Video capsule endoscopy findings in dogs with chronic enteropathy and in healthy dogs.

BACKGROUND: Video capsule endoscopy is a noninvasive technique for evaluation of the gastrointestinal tract. OBJECTIVE: To investigate the safety of using the video capsule ALICAM in dogs with chronic enteropathy (CE) >10 kg, and to compare macroscopic gastrointestinal morphology between CE dogs and healthy controls (HC). ANIMALS: Fifteen CE dogs and 15 similarly breed, age and body weight matched HC. METHODS: All dogs underwent a clinical work up including blood analyses, fecal samples, abdominal ultrasonographic examination, and blood pressure measurement. The dogs were withheld from food for 16 hours before and 8 hours after they PO received an ALICAM. All recordings were quality assessed, and blindly evaluated by 2 trained observers. RESULTS: The median age of CE dogs and HC was 3.3 (interquartile range [IQR] 2.5-5.9) years and 4.7 (IQR 3.3-5.6) years, respectively. The median body weight in the CE dogs and HC was 25.9 (IQR 20.6-30.9) kg, and 29 (IQR 16.2-30.5) kg, respectively. Complete recordings of the gastrointestinal tract were obtained from all dogs without complications. No significant differences were found between groups regarding number of abnormalities such as irregular mucosa, erythema, nonbleeding erosions, bleeding erosions, and dilated lacteals, as well as severity and extent of the abnormalities. CONCLUSIONS AND CLINICAL IMPORTANCE: The use of ALICAM for evaluation of the gastrointestinal tract in CE dogs and HC seems safe and feasible regarding gastrointestinal transit and macroscopic morphology assessment in dogs >10 kg. Abnormalities were found in similar proportions in CE dogs and HC.

Effects of fixation and demineralization on histomorphology and DNA amplification of canine bone marrow.

Fixation and demineralization protocols for bone marrow (BM) across diagnostic laboratories are not standardized. How different protocols affect histomorphology and DNA amplification is incompletely understood. In this study, 2 fixatives and 3 demineralization methods were tested on canine BM samples. Twenty replicate sternal samples obtained within 24 hours of death were fixed overnight in either acetic acid-zinc-formalin (AZF) or 10% neutral-buffered formalin (NBF) and demineralized with formic acid for 12 hours. Another 53 samples were fixed in AZF and demineralized with hydrochloric acid for 1-hour, formic acid for 12 hours, or ethylenediamine tetraacetic acid (EDTA) for 24 hours. Histologic sections were scored by 4 raters as of insufficient, marginal, good, or excellent quality. In addition, DNA samples extracted from sections treated with the different fixation and demineralization methods were amplified with 3 sets of primers to conserved regions of T cell receptor gamma and immunoglobulin heavy chain genes. Amplification efficiency was graded based on review of capillary electrophoretograms. There was no significant difference in the histomorphology scores of sections fixed in AZF or NBF. However, EDTA-based demineralization yielded higher histomorphology scores than demineralization with hydrochloric or formic acid, whereas formic acid resulted in higher scores than hydrochloric acid. Demineralization with EDTA yielded DNA amplification in 29 of 36 (81%) samples, whereas demineralization with either acid yielded amplification in only 2 of 72 (3%) samples. Although slightly more time-consuming and labor-intensive, tissue demineralization with EDTA results in superior morphology and is critical for polymerase chain reaction (PCR) amplification with the DNA extraction method described in this article.

Determination of the reference interval for urine kidney injury molecule-1 in 50 healthy cats.

