Randomized, Controlled, Crossover trial of Prevention of ClindamycinInduced Gastrointestinal Signs Using a Synbiotic in Healthy Research Cats

J.E. Stokes, J.M. Price, J.C. Whittemore

Vet Intern Med2017;31:1406–1413

Background

Synbiotics often are prescribed to limit antibiotic‐associated gastrointestinal signs (AAGS) in cats, but data to support this recommendation are lacking.

Objective

To determine whether synbiotic co‐administration mitigates AAGS in healthy research cats treated with clindamycin.

Animals

16 healthy research cats.

Methods

A randomized, double‐blinded, placebo‐controlled, 2‐way, 2‐period, crossover study with a 6‐week washout was performed. Each study period consisted of a 1‐week baseline and a 3‐week treatment period. Cats received 75 mg clindamycin with food once daily for 3 weeks, followed 1 hour later by either 2 capsules of a synbiotic or placebo. Food consumption, vomiting, fecal score, and completion of treatment were compared using repeated measures split plot or crossover designs with covariates, with P < 0.05 considered significant.

Results

Cats that received the synbiotic were more likely to complete treatment in period 1 (100% vs. 50%, P = 0.04). Cats vomited less when receiving the synbiotic but this was not significant, but there were significant period effects (F‐value = 11.4, P < 0.01). Cats had higher food intake while receiving the synbiotic (F‐value = 31.1, P < 0.01) despite period effects (F‐value = 8.6, P < 0.01). There was no significant effect of treatment on fecal scores, which significantly increased over time (F‐value = 17.9, P < 0.01).

Conclusions and Clinical Importance

Administration of a synbiotic 1 hour after clindamycin administration decreased hyporexia and vomiting in healthy cats. Additionally, significant period effects suggest that clinical benefits of synbiotic administration persist for at least 6 weeks after discontinuation, decreasing the severity of AAGS in cats that subsequently received clindamycin with placebo. Unlike in people, synbiotic administration did not decrease antibiotic‐associated diarrhea.


Evaluation of Gastric pH and Serum Gastrin Concentrations in Cats with Chronic Kidney Disease

M.K. Tolbert, S. Olin, S. MacLane, E. Gould, J.M. Steiner, S. Vaden, J. Price

J Vet Intern Med2017;31:1414–1419

Background

Chronic kidney disease (CKD) is a highly prevalent condition in cats. Advanced CKD is associated with hyporexia and vomiting, which typically are attributed to uremic toxins and gastric hyperacidity. However, gastric pH studies have not been performed in cats with CKD.

Hypothesis/Objectives

To determine if cats with CKD have decreased gastric pH compared to age‐matched, healthy cats. Based on previous work demonstrating an association of hypergastrinemia and CKD, we hypothesized that cats with CKD would have decreased gastric pH compared to healthy, age‐matched control cats.

Animals

10 CKD cats; 9 healthy control cats.

Methods

All cats with concurrent disease were excluded on the basis of history, physical examination, CBC, plasma biochemistry profile, urinalysis, urine culture, serum total thyroxine concentration, and serum symmetric dimethylarginine concentration (controls only) obtained within 24 hours of pH monitoring and assessment of serum gastrin concentrations. Serum for gastrin determination was collected, and 12‐hour continuous gastric pH monitoring was performed in all cats. Serum gastrin concentration, mean pH, and percentage time that gastric pH was strongly acidic (pH <1 and <2) were compared between groups.

Results

No significant differences in serum gastrin concentrations were observed between groups (medians [range]: CKD, 18.7 ng/dL [<10–659.0]; healthy, 54.6 ng/dL [<10–98.0]; P‐value = 0.713) or of any pH parameters including mean ± SD gastric pH (CKD, 1.8 ± 0.5; healthy, 1.6 ± 0.3; P‐value = 0.23).

Conclusions and Clinical Importance

These findings suggest that cats with CKD may not have gastric hyperacidity compared to healthy cats and, therefore, may not need acid suppression. Thus, further studies to determine if there is a benefit to acid suppression in cats with CKD are warranted.


Association between Gallbladder Ultrasound Findings and Bacterial Culture of Bile in 70 Cats and 202 Dogs

R. Policelli Smith, J.L. Gookin, W. Smolski, M.F. Di Cicco, M. Correa, G.S. Seiler

J Vet Intern Med2017;31:1451–1458

Background

Bacterial cholecystitis often is diagnosed by combination of gallbladder ultrasound (US) findings and positive results of bile culture. The value of gallbladder US in determining the likelihood of bile bacterial infection in cats and dogs with suspected biliary disease is unknown.

Hypothesis/Objectives

To determine the value of gallbladder US in predicting bile bacterial culture results, identify most common bacterial isolates from bile, and describe complications after cholecystocentesis in cats and dogs with suspected hepatobiliary disease.

Animals

Cats (70) and dogs (202) that underwent an abdominal US and submission of bile for culture were included in the study.

Methods

A cross‐sectional study design was used to determine the association of gallbladder US abnormalities and the results of bile cultures, and complications of cholecystocentesis.

Results

Abnormal gallbladder US had high sensitivity (96%) but low specificity (49%) in cats with positive and negative results of bile bacterial culture, respectively. Cats with normal gallbladder US findings were unlikely to have positive bile bacterial culture (negative predictive value of 96%). Gallbladder US had lower sensitivity (81%), specificity (31%), positive predictive value (20%), and negative predictive value (88%) in dogs. The most common bacterial isolates were of enteric origin, the prevalence being higher in cats. Incidence of complications after cholecystocentesis was 3.4%.

Conclusions and clinical importance

Gallbladder US has a high negative predictive value for bile culture results in cats. This modality is less predictive of infection in dogs. Percutaneous US‐guided cholecystocentesis has a low complication rate.


Effects of 6 Weeks of Parenteral Cobalamin Supplementation on Clinical and Biochemical Variables in Cats with Gastrointestinal Disease

J. Kempf, M. Hersberger, R.H. Melliger, C.E. Reusch, P.H. Kook

J Vet Intern Med2017;31:1664–1672

Background

Effects and duration of commonly used protocols for cobalamin (Cbl) supplementation on cellular Cbl deficiency have not been determined in hypocobalaminemic cats.

Hypothesis/Objectives

To evaluate effect of Cbl supplementation on clinical signs, serum and urine methylmalonic acid (MMA) concentrations over 16 weeks.

Animals

Twenty client‐owned hypocobalaminemic cats with enteropathy.

Methods

Prospective study. Serum Cbl and serum and urine MMA concentrations were determined prospectively in cats at enrollment (t0), immediately before (t6), and 4 (t10) and 10 weeks (t16) after 6th Cbl injection (250 μg, IM q 7 days). Clinical signs severity (activity, appetite, vomiting, diarrhea, body weight) graded at each time point and expressed as clinical disease activity score.

Results

Clinical disease activity score decreased during supplementation and increased after treatment discontinuation. Median serum Cbl concentration increased significantly from t0 (111 pmol/L, range 111–212) to t6 (2,332.5 pmol/L, range 123–22,730) (P < 0.01). Values at t10 were 610.5 pmol/L (range, 111–2,527) and 180.5 pmol/L (range, 111–2,262) at t16 (P < 0.01). Median baseline serum MMA concentration (372 μmol/L, range 0.39–147,000) decreased significantly to 1.62 μmol/L (range, 0.18–806) at t6 (P < 0.01) and gradually increased to 5.34 μmol/L (range, 0.13–1,730) at t10 and 189 μmol/L (range, 0.4–983) at t16. Similar, nonsignificant, pattern observed for urine MMA concentration. Serum and urine MMA concentrations had not normalized in 12 and 6 cats, respectively, at t6.

