Oral Lesions Associated with Orotracheal Administered Mechanical Ventilation in Critically III Dogs

The incidence and clinical progression of oral lesions in a cohort of critically ill patients administered mechanical ventilation via orotracheal intubation were observed prospectively in the Intensive Care Unit (ICU) of the University of California, Davis Veterinary Medical Teaching Hospital. Oral cavities of these patients were examined within 24 hours of being placed on the ventilator and at least daily thereafter during ventilator therapy. As part of the study protocol, any lesion noted was treated. Twenty-one critically ill canine patients (median age of 7 yrs; range <1 to 19 yrs) were observed from 1 January 1995 through 31 August 1995. Over ninety percent (90.5%) of the observed patients developed oral lesions subsequent to being mechanically ventilated. Erosive and ulcerative mucosal lesions were the most frequently observed (15/43) with the tongue being the most frequently involved oral structure. Most of the observed soft tissue oral lesions appeared secondary to persistently applied pressure from teeth, mouth gags, endotracheal tubes, and other monitoring devices. Efforts taken to prevent persistently applied trauma, such as periodic positional changes of equipment and padding of susceptible structures, apeared effective in preventing oral lesions. There were indications of gastric reflux in 6 patients (28.6%), as evidenced by secretions in the oral cavity with a pH of <6 and containing digested blood. Ulcerative lesions in the subset of patients with gastric reflux seemed to worsen in severity with exposure to the low pH secretions. Over the course of the study, the ICU nursing staff developed an effective protocol for the care of the oral cavity: treating mucosal erosions and ulcers topically8 with a dilute chlorhexidine solution (0.05%), removing oral secretions via suction as needed, and padding persistently traumatized tissues with glycerin moistened gauze. Oral lesions in orotrachealy intubated and mechanically ventilated patients are predictable, preventable, and treatable. Most lesions are pressure induced, associated with monitoring/therapeutic equipment, and appear to be preventable with appropriate nursing protocls. Most observed oral lesions clinically improved with routine, periodic dilute chlorhexidine rinses and relief of applied pressure.     

Avian polyomavirus infection and disease in a green aracaris (Pteroglossus viridis).

Avian polyomavirus (APV) is one of the most significant pathogens of domestically raised psittacine birds (parrots). One or more APVs are suspected to infect nonpsittacine cage birds, but the relationship of these viruses to the APV infecting parrots remains unclear. In this report, for the first time, we fully document an APV infection in a nonpsittacine cage bird, a green aracaris (Pteroglossus viridis). Grossly, this bird evidenced generalized hemorrhage. Histologically, there was severe hepatic necrosis, splenic necrosis, and the presence of lightly basophilic to clear pannuclear inclusion bodies and karyomegaly in splenocytes and renal mesangeal cells, all characteristic lesions of APV infection in parrots. APV DNA was amplified directly from the liver by polymerase chain reaction and sequenced. The virus differed from the original APV sequence by only 24 base pairs (0.48% of the genome), demonstrating that it is a variant of the APV. A serologic survey of the remaining birds in the aviary demonstrated anti-APV antibody in two cockatoos, two cockatiels, a laughing kookaburra, a Lady Ross turaco, and five zebra finches. The remaining green aracaris was seronegative. The sequence and serologic data suggest that the APV that infected the green aracaris originated in a parrot and was capable of infecting birds from at least four orders.     

Food as the Dominant Pathway of Methylmercury Uptake by Fish

A field experiment was conducted to determine the degree to which fish accumulated methylmercury (MeHg) via their food or via passive uptake from water through the gills. Finescale dace (Phoxinus neogaeus) were held in 2000 L enclosed pens floating in an undisturbed, oligotrophic lake in northwestern Ontario. Fish were exposed to water containing either low (0.10–0.40 ng L^-1), intermediate (0.45–1.30 ng L^-1), or high (0.80–2.1 ng L^-1) concentrations of MeHg. Zooplankton with either low (0.16–0.18 µg g^-1 d.w.) or high (0.28–0.76 µg g^-1 d.w.) concentrations of MeHg were added daily to each pen. Fish fed zooplankton with high concentrations of MeHg had significantly higher concentrations of mercury in muscle after 32 days than fish fed zooplankton with low concentrations of MeHg (ANCOVA, P<0.0001). Fish feeding on zooplankton with low concentrations of MeHg had the same amount of Hg in their tissues as fish at the start of the experiment. Uptake from water was at most 15%. This is the first experiment to confirm that food is the dominant pathway of MeHg bioaccumulation in fish at natural levels of MeHg.     

Avian practice tips.

This article reviews the therapy of the sick bird. Common differential diagnoses, inpatient versus outpatient therapy, preventive medicine, and post-purchase examinations are discussed. The importance of client education is stressed.     