OBJECTIVES: The aim of the present study was to establish a reference interval (RI) for urine kidney injury molecule-1 (KIM-1) in healthy cats. METHODS: History, physical examination, blood pressure, and feline immunodeficiency virus and feline leukemia virus serology status were determined. A complete blood cell count, serum biochemical profile, urinalysis and kidney ultrasound were performed, and N-terminal pro-brain natriuretic peptide, total thyroxine (TT4) and urine KIM-1 were measured. An RI was calculated and the effect of age, sex, body condition score (BCS), blood pressure, symmetric dimethylarginine (SDMA), serum creatinine concentration (SCr), phosphorus, TT4, urine specific gravity (USG) and mid-sagittal kidney length on urine KIM-1 was evaluated using a general linear model. RESULTS: Of 69 recruited cats, 50 met the inclusion criteria. There were 35 male cats and 15 female cats, with a median age of 4.3 years (range 1.0-12.3), median weight of 5.11 kg (range 2.52-8.45) and median BCS of 6/9 (range 3-8). The median serum concentrations were SDMA 11.0 µg/dl (range 2-14), SCr 88.5 µmol/l (range 47-136), phosphorus 1.41 mmol/l (range 0.8-2.2) and TT4 32.0 nmol/l (range 17-51). Median USG was 1.057 (range 1.035-1.076), mid-sagittal left kidney length was 3.50 cm (range 2.94-4.45) and mid-sagittal right kidney length was 3.70 cm (range 3.06-4.55). The derived RI for urine KIM-1 was 0.02-0.68. USG was a significant (P <0.001) predictor of urine KIM-1. Individually, age, sex, blood pressure, BCS, SDMA, SCr, phosphorus, TT4 and mid-sagittal kidney length were not significant predictors of urine KIM-1. In a multivariate model, if combined with USG, SDMA concentration was predictive (P = 0.030) of urine KIM-1. CONCLUSIONS AND RELEVANCE: Urine concentration was significantly correlated with urine KIM-1, which will be an important consideration when interpreting findings in cats with potential kidney injury.

Gastrointestinal angiodysplasias diagnosed using video capsule endoscopy in 15 dogs.

BACKGROUND: Angiodysplasia (AGD) is rarely diagnosed in dogs with gastrointestinal bleeding (GIB) and is reported in case reports in dogs. OBJECTIVE: Describe signalment, clinical and diagnostic features of dogs with gastrointestinal (GI) AGD diagnosed by video capsule endoscopy (VCE). ANIMALS: Dogs with overt or suspected GIB which underwent VCE. METHODS: Dogs for which a VCE was submitted for overt or suspected GIB from 2016 to 2021 were selected retrospectively. Medical records and full-length VCE recordings where AGDs were initially detected, were reviewed by 2 trained internists. AGD was considered definitive if 2 readers detected it. Signalment, clinical signs, blood work, medications, concurrent diseases, findings of previous conventional endoscopy, and surgical exploration (if applicable) of dogs with AGD were recorded. RESULTS: Definitive AGD was diagnosed in 15 of 291 (5%) dogs (12 males, 3 females). Twelve (80%) had overt GIB, 11 (73%) had hematochezia, and 6 (40%) had microcytic and hypochromic anemia. AGD was missed by conventional endoscopy in 9/9 dogs and exploratory surgery in 3/3 dogs. Thirteen capsules were administered by mouth (1 incomplete study), and 2 via endoscopy directly into the duodenum. AGD was visualized in the stomach of 3 dogs, in the small intestine of 4, and in the colon of 13 dogs. CONCLUSION AND CLINICAL IMPORTANCE: Although rare, AGD should be considered in dogs with suspected GIB after a negative conventional endoscopy or surgical exporation. Video capsuel endoscopy appears to be a sensitive test to identify AGD within the GI tract.

Effect of up to 30-days of storage at different temperatures on detection of feline kidney injury molecule-1 in urine.

BACKGROUND: In humans, kidney injury molecule-1 (KIM-1) is a biomarker of acute kidney injury that can be quantified in urine. Preliminary investigation in cats with experimentally induced acute kidney injury showed that KIM-1 urine concentration correlated with kidney injury histopathology scores. A lateral flow assay (LFA) has recently become available for patient-side feline KIM-1 measurement. In vitro parameters of the assay have not yet been determined. The objectives of this study were to determine detection of KIM-1 in urine stored at different temperatures over time, to establish the linear range of the LFA, and to assess the intra-assay repeatability of measurements.  RESULTS: Ten urine samples with a range of KIM-1 concentrations were stored at room temperature (22o C), 4o C or -20o C, and tested with the LFA on days 0, 1, 2, 3, 7, 14, and 30. The concentration of KIM-1 in samples was not significantly different from the day 0 value, except one sample that had been stored for 30 days at room temperature yielded a significantly higher value. The assay results had a correlation coefficient of 0.922. The mean coefficient of variation for all samples was 15.7%. The slope of the curve of expected versus measured values in samples diluted two-fold nine times was 0.908, and results were linear over all dilutions. CONCLUSIONS: The LFA for feline KIM-1 yields consistent results from stored urine samples. These characteristics will allow for KIM-1 to be measured retrospectively if immediate testing is not feasible. Within assay precision was high, and linearity over 9 logs of dilution suggests suitability for a range of subclinical and clinical kidney injuries.