Conclusion and Clinical Importance

The Cbl supplementation protocol used here did not lead to complete normalization of cellular Cbl deficiency in all examined cats, and biochemical improvements were transient.


Effect of Laparoscopicassisted Gastropexy on Gastrointestinal Transit Time in Dogs

I.M. Balsa, W.T.N. Culp, K.J. Drobatz, E.G. Johnson, P.D. Mayhew, S.L. Marks

J Vet Intern Med2017;31:1680–1685

Background

Prophylactic gastropexy has been promoted as a means of preventing gastric volvulus during gastric dilatation and volvulus (GDV) syndrome. Little is known about the impact of gastropexy on gastrointestinal transit time.

Hypothesis

Laparoscopic‐assisted gastropexy (LAG) will not alter gastrointestinal transit times when comparing gastric (GET), small and large bowel (SLBTT), and whole gut transit times (TTT) before and after surgery.

Animals

10 healthy client‐owned large‐breed dogs.

Methods

Prospective clinical trial. Before surgery, all dogs underwent physical examination and diagnostic evaluation to ensure normal health status. Dogs were fed a prescription diet for 6 weeks before determination of gastrointestinal transit with a wireless motility capsule. LAG was then performed, and dogs were fed the diet for 6 additional weeks. Measurement of transit times was repeated 6 weeks after surgery.

Results

Ten dogs of various breeds at‐risk for GDV were enrolled. No complications were encountered associated with surgery or capsule administration. There were no significant differences in GET 429 [306–1,370] versus 541 [326–1,298] (P = 0.80), SLBTT 1,243 [841–3,070] versus 1,540 [756–2,623] (P = 0.72), or TTT 1,971 [1,205–3,469] versus 1,792 [1,234–3,343] minutes (median, range) (P = 0.65) before and after LAG.

Conclusions and Clinical Importance

An effect of LAG on gastrointestinal transit time was not identified, and wireless motility capsule can be safely administered in dogs after LAG.


Risk Factors for Death in Dogs Treated for Esophageal Foreign Body Obstruction: A Retrospective Cohort Study of 222 Cases (1998–2017)

A.G. Burton, C.T. Talbot, M.S. Kent

J Vet Intern Med2017;31:1686–1690

Background

Limited data exist describing risk factors for death, and long‐term outcomes in dogs with esophageal foreign body (EFB) obstruction.

Hypothesis/Objectives

To evaluate short‐ and long‐term outcomes, and analyze risk factors for death in dogs with EFB obstruction. We hypothesized duration of entrapment and treatment type would affect outcome.

Animals

A total of 222 dogs were treated for EFB obstruction at an emergency and referral hospital between March 1998 and March 2017.

Methods

Medical records for dogs with EFB were retrospectively evaluated.

Results

Foreign material most frequently was osseous (180/222 [81%]), with distal esophagus the most common location (110/222 [49.5%]). Duration of clinical signs was not associated with risk of death (OR = 1.08, 95% CI 0.99–1.17; P = 0.2). Entrapment was treated by endoscopy (204/222 [91.8%]), surgery after endoscopic attempt (13/222 [5.9%]), and repeat endoscopy after surgery was recommended but declined (5/222 [2.3%]). In‐hospital case fatality rate was 11/222 (5%). Risk of death was significantly higher with surgery (OR = 20.1, 95% CI 3.59–112.44; P = 0.001), and 5/5 (100%) of dogs died if undergoing endoscopy after surgery was recommended but declined. Increasing numbers of postprocedural complications (OR = 3.44, CI 2.01–5.91; P < 0.001), esophageal perforation (OR = 65.47, CI 4.27–1004.15; P = 0.003), and postprocedure esophageal hemorrhage (OR = 11.81, CI 1.19–116.77; P = 0.04) increased in‐hospital risk of death. Esophageal strictures were reported in 4/189 (2.1%) of survivors available for follow‐up.

Conclusions and Clinical Importance

Death is uncommon in canine EFB; however, treatment type affects outcome, and these data should be used to guide decision‐making in dogs with EFB.


Antihistone Autoantibodies in Dobermans With Hepatitis

H. Dyggve, S. Meri, T. Spillmann, H. Jarva, M. Speeti

J Vet Intern Med2017;31:1717–1723

Background

Immune system involvement is suggested as an underlying cause for Doberman hepatitis (DH) based on female predisposition, lymphocyte infiltration, abnormal hepatocyte expression of major histocompatibility complex class II antigens, and homozygosity for dog leukocyte antigen DRB1*00601.

Objective

To measure serum antinuclear antibodies (ANA) and serum antihistone antibodies (AHA) in Dobermans with hepatitis. To determine whether increased serum ANA or serum AHA could be used to support the diagnosis of Doberman hepatitis (DH).

Animals

Privately owned 25 subclinically and 13 clinically affected DH Dobermans and 17 healthy control Dobermans.

Methods

Case–control study. Indirect immunofluorescence (IIF) microscopy and line blot tests were employed for the ANA pilot studies and an enzyme‐linked immunosorbent assay (ELISA) assay for detection of IgG AHA.

Results

Indirect immunofluorescence revealed ANA‐positive cases, and line blot showed AHA reactivity. In ELISA, importantly increased concentrations of AHA were found in 92% (23/25) of dogs in the subclinical stage and 84.6% (11 of 13) of dogs in the clinical stage of DH compared with no control dogs (0/17) (P < 0.0005). The mean AHA absorbance values of the blood samples obtained from the 25 subclinical DH dogs (1.36 ± 0.60, mean ± SD) and the 13 clinically affected dogs (1.46 ± 0.49) were significantly higher than in 17 control dogs (0.51 ± 0.18; P < 0.0001).

Conclusions and Clinical Importance

As the presence of AHA indicates autoimmune activity, our results favor an autoimmune background as one cause for DH. Antihistone antibody could represent a novel means for screening Dobermans with increased serum alanine transaminase concentrations and suspicion of DH.


The Gastrointestinal Microbiome: A Review

P.C. Barko, M.A. McMichael, K.S. Swanson, D.A. Williams

J Vet Intern Med2018;32:9–25

The gastrointestinal microbiome is a diverse consortium of bacteria, archaea, fungi, protozoa, and viruses that inhabit the gut of all mammals. Studies in humans and other mammals have implicated the microbiome in a range of physiologic processes that are vital to host health including energy homeostasis, metabolism, gut epithelial health, immunologic activity, and neurobehavioral development. The microbial genome confers metabolic capabilities exceeding those of the host organism alone, making the gut microbiome an active participant in host physiology. Recent advances in DNA sequencing technology and computational biology have revolutionized the field of microbiomics, permitting mechanistic evaluation of the relationships between an animal and its microbial symbionts. Changes in the gastrointestinal microbiome are associated with diseases in humans and animals including inflammatory bowel disease, asthma, obesity, metabolic syndrome, cardiovascular disease, immune‐mediated conditions, and neurodevelopmental conditions such as autism spectrum disorder. While there remains a paucity of data regarding the intestinal microbiome in small animals, recent studies have helped to characterize its role in host animal health and associated disease states. This review is intended to familiarize small animal veterinarians with recent advances in the field of microbiomics and to prime them for a future in which diagnostic tests and therapies will incorporate these developments into clinical practice.


