Factors associated with outcome in foals with neonatal isoerythrolysis (72 cases, 1988-2003)

Background: Neonatal foals with isoerythrolysis (NI) often die, but the risk factors for death have not been identified.
Objectives: To identify factors associated with outcome in foals with NI and to identify factors associated with death from liver failure or kernicterus in the same population.
Animals: Seventy-two foals with NI examined at referral institutions.
Methods: Retrospective case series. Information on signalment, clinical examination findings, laboratory testing, treatment, complications, outcome, and necropsy results were obtained.
Results: The overall survival rate was 75% (54 of 72). Liver failure (n = 7), kernicterus (n = 6), and complications related to bacterial sepsis (n = 3) were the 3 most common reasons for death or euthanasia. The number of transfusions with blood products was the factor most strongly associated with nonsurvival in a multivariate logistic regression model. The odds of liver failure developing in foals receiving a total volume of blood products ≥ 4.0 L were 19.5 (95% confidence intervals [CI]: 2.13–178) times higher than that of foals receiving a lower volume ( P = .009). The odds of kernicterus developing in foals with a total bilirubin ≥ 27.0 mg/dL were 17.0 (95% CI: 1.77–165) times higher than that of foals with a lower total bilirubin ( P = .014).
Conclusions and Clinical Importance: Development of liver failure, kernicterus, and complications related to bacterial sepsis are the most common causes of death in foals with NI. Foals administered a large volume of blood products are at greater risk for developing liver failure.     

Parenteral nutrition in foals: a retrospective study of 45 cases (2000--2004)

REASONS FOR PERFORMING STUDY: Adequate nutritional support of sick foals in critical care is an important aspect of treatment. When enteral feeding is contraindicated, parenteral nutrition (PN) provides a source of energy and protein. However, no study has critically assessed the use of PN in a large group of foals. OBJECTIVE: The administration of PN to clinically ill foals was examined retrospectively to determine the effects of PN formulation and variables on the incidence of PN-associated complications and outcome. HYPOTHESES: There was no effect of PN formula on 1) the occurrence or type of complications; 2) of PN formula on outcome; 3) of disease severity on the occurrence or type of complications; and 4) of disease severity on outcome. METHODS: Medical records of 45 foals, presented to the Marion duPont Scott Equine Medical Center, which received PN, were reviewed for the years 2000-2004. RESULTS: The indications for PN were recumbency, depression or gastrointestinal conditions. Formulation of PN was not associated with the development of complications, and there was no association of PN formula with patient survival. Disease severity was positively associated with the development of PN complications and the occurrence of PN complications was associated with an increased risk of nonsurvival. CONCLUSION AND POTENTIAL RELEVANCE: The use of lipid-containing PN solutions facilitates the delivery of energy to the critically-ill foal without increasing the risk of deleterious side effects. Severely ill foals are more prone to develop complications associated with PN and to have a poor outcome.     

Use of Total Parenteral Nutrition in Dogs: 209 Cases (1988-1995)

The medical records of 209 dogs receivingtotal parenteral nutrition (TPN) over a 84-month period were examined retrospectively to determine patient profiles, frequency and type of complications, and prognostic factors affecting clinical outcome. TPN administration accounted for 895 patient days. Dogs with diarrhea or vomiting associated with gastrointestinal disease, pancreatitis, or renal failure constituted the largest proportion of patient receiving TPN. The median duration of TPN administration was 3.5 days (range 0.05 to 25 days). The median length of hospitalization before initiation of TPN was 1.5 days (range 0.05 days to 15 days). and this durationwas not associated with survival. Metabolic complications were frequent (329 of 473 complications observed) and were due predominantly to hyperglycemia. Mechanical (118 of 473) and septic (26 of 473) complications occurred less commonly. The overall mortality rate for dogs receiving TPN was 48.8%. Our conclusion: TPN can be a beneficial mode of therapy for carefully selected dogs that have impaired gastrointestinal function (parvovirus, pancreatitis, or inflammatory bowel disease) and are expected to be anorectic for morethan 5 days.     

