Repeated Famotidine Administration Results in a Diminished Effect on Intragastric pH in Dogs

M.K. Tolbert, A. Graham, A. Odunayo, J. Price, J.M. Steiner, K. Newkirk, S. Hecht

Background Famotidine is an acid suppressant commonly administered to dogs. Prolonged famotidine use in people results in decreased efficacy, but the effect in dogs is unknown.

Hypothesis/Objectives To compare the effect of repeated oral administration of famotidine or placebo on intragastric pH and serum gastrin in dogs. We hypothesized that famotidine would have a diminished effect on intragastric pH on day 13 compared to day 1.

Animals Six healthy adult colony Beagles.

Methods Randomized, 2-factor repeated-measures crossover design. All dogs received oral placebo or 1.0 mg/kg famotidine q12h for 14 consecutive days. Intragastric pH monitoring was used to continuously record intragastric pH on treatment days 1–2 and 12–13. Mean pH as well as mean percentage time (MPT) that intragastric pH was ≥3 or ≥4 were compared between and within groups by analysis of variance. Serum gastrin was measured on days 0, 3, and 12 for each treatment.

Results Continued administration of famotidine resulted in a significant decrease in mean pH, MPT ≥3, and MPT ≥4 (P < .0001) on day 12 and 13. This resulted in a mean decrease in pH by 1.63 on days 12 and 13 compared to days 1 and 2. Furthermore, a mean decrease of MPT ≥3 and MPT ≥4 by 33 and 45% was observed for the same time period, respectively.

Conclusions and Clinical Importance Continued administration of famotidine results in a diminished effect on intragastric pH in dogs. Caution is advised when recommending long-term, daily oral administration of famotidine to dogs.

(J Vet Intern Med. 2017 Jan-Feb; 31(1): 117–123)


Applicability of 99m Tc-Labeled Human Serum Albumin Scintigraphy in Dogs With Protein-Losing Enteropathy

Engelmann N, Ondreka N, von Pückler K, Mohrs S, Sicken J, Neiger R. 

Background:Diagnosis of protein loss into the gastrointestinal tract using noninvasive techniques is challenging. In people, scintigraphy not only is a sensitive tool to confirm protein-losing enteropathy (PLE), but it also allows for localization of protein loss.

Hypothesis/objectives: To investigate the feasibility of 99m Tc-labeled human serum albumin (HSA) scintigraphy in dogs with PLE in comparison with control dogs.

Animals: A total of 8 clinically healthy control research dogs and 7 client-owned dogs with gastrointestinal clinical signs and hypoalbuminemia (serum albumin concentration <2.0 g/dL).

Methods: Prospective case-control study. After IV injection of 400 MBq freshly prepared 99m Tc HSA (30 mg/dog), images of the abdomen were obtained 10, 60, 120, and 240 minutes postinjection. Additional images of the salivary and thyroid glands were obtained to rule out free 99m Tc. A scan was considered positive for PLE when radiopharmaceutical exudation was detectable in the intestinal tract.

Results: Only 1 control dog showed exudation of the radiopharmaceutical into the intestinal tract. No free 99m Tc was detected in any dog. In dogs with PLE, focal small intestinal and diffuse small intestinal radiopharmaceutical exudation into the bowel was detected in 2 and 3 dogs, respectively, whereas in 2 dogs, there was disagreement about whether radiopharmaceutical exudation was focal or diffuse.

Conclusion and clinical importance: 99m Tc-labeled HSA scintigraphy was feasible to diagnose PLE in dogs.

(J Vet Intern Med. 2017 Mar;31(2):365-370)


Histopathologic Characteristics of Intestinal Biopsy Samples from Dogs With Chronic Inflammatory Enteropathy With and Without Hypoalbuminemia.

Wennogle SA, Priestnall SL, Webb CB.

Background: Previous studies have identified hypoalbuminemia as a risk factor for negative outcome in dogs with chronic enteropathy (CE), but it has not been determined whether histopathology differs between CE dogs with and without hypoalbuminemia.

ObjectiveTo compare histopathologic findings in dogs with biopsy-diagnosed inflammatory CE with and without hypoalbuminemia.

Animals: 83 dogs that had intestinal biopsy performed between January 2010-July 2015. Dogs had signs compatible with CE of at least 3-weeks' duration and no evidence of clinically relevant extra-gastrointestinal (GI) disease or potential non-GI causes of hypoalbuminemia. Dogs had primary diagnosis of inflammatory enteritis based on histopathology.

Methods: Dogs were grouped into CE with normoalbuminemia (CEN; serum albumin concentration ≥3.0 g/dL, N = 46) or chronic enteropathy with hypoalbuminemia (CEH; serum albumin concentration <3.0 g/dL, N = 37). A pathologist (SLP) blinded to the groups reviewed biopsy samples and applied the World Small Animal Veterinary Association scoring system to all samples.

Results: Intestinal biopsy samples from dogs in the CEH group were significantly more likely to display villous stunting, epithelial injury, crypt distension, and lacteal dilatation, and were more likely to have intraepithelial lymphocytes and lamina propria neutrophils than biopsy samples from dogs in the CEN group. Additionally, higher scores for each of the above listed histopathologic criteria were associated with a lower serum albumin concentration.

Conclusion and clinical importanceHistopathologic features of chronic inflammatory enteropathy differ between dogs that are hypo- versus normoalbuminemic. Additional work is needed to elucidate the clinical relevance of these differences.

(J Vet Intern Med. 2017 Mar;31(2):371-376)


Efficacy of a Probiotic-Prebiotic Supplement on Incidence of Diarrhea in a Dog Shelter: A Randomized, Double-Blind, Placebo-Controlled Trial    

Rose L, Rose J, Gosling S, Holmes M.

Background: Diarrhea is the most frequent morbidity affecting kenneled dogs in animal shelters. Diarrhea impacts animal welfare and the finances of the shelter as they must treat, clean, and house affected animals until recovered.

Hypothesis/Objectives: Supplementing dogs entering an animal shelter with a probiotic-prebiotic, known as a synbiotic, will decrease the incidence of diarrhea.

