Evaluation of Iatrogenic Hypocortisolemia Following Trilostane Therapy in 48 Dogs with Pituitary-Dependent Hyperadrenocorticism.

This study aimed to retrospectively describe the clinical progression following diagnosis of iatrogenic hypocortisolemia (iHC) in 48 dogs receiving trilostane for pituitary-dependent hyperadrenocorticism. Cortisol concentrations were ≥1.5 mg/dL within 6 mo following diagnosis of iHC in 76.3% of dogs (95% confidence interval [CI] 59.8-88.6%). At the time of study completion, 25% of dogs (95% CI 13.6-39.6%) were receiving either glucocorticoids or mineralocorticoids or both; 42% of dogs (95% CI 27.6-56.8%) were on no adrenal-related medications; and the remaining 33% of dogs (95% CI 20.4-48.4%) were receiving trilostane. No patient-, clinicopathologic-, or trilostane-associated factors were identified to influence adrenal recovery following diagnosis of iHC, and it remains difficult to predict the clinical progression in this population of dogs.

A retrospective analysis of environmental risk factors for the diagnosis of deep stromal abscess in 390 horses in North Central Florida from 1991 to 2013.

PURPOSE: The purpose of this investigation was to identify potential environmental risk factors for the diagnosis of equine deep stromal abscesses (DSA) in the subtropical climate at the University of Florida Veterinary Medical Center (UFVMC). METHODS: Cases included were selected from the UFVMC medical record and imaging database, and included all cases of equine DSA diagnosed during the period from December 1991 to December 2013 in patients residing in north central Florida. Patient date of diagnosis and atmospheric data was obtained for north central Florida for the corresponding time period. Univariate and multivariate general linear models were generated testing effects and interactions between environmental conditions. RESULTS: When year, sulfur dioxide (SO2 ) and wind were analyzed in the presence of each other, a one-mile per hour increase in wind (P = 0.005) significantly increased the number of DSA cases by 1.63 cases per year. When the influence of temperature was evaluated in conjunction with year and nitrogen dioxide (NO2 ), the number of cases decreased by 0.1534 per year for every degree increase in temperature (°C) (P = 0.039). CONCLUSIONS: Wind speed is the first significant atmospheric risk factor to be identified for DSA formation in the horse. The importance of environmental variance in the incidence of DSA indicates that the pathogenesis of DSA formation may be multifactorial, interdependent and provides support in some horses for the micropuncture hypothesis of DSA formation related to the involvement of environmental conditions causing precorneal tear film and epithelial damage.

Lack of significant improvements in long-term allograft survival in pediatric solid organ transplantation: A US national registry analysis.

Improvements across many facets of transplantation have led to better 1-yr outcomes of transplanted organs. In this study, we assessed whether longer-term attrition rates improved in pediatric kidney (KI), liver (LI), heart (HR) and lung (LU) transplant (TX) survival. We analyzed data between 1989 and 2008 from 5747 KI, 7348 LI, 5103 HR, and 715 LU TXs (under 18 yr of age at transplant, first solitary transplant only), from the National Scientific Registry of Transplant Recipients database in the USA. Kaplan-Meier (K-M) or ordinary least square (OLS) estimates were used to calculate median and projected survival half-lives. Attrition rates, defined as percent failing within a given time period, were stratified by year of TX. Median half-lives from 1989 TX year to 2005 TX year have shown a major improvement only in LI TX, remaining unchanged in HR and KI TX, or remaining very low in LU TX. All four organ TX types have shown a dramatic drop in first-year attrition rates from 1989 to 2008. However, longer-term attrition rates (1-3, 3-5, 5-10 yr) have remained largely unchanged for all four organ TX types. Further progress in long-term survival will need targeting end-points beyond first-year rejection and survival rates.

Across all solid organs, adolescent age recipients have worse transplant organ survival than younger age children: A US national registry analysis.