Hepatic Fibrosis in Dogs

V.M. Eulenberg, J.A. Lidbury

J Vet Intern Med2018;32:26–41

Hepatic fibrosis is commonly diagnosed in dogs, often as a sequela to chronic hepatitis (CH). The development of fibrosis is a crucial event in the progression of hepatic disease that is of prognostic value. The pathophysiology of hepatic fibrosis in human patients and rodent models has been studied extensively. Although less is known about this process in dogs, evidence suggests that fibrogenic mechanisms are similar between species and that activation of hepatic stellate cells is a key step. Diagnosis and staging of hepatic fibrosis in dogs requires histopathological examination of a liver biopsy specimen. However, performing a liver biopsy is invasive and assessment of fibrotic stage is complicated by the absence of a universally accepted staging scheme in veterinary medicine. Serum biomarkers that can discriminate among different fibrosis stages are used in human patients, but such markers must be more completely evaluated in dogs before clinical use. When successful treatment of its underlying cause is feasible, reversal of hepatic fibrosis has been shown to be possible in rodent models and human patients. Reversal of fibrosis has not been well documented in dogs, but successful treatment of CH is possible. In human medicine, better understanding of the pathomechanisms of hepatic fibrosis is leading to the development of novel treatment strategies. In time, these may be applied to dogs. This article comparatively reviews the pathogenesis of hepatic fibrosis, its diagnosis, and its treatment in dogs.


Efficacy of Radiation Therapy for the Treatment of Sialocele in Dogs

V.J. Poirier, S. Mayer‐Stankeová, J. Buchholz, D.M. Vail, B. Kaser Hotz

J Vet Intern Med2018;32:107–110

Background

Sialocele is a collection of saliva that has leaked from a damaged salivary gland or duct and is surrounded by granulation tissue. Surgery is the recognized first‐line treatment. Recurrence rate after surgery is 5–14%. Salivary gland tissue is very sensitive to radiation therapy (RT).

Hypothesis/Objectives

Radiation therapy will be useful for the treatment of sialocele. The aims were to characterize response rate and clinical course of dogs with sialocele treated with RT and to determine a starting dose for clinical use.

Animals

Eleven dogs with sialocele.

Methods

Retrospective study of response and outcome after RT.

Results

All dogs had cervical sialocele. Seven dogs (63.6%) were treated with 3 weekly fractions of 4 Gray (Gy); (total dose, 12 Gy). Three dogs (27.3%) received 4 fractions of 4 Gy (16 Gy) and 1 dog received 5 fractions of 4 Gy (20 Gy) on a Monday‐Wednesday‐Friday schedule. Six dogs (54%) achieved a complete response (CR), and 5 dogs (45%) achieved a partial response (PR). Three dogs had progression of their sialocele 2, 3, and 9 months after RT; all three had received 12 Gy initially and 2 received 2 additional fractions of 4 Gy (cumulative total dose, 20 Gy) and subsequently achieved remission for >2 years.

Conclusions and Clinical Importance

Radiation therapy is useful for the treatment of recurrent sialocele refractory to surgical management and a minimum total dose of 16 or 20 Gy in 4 Gy fractions appears effective.


Cholangitis and Cholangiohepatitis in Dogs: A Descriptive Study of 54 Cases Based on Histopathologic Diagnosis (2004–2014)

J.L. Harrison, B.J. Turek, D.C. Brown, C. Bradley, J. Callahan Clark

J Vet Intern Med2018;32:172–180

Background

Cholangitis in dogs appears to be more common than previously thought, but understanding of the disease remains incomplete.

Objective

To describe a population of dogs with cholangitis or cholangiohepatitis.

Animals

Fifty‐four client‐owned dogs with cholangitis or cholangiohepatitis.

Methods

Medical records of dogs with cholangitis or cholangiohepatitis confirmed by histopathology between January 2004 and December 2014 were identified using a computer‐based search and retrospectively reviewed.

Results

Clinical signs included vomiting (72.2%), lethargy (70.4%), and inappetence (64.8%). Most dogs (49/50) had increased liver enzyme activities, hyperbilirubinemia (32/50), and hypercholesterolemia (24/43). Ultrasonographic abnormalities of the hepatobiliary system were seen in 84% of cases. On histopathology, 53 of 54 affected dogs had neutrophilic cholangitis (NC) or cholangiohepatitis, whereas 1 dog had lymphocytic cholangitis. Most cases (42/54) were chronic. Evidence of concurrent biliary disease (46.2%) and biliary tract obstruction (42.6%) was common. Seventeen of 36 biliary and 11 of 25 liver cultures were positive for bacterial growth; Escherichia coli and Enterococcus spp. were most common. Median patient survival was 671 days (95% confidence interval [CI]: 114–1,426). On Cox regression, dogs that did not have a cholecystectomy performed had a 2.1 greater hazard for death (P = 0.037; 95% CI: 1.0–4.3) compared to cholecystectomized dogs. Dogs >13 years old had a 5.0 greater hazard for death (P = 0.001; 95% CI: 1.9–13.2) compared to younger dogs.

Conclusions and Clinical Significance

Chronic NC or cholangiohepatitis was most common. Cholecystitis and biliary tract obstruction often occurred in conjunction with cholangitis. Cholecystectomized dogs had decreased risk of death; thus, cholecystectomy may improve patient outcome.


Sonographic Evaluation of Liver Hemodynamic Indices in Overweight and Obese Dogs

A.F. Belotta, C.R. Teixeira, C.R. Padovani, S.C. Rahal, M.N. Mayer, M.J. Mamprim

J Vet Intern Med2018;32:181–187

Background

Hepatic circulatory disturbances have been associated with obesity and fatty liver in humans. In the veterinary literature, however, there is limited information regarding the effects of different body condition scores (BCS) on liver hemodynamic indices in dogs.

Objectives

To investigate the influence of BCS on liver hemodynamic indices.

Animals

Fifty‐three client‐owned dogs of various breeds were included.

Methods

Prospective observational study. Dogs were divided into 3 BCS groups using a 5‐point scale: G1 – 12 ideal dogs, G2 – 21 overweight dogs, G3 – 20 obese dogs. Mean portal velocity (MPV), portal blood flow volume (PBFV), portal congestion index (PCI), hepatic artery resistivity index (HARI), and hepatic vein (HV) spectral wave were obtained by pulsed Doppler sonography. Alkaline phosphatase (ALP), gamma‐glutamyl transferase (GGT), and alanine aminotransferase (ALT) activities were determined. Liver enzymes activities and liver hemodynamic indices were compared among groups.

Results

Obese dogs had lower MPV, higher percentage of abnormal hepatic vein spectral wave and higher median ALP activity than did ideal dogs (P < 0.05). Overweight and obese dogs had lower PBFV than ideal dogs (P < 0.01). Overweight dogs had higher median GGT activity than ideal dogs (P < 0.05). No difference was observed for PCI, HARI and median ALT activity among the groups.

Conclusions and Clinical Importance

Obesity was associated with changes in portal vein indices and in HV spectral wave. These changes were accompanied by significant differences in some liver enzymes activities and could be a sign of early liver disease.


