Bile duct obstruction associated with pancreatitis in 46 dogs.

BACKGROUND: Pancreatitis is a common cause of extrahepatic bile duct obstruction (EHBDO) in dogs. Information describing the clinical course of dogs with pancreatitis associated bile duct obstruction (PABDO) is limited. OBJECTIVES: To describe the clinical course of PABDO in dogs and determine if presumed markers of disease severity are predictors of survival. ANIMALS: Forty-six client-owned dogs with PABDO. METHODS: A retrospective review of medical records from dogs diagnosed with PABDO was performed. Data, including clinical signs and biochemical changes, were collected 6 times throughout the course of disease. Outcome was defined as either survival (discharge from the hospital) or death. RESULTS: Thirty-three (79%) out of 42 dogs with PABDO survived. Thirty-one (94%) of the 33 dogs that survived received medical management alone. Time from onset of clinical signs to initial documented increase in serum bilirubin concentration, peak bilirubin elevation, and initial decline in serum bilirubin concentration were 7 (median), 8, and 15 days, respectively. The median number of days from onset of clinical signs to outcome date was 13. Clinical signs of fever, vomiting, and anorexia were decreased in frequency from the onset of clinical signs to the time of peak bilirubin. Median bile duct dilatation at the time of ultrasonographic diagnosis of PABDO and peak bilirubin were not different between survivors (7.6 mm, 11.7 mg/dL) and nonsurvivors (6 mm, 10.6 mg/dL, P = .12, P = .8). CONCLUSIONS: Dogs with PABDO often have a prolonged course of illness and improve clinically despite biochemical evidence of progression of EHBDO.

Giardia duodenalis assemblages in cats from Virginia, USA.

Giardia duodenalis is considered a species complex that is divided into 8 genetically distinct but morphologically identical assemblages (A-H). Assemblages C-H are generally host adapted, while A and B infect both people and animals and are considered potentially zoonotic. Furthermore, within assemblage A there are four subtypes (AI, AII, AIII, and AIV) of varying zoonotic potential; human isolates belong to AI and AII, while animal isolates belong to AI, AIII and AIV. Assemblages A, B, C, D, and F have all been reported from cats. The objective of this study was to determine the assemblage(s) of G. duodenalis present in cats from Virginia using multilocus genotyping and to assess if there were any differences among the assemblage(s) found in the populations of cats surveyed (free-roaming, shelter, owned) or their geographic location within Virginia. Samples that were positive for G. duodenalis cysts by microscopy using centrifugal flotation with ZnSO4 solution and/or direct immunofluorescence assay were genotyped using PCR and sequencing targeting fragments of the SSU rRNA, gdh, bg, and tpi genes. In total, 54 cyst-positive samples were analyzed by PCR and sequencing: 43 produced amplicons, and 37 samples had interpretable sequence data at one or more loci. Assemblage F was detected in 21/37 samples, AI was detected in 12/37 samples, and in 4/37 samples both assemblages F and AI were detected. The potentially zoonotic assemblage AI was detected in cats from two widely separated animal shelters and from one free-roaming cat. These genotyping data demonstrate that potentially zoonotic G. duodenalis assemblages are present in cats in Virginia.

Effects of prednisone alone or prednisone with ultralow-dose aspirin on the gastroduodenal mucosa of healthy dogs.

BACKGROUND: The coadministration of prednisone and ultralow-dose aspirin has been recommended for the management of various diseases, but the safety of this combination in dogs has not been studied. HYPOTHESES: The gastroduodenal lesions associated with prednisone and ultralow-dose aspirin administration will be similar to those caused by prednisone alone, but both treatments will result in more severe lesions than placebo. ANIMALS: Eighteen healthy adult purpose-bred dogs. METHODS: Randomized, blinded, placebo-controlled study of 3 treatment groups for 27 days: placebo, prednisone, and prednisone and aspirin. Gastroduodenoscopy was performed before and on days 5, 14, and 27 of treatment and mucosal lesions scores were assigned. Mucosal lesion scores were compared by a Kruskal-Wallis test. Clinical signs were compared by the Friedman's chi-square test (significance at P < .05). RESULTS: There were no significant differences in the gastroduodenal lesion scores among groups, or within groups at any time during the study. Significantly more dog-days of diarrhea occurred in the prednisone and aspirin group during treatment, compared with baseline. No significant differences in clinical signs were found among any of the groups. CONCLUSION: The concurrent use of prednisone and ultralow-dose aspirin did not increase the severity of gastroduodenal lesions compared with prednisone or placebo. Coadministration of prednisone and ultralow-dose aspirin increases the frequency of mild, self-limiting diarrhea in some dogs.

