GATA2 deficiency and haematopoietic stem cell transplantation: challenges for the clinical practitioner.

GATA2 deficiency, first described in 2011, is a bone marrow failure disorder resulting in a complex haematological and immunodeficiency syndrome characterised by cytopenias, severe infections, myelodysplasia and leukaemia. The only curative treatment is allogeneic haematopoietic stem cell transplantation (HSCT). Although knowledge on this syndrome has greatly expanded, in clinical practice many challenges remain. In particular, guidelines on optimal donor and stem cell source and conditioning regimens regarding HSCT are lacking. Additionally, genetic analysis of GATA2 is technically cumbersome and could easily result in false-negative results. With this report, we wish to raise awareness of these pitfalls amongst physicians dealing with haematological malignancies and primary immunodeficiencies.

Evaluation of Surgical Technique and Clinical Results of a Procedure-Specific Fixation Method for Tibial Tuberosity Transposition in Dogs: 37 Cases.

OBJECTIVE: The aim of this study was to describe the use of a procedure-specific fixation method for tibial tuberosity transposition and report clinical outcome. STUDY DESIGN: This is a multi-institutional case series, evaluating 37 cases that were treated surgically for medial patellar luxation (MPL) and in which the tibial tuberosity transposition (TTT) was performed using the Rapid Luxation Plating System (RLPS). Surgical technique, implants, clinical outcome, and complications are reported. RESULTS: Surgery was successfully performed in dogs weighing 2.5 to 36.2 kg. Postoperative minor complications occurred in 13 cases (35%) and major complications occurred in 3 cases (8%). No implant-related complications or tibial tuberosity avulsions or fractures were seen. Outcome related to surgery was good or excellent in all cases. CONCLUSION: The RLPS for TTT provides a feasible technique in a large range of patients with MPL and lowers the occurrence of implant-related complications and tibial tuberosity avulsion or fracture.

A Cross-Sectional Study on Canine and Feline Anal Sac Disease.

Limited data are available on canine and feline non-neoplastic anal sac disease. Therefore, the aim of this study was to obtain observational data on the incidence, predisposing factors, diagnosis, treatment, and recurrence rate of canine and feline anal sac disease. To this end, a questionnaire was distributed among veterinarians. The incidence of non-neoplastic anal sac disease was estimated at 15.7% in dogs and 0.4% in cats. Predisposing factors were diarrhea, skin problems, several dog breeds, and particularly small breed dogs, male cats, British shorthairs, and obesity in dogs. Diagnosis was made based on the presence of clinical signs and characteristics of the anal sac content. Manual expression and treating any potential underlying disease were the most important treatments for all three types of non-neoplastic anal sac disease. Anal sacculectomy was performed in refractory cases. The most recurrent anal sac disease condition was impaction. Diagnosis of anal sac disease should be based on clinical signs and rectal examination, as the evaluation of the anal sac content is not reliable. Surgical outcomes of anal sacculectomy can be improved when surgery is performed after medical management. Future studies should investigate these findings in prospective trials.

Prospective Evaluation of Local Sustained Release of Celecoxib in Dogs with Low Back Pain.

Back pain affects millions globally and in 40% of the cases is attributed to intervertebral disc degeneration. Oral analgesics are associated with adverse systemic side-effects and insufficient pain relief. Local drug delivery mitigates systemic effects and accomplishes higher local dosing. Clinical efficacy of intradiscally injected celecoxib (CXB)-loaded polyesteramide microspheres (PEAMs) was studied in a randomized prospective double-blinded placebo controlled veterinary study. Client-owned dog patients suffering from back pain were treated with CXB-loaded (n = 20) or unloaded PEAMs ("placebo") (n = 10) and evaluated by clinical examination, gait analysis, owners' questionnaires, and MRI at 6 and 12 weeks follow-up. At 6 and 12 weeks, CXB-treated dogs experienced significantly less pain interference with their daily life activities compared to placebo. The risk ratio for treatment success was 1.90 (95% C.I. 1.24-2.91, p = 0.023) at week 6 and 1.95 (95% C.I. 1.10-3.45, p = 0.036) at week 12. The beneficial effects of CXB-PEAMs were more pronounced for the subpopulation of male dogs and those with no Modic changes in MRI at inclusion in the study; disc protrusion did not affect the outcome. It remains to be determined whether intradiscal injection of CXB-PEAMs, in addition to analgesic properties, has the ability to halt the degenerative process in the long term or restore the disc.

Ununited accessory caudal glenoid ossification centre and associated joint mouse as a cause of lameness in a cat.

CASE SUMMARY: A 16-year-old neutered female domestic shorthair cat was evaluated for chronic lameness of the right thoracic limb. On clinical examination, pain was localised to the right glenohumeral joint. Radiography and arthrography of the right glenohumeral joint revealed an ununited accessory caudal glenoid ossification centre, abbreviated here to ununited caudal glenoid (UCG), and a joint mouse. The UCG and attached joint mouse were removed via arthroscopy and this resulted in complete resolution of the clinical signs. The cat was euthanased 3 years later, for an unrelated cause, having shown no recurrence of lameness. RELEVANCE AND NOVEL INFORMATION: UCG should be considered as a differential diagnosis for cats with lameness of the thoracic limb. The clinical implications of a UCG have been described in dogs, but to our knowledge have not yet been described in cats. Excision of the UCG, as described in dogs, may be an effective treatment for this condition.

Dogs as vectors of Streptobacillus moniliformis infection?

Rat bite fever is a bacterial zoonosis transmitted through the bite of rats. One of the two etiological agents that cause rat bite fever is Streptobacillus moniliformis. Rat bite fever is rare and very likely under diagnosed but occurs worldwide. Other animals, like dogs and cats that have mouthed a rat are often mentioned in the literature as potential risks for the attraction of rat bite fever. However, rat bite fever caused by the bite of a dog or cat has very seldom been documented. Therefore, to identify the possible risk for humans to become infected with S. moniliformis after having been bitten by a dog that has been in contact with rats, the presence of S. moniliformis in the mouth of these dogs was tested with molecular methods. Swabs taken from the mouth of 18 dogs with proven contacts with rats were tested for the presence of S. moniliformis DNA by PCR. An amplicon of the right size was obtained in 10 of the 18 dogs. Nucleotide sequencing of five amplicons of PCR positive samples demonstrated the presence of S. moniliformis DNA in the mouth of three dogs. A bite by these dogs therefore might infect humans with S. moniliformis and cause rat bite disease.