Aldosterone-to-renin and cortisol-to-adrenocorticotropic hormone ratios in healthy dogs and dogs with primary hypoadrenocorticism

In dogs with primary hypoadrenocorticism, hypocortisolism and hypoaldosteronism usually are present, but these deficiencies also may occur in isolated forms. The diagnosis is commonly made by measuring plasma cortisol concentration before and after stimulation with ACTH, thereby ignoring aldosterone. In search of an alternative approach that would include assessment of glucocorticoid and mineralocorticoid production, 2 pairs of endocrine variables were measured: (1) plasma concentration of cortisol and ACTH, and (2) plasma aldosterone concentration and plasma renin activity. In addition, the cortisol-to-ACTH ratio (CAR) and the aldosterone-to-renin ratio (ARR) were calculated. Reference intervals were established in a population of 60 healthy dogs. In these dogs, CAR ranged from 1.1 to 26.1 and ARR ranged from 0.1 to 1.5. The variables were compared with those of 22 dogs with spontaneous primary hypoadrenocorticism. Plasma concentration of cortisol and ACTH in both groups of dogs overlapped, whereas CAR did not. Similarly, plasma aldosterone concentration and plasma renin activity overlapped, whereas ARR did not. These observations indicate that measurement of these endogenous variables (in one blood sample) allows the specific diagnoses of primary hypocortisolism and primary hypoaldosteronism.     

Evaluation of acute congestive heart failure in dogs and cats: 145 cases (2007–2008)

Objective – To characterize the clinical presentation, management, and in‐hospital outcomes of dogs and cats diagnosed with acute congestive heart failure (CHF). Design – Retrospective study of animals seen between January 2007 and May 2008. Setting – Emergency service at a university teaching hospital. Animals – Ninety dogs and 55 cats with CHF. Measurements and Main Results – Patient characteristics, including age, clinical signs, clinicopathologic abnormalities, diagnostic testing, and outcome were recorded. Forty‐eight of the animals already were receiving cardiac medications at the time of presentation. The most common diseases represented were chronic valvular disease and cardiomyopathies. Cats had significantly lower median body temperature at admission compared with dogs (P<0.001). The most common abnormalities were elevated lactate (64%), elevated BUN (52%), hypochloremia (31%), hyperglycemia (27%), and elevated liver enzymes (26%). Many of these became even more prevalent during hospitalization. One hundred and sixteen animals were discharged from the hospital, for a survival rate of 80%. There was no survival difference between dogs and cats (P=0.39). Dogs that developed hypokalemia during hospital stay (P=0.04) were more likely to survive compared with those without hypokalemia and initial body temperature was lower for those cats that did not survive (P=0.02). Of those that did not survive, the majority were euthanized (n=25), while 4 dogs died. Conclusions – Dogs and cats presented to the emergency service with CHF had a high survival rate. In cats, initial body temperature was lower for those cats that did not survive. Although clinicopathologic abnormalities were common in both species, only dogs with hypokalemia had improved survival to hospital discharge.     

Horner's syndrome in dogs and cats: 49 cases (1980-1986)

Medical records of 49 dogs and cats with Horner's syndrome were reviewed. Causes included head, neck, and chest trauma, chronic otitis, cranial thoracic mass, and injury attributable to cleaning of the external ear canal. Cause could not be delineated in 54.5% of the dogs. Numerous diagnostic tests and pharmacologic challenge exposure with epinephrine were used to localize the site of injury. Resolution of all clinical signs was observed in 36 animals and required a mean of 7.7 weeks.     

