Evaluating quality and adequacy of gastrointestinal sampels collected using reusable or disposable forces

J Vet Intern Med 2016;30:1002-1007

J.A. Cartwright, T.L. Hill, S. Smith, and D. Shaw

Background: Sample quality of gastrointestinal endoscopic biopsies is of paramount importance for accurate histologicaldiagnosis. Many veterinary practices use reusable forceps as a result of perceived decreased cost. With reusable forceps, itremains unknown whether sample quality declines with repeated use and becomes inferior to single-use forceps and is therefore more or less cost effective than single-use forceps.

Hypothesis/Objectives: The study hypothesis was that reusable forceps sample quality would deteriorate after repeateduse as compared to single-use forceps.

Animals: Sixty-five dogs undergoing gastrointestinal endoscopy for diagnostic investigations at the Hospital for SmallAnimals, Edinburgh University.

Method: A prospective, pathologist-blinded study comparing single-use and reusable alligator standard cup biopsy forceps(Olympus 2.0 mm 1550 mm) with 5 randomized reusable forceps. Sample quality (stomach, duodenum, ileum, and colon)was assessed by a single pathologist using the WSAVA guidelines.

Results: There was no difference in the adequacy, depth, villi number, or crush artifact in the 4 intestinal areas betweenforceps type with at least 10, and up to 15, repeated uses of the reusable forceps.

Conclusions and clinical importance: This study demonstrates that reusable cup biopsy forceps provide equivalent biopsyquality after repeated uses to single-use forceps and are cost effective at 10-case use.


Complications of percutaneus endoscopic gastrotomy in dogs and cats receiving corticosteroid treatment

J Vet Intern Med 2016;30:1008-1013

J. Aguiar, Y.M. Chang, and O.A. Garden

Background: Corticosteroid treatment is commonly required in veterinary patients for treatment of inflammatory,immune-mediated, neurologic, and neoplastic diseases, which also may require assisted enteral nutrition via percutaneousendoscopic gastrostomy (PEG).

Objective: To evaluate complications associated with PEG use in dogs and cats receiving corticosteroid treatment.

Animals: Forty-two animals were included in the study: 12 dogs and 2 cats in the steroid group and 26 dogs and 2 cats inthe control group.

Methods: Medical records, between January 2006 and March 2015, were reviewed. Patients were included if the PEG tubewas in use for at least 24 hours and if complete medical records were available. Patients were assigned to the control group ifthey were not treated with corticosteroids during PEG use or to the steroid group if they had received corticosteroids during PEG tube use. Complications were classified as minor, moderate, and major in severity. Maximum severity complication ratewas compared between groups.

Results: The general prevalence of complications was found to be similar between groups (P = .306), but in the steroidgroup, 43% of the cases developed a major severity complication compared with 18% of the control group (P = .054).

Conclusion and Clinical Importance: Owners of dogs and cats receiving corticosteroids, in which PEG is planned, shouldbe counseled about possible complications beyond those associated with PEG tube usage alone.


Focal intestinal lipogranulomatous lymphangitis in 10 dogs

Journal of Small Animal Practice (2016) 57, 465-471

A.Lecoindre, P.Lecoindre, J. L.Cadoré, M.Chevallier, S.Guerret, G.Derré, S. P.Mcdonough

OBJECTIVES:To describe the clinical and pathological features of canine focal lipogranulomatouslymphangitis, to evaluate its underlying infectious cause and to compare it with human Crohn's disease.

METHODS:Retrospective review of case records with a histopathological diagnosis of focal lipogranulomatouslymphangitis. Bacterial and fungal colonisation was evaluated using fluorescence in situ hybridisationand histochemical staining, respectively. A comparison with Crohn's disease was performed by a humanpathologist.

RESULTS:Ten dogs were evaluated. The historical complaints were predominantly chronic diarrhoea(10/10) and vomiting (5/10). The biochemical abnormalities included hypoalbuminaemia (6/10) andhypocobalaminaemia (4/6). Abdominal sonography revealed a thickened distal ileum±ileocolic junction.Colonoscopy showed a swollen caecal ostium and oedematous caecum in 7/10 dogs. A stenotic ileocolic opening prevented endoscopic intubation in all dogs. Histology from the resected lesions revealedgranulomatous inflammation involving the muscularis and serosa. Fluorescence in situ hybridizationdemonstrated invasive bacteria in 2/10 dogs. Post-resection, all dogs received metronidazole and taperingimmunosuppressive doses of prednisolone. Remission (median 17 months) was achieved in 8/10 dogs.

CLINICAL SIGNIFICANCE:Focal lipogranulomatous lymphangitis is a rare and severe form of canine inflammatorybowel disease with preferential localisation to the ileum and the ileocolic junction. An underlyinginfectious aetiology was not identified


Serum C-reactive protein and S100A12 concentrations in dogs with hepatic disease

Journal of Small Animal Practice (2016) 57, 459-464

S. M.Craig, J. K.Fry, A.Rodrigues Hoffmann, P.Manino, R. M.Heilmann, J. S.Suchodolski, J. M.Steiner, H. A.Hottinger, S. L.Hunter and J. A.Lidbury

OBJECTIVES:To describe serum C-reactive protein and S100A12 concentrations in dogs with hepaticdisease and to determine whether there is a relationship between the concentration of either and theseverity of hepatic necroinflammation.

METHODS:Serum C-reactive protein and S100A12 concentrations were measured in 46 dogs undergoinghepatic biopsy. Dogs were divided into three groups: congenital portosystemic shunts, chronic hepatitisand hepatic neoplasia. The histological severity of hepatic necroinflammation was scored.

