Establishment of Reference Intervals for Caudal Vena Cava-to-Aorta Ratio Measured Ultrasonographically in Healthy Nonsedated Dogs.

The ultrasonographic assessment of the caudal vena cava-to-aorta ratio (CVC:Ao) appears to be a promising method for early recognition of alterations of intravascular volume status in veterinary medicine. The primary objective of this study was to establish the reference intervals of the CVC:Ao ratio with ultrasound in nonsedated healthy dogs. Secondary objectives were to determine the influence of the respiratory cycle and to evaluate correlations between ultrasonographic measurements, signalment and physical exam findings. Ultrasonographic measurements of Ao and CVC diameters were successfully obtained for all sixty dogs included. No evidence of a difference was observed between the measurements of Ao and CVC diameters, and CVC:Ao ratio between inspiration and expiration (P = .373, P = .318, and P = .537, respectively). The reference interval for CVC:Ao ratio (95% CI), generated from US measurements performed at any moment of the respiratory cycle was defined as 0.93 (0.91-0.95) -1.32 (1.30-1.34). The CVC:Ao ratio was significantly negatively correlated with age (r = -0.341, P = .008) and positively correlated with respiratory rate (r = 0.423, P < .001), but not with heart rate (P = .573) or arterial systolic blood pressure (P = .166). A low inter- and intraoperator variability in repeated measurements was observed for each operator and between operators. The ultrasonographic measurement of the CVC:Ao ratio appears as a simple method with low inter- and intraoperator variability using the ultrasonographic protocol described in the current study. With the reference interval established in the present study in healthy nonsedated dogs, further studies should evaluate the utility of this simple method in assessing and monitoring volume status in hypo- and hypervolemic dogs.

Effectiveness of chest physiotherapy using passive slow expiratory techniques in dogs with airway fluid accumulation: A randomized controlled trial.

BACKGROUND: Prolonged slow expiration (PSE) and assisted cough (AC) are airway clearance techniques feasible and well tolerated in dogs. OBJECTIVES: To evaluate the effectiveness of PSE and AC as chest physiotherapy (CP) techniques in dogs with airway fluid accumulation. ANIMALS: Thirty-one client-owned dogs hospitalized in an intensive care unit from October 2014 to May 2018. METHODS: Prospective randomized controlled trial. Dogs presented with or developing acute dyspnea during hospitalization associated with airway fluid accumulation were assigned to CP group (medical treatment and CP, 15 dogs) or control group (medical treatment alone, 16 dogs). The arterial partial pressure of oxygen (PaO2 ) to fraction of inspired oxygen (FiO2 ) ratio (P/F ratio; PaO2 /FiO2 × 100) was calculated daily for the 1st 48 hours of hospitalization and using the last arterial blood gas performed before discharge or death. The ratio of days of hospitalization with oxygen/total number of hospitalization days (ratio of oxygen-free-days [O2 Free]) was calculated. RESULTS: During the 1st 48 hours, the P/F ratio increased significantly in the CP group compared to the control group (+ 35.1 mm Hg/day; 95% confidence interval [CI] = 0.4-57.5; P = .03). The (median; 1st quartile to 3rd quartile) difference between the P/F ratio at discharge and inclusion was significantly higher in the CP group (178 mm Hg; 123-241) than in the control group (54 mm Hg; -19 - 109; P = .001). Mean O2 Free increased by 46.4% in the CP group compared with control group (95% CI = 16-59; P = .001). Mortality was 13% (2/15) in the CP group and 44% (7/16) in the control group (P = .07). CONCLUSIONS AND CLINICAL IMPORTANCE: Prolonged slow expiration and AC improved P/F ratio within 48 hours and decreased need for oxygenation in dyspneic dogs with acute airway fluid accumulation.

Hematological and Hemostatic Alterations Associated With a Single Extracorporeal Renal Replacement Therapy in Dogs With Acute Kidney Injury Associated Leptospirosis: A Pilot Study.