Left atrial rupture in dogs: 14 cases (1990–2005)

Objective: To describe the clinical parameters, treatment, and prognosis of dogs with left atrial rupture secondary to chronic mitral valve insufficiency. Design: Retrospective study. Setting: University referral hospital. Animals: 14 dogs with left atrial rupture. Interventions: None. Measurements and main results: Mixed breed dogs (n=6, 43%) and Shetland Sheepdogs (n=3, 21%) were most commonly affected. The median age was 12 years (range 5.8–18 y). The median weight was 11 kg (range 4–30 kg). Eight dogs had been previously diagnosed with chronic valvular disease. The most common presenting complaints included collapse (13/14), cough (9/14), and dyspnea (8/14). Four dogs were presented in either respiratory or cardiac arrest. Pericardial effusion was present in 13 dogs. The median left atrium:aortic outflow ratio was 2.66 (range 1.66:1–5.52:1). Pericardiocentesis was performed to alleviate tamponade in 3 dogs. Five dogs were discharged from the hospital, 3 of which were euthanized within 35 days of initial diagnosis for recurrence of clinical signs (n=2) and for hematochezia and lethargy (n=1). Five dogs were euthanized while in the hospital for a variety of reasons including DIC, progressive azotemia, collapse and recurrence of pericardial effusion, or possible seizure episode. Conclusions: Although rare, left atrial rupture resulting in pericardial effusion should be considered in older small‐ to medium‐sized dogs presenting with collapse, cough, and dyspnea. The overall prognosis appears poor.     

Low ratios of sodium to potassium in the serum of 238 dogs

Serum sodium:potassium (Na:K) ratios are often reported in biochemical studies of dogs, although their value has not been assessed. The aims of this study were to identify diseases associated with a low Na:K ratio in dogs and to compare their prevalence with the prevalence in dogs from the same referral hospital with normal Na:K ratios. A total of 238 dogs with a Na:K ratio less than 27 were identified from medical records. Sample contamination with edta was suspected in 74 cases (31 per cent) and these and two cases that had been supplemented with potassium were removed from the analysis. The remaining 162 cases and 147 control dogs were divided into five categories depending on the organ system affected. Among the cases there were significantly more in the endocrine category than among the control dogs. Hypoadrenocorticism was the most single common cause of a low Na:K ratio and affected 27 (16.7 per cent) of the cases. Other clinical problems associated with low Na:K ratios included different urogenital, cardiorespiratory and gastrointestinal diseases.     

Prevalence of mucopolysaccharidosis type VI mutations in Siamese cats

Mucopolysaccharidosis type VI (MPS VI), a lysosomal storage disease, is one of the more prevalent inherited diseases in cats and is commonly found in cats with Siamese ancestry. The prevalence of 2 known MPS VI mutations in cats was investigated in 101 clinically normal Siamese cats, in 2 cats with clinical signs of MPS VI, and in 202 cats from 4 research colonies. The mutation L476P which causes a severe clinical phenotype, was present on both alleles in the known MPS VI cats from Italy and North America and was present in all research colonies that originated from North America. However, LA76P was not detected in the Siamese population screened. In contrast, the mutation D520N, which causes a mild clinical phenotype, was identified in 23 of 202 (11.4%) alleles tested in Siamese cats from 3 continents, 2 of which were homozygous for D520N. Thus, the D520N mutation was widespread, and it is likely that cats inheriting both mutations (LA76P/D520N compound heterozygotes) would be in the general Siamese population, particularly in North America. Practitioners should note the high incidence of degenerative joint disease in these animals.     

Comparison of liver cytology and biopsy diagnoses in dogs and cats: 56 cases

Abstract: The results of liver cytology and corresponding biopsy specimens submitted to the Pathology Department at Angell Memorial Animal Hospital during 1998 were retrospectively reviewed to objectively assess the diagnostic value of liver cytology. A "corresponding" biopsy was defined as a biopsy specimen obtained within 1 day of the cytology specimen. Fifty-six cases were reviewed, including 25 from dogs and 31 from cats. Results were in complete agreement in 34 cases, in partial agreement in 11 cases, and in disagreement in 11 cases. Agreement occurred most often in cases of fatty change (10 cases) and neoplasia (7 cases of lymphoma and 3 cases of epithelial tumor). Disagreement was most common in cases of hepatitis (6 cases) in which inflammation was not seen in cytologic specimens. Other causes for disagreement included fibrosis (2 cases), and 1 case each of amyloidosis, hemangiosarcoma, and lymphoma. Three cytologic specimens were considered suggestive of hepatitis because of leukocytosis in the background, although clinicians were advised to compare cytologic observation to CBC results. Cytologic evaluation of the liver was useful for determining disease processes, especially when disease distribution was diffuse.     