Gallbladder Agenesis in 17 Dogs: 2006–2016

K. Sato, M. Sakai, S. Hayakawa, Y. Sakamoto, Y. Kagawa, K. Kutara, K. Teshima, K. Asano, T. Watari

J Vet Intern Med2018;32:188–194

Background

Gallbladder agenesis (GBA) is extremely rare in dogs.

Hypothesis/Objectives

To describe the history, clinical signs, diagnosis, treatment, and outcomes of dogs with GBA.

Animals

Seventeen client‐owned dogs with GBA.

Methods

Medical records from 2006 through 2016 were retrospectively reviewed. Dogs were included when GBA was suspected on abdominal ultrasonography and confirmed by gross evaluation. Signalment, clinical signs, clinicopathological data, diagnostic imaging, histopathology, treatment, and outcome were recorded.

Results

Dogs were of 6 different breeds, and Chihuahuas (10 of 17) were most common. Median age at presentation was 1.9 (range, 0.7–7.4) years. Clinical signs included vomiting (5 of 17), anorexia (2 of 17), ascites (2 of 17), diarrhea (1 of 17), lethargy (1 of 17), and seizures (1 of 17). All dogs had increased serum activity of at least 1 liver enzyme, most commonly alanine aminotransferase (15 of 17). Fifteen dogs underwent computed tomography (CT) cholangiography; common bile duct (CBD) dilatation was confirmed in 12, without evidence of bile duct obstruction. Gross evaluation confirmed malformation of the liver lobes in 14 of 17 dogs and acquired portosystemic collaterals in 5 of 17. Ductal plate malformation was confirmed histologically in 16 of 17 dogs. During follow‐up (range, 4–3,379 days), 16 of 17 dogs remained alive.

Conclusions and Clinical Importance

Dogs with GBA exhibit clinicopathological signs of hepatobiliary injury and hepatic histopathological changes consistent with a ductal plate abnormality. Computed tomography cholangiography was superior to ultrasound examination in identifying accompanying nonobstructive CBD distention. Computed tomography cholangiography combined with laparoscopic liver biopsy is the preferable approach to characterize the full disease spectrum accompanying GBA in dogs.


Gallbladder Mucocele: Variables Associated with Outcome and the Utility of Ultrasonography to Identify Gallbladder Rupture in 219 Dogs (2007–2016)

J.A. Jaffey, A. Graham, E. VanEerde, E. Hostnik, W. Alvarez, J. Arango, C. Jacobs, A.E. DeClue

J Vet Intern Med2018;32:195–200

Background

Gallbladder mucocele (GBM) is an increasingly recognized extrahepatic biliary disease in dogs.

Objectives

To investigate cases of GBM and identify variables associated with survival and the sensitivity and specificity of ultrasonography to identify gallbladder rupture.

Animals

Two hundred and nineteen client‐owned dogs with GBM.

Methods

Multicenter, retrospective study of dogs with GBM, presented from January 2007 to November 2016 to 6 academic veterinary hospitals in the United States. Interrogation of hospital databases identified all cases with the inclusion criteria of a gross and histopathologic diagnosis of GBM after cholecystectomy and intraoperative bacteriologic cultures of at least 1 of the following: gallbladder wall, gallbladder contents, or abdominal effusion.

Results

Two hundred and nineteen dogs fulfilled the inclusion criteria. Dogs with GBM and gallbladder rupture with bile peritonitis at the time of surgery were 2.7 times more likely to die than dogs without gallbladder rupture and bile peritonitis (P = 0.001; 95% confidence interval [CI], 1.50–4.68; n = 41). No significant associations were identified between survival and positive bacteriologic cultures, antibiotic administration, or time (days) from ultrasonographic identification of GBM to the time of surgery. The sensitivity, specificity, positive, and negative likelihood ratios for ultrasonographic identification of gallbladder rupture were 56.1% (95% CI, 39.9–71.2), 91.7% (95% CI, 85.3–95.6), 6.74, and 0.44, respectively.

Conclusion and Clinical Importance

Dogs in our study with GBM and intraoperative evidence of gallbladder rupture and bile peritonitis had a significantly higher risk of death. Additionally, abdominal ultrasonography had low sensitivity for identification of gallbladder rupture.


Evaluation of SNAP cPL, Spec cPL, VetScan cPL Rapid Test, and Precision PSL Assays for the Diagnosis of Clinical Pancreatitis in Dogs

H. Cridge, A.G. MacLeod, G.E. Pachtinger, A.J. Mackin, A.M. Sullivant, J.M. Thomason, T.M. Archer, K.V. Lunsford, K. Rosenthal, R.W. Wills

J Vet Intern Med2018;32:658–664

Background

The sensitivity, specificity, and agreement of 4 diagnostic assays (SNAP canine pancreatic lipase (cPL), specific cPL (Spec cPL), VetScan cPL Rapid Test, and Precision PSL) for pancreatitis in dogs have not been directly compared.

Hypothesis/Objectives

To determine the level of agreement among each of the 4 assays and a clinical suspicion score, level of agreement among the assays, and sensitivity and specificity of each assay in a clinically relevant patient group.

Animals

Fifty client‐owned dogs with clinical signs of gastrointestinal disease.

Methods

Prospective study. History, physical examination, complete blood count, serum biochemistry, abdominal ultrasound examination, and the 4 diagnostic assays for pancreatitis were performed. Intraclass correlation coefficients (ICC) were used to determine the level of agreement between each assay and a clinical suspicion score determined by a panel of 5 board‐certified veterinary internists.

Results

The ICC between the clinical suspicion score and the 4 assays were SNAP cPL, 0.61; Spec cPL, 0.68; VetScan cPL Rapid Test, 0.68; and Precision PSL, 0.60. The sensitivities of the assays ranged from 73.9 to 100.0%, whereas the specificities were SNAP cPL, 71.1–77.8%; Spec cPL, 74.1–81.1%; VetScan cPL Rapid Test, 76.9–83.8%; and Precision PSL, 64.0–74.3%.

Conclusions and Clinical Importance

A good to excellent level of agreement was demonstrated among the 4 assays. The previously unreported sensitivity and specificity of the VetScan cPL Rapid Test were 73.9–83.3% and 76.9–83.8%, respectively. Results of any of the 4 diagnostic assays alone, in the absence of supporting clinical findings, are insufficient to establish a diagnosis of clinical pancreatitis in dogs.


Effect of sucralfate on gastric permeability in an ex vivo model of stressrelated mucosal disease in dogs

J Vet Intern Med. 2018;32:670–678

Tracy L. Hill, B. Duncan X. Lascelles, Anthony T. Blikslager

Background

Sucralfate is a gastroprotectant with no known systemic effects. The efficacy of sucralfate for prevention and treatment of stress‐related mucosal diseases (SRMD) in dogs is unknown.

Hypothesis/Objectives

To develop a canine ex vivo model of SRMD and to determine the effect of sucralfate on mucosal barrier function in this model.

Animals

Gastric antral mucosa was collected immediately postmortem from 29 random‐source apparently healthy dogs euthanized at a local animal control facility.

Methods

Randomized experimental trial. Sucralfate (100 mg/mL) was applied to ex vivo canine gastric mucosa concurrent with and after acid injury. Barrier function was assessed by measurement of transepithelial electrical resistance (TER) and radiolabeled mannitol flux.