Animals: Seven hundred and seventy-three dogs entering an animal shelter in the United Kingdom.

Methods: A prospective double-blind, randomized, placebo-controlled trial.

Results: Statistical difference was found between the groups across 3 measures of diarrhea incidence. First, the mean percentage of scored days per dog that were scored as diarrhea throughout their stay was 2.0% in the synbiotic group and 3.2% in the placebo group (P = .0022). Second, the occurrence of diarrhea within the first 14 days' stay was 18.8% in the synbiotic product group and 27.2% in the placebo group (P = .0008). Third, the occurrence of ≥2 consecutive days of diarrhea within the first 14 days' stay was 4.6% in the synbiotic product group and 8.0% in the placebo group (P = .0300).

Conclusion and clinical importanceSupplementing healthy dogs entering an animal shelter with a synbiotic supplement significantly decreased the incidence of diarrhea in this trial. Animal shelters can use synbiotic supplements to improve animal welfare and decrease costs involved in cleaning and housing animals as well as potentially decreasing veterinary intervention.

 

 (J Vet Intern Med. 2017 Mar;31(2):377-382)


Prevalence of Gastroesophageal Reflux in Cats During Anesthesia and Effect of Omeprazole on Gastric pH

Garcia RS, Belafsky PC, Della Maggiore A, Osborn JM, Pypendop BH, Pierce T, Walker VJ, Fulton A, Marks SL.

BACKGROUND: Gastroesophageal reflux (GER) is poorly characterized in anesthetized cats, but can cause aspiration pneumonia, esophagitis, and esophageal stricture formation.

OBJECTIVE: To determine whether pre-anesthetic orally administered omeprazole increases gastric and esophageal pH and increases serum gastrin concentrations in anesthetized cats, and to determine the prevalence of GER using combined multichannel impedance and pH monitoring.

ANIMALS: Twenty-seven healthy cats undergoing elective dental procedures.

METHODS: Prospective, double-masked, placebo-controlled, randomized clinical trial. Cats were randomized to receive 2 PO doses of omeprazole (1.45-2.20 mg/kg) or an empty gelatin capsule placebo 18-24 hours and 4 hours before anesthetic induction. Blood for measurement of serum gastrin concentration was collected during anesthetic induction. An esophageal pH/impedance catheter was utilized to continuously measure esophageal pH and detect GER throughout anesthesia.

RESULTS: Mean gastric pH in the cats that received omeprazole was 7.2 ± 0.4 (range, 6.6-7.8) and was significantly higher than the pH in cats that received the placebo 2.8 ± 1.0 (range, 1.3-4.1; P < .001). Omeprazole administration was not associated with a significant increase in serum gastrin concentration (P = .616). Nine of 27 cats (33.3%) had ≥1 episode of GER during anesthesia.

CONCLUSIONS AND CLINICAL RELEVANCE: Pre-anesthetic administration of 2 PO doses of omeprazole at a dosage of 1.45-2.20 mg/kg in cats was associated with a significant increase in gastric and esophageal pH within 24 hours, but was not associated with a significant increase in serum gastrin concentration. Prevalence of reflux events in cats during anesthesia was similar to that of dogs during anesthesia.

 

(J Vet Intern Med. 2017 May;31(3):734-742) 


Pharmacokinetics and Acid Suppressant Efficacy of Esomeprazole after Intravenous, Oral, and Subcutaneous Administration to Healthy Beagle Dogs.

Hwang JH, Jeong JW, Song GH, Koo TS, Seo KW.

BACKGROUND: Esomeprazole is an S-enantiomer of omeprazole that has favorable pharmacokinetics and efficacious acid suppressant properties in humans. However, the pharmacokinetics and effects on intragastric pH of esomeprazole in dogs have not been reported.

OBJECTIVE: To determine the pharmacokinetics of esomeprazole administered via various routes (PK study) and to investigate the effect of esomeprazole on intragastric pH with a Bravo pH monitoring system (PD study).

ANIMALS: Seven adult male Beagle dogs and 5 adult male Beagle dogs were used for PK and PD study, respectively.

METHODS: Both studies used an open, randomized, and crossover design. In the PK study, 7 dogs received intravenous (IV), subcutaneous (SC), and oral doses (PO) of esomeprazole (1 mg/kg). Each treatment period was separated by a washout period of at least 10 days. Esomeprazole plasma concentrations were measured by HPLC/MS/MS. In the efficacy study, intragastric pH was recorded without medication (baseline pH) and following IV, SC, and PO esomeprazole dosing regimens (1 mg/kg) in 5 dogs.

RESULTS: The bioavailability of esomeprazole administered as PO enteric-coated granules and as SC injections was 71.4 and 106%, respectively. The half-life was approximately 1 hour. Mean ± SD percent time intragastric pH was ≥3 and ≥4 was 58.9 ± 21.1% and 40.9 ± 17.3% for IV group, 75.8 ± 16.4% and 62.7 ± 17.7% for SC group, 88.2 ± 8.9% and 82.5 ± 7.7% for PO group, and 12.5 ± 3.6% and 3.7 ± 1.8% for baseline. The mean percent time with intragastric pH was ≥3 or ≥4 was significantly increased regardless of the dosing route (P < .05).

CONCLUSION: The PK parameters for PO and SC esomeprazole administration were favorable, and esomeprazole significantly increased intragastric pH after IV, PO, and SC administration. IV and SC administration of esomeprazole might be useful when PO administration is not possible. No significant adverse effects were observed.

 

(J Vet Intern Med. 2017 May;31(3):743-750)


Interobserver Agreement Using Histological Scoring of the Canine Liver 

Lidbury JA, Rodrigues Hoffmann A, Ivanek R, Cullen JM, Porter BF, Oliveira F, Van Winkle TJ, Grinwis GC, Sucholdolski JS, Steiner JM.

BACKGROUND: Grading schemes for the assessment of hepatic fibrosis and necroinflammatory activity in humans previously have been applied to dogs with chronic hepatitis. Interobserver agreement is a desirable characteristic for any histological scoring scheme.

