Blindness in dogs with pituitary dependent hyperadrenocorticism: relationship with glucose, cortisol and triglyceride concentration and with ophthalmic blood flow

Pituitary dependent hyperadrenocorticism (PDH) shows a high morbidity and blindness is one of its complications. Compression of the optic chiasm (OC) by the hypophysis adenoma is one of the causes. Another cause could be due to vascular and metabolic alterations of the PDH. Out of a total of 70 dogs with confirmed diagnosis of PDH, 12/70 showed blindness. In only 2/12 the OC was compromised. Electroretinography in dogs without the OC being compromised showed altered A and B wave patterns. Ophthalmological Doppler showed an alteration of the blood flow only in blind dogs without OC compression. Cortisol concentrations (Co), triglycerides (Tg) and glycaemia (G) were greater in 10 dogs with non-compressive blindness vs. dogs with conserved vision. Loss of vision correlated with the increase in these variables. Blindness in dogs with PDH would be related to changes in retinal blood flow, associated to higher Co, Tg and G concentrations.     

Comparison of high definition oscillometric and Doppler ultrasound devices with invasive blood pressure in anaesthetized dogs

Objective To use the American College of Veterinary Internal Medicine (ACVIM) validation criteria to evaluate the performance of high definition oscillometric (HDO) and Doppler blood pressure measurement techniques against invasive blood pressure measurements in anaesthetized dogs. Study design Prospective clinical study. Animals Twenty client‐owned dogs. Materials and Methods Invasive blood pressure was measured using a catheter inserted into a pedal artery and an electronic transducer. The sites of cuff placement for the HDO measurements were the mid antebrachium or the proximal tail and, for the Doppler technique, the distal tibia. Agreement between invasive and non‐invasive blood pressure measurements was estimated by the Bland–Altman method. Results Only 10% and 34% of Doppler measurements were within 10 and 20 mmHg of invasive blood pressure values, respectively. The Doppler device failed to meet the ACVIM validation criteria for blood pressure measurement devices. The best agreement between HDO and invasive blood pressure measurement technique was observed for mean arterial blood pressure (MAP); 67% and 95% of readings were within 10 and 20 mmHg of invasive blood pressure values respectively. In addition, 52% and 87% of diastolic arterial blood pressure (DAP) measurements were within 10 and 20 mmHg of invasive readings. High definition oscillometric readings did not meet ACVIM recommended limits for SAP. Conclusion and clinical relevance The Doppler technique overestimated and the HDO device showed limited agreement with invasive blood pressure measurement in anaesthetized dogs. High definition oscillometry met most of the ACVIM requirements for MAP and DAP while the Doppler technique did not.     

Methods and mortality results of a health survey of purebred dogs in the UK

Objectives : To collect information on the cause of death and longevity of dogs owned by members of the numerically largest breed clubs of 169 UK Kennel Club-recognised breeds. Methods : A cross-sectional study was carried out. Approximately 58,363 questionnaires were sent out to breed club members in 2004 (nine clubs failed to report the exact number of questionnaires sent out). Owners reported age at death and cause(s) of death for all dogs that had died within the previous 10 years. Results : A total of 13,741 questionnaires (24% response rate) containing information on 15,881 deaths were included in the analysis. Breed-specific response rates ranged from 64·7 to 4·5%. The median age at death was 11 years and 3 months (minimum=2 months, maximum=23 years and 5 months) and it varied by breed. The most common causes of death were cancer (n=4282, 27%), “old age” (n=2830, 18%) and cardiac conditions (n=1770, 11%). Clinical Significance : This survey shows breed differences in lifespan and causes of death, and the results support previous evidence that smaller breeds tend to have longer lifespan compared with larger breeds. Although many of the breeds in the study may not be representative of the general pedigree dog population in the UK, the results do contribute to the limited information currently available.     