Results

Application of acidified Ringers solution to the mucosal side of gastric antrum caused a reduction in gastric barrier function, and washout of acidified Ringers solution allowed recovery of barrier function (TER: 34.0 ± 2.8% of control at maximum injury, 71.3 ± 5.5% at recovery, P < .001). Sucralfate application at the time of injury or after injury significantly hastened recovery of barrier function (TER: 118.0 ± 15.2% of control at maximum injury, P < .001 and 111.0 ± 15.5% at recovery, P = .35).

Conclusions and Clinical Importance

Sucralfate appeared effective at restoring defects in gastric barrier function induced by acid and accelerating repair of tissues subjected to acid in this model, suggesting that sucralfate could have utility for the treatment and prevention of SRMD in dogs.


Association of fecal calprotectin concentrations with disease severity, response to treatment, and other biomarkers in dogs with chronic inflammatory enteropathies

Romy M., Heilmann, Nora Berghoff, Joanne Mansell, Niels Grützner, Nolie K. Parnell, Corinne Gurtner, Jan S. Suchodolski, Jörg M. Steiner

J Vet Intern Med. 2018;32:679–692

Background

Calprotectin is a marker of inflammation, but its clinical utility in dogs with chronic inflammatory enteropathies (CIE) is unknown.

Objective

Evaluation of fecal calprotectin in dogs with biopsy‐confirmed CIE.

Animals

127 dogs.

Methods

Prospective case‐control study. Dogs were assigned a canine chronic enteropathy clinical activity index (CCECAI) score, and histologic lesions severity was assessed. Fecal calprotectin, fecal S100A12, and serum C‐reactive protein (CRP) were measured. Food‐ or antibiotic‐responsive cases (FRE/ARE, n = 13) were distinguished from steroid‐/immunosuppressant‐responsive or ‐refractory cases (SRE/IRE, n = 20). Clinical response to treatment in SRE/IRE dogs was classified as complete remission (CR), partial response (PR), or no response (NR).

Results

Fecal calprotectin correlated with CCECAI (ρ = 0.27, P = .0065) and fecal S100A12 (ρ = 0.90, P < .0001), some inflammatory criteria, and cumulative inflammation scores, but not serum CRP (ρ = 0.16, P = .12). Dogs with SRE/IRE had higher fecal calprotectin concentrations (median: 2.0 μg/g) than FRE/ARE dogs (median: 1.4 μg/g), and within the SRE/IRE group, dogs with PR/NR had higher fecal calprotectin (median: 37.0 μg/g) than dogs with CR (median: 1.6 μg/g). However, both differences did not reach statistical significance (both P = .10). A fecal calprotectin ≥15.2 μg/g separated both groups with 80% sensitivity (95% confidence interval [95%CI]: 28%‐100%) and 75% specificity (95%CI: 43%‐95%).

Conclusions and Clinical Importance

Fecal calprotectin could be a useful surrogate marker of disease severity in dogs with CIE, but larger longitudinal studies are needed to evaluate its utility in predicting the response to treatment.


Prospective evaluation of an indwelling esophageal balloon dilatation feeding tube for treatment of benign esophageal strictures in dogs and cats

Desmond K. Tan,  Chick Weisse, Allyson Berent, Kenneth E. Lamb

Background

Despite multiple dilatation procedures, benign esophageal strictures (BES) remain a recurring cause of morbidity and mortality in dogs and cats.

Objective

Investigate the use of an indwelling Balloon Dilatation esophagostomy tube (B‐Tube) for treatment of BES in dogs and cats.

Animals

Nine dogs and 3 cats.

Methods

Animals with BES were recruited for our prospective study. Endoscopic and fluoroscopic evaluation of the esophagus and balloon dilatation were performed under general anesthesia, followed by placement of an indwelling B‐Tube. The animals' owners performed twice daily at‐home inflations for approximately 6 weeks. Repeat endoscopy was performed before B‐Tube removal. Animals were reevaluated for changes in modified dysphagia score (MDS) after B‐Tube removal.

Results

The B‐Tube management was relatively well tolerated and effective in maintaining dilatation of a BES while in place. These animals underwent a median of 2 anesthetic episodes and were monitored for a median of 472 days (range, 358‐1736 days). The mean MDS before treatment was 3.1 ± 0.5/4.0 and final follow‐up MDS were significantly (P < .0001) improved at 0.36 ± 0.65/4.0. Eleven of 12 animals (91.7%) had improved MDS at the end of the follow‐up period, with 8/12 (66.7%) having an MDS of 0/4, 2/12 (16.7%) an MDS of 1/4, and 1/12 (8.3%) an MDS of 2/4. One dog died.

Conclusions and Clinical Importance

The B‐Tube offers an effective, and more economical method, and often decreased anesthetic time to repeated balloon dilatation procedures for the treatment of BES in dogs and cats.


Comparison of diagnostic accuracy of laparoscopic 3 mm and 5 mm cup biopsies to wedge biopsies of canine livers

Tiffany L. Kimbrell, Milan Milovancev, Ronald Olsen, Christiane V. Löhr

J Vet Intern Med. 2018;32:701–706

Background

Diagnostic accuracy of the 3 mm laparoscopic cup biopsy forceps for collection of tissue samples from canine livers is unproven.

Hypotheses/Objectives

Compare sample surface area and portal triad count between 3 mm and 5 mm laparoscopic cup biopsies and compare the histologic diagnosis obtained by each instrument to a standard necropsy wedge. The hypothesis was that more portal triads and greater sample surface area would be found with the 5 mm samples and the laparoscopic instruments would not have significantly different levels of agreement with necropsy wedge diagnosis.

Animals

Twenty‐one client‐owned dogs undergoing necropsy.

Methods

Prospective ex vivo study. Three samples (3 mm, 5 mm, and wedge) were taken of 2 different hepatic divisions within 24 hours of death. Morphologic diagnosis, World Small Animal Veterinary Association histologic features, surface area, and portal triad numbers were compared among the 3 samples.

Results

There were significantly more portal triads (mean 21.4 versus 13.8; P < .0001) and a higher surface area (20.3 mm2 versus 11.5 mm2; P < .0001) in the 5 mm samples compared to 3 mm samples. Kappa coefficients and percent agreement for histologic diagnosis as compared to the wedge biopsy were not significantly different between the 2 instrument sizes (κ = 0.383 and 0.436, respectively; 67% and 69%, respectively).

Conclusions and Clinical Importance

Despite yielding smaller sample sizes, the 3 mm laparoscopic cup biopsy has a similar level of histologic diagnostic accuracy to the 5 mm instrument.


Fecal microbiota transplantation in puppies with canine parvovirus infection

Giorgio Q. Pereira, Lucas A. Gomes, Iago S. Santos, Alice F. Alfieri, J. S. Weese, Marcio C. Costa

J Vet Intern Med. 2018;32:707–711

Background

Diarrhea associated with parvovirus infection is common in dogs. Supportive care is the mainstay of treatment, but recovery may be prolonged and mortality rate can be high. Modification of the intestinal bacterial microbiota has been promising in human and veterinary medicine as an adjunctive treatment of various enteric diseases.

Objectives

To investigate the safety and efficacy of fecal microbiota transplantation (FMT) on the clinical recovery of puppies with acute hemorrhagic diarrhea syndrome.