Univariate analyses suggest that adolescents have worse long-term allograft survival versus younger children across different SOT. This study's objective was to determine whether multivariate analyses of a large national database recording all deceased SOT (KI; LI; HR; LU) also show worse adolescent allograft survival in the different organs. Using data from the national Scientific Registry for Transplant Recipients in the USA for pediatric primary SOT from 1989 to 2010, we calculated median half-lives and constructed K-M graft survival curves. Recipient age at transplant (<12 or adolescent 12-17 yr) was fitted with other identical covariates into multivariate Cox proportional hazards models. In all SOT recipients, unadjusted graft survival curves demonstrated better graft survival for adolescents initially, followed by crossing of the lines, such that adolescent SOT recipients had worse survival after one yr (KI), 4.6 yr (LI), 4.4 yr (HR), and 1.6 yr (LU). Multivariate models of the post-cross period showed a significantly higher AHR for worse graft survival in adolescent age across all four SOTs: AHR 1.400 (KI), 1.958 (LI), 1.414 (HR), and 1.576 (LU). Improving adolescent long-term outcomes across all four organs will be a defining issue in the future.

ESTABLISHMENT OF ECHOCARDIOGRAPHIC PARAMETERS OF CLINICALLY HEALTHY FLORIDA MANATEES (TRICHECHUS MANATUS LATIROSTRIS).

A standardized echocardiographic technique was recently established for the Florida manatee (Trichechus manatus latirostris). There are no available published data on normal echocardiographic parameters in any Sirenian species. The purpose of this study was to report reference parameters for various echocardiographic measurements. These parameters are intended to serve as a comparison for future research into the prevalence of cardiac diseases in the manatee and to aid in diagnosing animals with suspected cardiac disease in rehabilitation facilities. Annual health assessments of free-ranging manatees in Crystal River National Wildlife Refuge, Florida, and pre-release health assessments of rehabilitated manatees at Tampa's Lowry Park Zoo permitted comparison of echocardiographic measurements in adult (n=14), subadult (n=7), and calf (n=8) animals under manual restraint.

Burnout symptoms and workplace satisfaction among veterinary emergency care providers.

OBJECTIVES: To measure symptoms of burnout among veterinary emergency care providers (VECPs), determine how burnout symptoms among VECPs compare to human emergency care providers, and identify what demographic and workplace variables are associated with these symptoms. DESIGN: Cross-sectional study using an online survey and convenience sampling. SUBJECTS: A total of 1204 VECPs including mostly veterinarians and technicians. INTERVENTIONS: An online questionnaire using the Maslach Burnout Inventory and Areas of Worklife Survey was distributed between May and July 2018 via an email list and social media. VECPs working less than part-time (<20 h/week) and incomplete survey responses were excluded. MEASUREMENTS AND MAIN RESULTS: VECPs had higher total emotional exhaustion and depersonalization scores and lower total personal accomplishment scores compared to emergency department human healthcare professionals (P < 0.001). Subsets of VECPs with the highest burnout symptom scores included females, residents, those working in private or corporate referral hospitals, and those with off-shift duties. Workplace variables positively associated with burnout symptom scores among these groups typically included perceptions of an unmanageable workload, lack of control over work, little reward (recognition) for work, or an unfair allocation of resources at work. Conversely, VECPs working >20 years and those married or with children at home had lower burnout symptom scores. Workplace variables negatively associated with burnout symptom scores among respondents included perceptions of having a manageable workload, control over work, reward for work, or a fair allocation of resources at work. Multivariable analysis revealed that the variable most positively associated with emotional exhaustion and depersonalization was workload, whereas reward was most positively associated with personal accomplishment (P < 0.001). CONCLUSIONS: Burnout symptom scores are higher among VECPs compared to human emergency department teams. Targeting workplace variables such as workload and reward is warranted in future studies to determine strategies for reducing burnout among VECPs.

N-terminal brain natriuretic peptide, cardiac troponin-I, and point-of-care ultrasound in dogs with cardiac and noncardiac causes of nonhemorrhagic ascites.