High-dose-rate brachytherapy for intranasal tumours in dogs: results of a pilot study

This prospective study describes the feasibility and toxicity of ¹⁹²Iridium high‐dose‐rate (HDR) brachytherapy as an alternative strategy for the treatment of canine intranasal tumours. Fifteen dogs with malignant intranasal tumours were treated twice weekly using a hypofractionated protocol with eight fractions, 5 Gy per fraction, resulting in a total dose of 40 Gy. Acute and chronic adverse side‐effects appeared to be rare. Only 7% of the acute side‐effects and 5% of the chronic were classified as severe (grade 3). Eight dogs showed clinical complete remission, and five dogs had partial remission, with a resolution of tumour‐related symptoms. Magnetic resonance imaging showed a reduced tumour mass in 12 cases. Median survival time was 17 months (range 4–48 months), with four dogs (three without disease) still alive. Median time to recurrence of these dogs was 14 months. In nine dogs, progression or recurrence of the tumour was the cause of death. This study suggests that HDR brachytherapy is feasible and well tolerated.     

Entropion correction in dogs and cats using a combination Hotz-Celsus and lateral eyelid wedge resection: results in 311 eyes

A novel surgical combination technique for the correction of lateral lower lid entropion in dogs and cats is described, involving a combination of Hotz-Celsus and lateral eyelid wedge resection procedures. The technique was used to treat 311 eyes with lower lid entropion: 269 canine (109 bilateral, 51 unilateral) and 42 feline (16 bilateral, 10 unilateral). The most common canine breeds were the Shar Pei, Rottweiler, Bull Mastiff and Labrador Retriever. Domestic cats made up the majority of feline cases. The overall success rate for a single surgical procedure to correct lower lid entropion with this technique was 94.2% per eye.     

Nasal aspergillosis and penicilliosis in dogs: results of treatment with thiabendazole

Forty-seven dogs with nasal aspergillosis or penicilliosis were treated with thiabendazole (20 mg/kg orally for 6 weeks). Nasal turbinectomy was performed on 26 of the dogs. Six months or more later, 43% of the dogs were clinically normal or considerably improved; results were better in dogs not treated surgically. It was concluded that thiabendazole at a dosage of 20 mg/kg is not an effective treatment for nasal aspergillosis or penicilliosis in dogs.     

Thoracic bite trauma in dogs: a comparison of clinical and radiological parameters with surgical results

OBJECTIVES: Canine bite wounds may cause severe underlying tissue trauma even with no clinically evident puncture wounds. In order to assess the ability of pre-operative diagnostic parameters to predict the extent of internal damage inflicted by a thoracic bite wound, the clinical, radiological and surgical data of 45 dogs that sustained thoracic bite trauma were recorded. METHODS: Clinical, radiographic and surgical parameters from 45 dogs of various breeds with thoracic bite trauma, were analysed (P<0.05). All dogs were treated according to a previously described protocol and had exploratory surgery including a thoracotomy. RESULTS: Mainly small-breed dogs were traumatised. Clinical and radiological data were suggestive of internal trauma but not reliable as accurate indicators for internal lesions. Only radiological evidence of lung contusion was significantly associated with the presence of surgically confirmed lung contusion (P=0.006). Dogs with postoperative wound complications had a significantly higher risk of dying than those without complications (P=0.04). CLINICAL SIGNIFICANCE: This study concludes that according to protocol an optimal management of thoracic bite wounds in small dogs includes surgical exploration of the wound and the thoracic cavity in the presence of flail or pseudo-flail chest, fractured ribs, radiological evidence of lung contusion, pneumothorax or any combination of these.     

Cisterna chyli ablation with thoracic duct ligation for chylothorax: results in eight dogs

OBJECTIVE: To report use of combined cisterna chyli ablation (CCA) and thoracic duct ligation (TDL) for treatment of spontaneously occurring chylothorax in dogs. STUDY DESIGN: Retrospective study. ANIMALS: Eight dogs with chylothorax. METHODS: TDL was performed through a right caudal intercostal thoracotomy and CCA through a left flank paracostal approach or ventral median celiotomy. Long-term outcome (range, 2-48 months; median, 11.5 months) was evaluated by telephone communication with owners. RESULTS: Seven dogs were free of clinical signs related to chylothorax at last follow-up (range, 4-48 months; median, 15.5 months). One dog was euthanatized 2 months after surgery because of lack of improvement. No major complications occurred from CCA. CONCLUSION: CCA and TDL resolved chylothorax in most dogs (88%). CLINICAL RELEVANCE: CCA combined with TDL may improve the outcome of chylothorax in dogs.     