Classification of smoke tainted wines using mid-infrared spectroscopy and chemometrics

In this study, the suitability of mid-infrared (MIR) spectroscopy, combined with principal component analysis (PCA) and linear discriminant analysis (LDA), was evaluated as a rapid analytical technique to identify smoke tainted wines. Control (i.e., unsmoked) and smoke-affected wines (260 in total) from experimental and commercial sources were analyzed by MIR spectroscopy and chemometrics. The concentrations of guaiacol and 4-methylguaiacol were also determined using gas chromatography-mass spectrometry (GC-MS), as markers of smoke taint. LDA models correctly classified 61% of control wines and 70% of smoke-affected wines. Classification rates were found to be influenced by the extent of smoke taint (based on GC-MS and informal sensory assessment), as well as qualitative differences in wine composition due to grape variety and oak maturation. Overall, the potential application of MIR spectroscopy combined with chemometrics as a rapid analytical technique for screening smoke-affected wines was demonstrated.     

The effect of moderate hypovolemia on cardiopulmonary function in dogs

Objective: To collate canine cardiopulmonary measurements from previously published and unpublished studies in instrumented, unsedated, normovolemic and moderately hypovolemic dogs. Design: Collation of data obtained from original investigations in our research laboratory. Setting: Research laboratory, School of Veterinary Medicine. Subjects: Sixty‐eight dogs. Interventions: Subjects were percutaneously instrumented with an arterial catheter and a thermodilution cardiac output catheter. A femoral artery catheter was percutaneously placed for blood removal. Measurements and main results: Body weight, arterial and mixed‐venous pH and blood gases, arterial, pulmonary arterial, pulmonary artery occlusion, and central venous blood pressure, cardiac output, and core body temperature were measured. Body surface area, bicarbonate concentration, standard base excess, cardiac index (CI), stroke volume, systemic and pulmonary vascular resistance, left and right ventricular work and stroke work indices, left and right rate‐pressure product, alveolar PO₂, alveolar–arterial PO₂ gradient, arterial and mixed‐venous and pulmonary capillary oxygen content, oxygen delivery, oxygen consumption, oxygen extraction, venous admixture, arterial and venous blood carbon dioxide content, arterial–venous carbon dioxide gradient, carbon dioxide production were calculated. In 68 dogs, hypovolemia sufficient to decrease mean arterial blood pressure (ABPm) to an average of 62 mmHg, was associated with the following changes: arterial partial pressure of carbon dioxide (PaCO₂) decreased from 40.0 to 32.9 mmHg; arterial base deficit (BDa) increased from ?2.2 to ?6.3 mEq/L; lactate increased from 0.85 to 10.7 mm /L, and arterial pH (pHa) did not change. Arterial partial pressure of oxygen (PaO₂) increased from 100.5 to 108.3 mmHg while mixed‐venous PO₂ (PmvO₂) decreased from 49.1 to 34.1 mmHg. Arterial and mixed‐venous oxygen content (CaO₂ and CmvO₂) decreased from 17.5 to 16.5 and 13.8 to 9.6 mL/dL, respectively. The alveolar–arterial PO₂ gradient (A‐a PO₂) increased from 5.5 to 8.9 mmHg while venous admixture decreased from 2.9% to 1.4%. The ABPm decreased from 100 to 62 mmHg; pulmonary arterial pressure (PAPm) decreased from 13.6 to 6.4 mmHg; and pulmonary arterial occlusion pressure (PAOP) decreased from 4.9 to 0.1 mmHg. CI decreased from 4.31 to 2.02 L/min/m². Systemic and pulmonary vascular resistance (SVRI and PVRI) increased from 1962 to 2753 and 189 to 269 dyn s/cm⁵, respectively. Oxygen delivery (DO₂) decreased from 787 to 340 mL/min/m² while oxygen consumption (VO₂) decreased from 172 to 141 mL/min/m². Oxygen extraction increased from 20.9% to 42.3%. Conclusions: Moderate hypovolemia caused CI and oxygen delivery to decrease to 47% and 42% of baseline. Oxygen extraction, however, doubled and, therefore, oxygen consumption decreased only to 82% of baseline.     

Cutting balloon catheterization for interventional treatment of cor triatriatum dexter: 2 Cases

Cutting balloon dilatation was performed successfully in two dogs with cor triatriatum dexter and clinical signs of ascites. The cutting balloon catheter uses incisional microtomes embedded in a balloon catheter. During balloon expansion, these microtomes incise the adjacent tissue, decreasing circumferential wall stress. This theoretically reduces both the likelihood of fracturing the adjacent tissues in an uncontrolled manner and the potential neoproliferative response to standard balloon dilatation and the subsequent incidence of re-stenosis. In both cases described, clinical signs resolved completely following cutting balloon dilatation of the anomalous membrane. Based on the outcome of these 2 cases, cutting balloon dilatation appears to be a viable treatment option for dogs affected with cor triatriatum dexter.