Primary tracheal collapse in a cat.

A 7-year-old, neutered male, domestic shorthair cat was presented for severe inspiratory dyspnea of 2 to 3 days' duration. Radiography and tracheobronchoscopy confirmed the diagnosis of primary extrathoracic tracheal collapse. The cat was treated with oxygen, dexamethasone, and terbutaline, but no improvement was seen. Surgical correction was performed using nine prosthetic tracheal ring implants. Clinical signs improved after surgery, and the cat continued to do well 11 months after surgery, despite development of unilateral laryngeal paralysis.

Esophageal foreign body obstruction caused by a dental chew treat in 31 dogs (2000-2006).

OBJECTIVE: To evaluate the signalment, clinical signs, diagnosis, treatment, and outcome associated with esophageal obstruction caused by a dental chew treat in dogs. DESIGN: Retrospective case series. ANIMALS: 31 dogs. PROCEDURES: Medical records were contributed from 19 hospitals via responses to a questionnaire that was developed for veterinarians who managed the cases. RESULTS: Esophageal obstructions with the dental chew treat occurred primarily in small dogs (26/31 [83.9%]). The most common clinical signs were gagging, regurgitation, vomiting, anorexia, and lethargy. Diagnosis was usually made via survey thoracic radiography. Obstructions were most commonly located in the distal portion of the esophagus (23/31; 74.2%). Esophageal lesions were moderate or severe in 86.7% (26/30) of the dogs. Orad endoscopic removal of the foreign bodies was uncommon (8/31 [25.8%]); most were pushed into the stomach. Thoracotomy was necessary in 6 dogs. Esophageal strictures developed in 6 of 25 (24%) dogs that survived initial hospitalization. Overall mortality rate was 25.8%. CONCLUSIONS AND CLINICAL RELEVANCE: Esophageal obstructions with a dental chew treat were difficult to remove orally via endoscopy, resulted in moderate or severe esophageal damage, frequently were associated with stricture formation, and were associated with a high mortality rate.

Triple antimicrobial therapy and acid suppression in dogs with chronic vomiting and gastric Helicobacter spp.

BACKGROUND: Helicobacter pylori is a common cause of gastritis and peptic ulcers in humans. Many dogs, including those with gastritis and chronic vomiting, are infected with Helicobacter spp. HYPOTHESIS: Triple antimicrobial therapy will eradicate Helicobacter infection, improve gastritis, and reduce clinical signs. The addition of acid suppression medication will not improve results. ANIMALS: Twenty-four pet dogs with chronic vomiting and gastric Helicobacter spp. METHODS: Dogs were randomly assigned to triple antimicrobial therapy with or without famotidine. Gastroduodenoscopy was performed 4 weeks and 6 months after therapy. Helicobacter spp status was determined by histologic assessment of gastric mucosal biopsy specimens. RESULTS: Eradication rates for each treatment were not significantly different and combined were 75 and 42.9% at 4 weeks and 6 months, respectively. A greater improvement in gastritis scores occurred in dogs that became Helicobacter spp negative. Overall, the frequency of vomiting was reduced by 86.4%, but there were no differences between treatments. CONCLUSIONS AND CLINICAL IMPORTANCE: Eradication rates of Helicobacter spp with both treatments were not significantly different. Eradication rates at 6 months were modest, and more effective treatments should be developed. Acid suppression is not a necessary component of treatment protocols for dogs. Eradication of gastric Helicobacter spp was associated with improvement in gastritis scores. Dramatic reduction of the vomiting frequency occurred with both treatment protocols. Gastric Helicobacter spp may cause or contribute to chronic vomiting and gastritis in some dogs.

Effects of deracoxib or buffered aspirin on the gastric mucosa of healthy dogs.