Extracorporeal renal replacement therapy (ERRT) used in dogs with acute kidney injury (AKI) may be associated with hematological and hemostatic disorders. However, its characteristics are not fully described in dogs. The purpose of this pilot study was to characterize the impact of ERRT on hematological, hemostatic, and thromboelastometric parameters in dogs with AKI. We conducted a prospective observational single cohort study in 10 client-owned dogs with AKI associated leptospirosis undergoing ERRT. Results from the CBC, coagulation tests (prothrombin and activated partial thromboplastin times [aPTT]) and rotational thromboelastometry (TEM; intrinsic TEM [inTEM] and heparinase-based TEM [hepTEM]) were recorded before and after the first ERRT session. Blood abnormalities observed before the ERRT session included thrombocytopenia (10/10), anemia (8/10), leukocytosis (4/10), prolonged aPTT (4/10) and leukopenia (1/10). After ERRT, the platelet count decreased (-25%; P = .012) whereas leukocytes (+15%; P = .046) and aPTT (+24%; P = .006) increased. The clotting time (CT) on inTEM assay and the relative variation of CT based on inTEM and hepTEM profiles increased after the ERRT session (P = .037 and P = .048, respectively). Seven dogs, 2 dogs, and 1 dog were defined as having a normal, hypocoagulable, and hypercoagulable inTEM profile after ERRT, respectively. After ERRT, no hepTEM parameter was significantly different from before treatment. Platelet count, leukocytes, aPTT and CT were altered after the first ERRT session. Beyond the hemostatic abnormalities expected by the use of UFH, thrombocytopenia appears as the only hemostatic change after a single ERRT session in dogs with AKI.

Acute kidney injury management using intermittent low efficiency haemodiafiltration in a critical care unit: 39 dogs (2012-2015).

BACKGROUND: Veterinary studies describing acute kidney injury (AKI) management using renal replacement therapy (RRT) are limited and have primarily focused on intermittent haemodialysis in North American populations. European data are lacking, although differences in populations, pathogen and toxin exposure and RRT modalities may exist between Europe and North America. The present study reviewed RRT-managed cases from the intensive care unit (ICU) of VetAgro Sup, Lyon, France, for the period 2012-2015. The aims were to describe a 4-h RRT protocol of intermittent low efficiency haemodiafiltration, population characteristics and outcomes in canine AKI cases requiring RRT and to identify prognostic variables. We defined DeltaCreat/h as the difference between the serum creatinine level after RRT treatment N and that before treatment N + 1 divided by the time between treatments (in hours). RESULTS: Thirty-nine dogs were included, and 67% were males. The median (range) age, weight, hospitalization length and number of RRT treatments were 4.4 (0.25-15) years, 26.6 (6.7-69) kg, 8 (1-23) days and 3 (1-8) treatments, respectively. The main AKI causes were leptospirosis (74.4%) and nephrotoxins (15.4%). Age (4.0 vs 5.4 years; P = 0.04), admission urine output (0.5 mL/kg/h vs 0 mL/kg/h; P = 0.02) and hospitalization length (10 vs 4 days; P < 0.001) differed between survivors and non-survivors. Hospitalization length [odds ratio (OR) = 0.4], number of treatments (OR = 5.1), serum potassium level on day 2 (OR = 1.9), DeltaCreat/h between the first and second treatments (OR = 1.2), and UOP during hospitalization (OR = 0.2) were correlated with outcome. The main causes of death were euthanasia (44%) and haemorrhagic diatheses (33%). The overall survival rate was 54%, with 55% of survivors discharged with a median creatinine < 240 µmol/L. CONCLUSIONS: This is the first description in the veterinary literature of a 4-h protocol of intermittent low efficiency haemodiafiltration to provide RRT in a veterinary critical care unit. While this protocol appears promising, the clinical application of this protocol requires further investigation. Among parameters associated with survival, UOP and DeltaCreat/h between the first and second RRT treatments may be prognostic indicators. The applicability of these parameters to other populations is unknown, and further international, multicentre prospective studies are warranted to confirm these preliminary observations.

Infrared thermography: a rapid and accurate technique to detect feline aortic thromboembolism.

