Tetanus: pathophysiology, clinical signs, diagnosis, and update on new treatment modalities

Objective: To review the pathophysiology, clinical signs, diagnosis, and current treatment modalities used in treating tetanus in small animals and humans. Etiology: Tetanus is caused by the activity of a toxin released from the bacterial organism, Clostridium tetani. The disease has an incubation period of 3 days to 3 weeks and usually follows a deep penetrating wound. Diagnosis: The diagnosis of tetanus is usually based on history and clinical signs. Therapy: Therapy of tetanus consists of direct and supportive care and includes toxin neutralization via human or equine derived immunoglobulin, antimicrobial therapy to eliminate C. tetani, and central and peripheral muscle relaxants to control hypertonicity. Adjunctive care may include positive pressure ventilation, anticonvulsant medication, drugs to treat autonomic dysfunction, and nutritional support. Prognosis: Prognosis varies based on severity of clinical signs at the time of diagnosis and the availability of appropriate care.     

Hepatoencephalopathy syndrome due to Cassia occidentalis (Leguminosae,Caesalpinioideae) seed ingestion in horses

Cassia occidentalis is a bush from the Leguminosae family, subfamily Caesalpinoideae, and is a toxic plant of veterinary interest due to the occasional contamination of animal rations. This report describes the clinical and histopathological findings of an outbreak of C. occidentalis poisoning in horses. Twenty mares were poisoned after consuming ground corn contaminated with 8% of C. occidentalis seeds. Of the 20 animals affected, 12 died: 8 mares were found dead, 2 died 6 h after the onset of clinical signs compatible with hepatic encephalopathy and the 2 other animals were subjected to euthanasia 12 h after the onset of the clinical signs. The remaining 8 mares presented with mild depression and decreased appetite, but improved with treatment and no clinical sequelae were observed. In 6 animals that underwent a necropsy, an enhanced hepatic lobular pattern was noted and within the large intestine, a large number of seeds were consistently observed. Hepatocellular pericentrolobular necrosis and cerebral oedema were the main histological findings. In one mare, there was mild multifocal semimembranosus rhabdomyocytic necrosis and haemorrhage. Seeds collected from intestinal contents and sifted from the culpable feedstuff were planted. Examination of the leaves, flowers, fruits and seeds of the resultant plants identified C. occidentalis. Horses poisoned by C. occidentalis seeds demonstrate clinical signs associated with hepatoencephalopathy and frequently die suddenly. Lesions primarily involve the liver and secondarily, the central nervous system. Cassia occidentalis poisoning should be considered a differential diagnosis in horses with hepatoencephalopathy and special caution should be taken with horse rations to avoid contamination with seeds of this toxic plant.     

Identification and cloning of two immunogenic Clostridium perfringens proteins, elongation factor Tu (EF-Tu) and pyruvate:ferredoxin oxidoreductase (PFO) of C. perfringens

Clostridium-related poultry diseases such as necrotic enteritis (NE) and gangrenous dermatitis (GD) cause substantial economic losses on a global scale. Two antigenic Clostridium perfringens proteins, elongation factor Tu (EF-Tu) and pyruvate:ferredoxin oxidoreductase (PFO), were identified by reaction with immune sera from commercial meat-type chickens with clinical outbreak of Clostridium infections. In addition to the genes encoding EF-Tu and PFO, C. perfringens alpha-toxin and necrotic enteritis B-like (NetB) toxin were also expressed in Escherichia coli and their corresponding recombinant proteins were purified. Using the four recombinant proteins as target antigens in ELISA immunoassays, high serum antibody titers were observed not only in chickens with clinical signs of Clostridium infections, but also in apparently healthy animals from the same disease-endemic farm. By contrast, no antibodies against any of the proteins were present in the serum of a specific pathogen-free bird. In ELISA using recombinant proteins of C. perfringens, the levels of anti-bacterial protein antibodies were also higher in chickens which were experimentally induced to show NE clinical signs after co-infection with C. perfringens and Eimeria maxima compared with uninfected controls. These results show that two antigenic C. perfringens proteins, EF-Tu and PFO can be useful detection antigens for C. perfringens-afflicted infections in commercial poultry.     

