Evaluation of clinical characteristics, diagnostic test results, and outcome in horses with internal infection caused by Corynebacterium pseudotuberculosis: 30 cases (1995-2003)

OBJECTIVE: To determine clinical signs, results of diagnostic testing, and outcome in horses with internal Corynebacterium pseudotuberculosis infection. DESIGN: Retrospective study. ANIMALS: 30 horses. PROCEDURE: Information pertaining to clinical data, results of diagnostic tests, and costs of hospitalization and treatment was extracted from medical records of affected horses. RESULTS: Internal C. pseudotuberculosis infection was diagnosed on the basis of clinical signs, diagnostic imaging, and clinicopathologic data, including results of serologic tests and bacterial culture. The most common clinical signs were concurrent external abscesses, anorexia, fever, lethargy, weight loss, and signs of respiratory tract disease or abdominal pain. Clinicopathologic abnormalities included a geometric mean reciprocal serum synergistic hemolysin inhibition titer > or = 512, leukocytosis with neutrophilia, hyperglobulinemia, hyperfibrinogenemia, and anemia. Specific organ involvement was diagnosed in 27 of 30 horses. Affected organs included the liver (18 horses), lungs (12), kidneys (7), and spleen (3); multiple organs were affected in 10 horses. Treatment with antimicrobials for a median of 36 days (range, 7 to 97 days) was usually successful, yielding an overall survival rate of 71%. CONCLUSIONS AND CLINICAL RELEVANCE: Early diagnosis and long-term antimicrobial treatment were important for a successful outcome in horses with internal C. pseudotuberculosis infection. Ultrasonographic imaging was an important technique for identifying specific organs affected, aiding in obtaining samples for a definitive diagnosis, and monitoring response to treatment. Pregnant mares with internal infections are at risk for fetal loss. Preexisting chronic organ disease may be associated with a poor prognosis.     

MAGNETIC RESONANCE IMAGING FEATURES OF OBLIQUE AND STRAIGHT DISTAL SESAMOIDEAN DESMITIS IN 27 HORSES

Injury to the oblique and straight distal sesamoidean ligaments is becoming recognized as a more common cause of lameness in horses than was previously thought. The purpose of this study was to review the magnetic resonance (MR) imaging findings of 27 horses affected with desmitis of the oblique and/or straight distal sesamoidean ligament and determine long-term prognosis for horses with this diagnosis. Imaging was performed with horses in right lateral recumbency in a high-field 1 T magnet. All horses had lameness localized to the digit or metacarpophalangeal/metatarsophalangeal joint region with diagnostic local anesthetic blocks. Ten horses had forelimb lameness and 17 horses had hind limb lameness. MR imaging revealed abnormalities in the oblique distal sesamoidean ligaments in 18 horses, in the straight distal sesamoidean ligament in three horses, and in both the oblique and straight distal sesamoidean ligament in six horses. Treatment consisted of a 6-month rest and rehabilitation program in all horses. The digital flexor tendon sheath was injected with methylprednisolone acetate and hyaluronic acid in 22 horses to decrease inflammation in the injured ligaments before starting the rest and rehabilitation program. Two horses had ligament splitting performed, one in the oblique distal sesamoidean ligament and one in the straight distal sesamoidean ligament. MR imaging is an effective method for diagnosing injury to the oblique and straight distal sesamoidean ligaments in horses. Treatment, primarily a 6-month rest and rehabilitation program, allowed 76% of the horses to successfully resume performance.     

Clinical signs, underlying cause, and outcome in cats with seizures: 17 cases (1997-2002)

OBJECTIVE: To determine clinical signs, results of diagnostic testing, underlying cause, and outcome in cats with seizures. DESIGN: Retrospective study. ANIMALS: 17 cats with seizures. PROCEDURE: Only those cats in which an underlying metabolic abnormality causing the seizures had been identified, diagnostic imaging of the brain and CSF analysis had been done, or a necropsy had been performed were included. Seizures were classified as being a result of metabolic disease, symptomatic epilepsy (ie, epilepsy resulting from a structural lesion of the brain), or probably symptomatic epilepsy (ie, epilepsy without any extracranial or identifiable intracranial disease that is not suspected to be genetic in origin). RESULTS: 3 cats had seizures associated with an underlying metabolic disease (hepatic encephalopathy), 7 had symptomatic epilepsy (3 with neoplasia and 4 with meningoencephalitis), and 7 had probably symptomatic epilepsy. Six of the 7 cats with symptomatic epilepsy died or were euthanatized within 3 months after the diagnosis was made, whereas 6 of the 7 cats with probably symptomatic epilepsy survived for at least 12 months after the diagnosis was made. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cats with probably symptomatic epilepsy may have a good long-term prognosis.     

