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OBJECTIVE: To describe changes in circulating hyaluronic acid (HA) concentration, a biomarker of endothelial glycocalyx degradation, after administration of fresh-frozen plasma (FFP) in critically ill dogs. ANIMALS: 12 client-owned dogs receiving an FFP transfusion due to underlying disease. METHODS: Plasma samples were collected for HA concentration measurement pre-FFP transfusion (T0) and 10 minutes (T10) and 90 minutes (T90) following completion of FFP transfusion of a minimum volume of 7 mL/kg. Hyaluronic acid was also measured in the transfused FFP units following in-house validation of a commercial HA assay on citrate phosphate dextrose-anticoagulated plasma. Potential associations of the difference between pre-FFP and post-FFP HA plasma concentrations with the volume of FFP transfused, the cumulative volume of IV fluids administered during the study period, and the HA concentration in the transfused unit were explored. RESULTS: Concentrations of HA were not significantly different between pre- and post-FFP transfusion measurements. The volume of FFP transfused, the cumulative volume of other IV fluids administered during the study time, and the concentration of HA in the FFP units had no significant effect on the change in HA concentration following FFP transfusion in this study. CLINICAL RELEVANCE: This pilot study did not demonstrate an association between FFP administration and changes in plasma HA concentration. The results of this study may serve to help design future research. A commercial assay was validated to measure HA in citrate phosphate dextrose-anticoagulated plasma.
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Management of immune thrombocytopenia (ITP) in dogs and cats is evolving, but there are no evidence-based guidelines to assist clinicians with treatment decisions. Likewise, the overall goals for treatment of ITP have not been established. Immunosuppressive doses of glucocorticoids are the first line treatment, but optimal treatment regimens beyond glucocorticoids remain uncertain. Additional options include secondary immunosuppressive drugs such as azathioprine, modified cyclosporine, and mycophenolate mofetil, usually selected based on clinician preference. Vincristine, human IV immunoglobulin (hIVIg), and transfusion of platelet or red blood cell-containing products are often used in more severe cases. Splenectomy and thrombopoietin receptor agonists are usually reserved for refractory cases, but when and in which patient these modalities should be employed is under debate. To develop evidence-based guidelines for individualized treatment of ITP patients, we asked 20 Population Intervention Comparison Outcome (PICO) format questions. These were addressed by 17 evidence evaluators using a literature pool of 288 articles identified by a structured search strategy. Evidence evaluators, using panel-designed templates and data extraction tools, summarized evidence and created guideline recommendations. These were integrated by treatment domain chairs and then refined by iterative Delphi survey review to reach consensus on the final guidelines. In addition, 19 non-PICO questions covering scenarios in which evidence was lacking or of low quality were answered by expert opinion using iterative Delphi surveys with panelist integration and refinement. Commentary was solicited from multiple relevant professional organizations before finalizing the consensus. The rigorous consensus process identified few comparative treatment studies, highlighting many areas of ITP treatment requiring additional studies. This statement is a companion manuscript to the ACVIM Consensus Statement on the Diagnosis of Immune Thrombocytopenia in Dogs and Cats.