BACKGROUND: Nonhemorrhagic ascites (NHA) can be caused by cardiac diseases (cNHA) and noncardiac diseases (ncNHA). N-terminal brain natriuretic peptide (NT-proBNP), cardiac troponin-I (cTnI), and point-of-care ultrasound (POCUS) may differentiate between cNHA and ncNHA. HYPOTHESIS/OBJECTIVES: We compared NT-proBNP and cTnI concentrations as well as POCUS findings in dogs presented with cNHA and ncNHA. ANIMALS: Dogs (n = 60) were enrolled based on identification of NHA with an effusion packed cell volume < 10%. METHODS: Blood samples were collected and POCUS was performed on all dogs. Dogs were diagnosed with cNHA (n = 28) or ncNHA (n = 32) based on echocardiography. The cNHA group was subdivided into cardiac non-pericardial disease (n = 17) and pericardial disease (n = 11). RESULTS: The NT-proBNP concentration (median; range pmol/L) was significantly higher in the cNHA group (4510; 250-10 000) compared to the ncNHA group (739.5; 250-10 000; P = .01), with a sensitivity of 53.8% and specificity of 85.7% using a cut-off of 4092 pmol/L. The NT-proBNP concentrations were significantly higher in the cardiac non-pericardial disease group (8339; 282-10 000) compared with the pericardial disease group (692.5; 250-4928; P = .002). A significant difference in cTnI concentration (median; range ng/L) between the cNHA group (300; 23-112 612) and ncNHA group (181; 17-37 549) was not detected (P = .41). A significantly higher number of dogs had hepatic venous and caudal vena cava distension in the cNHA group compared to the ncNHA group, respectively (18/28 vs 3/29, P < .0001 and 13/27 vs 2/29, P < .001). Gall bladder wall edema was not significantly different between groups (4/28 vs 3/29, P = .74). CONCLUSIONS AND CLINICAL IMPORTANCE: NT-proBNP concentration and POCUS help distinguish between cNHA and ncNHA.

An inducible system for highly efficient production of recombinant adeno-associated virus (rAAV) vectors in insect Sf9 cells.

Production of clinical-grade gene therapy vectors for human trials remains a major hurdle in advancing cures for a number of otherwise incurable diseases. We describe a system based on a stably transformed insect cell lines harboring helper genes required for vector production. Integrated genes remain silent until the cell is infected with a single baculovirus expression vector (BEV). The induction of expression results from a combination of the amplification of integrated resident genes (up to 1,200 copies per cell) and the enhancement of the expression mediated by the immediate-early trans-regulator 1 (IE-1) encoded by BEV. The integration cassette incorporates an IE-1 binding target sequence from wild-type Autographa californica multiple nuclear polyhedrosis virus, a homologous region 2 (hr2). A feed-forward loop is initiated by one of the induced proteins, Rep78, boosting the amplification of the integrated genes. The system was tested for the coordinated expression of 7 proteins required to package recombinant adeno-associated virus (rAAV)2 and rAAV1. The described arrangement provided high levels of Rep and Cap proteins, thus improving rAAV yield by 10-fold as compared with the previously described baculovirus/rAAV production system.

Computed tomographic assessment of principal bronchial anatomy in dogs of various thoracic conformations: 93 cases (2012-2017).

OBJECTIVE: To better understand spatial relationships between principal bronchi and other intrathoracic structures by use of CT images of dogs of various somatotypes. ANIMALS: 93 dogs that underwent thoracic CT. PROCEDURES: Information was collected from medical records regarding signalment and physical examination and echocardiographic findings. Two investigators recorded multiple measurements on a thoracic axial CT image from each dog. RESULTS: Thoracic height-to-width ratio (H:W) was associated with left principal bronchus (LPB) and right principal bronchus (RPB) H:W, aortic-LPB separation, focal LPB narrowing, and aortic-vertebral overlap. Thoracic H:W was not associated with dog age, weight, sex, or brachycephalic breed. Twenty-five (27%) dogs had focal LPB narrowing, compared with 5 (5%) dogs with focal RPB narrowing (P < 0.001). Ten of 25 dogs had overlap or contact between vertebrae, aorta, LPB, and heart, suggesting a cumulative compressive effect on the LPB, while 15 had LPB-aorta contact and lack of contact between the aorta and thoracic vertebrae, suggesting an aortic constrictive effect on the LPB. None had LPB narrowing without contact from surrounding structures. Inter-rater agreement was high. CLINICAL RELEVANCE: In dogs that underwent CT and were not selected for clinical suspicion of bronchial disease, principal bronchial morphology was associated with thoracic conformation. Focal LPB narrowing occurred more often than RPB narrowing. Focal LPB narrowing occurred with evidence of extraluminal compression, with or without contact between aorta and vertebrae. Brachycephalic breed could not be used for predicting thoracic H:W.

Effect of Nail Grips on Weight Bearing and Limb Function in 30 Dogs 2 Weeks Post Tibial Plateau Leveling Osteotomy.

