A case report: Null-cell cardiac lymphoma in an English bulldog.

This case report describes a novel example of an extranodal null-type lymphoma in the myocardium of a middle-aged English bulldog who presented with signs of right heart failure. An echocardiogram found, in addition to the pericardial effusion, thickened right and left ventricular free walls and the interventricular septum. The right ventricular free wall myocardium had multinodular lesions, suspicious for infiltrative disease. The owner elected humane euthanasia, and permission for necropsy was obtained. Multifocal left and right ventricular nodules and an incidental aortic root mass were detected, the latter of which was later confirmed as a chemodectoma. Microscopically, the myocardial nodules were sheets of round cells consistent with a high-grade lymphoma. Neoplastic cells were not immunoreactive to CD3 (T-cell) or CD20 and CD79a (B-cell), Mum-1 (plasma cell), CD117 (mast cell), or CD18 (histiocyte). These findings are consistent with a high-grade, null-cell-type lymphoma.

Single center retrospective clinical audit and comparison of outcome between epicardial and transvenous endocardial permanent pacemaker implantations in dogs.

The aim of this retrospective cohort study was to provide a single-center clinical audit of complications for single chamber permanent pacemaker implantation (PPI) techniques and determine if the clinical parameters, PPI technique or complications were associated with outcome. The electronic medical records were searched for dogs treated for bradyarrhythmia with PPI. Data related to presenting complaint, signalment of the dog, ECG diagnosis, echocardiographic findings, PPI technique, and programing of the pacemaker were recorded. Survival length (days) was recorded as the last veterinary visit; if the dog was dead the reason was documented. Cumulative survival of each pacemaker was examined by a Kaplan-Meier survival curve and the two techniques compared with a logrank test. Chi-square was used to determine the association between major complications and death. A total of 66 dogs with 52 transvenous and 30 epicardial PPIs were included. All epicardial pacemakers were implanted via transdiaphragmatic approach. A total of 31 life-threatening complications were reported. There were nine deaths related to major complications (13.6% of the study sample). The median follow-up period was 366 days, with a median survival of 255 days, and a significant difference in cumulative survival of each pacemaker (P = 0.01) between epicardial (93 days, range 0-1882 days) and transvenous (334 days, range 0-2745) PPIs but no significant difference in cumulative survival between the two techniques when only the first pacemaker was considered (p = 0.07). The presence of a major complications had a significant association with death due to pacemaker complications (P<0.001). The decision to perform epicardial PPI in failed transvenous PPI patients may have skewed the cumulative survival as was evident in the lack of significant difference in survival when only first PPI were examined. Major complication rates between the two techniques were similar and the authors consider both techniques equally reliable to manage symptomatic bradycardia in dogs.

ECHOCARDIOGRAPHIC MEASUREMENTS IN ANESTHETIZED CAPTIVE RED PANDAS (AILURUS FULGENS).

A recent review of mortality in captive red pandas (Ailurus fulgens) listed cardiac pathology as the most common cause of death in the adult age group. The aim of this study was to describe the standard echocardiographic variables in 13 captive, healthy, adult red pandas that underwent an elective health examination. In addition, differences between the two subspecies of red panda, A. f. styani than in A. f. fulgens, and association of these echocardiographic variables with age, sex, and body condition score, were examined. Anesthesia was induced and maintained with isoflurane inhalant anesthetic. All animals underwent a full physical examination and comprehensive echocardiogram including 2D, M-mode, and Doppler modes of ultrasound examination. Mean and SD of the echocardiographic variables are reported. Systolic performance was considered subnormal due to the effect of the anesthetic agent. The echocardiographic variables were similar for the two subspecies and sexes, with the exception of the left atrial dimension (2D), which measured larger (P= 0.03) in A. f. styani than in A. f. fulgens, and left ventricular internal diameter in diastole, which measured larger (P = 0.04) in males than females. Several echocardiographic measurements were correlated with age (P < 0.05), whereas the only measurement that significantly correlated with body condition score was end diastolic volume (P = 0.01). These results provide ranges that can offer guidance for predicting cardiac disease in red panda.

ECHOCARDIOGRAPHY AND DIRECT ARTERIAL BLOOD PRESSURE MEASUREMENT IN CAPTIVE CHIMPANZEES (PAN TROGLODYTES) DURING TWO PHASES OF AN ANESTHETIC PROTOCOL.