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Enfermedades de los Gatos , Enfermedades de los Perros , Púrpura Trombocitopénica Idiopática , Perros , Gatos , Enfermedades de los Perros/terapia , Enfermedades de los Perros/tratamiento farmacológico , Enfermedades de los Gatos/terapia , Enfermedades de los Gatos/tratamiento farmacológico , Animales , Púrpura Trombocitopénica Idiopática/veterinaria , Púrpura Trombocitopénica Idiopática/terapia , Púrpura Trombocitopénica Idiopática/tratamiento farmacológico , Inmunosupresores/uso terapéutico , ConsensoRESUMEN
Purpose: Pet guardians are increasingly seeking vegan dog foods. However, research on the impact of these diets on gastrointestinal (GI) physiology and health is limited. In humans, vegan diets modify the GI microbiota, increasing beneficial digestive microorganisms. This study aimed to examine the canine fecal microbiota in response to a vegan diet compared to an animal-based diet. Methods: Sixty-one client-owned healthy adult dogs completed a randomized, double-blinded longitudinal study. Dogs were randomly assigned into two groups that were fed either a commercial extruded animal-based diet (MEAT, n = 30) or an experimental extruded vegan diet (PLANT, n = 31) for 12 weeks. Fecal collections occurred at the start of the experimental period and after 3 months of exclusively feeding either diet. Bacterial DNA was extracted from the feces, and the V4 region of the 16S rRNA gene was amplified using PCR and sequenced on Illumina MiSeq. Beta-diversity was measured using Jaccard and Bray-Curtis distances, and the PERMANOVA was used to assess for differences in fecal microbiota within and between groups. Alpha-diversity indices for richness, evenness, and diversity, as well as relative abundance, were calculated and compared between groups. Results: Beta-diversity differences occurred between diet groups at exit time-point with differences on Bray-Curtis distances at the family and genus levels (p = 0.007 and p = 0.001, respectively), and for the Jaccard distance at the family and genus level (p = 0.006 and p = 0.011, respectively). Significant differences in alpha-diversity occurred when comparing the PLANT to the MEAT group at the exit time-point with the PLANT group having a lower evenness (p = 0.012), but no significant differences in richness (p = 0.188), or diversity (p = 0.06). At exit-timepoint, compared to the MEAT group, the relative abundance of Fusobacterium, Bacteroides, and Campylobacter was lower in the PLANT group. The relative abundance of Fusobacterium decreased over time in the PLANT group, while no change was observed in the MEAT group. Conclusion: These results indicate that vegan diets may change the canine gut microbiota. Future studies are warranted to confirm our results and determine long-term effects of vegan diets on the canine gut microbiome.
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OBJECTIVES: Clopidogrel is the recommended first-line antithrombotic in cats for a variety of conditions; however, it is ineffective in 15-20% of cats. The determination of clopidogrel effectiveness with platelet function assays has historically been limited to specialty centers; however, recent work has suggested that in-hospital or shipped analyses of samples may be feasible. The aim of the present study was to investigate the utility of an in-house analysis and shipping of blood samples collected in primary practices for the determination of clopidogrel effectiveness. METHODS: Citrated blood samples were collected from cats receiving clopidogrel therapy by veterinarians in clinical practices across Canada, a median of 304.4 km from the reference laboratory (range 8-4425). Samples were analyzed in-house using Plateletworks ADP and shipped for remote analysis using PFA-200 P2Y and COL/ADP cartridges. RESULTS: A total of 30 samples were collected from 25 cats. Of these, the percentage of samples analyzable for the presence or absence of the clopidogrel effect was 86% for Plateletworks ADP, 90% for PFA-200 P2Y and 87% for PFA-200 COL/ADP. There was no significant difference in the number of samples unable to be analyzed by each modality (P = 0.689) due to flow obstruction or other sample characteristics. The prevalence of absence of clopidogrel effectiveness on platelet function assays was 8% with the PFA-200 COL/ADP assay, 25% with the PFA-200 P2Y assay and 30% with the Plateletworks ADP assay. CONCLUSIONS AND RELEVANCE: The results of this study confirm that samples of feline blood can be collected in clinical practices and shipped to a reference laboratory for PFA-200 analysis with a high rate of success, comparable to point-of-care analysis.
