Outcome associated with use of a percutaneously controlled hydraulic occluder for treatment of dogs with intrahepatic portosystemic shunts

OBJECTIVE: To evaluate efficacy of a hydraulic occluder (HO) used for treatment of dogs with an intrahepatic portosystemic shunt (IHPSS). DESIGN: Prospective study. ANIMALS: 10 dogs with an IHPSS. PROCEDURES: Serum biochemical and postprandial bile acids (PPBA) analyses and transcolonic scintigraphy were performed before surgery. Laparotomy was performed, and an uninflated HO was placed around the portal vein branch leading to the IHPSS. After surgery, 0.9% NaCl solution was injected into subcutaneous injection ports at 2, 4, 6, and 8 weeks to achieve staged occlusion of the HO. Serum biochemical analyses, PPBA analysis, and scintigraphy were performed 2 weeks after occlusion. Serum biochemical analyses were repeated 1 year after surgery. RESULTS: Implant revision was required in 3 dogs because of rupture of the HO (n = 2) or detachment of the actuating tubing (1). Serum biochemical values and clinical signs improved in all dogs after surgery. Six of 10 dogs had PPBA concentration within reference range 2 weeks after occlusion, and 2 additional dogs had concentrations within reference range at 1 year. Only 5 of 10 dogs had complete resolution of portosystemic shunting 2 weeks after occlusion. Two dogs were lost to follow-up, and 8 dogs remained alive with no recurrence of clinical signs at a median of 22 months after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Use of the HO appeared to be an effective method for surgical treatment for dogs with IHPSS, although problems with implant reliability indicate a need for modifications in design and manufacturing.     

Relationship of Plasma N‐terminal Pro‐brain Natriuretic Peptide Concentrations to Heart Failure Classification and Cause of Respiratory Distress in Dogs Using a 2nd Generation ELISA Assay

Background

Cardiac biomarkers provide objective data that augments clinical assessment of heart disease (HD).

Hypothesis/Objectives

Determine the utility of plasma N‐terminal pro‐brain natriuretic peptide concentration [NT‐proBNP] measured by a 2nd generation canine ELISA assay to discriminate cardiac from noncardiac respiratory distress and evaluate HD severity.

Animals

Client‐owned dogs (n = 291).

Methods

Multicenter, cross‐sectional, prospective investigation. Medical history, physical examination, echocardiography, and thoracic radiography classified 113 asymptomatic dogs (group 1, n = 39 without HD; group 2, n = 74 with HD), and 178 with respiratory distress (group 3, n = 104 respiratory disease, either with or without concurrent HD; group 4, n = 74 with congestive heart failure [CHF]). HD severity was graded using International Small Animal Cardiac Health Council (ISACHC) and ACVIM Consensus (ACVIM‐HD) schemes without knowledge of [NT‐proBNP] results. Receiver‐operating characteristic curve analysis assessed the capacity of [NT‐proBNP] to discriminate between dogs with cardiac and noncardiac respiratory distress. Multivariate general linear models containing key clinical variables tested associations between [NT‐proBNP] and HD severity.

Results

Plasma [NT‐proBNP] (median; IQR) was higher in CHF dogs (5,110; 2,769–8,466 pmol/L) compared to those with noncardiac respiratory distress (1,287; 672–2,704 pmol/L; P < .0001). A cut‐off >2,447 pmol/L discriminated CHF from noncardiac respiratory distress (81.1% sensitivity; 73.1% specificity; area under curve, 0.84). A multivariate model comprising left atrial to aortic ratio, heart rate, left ventricular diameter, end‐systole, and ACVIM‐HD scheme most accurately associated average plasma [NT‐proBNP] with HD severity.

Conclusions and Clinical Importance

Plasma [NT‐proBNP] was useful for discriminating CHF from noncardiac respiratory distress. Average plasma [NT‐BNP] increased significantly as a function of HD severity using the ACVIM‐HD classification scheme.     

Laminitis and dermatitis in heifers associated with excessive carbohydrate intake: skin lesions and biochemical findings

The effects of a sudden addition of a large quantity of readily fermentable carbohydrate to the feed ration of pregnant heifers are described. Clinical and pathological changes caused by the resulting disease were confined to the digits and skin. The 4 acutely affected heifers were reluctant to get up or move (group II). They tended to lie down or stand with feet bunched together and the back arched, often shifting weight from limb to limb. They walked stiffly with great tenderness and pain in the digits. Extreme pain was noticed when the digits were examined. In 4 of 8 heifers, separation of the sole at the heel, with leakage of exudate, and under-running of the sole were observed. Necrotic dermatitis of the legs, alopecia and hyperkeratosis of the tail were noticed in all 8 heifers. Skin lesions appeared simultaneously. Four of the heifers (group I) recovered, and the other 4 (group II) were sent to slaughter. No post mortem examination was performed. The biochemical findings revealed a significantly higher concentration of total serum globulins and sodium, and increased activity, in CK, LDH and AST. A significantly decreasing pattern was noted in blood urea concentration, cholesterol, triglycerides, albumin and calcium. No significant differences among the various groups were found in the activities of amylase, GGT, and concentration of creatinine, total bilirubin, inorganic phosphorus, magnesium and potassium.     

Treatment of feline hyperthyroidism using orally administered radioiodine: a study of 40 consecutive cases

SUMMARY Forty cats with hyperthyroidism were treated using 200 to 300 (typically 250) mBq of orally administered ¹³¹I. Thirty-six cases (90%) were successfully treated, as assessed by resolution of clinical signs and reduction In plasma thyroxine concentrations to normal or reduced values after treatment. Although higher doses of ¹³¹I appear to be required when the radioisotope is administered orally rather than Intravenously, a less stressful administration procedure and greater availability of therapy capsules offer useful advantages for treating thyrotoxic cats.     

Investigation and control of mastitis outbreaks caused by Pseudomonas aeruginosa in a sheep flock and a goat herd

Outbreaks of mastitis in a sheep flock and a goat herd caused by Pseudomonas aeruginosa, and their control are described.The morbidity rates of mastitis in a sheep flock and in a goat herd were 18.7 and 18.2 per cent, respectively. The lethality and involuntary culling rates of the animals with sub-clinical mastitis correspond to the morbidity rate.The highest morbidity rates were noted in yearlings--22.5 and 30 per cent, as well as in animals pre- and post partum (7 and 20 per cent, in sheep and goats, respectively). The morbidity periods in the flock and in the herd were 20 and 27 months, respectively. A strict-hygiene milking programme and maintenance of the milking devices was introduced. In addition, prevention of crowding, provision of dry bedding and thorough cleaning of water troughs have also been instituted. Ruthless culling of all infected and carrier animals was an essential part of the control program against Pseudomonas aeruginosa mastitis.     

Successful ovariectomy in a dog with Glanzmann thrombasthenia

Ovariectomy was performed in a 7-month-old Great Pyrenees with a severe congenital bleeding disorder. A diagnosis of Glanzmann thrombasthenia, a rare, congenital bleeding disorder characterized by a functional platelet defect, was later confirmed by isolation of genomic DNA from blood and amplification of exon 13 and intron 13 of the gene encoding for platelet glycoprotein subunit alphaIIb. Perioperative management consisted of administration of platelet-rich plasma prior to surgery and the use of high-frequency electrocoagulation to minimize tissue trauma. In addition, ovariectomy, rather than ovariohysterectomy, was performed to minimize surgical exposure required and manipulation of the urogenital tract. Results in this dog suggest that a combination of preoperative transfusion with functional platelets and use of techniques to minimize tissue trauma may allow abdominal surgery to be performed successfully in dogs with functional platelet disorders.