The objective of this study was to assess the functional outcomes of dogs wearing nail grips in the first 2 weeks following tibial plateau leveling osteotomy (TPLO). Thirty dogs were included (n = 13 nail grips and n = 17 sham grips). Visual lameness scores (VLS), total pressure index (TPI), and client-specific outcome measures (CSOMs) were obtained by blinded observers on day 1 and day 14 +/- 3 post TPLO. CSOMs were also obtained on day 7. There were no differences in VLS and TPI between the treatment and sham group on day 14 (p = 0.44 and p = 0.59, respectively) or at any time point. CSOMs assessing walking on slippery flooring, ability to rise, and consistent use of surgical limb on a 5 min walk were also not different between groups (p = 0.78, p = 0.80, and p = 0.63) at any time point. Nail grips were well tolerated in dogs after orthopedic surgery. This study did not demonstrate a benefit for dogs wearing nail grips during the first two weeks after TPLO; however, further studies are warranted.

Pharmacokinetic study comparing doxorubicin concentrations after chemoembolization or intravenous administration in dogs with naturally occurring nonresectable hepatic carcinoma.

BACKGROUND: Chemoembolization is a viable treatment option for patients with nonresectable hepatic carcinoma (HC) and may allow delivery of chemotherapeutic drugs with decreased systemic toxicity. HYPOTHESIS/OBJECTIVE: Compare the serum concentrations of doxorubicin after chemoembolization or IV administration in the same patient. We hypothesized that locoregional delivery may result in increased tumor chemotherapeutic drug concentrations, reflected by decreased measurable serum drug concentrations. Adverse hematological events were hypothesized to be decreased after locoregional delivery. ANIMALS: Seventeen client-owned dogs with incompletely resectable HC. METHODS: Prospective, single-arm clinical trial. Drug-eluting bead transarterial chemoembolization was performed to varying levels of blood flow stasis (NO STASIS, STASIS). Intravenous doxorubicin (IVC) subsequently was administered in selected patients. Systemic exposure was quantified by area under the serum doxorubicin concentration time curve (AUC), maximum serum doxorubicin concentration (Cmax ), and time doxorubicin was last above the limit of quantitation (Tlast ). Nadir test results after treatments were used to evaluate adverse hematological events. RESULTS: Thirteen NO STASIS treatments, 15 STASIS treatments, and 9 IVC treatments were performed. Maximum serum doxorubicin concentration, AUC, and Tlast were significantly lower when comparing NO STASIS or STASIS to IVC treatments. Of the patients with nadir results available, no adverse hematological events were observed after NO STASIS or STASIS treatments. Two patients developed adverse hematological events after IVC treatment. CONCLUSIONS/CLINICAL RELEVANCE: Drug-eluting bead transarterial chemoembolization offers a viable treatment option for patients with incompletely resectable HC with the potential for increased local tumor doxorubicin concentrations, decreased systemic chemotherapeutic exposure, and fewer adverse hematological events.

Evaluation of preoperative ultrasonographic parameters to predict renal recovery in long-term survivors after treatment of feline ureteral obstructions: 2012-2019.

OBJECTIVES: The aim of this study was to determine whether preoperative ultrasound imaging characteristic(s) in cats suffering from unilateral benign ureteral obstructions are predictive of outcome after successful renal decompression with a subcutaneous ureteral bypass (SUB) device. METHODS: This was a retrospective study of 37 cats with unilateral, benign ureteral obstruction. Preoperative imaging characteristics (including renal pelvis diameter, parenchymal thickness [transverse plane], renal length and pelvic size:overall renal size) and biochemical data were evaluated for all cats diagnosed with a unilateral ureteral obstruction treated with a SUB device. Any patient with bilateral obstructions or documented bacteriuria/infection in the data collection period was excluded. All patients were followed between 3 and 6 months postoperatively to obtain postoperative biochemical data. Long-term outcome was defined as serum creatinine concentration at 3-6 months postoperatively. RESULTS: No preoperative imaging characteristics or biochemical findings were found to be significantly associated with long-term serum creatinine concentrations. The length of the kidney was found to be associated with change in blood urea nitrogen and creatinine with decompression but not with long-term renal values. CONCLUSIONS AND RELEVANCE: In this study, long-term renal function based on preoperative ultrasound imaging findings could not be predicted in cats with unilateral ureteral obstruction, regardless of the severity of the biochemical parameters, renal pelvic dilation (large or small pelvis), kidney size or thickness of renal parenchyma assessed.

In a Randomized, Placebo-Controlled Cross-Over Study, Administration of 6 and 12 G Fortetropin® Does Not Reduce Serum Myostatin in Healthy Adult Dogs Over 72-Hours.