Septic osteitis of the distal phalanx in foals: 22 cases (1995-2002)

OBJECTIVE: To determine the clinical characteristics and outcome of foals with septic osteitis of the distal phalanx. DESIGN: Retrospective case series. ANIMALS: 22 foals. PROCEDURES: Information obtained from medical records included signalment; clinical, laboratory, and radiographic findings; treatment method; and outcome. Foals included in the study had lameness referable to the foot, radiographic evidence of localized lysis or focal loss of bone density of the distal phalanx, and suppurative discharge or necrosis of the affected bone evident at surgery. Foals with a history or evidence of penetrating wounds or subsolar abscessation were excluded. RESULTS: Mean age of foals at initial evaluation was 40.8 days (range, 3 to 122 days). Twenty-one (95%) foals had lameness as the primary complaint. Lesions consistent with septic osteitis of the distal phalanx localized to specific areas of the bone on the basis of radiographic and surgical findings were located on the solar margin or toe (14/22 [64%]), extensor process (5/22 [23%]), and palmar or plantar process (3/22 [13%]). Hind limbs (18/26 [69%] affected limbs) were more frequently affected. Two foals had > 1 affected limb, 2 had additional sites of osteomyelitis, and 4 had concurrent septic arthritis. Surgical debridement and regional antimicrobial perfusion were performed during general anesthesia. Extensor process lesions were not debrided. Nineteen of 22 (86%) foals survived to be discharged from hospital, and 16 horses reached racing age. Eleven of 16 had race starts, of which 8 had official race starts and 3 had unofficial race starts. CONCLUSIONS AND CLINICAL RELEVANCE: Septic osteitis of the distal phalanx should be considered as a source of lameness in foals with signs referable to the foot and does not necessarily preclude a career in racing. Although infection may occur secondary to bacterial penetration of the hoof or sole, the distal phalanx should also be considered as a potential site for hematogenous septic arthritis or osteomyelitis in foals.     

Gallbladder disease in Shetland Sheepdogs: 38 cases (1995-2005)

OBJECTIVE: To determine risk, clinical features, and treatment responses for gallbladder disorders in Shetland Sheepdogs. DESIGN: Retrospective case-control study. ANIMALS: 38 Shetland Sheepdogs with gallbladder disease. PROCEDURES: Medical records were reviewed for signalment, history, physical findings, laboratory results, imaging features, coexistent illnesses, histologic findings, treatments, and survival rates. RESULTS: Mature dogs with gastrointestinal signs were predisposed (odds ratio, 7.2) to gallbladder disorders. Gallbladder mucocele was confirmed in 25 dogs. Concurrent problems included pancreatitis, hyperlipidemia, corticosteroid excess, hypothyroidism, protein-losing nephropathy, diabetes mellitus, cholelithiasis, and gallbladder dysmotility. Mortality rate was 68% with and 32% without bile peritonitis. Nonsurvivors had high WBC and neutrophil count and low potassium concentration. Although preprandial hypercholesterolemia, hypertriglyceridemia, and high serum liver enzyme activities were common, gallbladder disease was serendipitously discovered in 11 of 38 dogs. Histologic examination (n=20 dogs) revealed gallbladder cystic mucosal hyperplasia in 20 dogs, cholecystitis in 16, periportal hepatitis in 9, and vacuolar hepatopathy in 7. Surgery included cholecystectomy (n=17) and cholecystoenterostomy (4). In 1 hyperlipidemic dog without clinical signs, gallbladder mucocele resolved 6 months after beginning use of a fat-restricted diet and ursodeoxycholic acid. CONCLUSIONS AND CLINICAL RELEVANCE: Shetland Sheepdogs are predisposed to gallbladder disorders, with mucoceles and concurrent dyslipidemia or dysmotility in many affected dogs. Most dogs were without clinical signs during mucocele development. Low survival rate after cholecystectomy in clinically affected dogs suggested that preemptive surgical interventions may be a more appropriate treatment strategy.     

Juvenile idiopathic epilepsy in Egyptian Arabian foals: 22 cases (1985-2005)