Feasibility, complications, and quality of visualization using video capsule endoscopy in 40 dogs with overt or questionable gastrointestinal bleeding.

BACKGROUND: Prospective studies describing video capsule endoscopy (VCE), its feasibility, and complications in dogs are limited. OBJECTIVE: To assess VCE, quality of visualization, complications, and risk factors for incomplete studies in dogs with overt or questionable gastrointestinal bleeding (GIB). ANIMALS: Forty dogs with overt or questionable GIB. METHODS: Prospective, multicenter, interventional study. From August 2017 to March 2020, dogs were examined by VCE (ALICAM) because of overt or questionable GIB. Reported outcomes included diagnostic results of VCE study, quality of visualization, and complications. Risk factors for incomplete studies were evaluated using logistic regression. RESULTS: In total, 40 dogs (13 overt, 27 questionable GIB) were included. The capsules were administered PO in 29 and endoscopically in 11 dogs (6 duodenum, 5 stomach). One capsule was not retrieved. In 24 of 39 recordings, bleeding lesions were identified (10 overt GIB, 14 questionable GIB). Overall, the quality of visualization was poor to limited in the stomach and colon, and adequate to good in the small intestine. The most common complication was an incomplete study in 15/39 studies, particularly after oral administration (13/28). Risk factors for incomplete study after oral administration included administration of simethicone or opioids, chronic enteropathy, and capsule gastric transit time >6 hours. CONCLUSIONS AND CLINICAL IMPORTANCE: Video capsule endoscopy can be used to diagnose a variety of lesions causing bleeding in the gastrointestinal tract of dogs with questionable GIB. Incomplete studies are the most common complications in dogs after oral administration of capsules.

Diagnostic evaluation of urea nitrogen/creatinine ratio in dogs with gastrointestinal bleeding.

BACKGROUND: Urea nitrogen/creatinine ratio (UCR) is a marker for upper gastrointestinal bleeding (GIB) in people. OBJECTIVES: To assess the usefulness of UCR to predict occult GIB and distinguish upper from lower GIB in dogs. ANIMALS: Eighty-nine dogs with GIB and 65 clinically healthy dogs. Dogs were grouped according to 65 overt GIB and 24 occult GIB, and based on lesion localization (37 upper, 13 lower, and 8 both). METHODS: Seventy-four dogs were included retrospectively and 15 dogs prospectively. Serum urea nitrogen and creatinine concentrations, UCR, hemoglobin concentration, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin concentration were compared between groups. Logistic regression models were fitted to assess if variables could distinguish occult GIB from being healthy and upper from lower GIB. RESULTS: The UCR was significantly higher in dogs with overt GIB compared to control dogs (P = .02) and dogs with occult GIB (P = .05). The UCR was not significantly associated with occult GIB vs being healthy, or upper vs lower GIB (P > .05 each). Dogs with higher hemoglobin concentration and hematocrit had significantly lower odds of having occult GIB than being healthy (P < .0001 each). CONCLUSIONS AND CLINICAL IMPORTANCE: The UCR does not seem to be a clinically useful marker of occult GIB and appears to have poor discriminatory ability between upper and lower GIB. An increased UCR in a dog without signs of overt GIB, especially if its hematocrit is within the middle or upper reference interval, does not appear to warrant prompt prescription of gastrointestinal protectants.

Case-Based e-Learning Experiences of Second-Year Veterinary Students in a Clinical Medicine Course at the Ontario Veterinary College.

Exposure to real-life clinical cases has been regarded as the optimal method of achieving deep learning in medical education. Case-based e-learning (CBEL) has been considered a promising alterative to address challenges in the availability of teaching cases and standardizing case exposure. While the use of CBEL has been positive in veterinary medical education, insight into students' learning experience with a CBEL tool have not been considered. This article investigates students' views around the utility and usability of a CBEL tool, as well as perceived effectiveness, clinical confidence, and impact of veterinary students' learning preferences on CBEL use. Through focus groups as well as pre- and post-use questionnaires, students expressed that the design and utility of the online cases, including their authenticity, played an instrumental role in perspectives and acceptance of the CBEL tool. Students perceived the CBEL tool as highly effective in both achieving CBEL outcomes and teaching a methodical approach to a clinical case. CBEL elements were also perceived to potentially contribute to increased clinical confidence after CBEL use. Additionally, exploration of students' preferred approach to learning revealed that hands-on learners and those who prefer to learn by practicing and applying knowledge were more likely to show positive perceptions of a CBEL tool. This article's findings can help guide educators in the future design and implementation of online cases in various capacities and provide a platform for further exploration of the effectiveness and use of CBEL in veterinary medical education.

