Tolerability of naso-esophageal feeding tubes in dogs and cats at home: Retrospective review of 119 cases.

BACKGROUND: The use of naso-esophageal feeding tubes (NFT) at home could represent an alternative way to reduce the costs for owners and facilitate enteral feeding until recovery of a spontaneous appetite. OBJECTIVE: To describe the use of NFT at home in dogs and cats and evaluate the satisfaction of owners and their capacity to handle the device. ANIMALS: One hundred nineteen client-owned animals (90 cats and 29 dogs) which remained anorexic during hospitalization and were discharged with NFT for at least 24 hours after placement. METHODS: Medical records were reviewed retrospectively, and owners were contacted by telephone calls. Complications were reported according to their relative severity (minor and major). Owners were asked to report their experience and comfort with NFT management. RESULTS: Naso-esophageal feeding tubes were kept in place at home for a median of 6 days (range, 1-17) and 62.2% (95% confidence interval [CI]: 53.3-70.7) of animals recovered a spontaneous appetite while wearing NFT, 60% (95% CI: 44.4-75.6) of the remaining animals recovered a spontaneous appetite after removal. Overall complication rate was 65.5% (95% CI: 57.0-74.0), but only 18.5% (95% CI: 11.5-25.5) required a consultation and no life-threatening complication occurred. Owners were satisfied in 94.1% (95% CI: 89.9-98.3) of cases. CONCLUSION AND CLINICAL IMPORTANCE: Although most animals discharged with NFT at home presented complications, no major adverse effects were reported and NFT were easily handled by owners. This study provides evidence that NFT can be well tolerated at home.

Update on the use of trilostane in dogs.

Many articles published in the past few years have contributed to a better understanding of the use of trilostane in dogs. Trilostane is a competitive inhibitor of 3ß-hydroxysteroid dehydrogenase, the enzyme essential for synthesis of cortisol and all other steroids. Trilostane is reported to be safe and effective in the treatment of pituitary-dependent hyperadrenocorticism (HAC), adrenal-dependent HAC, and alopecia X. While trilostane controls most of the clinical signs associated with HAC, abnormalities such as hypertension, hypercoagulability, and proteinuria may persist despite therapy. Because the duration of cortisol suppression after a dose of trilostane is often less than 12 hours, many dogs with HAC could benefit from low dose trilostane treatment every 12 hours. Many controversies regarding trilostane still exist. This review provides a comprehensive commentary on trilostane's indications, mode of action, dose, monitoring, efficacy, and adverse effects.

Mise à jour sur l'utilisation du trilostane chez les chiens. De nombreux articles publiés au cours des dernières années ont contribué à une meilleure compréhension de l'utilisation du trilostane chez les chiens. Le trilostane est un inhibiteur compétitif de la 3ß-hydroxystéroïde déshydrogénase, l'enzyme essentiel pour la synthèse du cortisol et de tous les autres stéroïdes. On signale que le trilostane est sûr et efficace pour le traitement de l'hyperadrénocorticisme pituitaire (HAC), le HAC adrénal et l'alopécie X. Bien que le trilostane maîtrise la plupart des signes cliniques associés au HAC, des anomalies comme l'hypertension, l'hypercoagulabilité et la protéinurie peuvent persister malgré la thérapie. Parce que la durée de la suppression du cortisol après une dose de trilostane est souvent de moins de 12 heures, plusieurs chiens atteints de HAC pourraient bénéficier d'un traitement à faible dose de trilostane toutes les 12 heures. Il subsiste encore beaucoup de controverse concernant le trilostane. Cet examen fournit un commentaire exhaustif sur les indications, le mode d'action, la dose, la surveillance, l'efficacité et les effets secondaires du trilostane.(Traduit par Isabelle Vallières).

The use of intravesicular alteplase for thrombolysis in a dog with urinary bladder thrombi.