Combined cytosine arabinoside and prednisone therapy for meningoencephalitis of unknown aetiology in 10 dogs

OBJECTIVES: The differential diagnosis for young to middle-aged dogs with progressive neurological signs, focal or multifocal computed tomography/magnetic resonance imaging lesions, mononuclear cerebrospinal fluid pleocytosis and negative infectious titres includes granulomatous meningoencephalomyelitis, breed-specific meningoencephalitis, infectious meningoencephalitis of unknown origin and central nervous system neoplasia. The terminology meningoencephalitis of unknown aetiology may be preferable for cases that lack histopathological diagnoses. The safety and efficacy of a combination of cytosine arabinoside and prednisone protocol is evaluated, in this study, for the treatment of meningoencephalitis of unknown aetiology in 10 dogs. METHODS: Cases were selected based on neuroanatomical localisation, negative regional infectious disease titres, cerebrospinal fluid pleocytosis and brain imaging. Clinical response was gauged through follow-up examinations, owner and referring veterinarian surveys and review of medical records. RESULTS: Partial or complete remission was achieved in all dogs; the median survival time for the 10 dogs was 531 days (range 46 to 1025 days), with five of the 10 dogs alive at the time of writing. CLINICAL SIGNIFICANCE: Prednisone/cytosine arabinoside is a safe empirical therapy for dogs with meningoencephalitis of unknown aetiology; this drug combination may prolong survival time.     

A review of dicrocoeliosis of ruminants including recent advances in the diagnosis and treatment

Despite its widespread presence among grazing ruminants, dicrocoeliosis, also known as "small liver fluke" disease, is poorly known and often underestimated by researchers and practitioners in many countries. This is primarily due to the multiple parasitic infections which affect ruminant livestock and mask the pathology of dicrocoeliosis, to the difficulties in diagnosing it with coprological techniques and, finally, to the few effective drugs found. Furthermore, the biological cycle of Dicrocoelium, which requires a snail and an ant as intermediate hosts, and the high number of ecological and epidemiological variables affecting the disease make it difficult to set up experimental designs to study dicrocoeliosis. In the past 50 years, many aspects of this disease have been broadly investigated (aetiology, life cycle, diffusion, epidemiology, pathogenesis and immunology) but its diagnosis and treatment still remain moot issues. Dicrocoeliosis often remains clinically undetected and its diagnosis is mostly based on adult dicrocoelia recovered in the liver post mortem or on egg detected at coprological examination. The prophylaxis of the small liver fluke has been difficult and unsatisfactory to date due to the complexity of its biological life cycle and epidemiology. Many anti-helminthic drugs are practically ineffective against dicrocoeliosis if used at the dosage recommended against other gastrointestinal helminths and lungworms. The most important aspects of the aetiology, biological cycle, spread, epidemiology and pathogenesis of dicrocoeliosis are reviewed and the recent advances in the diagnosis and treatment are focused on.     

Metaphyseal osteopathy (hypertrophic osteodystrophy) in growing dogs. A clinical study

Based on the different investigations performed, the author finds that the diseases called skeletal scurvy, infantile scurvy, Jvfcller Barlow's disease, hypertrophic osteodystrophy and osteodystrophy II must be the same entity.
This study deals with twenty-six dogs suffering from this disease. Contrary to earlier reports, the prognosis is favourable. There were no significant differences in recovery between dogs intensively treated and those not treated. Relapses were rare, and only two dogs subsequently developed classical hypertrophies.
Based on these findings, and recognizing that the aetiology is still unknown, the author suggests the name metaphyseal osteopathy for this affection.     