The effects of α-2 agonists on echocardiographic findings in great apes are not well documented, and knowledge of these effects would expand the understanding of cardiac examinations of chimpanzees under anesthesia with protocols using these drugs. Ten adult chimpanzees (Pan troglodytes), four males and six females, underwent echocardiographic examinations after anesthesia with dexmedetomidine, midazolam, and ketamine (phase 1). Four animals required isoflurane to achieve an adequate plane of anesthesia. Atipamezole was used to antagonize dexmedetomidine, and all remaining animals were placed on isoflurane (phase 2), and then a second echocardiogram was performed. Direct arterial blood pressure was monitored during the anesthetic event. Measurements and recordings were assessed for statistically significant differences between the two phases and sex. There were no significant differences between phases or sex for any two-dimensional echocardiographic measurement of systolic function, although interventricular septum thickness at end systole approached a significant decrease from phase 1 to phase 2 (P = 0.058) when sex was considered a between-subject factor. Left ventricular outflow tract (P = 0.017) and pulmonary artery (P = 0.028) velocities increased after reversal of the dexmedetomidine. Diastolic transmitral flow was consistent with grade 3 diastolic dysfunction (median early to late ventricular filling velocities (E/A) of 2.02, interquartile range [IQR], 1.53-2.13) with a nonsignificant decrease of E velocity and increase in A velocity and decreased E/A after reversal. Trace mitral and tricuspid regurgitation were common findings in the sample population. Arterial blood pressure significantly decreased between phase 1 and phase 2 (P < 0.01). All chimpanzees entered a hypotensive state (mean arterial pressure < 60 mm Hg) during phase 2. Although limited by the small number of chimpanzees, this study showed an increase in afterload, potential diastolic dysfunction, and a decrease in blood pressure after the antagonism of dexmedetomidine. Additional studies to further assess the effects of α-2 agonists in chimpanzees are warranted.

Cardiovascular-renal axis disorder and acute-phase proteins in cats with congestive heart failure caused by primary cardiomyopathy.

BACKGROUND: Currently, the pathogenesis of congestive heart failure (CHF) in cats is not fully understood. OBJECTIVE: To identify novel biomarkers for CHF in cats caused by primary cardiomyopathy, particularly related to cardiovascular-renal axis disorder and systemic inflammatory response. ANIMALS: Twenty-five cats in CHF caused by primary cardiomyopathy, 12 cats with preclinical cardiomyopathy, and 20 healthy controls. METHODS: Case control and observational case series. The following serum biomarkers were compared among the 3 cat groups: a cardiorenal profile that included N-terminal pro-brain natriuretic peptide (NT-proBNP), symmetric dimethylarginine (SDMA), and creatinine and an inflammatory profile that included 7 acute-phase proteins (APPs). Survival analyses and longitudinal studies were performed in CHF cats. RESULTS: All cardiorenal biomarkers were positively correlated and higher in CHF cats, and high NT-proBNP and SDMA were associated with poor clinical outcome. Cats with CHF had significantly higher leucine-rich alpha-2-glycoprotein 1, serum amyloid A, and ceruloplasmin, and these APPs were positively correlated with NT-proBNP and left atrial size. In a multivariable survival analysis, alpha-1-acid glycoprotein concentration (P = .01), body weight (P = .02) and left atrial-to-aortic root ratio (P = .01) were independent prognostic factors for CHF in these cats. CONCLUSIONS AND CLINICAL IMPORTANCE: In cats, CHF is an inflammatory disorder and outcome in CHF may be determined by the extent of inflammation and possibly the amount of residual renal function. These novel biomarkers have potential use for the clinical management, prognosis, and future research into CHF and cardiomyopathy in cats.

Comparison of biomarkers adiponectin, leptin, C-reactive protein, S100A12, and the Acute Patient Physiologic and Laboratory Evaluation (APPLE) score as mortality predictors in critically ill dogs.