HYPOTHESIS/OBJECTIVES: To assess interobserver agreement associated with pathologists using a previously published histological scoring scheme to assess hepatic fibrosis and necroinflammatory activity in dogs and to compare fibrosis scores assigned to serial sections stained with hematoxylin & eosin (H&E) and picrosirius red.

ANIMALS: Histological sections of liver from 50 dogs with variable degrees of hepatic fibrosis and necroinflammatory activity were selected from institutional tissue archives.

METHODS: Six board-certified veterinary anatomic pathologists assigned fibrosis and necroinflammatory activity scores to the histological sections. The multiuser kappa statistic was calculated to assess interobserver agreement. Fibrosis stage assigned to serial sections stained with picrosirius red and H&E was compared using the Wilcoxon signed-rank test.

RESULTS: Multiuser kappa statistics for assessment of fibrosis and necroinflammatory activity from H&E-stained sections were 0.35 and 0.16, respectively. There was no difference in median fibrosis scores assigned to serial section stained with H&E and picrosirius red (P = .248).

CONCLUSIONS AND CLINICAL IMPORTANCE: There was fair interobserver agreement when pathologists assessed fibrosis and poor agreement when they assessed necroinflammatory activity. This suboptimal agreement must be taken into account by clinicians making decisions based on histology reports of the liver and in the design of studies evaluating these findings. To decrease this variability, ideally >1 pathologist should evaluate each section.

(J Vet Intern Med. 2017 May;31(3):778-783)


Sensitivity and Specificity of Plasma ALT, ALP, and Bile Acids for Hepatitis in Labrador Retrievers 

Dirksen K, Burgener IA, Rothuizen J, van den Ingh TSGAM, Penning LC, Spee B, Fieten H.

BACKGROUND: Biochemical indicators for diagnosing liver disease are plasma alanine aminotransferase activity (ALT), alkaline phosphatase activity (ALP), and bile acid concentration (BA).

OBJECTIVES: To determine the sensitivity and specificity of ALT, ALP, and BA for detecting primary hepatitis (PH) in clinically healthy Labrador retrievers and investigate whether ALT and ALP can discriminate between dogs with PH and nonspecific reactive hepatitis (RH).

ANIMALS: 191 clinically healthy and 51 clinically ill Labrador retrievers with hepatic histopathology.

METHODS: Retrospective study. Medical records were reviewed for ALT, ALP, preprandial BA, liver histopathology, and hepatic copper concentrations.

RESULTS: In 64% (122/191) of the clinically healthy Labrador retrievers, hepatic histology revealed inflammatory infiltrates. This frequency might be biased because part of them was included as first-line relatives of dogs with copper-associated hepatitis. Sensitivity of ALT, ALP, and BA in this population for detecting acute hepatitis was 45, 15, and 15%, respectively. For chronic hepatitis, sensitivity was 71, 35, and 13%, respectively. Specificity of ALT, ALP, and BA was >90% for AH, CH, and RH. When increased liver enzymes were present, median ALT was significantly higher in PH cases (312 U/L, range 38-1,369) compared to RH cases (91 U/L, range 39-139) (P < .001). There was no difference in ALP between dogs with a PH and a RH (P = .361).

CONCLUSIONS AND CLINICAL IMPORTANCE: Histopathologic abnormalities in the liver were present in the majority of apparent clinically healthy Labrador retrievers. The sensitivity of ALT, ALP, and BA for detecting acute and chronic hepatitis in this population was low. More sensitive biomarkers are needed for early detection of liver disease in apparent clinically healthy dogs.

(J Vet Intern Med. 2017 Jul;31(4):1017-1027)


Chronic Diarrhea in Dogs - Retrospective Study in 136 Cases 

Volkmann M, Steiner JM, Fosgate GT, Zentek J, Hartmann S, Kohn B.

BACKGROUND: Chronic diarrhea (CD) is common in dogs, and information on frequency and distribution of primary and secondary causes is lacking.

OBJECTIVES: To evaluate underlying causes and predictors of outcome in dogs with CD.

ANIMALS: One hundred and thirty-six client-owned dogs with CD (≥3 weeks duration).

METHODS: Retrospective review of medical records (Small Animal Clinic, Freie Universität Berlin, Germany, 09/2009-07/2011). Quantification of final diagnoses and comparison of clinical aspects including disease severity and clinicopathological abnormalities among dogs with clinical remission (either complete [gastrointestinal signs absent] or partial [clinical improvement of gastrointestinal signs and reduced episodes with shortened duration]), and those without recovery.

RESULTS: Ninety percent of dogs were diagnosed with a primary enteropathy: inflammatory (71%; of those 66% dietary responsive, 23% idiopathic, 11% antibiotic responsive), infectious (13%), neoplastic (4%), and in one dog each mechanical disease or systemic vasculitis. Secondary causes were diagnosed in 10% of dogs: exocrine pancreatic (6%), endocrine (2%), and in one dog each hepatic, renal, and cardiac disease. In total, 87% of dogs had clinical remission, whereas 13% died or did not respond to treatment: Lack of recovery was frequently recorded for dogs with primary inflammatory (idiopathic) or neoplastic disease and was significantly associated with increased disease severity scores (P = .005), anemia (hematocrit < 40%, P < .001), severe hypoalbuminemia (serum albumin <2.0 g/dL, P = .008), and severe hypocobalaminemia (serum cobalamin concentration <200 pg/mL, P = .006).

CONCLUSIONS AND CLINICAL IMPORTANCE: Inflammatory enteropathies and particularly those of dietary origin were the most common causes of CD in dogs. Findings support the usefulness of hematocrit, and serum albumin and cobalamin concentration as prognostic markers in dogs with CD.

 (J Vet Intern Med. 2017 Jul;31(4):1043-1055)


Evaluation of Serum 3-Bromotyrosine Concentrations in Dogs with Steroid-Responsive Diarrhea and Food-Responsive Diarrhea

Sattasathuchana P, Allenspach K, Lopes R, Suchodolski JS, Steiner JM.

BACKGROUND: The clinical usefulness of serum 3-BrY concentrations for subclassifying dogs with food-responsive diarrhea (FRD) and steroid-responsive diarrhea (SRD) has not been studied.