Evaluation of different sampling methods and results of real-time PCR for detection of feline herpes virus-1, Chlamydophila felis and Mycoplasma felis in cats

Objective To investigate how different sampling techniques affect detection of DNA from feline herpes virus Type 1 (FHV-1), Chlamydophila felis and Mycoplasma felis and to study the correlation between positive test results and clinical signs in cats. Animals Fifty-one cats; 24 with ocular signs and 27 healthy control cats. Procedures Samples were collected from all cats using cotton swabs, conjunctival and corneal biopsies, and corneal scrapings. Samples were analyzed for presence of FHV-1, C. felis, M. felis, and feline DNA, defined by 28S rDNA, by using real-time PCR. Results In affected cats, FHV-1 was detected in only one cat; C. felis and M. felis were not detected in any affected cats. None of the three organisms was detected in any control cats. Feline DNA was demonstrated in all conjunctival samples, in 82% of corneal swabs, 92% of corneal scrapings, and 100% of keratectomy samples. Conclusions Because of the generally low detection rate for FHV-1, C. felis, and M. felis DNA in this study, differences regarding sampling technique could not be determined and correlation between positive test results and degree of clinical signs could not be made. Detection of feline DNA in most samples irrespective of sampling technique, suggests a low prevalence of FHV-1, C. felis and M. felis in this population of cats.     

Emergency presentations of 4 dogs with suspected neurologic toxoplasmosis

Objective: To review the signalment, clinical signs, abnormal laboratory data, therapeutics, and response to therapy of dogs with clinical signs consistent with toxoplasmosis infection. Series summary: A retrospective review was performed on the records of 4 dogs presented to the Animal Emergency Center between January 1998 and February 2000 exhibiting neurologic signs and having elevated titers for Toxoplasma gondii. A tentative diagnosis of toxoplasmosis was based upon one of the following criteria: (1) a serial 4‐fold or greater change in serum T. gondii IgG titers; 2) serially decreasing serum T. gondii IgM titers with concurrent increasing serum T. gondii IgG titers; or 3) positive cerebrospinal fluid (CSF) T. gondii titers. In addition, inclusion of cases was limited to dogs that showed improvement of neurologic signs following treatment with antiprotozoal drugs. Trimethoprim–sulfamethoxazole treatment was associated with successful elimination of clinical signs in all of the dogs. Two of the dogs developed side effects potentially attributed to the trimethoprim–sulfamethoxazole (TMS), and antiprotozoal treatment was continued using clindamycin. Unique information presented: Toxoplasmosis is an important differential diagnosis in any dog that presents as an emergency with central or peripheral neurologic signs. Affected dogs need not be immunocompromised for clinical signs of toxoplasmosis to occur. Appropriate treatment with TMS or clindamycin can lead to resolution of clinical signs.     

Serological Evidence for Borrelia burgdorferi Infection Associated with Clinical Signs in Dairy Cattle in Slovakia

In the course of epizootological research on Lyme borreliosis in domestic and farm animals, the serological evidence for the occurrence of this zoonosis in cattle was screened. An ELISA showed that 25.2% of cattle from seven geographical areas in Slovakia were positive for anti-Borrelia IgG antibodies. In particular localities, the seroprevalence ranged from 0.6% to 34.3%. Of 33 cases with clinical signs, 20 ELISA-positive samples were also confirmed in Western blots. The most frequent clinical signs were lameness and swollen joints, but most of the cases were asymptomatic. The occurrence of Borrelia burgdorferi antibodies and suspected clinical signs in cattle of Slovak regions indicates that veterinarians should pay attention to this disease in their clinical practice and include it within the differential diagnosis.     

Sows Intramammarily Inoculated with Escherichia coli: Influence of Time of Infection,Hormone Concentrations and Leucocyte Numbers on Development of Disease