Bronchoalveolar lavage hemosiderosis in dogs and cats with respiratory disease.

BACKGROUND: Hemosiderophages can be found in bronchoalveolar lavage samples and have been reported in association with a wide range of respiratory and cardiovascular disorders in cats and humans. OBJECTIVES: This study aimed to retrospectively evaluate the presence of hemosiderin in canine and feline bronchoalveolar lavage (BAL) samples. It also aimed to examine the association of BAL hemosiderin with signalment, clinical signs, and historical disease prior to BAL, with prior transthoracic fine-needle aspiration (FNA), with bronchoalveolar lavage duration, and with cytologic interpretation. METHODS: The medical records of dogs and cats with respiratory disease that underwent BAL between 2007 and 2016 were reviewed. Appropriate medical information and BAL results were available from 171 dogs and 34 cats. Cases were assigned to four disease categories based on BAL cytologic findings: pneumonia, inflammatory disease, neoplasia, or normal airways. The degree of hemosiderosis was classified based on a semi-quantitative scoring scale. Exact logistic regression analysis was used to evaluate the relationship between risk factors and the presence of BAL hemosiderosis on cytology. RESULTS: Hemosiderin was identified in 13/171 (7.6%) canine samples and 18/34 (52.9%) feline samples. Cats were 13.33 times more likely to have pulmonary hemosiderosis on bronchoalveolar lavage cytology compared with dogs (P < 0.001). Increased respiratory rates, prolonged bronchoalveolar lavage times, concurrent transthoracic FNAs, and cytologic diagnoses were associated with an increased risk of hemosiderosis in dogs. No specific risk factors associated with pulmonary hemosiderosis in cats were identified. CONCLUSIONS: Hemosiderosis is more common in BAL samples from cats than from dogs and is associated with a diverse range of disease conditions.

Comparison of bronchoscopic and nonbronchoscopic bronchoalveolar lavage in healthy cats.

OBJECTIVE To compare bronchoalveolar lavage (BAL) accomplished by use of a bronchoscopic (B-BAL) and a nonbronchoscopic (NB-BAL) technique in healthy cats. ANIMALS 12 healthy cats. PROCEDURES Two BALs were performed in a randomized order 2 weeks apart in each cat. Cats were anesthetized, and a 2.9-mm fiberoptic bronchoscope (B-BAL) or 8F red rubber catheter (NB-BAL) was wedged in a bronchus. Two 5-mL aliquots of saline (0.9% NaCl) solution were infused into the left and right caudal lung fields and aspirated manually with a 20-mL syringe. Proportion of BAL fluid (BALF) retrieved, depth of wedging, and anesthetic complications were recorded. Total nucleated cell count, differential cell count, and semiquantitative scores of cytologic slide quality were determined for all BALF samples. Results were compared with ANOVAs and Wilcoxon signed rank tests. RESULTS Proportion of retrieved BALF and depth of wedging were significantly greater for B-BAL than NB-BAL. Differential cell counts and cytologic slide quality did not differ significantly between techniques. Complications included transient hemoglobin desaturation (24/24 [100%] BALs) and prolonged anesthetic recovery time (4/24 [17%] BALs). Anesthetic recovery scores did not differ significantly between techniques. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that NB-BAL was noninferior to B-BAL with regard to ease of performance, anesthetic variables, and cytologic slide quality for cats without clinical respiratory tract disease.

Risk factors and prognostic indicators for surgical outcome of dogs with esophageal foreign body obstructions.