Key considerations in the approach to congenital heart disease in dogs and cats

Congenital heart disease is an important subset of all cardiovascular disease in dogs and cats that is present at birth and most often detected in young animals but can be diagnosed in adulthood. The range of abnormalities that can occur during development of the heart is vast incorporating simple and complex defects, varying degrees of severity and clinical presentations that include heart failure and cyanosis. While some defects do not result in morbidity in an individual animal, others cause severe clinical signs and death at a young age. Advances in imaging and expanding treatment options offer increasingly more possibilities in the diagnosis and management of congenital heart disease which is the focus of this review. The objective is to provide a broad overview of current practice and highlight key aspects to guide practitioners in their approach to congenital heart disease diagnosis and knowledge of available treatment options.     

Hips, elbows and stifles: common joint diseases in the cat

PRACTICAL RELEVANCE: Cats commonly present with joint disease and trauma. A methodical approach to diagnostics and treatment can aid the clinician in the management of these cases. CLINICAL CHALLENGES: Cats with joint disease may present with a vague history owing to their independent nature, and gait assessment is often challenging when compared with the dog. Knowledge of feline-specific anatomy is important to avoid over- or misinterpretation of physical examination or imaging findings. AUDIENCE: This review of feline joint disease focuses on the more common, non-traumatic conditions of the hip, stifle and elbow. It aims to provide first opinion clinicians with a guide to decision making that will assist them in achieving a diagnosis and formulating a management strategy. EVIDENCE BASE: There is an extensive body of original articles and textbooks in the published literature relating to aspects of feline joint disease. This article combines information from key companion animal and feline-specific references together with the author's clinical experience to provide a practical overview of joint disease, and highlight important differences between cats and dogs in terms of presentation and treatment.     

Feline eosinophilic granuloma complex(ities): some clinical clarification

PRACTICAL RELEVANCE: The feline eosinophilic granuloma complex (EGC) comprises a group of clinically well recognised but poorly understood dermatoses that are common in cats. In many cases, lesions are severe and can be accompanied by varying degrees of (and sometimes considerable) pruritus and/or pain. In addition, lesions can be chronic and recurrent. It is, therefore, important to achieve a prompt and accurate diagnosis in order to provide optimal, often life-long, treatment for affected cats. PATIENT GROUP: There is no age predisposition or well documented breed predilection for the development of EGC lesions in cats. Some studies have reported a possible female predisposition, but this has not been consistently documented. CLINICAL CHALLENGES: The clinical diagnosis of EGC lesions is usually straightforward, but investigation of the potential underlying aetiology can pose a challenge for the clinician. Information on the indication for various diagnostic tests and their interpretation is lacking, and the tendency for these cases to be managed with chronic medical intervention prior to achieving a definitive diagnosis can further complicate the interpretation of any diagnostic investigation. In addition, successful therapeutic management of these cases can be challenging. Some cats suffer only a single episode of disease that resolves with treatment, while others have recurrent lesions and some of these can be refractory to treatment. The individual variation in both the clinical nature of the disease and the response to therapy could be related to disease severity, but could also be explained by differences in the underlying aetiopathogenesis. EVIDENCE BASE: This article reviews the published literature to discuss the complex aetiology of the EGC and present an overview of the different clinical presentations and diagnosis. A further and particular aim has been to provide some evidence-based recommendations for the management of this unusual group of dermatoses.     

Canine hypoadrenocorticism: Part II

Dogs with chronic, vague gastrointestinal signs and those with signs and laboratory abnormalities suggestive of an Addisonian crisis should be tested for hypoadrenocorticism. A previous article (Part I; Can Vet J 2009;50:63–69) discussed the etiology, pathophysiology, clinical signs, and diagnostic abnormalities found in these patients. The present article discusses definitive diagnosis and treatment for both the acute and the chronic Addisonian patient. Expedient treatment remains the cornerstone of management for these patients, particularly those in the former category. The long-term prognosis is excellent for these patients, given well-educated, committed, and vigilant owners.     