The aim of this study was to identify factors that influence the development of disease in sows inoculated with Escherichia coli in the mammary gland. Ten cross‐bred primiparous sows were intramammarily inoculated with living E. coli bacteria at different time points before parturition: seven sows within 48 h before parturition and three sows approximately 96 h before parturition. Before and after inoculation, blood samples and mammary gland biopsy specimens were collected and clinical observations were made. All seven sows inoculated close to parturition developed a rectal temperature of >39.5°C during the first 48 h post‐partum and two of them also showed other signs of clinical disease. In the sows inoculated 4 days before parturition, the rectal temperature never exceeded 39.5°C during the first 48 h post‐partum and none of them showed any other sign of clinical disease. There was a tendency (P < 0.1) that histological signs of mastitis were more frequent in the sows inoculated close to parturition. There were no overall differences between the two groups of sows in plasma concentrations of cortisol, oestradiol‐17β and 15‐ketodihydro‐PGF_2α before inoculation. Before inoculation, the number of neutrophils in the blood was overall higher (P < 0.05) in the group of sows that were inoculated close to parturition. In comparison, the number of lymphocytes before inoculation had a tendency (P < 0.1) to be lower in that group. The data suggest that the time of infection of the mammary gland relative to parturition and the number of circulating neutrophils at the time of infection influence the development of clinical coliform mastitis in the sow.     

Induction of feline flea allergy dermatitis and the incidence and histopathological characteristics of concurrent indolent lip ulcers

The objectives of this study were to characterize the role of intermittent vs. continual flea exposure in the development of flea allergy dermatitis (FAD) in cats, assess the accuracy of intradermal skin testing (IDST) and in vitro testing, and document the incidence and histopathological features of indolent lip ulcers. Ten flea‐naive cats were divided into two groups. One group received intermittent flea exposure for 120 days. Thereafter, both groups of cats received continuous flea exposure for 120 days. In vitro testing for flea salivary antibody and IDST utilizing both whole flea antigen and flea salivary antigen were performed. Eight of 10 cats developed clinical signs of FAD within 3 months and five of these eight cats developed lip ulcers which where characterized histopathologically by ulceration with predominantly neutrophilic inflammation and surface bacterial colonization. There was no association between the presence or absence of clinical signs and positive IDST or in vitro results, and no difference in the development of clinical signs was noted between the two groups of cats.     

Clinical features and diagnosis of sacroiliac joint region pain in 296 horses: 2004–2014

There has been no large‐scale study of the clinical signs of sacroiliac (SI) joint region pain and its association with lameness and/or thoracolumbar pain. Horses with a positive response to infiltration of local anaesthetic solution around the SI joint regions (SI block) and/or abnormal radiopharmaceutical uptake (RU) in the region of the SI joints were included. History, clinical signs, diagnostic imaging findings, response to SI block, and concurrent lameness and/or thoracolumbar pain were recorded. Horses (n = 296) were divided into 2 groups: SI joint region pain only (Group 1, n = 43) and SI joint region pain and concurrent source(s) of pain (Group 2, n = 253). Clinical signs in Group 1 included increased tension in the longissimus dorsi muscles (40%), restricted flexibility of the thoracolumbar region (44%), trunk stiffness during exercise (61%) and poor hindlimb impulsion (56%). When ridden 65% had a poor contact with the bit, in 81% canter quality was worse than trot, and 35% bucked or kicked out with a hindlimb during canter. In both Groups 1 and 2 clinical signs were seen in a significantly greater proportion of horses during ridden work than lungeing (P<0.0001). Following SI block, 98% of horses showed dramatic improvement in clinical signs, including greater overall movement through the trunk, increased hindlimb impulsion and better quality canter. Abnormal RU in the SI joint regions was seen in 85/180 (47%) horses. Of horses with a positive response to SI block that underwent scintigraphy, only 43% had abnormal RU. Per rectum ultrasonographic examination of the SI joint region revealed abnormalities in 41/129 (32%) horses. Clinical signs of SI joint region pain are worse when horses are ridden. Sacroiliac joint region diagnostic analgesia is a useful, safe but nonspecific block. Ultrasonography and scintigraphy can provide additional information in some horses, but negative results do not preclude SI joint region pain.     

