Leeching as initial treatment in a cat with polycythaemia vera.

Polycythaemia vera was diagnosed in a three-year-old domestic shorthaired cat referred because of seizures and a high packed cell volume (PCV). Laboratory examination revealed severe erythrocytosis (PCV 79 per cent). Diagnosis was reached by excluding causes for relative and secondary absolute polycythaemia. As phlebotomy proved impossible for initial treatment due to hyperviscosity, four leeches were used to suck blood and the PCV was consequently reduced to 64 per cent. A further 24 hours later, when bleeding at the sites of sucking had stopped, the PCV was 56 per cent. Long-term management of the condition was achieved with hydroxyurea (100 mg/cat once daily) and intermittent phlebotomy. Initial treatment using leeches in cases of polycythaemia vera is a simple, non-invasive, well tolerated and effective method where phlebotomy is not possible.     

Urinary catecholamine and metanephrine to creatinine ratios in healthy dogs at home and in a hospital environment and in 2 dogs with pheochromocytoma

BACKGROUND: Measurement of high concentrations of urine catecholamines and metanephrines is useful in diagnosing pheochromocytoma in humans. Stress increases catecholamine excretion in urine. HYPOTHESIS: Stress of a hospital visit increases urinary catecholamine and metanephrine excretion in dogs. ANIMALS: Fourteen clinically normal dogs, 2 dogs with pheochromocytoma. METHODS: Voided urine samples were collected by the owners 7 days before (t-7), during the hospital visit immediately after diagnostic procedures (t0), as well as 1 (t1) and 7 days (t7) after the hospital visit. Urine catecholamine and metanephrine concentrations were measured using high-pressure liquid chromatography and expressed as ratios to urine creatinine concentration. RESULTS: In client-owned dogs epinephrine and norepinephrine ratios at t0 were significantly higher compared with ratios at t7. Metanephrine and normetanephrine ratios at t-7, t0, and t1 did not differ significantly from each other; however, at t7 they were significantly lower compared to values at t-7. In staff-owned dogs no significant differences were detected among the different collecting time points for any variable. Metanephrine and normetanephrine ratios were significantly higher in client-owned dogs compared to staff-owned dogs at t-7, t0, and t1 but not at t7. CONCLUSIONS AND CLINICAL IMPORTANCE: Stress associated with a hospital visit and with the sampling procedure causes increases in urine catecholamine and metanephrine excretion. Urine collection for the diagnosis of pheochromocytoma probably should take place at home after adaptation to the sampling procedure.     

Thyrotropin-releasing hormone stimulation test to assess thyroid function in severely sick cats

Basal serum thyroxine (T4) concentration and the thyrotropin-releasing hormone (TRH) stimulation test were used to assess thyroid function in 36 critically ill cats examined between July 1996 and October 1998. Of the 36 cats. hyperthyroidism (as underlying or complicating disease) was suspected in 22 based on clinical signs, palpable thyroid nodules, and abnormal thyroid gland histology (study group). Hyperthyroidism was not suspected in the remaining 14 cats, which served as the control group. Based on serum T4 concentrations, suppression of thyroid function was documented in 14 (64%) cats of the study group and in 10 (71%) cats of the control group. The TRH stimulation test revealed an increase in serum T4 of less than 50% of the baseline concentration in 18 (82%) cats of the study group, and in 6 (43%) cats of the control group. In conclusion, based on the results of serum T4 determinations and the TRH stimulation tests, it was not possible to differentiate between cats with clinical and histologic evidence of thyroid dysfunction (hyperthyroidism) and cats with severe nonthyroidal illnesses.     

Sebaceous adenitis in the Akita: clinical observations, histopathology and heredity

Ninety-seven pure-bred Akitas were examined clinically and histologically for sebaceous adenitis. The diagnosis was established histologically in 23 Akitas by demonstrating an inflammatory reaction targeted against the sebaceous glands or a reduction in the number of glands. The clinical course of sebaceous adenitis in the Akita was similar to that seen in other breeds. The first skin lesions occurred mainly on the dorsal midline and ears. Compared with the Poodle, the age at first onset of the disease was more variable and the hair loss affected mainly the undercoat. The progression of sebaceous gland destruction varied between dogs and was not seen in all cases. Because bud-like sebaceous gland proliferation could be identified, it seems that regeneration of the sebaceous glands may occur. An autosomal recessive inheritance appears to be possible. Apart from a genetic background, immune-mediated factors possibly influence the onset and course of sebaceous adenitis.     