Animals

Sixty‐six puppies with parvovirus infection were evaluated at 2 veterinary hospitals.

Methods

Randomized clinical trial. Puppies were randomly distributed into 2 groups: standard treatment (STD) and standard treatment + FMT (STD + FMT). The STD puppies (n = 33) received only treatment with IV fluids and antimicrobials and the STD + FMT puppies (n = 33) received FMT in addition to standard treatment. For FMT, 10 g of feces from a healthy dog diluted in 10 mL of saline were administered rectally 6‐12 hours post‐admission.

Results

Among survivors, treatment with FMT was associated with faster resolution of diarrhea (P < .001) and shorter hospitalization time (P = .001; median, 3 days in STD + FMT; median, 6 days in STD) compared to standard treatment. Mortality in STD was 36.4% (12/33) as compared to 21.2% (7/33) in puppies treated with FMT, but there was no statistical difference between groups (P = .174). Polymerase chain reaction indicated that all animals carried canine parvovirus, strain CPV‐2b.

Conclusions

Fecal microbiota transplantation in parvovirus‐infected puppies was associated with faster resolution of diarrhea.


Vitamin D Receptor Expression in Dogs

J.A. Cartwright, A.G. Gow, E. Milne, D. Drummond, S. Smith, I. Handel, R.J. Mellanby

J Vet Intern Med2018;32:764–774

Background

There is growing evidence linking low blood vitamin D concentration to numerous diseases in people and in dogs. Vitamin D influences cellular function by signaling through the vitamin D receptor (VDR). Little is known about which non‐skeletal tissues express the VDR or how inflammation influences its expression in the dog.

Objectives

To define which non‐skeletal canine tissues express the VDR and to investigate expression in inflamed small intestine.

Animals

Thirteen non‐skeletal tissues were collected prospectively from 6 control dogs. Thirty‐five dogs diagnosed with a chronic enteropathy (CE) and 24 control dogs were prospectively enrolled and duodenal biopsies were evaluated for VDR expression.

Methods

Prospective; blinded assessment of canine intestinal VDR. Dogs with CE were included once other identifiable causes of intestinal disease were excluded. Age matched controls were included with no intestinal clinical signs. VDR expression was assessed immunohistochemically in all samples, using a Rat IgG VDR monoclonal antibody. Quantitative real‐time polymerase chain reaction (qPCR) was also used for duodenal biopsies.

Results

VDR expression as assessed by immunohistochemistry (IHC) was highest in the kidney, duodenum, skin, ileum and spleen, and weak in the colon, heart, lymph node, liver, lung, and ovary. Gastric and testicular tissue did not express the VDR. There was no statistical difference in duodenal VDR expression between the 24 healthy dogs and 34 dogs with CE when quantified by either qPCR (P = 0.87) or IHC (P = 0.099).

Conclusions and Clinical Importance

The lack of down regulation of VDR expression in inflamed intestine contrasts with previous studies in humans. Our findings support future studies to investigate whether vitamin D and its analogues can be used to modulate intestinal inflammation in the dog.


How useful is abdominal ultrasonography in dogs with diarrhoea?

E. K. Mapletoft, K. Allenspach, C. R. Lamb

PAPER 32 Journal of Small Animal Practice  •  Vol 59  •  January 2018  •  © 2017 Journal of Small Animal Practice (2018) 59, 32–37

Objective

To assess the utility of abdominal ultrasonography in the diagnostic work‐up of dogs with diarrhoea.

Methods

Retrospective cross‐sectional study based on a referral population of dogs with diarrhoea. Associations between the clinical signs, use of abdominal ultrasonography, results of abdominal ultrasonography and subsequent work‐up were examined. The utility of abdominal ultrasonography was scored as high, moderate, none or counterproductive based on review of medical records.

Results

Medical records of 269 dogs were reviewed, of which 149 (55%) had abdominal ultrasonography. The most frequent result was no ultrasonographic abnormalities affecting the intestine in 65 (44%) dogs. Ultrasonography results were associated with subsequent work‐up as follows: (1) no detected abnormalities and dietary trial; (2) focal thickening of the intestinal wall, loss of intestinal wall layers or enlarged abdominal lymph nodes and ultrasound‐guided fine‐needle aspirates; (3) diffuse thickening of the intestinal wall or hyperechoic striations in the small intestinal mucosa and endoscopy; and (4) small intestinal foreign body and coeliotomy. Abdominal ultrasonography was considered to be diagnostic without further testing in only four (3%) dogs: two had a portosystemic shunt identified ultrasonographically, one had a linear foreign body and one had a perforated pyloric ulcer. Abdominal ultrasonography had moderate utility in 56 (38%) dogs and no utility in 79 (53%) dogs. Abdominal ultrasonography was considered counterproductive in 10 (7%) dogs because results were either falsely negative or falsely positive.

Clinical Significance

These results should prompt clinicians to reconsider routine use of abdominal ultrasonography in dogs with diarrhoea.


Endoscopic and surgical removal of oesophageal and gastric fishhook foreign bodies in 33 animals

M. Binvel, L. Poujol, C. Peyron, A. Dunie‐Merigot, F. Bernardin

Journal of Small Animal Practice (2018) 59, 45–49

Objectives

To describe the location, retrieval, frequency of surgery and complications associated with fishhook foreign bodies.

Materials and Methods

Retrospective evaluation of the medical records of cats and dogs admitted between 2010 and 2016 after fishhook ingestion.

Results

A total of 33 cases (2 cats and 31 dogs) were included. The most common locations were the proximal oesophagus [12/33 (36%)] and stomach [11/33 (33%)]. Endoscopic retrieval was successful in 27 of 33 cases (82%); oesophageal perforation was the only recorded complication, occurring in six of 33 (18%) cases. Surgery was performed in six cases (18%), and no early complications were recorded. The survival rate was 100%.

Clinical Significance

The endoscopic removal of ingested fishhooks is highly successful. In the present study, survival to discharge was 100%, even in cases of oesophageal perforation or in cases requiring surgery.


Lowgrade gastrointestinal lymphoma in dogs: 20 cases (2010 to 2016)

J. Lane, J. Price, A. Moore, J. R. S. Dandrieux, C. Clifford, K. Curran, K. Choy, C. Cannon

Journal of Small Animal Practice (2018) 59, 147–153

Objectives

To report the clinical presentation, treatment and prognosis of dogs with low‐grade gastrointestinal lymphoma.

Materials and Methods

Cases were solicited from the American College of Veterinary Internal Medicine Oncology Diplomate listserv. Medical records of dogs with low‐grade gastrointestinal lymphoma diagnosed via a combination of histology and immunohistochemistry with or without analysis of polymerase chain reaction for antigen receptor rearrangement were included. Signalment, clinical signs, diagnostic test results, chemotherapy protocol, response to treatment, date of first progression, rescue therapies and date and cause of death or last follow‐up visit were collected.

Results

Twenty cases were included. Males and small breed dogs were over‐represented. Frequent clinical signs included weight loss, vomiting and diarrhoea. Most lymphomas were T‐cell phenotype (95%), and epitheliotropism was commonly described (60%). Immunohistochemistry, polymerase chain reaction for antigen receptor rearrangement or both were frequently required for definitive diagnosis. Two dogs had resection of an intestinal mass, and all dogs were treated with chemotherapy; chlorambucil and prednisone were most commonly prescribed. Overall response rate was 70%, and median survival time was 424 days (95% confidence interval: 105 to 1206 days).