A Strain of Siniperca chuatsi Rhabdovirus Causes High Mortality among Cultured Largemouth Bass in South China

Abstract

In April 2011, 40% mortality of Largemouth Bass Micropterus salmoides juveniles occurred at a farm of Zhongshan City, Guangdong Province, China. Infected fish became lethargic, exhibited corkscrew and irregular swimming, and developed a distended abdomen and crooked body. Fish began to die within 2 d after the appearance of clinical signs. In order to analyze the pathogeny and diagnose the disease earlier, observation of clinical signs, cell infection, titer calculation, electron microscopy, immersion infection assay for fish, and nucleotide sequence analysis were carried out. Fathead minnow (FHM) cell cultures, inoculated with filtrate of liver and spleen homogenates from the diseased fish, developed the obvious cytopathic effect 46 h after inoculation in the primary culture and 24 h at the first passage. Typical rhabdovirus particles, 115–143 nm in length and 62–78 nm in diameter, were observed in infected FHM cells by direct transmission electron microscopy. The isolated virus produced a titer of 10^7.15 TCID50/mL. Immersion-Fish infected with the virus had similar clinical signs and 80% mortality with 10^2.5 LD50/mL. The data indicated that the rhabdovirus was the lethal pathogeny of the current disease. Based on nucleoprotein-gene nucleotide sequence multiple alignment analysis, the newly isolated virus is a strain of Siniperca chuatsi rhabdovirus (SCRV) under family Rhabdoviridae, which was initially isolated from Mandarin Fish Siniperca chuatsi. Up to the present, at least four virus strains have been isolated from diseased Largemouth Bass, which have had different clinical signs. Comparison of the clinical signs can help in an early diagnosis of the disease.

Received October 30, 2012; accepted April 19, 2013     

Restriction endonuclease analysis of BHV-1 and BHV-5 strains isolated in argentina

The genomes of 10 bovine herpesvirus 1 and 5 strains isolated in Argentina from 1989 to 1994, recovered from animals showing different clinical signs, and two reference strains (Los Angeles and A663) were compared by restriction endonuclease analysis. Four restriction enzymes, HindIII, BamHI, EcoRI and PstI, were used and analysis of the restriction patterns used to assign the isolate to either the BHV-1.1, BHV-1.2 or BHV-5 genotype. There was a correlationship between restriction pattern and clinical signs in six out of ten Argentinian isolates.     

A randomized, open-label, positively-controlled field trial of a hydrolyzed protein diet in dogs with chronic small bowel enteropathy

Background: Hydrolyzed protein diets are commonly used to manage canine chronic enteropathies (CE), but their efficacy has not yet been critically evaluated. Hypothesis: A hydrolyzed protein diet is superior to that of a highly digestible (control) diet in the management of CE in dogs. Animals: Twenty‐six dogs (18 test diet, 8 control diet) referred for investigation and management of naturally occurring chronic small intestinal disease. Methods: Randomized, open‐label, positively controlled trial. After a full diagnostic investigation, which included endoscopy, dogs were assigned either to the test diet or control diet on a 2 : 1 basis (test : control). Cases were re‐evaluated 3 times (at approximately 3, 6–12 months, and 3 years). Outcome measures included response of clinical signs (complete, partial, none), change in severity of signs (based upon clinical disease activity index; canine inflammatory bowel disease activity index [CIBDAI]), change in body weight, and need for other therapy. Results: There were no significant differences in baseline characteristics (eg, signalment, body weight, and duration of clinical signs), and histopathologic severity between test and control diet groups. However, despite randomization, CIBDAI was significantly higher in the test diet group (P= .013). Most dogs had responded by first evaluation, with no difference between groups (P= .87). However, significantly more dogs on the test diet remained asymptomatic at both the second (P= .0012) and third (P < .001) re‐evaluation, and the decrease in CIBDAI was significantly greater (P= .010). Conclusions and Clinical Importance: A hydrolyzed protein diet can be highly effective for long‐term management of canine chronic small bowel enteropathy.     

Brucella suis in three dogs: presentation,diagnosis and clinical management

Brucella suis is an emerging, zoonotic disease predominantly affecting dogs and humans that engage in feral pig hunting in Australia and other countries. Although B. suis infection in dogs shares some clinical similarities to the host-adapted species (B. canis), B. suis remains an incompletely understood pathogen in dogs with limited published data on its pathogenesis and clinical features. This case series describes the presentations, diagnosis, and clinical management of B. suis infection in three dogs: (1) a bitch with dystocia, abortion and mastitis; (2) an entire male dog with septic arthritis and presumptive osteomyelitis; and (3) a castrated male dog with lymphadenitis. Unique features of these cases are reported including the first documented detection of B. suis from milk and isolation from lymph nodes of canine patients, as well as the follow-up of pups born to a B. suis-infected bitch. Consistent with previous reports, all three dogs showed a favourable clinical response to combination antibiotic therapy with rifampicin and doxycycline. Individually tailored drug regimens were required based on the clinical presentation and other factors, including owner expectations and compliance with therapy as well as a zoonotic risk assessment (generally considered low, except around time of whelping). The authors include their recommendations for the clinical management of dogs that are at-risk or seropositive for B. suis with or without clinical signs or laboratory-confirmed infection.     