Objective: To evaluate the effect of a single administration of 6 and 12 g of Fortetropin compared to placebo on serum myostatin in healthy, adult dogs over a 72-h period. Methods: Prospective, placebo-controlled, randomized, double-blind, crossover study. Ten hospital-employee-owned healthy adult dogs aged 2 to 8 years old were enrolled in the study. Blood samples were collected prior to and then 12-, 24-, 36-, 48-, and 72-h following administration of the test agent (6 and 12 g) or placebo. Serum samples were processed according to manufacturer's guidelines for canine serum using GDF-8/Myostatin Quantikine ELISA kit (R&D Systems). Analysis-of-variance (ANOVA) analyses were carried out where P < 0.05 was deemed significant. Results: Mean serum myostatin was not significantly lower in treatment groups of either low or high dose compared to placebo at any time point. Baseline mean serum myostatin in low and high dose treatment groups was 29,481 (SD = 5,224) and 32,214 pg/mL (SD = 7,353), respectively. Placebo group low and high dose baseline mean serum myostatin was 30,247 (SD = 5,875) and 28,512 (SD = 5,028). Conclusion: The results of this study indicate that administration of single 6 or 12 g dose of Fortetropin does not reduce serum myostatin in healthy adult dogs over a 72-h period. Clinical Importance: Oral supplements, like Fortetropin, require further studies to determine the efficacy and bioavailability in order to guide clinical use in dogs.

Serum haptoglobin concentrations in feline inflammatory bowel disease and small-cell alimentary lymphoma: a potential biomarker for feline chronic enteropathies.

OBJECTIVES: The aim of this study was to evaluate serum haptoglobin as a biomarker to differentiate between small-cell alimentary lymphoma and inflammatory bowel disease in cats. METHODS: Client-owned domestic cats with and without chronic gastrointestinal signs were enrolled in the study. Serum was collected from each patient and serum haptoglobin levels were measured using ELISA. In cats with gastrointestinal signs, histopathologic evaluation of endoscopic biopsies harvested from the intestinal tract was used to separate them into inflammatory bowel disease and small-cell lymphoma cohorts. Serum haptoglobin levels were statistically analyzed and compared among the three groups: healthy cats; cats with inflammatory bowel disease; and cats with small-cell alimentary lymphoma. RESULTS: Sixty-two cats were enrolled in the study, including 20 clinically normal cats, 14 cats with small-cell alimentary lymphoma and 28 cats with inflammatory bowel disease. The mean ± SD serum haptoglobin was 73.2 ± 39.1 mg/dl in normal cats, 115.3 ± 72.8 mg/dl in cats with inflammatory bowel disease and 133.1 ± 86.1 mg/dl in cats with small-cell alimentary lymphoma. Cats with inflammatory bowel disease and lymphoma had significantly higher serum haptoglobin than controls, with P values of 0.0382 and 0.0138, respectively. There was no statistical difference between the inflammatory bowel disease and lymphoma cohorts (P = 0.4235). For every one unit increase in serum haptoglobin, the odds of gastrointestinal inflammatory disease (inflammatory bowel disease or small-cell alimentary lymphoma) increased by 1.41% (P = 0.0165). CONCLUSIONS AND RELEVANCE: Serum haptoglobin is a useful biomarker for distinguishing between normal cats and those with gastrointestinal inflammatory disease, but it could not significantly differentiate between inflammatory bowel disease and lymphoma. Additional studies may be beneficial in determining the prognostic significance of serum haptoglobin as it may relate to the severity of gastrointestinal inflammation.

Incidence and treatment of feline renal lymphoma: 27 cases.