RESULTS:C-reactive protein andS100A12 concentrations were greater than the upper limit of the referenceintervals in 39 and 26% of dogs, respectively. There was no association of disease group with C-reactiveprotein (P=0·1733) orS100A12 (P=0·1513) concentrations. There was a positive correlation betweenserum C-reactive protein concentration and hepatic necroinflammatory activity (rs=0·428, P=0·006).

CLINICAL SIGNIFICANCE:Increased serum C-reactive protein andS100A12 concentrations were observed in asubpopulation of dogs with various types of hepatic diseases, suggesting acute-phase inflammation andactivation of phagocytic cells, respectively. Dogs with higher hepatic necroinflammatory activity scorestended to have higher serum C-reactive protein concentrations. Further studies are needed to confirmthis finding in a larger group of dogs.


Differentiating feline inflammatory bowel disease from alimentary lymphoma in duodenal endoscopic biopsies

Journal of Small Animal Practice (2016) 57, 396-401

S.Sabattini, E.Bottero, M. E.Turba, F.Vicchi, S.Bo and G.Bettini

OBJECTIVES:This study aimed to evaluate the agreement between microscopic and molecular testingfor differentiating feline intestinal bowel disease and small cell alimentary lymphoma in duodenalendoscopic biopsies.

METHODS:Four different diagnostic methods (cytology, histology, immunohistochemistry and clonality)were sequentially applied to 77 cases of feline chronic enteropathies. The agreement between thedifferent diagnostic methods was calculated and survival data were obtained to assess the most reliablemethod for predicting outcome.

RESULTS:Seventy-seven cases were included in the study. On multivariate survival analysis, only theclonality-based diagnosis of lymphoma was significantly associated with poor survival, with a risk ofenteropathy-related death 2·8 times higher. By comparing the other tests with clonality, specificitywas high (87 to 97%), whereas sensitivity was 36·8% for cytology, 39·5% for histology, 63·2% forimmunohistochemistry, resulting in an overall accuracy of 62·3, 68·8 and 80·5%, respectively.

CLINICAL SIGNIFICANCE:Clonality analysis can consistently increase the possibility of correctly and earlydiagnosing small cell lymphoma on endoscopic biopsies. Histological suspicion of alimentary lymphoma,even if not confirmed by clonality, should never be ignored, as it may represent a debutant form oflymphoma or it may later progress to lymphoma


Antimicrobial-resistant Escherichia coli in hospitalised companion animals and their hospital environment

Journal of Small Animal Practice (2016) 57, 339-347

I.Tuerena, N. J.Williams, T.Nuttall and G.Pinchbeck

INTRODUCTION:Antimicrobial resistance is a growing concern with implications for animal health. Thisstudy investigated the prevalence of antimicrobial resistance among commensal and environmentalEscherichia coli isolated from animals sampled in referral hospitals in theUK.

MATERIALS AND METHODS:Resistant Escherichia coli isolated from animal faeces and practice environmentswere tested for susceptibility to antimicrobial agents.PCR and sequencing techniques were used toidentify extended spectrum beta-lactamase andAmpC-producer genotypes.

RESULTS:In total, 333 faecal and 257 environmental samples were collected. Multi-drug resistantEscherichiacoli were found in 13·1% of faecal and 8·9% of environmental samples. Extended spectrum beta-lactamaseandAmpC genes were identified 14% and 7·7% of faecal samples and 8·6% and 8·6% of environmentalsamples, respectively. The most common extended spectrum beta-lactamase gene type detected wasblaCTX-M −15, althoughblaTEM-158 was detected in faecal and environmental samples from one practice.

CLINICAL SIGNIFICANCE:Escherichia coli resistant to key antimicrobials were isolated from hospitalisedanimals and the practice environment. We identified the emergence of the inhibitor resistant andextended spectrum beta-lactamaseblaTEM-158 in companion animals. Further investigation to determinerisk factors for colonisation with antimicrobial-resistant bacteria is needed to provide evidence forantimicrobial stewardship and infection control programmes.


Development and evaluation of a protocol for control of Giardia duodenalis in a colony of group-housed dogs at a veterinary medical college

 JAVMA September 15, 2016, Vol. 249, No. 6, Pages 644-649

Meriam N. Saleh BS; Alexandra D. Gilley DVM; Meghan K. Byrnes DVM; Anne M. Zajac DVM, PhD

OBJECTIVE To develop and evaluate a protocol for control of Giardia duodenalis in naturally infected group-housed dogs at a veterinary medical college.

DESIGN Prospective evaluation study.

ANIMALS 34 dogs.

PROCEDURES All dogs were tested for evidence of G duodenalis infection. Dogs were treated with fenbendazole on study days 1 through 10. On day 5, dogs were bathed and moved into clean, disinfected kennels in a different room to allow for disinfection and drying of their assigned kennels at 26.7°C (80°F) for 24 hours on day 6. After treatment, dogs were returned to their original housing; fecal samples were collected weekly from days 8 through 41 and then every 3 weeks until day 209. Samples were fixed in formalin and examined by direct immunofluorescence assay. Additionally, 1 pretreatment sample underwent PCR assay and DNA sequencing to determine the assemblage (genotype) of the organism. Normal handling routines for the dogs and their use in teaching activities were not changed.

RESULTS Initially, all dogs in the colony shed G duodenalis cysts. During and immediately after treatment (days 8 and 13), no cysts were detected in any dogs. On day 20, 1 cyst was observed in the fecal sample from 1 dog; results for all subsequent fecal analyses were negative. The G duodenalis cysts collected from the pretreatment sample had an assemblage C genotype.

CONCLUSIONS ANDCLINICAL RELEVANCE The integrated protocol was successful in controlling G duodenalis infection in this dog colony, despite exposure of dogs to a variety of environments and frequent handling by multiple individuals. Sequence analysis identified an assemblage typically found in dogs but not in people, indicating that zoonotic transmission would be unlikely.