OBJECTIVE: To describe the use of alteplase for intravesicular thrombolysis in a dog after development of urinary tract obstruction from a blood clot in the urinary bladder. CASE SUMMARY: A 5.8 kg, 6.5-year-old female neutered Bichon Frise was presented for signs of acute hematuria. A complete blood count (CBC) revealed marked thrombocytopenia and leukopenia, and nonregenerative anemia. Bone marrow aspirate cytology revealed mild hypercellularity, mild megakaryocytic hyperplasia, mildly left-shifted erythroid maturation, and moderately left-shifted myeloid maturation, suggesting ongoing recovery from an acute bone marrow insult. Thrombocytopenia and hematuria resolved concurrently; however, stranguria and oliguria developed acutely. Ultrasonography identified two large presumed thrombi within the urinary bladder. A urinary catheter was placed and 4 doses of 0.5 mg of alteplase diluted in 10 mL of 0.9% sodium chloride were instilled into the bladder with a 4-hour dwell time at 12-hour intervals. Prothombin and activated partial thromboplastin times were monitored during therapy and remained within normal limits. One thrombus was successfully dissolved after 48 hours of therapy and the remaining thrombus was reduced in size and was voided upon removal of the urinary catheter. NEW OR UNIQUE INFORMATION PROVIDED: This report describes the use of alteplase in a dog for thrombolysis of intravesicular thrombi. In patients that develop intravesicular thrombi, intravesical instillation of alteplase can be considered as a method for dissolution of these thrombi.

Primary intranasal melanoma with brain invasion in a dog.

A 6-year-old castrated male boxer dog with right-sided dark purulent nasal discharge and acute bilateral blindness was diagnosed on magnetic resonance imaging (MRI) and then on necropsy with primary nasal malignant melanoma that extended into the brain, as well as concurrent ocular melanosis. There was no evidence of metastasis in other organs.

Un cas de mélanome primitif des fosses nasales avec invasion cérébrale chez un chien. Un boxer mâle castré de 6 ans a été présenté pour écoulement nasal purulent et de couleur foncée à droite et perte de vision bilatérale aiguë. Un mélanome malin nasal primaire qui s'étendait dans le cerveau, ainsi qu'une mélanose oculaire, ont été diagnostiqués par imagerie à résonnance magnétique (IRM) puis nécropsie. Il n'y avait pas d'évidence de métastases dans les autres organes.(Traduit par les auteurs).

Multiple liver abscesses in a dog secondary to the liver fluke Metorchis conjunctus treated by percutaneous transhepatic drainage and alcoholization.

A 1-year-old German shepherd × husky cross dog was diagnosed with multiple liver abscesses and severe cholangitis secondary to the liver fluke Metorchis conjunctus. The dog was successfully treated with 2 percutaneous transhepatic drainage and alcoholization procedures, and a prolonged course of antibiotics and praziquantel.

Abcès hépatiques multiples chez un chien secondaire à une douve du foieMetorchis conjunctustraitée par drainage transhépatique percutané et alcoolisation. Un chien de race croisée Berger allemand et Husky âgé de 1 an a été diagnostiqué avec des abcès hépatiques multiples et une cholangite grave secondaire à la douve du foie Metorchis conjunctus. Le chien a été traité avec succès à l'aide de deux interventions de drainage transhépatique percutané et d'alcoolisation ainsi que d'un traitement prolongé aux antibiotiques et au praziquantel.(Traduit par Isabelle Vallières).

Inflammatory joint disease in cats: diagnostic approach and treatment.

PRACTICAL RELEVANCE: Osteoarthritis, a degenerative non-inflammatory joint disease, is common in cats, usually causing gradual changes in behavior and lifestyle rather than severe lameness. Inflammatory arthritis occurs much less frequently and is nearly always associated with debilitating lameness. It may have an infectious or immune-mediated cause - but, unlike the canine disease, is much more likely to be infectious in origin. CLINICAL CHALLENGES: Cats with inflammatory joint disease are presented for evaluation of lethargy, anorexia, reluctance to walk or fever. Synovial fluid collection and analysis is required to confirm joint inflammation, but this is a procedure many veterinarians are not comfortable performing in cats. Once inflammatory arthritis is confirmed, extensive testing is required to diagnose infectious causes and determine appropriate treatment. Immune-mediated polyarthritis can be treated with immunosuppressive drugs only after all infectious possibilities are eliminated. Radiographs are used to characterize the arthritis as erosive or nonerosive, but radiographic changes in cats are often subtle compared with those described in canine rheumatoid-like arthritis. AUDIENCE: This review, aimed at all veterinarians who treat cats, describes the general clinical approach to feline joint disease, the collection and analysis of synovial fluid, and the diagnosis and management of inflammatory joint diseases affecting cats. The diagnostic approach to an unusual case of erosive polyarthritis is discussed in the Case Notes. EVIDENCE BASE: To date, the veterinary literature on inflammatory joint disease in cats has been limited to older reviews of immune-mediated disorders and multiple single case reports or small case series describing infectious disorders. This article offers a current comprehensive review of these disorders.