OBJECTIVE To determine risk factors for surgical intervention, complications, and outcome in dogs with an esophageal foreign body (EFB). DESIGN Retrospective observational study. ANIMALS 224 incidents of EFB in 223 dogs evaluated at a veterinary teaching hospital from 1995 through 2014. PROCEDURES Hospital records were reviewed to collect data regarding signalment, history, clinical signs, EFB type and location, procedures, complications, and outcomes. Breed distributions were compared between dogs with EFB and the entire canine patient population during the study period. Variables were tested for associations with each other and with outcomes. RESULTS Terrier breeds were most common (71/233 [30.5%]). Duration of EFB entrapment, body weight, anorexia, lethargy, rectal temperature, and esophageal perforation were associated with the need for surgical intervention. Older age, longer duration of EFB entrapment, and perforation were associated with a poorer prognosis. Endoscopic retrieval or advancement into the stomach was successful for 183 of 219 (83.6%) EFBs, and 16 of 143 (11.2%) entrapments resulted in postprocedural esophageal stricture. Overall median duration of hospitalization was brief (1 day), and the need for surgical intervention was associated with a longer duration. Overall mortality rate was 5.4% (12/223); 90 of 102 (88.2%) dogs with a median follow-up period of 27 months after EFB treatment had an excellent outcome. CONCLUSIONS AND CLINICAL RELEVANCE Study findings suggested that endoscopic EFB retrieval remains the initial treatment option of choice for affected dogs, provided that esophageal perforation does not necessitate surgical intervention. Although esophageal stricture formation was the most common complication, the overall rate of this outcome was low.

Passive ureteral dilation and ureteroscopy after ureteral stent placement in five healthy Beagles.

OBJECTIVE To determine whether passive ureteral dilation (PUD) would occur after an indwelling ureteral stent was left in place in healthy dogs for 2 or 6 weeks, ureteroscopy would be possible at the time of stent removal, and PUD would be reversible after stent removal. ANIMALS 5 healthy adult female Beagles. PROCEDURES A ureteral stent was cystoscopically placed in each ureter of each dog with fluoroscopic guidance (week 0). One stent was removed from 1 ureter in each dog after 2 weeks (ureter group 1), and the other was removed after 6 weeks (ureter group 2); removal timing was randomized. Computed tomographic excretory urography was performed every 2 weeks from weeks 0 through 10 to measure ureteral diameters. Ureteroscopy was attempted at the time of ureteral stent removal in each group. Ureteral diameters were compared among measurement points. RESULTS The degree of PUD was significant after 2 and 6 weeks of stent placement in both ureter groups. Mean diameter of the midportion of the ureter in both groups prior to stent placement was 1.70 mm (range, 1.3 to 2.7 mm). At stent removal, mean diameter of the midportion of the ureter was 2.86 mm (range, 2.4 to 3.1 mm) in group 1 and 2.80 mm (range, 2.1 to 3.4 mm) in group 2. Ureteroscopy was successfully performed in all dogs up to the renal pelvis. Compared with week 0 values for diameter of the midportion of the ureter, the degree of PUD induced by stent placement had reversed by week 8 in group 1 (mean diameter, 2.00 mm [range, 1.5 to 2.3 mm]). CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that ureteral stent placement for 2 weeks would result in sufficient PUD in healthy dogs to allow ureteroscopy at the time of stent removal and that the original ureteral diameter would eventually be restored. Additional research is needed to determine whether findings would be similar for dogs with urinary tract disease.

Management of dogs and cats with endotracheal tube tracheal foreign bodies.

Two cats and 3 dogs were treated for an endotracheal tube tracheal foreign body (ETFB) during recovery from general anesthesia. Bronchoscopy was used to remove the ETFB. Animals were clinically normal at discharge. While rare, ETFB can occur upon recovery from anesthesia. Bronchoscopy is an effective way to remove ETFB.

Gestion des chiens et des chats avec un corps étranger trachéal à cause du tube endotrachéal. Deux chats et 3 chiens ont été traités pour un corps étranger trachéal à cause du tube endotrachéal (CETTT) durant le réveil de l'anesthésie générale. Une bronchoscopie a été utilisée pour enlever le CETTT. Les animaux étaient cliniquement normaux au congé. Quoique rare, le CETTT, peut se produire au réveil de l'anesthésie. La bronchoscopie est une manière efficace d'enlever le CETTT.(Traduit par Isabelle Vallières).

Comparison of feline core bone marrow biopsies from different sites using 2 techniques and needles.