OBJECTIVES: Lymphoma is the most common feline hematopoietic malignancy. Incidence of renal lymphoma has not been reported as a subset of a large population of feline lymphoma cases. Previous studies have reported renal lymphoma as both a singular entity as well as a component of multicentric disease. The clinical presentation, diagnostic evaluation, therapy and outcomes related to renal lymphoma have not been reported since Mooney et al in 1987. This retrospective study aimed to describe the incidence of renal lymphoma, clinical signs, treatment and survival. METHODS: Using a database of cats diagnosed with lymphoma between January 2008 and October 2017, cats with renal lymphoma were selected for further analysis. Cases were retrospectively staged according to Mooney et al (1987) and Gabor et al (1998). Data collected included age, clinical signs, clinicopathologic data, diagnostic imaging findings, lymphoma diagnostic method(s), treatment protocol(s) and survival time. Analyses comparing median survival based on therapy administered, renal lymphoma vs multicentric lymphoma, central nervous system involvement, presence of azotemia, anemia and International Renal Interest Society (IRIS) stage at diagnosis were performed. RESULTS: From a population of 740 cats with lymphoma, 27 cats had renal lymphoma (incidence, 3.6%), and 14 of those cats had multicentric lymphoma. Fewer stage IV and V cases were identified in this data set compared with Mooney et al; however, not all cats were completely staged. Median survival (range) for cats receiving corticosteroids alone compared with those receiving an L-CHOP (L-asparaginase, vincristine, cyclophosphamide, doxorubicin, prednisolone)-based protocol was 50 days (20-1027 days) in the corticosteroid group and 203 days (44-2364 days) for the L-CHOP group (P = 0.753) for cats that died secondary to lymphoma. CONCLUSIONS AND RELEVANCE: Neither clinical stage nor other factors were predictive of survival. Prospective studies are required to determine the optimal chemotherapy protocol.

Retrospective study of proliferative urethritis in dogs: Clinical presentation and outcome using various treatment modalities in 11 dogs.

BACKGROUND: Proliferative urethritis (PU) is an uncommon inflammatory and infiltrative disease of the urethra in female dogs, often associated with urinary tract infection (UTI). It typically presents with evidence of urethral obstruction (UO). OBJECTIVES: Identify clinical features in dogs with PU and determine outcome after different treatment modalities. ANIMALS: Eleven client-owned dogs. METHODS: Medical records of dogs with histopathologic diagnosis of PU from 2011 to 2020 were retrospectively evaluated, including information on clinical pathology, imaging, and histopathology. Outcomes of various treatment modalities were recorded and compared. Long-term urethral patency (>6 months) was considered treatment success. RESULTS: All dogs were female and presented with UO. Eight (73%) had a history of UTI. Ten of 11 survived to discharge and were used for long-term data collection. Seven of 10 (70%) were treated using an effacement procedure (balloon dilatation [BD], stent, or both) and 6/7 (86%) achieved long-term urethral patency (>6 months). Seven of 10 had UO recurrence after their first procedure, including 3/3 (100%) that did not have effacement and 4/7 that did (57%), at a median of 101 days and 687 days, respectively. After effacement, the duration of patency was longer for those treated using a stent than BD alone (median, 843 days and 452 days, respectively). CONCLUSIONS AND CLINICAL IMPORTANCE: Proliferative urethritis is a recurrent disease often associated with UTI. The best outcome of long-term urethral patency occurred after lesion effacement, either by BD or stenting. Future prospective studies should determine the impact of immunosuppressive treatment.

The Stryker Regenkit PRP Kit Does Not Concentrate Canine Platelets.

Platelet Rich Plasma (PRP) works to recruit growth factors, anti-inflammatory mediators, and blood supply to an area that may not heal well under normal conditions (e.g., joints, tendons, ligaments). Previous research has demonstrated that various PRP systems create vastly different final products. The objective of this study was to evaluate the cellular composition of the final plasma product using the Stryker RegenKit system in dogs. A peripheral blood sample was obtained from ten healthy adult dogs and compared to the final plasma product. A standard CBC was performed prior to testing and an additional sample was processed according the manufacturing guidelines for obtaining PRP (10 ml total blood). Comparisons of mean platelet count, erythrocyte count, and leukocyte count were made between the peripheral blood sample and the final plasma product. Results showed that there was no significant difference in platelet count between the peripheral blood CBC and final PRP CBC (p = 0.349). There were significantly fewer erythrocytes and leukocytes in the final plasma product when compared with peripheral blood (p = < 0.0001, p = 0.0318, respectively). These results indicate that the Stryker Regenkit PRP Kit decreases leukocyte and erythrocyte concentrations but does not consistently change platelet concentrations in its final plasma product. This study, in combination with results from similar studies, may allow clinicians to better choose the appropriate PRP system to treat various musculoskeletal conditions in dogs.

The Incidence of Radiographic Lesions of Endodontic Origin Associated With Uncomplicated Crown Fractures of the Maxillary Fourth Premolar in Canine Patients.

