Successful use of a benchtop fluorescent enzyme immunoassay analyzer to measure serum cortisol concentration as a screening test for hypoadrenocorticism in dogs.

OBJECTIVE: To assess the diagnostic performance of a benchtop fluorescent enzyme immunoassay analyzer (AIA-360; Tosoh Bioscience Inc) for the measurement of serum cortisol concentration as a screening test for hypoadrenocorticism in dogs. ANIMALS: 173 client-owned dogs (20 with hypoadrenocorticism and 153 with nonadrenal illness). PROCEDURES: Medical records of all dogs that underwent an ACTH stimulation test between June 2015 and October 2019 were reviewed retrospectively. Dogs were excluded if the ACTH stimulation test was performed on the basis of a suspicion of hypercortisolism, serum cortisol concentrations were measured using an analyzer other than the one assessed in the present study, or dogs had received medication known to affect the pituitary-adrenal axis in the 4 weeks1,2 preceding ACTH stimulation testing. The diagnostic performance of the benchtop analyzer was evaluated by calculating sensitivity, specificity, and likelihood ratios at various cutoff points. RESULTS: Serum resting cortisol cutoff point concentrations of 0.8 µg/dL (22 nmol/L), 1 µg/dL (28 nmol/L), and 2 µg/dL (55 nmol/L) had a sensitivity of 100%. An optimal serum resting cortisol cutoff point of 0.58 µg/dL (16 nmol/L) had a sensitivity, specificity, and positive and negative likelihood ratios of 100%, 97%, and 30.6 and 0.0, respectively. CLINICAL RELEVANCE: Findings indicated that previously derived cutoff points could be used with excellent sensitivity to exclude hypoadrenocorticism in this population of dogs when serum cortisol concentration was measured with the evaluated benchtop analyzer. An ACTH stimulation test may need to only be performed to diagnose hypoadrenocorticism if resting serum cortisol concentration is ≤ 0.58 µg/dL when measured with the evaluated benchtop analyzer.

Evaluation of serum cortisol concentration as a prognostic indicator for nonsurvival to hospital discharge in critically ill dogs.

OBJECTIVE: To investigate whether serum cortisol (SC) concentration is a useful prognostic indicator for survival versus nonsurvival to hospital discharge in critically ill dogs. ANIMALS: 229 client-owned dogs. PROCEDURES: Medical records were retrospectively reviewed to identify critically ill dogs that were hospitalized between January 2010 and May 2018 and that had SC concentrations measured ≤ 3 days after admission. Results for SC concentrations were compared for dogs grouped by survival versus nonsurvival to hospital discharge, with versus without sepsis, and other variables of interest. The predictive value of SC concentration for nonsurvival to hospital discharge was assessed (OR, sensitivity, and specificity) for cutoffs determined from a ROC curve or reference limit. RESULTS: Median SC concentration was higher in dogs that did not survive to hospital discharge (8.5 µg/dL; interquartile [25th to 75th percentile] range, 4.8 to 11.8 µg/dL), compared with concentration in those that were discharged alive (4.5 µg/dL; interquartile range, 2.5 to 6.9 µg/dL). The area under the ROC curve was 0.72 (95% confidence interval [CI], 0.64 to 0.81) for SC concentration predicting nonsurvival. The calculated optimum cutoff of SC concentration was 7.6 µg/dL, at which the OR, sensitivity, and specificity for nonsurvival were 5.4 (95% CI, 2.7 to 10.9), 58%, and 80%, respectively. Alternatively, when the upper reference limit for SC concentration (5.8 µg/dL) was used as the cutoff, the OR, sensitivity, and specificity for nonsurvival were 3.6 (95% CI, 1.8 to 7.1), 67%, and 64%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that SC concentration could be used as part of an overall assessment of prognosis in critically ill dogs.

Comparison between a flash glucose monitoring system and a portable blood glucose meter for monitoring dogs with diabetes mellitus.

BACKGROUND: Flash glucose monitoring system (FGMS; FreeStyle Libre) was recently validated for use in diabetic dogs (DD). It is not known if this system is clinically useful in monitoring DD. OBJECTIVE: To compare the clinical utility of FGMS against blood glucose curves (BGCs) obtained with a portable blood glucose meter (PBGM) in monitoring DD. ANIMALS: Twenty dogs with diabetes mellitus. METHODS: Prospective study. Dogs with diabetes mellitus on insulin treatment for at least 1 month were included. Comparisons of insulin dose recommendations based on the in-hospital GCs acquired using FGMS and a PBGM, consecutive-day interstitial GCs (IGCs) acquired at home using the FGMS, and consecutive-day, home vs hospital IGCs acquired using the FGMS were made using concordance analysis. RESULTS: There was good concordance between insulin dose recommendations based on FGMS and PBGM generated GCs and IGCs obtained in the 2 different environments on 2 consecutive days, but almost absent concordance between IGCs obtained on 2 consecutive days at home. Glucose nadirs were detected in 34/43 (79%) of Ambulatory Glucose Profile (AGP) reports of the FGMS. In comparison, concordant glucose nadirs were identified in 14/34 (41%) BGCs using PBGM. The individual FGMS scans and PBGM identified 60% and 9% of low IG/hypoglycemic episodes, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Insulin dose adjustments based on BGCs can be suboptimal. The FGMS allows a more accurate identification of the glucose nadirs and hypoglycemic episodes compared to the use of a PBGM and assessment of day-to-day variations in glycemic control.