Comparison of fractional excretion and 24-hour urinary excretion of sodium and potassium in clinically normal cats and cats with induced chronic renal failure.

The influence of induced chronic renal failure on 24-hour urinary excretion and fractional excretion of sodium and potassium was studied in cats. Induction of chronic renal failure significantly increased fractional excretion of potassium (P less than 0.0001) and sodium (P less than 0.05); however, 24-hour urinary excretion of sodium and potassium decreased slightly following induction of chronic renal failure. Fractional excretion and 24-hour urinary excretion of sodium and potassium were compared by linear regression in clinically normal cats, cats with chronic renal failure, and clinically normal and affected cats combined. In clinically normal cats, linear regression revealed only moderate correlation between fractional excretion and 24-hour urinary excretion for sodium and potassium. Linear regression of these same relationships in cats with chronic renal failure, and in clinically normal cats and cats with chronic renal failure combined, indicated low correlation. Fractional excretions of sodium and potassium were not reliable indicators of 24-hour urinary excretion of these electrolytes in cats with chronic renal failure or unknown glomerular filtration rate. Fractional excretion of potassium and sodium correlated only moderately with 24-hour urinary excretion in clinically normal cats.     

High urinary corticoid/creatinine ratios in cats with hyperthyroidism

Measurement of the urinary corticoid : creatinine (C : C) ratio provides an assessment of cortisol secretion over a period of time. Therefore, this test is a very sensitive measure of adrenocortical function. The stress of the diagnostic procedure and nonadrenal disease may increase the urinary C : C ratio. In addition, diseases such as hyperthyroidism may influence the metabolic clearance of cortisol. To evaluate the effect of thyroid hormone excess, urinary C : C ratios were measured in 32 cats with hyperthyroidism and 45 healthy household cats. In 7 cats, urinary C : C ratios were measured both before and after treatment for hyperthyroidism. With data from the healthy cats, the reference range for the urinary C : C ratio was determined to be 8.0 to 42.0 X 10(-6). The urinary C : C ratios in the cats with hyperthyroidism (median, 37.5 x 10(-6); range, 5.9-169.5 x 10(-6)) were significantly (P = .001) higher than those in the healthy cats (median, 16 x 10(-6); range, 4.8-52.5 x 10(-6)). In 15 cats with hyperthyroidism, the urinary C : C ratios exceeded the upper limit of the reference range. Treatment for hyperthyroidism led to a marked decrease in urinary C : C ratios. The results of this study demonstrate that the urinary C : C ratio may be abnormally high in cats with hyperthyroidism, probably because of increased metabolic clearance of cortisol and activation of the pituitary-adrenocortical axis by disease. Although the clinical features of hyperthyroidism and hyperadrenocorticism in cats are different, hyperthyroidism should be ruled out when cats are suspected of hyperadrenocorticism on the basis of abnormally high urinary C : C ratios.     

Retrobulbar tumors in dogs and cats: 25 cases

Twenty-five cases of retrobulbar tumors are presented and discussed. Affected animals were dogs and cats (average 10.7 years). No breed or sex predisposition was noted. The most common clinical signs were exophthalmos (84%), conjunctival hyperemia (40%), protrusion of the nictitating membrane (28%), exposure keratitis (20%) and fundus abnormalities (20%). Diagnostic tools included fine needle aspiration, radiography, ultrasonography, computed tomography and histology. Surgical treatment by orbitotomy or exenteration was combined with chemotherapy and radiotherapy in some cases. The prognosis was poor with low survival times: 1 month in cats, and 10 months in dogs, with a high rate of euthanasia (35%) at the time of diagnosis.     

