Cerebral Blastomyces dermatitidis infection in a cat

CASE DESCRIPTION: An 8-year-old domestic shorthair cat was evaluated because of signs of depression, circling, and visual deficits. CLINICAL FINDINGS: The cat had no cutaneous lesions, and results of an ophthalmologic examination and thoracic radiography were within reference limits. Computed tomography of the brain revealed a mass lesion involving the right parietal, temporal, and occipital lobes; the mass was in broad-based contact with the skull and smoothly marginated and had strong homogenous enhancement after contrast agent administration. During craniectomy, samples of the mass were collected for cytologic and histopathologic evaluations and microbial culture. A diagnosis of Blastomyces dermatitidis-associated meningoencephalitis with secondary pyogranulomatous inflammation was made. TREATMENT AND OUTCOME: Amphotericin B (0.25 mg/kg [0.11 mg/lb], IV) was administered on alternate days (cumulative dose, 1.75 mg/kg [0.8 mg/lb]). To minimize the risk of nephrotoxicosis, assessments of serum biochemical variables (urea nitrogen and creatinine concentrations) and urinalyses were performed at intervals. The third dose of amphotericin B was postponed 48 hours because the cat became azotemic. The cat subsequently received fluconazole (10 mg/kg [4.5 mg/lb], PO, q 12 h) for 5.5 months. Six months after discontinuation of that treatment, the cat appeared healthy and had no signs of relapse. CLINICAL RELEVANCE: Brain infection with B dermatitidis is typically associated with widespread disseminated disease. The cat of this report had no evidence of systemic disease. Blastomycosis of the CNS should be considered as a differential diagnosis for brain lesions in cats from areas in which B dermatitidis is endemic.     

The risk of salmonellae shedding by dogs fed Salmonella-contaminated commercial raw food diets

Twenty-eight research dogs were enrolled to determine the prevalence of salmonellae shedding after consumption of 1 Salmonella-contaminated commercial raw food diet meal. Sixteen dogs were exposed to Salmonella-contaminated commercial raw food diets and 12 to Salmonella-free commercial raw food diets. Seven of the exposed dogs shed salmonellae 1-7 days after consumption of Salmonella-contaminated raw food diets. None of the dogs fed Salmonella-free diets shed salmonellae. No clinical signs were observed in either group. Five of the 7 dogs shed the same serotypes as those recovered from food samples used for feeding. Results showed the same serotypes and antimicrobial resistance pattern in 2 of the 7 shedders. Dogs fed Salmonella-contaminated raw food diets can shed salmonellae and may, therefore, be a source of environmental contamination potentially leading to human or animal illness.     

Use of bone morphogenetic proteins for augmentation of bone regeneration

A large body of preclinical and clinical data now documents that recombinant BMPs can be used for skeletal regeneration in humans and animals. Recombinant human BMP-2 and BMP-7 have been approved for use in human patients with long-bone fractures and nonunions and in patients undergoing lumbar fusion or various maxillofacial and dental regenerative procedures. These products have also been made available for veterinary use.     

Treatment of a metallic foreign body in the cranial cervical region of a horse

Ingestion of foreign bodies is uncommon in horses when compared with indiscriminate grazers such as cattle. This case report describes the diagnosis and treatment of a cervical abscess in a Thoroughbred racehorse thought to be associated with ingestion of wire. Radiographic and ultrasonographic examination provided a diagnosis, and conservative treatment of the lesion with antimicrobials initially allowed the lesion to localise closer to the skin for safer surgical exploration. Intra-operative ultrasonographic imaging facilitated surgical access, removal of the foreign body, and drainage. While surgical treatment is usually necessary to resolve an abscess, initially conservative therapy may help to improve the prognosis by simplifying surgical access and reducing the risk of surgical complications.     

Incisional complications following exploratory celiotomy: does an abdominal bandage reduce the risk?

REASONS FOR PERFORMING STUDY: Post operative complications following exploratory laparotomy can be potentially life-threatening, increase post operative morbidity and result in an increase in the length of hospitalisation of the affected individual. No study has evaluated the efficacy of specific strategies to reduce the incidence of post operative incisional complications. HYPOTHESIS: The use of an abdominal bandage following colic surgery through a celiotomy incision would significantly reduce the prevalence of post operative incisional complications. METHODS: A controlled, randomised clinical trial to test the hypothesis was devised. Horses eligible for inclusion in the study were assigned randomly either to the study or control group following recovery from general anaesthesia. Any post operative incisional complications occurring during hospitalisation were recorded. Long-term follow-up was obtained via telephone questionnaires. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. Multivariable analyses were conducted for all outcomes of interest. RESULTS: There was an ARR of the likelihood of developing a post operative incisional complication of 45% when using compared to not using an abdominal bandage in the post operative period. Therefore, it would be necessary to treat 2.2 horses with an abdominal bandage in order to prevent one horse developing any post operative incisional complications. CONCLUSIONS: Although incisional complications continue to be a problem following an exploratory celiotomy for colic, the proportion of horses affected was significantly reduced by use of a bandage. POTENTIAL RELEVANCE: Using an abdominal bandage following an exploratory laparotomy may help reduce the prevalence of post operative incisional complications, and prevent the development of potentially life-threatening complications.     