Clinical Significance

Low‐grade gastrointestinal lymphoma appears to be a rare condition in dogs, and treatment with chemotherapy results in a high response rate and favourable survival times. Further study is needed to determine its prevalence in dogs with chronic enteropathies.


Systemic Scedosporium prolificans infection in an 11monthold Border collie with cobalamin deficiency secondary to selective cobalamin malabsorption (canine ImerslundGräsbeck syndrome)

K. Erles, A. Mugford, D. Barfield, T. Leeb, P. H. Kook

Journal of Small Animal Practice (2018) 59, 253–256

An 11‐month‐old Border collie presented collapsed and continued to deteriorate rapidly despite supportive treatment. The dog had a history of failure to thrive and recurring respiratory infection. Laboratory abnormalities included neutrophilic leucocytosis, Heinz body anaemia, hyperammonaemia, hyperbilirubinaemia, proteinuria and hypocobalaminaemia. Post‐mortem examination revealed multi‐focal necrosis within the heart, kidneys, pancreas, liver, meninges and cerebral cortex. Fungal hyphae in lesions were identified as Scedosporium prolificans following culture. Subsequent genotyping confirmed that the dog carried the CUBN:c.8392delC mutation in a homozygous state, verifying hereditary cobalamin deficiency (a.k.a. Imerslund‐Gräsbeck syndrome). Cobalamin deficiency may have been a predisposing factor for the development of systemic fungal infection in this dog.


Clinical and histologic features of acute-onset erythroderma in dogs with gastrointestinal disease: 18 cases (2005–2015)

Christine L. Cain dvm Charles W. Bradley II vmd Elizabeth A. Mauldin dvm

J Am Vet Med Assoc 2017;251:1439–1449

OBJECTIVE

To describe the clinical and histologic features of acute erythroderma in dogs with gastrointestinal disease.

DESIGN

Retrospective case series.

ANIMALS

18 dogs with erythroderma and gastrointestinal disease.

PROCEDURES

Medical records and biopsy specimens were reviewed. Information collect- ed from medical records included signalment, clinical signs, physical exami- nation and diagnostic test results, treatment, and outcome. The Naranjo algorithm was used to estimate the probability of an adverse drug reaction for each dog.

RESULTS

All dogs had an acute onset of erythematous macules or generalized eryth- roderma. Histologic features of skin biopsy specimens had 3 patterns repre- senting a progressive spectrum of in ammation. Most dogs had vomiting (n = 17) and hematochezia (10). Signs of gastrointestinal disease became evi- dent before, after, or concurrent with the onset of skin lesions in 10, 3, and 5 dogs, respectively. In ammatory bowel disease, pancreatitis, and adverse food reaction were diagnosed in 5, 3, and 3 dogs, respectively. The cause of the gastrointestinal signs was not identi ed for 8 dogs. Eight dogs had a Naranjo score consistent with a possible adverse drug reaction. Treatment of skin lesions included drug withdrawal (n = 15), antihistamines (16), and corticosteroids (14). Signs of gastrointestinal disease and skin lesions re- solved at a mean of 4.6 days and 20.8 days, respectively, after onset.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated acute erythroderma may be associated with > 1 gastro- intestinal disease or an adverse drug reaction in some dogs. Recognition of the clinical and histologic features of this syndrome is essential for accurate diagnosis. (J Am Vet Med Assoc 2017;251:1439–1449)


Intestinal lymphoma in dogs: 84 cases (1997–2012)

Naoko Sogame dvm, phd Rebecca Risbon dvm Kristine E. Burgess dvm

J Am Vet Med Assoc 2018;252:440–447

OBJECTIVE

To describe signalment, clinicopathologic features, and outcomes of dogs with con rmed primary intestinal lymphoma and assess factors associated with survival times in these patients.

DESIGN

Retrospective case series.

ANIMALS

84 client-owned dogs.

PROCEDURES

Medical records from 7 veterinary institutions were retrospectively re- viewed to identify dogs with primary intestinal lymphoma. Data collected included signalment, clinical signs, anatomic location of tumors, diagnostic procedures, treatment, outcome, and dates of diagnosis and death.

RESULTS

Overall median survival time (MST) was 62 days (range, 1 to 537 days). Fac- tors associated with shorter survival time on univariate analysis included anorexia or septic peritonitis at the time of diagnosis and tumor location (intestinal tract only, intestinal tract and abdominal lymph nodes, or intes- tinal tract and extraintestinal organs). The most commonly noted changes in the intestinal tract were altered wall thickening with loss of layering (41 dogs) and presence of ≥ 1 discrete mass (24 dogs). Protocols based on cy- clophosphamide, doxorubicin, vincristine, and prednisone with or without l-asparaginase (48 dogs) or 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (14 dogs) were most commonly used as rst-line treatment; the MSTs of dogs receiving these treatments (60 and 144 days, respectively) did not dif- fer signi cantly.

CONCLUSIONS AND CLINICAL RELEVANCE

The MST of dogs with primary intestinal lymphoma was poor, regardless of rst-line treatment used. Anorexia and septic peritonitis were associated with poor prognosis. 


Comparison of the use of fresh-frozen canine cadavers and a realistic composite ex vivo simulator for training in small animal  exible gastrointestinal endoscopy

Eva M. Pérez-Merino dvm, phd

Jesús Usón-Gargallo dvm, phd

Francisco M. Sánchez-Margallo dvm, phd Jesús M. Usón-Casaús dvm, phd

J Am Vet Med Assoc 2018;252:839–845

OBJECTIVE

To compare the usefulness of fresh-frozen canine cadavers (FFCCs) and a validated canine simulator model for training veterinary students in basic gastrointestinal endoscopic procedures.

DESIGN

Randomized trial.

SAMPLE

48 veterinary students in their nal year of training.

PROCEDURES

Students were randomly assigned to receive basic gastrointestinal endo- scopic training on a canine simulator or FFCC. All students were trained as assigned in esophagogastroduodenoscopy, endoscopic gastric biopsy, and gastric foreign body removal for 2 h/d for 5 days. They then performed each procedure on a live dog, and procedure completion time and performance ability were compared between groups. Two experienced endoscopists used a validated Likert-type procedural rating scale to rate the students’ performance. Students completed a survey to rate their training model.

RESULTS

No signi cant differences were identi ed between groups in quality of performance of the 3 endoscopic procedures on a live dog. Students re- quired signi cantly less time to complete the procedures on a live dog when trained on an FFCC versus canine simulator. Although both training models were considered equally useful by students, training on the simulator was signi cantly more stimulating.

CONCLUSIONS AND CLINICAL RELEVANCE

Students showed the same skill level in performing basic endoscopic proce- dures on live dogs regardless of the training model used, although students who trained on the FFCC completed these procedures faster than students trained on the canine simulator. Use of the simulator appeared to be a vi- able alternative to use of FFCCs for veterinary endoscopic training, provid- ing students with a good level of pro ciency before performing endoscopic procedures on live dogs. 