Idiopathic hypertrophic pachymeningitis in six dogs: MRI, CSF and histological findings, treatment and outcome

Idiopathic hypertrophic pachymeningitis has been described in humans as a rare, chronic progressive non-specific inflammatory and fibrotic disease of the dura mater. This is a case series of six canine cases of presumptive or confirmed intracranial idiopathic hypertrophic pachymeningitis. These dogs were included in this retrospective study, based on magnetic resonance imaging findings. All presented with pachymeningeal thickening and enhancement without involvement of the leptomeninges on magnetic resonance imaging and no underlying cause identified on cerebrospinal fluid analysis, complete blood count, serum biochemistry and infectious disease titres. Histopathological examination was available in one case. Response to immunomodulatory treatment (corticosteroids and cytosine arabinoside) was achieved in five cases. Idiopathic hypertrophic pachymeningitis should be considered as a possible differential diagnosis for dogs with pachymeningeal thickening on magnetic resonance imaging and no identified underlying cause. The prognosis appears to be fair to poor.     

Paecilomycosis in dogs and horses and a review of the literature

We reviewed 14 cases of paecilomycosis in a tertiary care veterinary hospital and all reports of the disease in the veterinary literature. Paecilomycosis is a rare disease primarily of dogs, horses, reptiles, and humans. Clinical manifestations in veterinary patients vary but include disseminated disease and diskospondylitis, particularly in dogs: pneumonia in dogs, horses, and reptiles; keratitis in horses; and miscellaneous local infections. It is important to have an appropriate index of suspicion because the diagnosis can be difficult, particularly in localized disease where it is difficult to determine whether a positive culture represents an etiology or a contamination with an environmental saprophyte. Spinal radiographs, transtracheal washes, histopathology, and fungal culture have proven to be valuable diagnostic tools. The prognosis for paecilomycosis is poor, although some treatment success has been reported, and success rates could improve if additional information were available regarding fungal species occurring in veterinary patients and drugs to which these fungi are susceptible.     

Congenital heart disease in the dog

The clinical findings and investigation of dogs with congenital cardiac disease is described and the role of diagnostic aids including radiography, electrocardiography and echocardiography is outlined. The physical findings, prognosis and therapy of the common defects are reviewed and their aetiology is briefly discussed.     

Postweaning multisystemic wasting syndrome: a review of aetiology, diagnosis and pathology

This review paper concentrates on the aetiology, diagnosis, and pathological aspects of postweaning multisystemic wasting syndrome (PMWS). PMWS was first recognized in Canada in 1996 as a new emerging disease which caused wasting in postweaned pigs. Since then, PMWS has been recognized in pigs in many countries. The syndrome is caused by a DNA virus referred to as porcine circovirus 2 (PCV2), which is classified in the family Circoviridae. PMWS primarily occurs in pigs between 25 and 120 days of age with the highest number of cases occurring between 60 and 80 days of age. The diagnosis of PMWS must meet three criteria: (i) the presence of compatible clinical signs, (ii) the presence of characteristic microscopic lesions, and (iii) the presence of PCV2 within these lesions. In order to establish the diagnosis, techniques are required that link virus and tissue lesions, such as immunohistochemistry and in situ hybridization, but not polymerase chain reaction or virus isolation. The three criteria considered separately are not diagnostic of PMWS. For example, the detection of PCV2 alone does not indicate PMWS but merely PCV2 infection. A hallmark of microscopic lesions of PMWS is granulomatous inflammation in the lymph nodes, liver, spleen, tonsil, thymus, and Peyer's patches. Large, multiple, basophilic or amphophilic grape-like intracytoplasmic inclusion bodies are often seen in the cytoplasm of macrophages and multinucleated giant cells.     

Supernumerary cheek teeth (n = 24): clinical features, diagnosis, treatment and outcome in 15 horses