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Clopidogrel , Pruebas de Función Plaquetaria , Animales , Gatos , Enfermedades de los Gatos/sangre , Enfermedades de los Gatos/tratamiento farmacológico , Clopidogrel/uso terapéutico , Inhibidores de Agregación Plaquetaria/farmacología , Pruebas de Función Plaquetaria/veterinaria , Sistemas de Atención de PuntoRESUMEN
This study aimed to investigate the serum metabolomic profile of obese and lean cats as well as obese cats before and after energy restriction for weight loss. Thirty cats, 16 obese (body condition score 8 to 9/9) and 14 lean (body condition score 4 to 5/9), were fed a veterinary weight loss food during a 4-week period of weight maintenance (L-MAINT and O-MAINT). The 16 obese cats were then energy restricted by a 60% energy intake reduction with the same food for a 10-week period (O-RESTRICT). Fasted serum metabolites were measured using nuclear magnetic resonance and direct infusion mass spectrometry after the maintenance period for L-MAINT and O-MAINT cats and after the energy restriction period for O-RESTRICT and compared between groups using a two-sided t-test. Obese cats lost 672 g ± 303 g over the 10-week restriction period, representing a weight loss rate of 0.94 ± 0.28% per week. Glycine, l-alanine, l-histidine, l-glutamine, 2-hydroxybutyrate, isobutryric acid, citric acid, creatine, and methanol were greater in O-RESTRICT compared to O-MAINT. There was a greater concentration of long-chain acylcarnitines in O-RESTRICT compared to both O-MAINT and L-MAINT, and greater total amino acids compared to O-MAINT. Glycerol and 3-hydroxybutyric acid were greater in O-MAINT compared to L-MAINT, as were several lysophosphatidylcholines. Thus, energy restriction resulted in increased dispensable amino acids in feline serum which could indicate alterations in amino acid partitioning. An increase in lipolysis was not evident, though greater circulating acylcarnitines were observed, suggesting that fatty acid oxidation rates may have been greater under calorie restriction. More research is needed to elucidate energy metabolism and substrate utilization, specifically fatty acid oxidation and methyl status, during energy restriction in strict carnivorous cats to optimize weight loss.
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Carnitina/análogos & derivados , Obesidad , Pérdida de Peso , Gatos , Animales , Obesidad/metabolismo , Alimentos , Ácidos Grasos/metabolismo , AminoácidosRESUMEN
The Platelet Function Analyzer 200 (PFA-200; Siemens) is an in vitro substitute for in vivo bleeding time that is designed to investigate platelet function in a more physiologic manner than traditional aggregometry. The analyzer reports a closure time (CT) as a marker of platelet function, and may also report the calculated platelet function measurement primary hemostasis components, PHC1 and PHC2. These incorporate the measured total volume (TV) of blood aspirated and the initial flow rate (IF). We determined, for the COL/ADP and P2Y cartridges, the median total volume (TVmedian), and RIs for CT, IF, TV, PHC1, and PHC2, and investigated the sensitivity and specificity of those parameters at the determined interpretation thresholds in determination of the clopidogrel effect. Healthy client-owned cats were recruited prospectively to determine RIs for CT, IF, TV, PHC1, and PHC2. Healthy blood-donor cats and cats on clopidogrel therapy were included retrospectively to determine test performance. In 20 healthy cats, RIs for COL/ADP were CT (19.5-87.2 s), IF (199-278 µL/min), TV (199-332 µL), PHC1 (94-106%), and PHC2 (52-148%); and for P2Y, CT (4.2-94.3 s), IF (112-208 µL/min), TV (151-294 µL), PHC1 (35-178%), and PHC2 (90-109%). CVs were calculated for all of these values. Specificity for detection of the clopidogrel effect was calculated from a group of healthy blood donors, and sensitivity for detection of the clopidogrel effect from a group of cats with known clopidogrel effect. Sensitivity and specificity were, for COL/ADP: CT (83.3%, 66.6%), IF (41.4%, 83.3%), TV (83.3%, 100%), PHC1 (100%, 100%) and PHC2 (100%, 83.3%); and for P2Y: CT (100%, 94.4%), IF (30%, 44.4%), TV (100%, 94.4%), PHC1 (100%, 100%), and PHC2 (100%, 97.7%). These PFA-200 values may be beneficial in the determination of platelet function in cats.