Fractured maxillary fourth premolar teeth are commonly diagnosed in canine patients. These fractures are subdivided into uncomplicated and complicated, depending on absence or presence of pulp exposure, respectively. Pulp injury associated with fractures can lead to pulpitis, pulp necrosis, and "lesions of endodontic origin" (LEO) on intraoral radiographs. The incidence of LEO associated with uncomplicated crown fractures (UCFs) of the maxillary fourth premolar in canine patients is currently unknown. We hypothesized that a significant number of UCFs of the maxillary fourth premolar would have LEO evident on intraoral radiographs. The purpose of this article was to identify this incidence and to illustrate the importance of radiographing these teeth. This was a retrospective study of 111 UCFs and 500 nonfractured (control) maxillary fourth premolars in domestic canine patients. The frequency of LEO was 24.3% (27/111) in the UCF population and 0% (0/500) in the control population (P < .0001). These findings are important because UCFs are sometimes ignored or considered insignificant, when in fact a large proportion of them have LEO, indicating periapical pathology. These results suggest that all UCFs be radiographed, even if there are no other abnormalities noted on clinical oral examination.

Comparison of closed root planing with versus without concurrent doxycycline hyclate or clindamycin hydrochloride gel application for the treatment of periodontal disease in dogs.

OBJECTIVE To compare improvements in values for periodontal disease indices in dogs following treatment with closed root planing (CRP) alone, CRP with concurrent 8.5% doxycycline hyclate gel application, and CRP with concurrent 2% clindamycin hydrochloride reverse-polymer hydrogel application. DESIGN Randomized, blinded, controlled clinical trial. ANIMALS 34 client-owned dogs with periodontal pockets measuring 3.5 to 5.5 mm deep. PROCEDURES Dogs were randomly assigned to receive 1 of 3 treatments: CRP alone (n = 10) or CRP plus 8.5% doxycycline hyclate (12) or 2% clindamycin hydrochloride (12) gel applied within the periodontal pockets. Indices of periodontal disease severity were recorded before and 12 weeks after treatment, and outcomes were compared among treatment groups. RESULTS Except for gingivitis index, no significant differences were identified among the 3 treatment groups in the amount of improvement observed in values for periodontal disease indices following treatment. A minor but clinically unimportant improvement in mean gingivitis index values was identified for dogs treated with CRP plus doxycycline gel, which differed significantly from improvements in the other 2 groups. Teeth that were initially more severely affected (pocket depths, 5.0 to 5.5 mm) had the greatest amount of improvement, whereas teeth with only mildly high initial pocket depths (3.5 to 4.0 mm) had less improvement. CONCLUSIONS AND CLINICAL RELEVANCE Overall, addition of doxycycline or clindamycin gel application to CRP for the treatment of periodontal disease in dogs yielded no clinically relevant benefit over CRP during the 12-week follow-up period.

Correlations among tracheal dimensions, tracheal stent dimensions, and major complications after endoluminal stenting of tracheal collapse syndrome in dogs.

BACKGROUND: Endoluminal tracheal stenting can relieve signs associated with tracheal collapse syndrome (TCS) in dogs, but major complications can result. OBJECTIVE: To identify associations among tracheal dimensions, stent dimensions, and subsequent complications requiring additional stent placement after endoluminal stenting for TCS. ANIMALS: Fifty-two dogs from the hospital population. METHODS: Medical records of dogs that received an endoluminal self-expanding tracheal stent for TCS by the interventional radiology service between 2009 and 2014 were reviewed for relevant data. Signalment and clinical details, including tracheal collapse type, tracheal measurements, nominal stent dimensions, follow-up evaluation times, and stent complications, were recorded. RESULTS: Fifty-two dogs that received an endoluminal stent for TCS met the inclusion criteria. Major complications included stent fracture (13/52; 25%), obstructive tissue ingrowth (10/52; 19%), and progressive tracheal collapse (6/52; 12%). Natural tracheal taper (P = .04) and more stent diameter oversizing (P = .04) in the intrathoracic (IT) trachea were associated with caudodorsal stent fracture. Only stents with a 14-mm nominal diameter fractured. Progressive tracheal collapse was associated with smaller maximum tracheal diameters (P = .02). The majority of dogs with obstructive tissue ingrowth (7/10; 70%; P = .30) and all dogs with thoracic inlet fractures (3/3; 100%) had tracheal malformations. CONCLUSIONS AND CLINICAL IMPORTANCE: A higher taper in tracheal diameter may lead to increased risk of fracture in the IT location. Dogs with tracheal malformations may have higher risk for thoracic inlet fracture and development of obstructive tissue ingrowth. Clinicians should be aware of the possible risk factors for tracheal stent complications.