HYPOTHESIS/OBJECTIVES: To compare serum 3-BrY concentrations in dogs with FRD, dogs with SRD, and healthy control dogs.

ANIMALS: 38 dogs with FRD, 14 dogs with SRD, and 46 healthy dogs.

METHODS: Prospective study. Measurement of 3-BrY concentration in serum samples was performed by gas chromatography/mass spectrometry.

RESULTS: There was no association of peripheral eosinophilia in dogs with FRD, SRD, and healthy control dogs (P = 0.069). There was no significant correlation between peripheral eosinophil counts and serum 3-BrY concentrations (ρ = -0.15, P = 0.13). Serum 3-BrY concentrations in dogs with SRD (median [range] = 3.27, 0.9-26.23 μmol/L) were significantly higher than in dogs with FRD (median [range] = 0.99, 0.62-8.82 μmol/L; P = 0.007) or in healthy dogs (median [range] = 0.62, 0.62-1.79 μmol/L; P < 0.001). Also, serum 3-BrY concentrations in dogs with FRD were significantly higher than in healthy dogs (P = 0.025). There was no significant correlation between the canine chronic enteropathy clinical activity index and serum 3-BrY concentrations (ρ = 0.17, P = 0.23).

CONCLUSIONS AND CLINICAL IMPORTANCE: Measurement of serum 3-BrY concentrations, but not the peripheral eosinophil count, is helpful for detecting dogs with SRD and FRD.

 

(J Vet Intern Med. 2017 Jul;31(4):1056-1061)


Use of a Granulocyte Immunofluorescence Assay Designed for Humans for Detection of Antineutrophil Cytoplasmic Antibodies in Dogs with Chronic Enteropathies

Florey J, Viall A, Streu S, DiMuro V, Riddle A, Kirk J, Perazzotti L, Affeldt K, Wagner R, Vaden S, Harris T, Allenspach K.

BACKGROUND: Perinuclear antineutrophil cytoplasmic antibodies (pANCA) previously have been shown to be serum markers in dogs with chronic enteropathies, with dogs that have food-responsive disease (FRD) having higher frequencies of seropositivity than dogs with steroid-responsive disease (SRD). The indirect immunofluorescence (IIF) assay used in previous publications is time-consuming to perform, with low interobserver agreement.

HYPOTHESIS/OBJECTIVES: We hypothesized that a commercially available granulocyte IIF assay designed for humans could be used to detect perinuclear antineutrophil cytoplasmic antibodies in dogs.

ANIMALS: Forty-four dogs with FRD, 20 dogs with SRD, 20 control dogs, and 38 soft-coated wheaten terrier (SCWT) or SCWT-cross dogs.

METHODS: A granulocyte assay designed for humans was used to detect pANCA, cANCA, and antinuclear antibodies (ANA), as well as antibodies against proteinase-3 protein (PR-3) and myeloperoxidase protein (MPO) in archived serum samples.

RESULTS: Sensitivity of the granulocyte assay to predict FRD in dogs was 0.61 (95% confidence interval (CI), 0.45, 0.75), and specificity was 1.00 (95% CI, 0.91, 1.00). A significant association was identified between positive pANCA or cANCA result and diagnosis of FRD (P < 0.0001). Agreement between the two assays to detect ANCA in the same serum samples from SCWT with protein-losing enteropathy/protein-losing nephropathy (PLE/PLN) was substantial (kappa, 0.77; 95% CI, 0.53, 1.00). Eight ANCA-positive cases were positive for MPO or PR-3 antibodies.

CONCLUSIONS AND CLINICAL IMPORTANCE: The granulocyte immunofluorescence assay used in our pilot study was easy and quick to perform. Agreement with the previously published method was good.

(J Vet Intern Med. 2017 Jul;31(4):1062-1066)


Whole-Blood Taurine Concentrations in Cats With Intestinal Disease

Kathrani A, Fascetti AJ, Larsen JA, Maunder C, Hall EJ.

BACKGROUND: Increased delivery of taurine-conjugated bile acids to the distal bowel can lead to dysbiosis resulting in colitis in mouse models of inflammatory bowel disease. A similar situation also could occur in cats with intestinal disease and might therefore result in decreased whole-body taurine concentration.

HYPOTHESIS/OBJECTIVES: To determine whether whole-blood taurine concentrations are decreased at the time of diagnosis in cats with intestinal disease and to correlate concentrations with clinical and laboratory variables.

ANIMALS: Twenty-one cats with chronic inflammatory enteropathy and 7 cats with intestinal neoplasia from the University of Bristol.

METHODS: Cats that had undergone a thorough investigation consisting of a CBC, serum biochemistry, serum cobalamin and folate concentrations, transabdominal ultrasound examination and histopathology of intestinal biopsy specimens, as well as additional testing if indicated, were included. Whole-blood from these cats collected at the time of histologic diagnosis and stored in ethylenediaminetetraacetic acid was retrospectively analyzed for taurine with an automated high-performance liquid chromatography amino acid analyzer.

RESULTS: Although whole-blood taurine concentrations remained within the reference range, those cats with predominantly large intestinal clinical signs had significantly lower concentrations than did cats with small intestinal and mixed bowel clinical signs (P = 0.033) and this difference also was significant when assessed only in cats with chronic inflammatory enteropathy (P = 0.019).

CONCLUSIONS AND CLINICAL IMPORTANCE: Additional studies are needed to determine whether large intestinal signs in cats with chronic inflammatory enteropathy are caused by alterations in the microbiota arising as a consequence of increased delivery of taurine-conjugated bile acids.

(J Vet Intern Med. 2017 Jul;31(4):1067-1073)


Diagnostic contribution of cytological specimens obtained from biopsies during gastrointestinal endoscopy in dogs and cats

G. Ruiz, L. Verrot, E. Laloy, G. Benchekroun

Objectives The aims of this study were to compare cytological samples obtained from endoscopic biopsies using “imprint” and “squash” techniques, and to evaluate the potential value of cytology compared to histology in reaching the diagnosis.