Assessment of decompressive surgery in dogs with degenerative lumbosacral stenosis using force plate analysis and questionnaires

Objective— To evaluate the long-term outcome after decompressive surgery in dogs with degenerative lumbosacral stenosis (DLS), using force plate analysis (FPA) and owner questionnaires.
Study Design— Prospective clinical study.
Animals— Dogs with DLS (n=31) and 24 clinically normal Labrador Retrievers.
Methods— FPA was performed before surgery (31 dogs) and at 3 days, 6 weeks, 6 months (each, 31 dogs) and ≥1.5 years (12 dogs) after surgery. Peak vertical forces (Fz⁺), braking (Fy⁺), and propulsive forces (Fy⁻), and the corresponding impulses were determined. Questionnaires were completed by the owners before and at 6 months and ≥1.5 years after surgery.
Results— Fy⁻ of the pelvic limbs and the ratio pelvic/thoracic of Fy⁻ (P/TFy⁻) were significantly smaller in dogs with DLS than controls. Fy⁻ and P/TFy⁻ decreased significantly 3 days after surgery, and increased during 6 months follow-up, but with long-term follow-up the values remained the same and were smaller than controls. From questionnaires there was a significant improvement after surgery compared with function before surgery. Most owners were satisfied with outcome after surgery.
Conclusions— Propulsive forces of the pelvic limbs in dogs with DLS are impaired and are partially restored by decompressive surgery.
Clinical Relevance— Owner's questionnaires illustrate that decompressive surgery restores function as perceived by owners whereas FPA continues to show impaired propulsive forces for the pelvic limbs.     

Development of a retrobulbar injection technique for ocular surgery and analgesia in dogs

OBJECTIVE: To develop and compare 3 techniques for retrobulbar injection of local anesthetic agents for ocular surgery and analgesia in dogs. DESIGN: Prospective study. ANIMALS: 17 dogs (including 9 cadavers). PROCEDURES: Inferior-temporal palpebral (ITP), perimandibular, and combined superior-inferior peribulbar injection techniques were compared by assessing the distribution of latex after injection into the orbits of 5 canine cadavers; magnetic resonance imaging (MRI) evaluation of the distribution of contrast agent after injection in the retrobulbar space of 4 canine cadavers; and assessment of the efficacy and MRI evaluation of the anatomic distribution of injections of a lidocainecontrast agent mixture in 4 anesthetized, nonrecovery dogs. By use of the preferred technique (ITP), the ocular effects of lidocaine anesthesia were evaluated in 4 dogs; during a 2-week period after treatment, dogs underwent ophthalmic examination, Schirmer tear testing (STT), intraocular pressure (IOP) measurement, and Cochet-Bonnet esthesiometry. RESULTS: Of the 3 techniques, the ITP technique was the preferred method for retrobulbar administration of anesthetic agent in dogs because it was efficacious (pupil dilation and central rotation of the globe achieved in all eyes), easiest to perform, and provided thorough coverage of the intraconal retrobulbar space without complication. During the 2-week follow-up period, the ITP injection did not significantly affect STT, IOP, or Cochet-Bonnet esthesiometry values in dogs. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs, retrobulbar administration of anesthetic agents via the ITP technique is a potential alternative to systemic administration of neuromuscular blocking agents for ophthalmic surgery and provides the additional benefit of local ocular analgesia.     

Systemic lidocaine infusion as an analgesic for intraocular surgery in dogs: a pilot study