OBJECTIVES: To determine if selected serum biomarkers are superior to the acute patient physiologic and laboratory evaluation (APPLE) complete score in predicting 30-day mortality in a non-homogeneous disease population of critically ill dogs. DESIGN: Prospective cohort study comparing the serum biomarkers adiponectin, leptin, C-reactive protein, and S100A12 concentrations between surviving and nonsurviving critically ill dogs. SETTING: University small animal teaching hospital. ANIMALS: Seventy critically ill dogs were prospectively recruited, and an APPLE complete score was calculated within 24 hours of being admitted to the intensive care unit. Logistic regression models were fit to estimate the association between biomarkers and 30-day survival. Results were interpreted at the 5% level of significance. MEASUREMENTS AND MAIN RESULTS: Leptin was the only biomarker that was significantly correlated with the APPLE complete score (P < 0.001). Only the APPLE complete score (P = 0.003) and illness duration of < 1 day (P = 0.043) were significantly associated with outcome. CONCLUSION: Based on the results of this study, there appears to be no benefit in using biomarkers over the APPLE score for disease severity stratification. Serum leptin concentration was significantly correlated with disease severity as determined by APPLE scoring. Longer duration of illness prior to admission was associated with a higher risk of death. APPLE scores were highest in dogs with infectious and immune-mediated diseases and bite wounds.

The Effects of Music during a Physical Examination Skills Practice: A Pilot Study.

Some veterinary students experience elevated stress, anxiety, and depression resulting in disease and psychological changes. Elevated arousal, negative moods, and lack of interest can negatively affect performance and learning. Psychoacoustic music promotes calming effects using simple and slow piano sounds and can positively impact well-being and functioning. This pilot study assessed the effects of music on blood pressure, pulse, arousal, and mood during a canine physical examination laboratory. In an AB/BA crossover study, 17 students were randomly allocated to practice physical examination skills while listening to Through a Dog's Ear, Volume 1. Psychological and physiologic data were collected. Nonparametric methods were used to test for significant differences in psychological and physiologic data and a linear mixed models approach was used to test for physiological differences. There were no significant baseline differences between the music and no music groups for DASS-21 depression, anxiety, or stress scores; however, there were significant time differences between pretest and posttest on arousal and mood as measured by the Profile of Mood Sates (POMS) Depression, Fatigue-Inertia, and Tension Anxiety subscales. Linear mixed models revealed no significant treatment effect on the pulse and diastolic blood pressure; however, there was a significant systolic blood pressure treatment effect. Future indications include repeating the study with a larger sample to examine longitudinal psychological and physiological benefits.

Diagnosis of pancreatic disease in feline platynosomosis.

Objectives Platynosomum species are cat-specific parasitic trematodes that parasitize the biliary ducts and gall bladder. Due to the common connection to the major duodenal papilla of the pancreas and common bile ducts in addition to the periductal proximity of the pancreas, it is possible that platynosomosis could cause pancreatitis. The objective of this study was to determine whether platynosomosis, a commonly diagnosed parasitic disease in cats on St Kitts, has any association with pancreatic disease. Methods To investigate this possibility, the pancreas of free-roaming cats with naturally acquired platynosomosis were evaluated via ultrasound, serum concentrations of feline pancreatic lipase (fPL), cobalamin, folate and feline trypsin-like immunoreactivity (fTLI) and histopathology. Twenty free-roaming, young adult, feral cats, positive for feline immunodeficiency virus, and diagnosed with Platynosomum species infection via fecal analysis were recruited. The liver, biliary system and pancreas were evaluated via ultrasonography during a short duration anesthesia. Serum concentrations of fPL, fTLI, folate and cobalamin were measured. Sections of the right limb, left limb and body of the pancreas were evaluated histopathologically using hematoxylin and eosin (H&E) stain. Results None of the cats had sufficient criteria to fulfill the ultrasonographic diagnosis of pancreatitis. One cat had an elevated fPL concentration in the range consistent with pancreatitis. Four cats had cobalamin deficiencies and 11 had abnormal folate concentration. The fTLI concentration was equivocal for the diagnosis of exocrine pancreatic insufficiency in one cat. With a single exception, histopathology changes, when present (n = 12), were mild, non-specific and predominantly characterized by lymphocytic infiltrates and fibrosis. The exception was a cat that presented a chronic interstitial and eosinophilic pancreatitis of slightly increased severity, likely the result of platynosomosis. Conclusions and relevance The results of this study suggest that platynosomosis rarely induces pancreatic damage in cats. With only one exception, chronic pancreatitis diagnosed in cats with fluke-induced cholangitis and cholangiohepatitis was subtle and interpreted as an incidental background lesion unrelated to platynosomosis.