REASONS FOR PERFORMING STUDY: There are few reports of case series of horses with supernumerary cheek teeth (SCT) that document clinical findings, treatment and long-term outcome. OBJECTIVES: To review the clinical and ancillary diagnostic findings and responses to different treatments in horses with SCT. METHODS: The case records of 15 horses were reviewed and long-term outcomes obtained by telephone interview. RESULTS: Fifteen horses with a total of 24 SCT were identified. Two SCT were incidental findings and were not treated. Clinical signs were improved or resolved in 11 of 13 of the teeth treated conservatively and all 6 treated by extraction had a favourable outcome. Four horses were subjected to euthanasia within a short period of diagnosis, either due to a poor prognosis at the outset or failure to respond to initial conservative treatment. CONCLUSIONS: Some SCT are chance findings and do not cause clinical signs. In those instances where clinical signs of dental disease are mild, conservative treatment including the management of diastema and reduction of overgrowths is often effective. Horses with severe clinical signs attributable to an SCT are likely to require extraction of the offending tooth. POTENTIAL RELEVANCE: An SCT is an uncommon dental anomaly but should be considered in the differential diagnosis of cases with signs of severe dental disease. The preferred management for SCT is very variable and determined by the severity of the associated changes, but ranges from conservative measures through forceps extraction per os to major facial flap surgery.     

Pleuropneumonia

The historical, clinical, diagnostic, and therapeutic aspects of pleuropneumonia are reviewed with emphasis placed on aggressive treatment and ultrasound diagnosis. The common sequelae are described, and appropriate treatment recommendations are included. A favorable prognosis may be expected for horses receiving long-term treatment.     

Melioidosis in animals: a review on epizootiology, diagnosis and clinical presentation

Melioidosis, an infectious disease caused by Burkholderia pseudomallei is an emerging disease with high impact on animals and man. In different animal species, the clinical course varies and delayed diagnosis poses risks for the dissemination of the agent in non-endemic areas. Not only migration and transport of animals around the world but also tourism increases the risk that melioidosis can leave its endemic boundaries and establish itself elsewhere. Detection of the agent is a major challenge, as the agent has to be handled in laboratories of biosafety level 3 and test kits are not yet commercially available. Veterinarians and doctors should be aware of melioidosis not only as an agent of public interest but also in terms of a bioterrorist attack. The aim of this review is to describe the agent, its aetiology, the manifestation in a variety of animal species as well as to describe diagnostic procedures, typing techniques and countermeasures.     

Osteoma of the oral and maxillofacial regions in cats: 7 cases (1999-2009)

Objective-To describe clinical features of oral and maxillofacial osteomas in cats. Design-Retrospective case series. Animals-7 cats with oral or maxillofacial osteoma or both. Procedures-Medical records were reviewed for information on signalment, history, clinical signs, physical examination findings, diagnostic imaging findings, results of serum biochemical analyses and histologic testing, surgical procedures performed, and perioperative complications. Outcome was determined on the basis of follow-up telephone interviews of owners. Results-Cats ranged from 1 to 23 years of age. Clinical signs were observed in 5 cats and were attributed to the presence of the mass. Diagnostic imaging (radiography and computed tomography) and histologic examination confirmed the diagnosis of osteoma. Three cats were euthanatized; 1 cat was treated by mandibulectomy, 1 was treated by maxillectomy, and 2 were treated by debulking. At the time of follow-up at least 1 year after surgery, all 4 treated cats were alive, with owners reporting an acceptable quality of life. Conclusions and Clinical Relevance-Osteoma of the oral and maxillofacial regions is an uncommon tumor in cats. Most cats are examined during an advanced stage of the disease, when treatment options may be limited. Although osteoma is a benign tumor, the recommendation is to perform a clinical evaluation, diagnostic imaging, biopsy, and treatment early in the disease process, when less invasive surgical approaches may be feasible.     

Scapulohumeral osteoarthritis in 20 Shetland ponies, miniature horses and falabella ponies

This paper describes the clinical and diagnostic features of 20 cases of scapulohumeral osteoarthritis in Shetland ponies, miniature horses and falabella ponies. The history and clinical signs were similar in all the cases Radiographically they all had consistent changes which consisted predominantly of articular osteophytes and periarticular enthesiophytes. Six of the cases had radiographic evidence of dysplasia of the scapulohumeral joint, although it was uncertain whether this was a primary or a secondary finding. No specific treatment appeared to be advantageous. At follow up, six of the ponies had to be euthanased owing to continuing severe lameness; the other 14 ponies remained lame, but were maintained at pasture by the occasional use of oral non-steroidal anti-inflammatory drugs. No definitive aetiology for the condition was identified, but it is proposed that an underlying dysplasia, or lack of collateral support may predispose the scapulohumeral joint of miniature horse breeds to the disease.