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Plaquetas , Inhibidores de Agregación Plaquetaria , Humanos , Gatos , Animales , Clopidogrel/farmacología , Inhibidores de Agregación Plaquetaria/farmacología , Plaquetas/fisiología , Ticlopidina/farmacología , Agregación Plaquetaria , Pruebas de Función Plaquetaria/veterinaria , Estudios Retrospectivos , HemostasisRESUMEN
BACKGROUND: The Platelet function analyzer-200 can determine the effect of clopidogrel in cats. Flow obstruction is an error that causes uninterpretable results. Closure curves and parameters initial flow rate (IF) and total volume (TV) are displayed by the PFA-200 and may allow interpretation of results in cases of flow obstruction. The primary hemostasis components (PHC) are calculated values that normalize these parameters. OBJECTIVES: To determine if closure curves and research parameters allow detecting the effect of clopidogrel in cases of flow obstruction. METHODS: A review of closure curves identified those with flow obstruction and paired analysis that did not. Non-flow-obstructed curves were used to categorize curves with respect to clopidogrel effects. IF, TV, PHC(1), and PHC(2) were evaluated to determine if these could be used to categorize if a sample exhibited the effects of clopidogrel. Curves were visually analyzed, and characteristics identified that were more common with or without the effect of clopidogrel. Visual analysis of curves was performed by blinded observers to determine if a visual analysis was able to predict the effect of clopidogrel. RESULTS: Analysis of parameters was able to predict closure or non-closure in flow-obstructed curves. TV, PHC(1), and PHC(2) had area under the curve of the receiver operating characteristics of 0.79, 0.79, and 0.87. Visual curve analysis was unable to predict closure, with an average accuracy of only 55%, among three reviewers. Agreement between reviewers was poor (Fleiss' Kappa 0.06). CONCLUSIONS: Visual curve analysis was unable to determine the effect of clopidogrel in flow-obstructed samples. Numerical parameters were able to detect the effect of clopidogrel with a high degree of accuracy in flow-obstructed samples.
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Inhibidores de Agregación Plaquetaria , Ticlopidina , Gatos , Animales , Inhibidores de Agregación Plaquetaria/farmacología , Clopidogrel/farmacología , Ticlopidina/farmacología , Aspirina/farmacología , Plaquetas , Pruebas de Función Plaquetaria/veterinaria , Hemostasis , Agregación PlaquetariaRESUMEN
Bernard-Soulier syndrome (BSS), also known as hemorrhagiparous thrombocytic dystrophy (OMIA 002207-9615), is a rare defect in platelet function recognized in both dogs and humans. It is caused by a deficiency in glycoprotein 1b-IX-V, the platelet surface protein which acts as a receptor for the von Willebrand factor. The characteristic features of BSS in humans and dogs include macrothrombocytes and mild-to-moderate thrombocytopenia with a bleeding tendency. This condition has previously been reported in European Cocker Spaniel dogs; however, the results of platelet function tests in these animals have not been reported. This case report describes a European Cocker Spaniel dog with spontaneously occurring Bernard-Soulier syndrome and the results of point-of-care platelet function tests, including a prolonged buccal mucosal bleeding time (>8 min), prolongation (>300 s) of PFA-200 COL/ADP, COL/EPI, and P2Y closure times, and reduced aggregation (15%-48%) with Plateletworks ADP, but with normal aggregation (92%) with Plateletworks AA. This is the first description of the results of platelet function tests in canine Bernard-Soulier syndrome.
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Síndrome de Bernard-Soulier , Enfermedades de los Perros , Trastornos Hemorrágicos , Humanos , Perros , Animales , Síndrome de Bernard-Soulier/diagnóstico , Síndrome de Bernard-Soulier/veterinaria , Síndrome de Bernard-Soulier/metabolismo , Sistemas de Atención de Punto , Plaquetas/metabolismo , Hemostasis , Complejo GPIb-IX de Glicoproteína Plaquetaria , Trastornos Hemorrágicos/veterinaria , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/metabolismoRESUMEN
BACKGROUND: The Platelet function analyzer-200 (PFA-200) can determine the effect of clopidogrel in cats, but analysis traditionally must be performed at point-of-care (POC). The ability to ship samples of blood to a laboratory would allow widespread access. OBJECTIVES: We aimed to validate the shipping of blood samples for PFA-200 analysis in cats to determine the effect of clopidogrel. METHODS: Twenty healthy cats and 10 cats receiving clopidogrel were recruited. Blood was collected from cats and aliquoted into two samples, one was analyzed at POC within 2 hours using the PFA-200, and the other was packaged and transported to a location 4 km away, stored, and transported back to the lab for analysis the following day. RESULTS: Median closure times (CTs) with the collagen/adenosine diphosphate (COL/ADP) cartridge in healthy cats were 51.5 seconds (POC) and 78.8 seconds (shipped), which were significantly different (P < 0.001), and for cats on clopidogrel, median CTs were 147.5 seconds (POC) and 190 seconds (shipped), which were not significantly different (P = 0.131). Median CTs with the P2Y cartridge in healthy cats were 50.5 seconds (POC) and 64.9 seconds (shipped), which were significantly different (P = 0.03), and in cats receiving clopidogrel, median CTs were 300 seconds (POC) and 300 seconds (shipped) which were not significantly different (P = 1.000). Reference intervals for CTs differed for COL/ADP at POC (19.8-89.7 seconds) and shipped (50.9-161.6 seconds) and for P2Y at POC (35.5-118.8 seconds) and shipped (35.1-108.9 seconds). Receiver operating characteristics showed similar areas under the curve (AUCROCs) regarding the effect of clopidogrel for COL/ADP at POC (0.994 seconds) and shipped (0.932) and for P2Y at POC (0.904 seconds) and shipped (0.975 seconds). When classifying for the presence of clopidogrel effects, Cohen's Kappa was 0.62 for COL/ADP and 1.00 for P2Y. CONCLUSIONS: Shipping blood samples for PFA analysis are feasible with similar performance to POC analyses for determining the effect of clopidogrel in cats.