Asthma in an Adult Female Vervet Monkey (Chlorocebus sabaeus).

A 9-y-old, colony-bred, female vervet monkey (Chlorocebus sabaeus) presented with a 6-y history of open-mouth breathing, tachypnea, and sibilant wheezing. These symptoms did not significantly affect her activity or quality of life. Thoracic radiographs and results of bronchoalveolar lavage supported the diagnosis of asthma. Treatment comprising intramuscular prednisolone (tapered over 2 mo from twice daily to every other day), inhaled salmeterol-fluticasone (25 µg-250 µg per actuation twice daily) by mask, and a metered dose inhaler was successful in restoring a normal respiratory pattern. Despite the availability of several primate models of human asthma, this case represents the first report of spontaneous asthma in a NHP.

A syndrome of severe idiopathic pulmonary parenchymal disease with pulmonary hypertension in Pekingese.

This paper describes 35 Pekingese dogs with a syndrome characterized by dyspnea, cyanosis, episodic syncope, soft pulmonary "velcro" crackles, pulmonary hypertension (PH), and computed tomography and radiographic changes consistent with pulmonary parenchymal disease. The medical data base was searched with the criteria "Pekingese" and "syncope" or "dyspnea" or "tachypnea" or "pulmonary hypertension", over a 36-month period. Inclusion criteria were echocardiographic changes consistent with noninvasive diagnosis of PH, either subjectively by B-mode or objectively by Doppler. Dogs were excluded (n=106) if there were insufficient or poor-quality radiographic or echocardiographic records or if diseases other than chronic pulmonary disease were found to be the etiology. The records of 35 dogs met these criteria and presented with a respiratory crises preceded by a history of chronic exercise intolerance and episodic syncope. The average age was 14.5 years (range: 7-19 years), with 21 males and 14 females. Most of the dogs had an interstitial lung pattern with radiographic evidence of right heart enlargement. There was a 77% (n=27) mortality and a median survival of 60 days (interquartile range: 9-210 days). This study highlights a cor pulmonale syndrome from PH due to chronic pulmonary parenchymal disease, with a grave prognosis, in middle-aged to geriatric population of Hong Kong Pekingese.

Serum canine pancreatic-specific lipase concentrations in dogs with naturally occurring Babesia rossi infection.

Babesia rossi is the cause of a highly virulent multisystemic disease with a variable outcome, which is a reliable model of systemic inflammatory response syndrome (SIRS). The objective of this study was to determine the concentration of canine pancreatic-specific lipase (cPL) in a population of dogs with naturally acquired B. rossi infection. In addition, the associations between serum cPL and death and SIRS status were examined. An observational study recruited 87 dogs diagnosed with B. rossi infection and serum cPL concentrations were measured daily until discharge or death. The median concentration of serum cPL was 124.0 µg/L (interquartile range: 51.0 µg/L - 475.5 µg/L) on admission (n = 87) and 145.5 µg/L (62.3 µg/L - 434.0 µg/L) on day two of hospitalisation (n = 40). Twenty-four dogs (28%) had a serum cPL concentration within the diagnostic range for pancreatitis (> 400 µg/L) at admission with 13 dogs (32.5%) presenting as such on the second day of hospitalisation. The median concentration of serum cPL in dogs with SIRS was 158 µg/L (interquartile range: 52.5 µg/L - 571.5 µg/L; n = 53), which was significantly higher than in those without SIRS (75 µg/L; 50.3 µg/L - 131.8 µg/L; n = 32) (P = 0.018). This study demonstrated that an unexpectedly high number of dogs diagnosed with naturally acquired canine babesiosis had a serum cPL concentration within the diagnostic range for acute pancreatitis and a significantly higher serum cPL concentration was found in dogs that were classified as having SIRS.

Tritrichomonas foetus infection, a cause of chronic diarrhea in the domestic cat.