Materials and Methods Eighteen dogs and five cats undergoing endoscopy for chronic gastrointestinal signs were prospectively included. Imprint and squash samples were obtained from one biopsy and then analysed. Comparison between cytology and histology was performed using Cohen's j coefficient.

Results Appropriate samples for cytological evaluation were more often obtained with the squash technique (96% of the cases versus 68% with the imprint technique). The diagnoses obtained with cytological samples and by histology, considered as the gold standard, were compared. The same diagnosis was obtained with the squash technique in 65% of the cases. Furthermore, cytology was considered complementary to histology for gastric spiral organisms and mast cells identification.

Clinical Significance These results suggest that squash cytology obtained from endoscopic biopsies of the gastrointestinal tract can provide relevant and additional information to histology in dogs and cats.

(J Small Anim Pract, 58: 17–22)


Clinical findings and results of diagnostic imaging in 82 dogs with gastrointestinal ulceration

E. Fitzgerald, D. Barfield, K. C. L. Lee, C. R. Lamb

Objectives To describe clinical and imaging findings in dogs with confirmed gastrointestinal ulceration, to compare findings in dogs with perforated and non-perforated ulcers and to estimate the sensitivities of radiography, ultrasonography and computed tomography (CT) for gastrointestinal ulceration and perforation.

Methods Retrospective review of medical records of 82 dogs that had a macroscopic ulcer in the gastric or intestinal mucosa diagnosed directly at endoscopy, surgery or necropsy and had survey radiography, ultrasonography or a CT scan of the abdomen during the same period of hospitalisation.

Results The most frequent clinical signs were vomiting in 88% dogs, haematemesis in 32%, melaena in 31% and weight loss in 7%. The most frequent imaging findings in dogs with non-perforated ulcers were gastrointestinal mural lesion in 56%, mucosal defect compatible with an ulcer in 44% and peritoneal fluid in 21%. In dogs with perforated ulcers the most frequent imaging findings were peritoneal fluid in 83%, gastrointestinal mural lesion in 48%, peritoneal gas in 31% and mucosal defect compatible with an ulcer in 29%. Sensitivities of radiography, ultrasonography and CT were 30, 65 and 67% in dogs with non-perforated ulcers and 79, 86 and 93% in dogs with perforated ulcers, respectively.

Clinical Significance In dogs with non-perforated ulcers, survey radiography was usually negative whereas ultrasonography and CT frequently enabled detection of the site of the ulcer; in dogs with perforated ulcers, radiography was frequently positive for peritoneal gas and CT was a sensitive modality for both the ulcer and signs of perforation.

(J Small Anim Pract. 2017 Apr;58(4):211-218)


Gastro-oesophageal reflux disease in 20 dogs (2012 to 2014) 

M. Muenster, A. Hoerauf, M. Vieth

Objectives To describe the clinical features of canine gastro-oesophageal reflux disease.

Materials and Methods A search of our medical records produced 20 dogs with clinical signs attributable to oesophageal disease, hyper-regeneratory oesophagopathy and no other oesophageal disorders. The clinical, endoscopic and histological findings of the dogs were analysed.

Results The 3-year incidence of gastro-oesophageal reflux disease was 0·9% of our referral dog population. Main clinical signs were regurgitation, discomfort or pain (each, 20/20 dogs) and ptyalism (18/20 dogs). Oesophagoscopy showed no (5/20 dogs) or minimal (13/20 dogs) mucosal lesions. In oesophageal mucosal biopsy specimens, there were hyperplastic changes of the basal cell layer (13/20 dogs), stromal papillae (14/20 dogs) and entire epithelium (9/20 dogs). Eleven dogs received omeprazole or pantoprazole and regurgitation and ptyalism improved in eight and pain diminished in six of these dogs within three to six weeks.

Clinical Significance Our findings suggest that canine gastro-oesophageal reflux disease is a more common clinical problem than hitherto suspected.

(J Small Anim Pract. 2017 May;58(5):276-283)


Treatment of inflammatory rectal strictures by digital bougienage: a retrospective study of nine cases

A. Lamoureux, C. Maurey, V. Freiche

Objectives Inflammatory rectal strictures in dogs and cats have been rarely reported. The aim of this study was to describe nine cases and their treatment by digital bougienage.

Methods Medical records of dogs and cats referred for constipation, dyschezia or tenesmus and diagnosed with an inflammatory rectal stricture were obtained from the database of two referral centres between 2007 and 2014 and reviewed.

Results Four dogs and five cats met the inclusion criteria. Four of the five cats were purebred kittens. Three cats and two dogs had a history of diarrhoea and two dogs had a history of bone ingestion. Digital rectal examination revealed rectal strictures in all cases. Histopathology revealed a lymphoplasmacytic infiltration in all four dogs and in two cats. All cases were treated by digital bougienage. A psyllium-enriched diet was prescribed in all cats and in two dogs. A complete resolution of clinical signs was reported in all eight cases for which follow-up information was available.

Clinical Significance Benign rectal strictures associated with gastrointestinal inflammation should be routinely included in the differential diagnosis of constipation, tenesmus and dyschezia, especially after an episode of acute or chronic diarrhoea. The treatment described here is simple, minimally invasive and effective in the long term.

(J Small Anim Pract. 2017 May;58(5):293-297)


Percutaneous ultrasound-guided cholecystocentesis: complications and association of ultrasonographic findings with bile culture results

F. Schiborra, J. F. McConnell, T. W. Maddox

Objectives To retrospectively evaluate cases presented for percutaneous ultrasound-guided cholecystocentesis for associated complications, identify risk factors associated with complications and to assess ultrasonographic findings and relate these to bacterial culture results.

Methods Data on 300 patients presented for percutaneous ultrasound-guided cholecystocentesis were retrospectively collected and ultrasonographic images were assessed for defined structural changes. The incidence of major complications was determined. Multi-variable multi-level logistic regression was used to investigate the association of ultrasonographic findings with positive bile culture.