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Plaquetas , Clopidogrel , Manejo de Especímenes , Animales , Gatos , Adenosina Difosfato/farmacología , Clopidogrel/farmacología , Agregación Plaquetaria , Inhibidores de Agregación Plaquetaria/farmacología , Pruebas de Función Plaquetaria/veterinaria , Manejo de Especímenes/veterinariaRESUMEN
BACKGROUND: Platelet function testing is important for monitoring the effects of antiplatelet therapy but is not readily used due to time constraints for testing and the need for specialized equipment. OBJECTIVES: This study evaluated the effects of various storage methods on selected platelet function tests to determine if delayed platelet function testing is feasible in canine blood samples. Our hypotheses were that platelet function would not decline during storage and, thus, no differences in test results would be found over time. METHODS: Thirteen healthy dogs were studied. Citrated blood samples were tested with a Platelet Function Analyzer-200 (PFA), which mimics high-shear conditions, using P2Y and CADP cartridges, after being held at room temperature for 2 h and refrigerated for 24 and 48 h. Plateletworks (PW), which measures aggregation based on platelet counting, was performed on an optical hematology analyzer using 10-min-old native samples, citrated samples held at room temperature for 3-4 h and refrigerated for 24 and 48 h, and samples stored in the preservative solution, AGGFix, up to 7 days. RESULTS: PFA closure times increased with storage, especially with the P2Y cartridge. Median aggregation with fresh PW was 94%, and this was maintained at all time points (range of median values 88%-94%). Most samples showed decreased, yet still robust (>70%), aggregation with longer storage. Spontaneous aggregation in citrate was noted in most dogs. AGGFix stabilized platelet aggregates to allow for delayed testing. CONCLUSIONS: Delayed platelet function testing is feasible, but ranges of expected values may differ from tests using fresh samples.
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Agregación Plaquetaria , Pruebas de Función Plaquetaria , Perros , Animales , Pruebas de Función Plaquetaria/veterinaria , Plaquetas , Recuento de Plaquetas/veterinaria , HemostasisRESUMEN
Trazodone and gabapentin are common oral sedatives in cats, used alone or combined, but no pharmacokinetic studies exist for trazodone in this species. The objective of this study was to determine the pharmacokinetics of oral trazodone (T) alone, or in combination with gabapentin (G) in healthy cats. Cats (n = 6) were randomly allocated to receive T (3 mg/kg) intravenously (IV), T (5 mg/kg) orally (PO), or T (5 mg/kg) and G (10 mg/kg) PO with a 1-week washout period between treatments. Heart rate, respiratory rate, indirect blood pressure, and level of sedation were assessed, and venous blood samples were collected serially over 24 h. Analysis of plasma trazodone concentration was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Oral T administration resulted in a bioavailability of 54.9(7-96)%, and 17.2(11-25)% when administered with G. Tmax 0.17 (0.17-0.5) and 0.17 (0.17-0.75) h; Cmax 1.67 ± 0.91 and 1.22 ± 0.54 µg/mL, AUC 5.23 (2.0-18.76) and 2.37 (1.17-7.80) h*µg/mL; T1/2 5.12 ± 2.56 and 4.71 ± 1.07 h; for T and TG, respectively. Sedation was significant when compared to baseline in all groups from 20 or 45 min to 8 h indicating some lag between peak plasma concentration and sedative effects. Physiological variables remained within normal limits. This study concludes that oral trazodone is rapidly absorbed in healthy cats. Addition of gabapentin did not result in more profound sedation, showing no clinical advantage of combining these drugs in this study population.