Background:Epilepsy is relatively uncommon in horses compared with other species and limited information is available.
Hypothesis:The objectives of the study were to describe the age of onset, clinical signs, clinicopathologic data, electroencephalographic findings, treatment, and outcome, including long-term prognosis in Arabian foals with idiopathic epilepsy.
Animals:Twenty-two foals were included in the study.
Materials and Methods: Medical records from 1985 to 2005 were reviewed.
Results:The age of onset of affected foals ranged from 2 days to 6 months. Seizures were characterized by generalized tonic and clonic motor activity, staring, and loss of consciousness. The most common postictal signs were transient blindness and abnormal mental status. The interictal neurologic examination was otherwise normal. Clinicopathologic data and imaging diagnostics were normal except in 4 foals that developed complications. Electroencephalography revealed epileptiform activity in 9 of 13 foals. Foals were treated with benzodiazepines for the short-term; whereas phenobarbital was used over the long-term. Potassium bromide was added in 3 foals in which seizures were multiple, frequent, and difficult to control. The long-term prognosis was favorable with cessation of seizures by 1 year of age. The most common complication was head trauma. The most common concurrent disease was pneumonia.
Conclusions and Clinical Importance: Juvenile idiopathic epilepsy of Egyptian Arabian foals has an early clinical onset but appears to be self-limiting. Information obtained from this study strongly suggests a heritable condition that merits further investigation.     

Indications for and short- and long-term outcome of permanent tracheostomy performed in standing horses: 82 cases (1995-2005)

OBJECTIVE: To identify indications for and short- and long-term outcome of permanent tracheostomy performed in standing horses. DESIGN: Retrospective case series. ANIMALS: 82 horses undergoing permanent tracheostomy. PROCEDURES: Data obtained from medical records included signalment, diagnosis, surgical technique, complications, use of the horse before and after surgery, and owner satisfaction. Follow-up information was obtained through a telephone questionnaire administered to owners. RESULTS: Indications for permanent tracheostomy included nasopharyngeal cicatrix (n = 59), arytenoid chondropathy (55), and laryngeal hemiplegia (20); 54 horses had multiple indications for tracheostomy. Complications identified prior to discharge included partial dehiscence (n = 8), transient fever (10), and excessive swelling (13). Complications identified after discharge included partial dehiscence (n = 3), inversion of skin (2), and stenosis of the tracheostomy requiring repair (1). Long-term follow-up information was available for 64 horses. Fifty-seven of the 64 (89%) horses returned to their previous use, and owners of 63 (98%) horses reported being very satisfied with the results. The owner of 1 (2%) horse was unsatisfied with the results. The 1-year survival rate was 97% (95% confidence interval, 95% to 100%). Mean estimated truncated survival time (ie, failure-free period) was 9.7 years (95% confidence interval, 9.3 to 10.1 years). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that permanent tracheostomy can be safely performed in standing horses and was a viable treatment for horses with obstructive disease of the upper respiratory tract that was unresponsive to medical treatment or other surgical treatments.     

Outcome of cats with low-grade lymphocytic lymphoma: 41 cases (1995-2005)

OBJECTIVE: To evaluate factors associated with response to treatment, remission duration, and survival in cats with low-grade lymphoma affecting various organ systems. DESIGN: Retrospective case series. Sample POPULATION: 41 cats with histologically confirmed low-grade lymphocytic lymphoma. PROCEDURES: Medical records and biopsy specimens of cats with histologically confirmed low-grade lymphocytic lymphoma of various organ systems treated with prednisone and chlorambucil between 1995 and 2005 were reviewed. The Kaplan-Meier method was used to estimate remission duration and survival. Factors potentially associated with prognosis were compared. RESULTS: Common clinical signs were weight loss (83%), vomiting (73%), anorexia (66%), and diarrhea (58%). Seventy-eight percent of cats tested had low serum cobalamin concentrations. Lymphoma was confined to the gastrointestinal tract in 68% of cats. Fifty-six percent of cats achieved a complete response to treatment, and 39% achieved a partial response. Five percent of cats had no response. No association was found between any risk factors (including anatomic site) and response to treatment. Partial response was associated with shorter remission duration, compared with complete response; median remission duration was 428 days for cats achieving a partial response, compared with 897 days for cats achieving a complete response. No other factors were associated with remission duration. Overall median survival time was 704 days. No factors were significantly associated with survival time. CONCLUSIONS AND CLINICAL RELEVANCE: Most cats with lymphocytic lymphoma responded to treatment with prednisone and chlorambucil, and most factors evaluated were not associated with outcome.     

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.     