BACKGROUND: Commonly used 11ga or 13ga biopsy needles are relatively large for cats and often preclude successful collection of bone marrow (BM) core biopsies. OBJECTIVES: The objective was to compare 15ga to 13ga BM core biopsy ease of collection and specimen quality. METHODS: In 10 cats, humeral biopsies obtained with 15ga EZ-IO needles were compared with iliac biopsies obtained with 13ga Jamshidi needles. Body condition, ease of collection, section quality, postprocedure pain, and swelling at biopsy sites were scored. Specimen length on mounted slides was measured and specimens with quality scores of 3-5 out of a maximum value of 5 were considered to be of acceptable diagnostic quality. The distribution of all parameters was assessed by Shapiro-Wilk tests, and differences in parameters were assessed by ANCOVA. RESULTS: There were no significant differences between 15ga and 13ga biopsies, except that the 15ga humeral biopsy was judged to be easier to perform than 13ga iliac biopsy, and there was more severe postbiopsy swelling with 13ga biopsies. Facility score (mean ± SD), section quality score (median ± SD) and specimen length (mm, mean ± SD) were 12.7 ± 2.3, 2.0 ± 1.4, and 6.0 ± 2.1 for 15ga biopsies, respectively, and 8.9 ± 2.4, 1.0 ± 1.8, and 7.5 ± 2.5 for 13ga biopsies, respectively. Three specimens of acceptable quality were obtained with each 15ga and 13ga biopsies. CONCLUSIONS: In cats, BM biopsy of the humerus with a 15ga needle is easier and causes less postbiopsy swelling than biopsy of the ilium with a 13ga needle. Sites and needles are equivalent with respect to yielding specimens of acceptable quality. Neither technique consistently captured high-quality specimens.

The use of medetomidine-based sedation protocols to perform urohydropropulsion and cystoscopy in the dog.

Voiding urohydropropulsion and cystoscopy are routine procedures performed in the dog for diagnostic and therapeutic purposes. These procedures are typically performed under general anesthesia. The purpose of this study was to describe the use of medetomidine-based sedation protocols to perform voiding urohydropropulsion and cystoscopy in cardiovascularly healthy, non-diabetic dogs without evidence of urinary obstruction, renal disease, or hepatic disease. Results of this study revealed significantly shorter procedure times and decreased cost in sedated dogs, with diagnostic and therapeutic outcomes equivalent to those of patients that underwent general anesthesia. Based on the results of this retrospective study, the authors recommend medetomidine-based sedation protocols for voiding urohydropropulsion and cystoscopy in appropriately selected patients.

Usage des protocoles de sédation à la médétomidine pour réaliser l'urohydropropulsion et la cystoscopie chez un chien. L'urohydropropulsion permictionnelle et la cystoscopie sont des interventions de routine réalisées chez le chien à des fins diagnostiques et thérapeutiques. Ces interventions sont habituellement réalisées sous anesthésie générale. Le but de cette étude était de décrire l'usage des protocoles de sédation à la médétomidine afin d'effectuer l'urohydropropulsion permictionnelle et la cystoscopie chez des chiens en bonne santé cardiovasculaire et non diabétiques sans signe d'obstruction urinaire, de maladie rénale ni de maladie hépatique. Les résultats de cette étude ont révélé des temps d'intervention significativement réduits et une baisse du coût chez les chiens sous sédation, avec des résultats diagnostiques et thérapeutiques équivalant à ceux de patients qui avaient subi une anesthésie générale. Selon les résultats de cette étude rétrospective, les auteurs recommandent des protocoles de sédation à la médétomidine pour l'urohydropropulsion permictionnelle et la cystoscopie chez les patients choisis selon des critères appropriés.(Traduit par Isabelle Vallières).

Combined use of intravesicular ureteroneocystostomy techniques to correct ureteral ectopia in a male cat.

A 2 yr old castrated male Himalayan presented for evaluation and treatment of persistent urinary incontinence that had been present since birth. Ultrasonographic evaluation of the urinary tract revealed suspected bilateral, extramural, ureteral ectopia that was confirmed at the time of surgical exploration. Marked left hydroureter and a normal right ureter were found entering the urethra ∼ 2 cm caudal to the bladder neck. An intravesicular mucosal apposition (modified Leadbetter-Politano) and "drop-in" ureteroneocystostomy techniques were used for reimplantation of the left and right ureter, respectively. Postoperatively, the cat gained urinary continence and remained continent and clinically normal 6 mo following surgery.

Comparison of bronchoalveolar lavage fluid obtained by manual aspiration with a handheld syringe with that obtained by automated suction pump aspiration from healthy dogs.