BACKGROUND: Use of cyclo-oxygenase-2 specific nonsteroidal anti-inflammatory drugs such as deracoxib has been advocated because of their anti-inflammatory actions and apparently low incidence of gastrointestinal adverse effects. HYPOTHESIS: Deracoxib will cause less endoscopically detectable gastric injury in dogs than aspirin, a nonselective nonsteroidal anti-inflammatory drug. ANIMALS: Twenty-four random source healthy dogs. METHODS: A randomized, placebo-controlled trial compared gastroscopic findings of dogs receiving placebo (q8h), aspirin (25 mg/kg PO q8h), or deracoxib (1.5 mg/kg QD, placebo ql2h) for 28 days. Gastroscopy on days -7, 6, 14, and 28 evaluated 4 regions of the stomach separately and visible lesions were scored. Dogs were observed every 8 hours for vomiting and diarrhea. Median total scores for each group were compared each day of endoscopic examination and total dog-days of vomiting and diarrhea were compared. Significance was determined at P < .05. RESULTS: There were significant differences in total scores of the aspirin group and both the placebo and deracoxib groups on days 6, 14, and 28. No significant differences in total scores were found between placebo and deracoxib on days 6, 14, and 28. Significant differences in dog-days of vomiting were found between the aspirin and deracoxib groups whereas no significant differences were found between the deracoxib and placebo groups. There was no detectable effect of treatment on dog-days of diarrhea. CONCLUSIONS AND CLINICAL IMPORTANCE: Administration of deracoxib to healthy dogs resulted in significantly lower gastric lesion scores, and fewer days of vomiting compared to aspirin, indicating that deracoxib is better tolerated than aspirin in some dogs.

Diagnosis and surgical management of vascular ectasia in a dog.

CASE DESCRIPTION: An 8-year-old male Golden Retriever was evaluated because of an 8-week history of intermittent diarrhea with melena and hematochezia that were not responsive to medical treatment and resulted in severe anemia. CLINICAL FINDINGS: Exploratory celiotomy with intestinal and colonic biopsy revealed mild enterocolitis but did not result in diagnosis of the cause of melena and hematochezia. Endoscopy of the upper portion of the gastrointestinal tract and colonoscopy were performed. Multifocal areas of coalescing, tortuous mucosal blood vessels were observed in the cecum and all regions of the colon. A diagnosis of vascular ectasia (VE) was made on the basis of the endoscopic and histologic appearance of the lesions. TREATMENT AND OUTCOME: An ileorectal anastamosis was performed. Melena and hematochezia resolved within 3 days after surgery, and the anemia resolved within 6 weeks after surgery. Surgical resection of the cecum and colon and feeding of a highly digestible diet resulted in long-term (22 months) resolution of clinical signs. CLINICAL RELEVANCE: Initial exploratory celiotomy with intestinal and colonic biopsy failed to reveal the VE lesions responsible for the melena, hematochezia, and anemia. Endoscopic evaluation was necessary for detection of the colonic VE lesions. Surgical resection of the cecum and colon and feeding of a highly digestible diet may result in a favorable outcome in affected dogs.

Complications associated with 355 flexible colonoscopic procedures in dogs.

Flexible colonoscopy is commonly performed in dogs with signs of large-bowel diseases. Although considered to be a safe procedure, no reports of complications associated with colonoscopy have appeared in the veterinary literature. The purpose of this study was to describe the frequency and types of adverse events that developed during flexible colonoscopy in dogs. Medical records were reviewed from 355 scheduled colonoscopic procedures. Major complications were defined as adverse events in which the dog's life was potentially jeopardized and the complication required intensive treatment or monitoring. Major complications consisting of fatal aspiration of GoLYTELY, colonic perforation, and excessive hemorrhage after biopsy of an adenocarcinoma with rigid forceps occurred in 3 (0.85%) dogs. Minor complications associated with anesthesia or colonoscopy occurred during 3.4% of procedures. Complications were classified as minor if the adverse event required minimal treatment or monitoring, and the complication was not considered a threat to the dog's life. Vomiting of GoLYTELY occurred with the administration of 4.6% of doses in 6.5% of dogs. When administering GoLYTELY, clinicians should be prepared to rapidly remove the orogastric tube and mouth speculum if vomiting occurs to reduce the potential for aspiration. In this group of dogs undergoing flexible colonoscopy, major complications occurred infrequently and minor complications developed uncommonly. Overall, minor or major complications developed during 30 (8.5%) of 355 procedures. Mortality was rare (0.28%). Flexible colonoscopy appears to be a safe procedure in dogs with signs of large-bowel diseases.