Objective To determine if systemic administration of lidocaine during intraocular surgery reduces post-operative ocular pain. Study design Randomized, masked, controlled experimental trial. Animals Twelve dogs weighing 15.5 ± 1.7 kg (mean ± SD) and aged 2.5 ± 0.6 years. Methods All dogs underwent a baseline ophthalmic examination and subjective pain score. Anesthesia consisted of acepromazine (0.1 mg kg⁻¹, IM), propofol (4–6 mg kg⁻¹, IV), and isoflurane in oxygen. There were three groups each receiving a bolus followed by an infusion (n = 4): saline (0.3 mL kg⁻¹ IV + 0.2 mL kg⁻¹hour⁻¹ IV); morphine (0.15 mg kg⁻¹ IV + 0.1 mg kg⁻¹hour⁻¹ IV); and lidocaine (1.0 mg kg⁻¹ IV + 0.025 mg kg⁻¹minute⁻¹ IV). All treatments began 15 minutes prior to starting of phacoemulsification and lens removal from the right eye. Pain scores were recorded at 0.5, 1, 2, 3, 4, 6, 8, 16, and 24 hours after t = 0 (extubation). Rescue morphine was administered (1.0 mg kg⁻¹ IM) if the subjective pain score ≥9 (maximum = 24), and the dog was excluded from further data analysis. Differences in pain scores and time-to-treatment failure (TTF) were analyzed using the Wilcoxon's rank sum test. Differences in incidence of treatment failure were analyzed using Fisher's exact test. Physiologic data were analyzed using repeated measures anova . Significance was defined as P < 0.05. Results Incidence of treatment failure was 100% in saline-treated dogs and 50% in morphine- or lidocaine-treated dogs. There was no difference in intraocular pressure, aqueous flare, cell count (or protein) between groups in the operated eye at any time following extubation. Conclusion and clinical relevance This pilot study suggests that intraoperative lidocaine may provide analgesic benefits similar to morphine for intraocular surgery in dogs, but more definitive research is needed. This model appears to be appropriate for pain assessment studies as the negative control group demonstrated 100% failure rate.     

Concurrent pituitary and adrenal tumors in dogs with hyperadrenocorticism: 17 cases (1978-1995).

OBJECTIVE: To describe the clinicopathologic characteristics of dogs with hyperadrenocorticism and concurrent pituitary and adrenal tumors. DESIGN: Retrospective study. ANIMALS: 17 client-owned dogs. PROCEDURE: Signalment, response to treatment, and results of CBC, serum biochemical analysis, urinalysis, endocrine testing, and histologic examinations were obtained from medical records of dogs with hyperadrenocorticism and concurrent adrenal and chromophobe pituitary tumors. RESULTS: On the basis of results of adrenal function tests and histologic examination of tissue specimens collected during surgery and necropsy, concurrent pituitary and adrenal tumors were identified in 17 of approximately 1,500 dogs with hyperadrenocorticism. Twelve were neutered females, 5 were males (3 sexually intact, 2 neutered); and median age was 12 years (range, 7 to 16 years). Hyperadrenocorticism had been diagnosed by use of low-dose dexamethasone suppression tests and ACTH stimulation tests. During high-dose dexamethasone suppression testing of 16 dogs, serum cortisol concentrations remained high in 11 dogs but decreased in 5 dogs. Plasma concentrations of endogenous ACTH were either high or within the higher limits of the reference range (12/16 dogs), within the lower limits of the reference range (2/16), or low (2/16). Adrenal lesions identified by histologic examination included unilateral cortical adenoma with contralateral hyperplasia (10/17), bilateral cortical adenomas (4/17), and unilateral carcinoma with contralateral hyperplasia (3/17). Pituitary lesions included a chromophobe microadenoma (12/17), macroadenoma (4/17), and carcinoma (1/17). CLINICAL IMPLICATIONS: Pituitary and adrenal tumors can coexist in dogs with hyperadrenocorticism, resulting in a confusing mixture of test results that may complicate diagnosis and treatment of hyperadrenocorticism.     

Reduction and temporary stabilization of acetabular fractures using ASIF mandibular reduction forceps: technique and results using plate fixation in 25 dogs

OBJECTIVE: To report the results of acetabular fracture fixation in 25 dogs in which a specialized forceps (ASIF mandibular reduction forceps, Synthes USA, Paoli, PA) was used to obtain fracture reduction and stabilization. STUDY DESIGN: A retrospective clinical study. ANIMAL POPULATION: Twenty-five client-owned dogs with traumatic acetabular fractures. METHODS: The mandibular reduction forceps (MRF) use a screw on each side of the fracture to attach the clamp directly to the bone and permit direct manipulation of the fragments. Medical records from 25 dogs with acetabular fractures were reviewed to determine the effectiveness of this technique in obtaining, and then maintaining, fracture reduction while a plate was being applied. RESULTS: Clinical results were considered successful in 24 of 25 dogs; the small size of 1 dog prevented application of the MRF. The final reduction and fixation of the fractures was evaluated as anatomic in 17 dogs, near-anatomic in 6 dogs, and nonanatomic in 1 dog. CONCLUSIONS AND CLINICAL RELEVANCE: Application of the MRF is an effective technique for aiding the reduction of acetabular fractures in dogs. It maintains reduction while simultaneously permitting unimpeded access to the dorsal acetabular rim, thus facilitating accurate contouring of a plate. Accurate reduction and rigid fixation of articular fractures is essential to prevent secondary osteoarthritis.     