Tritrichomonas foetus is a very intriguing trichomonad protozoan with respect to its varied choice of residence in the different host species. It is an obligate parasite of the reproductive and the gastrointestinal tract of bovine and feline host respectively, leading to trichomonosis. Bovine trichomonosis is a sexually transmitted disease whereas feline trichomonosis is a disease with a purported fecal-oral route of spread. Further, the trichomonad is a commensal in the nasal passages, stomach, cecum and colon of swine host. Advances have been exponential in understanding the trichomonad biology and specifically feline trichomonosis since late 1990s and early 2000s when T. foetus was soundly determined to be a causative agent of chronic diarrhea in the domestic cat. It is a challenging task, even for a skilled investigator not to mention the busy clinical veterinarian, to keep up with the vast volume of information. Here we comprehensively reviewed the trichomonad biology, clinical manifestations, pathogenesis, host immunity, world map of distribution, risk factors, diagnosis and treatment. Risk factors associated with T. foetus-positive status in the domestic cat include young age, purebred, history of diarrhea, co-infections with other enteral pathogens. In addition, molecular similarity of bovine and feline isolates of T. foetus in DNA sequence was concisely discussed. The data presented serve as an information source for veterinarians, and investigators who are interested in biology of T. foetus and feline trichomonosis.

Gallbladder mucocoele: A review.

Gallbladder mucocoele (GBM) is an abnormal, intraluminal accumulation of inspissated bile and/or mucous within the gallbladder. Older, small- to medium-breed dogs seem to be predisposed, but no sex predilection has been identified. Clinical signs are often non-specific and include vomiting, lethargy, anorexia, abdominal pain, icterus and polyuria-polydipsia. Results of a complete blood count may be unremarkable, but serum biochemistry usually reveals increased liver enzymes. The ultrasonographic appearance is diagnostic and well described in the literature. Surgical intervention for the treatment of GBM remains the therapeutic gold standard, with short- and long-term survival for biliary surgery being 66%. The worst outcome is seen in those dogs requiring cholecystoenterostomy. With GBM becoming an apparently increasingly common cause of extrahepatic biliary disease in canines, it is essential that clinicians become familiar with the current literature pertaining to this condition. Numerous predisposing factors are highlighted in this review article and the role of certain endocrinopathies (e.g. hyperadrenocorticism and hypothyroidism) in the development of GBM is touched upon. Furthermore, the aetiopathogenesis of this disease is discussed with reference to the latest literature. Cholecystectomy remains the treatment of choice, but other options are considered based on a current literature review.

Trichomonosis in cats with diarrhoea in Hong Kong, China, between 2009 and 2014.

CASE SERIES SUMMARY: Infection of the domestic cat by Tritrichomonas blagburni, previously referred to as T foetus, may lead to a disease called feline trichomonosis, which manifests clinically as large bowel diarrhoea. The disease has a wide geographical distribution, including numerous countries in Europe, North America and Australia/Oceania. Nevertheless, it has occasionally been reported in Asia, South Korea and Japan. A retrospective study was carried out to include all domestic cats with diarrhoea, presented to two veterinary clinics in Hong Kong, China, between 1 July 2009 and 30 June 2014. A total of 29 cats with diarrhoea were diagnosed with Tritrichomonas species infection by means of quantitative PCR and direct microscopy. Tritrichomonas species was more frequently found in young (median age 10 months), male (66%) and purebred cats (86%). Giardia species was found in 31% of Tritrichomonas species-positive cats. The recommended dose of ronidazole (30 mg/kg q24h for 14 days) resolved clinical signs in 83% of diagnosed cats. RELEVANCE AND NOVEL INFORMATION: This case series describes Tritrichomonas species as a cause for feline chronic diarrhoea in cats in China. The high rate of failure (17%) in those cats receiving a standard regimen of ronidazole might be due to owner or patient compliance rather than protozoal resistance to the drug.

Canine babesiosis: a perspective on clinical complications, biomarkers, and treatment.

Canine babesiosis is a common tick transmitted disease of dogs worldwide. A number of Babesia sp. can infect dogs and the spectrum is increasing as molecular methods are developed to differentiate organisms. Clinical signs are generally attributed to hemolysis caused by the organisms in the erythrocytes but in some animals with some Babesia spp. there can be an immune mediated component to the anemia and/or a severe inflammatory reaction associated. This complicated form of canine babesiosis is associated with high morbidity and mortality. A variety of clinical markers has been investigated to enable clinicians to provide more accurate prognoses and adapt their treatments which vary according to the infecting species. In this review, we discuss the taxonomy, clinical signs, diagnostic imaging, clinical biomarkers, treatment, and prophylaxis of one of the most common and important diseases of dogs worldwide.