Effects of a MAPK p38 inhibitor on lung function and airway inflammation in equine recurrent airway obstruction

Reasons for performing study: It has been suggested that many of the beneficial effects of corticosteroids are mediated through mitogen‐activated protein kinase (MAPK) p38 inhibition. Objective: To investigate the efficacy of the MAPK p38 inhibitor compound MRL‐EQ1 to either prevent (Phase 1) or treat (Phase 2) recurrent airway obstruction (RAO) in horses. Methods: MRL‐EQ1 was administered i.v. at a dosage of 0.75‐1.5 mg/kg bwt q. 12 h. In Phase 1, susceptible horses in clinical remission were divided into 2 groups (n = 5/group), based on historical values of respiratory mechanics. All horses were entered in the study in pairs (one control, one treated horse) and exposed to the same environmental challenge (stabling, mouldy hay and dusty conditions). The treatment group received MRL‐EQ1 for 14 days while the control horses were untreated during the same period. In Phase 2, affected horses were ranked by severity of respiratory dysfunction and split randomly into either dexamethasone or MRL‐EQ1 treatment groups (n = 5/group). Bronchoalveolar lavage fluid, respiratory mechanic measurements, MRL‐EQ1 plasma concentration and tumour necrosis factor (TNF) whole blood activity were evaluated sequentially. Results: In Phase 1, MRL‐EQ1 did not prevent the occurrence of clinical signs and pulmonary inflammation. However, treatment was associated with a reduction in severity and a delay in the onset of signs and a reduction in pulmonary neutrophilia. In Phase 2, plasma concentrations achieved resulted in ex vivo suppression of lipopolysaccharide‐induced TNF production in equine blood. MRL‐EQ1 did not improve airway inflammation or lung function and was associated in a dose dependent manner with behavioural (depression, excitability) and blood changes (neutrophilia, increased serum muscle enzyme concentrations). Conclusions: Inhibition of p38 in the horse was partially effective in reducing clinical signs and airway inflammation when administered prior to, but not during clinical exacerbation in RAO. Potential relevance: Inhibitors of p38 MAPK with a better toxicity profile may be effective in the prevention or treatment of RAO.     

An overview of potentially life-threatening poisonous plants in dogs and cats

Objectives: This article discusses the toxicity of the most common poisonous plants known to cause life‐threatening systemic effects or death in dogs and cats as reported to the ASPCA Animal Poison Control Center (APCC). Data sources: The article presents an overview of geographic distribution, toxic principle, clinical signs, clinical chemistry alterations, and treatment of intoxication as reported in the literature and based upon data retrieved from the APCC between January 2001 and December 2003. Summary: Most plant exposures in dogs or cats result in mild to moderate signs of vomiting and diarrhea while liver, kidney, central nervous system, or cardiovascular effects are rare. Some garden or household plants can cause serious systemic effects or death when a small amount of plant material has been ingested. Based on APCC records, the most frequently reported poisonous plants causing serious systemic effects include Lily (Lilium and Hemerocallis spp.), Azalea (Rhododendron spp.), Oleander (Nerium oleander), Sago palm (Cycas spp.), Castor bean (Ricinus communis), Kalanchoe (Kalanchoe spp.), and Autumn Crocus (Colchicum autumnale). Conclusion: Despite the variety of toxins present in the plants listed above, early clinical signs of toxicosis in dogs and cats can be nonspecific and can include vomiting, lethargy, anorexia, salivation, or diarrhea. Cardiac arrhythmias may be present with oleander, azalea, or kalanchoe ingestion. Evidence of liver or kidney damage (Cycas, Lilium, Hemerocallis spp., Ricinus communis) may occur 1–2 days after the exposure. Treatment consists of early decontamination and supportive care and may vary according to the type of plant involved and clinical signs present.     