The effect of dosing interval on the efficacy of misoprostol in the prevention of aspirin-induced gastric injury.

The effect of twice-daily administration of misoprostol on aspirin-induced gastric injury was evaluated. Twenty-four random-source dogs were divided into groups that received aspirin and misoprostol as follows: group I, aspirin 25 mg/kg PO q8h and placebo PO q8h; group II, aspirin 25 mg/kg PO q8h and misoprostol 3 microg/kg PO q8h; group III, aspirin 25 mg/kg PO q8h, misoprostol 3 microg/kg PO q12h, and placebo PO q24h; and group IV, aspirin 25 mg/kg PO q8h, misoprostol 3 microg/kg PO q24h, and placebo PO q12h for 28 days. Gastroscopy was performed on days -9, 5, 14, and 28. Visible lesions were scored on a scale of 1 (mucosal hemorrhage) to 11 (perforating ulcer). No difference in total score was identified between groups I and IV on any day. Median total scores for groups II and III were significantly (P < or = .05) lower compared to groups I and IV on day 5. Group III had a significantly lower score (P < or = .05) than groups I, II, and IV on day 28. This study suggests that misoprostol 3 microg/kg PO q12h is as effective as misoprostol 3 microg/kg PO q8h in preventing aspirin-induced gastric injury in this model. However, misoprostol 3 microg/ kg PO q8h was less effective in preventing aspirin-induced gastric injury on days 14 and 28 than in previous studies. No difference among numbers of dog-days of vomiting, diarrhea, or anorexia was detected among groups.

Interobserver variation among histopathologic evaluations of intestinal tissues from dogs and cats.

OBJECTIVE: To determine whether substantial interobserver variation exists among diagnostic pathologists for descriptions of intestinal mucosal cell populations and whether histopathologic descriptions accurately predict when a patient does not have clinically evident intestinal disease. DESIGN: Comparative survey. Sample Population-14 histologic slides of duodenal, ileal, or colonic tissue from 10 dogs and 3 cats. PROCEDURE: Each histologic slide was evaluated independently by 5 pathologists at 4 institutions. Pathologists, who had no knowledge of the tissues' origin, indicated whether slides were adequate for histologic evaluation and whether the tissue was normal or abnormal. They also identified the main infiltrating cell type in specimens that were considered abnormal, and whether infiltrates were mild, moderate, severe, or neoplastic. RESULTS: Quality of all slides was considered adequate or superior by at least 4 of the 5 pathologists. For intensity of mucosal cellular infiltrates, there was uniformity of opinion for 1 slide, near-uniformity for 6 slides, and nonuniformity for 7 slides. Five dogs did not have clinical evidence of intestinal disease, yet the pathologists' descriptions indicated that their intestinal tissue specimens were abnormal. CONCLUSIONS AND CLINICAL RELEVANCE: Substantial interobserver variation was detected. Standardization of pathologic descriptions of intestinal tissue is necessary for meaningful comparisons with published articles. Clinicians must be cautious about correlating clinical signs and histopathologic descriptions of intestinal biopsy specimens.

The effect of dose and concentration on D-xylose absorption in healthy, immature dogs.

Nine combinations of dosages and concentrations of D-xylose were given orally to eight clinically normal, immature dogs. The concentrations and dosages of D-xylose consisted of 5%, 10%, and 20% at 250 mg/kg, 500 mg/kg, and 750 mg/kg. Serum samples were collected at 0, 30, 60, 90, 120, and 180 minutes. Serum xylose was quantitated using the phloroglucinol microassay technique. A peak in serum xylose concentration was seen for each treatment combination at 60 or 90 minutes after dosing. The dosage effect was important in influencing serum xylose values (P < 0.0001). As the test solution dosages increased from 250 mg/kg to 500 mg/kg and 750 mg/kg, serum xylose values (when dosage was analyzed over the length of the entire test) rose linearly (R(2) = 0.98). The treatment combinations of 5% and 20% xylose solutions dosed at 750 mg/kg produced the highest serum xylose values at the 60- and 90-minute peak intervals. The independent effect of concentration was significant (p < 0.001) but was overridden by the stronger dosage effect. Serum xylose concentrations varied little statistically (p > 0.05) when the 5%, 10%, and 20% solutions were compared at a specific dosage.