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Trazodona , Gatos , Masculino , Animales , Gabapentina , Hipnóticos y Sedantes , Cromatografía Liquida/veterinaria , Espectrometría de Masas en Tándem/veterinaria , Administración Oral , Área Bajo la Curva , Estudios CruzadosRESUMEN
BACKGROUND: Platelet function testing in cats allows determination of clopidogrel effect. Plateletworks assesses aggregation based on decreasing platelet counts on hematology analyzers in response to agonists. It has not been validated for the IDEXX ProCyte Dx analyzer. Ideal time to perform analysis and the utility of other platelet parameters have not been fully assessed. OBJECTIVES: To validate Plateletworks ADP on the ProCyte Dx, to investigate the utility of various platelet parameters using Plateletworks ADP, and determine the ideal time to perform analysis. ANIMALS: Twenty healthy cats recruited from the general population used for transference of reference intervals to a new analyzer, and 10 cats receiving clopidogrel to determine clopidogrel effect. METHODS: Plateletworks ADP using the ProCyte Dx and ADVIA 2120i analyzer was run simultaneously in both healthy cats and cats receiving clopidogrel, and CBC results at different timepoints were compared between analyzers. RESULTS: Aggregation was significantly different (P < .001) between analyzers. Cohen's kappa showed almost perfect agreement for determination of clopidogrel effect, and the area under the curve of the receiver operating characteristic was 1.0. Lower limits of the aggregation reference interval in healthy cats were 28.8% on the ProCyte Dx and 12.5% on the ADVIA 2120i. Coefficients of variation for platelet parameters were not different between analyzers. No significant changes in mean platelet volume, plateletcrit, large platelets, and mean platelet component were identified. No significant change in aggregation was observed within the first hour after phlebotomy. CONCLUSIONS AND CLINICAL IMPORTANCE: Our study validated the Plateletworks ADP system on the ProCyte Dx analyzer. Samples may be analyzed up to 1 h after collection.
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Agregación Plaquetaria , Pruebas de Función Plaquetaria , Gatos , Animales , Clopidogrel/farmacología , Pruebas de Función Plaquetaria/veterinaria , Pruebas de Función Plaquetaria/métodos , PlaquetasRESUMEN
The increasing use of ultrasound in veterinary private practice and demand for skilled operators upon graduation has placed an increased burden on the ever-dwindling number of academic radiologists. Simulation-based medical education can help prepare for and consequently reduce this burden, allowing for the acquisition of clinical skills through deliberate practice in a safe, controlled, and low-stakes environment. Ultrasound-guided fine needle placement is the foundation for more advanced interventions such as ultrasound-guided fine needle aspirates and centeses. A reusable novel ultrasound skill simulator consisting of metal targets wired to a circuit and suspended in ballistics gel was created to teach ultrasound-guided fine needle placement. Forty-seven second-year veterinary students watched an instructional video and performed two ultrasound-guided fine needle placement skill tests on the simulator with a period of practice between. Significant improvement in time to task completion (p = .0021) was noted after the period of practice. The majority of student feedback was positive with 89% (42/47) indicating they would use the simulator again to practice and that it should be incorporated into the curriculum, 74% (35/47) indicating their basic skills, knowledge, and confidence using ultrasound improved using the simulator, and 55% (26/47) indicating they could now teach this skill to a peer. The authors suggest further development of this model for ease of manufacture and increased variation in difficulty, and veterinary curriculum incorporation for basic ultrasound-guided fine needle placement training.