Congenital cardiac diseases in dogs: a retrospective analysis

In a time period of 6 years, 158 congenital cardiac defects were diagnosed in 146 dogs at the Clinic for Small Animal Medicine University of Zurich. In respect to all dogs with cardiac disease, these were 23.5% of the cases. Most common defects were subaortic stenosis (SAS, 31.5%), pulmonic stenosis (PS, 23.3%), ventricular septal defect (VSD, 14.4%), patent ductus arteriosus (PDA, 13.7%) and tricuspid dysplasia (TD, 7.5%). Complex defects were found in 8.2% of the dogs. Although single dogs per breed were affected by various defects, some breed-related tendencies could be observed. We found PS more numerously in boxers and Jack Russell Terriers whereas SAS, VSD and TD were also found in breeds reported to be predisposed. Congenital cardiac defects are an important clinical entity, and knowledge of prevalence is helpful when considering the differential diagnosis and for making a tentative diagnosis in an individual case.     

Recurrent fever as the only or predominant clinical sign in four dogs and one cat with congenital portosystemic vascular anomalies

Fever is not considered a typical clinical sign in animals with portosystemic vascular anomalies (PSVA). In a time period of 8 years, PSVA was diagnosed in 23 cases (20 dogs, 3 cats) at the Animal Hospital of the University of Zurich. Of these, recurrent fever was the only, the predominant or an early sign in 5 animals. Fever and associated unspecific clinical signs like lethargy, inappetence, and reluctance to move were present for weeks to months before the final diagnosis of PSVA was made. It was the lack of typical and well-known signs of PSVA that obscured and delayed the diagnosis. Therefore, PSVA should be included in the differential diagnosis of animals with fever of unknown origin (FUO).     

Accuracy of heart rate obtained by auscultation in atrial fibrillation

The accuracy of heart rate estimation by cardiac auscultation over a 15-second period, and the influence of clinical experience on accuracy were evaluated in a dog with chronic atrial fibrillation by test subjects of varying experience. Only 30% of all test subjects provided accurate heart rate estimates. Board-certified specialists, medicine residents, and experienced nurses were significantly more accurate in their estimates than surgery residents and students. Accurate estimates were provided by 12.5% of surgery residents and students, as opposed to 64% of the other test subjects. Auscultatory estimates of heart rate in atrial fibrillation may be significantly inaccurate, and under some circumstances they may not provide a sound basis for making clinical decisions.     

Use of human intravenous immunoglobulin in dogs with primary immune mediated hemolytic anemia

Immune mediated hemolytic anemia (IMHA) in dogs is a severe disease with a high mortality rate. As human immunoglobulin (HIG) was reported to be beneficial for the treatment of IMHA in dogs we examined the influence of HIG on the course of the disease in our dogs with IMHA. Of 22 dogs with primary IMHA 9 dogs received in addition to routine immunosuppressive therapy HIG at a dose of 0.19 to 0.68 g/kg (median 0.35 g/kg), 13 dogs did not receive HIG (-HIG group). Both groups were similar in terms of age, weight, the presence of autoagglutination, spherocytosis, positive Coombs' test, icterus and pigmenturia. The lowest hematocrit measured during the disease was significantly lower in the +HIG group compared to the -HIG group and dogs in the +HIG group received significantly more transfusions than those of the -HIG group. This is an indication for more severe disease signs of the +HIG group dogs. Although mortality during hospitalization and the time from hospital admission to release or death was not significantly different between the two groups, we interpret this similar course of the IMHA despite more severe signs of the +HIG group dogs as a potential positive effect of the HIG therapy.     

Evaluation of an Electrolyte Analyser for Measurement of Concentrations of Ionized Calcium and Magnesium in Cats

The goal of this study was to evaluate the Nova CRT 8 electrolyte analyser for determination of concentrations of ionized calcium (Ca_i) and magnesium (Mg_i) in cats, todetermine the effects of sample handling and storage and to establish reference ranges. The precision and analytical accuracy of the Nova CRT 8 analyser were good. The concentrations of Ca_i and Mg_i were significantly lower in aerobically handled serum samples than in those handled anaerobically. The concentrations of Ca_i and Mg_i differed significantly among whole blood, plasma and serum. In anaerobically handled serum, the concentration of Ca_i was stable for 8 h at 22°C, for 5 days at 4°C and for 1 week at −20°C. The concentration of Mg_i was stable for 4 h at 22°C but for less than 24 h at 4°C and for less than 1 week at −20°C. In serum from 36 cats, the reference ranges were 1.20–1.35 mmol/L for Ca_i and 0.47–0.59 mmol/L for Mg_i. The Nova CRT 8 electrolyte analyser is suitable for determination of Ca_i and Mg_i concentrations in cats. Anaerobically handled serum samples are recommended and, stored at room temperature, they yield accurate results when analysed within 4 h.