Long-term complications after phacoemulsification for cataract removal in dogs: 172 cases (1995-2002)

OBJECTIVE: To determine common postoperative complications and risk factors for development of postoperative glaucoma or failure to preserve vision after phacoemulsification for cataract removal in dogs. Design-Retrospective case series. ANIMALS: 172 dogs (290 eyes) that underwent phacoemulsification surgery for cataract removal. PROCEDURE: Medical records were reviewed for postoperative complications; prevalence rates for each complication were calculated for follow-up periods of 3 months, > 3 to 6 months, > 6 months to 1 year, > 1 to 2 years, > 2 to 3 years, > 3 to 4 years, and > 4 years. Odds ratios for breed, age, sex, cataract hypermaturity, lens-induced uveitis, and diabetes mellitus were determined with respect to glaucoma and failure (ie, blindness, enucleation, or evisceration). RESULTS: The most common complication was mild posterior capsule opacification. Retinal detachment was uncommon (1% to 2%) for all time periods. Prevalence of glaucoma increased with time, although it remained < 10% until after the 1-year follow-up period. Boston Terriers, Cocker Spaniels, Cocker Spaniel-Poodle crosses, and Shih Tzus had increased risk of developing glaucoma. Eyes with hypermature cataracts were more likely to develop glaucoma. Prevalence of failure increased with time, although it remained < 10% until after the 3-year follow-up period. Cocker Spaniel-Poodle cross and Shih Tzus were more likely to have failure. CONCLUSIONS AND CLINICAL RELEVANCE: Evaluation of breed and cataract hypermaturity may aid in the selection of patients. The increasing prevalence of postoperative complications with time indicated that longterm monitoring is warranted.     

Treatment response and athletic outcome of foals with tarsal valgus deformities: 39 cases (1988-1997)

OBJECTIVE: To evaluate the response to various treatments and long-term outcome of foals with tarsal valgus deformities. DESIGN: Retrospective study. ANIMALS: 39 foals with tarsal valgus deformities. PROCEDURE: Data collected from medical records, included signalment, history, reason for admission, and clinical findings. Radiographic views of the tarsus were evaluated for incomplete ossification of tarsal bones and were classified as normal in appearance, type-I incomplete ossification, or type-II incomplete ossification. Treatment and athletic outcome were documented for each foal. RESULTS: Radiographic assessment revealed that 22 of 39 foals (56%) had concomitant tarsal valgus deformities and incomplete ossification of the tarsal bones. Eight of 19 foals with tarsal valgus deformities that were treated with periosteal stripping responded favorably. Foals < or = 60 days old were significantly more likely to respond to periosteal stripping than older foals. Five of 8 foals with tarsal valgus deformities that were treated with growth plate retardation responded favorably. Eleven of 21 foals with long-term follow-up performed as intended. Compared with foals with type-II incomplete ossification, foals with tarsal bones that had a normal radiographic appearance or type-I incomplete ossification were significantly more likely to perform as intended. CONCLUSIONS AND CLINICAL RELEVANCE: Foals with tarsal valgus deformities should have lateromedial radiographic views of the tarsus obtained to assess the tarsal bones for incomplete ossification, which will affect athletic outcome. Because foals with type-II incomplete ossification of the tarsal bones respond poorly to periosteal stripping alone, treatment by growth-plate retardation is recommended.     

Spurious hypercreatininemia: 28 neonatal foals (2000–2008)

Objectives – To (1) determine the occurrence of spurious hypercreatininemia in a population of hospitalized foals <2 days old, (2) assess the resolution of the hypercreatininemia, and (3) determine its association with survival in these foals. Design – Retrospective case series. Setting – 2 Referral hospitals. Animals – Foals <2 days old with an admission creatinine >442 μmol/L (>5.0 mg/dL) from 2 referral hospitals. Interventions – None. Measurements and Main Results – The medical records of 33 foals were reviewed. Twenty‐eight had spurious hypercreatininemia and 5 had acute renal failure. Admission creatinine was not significantly different between the 2 groups (mean [standard deviation]). The creatinine was 1,202 μmol/L (663 μmol/L) (13.6 mg/dL [7.5 mg/dL]) versus 1,185 μmol/L (787 μmol/L) (13.4 mg/dL [8.9 mg/d]) (P=0.96) in each group, respectively, though BUN at the time of hospital admission was significantly higher for acute renal failure foals (P=0.009). In the spurious group, serum creatinine at admission decreased to 504 μmol/L (380 μmol/L) (5.7 mg/dL [4.3 mg/dL]) by 24 hours, and to 159 μmol/L (80 μmol/L) (1.8 mg/dL [0.9 mg/dL]) at 48 hours, and to 115 μmol/L (44 μmol/L) (1.3 mg/dL [0.5 mg/dL]) at 72 hours. Twenty‐three of 28 foals with spurious hypercreatininemia survived to hospital discharge and there was no difference in mean admission creatinine between survivors (1176 μmol/L [628 μmol/L]) (13.3 mg/dL [7.1 mg/dL]) and nonsurvivors (1308 μmol/L [857 μmol/L]) (14.8 mg/dL [9.7 mg/dL]) (P=0.67). Twenty of 28 foals had clinical signs suggestive of neonatal encephalopathy. Conclusion – Creatinine decreased by >50% within the initial 24 hours of standard neonatal therapy and was within the reference interval in all but 1 foal within 72 hours of hospitalization. The diagnosis of neonatal encephalopathy was common in these foals.     