Outcome of elective cholecystectomy for the treatment of gallbladder disease in dogs

Gabina Youn bvetmed Michelle J. Waschak dvm, ms Kevin A. R. Kunkel dvm Patrick D. Gerard phd

J Am Vet Med Assoc 2018;252:970–975

OBJECTIVE

To determine mortality rates for dogs undergoing cholecystectomy and variables associated with failure to survive to hospital discharge.

DESIGN

Retrospective cohort study.

ANIMALS

70 dogs that underwent cholecystectomy for biliary tract disease at a com- panion animal referral hospital from 2009 through 2015.

PROCEDURES

Medical records of dogs were reviewed and data collected; dogs with biliary diversion surgery were excluded. Included dogs were grouped by whether cholecystectomy had been elective (ie, dogs with no or mild clinical signs, with no indication of biliary obstruction, or that initially underwent sur- gery for a different procedure) or nonelective (ie, dogs with icterus and questionable patency of the biliary system). Mortality rates (proportions of dogs that failed to survive to hospital discharge) were compared between various groups.

RESULTS

45 (64%) dogs were included in the elective group and 25 (36%) in the nonelective group. Group mortality rates were 2% (1/45) and 20% (5/25), respectively, and differed signi cantly. Overall mortality rate was 9% (6/70). Serum albumin concentration was signi cantly lower and serum alanine aminotransferase activity and total bilirubin concentration were signi cant- ly higher in nonsurviving versus surviving dogs. Dogs with vomiting, signs of lethargy or anorexia, icterus, or azotemia were less likely to survive than dogs without these signs.

CONCLUSIONS AND CLINICAL RELEVANCE

Dogs that underwent elective cholecystectomy had a considerably lower mortality rate than previously reported. Elective cholecystectomy may be an appropriate recommendation for dogs with early signs of biliary disease to avoid the greater mortality rate associated with more advanced disease and nonelective cholecystectomy. 


Canine Hepatitis Associated with Intrahepatic Bacteria in Three Dogs

Joon Im, DVM, DACVIM, Derek P. Burney, DVM, PhD, DACVIM, Sean P. McDonough, DVM, PhD, DACVP, Brigid Nicholson, DVM, DACVIM, Adam Eatroff, DVM, DACVIM, Kenneth W. Simpson, BVMS, PhD, DACVIM, DECVIM-CA

J Am Anim Hosp Assoc 2018; 54:65–70. DOI 10.5326/JAAHA-MS-6492

This case report describes the detection of intrahepatic bacteria in formalin-fixed paraffin-embedded histopathological sections from three dogs with neutrophilic, pyogranulomatous, or lymphoplasmacytic hepatitis and cholangiohepatitis. In each of these cases, eubacterial fluorescence in situ hybridization enabled colocalization of intrahepatic bacteria with neutrophilic and granulomatous inflammation in samples that were negative for bacteria when evaluated by routine hematoxylin and eosin histopathology augmented with histochemical stains. Positive responses to antimicrobial therapy were observed in of 2 out of 2 patients that were treated with antimicrobials. These findings suggest that eubacterial fluorescence in situ hybridization analysis of formalin-fixed paraffin-embedded histopathological sections is more sensitive than conventional histochemical stains for the diagnosis of bacteria-associated canine hepatitis.


Comparison of efficacy of oral and parenteral cobalamin supplementation in normalising low cobalamin concentrations in dogs: A randomised controlled study

L.Toresson, J.M.Steiner, P.Razdan, E.Spodsberg, G.Olmedal, J.S.Suchodolski, T.Spillmanna

The Veterinary Journal 232 (2018) 27–32

The aim of this study was to compare the efficacies of parenteral and oral cobalamin supplementation protocols in dogs with chronic enteropathies and low cobalamin concentrations. It was hypothesised that both treatments would increase serum cobalamin concentrations significantly. Fifty-three dogs with chronic enteropathies and serum cobalamin concentrations < 285 ng/L (reference interval 244–959 ng/L) were enrolled. Dogs were randomised to treatment with either daily oral cobalamin tablets (0.25–1.0 mg cyanocobalamin daily according to body weight) or parenteral cobalamin (0.4–1.2 mg hydroxycobalamin according to body weight). Serum cobalamin concentrations were analysed 28 ± 5 days and 90 ± 15 days after initiation of supplementation. After 28 days, all dogs had serum cobalamin concentrations within the reference interval or above. In the parenteral group (n = 26), median (range) cobalamin concentrations were 228 (150–285) ng/L at inclusion, 2107 (725–10,009) ng/L after 28 days and 877 (188–1267) ng/L after 90 days. In the oral group (n = 27), median (range) serum cobalamin concentrations were 245 (150–285) ng/L at inclusion, 975 (564–2385) ng/L after 28 days and 1244 (738–4999) ng/L after 90 days. In both groups, there were significant differences in serum cobalamin concentrations between baseline and 28 days, and between 28 days and 90 days (P < 0.001). In conclusion, both parenteral and oral cobalamin supplementation effectively increase serum cobalamin concentrations in dogs with chronic enteropathies and low cobalamin concentrations.


New viruses associated with canine gastroenteritis

S.L.Caddy

The Veterinary Journal 232 (2018) 57–64

A number of novel viruses have been associated with canine gastroenteritis in recent years, from viral families as diverse as Caliciviridae and Picornaviridae to Parvoviridae and Circoviridae. The ability of many of these viruses to cause disease is uncertain, but epidemiological studies are continually adding to our knowledge of these potential pathogens. This review presents a summary of the latest research and current understanding of novel viruses associated with canine gastroenteritis.


Use of transfer learning to detect diffuse degenerative hepatic diseases from ultrasound images in dogs: A methodological study

T.Banzato, F.Bonsembiante, L.Aresu, M.E.Gelain, S.Burti, A.Zottia

The Veterinary Journal 233 (2018) 35–40

The aim of this methodological study was to develop a deep convolutional neural network (DNN) to detect degenerative hepatic disease from ultrasound images of the liver in dogs and to compare the diagnostic accuracy of the newly developed DNN with that of serum biochemistry and cytology on the same samples, using histopathology as a standard. Dogs with suspected hepatic disease that had no prior history of neoplastic disease, no hepatic nodular pathology, no ascites and ultrasonography performed 24 h prior to death were included in the study (n = 52). Ultrasonography and serum biochemistry were performed as part of the routine clinical evaluation. On the basis of histopathology, dogs were categorised as ‘normal’ (n = 8), or having ‘vascular abnormalities’(n = 8), or ‘inflammatory’(n = 0), ‘neoplastic’ (n = 4) or ‘degenerative’(n = 32) disease; dogs with ‘neoplastic’ disease were excluded from further analysis. On cytological evaluation, dogs were categorised as ‘normal’ (n = 11), or having ‘inflammatory’ (n = 0), ‘neoplastic’ (n = 4) or ‘degenerative’ (n = 37) disease. Dogs were categorised as having ‘degenerative’ (n = 32) or ‘non-degenerative’ (n = 16) liver disease for analysis due to the limited sample size. The DNN was developed using a transfer learning methodology on a pre-trained neural network that was retrained and fine-tuned to our data set. The resultant DNN had a high diagnostic accuracy for degenerative liver disease (area under the curve 0.91; sensitivity 100%; specificity 82.8%). Cytology and serum biochemical markers (alanine transaminase and aspartate transaminase) had poor diagnostic accuracy in the detection of degenerative liver disease. The DNN outperformed all the other non-invasive diagnostic tests in the detection of degenerative liver disease.