected concurrently, according to results of a review of medical records. The study involved 30 equids with detectable concentrations of oleandrin in serum, plasma, urine, or gastrointestinal fluid samples or detectable concentrations of digoxin in serum. Three animals died before or immediately after arrival at the hospital. Of the other 27, 23 had gastrointestinal tract abnormalities, 19 had azotemia, and 18 had an auscultable cardiac arrhythmia. Mortality rate was 50%.

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