Successful treatment and polymerase chain reaction (PCR) confirmation of Tyzzer's disease in a foal and clinical and pathologic characteristics of 6 additional foals (1986-2005)

BACKGROUND: Tyzzer's disease is a rapidly progressive and highly fatal hepatitis of foals caused by Clostridium piliforme. Survival of a confirmed case has not been reported previously. HYPOTHESIS: Successful therapy of C. piliforme infection in foals is possible. Polymerase chain reaction (PCR) can be used to diagnose Tyzzer's disease antemortem or postmortem. ANIMALS: Seven foals were included in the study. METHODS: Retrospective study was made to evaluate the clinical and pathologic characteristics of foals with Tyzzer's disease. Medical records of the Veterinary Medical Teaching Hospital at University of California Davis were reviewed. Foals <3 months old were included in the study if typical clinical signs were present and histologic examination identified multifocal coagulative necrosis and hepatitis with intracytoplasmic filamentous bacilli, consistent with C. piliforme. A real-time TaqMan assay was developed to detect C. piliforme gene sequences in liver tissue from affected foals. RESULTS: Median survival time from onset of disease in nonsurviving foals was 30 hours (mean 34.5 +/- 20.1; range, 16-62 hours). Common clinical findings included lethargy, recumbency, seizures, and fever. Laboratory findings included metabolic acidosis, hypoglycemia and increased activity of hepatobiliary enzymes. Treatment consisted of IV fluids, antimicrobial and antiinflammatory drugs, and parenteral nutrition. One filly survived, whereas 6 died. Postmortem examination of the 6 foals that died disclosed hepatomegaly with multifocal necrosis. Liver tissue from 4 foals was positive for C. piliforme gene sequences using PCR. CONCLUSIONS AND CLINICAL IMPORTANCE: Although the mortality rate of Tyzzer's disease is high, successful outcome is possible if intensive care is initiated promptly. PCR can be used for early and specific diagnosis.     

Ulcerative dermatitis, thrombocytopenia, and neutropenia in neonatal foals

This report describes transient ulcerative dermatitis, severe thrombocytopenia, and mild neutropenia in 6 foals from 4 mares from geographically diverse regions of the United States. The foals presented at <4 days of age with oral and lingual ulcers, and crusting and erythema around the eyes, muzzle, and perineal, inguinal, axillary, trunk, and neck regions. There was a severe thrombocytopenia (0-30,000 platelets/microL), leukopenia (1900-3200 white blood cells/microL), and mild neutropenia (500-1800 neutrophils/microL). Four of the 6 foals had petechiae and ecchymotic hemorrhages and 3 had bleeding tendencies. Results of examination of a bone marrow biopsy from 1 foal were normal and results of a platelet surface immunoglobulin test in another were negative. Histopathology of the skin in all foals showed subepidermal clefting with subjacent vascular dilation, dermal hemorrhage, and superficial papillary necrosis. The foals were treated supportively with broad-spectrum antibiotics (5/6), corticosteroids (3/6), gastric ulcer prophylaxis (6/6), whole-blood transfusion (4/6), and platelet-rich plasma (1/6). The skin lesions and thrombocytopenia (>50,000 platelets/microL) improved in 2 weeks (4/6). Two foals had a decline in their platelet counts when the steroids were decreased and needed protracted treatment. All foals survived and were healthy as yearlings. Two mares that had 2 affected foals each, upon subsequent pregnancies to different stallions, had healthy foals when an alternate source of colostrum was given. The findings in the cases in this report suggest a possible relationship between colostral antibodies or some other factor in the colostrum and the thrombocytopenia and skin lesions, although further investigation is warranted to confirm or refute this hypothesis.     