Results Three hundred percutaneous ultrasound-guided cholecystocentesis procedures performed in 201 dogs and 51 cats were included; 35 patients had the procedure performed more than once. The overall incidence of major complications was 8 of 300 procedures (2·7%). Bile peritonitis occurred in 2 of 300 procedures (0·7%). An ultrasonographically abnormal gall bladder was found in 52% of cases and had a sensitivity, specificity and accuracy of 82, 55·7 and 61·5% respectively, to predict a positive bile culture.

Clinical Significance Percutaneous ultrasound-guided cholecystocentesis is overall a safe technique when carried out in selected patients. Abnormal ultrasonographic findings are only a fair predictor of a positive bile culture.

(J Small Anim Pract. 2017 Jul;58(7):389-394)


Efficacy of feline anti-parvovirus antibodies in the treatment of canine parvovirus infection

M. Gerlach, A. L. Proksch, S. Unterer, S. Speck, U. Truyen, K. Hartmann

Objective This prospective, randomised, placebo-controlled, double-blinded study aimed to evaluate efficacy of commercially available feline anti-parvovirus antibodies in dogs with canine parvovirus infection.

Methods First, cross-protection of feline panleukopenia virus antibodies against canine parvovirus was evaluated in vitro. In the subsequent prospective clinical trial, 31 dogs with clinical signs of canine parvovirus infection and a positive faecal canine parvovirus polymerase chain reaction were randomly assigned to a group receiving feline panleukopenia virus antibodies (n=15) or placebo (n=16). All dogs received additional routine treatment. Clinical signs, blood parameters, time to clinical recovery and mortality were compared between the groups. Serum antibody titres and quantitative faecal polymerase chain reaction were compared on days 0, 3, 7, and 14.

Results In vitro, canine parvovirus was fully neutralised by feline panleukopenia virus antibodies. There were no detected significant differences in clinical signs, time to clinical recovery, blood parameters, mortality, faecal virus load, or viral shedding between groups. Dogs in the placebo group showed a significant increase of serum antibody titres and a significant decrease of faecal virus load between day 14 and day 0, which was not detectable in dogs treated with feline panleukopenia virus antibodies.

Clinical Significance No significant beneficial effect of passively transferred feline anti-parvovirus antibodies in the used dosage regimen on the treatment of canine parvovirus infection was demonstrated.

 

(J Small Anim Pract, 58: 408–415)


Long-term serum bile acid concentrations in 51 dogs after complete extrahepatic congenital portosystemic shunt ligation

P. Bristow, M. Tivers, R. Packer, D. Brockman, V. Ortiz, K. Newson, V. Lipscomb 

Objectives To report the long-term bile acid stimulation test results for dogs that have undergone complete suture ligation of a single congenital extrahepatic portosystemic shunt.

Materials and Methods Data were collected from the hospital records of all dogs that had undergone a complete suture ligation of a single congenital extrahepatic portosystemic shunt. Owners were invited to return to the referral centre or their local veterinarian for repeat serum bile acid measurement. Dogs diagnosed with idiopathic epilepsy and undergoing bile acid stimulation tests were used as a comparison population.

Results Fifty-one study dogs were included, with a mean follow-up time of 62 months. 48 dogs had no evidence of multiple acquired shunts and a significant reduction in the pre- and post-prandial serum bile acid concentrations at long-term follow-up compared with pre-operative measurements. Pre- and post-prandial serum bile acids were statistically significantly greater for dogs that had undergone a full ligation (with no evidence of multiple acquired shunts) at all time points compared to the control dogs (P<0·001 for all comparisons).

Clinical Significance The results suggest that in dogs treated with complete suture ligation mild increases in serum bile acids are not clinically relevant if there are no physical examination abnormalities, a normal body condition score and no relapse in clinical signs. 

 

(J Small Anim Pract, 58: 454–460)


The incidence of surgical site dehiscence following full-thickness gastrointestinal biopsy in dogs and cats and associated risk factors 

F. Swinbourne, N. Jeffery, M.S. Tivers, R. Artingstall, F. Bird, T. Charlesworth, I. Doran, A. Freeman, J. Hall, R. Hattersley, J. Henken, J. Hughes, B. de la Puerta, L. Rutherford, T. Ryan, H. Williams, S. Woods, I. Nicholson

Objectives The objectives of this study were to: (1) document the incidence of surgical site dehiscence after full-thickness gastrointestinal biopsy in dogs and cats and (2) identify potential risk factors.

Methods Data relating to dogs and cats undergoing full-thickness gastrointestinal biopsy were reviewed retrospectively following submission of a completed questionnaire by 12 referral institutions. Outcome measures were definite dehiscence, possible dehiscence (clinical records suggestive of dehiscence but not confirmed), suspected dehiscence (definite and possible combined) and death within 14 days. Logistic regression was planned for analysis of association of dehiscence with low preoperative serum albumin, biopsy through neoplastic tissue, biopsy alongside another major abdominal surgical procedure and biopsy of the colon.

Results Of 172 cats, two (1·2%) had definite dehiscence, and four (2·3%) had possible dehiscence. Low preoperative serum albumin was significantly associated with definite dehiscence in univariable analysis and with suspected dehiscence and death within 14 days in univariable analysis, but all odds ratios had wide 95% confidence intervals. A histopathological diagnosis of neoplasia was significantly associated with death within 14 days in univariable analysis. Of 195 dogs, two (1·0%) had definite dehiscence, and three (1·5%) had possible dehiscence. In dogs, there was no association between any outcome measure and the putative risk factors.

Clinical Significance Incidence of dehiscence following full-thickness gastrointestinal biopsy was low in this study. When determining the appropriateness of biopsy in individual cases, this information should be balanced against the potentially life-threatening consequences of dehiscence.

(J Small Anim Pract, 58: 495–503)


Comparison of two minimally invasive techniques for liver biopsy collection in dogs

N. Fernandez, J. del-Pozo, D. Shaw, A. I. C. Marques

Objectives High-quality biopsy is an essential factor for the successful diagnosis of canine liver disease. The aim of this study was to compare various aspects of biopsies obtained by two different techniques: pretied ligating loop and cup biopsy forceps.