Ileocolic junction resection in dogs and cats: 18 cases

There is limited veterinary literature about dogs or cats with ileocolic junction resection and its long-term follow-up. To evaluate the long-term outcome in a cohort of dogs and cats that underwent resection of the ileocolic junction without extensive (≥50%) small or large bowel resection. Medical records of dogs and cats that had the ileocolic junction resected were reviewed. Follow-up information was obtained either by telephone interview or e-mail correspondence with the referring veterinary surgeons. Nine dogs and nine cats were included. The most common cause of ileocolic junction resection was intussusception in dogs (5/9) and neoplasia in cats (6/9). Two dogs with ileocolic junction lymphoma died postoperatively. Only 2 of 15 animals, for which long-term follow-up information was available, had soft stools. However, three dogs with suspected chronic enteropathy required long-term treatment with hypoallergenic diets alone or in combination with medical treatment to avoid the development of diarrhoea. Four of 6 cats with ileocolic junction neoplasia were euthanised as a consequence of progressive disease. Dogs and cats undergoing ileocolic junction resection and surviving the perioperative period may have a good long-term outcome with mild or absent clinical signs but long-term medical management may be required.     

Efficacy of monensin sodium for the reduction of fecal shedding of Mycobacterium avium subsp. paratuberculosis in infected dairy cattle

Reducing the quantity of Mycobacterium avium subsp. paratuberculosis (MAP) being shed by cows with Johne's disease should decrease the risk of spread of this disease to young stock. Previous work has suggested that monensin sodium decreases the pathologic lesions associated with Johne's disease, but the impact on shedding of viable MAP remains unknown. After serologic screening of 32 dairy herds in southwestern Ontario, 228 cows from 13 of these herds were enrolled into a randomized clinical trial. Fecal culture and PCR were used to identify 114 cows as potential fecal shedders, while another 114 cows were enrolled as ELISA negative, herd and parity matched controls. All cows were randomized to receive either a monensin controlled release capsule (CRC) or a placebo capsule. Serial fecal and blood samples were collected for fecal culture and serum ELISA testing over a 98-day period. On day 98 of the study, treatments were switched for all cows continuing in the trial. These remaining cows were followed for another 98 days with a similar sampling protocol. Mixed effect models were used to measure the impact of treatment on the number of colony forming units identified on fecal cultures over time. During the first 98 days of the study, cows treated with a monensin CRC were found to shed 3.4 cfu per tube less than placebo treated cows (P = 0.05). The serum ELISA S/P ratio was reduced by 1.39 units in cows given monensin (P = 0.06). However, treatment with monensin did not reduce the odds of testing positive on serology. Only the cows shedding MAP on day 0 were found to have a reduced odds of testing positive on fecal culture when treated with monensin (OR = 0.27; P = 0.03). Monensin sodium administered to infected animals at 335 mg/day marginally reduced fecal shedding of MAP in mature dairy cattle, but the biological significance of this reduction is unknown.     

Retrospective Study: Cause and clinical characteristics of rib fractures in cats: 33 cases (2000–2009)

Objective – To characterize the clinical features and population differences among cats sustaining traumatic and nontraumatic rib fractures. Design – Retrospective clinical study. Setting – University small animal hospital. Animals – Thirty‐three cats with radiographic evidence of rib fractures. Interventions – None. Measurements and Main Results – Cats with rib fractures were identified by performing a computer search of the radiology database. Thirty‐three cats that sustained rib fractures were identified between January 2000 and September 2009. Seventeen cats had fractures due to trauma and 16 were deemed to occur from nontraumatic causes. A Mann‐Whitney rank‐sum test revealed statistically significant differences in the median ages between the 2 groups. Older cats were more likely to sustain rib fractures as a result of a presumed nontraumatic causes. A Chi‐square analysis showed that nontraumatic fractures occurred significantly more often in the midbody region and involved the 9th–13th ribs. The majority of cats with presumed nontraumatic rib fracture had respiratory disease; the remaining cats had chronic renal disease or neoplasia. Cats with traumatic rib fractures had external signs of trauma. Conclusion – Rib fractures in cats may be clearly associated with trauma, or may be an incidental finding in cats with comorbidities. Cats with diseases that cause prolonged respiratory effort or coughing, metabolic diseases, or certain neoplasms, are at increased risk of spontaneous nontraumatic rib fractures.