Comparison of a method using the HemoCue near patient testing device with a standard method of haemorrhage estimation in dogs undergoing spinal surgery

Objective  To compare an estimate of blood loss obtained using measurements from the Hemocue photometer with a standard estimate in dogs undergoing spinal surgery.
Study design  Prospective clinical study.
Animals  Twenty-nine client-owned dogs.
Methods  During surgery, blood and all lavage fluids were collected in the suction container and on to swabs. To prevent blood clot formation in the suction container, 10 mL citrate-phosphate dextrose adenine (CPDA) was added. At the end of the procedure, the total volume in the suction container was recorded. It was shaken to ensure uniformity and a 5 mL sample tested with the HemoCue photometer. Blood loss in the suction container was calculated as follows: Blood in suction (mL) = volume in bottle (mL) × [suction haemoglobin (Hb) concentration (g dL⁻¹)/pre-operative Hb concentration (g dL⁻¹)]. This volume was added to the estimated volume of blood on the swabs (weight of soaked swabs minus that of dry swabs) to provide the Hemocue estimate of total blood loss. A standard haemorrhage estimate was performed using the volume of fluid in the suction container at the end of surgery in excess of the total volume of lavage fluid available, minus 10 mL CPDA. This volume was added to the estimated volume of blood on the swabs to provide the standard estimate of total blood loss. Data were analyzed with a paired t -test. Retrospective power calculations demonstrated an 80% power to detect a mean difference of 25 mL between the two methods with a level of significance of 0.05.
Results  There was no significant difference in calculated blood loss between the two methods ( p  = 0.8, mean difference: −2 mL, 95% CI: −20 to 16 mL).
Conclusions and clinical relevance  The HemoCue may be used to help estimate blood loss in dogs undergoing spinal surgery.     

A clinical comparison between a non‐invasive blood pressure monitor using high definition oscillometry (Memodiagnostic MD 15/90 Pro) and invasive arterial blood pressure measurement in anaesthetized dogs

ObjectiveTo compare high definition oscillometry (HDO) to invasive blood pressure measurement in anaesthetized dogs.Study designProspective, clinical trial.AnimalsFifty dogs weighing 1.95–79 kg (mean 23.5 kg).Materials and methodsAnaesthetic and peri–anaesthetic management was chosen according to each dog's physical status and anaesthetist's preference. Direct arterial blood pressure measurements were performed using a catheter placed in the dorsal pedal artery and an electronic pressure transducer connected to a multiparameter monitor. Non–invasive blood pressure measurements were performed using an appropriately sized cuff placed around the tail base. Comparisons between the two methods were made using Bland and Altman plots. The data are reported as mean bias (lower, upper limits of agreement). Further analysis was performed after separating the data into the following categories based on invasive mean arterial blood pressure (MAP): high (MAP > 100 mmHg), medium (70 mmHg < MAP < 100 mmHg) and low (MAP < 70 mmHg) blood pressure (BP). The two methods were compared as used clinically.ResultsEight hundred measurement pairs for invasive and HDO BP readings were compared. Overall, the HDO measured lower values for SAP and DAP but higher for MAP than the invasive method. The lowest bias (upper, lower limits of agreement) were obtained for MAP, ?1 (?22, 19) mmHg. The biggest discrepancy between the methods was reflected by a large bias (limits of agreement) 5 (?34, 45) mmHg, was for SAP. The results for DAP were between those for SAP and MAP with a bias (limits of agreement) of 3 (?20, 27) mmHg. When the values were separated into the pressure range categories the HDO measured higher in the high, medium and low BP groups, with the exception of SAP in the low BP group.ConclusionsWhen considering the mean bias, the accuracy of HDO compared well with direct arterial blood pressure, but the precision was poor, as determined by wide limits of agreement.Clinical relevanceUsing trends and serial measurements rather than a single measurement for clinical decision making is recommended with both methods, when used as reported here.