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BACKGROUND: There are limited studies investigating the use of fecal microbial transplant (FMT) in dogs with inflammatory bowel disease (IBD). The aim of this preliminary study was to assess the feasibility of adding FMT to standard therapy (corticosteroids and a hypoallergenic diet) for dogs with IBD and to and to describe the changes in measured outcomes after 30 days of treatment. METHODS: Thirteen client-owned dogs with IBD were enrolled in this double blinded, randomized clinical trial. All dogs received corticosteroid therapy and a hypoallergenic diet; dogs were randomized to receive either placebo or FMT. Measured outcomes included the canine chronic enteropathy clinical activity index (CCECAI) at 1 week and 1 month after enrolment. Fecal microbiota were analyzed after extracting DNA from fecal samples and profiling using 16S amplicon sequencing. Dogs in the placebo group not responding to treatment after 1 month were offered FMT. RESULTS: The CCECAI significantly decreased over time in both groups (p = 0.001). There were no significant differences between the CCECAI of the placebo and FMT group at each time point (F test from ANOVA, p = 0.40). No adverse effects were reported in the 30 days following FMT. CONCLUSIONS: The addition of FMT to standard therapy for IBD was feasible. No significant differences were observed in the CCECAI between groups at each time point. Large scale clinical trials can be performed using these methods to evaluate the longer term effect of FMT on clinical signs, microbial diversity, and other outcomes.
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Enfermedades Inflamatorias del Intestino , Microbiota , Perros , Animales , Trasplante de Microbiota Fecal/métodos , Enfermedades Inflamatorias del Intestino/terapia , Enfermedades Inflamatorias del Intestino/veterinaria , Enfermedades Inflamatorias del Intestino/etiología , Heces , Inducción de Remisión , Resultado del TratamientoRESUMEN
OBJECTIVE: To describe veterinarians' communication of the companion animal physical exam (CAPE) to veterinary clients and to identify factors associated with the number of physical exam components communicated by veterinarians to clients. SAMPLE: 376 video-recorded veterinarian-client-patient interactions, involving 60 veterinarians. PROCEDURES: 18 CAPE components were studied in relation to veterinarians' use of 7 communication-related parameters. A mixed linear regression model was used to assess veterinarian, patient, and appointment factors associated with the number of components conveyed by a veterinarian. RESULTS: Veterinarians conveyed 1,566 of 2,794 (56.1%) of the components that they examined to clients, as having been examined. Of those components that were examined and conveyed by veterinarians, the impact of the finding was communicated for 496 of 1,566 (31.7%) of the components. Visual aids and take-home literature were each used in relation to an examined component during 15 of the 376 interactions (4%). A significant association was found between number of CAPE components conveyed and gender of the veterinarian (females conveyed 1.31 more), as well as the type of appointment (2.57 more were conveyed in wellness appointments and 1.37 more in problem appointments, compared to rechecks). CLINICAL RELEVANCE: Findings identify an opportunity for veterinarians to further emphasize components of the CAPE, which may in turn increase clients' perceived value of the CAPE due to understanding the benefits for their pet. This may be accomplished with the Talking Physical Exam, in which veterinarians discuss CAPE components findings with clients in real time, and the relevance of the findings to the patient's health.
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Veterinarios , Femenino , Animales , Humanos , Relaciones Interpersonales , Comunicación , Examen FísicoRESUMEN
OBJECTIVE: To establish the components of a best-practice, baseline companion animal physical exam (CAPE). SAMPLE: 25 small animal veterinary internists and 20 small animal primary care veterinarians, all teaching the CAPE at veterinary colleges in the US, Canada, and Australia. PROCEDURES: Using the Delphi Method of Consensus, 3 rounds of online questionnaires were sent to participants. The first round included demographic questions, questions about teaching the physical exam, and an open-ended question allowing participants to record details of how they conduct a CAPE. In the second round, participants were asked to rate components of the CAPE, which were derived from round 1, as "always examine," "only examine as needed," or "undecided." Following round 2, any component not reaching 90% consensus (set a priori) for the response "always examine" was put forth in round 3, with a summary of comments from the round 2 participants for each remaining component. RESULTS: 35 components of a baseline CAPE were identified from round 1. The 25 components that reached 90% consensus by the end of round 3 were checking the oral cavity, nose, eyes, ears, heart, pulse rate, pulse quality, pulse synchrony, lungs, respiratory rate, lymph nodes, abdomen, weight, body condition score, mucous membranes, capillary refill time, general assessment, masses, haircoat, skin, hydration, penis and testicles or vulva, neck, limbs, and, in cats only, thyroid glands. CLINICAL RELEVANCE: The findings establish an expert panel's consensus on 25 components of a baseline, best-practice CAPE that can be used to help inform veterinary curricula, future research, and the practice of veterinarians.