Composite Fasciola hepatica faecal egg sedimentation test for cattle.

Options for diagnosing Fasciola hepatica infection in groups of cattle are limited. Increasing the opportunities for herd-level diagnosis is important for disease monitoring, making informed treatment decisions and for flukicide efficacy testing. The sensitivity of a simple sedimentation method based on composite faecal samples for the detection of fluke eggs in cattle was assessed through a combination of experimental and statistical modelling techniques. Initially, a composite sample method previously developed for sheep was used to investigate the sensitivity of composite sample testing compared with individual counts on the same samples in cattle. Following this, an optimised, validated, qualitative (presence-absence) composite sample field test was developed for cattle. Results showed that fluke egg counts obtained from a composite sample are representative of those expected from individual counts. The optimal sampling strategy was determined to be 10 individual 10 g samples (100 g composite sample) from which a 10 g subsample is taken for sedimentation. This method yielded a diagnostic sensitivity of 0.69 (95 per cent CI 0.5 to 0.85). These results demonstrate the validity and usefulness of a composite faecal egg sedimentation method for use in the diagnosis and control of F. hepatica in groups of cattle, with the caveat that a negative test should be followed up with a second test due to limitations relating to test sensitivity.

Hepatic leptospiral infections in dogs without obvious renal involvement.

BACKGROUND: Reports of chronic hepatitis in dogs caused by Leptospira spp. are confined to small case series. Fluorescence in situ hybridization (FISH) allows the identification of spirochetes in liver samples. Consequently, this technique may help elucidate the role of Leptospira spp. in cases of chronic hepatitis. OBJECTIVES: To describe cases of hepatic leptospirosis in dogs diagnosed by FISH and subsequent polymerase chain reaction (PCR) speciation, with the absence of clinically relevant renal involvement. ANIMALS: Ten client-owned dogs. METHODS: Retrospective case series from the University of Cambridge presented between 2013 and 2016 or cases consulted by telephone advice during this time period. Cases were selected based on histopathologically confirmed granulomatous hepatitis and leptospiral organisms identified by FISH and PCR speciation (Leptospira interrogans/kirschneri). RESULTS: All cases had increased liver enzyme activities, and FISH in combination with PCR speciation-confirmed infection with L. interrogans/kirschneri. Four dogs underwent repeat liver biopsy, FISH and PCR speciation 4-15 months after initial presentation and doxycycline treatment with 1 dog undergoing repeat sampling at necropsy. Three dogs that underwent repeat biopsy remained positive for L. interrogans/kirschneri infection. Six dogs were alive at the time of manuscript preparation and 4 dogs were euthanized as a result of progressive liver disease. CONCLUSIONS AND CLINICAL IMPORTANCE: The presence of hepatic leptospiral organisms may be associated with chronic granulomatous hepatitis without clinical evidence of renal involvement. Further studies are necessary to elucidate the etiological role of these organisms in the disease.

Local dispersal of palaearctic Culicoides biting midges estimated by mark-release-recapture.

BACKGROUND: Farm to farm movement of Culicoides midges is believed to play a critical role in the spread of bluetongue (BT), Schmallenberg and other midge-borne diseases. To help understand and predict the spread of diseases carried by midges, there is a need to determine their dispersal patterns, and to identify factors contributing to the direction taken and distance travelled. METHODS: The dispersal of Obsoletus Group members was studied on 19 farms around Bala, north Wales. Field-collected Culicoides were trapped in a black-light (OVI) trap and self-marked in the collecting vessel, using micronized fluorescent dust. Culicoides were released at a central farm and OVI traps set on 18 surrounding farms, at distances of 1 to 4 km. The study was repeated using six colours of fluorescent dust over an 18 day period. RESULTS: An estimated 61,062 (95% CI = 56,298-65,830) marked Culicoides were released during the study and 12 (0.02%) Culicoides were recaptured. Of the females recaptured, six were C. obsoletus/scoticus, two C. dewulfi, two C. pulicaris and one C. festivipennis. The male was C. obsoletus. Recaptures occurred 1-2.5 km from the release site, with greatest numbers at 2.5 km. Most recaptures were 2 nights post-release; none were more than 3 nights post-release. Two females were recovered at 1.5 km on the night of release and one male at 1 km two nights post-release. The mean distance travelled (MDT) for males was 1 km, females was 2.21 km, and all recaptured Culicoides was 2.15 km. Recaptures were made both downwind and upwind of the prevailing wind direction during the trapping periods, highlighting possible passive and active dispersal of Culicoides between farms. CONCLUSIONS: This is the first study to demonstrate farm to farm movement of the main Palaearctic BT vector species, the Obsoletus Group. Such movement has disease control implications in terms of the vectoral movement of disease between farms. The results suggest that Culicoides control measures applied at an infected farm (trapping or killing Culicoides) will reduce risk of spread to neighbouring farms by lessening the number of Culicoides dispersing from that farm, as well as reducing transmission at the source farm itself.