Materials and Methods Fifteen client-owned dogs underwent laparoscopic liver biopsies for diagnosis of liver disease. Biopsies were obtained from the same liver lobe using a pre-tied ligating loop and cup biopsy forceps. Biopsy weight, volume, histological value and surgical time were compared between the two techniques. Surgical complications were recorded.

Results Samples obtained with the pre-tied ligating loop were significantly heavier and larger in volume than those obtained with cup biopsy forceps. Samples obtained with the ligating loop contained significantly more portal tracts and less crush and fragmentation artefacts. The time required to obtain a liver biopsy with the pre-tied ligating loop was approximately double that of the cup biopsy forceps technique.

Clinical Significance The use of a pre-tied ligating loop is a good alternative to the cup biopsy forceps technique when acquiring laparoscopic liver biopsies in dogs.

 

 (J Small Anim Pract, 58: 555–561)


Fine needle aspiration of abdominal organs: a review of current recommendations for achieving a diagnostic sample

R. Liffman, N. Courtman

With the improved accessibility to ultrasound, fine needle aspiration of abdominal organs is now performed frequently in many veterinary practices. Despite this, there are many ‘unknowns’ as to the best method to produce a high-quality sample. This report begins by highlighting recent literature on the risks and benefits of abdominal fine needle aspiration. It follows with recommendations about the equipment and method best suited to the procedure, including needle and syringe size and aspiration versus non-aspiration techniques. Various smear preparations and laboratory submission requirements are also discussed. The final aspect of the review more specifically discusses fine needle aspiration of specific abdominal organs: the liver, kidney, spleen, pancreas, urinary bladder, prostate and abdominal lymph nodes.

(J Small Anim Pract, 58: 599–609)


Colonoscopic and histologic features of rectal masses in dogs: 82 cases (1995–2012) 

Krista N. Adamovich-Rippe DVM; Philipp D. Mayhew BVM&S; Stanley L. Marks BVSc, PhD; Laura E. Selmic BVetMed, MPH; William T. N. Culp VMD; Angela M. Youello VMD, PhD; Jeffrey J. Runge VMD; David E. Holt BVSc; Philip H. Kass DVM, MPVM, PhD; John R. Peauroi DVM, MPVM

OBJECTIVE To evaluate colonoscopic and histologic features of rectal masses in dogs.

 

DESIGN Retrospective case series.

ANIMALS 82 client-owned dogs with rectal masses that underwent colonoscopy.

PROCEDURES Medical records of dogs with rectal masses that underwent colonoscopy were reviewed. History, signalment, clinical signs, results of physical examination, diagnostic imaging findings, and results of colonoscopy (including complications) were recorded. When available, tissue samples obtained during colonoscopy and by means of surgical biopsy were reviewed by a single board-certified pathologist. Histologic features and tumor grade (when applicable) of tissue samples obtained during colonoscopy versus surgical biopsy were compared.

RESULTS Multiple rectal masses were observed during colonoscopy in 6 of the 82 dogs, but no lesions were visualized orad to the colorectal junction. Results of histologic evaluation of surgical biopsy specimens were consistent with a diagnosis of epithelial neoplasia in 58 of 64 dogs, of which 71% were classified as benign adenoma or polyp and 29% were classified as adenocarcinoma in situ or adenocarcinoma. Complications of colonoscopy occurred in 3 of 82 dogs but were considered minor. A discrepancy in diagnosis occurred in 5 of 16 dogs for which both colonoscopic and surgical biopsy samples were available for histologic review.

 

CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that multiple rectal masses are uncommon in dogs, and secondary lesions orad to the colorectal junction were not found in this study. Colonoscopy was associated with few complications, but the need for colonoscopic assessment of the entire colon in this patient population may merit reevaluation.

(J Am Vet Med Assoc. 2017 Feb 15;250(4):424-430)


Agreement between microscopic examination and bacterial culture of bile samples for detection of bactibilia in dogs and cats with hepatobiliary disease

Medora B. Pashmakova DVM Julie Piccione DVM, MS Micah A. Bishop DVM, PhD Whitney R. Nelson DVM Sara D. Lawhon DVM, PhD

OBJECTIVE To evaluate the agreement between results of microscopic examination and bacterial culture of bile samples from dogs and cats with hepatobiliary disease for detection of bactibilia.

DESIGN Cross-sectional study.

ANIMALS 31 dogs and 21 cats with hepatobiliary disease for which subsequent microscopic examination and bacterial culture of bile samples was performed from 2004 through 2014.

PROCEDURES Electronic medical records of included dogs and cats were reviewed to extract data regarding diagnosis, antimicrobials administered, and results of microscopic examination and bacterial culture of bile samples. Agreement between these 2 diagnostic tests was assessed by calculation of the Cohen κ value.

RESULTS 17 (33%) dogs and cats had bactibilia identified by microscopic examination of bile samples, and 11 (21%) had bactibilia identified via bacterial culture. Agreement between these 2 tests was substantial (percentage agreement [positive and negative results], 85%; κ = 0.62; 95% confidence interval, 0.38 to 0.89) and improved to almost perfect when calculated for only animals that received no antimicrobials within 24 hours prior to sample collection (percentage agreement, 94%; κ = 0.84; 95% confidence interval, 0.61 to 1.00).

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that agreement between microscopic examination and bacterial culture of bile samples for detection of bactibilia is optimized when dogs and cats are not receiving antimicrobials at the time of sample collection. Concurrent bacterial culture and microscopic examination of bile samples are recommended for all cats and dogs evaluated for hepatobiliary disease.