Epidemiological and genetic study of exertional rhabdomyolysis in a Warmblood horse family in Switzerland

Reasons for performing study: Exertional rhabdomyolysis (ER) and its familial basis in Warmblood horses is incompletely understood. Objectives: To describe the case details, clinical signs and management of ER‐affected Warmblood horses from a family with a high prevalence of ER, to determine if histopathological signs of polysaccharide storage myopathy (PSSM) and the glycogen synthase (GYS1) mutation are associated with ER in this family, and to investigate potential risk factors for development of ER. Methods: A family consisting of a sire with ER and 71 of his descendants was investigated. History of episodes of ER, husbandry, feeding and use was assessed by interviewing horse owners using a standardised questionnaire. All horses were genotyped for GYS1. In 10 ER‐affected horses, muscle histopathology was evaluated. Results: Signs of ER were reported in 39% of horses and 51% of the entire family possessed the GYS1 mutation. Horses possessing the GYS1 mutation had a 7.1‐times increased risk for developing ER compared to those with the normal genotype (95% confidence interval [CI] 2.37–21.23, P = 0.0005). All muscle samples from horses in the family with ER showed polysaccharide accumulation typical for PSSM, amylase‐resistant in 9/10 cases. There was evidence (odds ratio 5.6, CI 1.00–31.32, P = 0.05) that fat or oil feeding improved clinical signs of ER. No other effects of environmental factors associated with clinical signs of ER were identified. Conclusion and potential relevance: PSSM associated with the GYS1 mutation is one identifiable cause of ER in Warmblood horses. Signs of ER are not always manifest in GYS1 positive horses and there are also other causes for ER in Warmblood horses. Breeding animals with the GYS1 mutation results in a high prevalence of ER due to its dominant mode of inheritance.     

CLINICAL,IMAGING, AND PATHOLOGIC CHARACTERISTICS OF GURLTIA PARALYSANS MYELOPATHY IN DOMESTIC CATS FROM CHILE

Gurltia paralysans is a rare metastrongylid nematode of domestic cats that is found mainly in the veins of the spinal cord subarachnoid space and parenchyma. Endemic regions for G. paralysans mainly include Chile and Argentina. The ante mortem diagnosis of gurltiosis is difficult and based primarily on neurological signs, epidemiological factors, and the exclusion of other causes of feline myelopathies. The purpose of this retrospective case series was to describe clinical, imaging, and pathologic characteristics in nine domestic cats naturally infected with G. paralysans. Imaging tests included radiography, myelography, computed tomographic myelography (myelo‐CT), and magnetic resonance imaging (MRI). Neurological signs included paraparesis, paraplegia, pelvic limb ataxia and proprioceptive deficits, pelvic limb tremors, lumbosacral hyperesthesia, and tail trembling or atony. Complete blood count findings included a decrease in the mean corpuscular hemoglobin concentration value in eight cats. Eosinophilia in peripheral blood was observed in three cats, and thrombocytopenia was observed in three cats. Cerebrospinal fluid analysis revealed mononuclear pleocytosis in five cases. Myelo‐CT showed diffuse enlargement of the spinal cord at the midthoracic, lumbar, and sacral regions in all cats. Magnetic resonance image findings in the thoracic and lumbar region demonstrated multiple small nodular areas of T2 hyperintensity in the periphery of the spinal cord parenchyma. Localized intraparenchymal areas of increased T2 intensity were also observed in the thoracolumbar spinal cord and lumbosacral conus medullaris. In conclusion, G. paralysans should be considered as a differential diagnosis for domestic cats in endemic regions that have this combination of clinical and imaging characteristics.     

The diagnosis and treatment of mange in the guinea-pig caused by Trixacarus (Caviacoptes) caviae (Fain,Hovell & Hyatt, 1972)*

The clinical features exhibited by ten privately-owned guinea-pigs in nine independent outbreaks of skin disease due to Trixacarus (Caviacoptes) caviae are described. The severity of the condition was related to the duration of the clinical signs but followed a constant pattern of pruritus, increased keratinization and alopecia. The diagnosis was confirmed by the demonstration of the mite in skin scrapings. One animal died before treatment but gamma benzene hexachloride washes produced complete resolution in the remainder.