Endoscopic assessment and treatment of lesions of the deep digital flexor tendon in the navicular bursae of 20 lame horses

REASONS FOR PERFORMING STUDY: Clinical lesions of the deep digital flexor tendon and navicular bone are being reported with increasing frequency. However, the role of direct visualisation by navicular bursoscopy in the diagnosis and management of such injuries has not been explored. HYPOTHESIS: Navicular bursoscopy: 1) corroborates information obtained from other, noninvasive imaging modalities; 2) allows direct visualisation of lesions unidentified by other diagnostic modalities; 3) provides further information on morphology of lesions; and 4) permits minimally invasive surgical access to lesions. METHODS: The case records of all horses that underwent diagnostic navicular bursoscopy for the investigation of lameness admitted to 2 referral clinics (the Royal Veterinary College and Reynolds House Referrals) were evaluated retrospectively. Follow-up information was obtained by telephone questionnaire. RESULTS: Twenty-three bursae were examined endoscopically in 20 horses. Tears of the deep digital flexor tendon were seen in all horses (22 bursae). In 8 bursae, cartilage lesions were also present and in one bursa this was the only abnormal finding. Computed tomography and low field magnetic resonance imaging predicted tendon lesions in most cases, but failed to identify cartilage damage. Greater than 6 month follow-up information was available for 15 animals of which 11 were sound and 9 had returned to preoperative levels of performance. CONCLUSION: Lameness localised to the foot may result from tears of the deep digital flexor tendon and/or navicular fibrocartilage loss. Navicular bursoscopy allows comprehensive evaluation of these changes and also permits appropriate lesion management. POTENTIAL RELEVANCE: The diagnostic information obtained from and therapeutic options offered by bursoscopy justify its use in horses with clinical findings localising lameness to the navicular bursa.     

Mesenchymal stem cell therapy in equine musculoskeletal disease: scientific fact or clinical fiction?

The goal in the therapeutic use of mesenchymal stem cells (MSCs) in musculoskeletal disease is to harness the regenerative nature of these cells focussing on their potential to grow new tissues and organs to replace damaged or diseased tissue. Laboratory isolation of MSCs is now well established and has recently been demonstrated for equine MSCs. Stem cell science has attracted considerable interest in both the scientific and clinical communities because of its potential to regenerate tissues. Research into the use of MSCs in tissue regeneration in general reflects human medical needs, however, the nature, prevalence and prognosis of superficial digital flexor tendonitis has put equine veterinary science at the forefront of tendon regeneration research. Much has been investigated and learnt but it must be appreciated that in spite of this, the field is still relatively young and both communities must prepare themselves for considerable time and effort to develop the technology into a highly efficient treatments. The promise of functional tissue engineering to replace old parts with new fully justifies the interest. At present, however, it is important to balance the understanding of our current limitations with a desire to progress the technology.     

Epidemiology of porcine non-specific colitis on Scottish farms

The objective of this study was to investigate epidemiological risk factors for porcine non-specific colitis (NSC). Forty-seven Scottish pig farms, with and without a clinical history of diarrhoea during the growing period (15-40 kg), were selected. The study included farm visits, clinical inspection of pigs, completion of farm management questionnaires, pathological tests into the cause of the diarrhoea and analysis of the non-starch polysaccharide (NSP) content of feeds. The results from 17 farms designated as NSC and 10 control farms suggest dietary associations with NSC. Farms with NSC fed diets with significantly higher levels of NSPs, especially containing the sugars glucose, arabinose and xylose. Few management factors were identified, although the high prevalence of infectious colitis reduced the power of the study.     

Importance of prudent antibiotic use on dairy farms in South Carolina: a pilot project on farmers' knowledge, attitudes and practices

Inappropriate use of antibiotics in humans and animals contributes to decreased antimicrobial susceptibility in bacteria of medical importance. Resistant bacteria being transferred from animals to humans are causing public health concern. In-person interviews were conducted with 20 dairy farmers in rural counties of South Carolina to determine farmers' knowledge and attitudes about prudent antibiotic use among livestock. Four focus groups (n = 22) were also conducted to ascertain farmers' specific information needs about proper antibiotic use. Survey results showed that participants (100%) typically determined a need for antibiotic treatment using symptom assessment and reported following some form of operating procedures regarding administration of antibiotics. Few farmers (32%) had actual written antibiotic protocols. Preferred information sources about antibiotics were veterinarians (100%) and other dairy farmers (50%). Most farmers (86%) were not concerned that overuse of antibiotics in animals could result in antibiotic resistance among farm workers. Qualitative analysis of focus groups revealed significant barriers to following proper antibiotic procedures including limited finances and lack of time. The need for bilingual educational resources for Hispanic/Latino dairy workers was expressed. Desired formats for educational materials were posters, flowcharts, videos, and seminars. Education of South Carolina dairy farmers by veterinarians and public health professionals on the appropriate use of antibiotics in dairy cattle is needed to ensure antibiotic effectiveness in both animals and humans.