OBJECTIVE: To compare bronchoalveolar lavage (BAL) fluid obtained by manual aspiration (MA) with a handheld syringe with that obtained by suction pump aspiration (SPA) in healthy dogs. ANIMALS: 13 adult Beagles. PROCEDURES: Each dog was anesthetized and bronchoscopic BAL was performed. The MA technique was accomplished with a 35-mL syringe attached to the bronchoscope biopsy channel. The SPA technique was achieved with negative pressure (5 kPa) applied to the bronchoscope suction valve with a disposable suction trap. Both aspiration techniques were performed in each dog in randomized order on opposite caudal lung lobes. Two 1 mL/kg aliquots of warm saline (0.9% NaCl) solution were infused per site. For each BAL fluid sample, the percentage of retrieved fluid was calculated, the total nucleated cell count (TNCC) and differential cell count were determined, and semiquantitative assessment of slide quality was performed. Comparisons were made between MA and SPA techniques for each outcome. RESULTS: 1 dog was removed from the study because of illness. The mean percentage of fluid retrieved (mean difference, 23%) and median TNCC (median distribution of differences, 100 cells/µL) for samples obtained by SPA were significantly greater than those for samples obtained by MA. CONCLUSIONS AND CLINICAL RELEVANCE: In healthy dogs, BAL by SPA resulted in a significantly higher percentage of fluid retrieval and samples with a higher TNCC than did MA. Further evaluation of aspiration techniques in dogs with respiratory tract disease is required to assess whether SPA improves the diagnostic yield of BAL samples.

Comparison of sternal, iliac, and humeral bone marrow aspiration in Beagle dogs.

BACKGROUND: Sternal bone marrow aspiration in dogs is not commonly performed as it is considered technically challenging in smaller dogs. However, the sternum is readily accessible and associated with less pain from aspiration compared with other sites. OBJECTIVES: The aim of the study was to investigate feasibility, ease, number of attempts, safety, and sample quality of sternal bone marrow aspirates in small dogs. METHODS: Bone marrow aspirates were obtained in a randomized order from 3 sites in 26 clinically healthy Beagles under general anesthesia. Samples were obtained from the sternum using one-inch 20- or 22-gauge hypodermic needles, from the right greater tubercle of the humerus, and the right iliac crest using 18-gauge Illinois needles. The difficulty of each procedure was scored. Two types of bone marrow smears were prepared and reviewed by a pathologist unaware of site of aspiration or dog. The number of particles per slide and overall slide quality were scored. The site of aspiration and the cranial thoracic wall were evaluated at autopsy for evidence of trauma or pneumothorax. RESULTS: The number of attempts and time for bone marrow aspiration were greater for ilium than for sternum or humerus, but the sternum was the easiest to aspirate. Smear quality and particle number were similar for all sites. Neither trauma at the site of aspiration nor pneumothorax were identified. CONCLUSIONS: Aspiration of sternal bone marrow with hypodermic needles is feasible and safe in Beagle dogs. Samples equivalent in quality to those from the humerus or ilium can be obtained from clinically normal dogs.

New alternatives for minimally invasive management of uroliths: nephroliths.

Urolithiasis is a common clinical problem in small animal veterinary patients. Management of upper urinary tract calculi can be particularly challenging in small animals, as traditional surgical removal can be associated with significant morbidity. In humans, minimally invasive treatment options have replaced traditional surgical removal in many cases. This article reviews the current literature on the various types of lithotripsy and some of the newer minimally invasive options available for management of nephrolithiasis in small animal veterinary patients. An article in the January 2013 issue addressed management of lower urinary tract uroliths; a future article will discuss current management strategies for ureteroliths.

New alternatives for minimally invasive management of uroliths: ureteroliths.

Ureterolithiasis is a serious clinical problem in small animal veterinary medicine, and management can be challenging and frustrating. Various traditional surgical treatment options exist but are associated with significant morbidity and mortality. In humans, minimally invasive treatment options have overtaken traditional surgical removal. This article reviews the current literature on the management of ureteral stone disease, including various types of lithotripsy, and discusses some of the newer minimally invasive options available for small animal veterinary patients. It is important to realize that much of the data in this article is only published in abstract form and is largely one institution's experience with these novel techniques. Articles on minimally invasive management of lower urinary tract uroliths and nephroliths were published in the January 2013 and February 2013 issues, respectively.