Objectives The objective of this study was to evaluate the diagnostic accuracy of infrared thermography in cats with acute pelvic paralysis to differentiate feline aortic thromboembolism (FATE) from non-ischaemic conditions. Methods Thermographic images were prospectively obtained at admission from cats presented for acute bilateral pelvic paralysis. Based on the final diagnosis, cats were divided into a FATE and a control group (ischaemic and non-ischaemic related pelvic paralysis, respectively). The maximum (Tmax), minimum (Tmin) and average (Tav) temperatures were determined for each of the four limbs within a hand-drawn region of interest on the dorsal limb extremity. Temperature differences between the forelimb (non-affected) and hindlimb (affected) with the highest temperature (ΔT), with the lowest temperature (δT) and from the right and left side (RightΔT and LeftΔT, respectively) were calculated. Results The FATE and control groups included 10 and six cats, respectively. In the FATE group, right hindlimb mean Tmax (23.6°C ± 1.9), left hindlimb mean Tmax (23.6°C ± 2.2) and mean Tav (22.7°C ± 2.2) were significantly lower than in the control group (26.6°C ± 3.5 [ P = 0.042]; 26.6°C ± 2.4°C [ P = 0.024] and 25.7°C ± 2.0 [ P = 0.020], respectively). ΔT, δT, RightΔT and LeftΔT were significantly higher in the FATE group than in the control group. A cut-off value of 2.4°C for RightΔTmax and LeftΔTmax allowed discrimination between the FATE and control groups with a sensitivity of 80% and 90%, respectively, a specificity of 100% for both, a positive predictive value of 100% for both, and a negative predictive value of 75% and 86%, respectively. Conclusions and relevance A minimal difference of 2.4°C between ipsilateral affected and non-affected limbs has an excellent specificity and high sensitivity for FATE diagnosis. Infrared thermography seems to be a promising, useful, easy, non-invasive and rapid method for detecting aortic thromboembolism in cats, particularly in emergency situations.

Pine processionary caterpillar Thaumetopoea pityocampa envenomation in 11 cats: a retrospective study.

Objectives The aim of this study was to describe the clinical manifestations in cats of contact with caterpillars of the pine processionary moth. Methods Data were retrospectively obtained from the medical records (2004-2016) of cats that had been in contact with caterpillars of the pine processionary moth. Results Eleven cats were included in the study. The prevalence of lepidopterism was 0.13%. Tongue lesions and ptyalism were both present in 10/11 (91%) cats. Systemic signs consisted exclusively of vomiting and were encountered in 4/11 (36%) cats. The survival rate was 100%. Long-term follow-up data were available for 7/11 cats, and none of the cats showed impaired quality of life or definitive sequelae. Conclusions and relevance The clinical presentation of lepidopterism in cats appears to be similar to that in other animals; however, the clinical signs are less severe than those previously reported, mainly owing to the cautious behaviour of this species. Moreover, the prognosis is excellent, the length of hospitalisation is short (maximum 48 h) and our study showed the absence of any long-term disability after hospital discharge.

Pine processionary caterpillar Thaumetopoea pityocampa envenomation in 109 dogs: A retrospective study.

Contact with the caterpillars of the pine processionary moth (CPPM) Thaumetopoea pityocampa induces severe local allergic reactions. The purpose of this large-scale retrospective cohort-study was to describe the clinical manifestations and related risk factors of CPPM exposure. This cohort-study included 109 dogs between the years of 2000 and 2016. Tongue lesions ranging from oedema to severe necrosis were observed in 94/109 dogs (86%). The following systemic signs were observed in 60/109 dogs (55%): vomiting (52/109, 48%), dyspnoea (6/109, 5%), hypovolemia (4/109, 4%) and diarrhoea (2/109, 2%). Based on the time elapsed from CPPM contact to the first oral flushing, three groups were defined: <2 h (group 1, 37/105, 35%), 2 h-6 h (group 2, 39/105, 37%) and >6 h (group 3, 29/105, 28%). Tongue necrosis (TN) at admission was significantly more common in the dogs in group 3 than those in groups 1 and 2 (45% vs. 5% and 5% respectively, p = 0.0002). In addition, the development of TN during hospitalisation was significantly more common in the dogs in group 3 (65%) than in those in the other groups (21% in group 1, p = 0.02) and 31% in group 2, p = 0.001). The dogs in group 3 presented a 14.63-fold higher risk of TN at admission and a 3.78-fold higher risk of developing necrosis during hospitalisation compared with the other groups. The survival rate after exposure was 97%. Long-term follow-up data were available for 69/109 dogs (63%). Twenty-three dogs (37%) had persistent, definitive TN without major consequences on quality of life. Elapsed time between contact and first oral flushing appears to be a key determinant for the progression of necrotic lesions, and the best results were observed when flushing occurred within 6 h of contact. The prognosis of CPPM envenomation is excellent, with a short hospitalisation duration.