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Mascotas , Examen Físico , Animales , Gatos , Consenso , Técnica Delphi , Femenino , Humanos , Masculino , Examen Físico/veterinaria , Encuestas y CuestionariosRESUMEN
Our goal was to validate a human hyaluronic acid (HA) ELISA (Hyaluronic acid plus ELISA; TECOmedical Group) for use in feline plasma. Plasma from 5 healthy cats and 5 critically ill cats was used for validation of the assay. Validation methods performed included intra- and inter-assay variability, spike-and-recovery, and dilutional linearity. All measurements were performed in duplicate. The precision study revealed good intra-assay CV of 7.4-8.9%; inter-assay CV was 3.4-4.2%. Extraction efficiency via spiking tests yielded mean recovery of 89.6%. The assay met criteria for acceptable linearity using 3 serial dilutions. Our results demonstrate that this commercial HA ELISA had acceptable analytical performance using feline plasma and could be a useful tool in the veterinary clinical research setting.
Asunto(s)
Ácido Hialurónico , Animales , Gatos , Ensayo de Inmunoadsorción Enzimática/veterinaria , HumanosRESUMEN
OBJECTIVE: To describe daily changes in serum concentrations of hyaluronic acid (HA), a biomarker of endothelial glycocalyx degradation, in dogs with septic peritonitis and to determine whether relationships exist among serum concentrations of HA and biomarkers of inflammation and patient fluid status. ANIMALS: 8 client-owned dogs. PROCEDURES: Serum samples that had been collected for a previous study and stored at -80°C were used. Blood samples were collected at admission and daily thereafter during hospitalization and were analyzed for concentrations of HA and interleukins 6, 8, and 10. Patient data including acute patient physiologic and laboratory evaluation score, type and amount of fluids administered daily, and daily CBC and lactate concentration results were recorded. To determine the significant predictors of HA concentration, a general linear mixed model for repeated measures was developed. RESULTS: All dogs survived to discharge. Concentrations of HA ranged from 18 to 1,050 ng/mL (interquartile [25th to 75th percentile] range, 49 to 119 ng/mL) throughout hospitalization. Interleukin-6 concentration was a significant predictor of HA concentration as was total administered daily fluid volume when accounting for interleukin-6 concentration. When fluid volume was analyzed independent of inflammatory status, fluid volume was not a significant predictor. Concentrations of HA did not significantly change over time but tended to increase on day 2 or 3 of hospitalization. CONCLUSIONS AND CLINICAL RELEVANCE: Results supported the theory that inflammation is associated with endothelial glycocalyx degradation. Dogs recovering from septic peritonitis may become more susceptible to further endothelial glycocalyx damage as increasing fluid volumes are administered.
Asunto(s)
Enfermedades de los Perros , Peritonitis , Animales , Biomarcadores , Perros , Glicocálix , Ácido Hialurónico , Inflamación/veterinaria , Peritonitis/veterinariaRESUMEN
OBJECTIVE: To use a systematic, evidence-based consensus process to develop definitions for transfusion reactions in dogs and cats. DESIGN: Evidence evaluation of the literature was carried out for identified transfusion reaction types in dogs and cats. Reaction definitions were generated based on synthesis of human and veterinary literature. Consensus on the definitions was achieved through Delphi-style surveys. Draft recommendations were made available through industry specialty listservs and comments were incorporated. RESULTS: Definitions with imputability criteria were developed for 14 types of transfusion reactions. CONCLUSIONS: The evidence review and consensus process resulted in definitions that can be used to facilitate future veterinary transfusion reaction research.