(J Am Vet Med Assoc. 2017 May 1;250(9):1007-1013)


Evaluation of Gastroesophageal Reflux in Anesthetized Dogs with Brachycephalic Syndrome

Stephanie L. Shaver, DVM, DACVS-SA, Laura A. Barbur, DVM†, David A. Jimenez, DVM, DACVR, Benjamin M. Brainard, VDM, DACVAA, DACVECC, Karen K. Cornell, DVM, PhD, DACVS§, MaryAnn G. Radlinsky, DVM, MS, DACVS, Chad W. Schmiedt, DVM, DACVS

Brachycephalic airway syndrome may predispose to gastroesophageal reflux (GER) because of the high negative intrathoracic pressures required to overcome conformational partial upper airway obstruction. To investigate this, 20 dogs presenting for elective correction of brachycephalic airway syndrome (cases) and 20 non-brachycephalic dogs (controls) undergoing other elective surgeries were prospectively enrolled. Dogs underwent a standardized anesthetic protocol, and esophageal pH was monitored. Signalment, body weight, historical gastrointestinal and respiratory disease, complete blood count, serum biochemical values, radiographic findings, and anesthetic and surgical time were compared between cases and controls, and dogs that did and did not have basic (pH > 7.5), acidic (pH < 4), or any GER. Controls had higher mean esophageal pH (6.3) compared to cases (5.6, P = .019), but there was no difference in % with GER (cases 60%, controls 40%, P = .34). When all dogs were evaluated, dogs with GER had increased creatinine (P = .01), % positive for esophageal fluid on radiographs (P = .05), and body weight (P = .04) compared to those without GER. GER was common in both cases and controls, and cases had lower esophageal pH; however, greater numbers are required to determine if a true difference exists in % GER.

(Journal of the American Animal Hospital Association: January/February 2017, Vol. 53, No. 1, pp. 24-31)


Thromboembolism in Dogs with Protein-Losing Enteropathy with Non-Neoplastic Chronic Small Intestinal Disease

Ana M. L. Jacinto, DECVIM-CA, MRCVS, Alison E. Ridyard, BVSc, DSAM, DECVIM-CA, MRCVS*, Itamar Aroch, DVM, DECVIM-CA, Penny J. Watson, MA, VetMD, CertVR, DSAM, DECVIM-CA, MRCVS, Linda R. Morrison, DECVP, BVMS, FRCPath, FHEA, MRCVS, Marge L. Chandler, MS, MANZCVSc, DACVN, Dip. ACVIM, DECVIM-CA, MRCVS, Sharon Kuzi, DVM, DECVIM-CA

 

Dogs with protein-losing enteropathy (PLE) are suggested to be at increased risk of developing thromboembolic events. However, with some exceptions, there are very few reports of thromboembolism in such dogs. This multicentre retrospective observational study describes a case series of thromboembolism (TE) in eight dogs with PLE secondary to non-neoplastic, chronic small intestinal disease. Seven dogs had poorly controlled PLE when the thromboembolic event occurred. Pulmonary thromboembolism (PTE) occurred in six dogs, while one dog developed splenic vein thrombosis and another had concurrent splenic vein and aortic TE. Six dogs died, all with PTE. Antithrombin activity was decreased in one of two dogs in which it was measured. Serum cobalamin and folate concentrations were measured in three dogs and cobalamin was subnormal in all three. Serum magnesium, measured in two dogs, was low in both. Dogs with uncontrolled chronic small intestinal disease and PLE are at risk for developing serious life-threatening TE, mostly PTE.

(Journal of the American Animal Hospital Association: May/June 2017, Vol. 53, No. 3, pp. 185-192)


Faecal shedding of canine parvovirus after modified-live vaccination in healthy adult dogs 

M.Freisl, S.Speck, U.Truyen, S.Reese, A.-L.Proksch, K.Hartmann

Since little is known about the persistence and faecal shedding of canine parvovirus (CPV) in dogs after modified-live vaccination, diagnostic tests for CPV can be difficult to interpret in the post-vaccination period. The primary aim of this study was to determine the incidence, duration and extent of CPV vaccine virus shedding in adult dogs and to investigate related factors, including the presence of protective antibodies, increase in anti-CPV antibody titres and development of any gastrointestinal side-effects. A secondary objective was to assess prevalence of CPV field virus shedding in clinically healthy dogs due to subclinical infections. One hundred adult, healthy privately owned dogs were vaccinated with a commercial CPV-2 modified-live vaccine (MLV). Faeces were tested for the presence of CPV DNA on days 0 (prior to vaccination), 3, 7, 14, 21 and 28 by quantitative real-time PCR. Pre- and post-vaccination serum titres were determined by haemagglutination inhibition on days 0, 7 and 28.

Transient excretion of CPV DNA was detected in 2.0% of dogs before vaccination. About one quarter of dogs (23.0%) shed CPV DNA during the post-vaccination period, but field and vaccine virus differentiation by VP2 gene sequencing was only successful in few samples. Faecal CPV excretion occurred despite protective serum antibody titres. Post-vaccination CPV shedding was not related to adequate antibody response after vaccination or to the occurrence of gastrointestinal side-effects. Despite individual differences, CPV DNA was detectable for up to 28 days after vaccination, although the faecal CPV DNA load in these clinically healthy dogs was very low.

(Vet J. 2017 Jan;219:15-21)


Serum biomarkers of oxidative stress in dogs with idiopathic inflammatory bowel disease

P.Rubio, S.Martínez-Subiel, J.Hernández-Ruiz, A.Tvarijonaviciute, J.J.Cerón, K.Allenspach 

The objective of this work was to study and compare a panel of various serum biomarkers evaluating both the antioxidant response and oxidative damage in dogs with idiopathic inflammatory bowel disease (IBD). Eighteen dogs with IBD and 20 healthy dogs were enrolled in the study. Trolox equivalent antioxidant capacity (TEAC), cupric reducing antioxidant capacity (CUPRAC), ferric reducing ability of the plasma (FRAP), total thiol concentrations, and paraoxonase 1 (PON1) activity were evaluated in serum to determine antioxidant response. To evaluate oxidative status, ferrous oxidation-xylenol orange (FOX), thiobarbituric acid reactive substances (TBARS) and reactive oxygen species production (ROS) concentrations in serum were determined.

Mean concentrations of all antioxidant biomarkers analyzed, with exception of FRAP, were significantly lower (P < 0.0001) in the sera of dogs with IBD than in healthy dogs. The oxidant markers studied were significantly higher (P < 0.0001) in sera of dogs with IBD than in healthy dogs. These findings support the hypothesis that oxidative stress could play an important role in the pathogenesis of canine IBD.

 

(Vet J. 2017 Mar;221:56-61)