Clinicopathologic findings and outcome in dogs with infective endocarditis: 71 cases (1992-2005)

OBJECTIVES: To evaluate clinical, laboratory, and necropsy findings in dogs with infective endocarditis (IE). DESIGN: Retrospective case series. ANIMALS: 71 dogs with possible or definite IE. PROCEDURES: Medical records were reviewed for signalment, clinical features, and results of clinicopathologic testing and diagnostic imaging. Yearly incidence and the effect of variables on survival were determined by use of survival curve analysis. RESULTS: The overall incidence of IE was 0.05%. Most affected dogs were of large breeds, and > 75% were older than 5 years. The aortic valve was affected in 36 of the 71 (51%) dogs, and the mitral valve was affected in 59%. Lameness caused by immune-mediated polyarthritis, septic arthritis, or peripheral arterial thromboembolism was observed in 53% of the dogs. Neurologic complications were diagnosed in 17 of 71 (24%) dogs. Thromboembolic disease was suspected in 31 of 71 (44%) of dogs. The mortality rate associated with IE was 56%, and median survival time was 54 days. Factors negatively associated with survival included thrombocytopenia, high serum creatinine concentration, renal complications, and thromboembolic complications. CONCLUSIONS AND CLINICAL RELEVANCE: A diagnosis of IE should be suspected in dogs with fever, systolic or diastolic murmur, and locomotor problems. Dogs with thrombocytopenia, high serum creatinine concentration, thromboembolism, or renal complications may have a shorter survival time.     

Indications for and outcome of positive-pressure ventilation in cats: 53 cases (1993-2002)

OBJECTIVE: To determine indications for and outcomes of positive-pressure ventilation (PPV) in cats, document ventilator management, and identify factors associated with outcome. DESIGN: Retrospective study. ANIMALS: 53 cats that underwent PPV. PROCEDURE: Information on signalment, history, concurrent diseases, clinical findings, results of venous blood gas analyses and clinicopathologic testing, treatment, ventilator settings, and outcome was retrieved from the medical records. Data for cats that survived were compared with data for cats that died or were euthanatized while undergoing PPV RESULTS: PPV was initiated for management of respiratory failure (36 cats [68%]), cardiac arrest (9 [17%]), neurologic impairment (6 [11%]), and nonresponsive hypotension (2 [4%]). Eight cats (15%) survived, 19 (36%) died, and 26 (49%) were euthanatized while undergoing PPV. Cats that survived had a longer duration of ventilation than did those that died or were euthanatized and had a significantly higher incidence of ventilator-associated pneumonia. Signalment and ventilator settings were not associated with outcome. Cats that had no clinical evidence of pulmonary disease but required PPV because of primary neurologic disease had a higher survival rate (2/6) than did cats that required PPV because of respiratory failure (5/36), cardiac arrest (1/9), or nonresponsive hypotension (0/2). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the survival rate for cats requiring PPV may be lower than reported survival rates for dogs. Death was attributable to progressive respiratory failure, non-responsive hypotension, kidney failure, or neurologic impairment.     

Outcome of and complications associated with tube cystostomy in dogs and cats: 76 cases (1995-2006)

OBJECTIVE: To determine indications for cystostomy tube use in dogs and cats, complications associated with their use, and outcome of dogs and cats in which cystostomy tubes had been inserted. DESIGN: Retrospective case series. ANIMALS: 37 dogs and 39 cats. PROCEDURES: Information was obtained from medical records. Long-term follow-up information was obtained by use of a client questionnaire. RESULTS: Indications for cystostomy tube placement were bladder dysfunction, urinary tract rupture, obstructive urinary tract neoplasia, urinary diversion following urogenital surgery, obstructive urolithiasis, and feline lower urinary tract disease. Median time tubes were in place was 11 days, but duration of tube use was significantly longer for animals with bladder dysfunction than for animals with urinary tract trauma, urinary diversion, or urinary tract obstruction. Thirty-seven (49%) animals had tube complications. Development of complications was not significantly associated with species, age, body weight, duration of tube use, or tube type, except that animals were significantly more likely to develop complications following long-rather than short-term use. In 42 animals, the underlying condition resolved and the tube was removed; 22 animals died or were euthanatized with the tube in place. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that cystostomy tubes may be used for animals with various conditions related to problems with urine outflow. Nearly half the animals in the study developed complications related to the cystostomy tube, suggesting that potential complications should be discussed with owners prior to tube placement. However, most complications were easily resolved.