Bilateral lung lobe torsions in a cat.

A 13-year-old spayed female domestic longhair cat was presented for tachypnea and was identified to have reduced lung sounds over the left hemithorax. Thoracic ultrasound examination and computed tomography identified changes consistent with bilateral lung lobe torsion. A median sternotomy confirmed torsion of both the cranial portion of the left cranial lung lobe and the right middle lung lobe. The affected lobes were resected. Pleural fluid analysis was indicative of a modified transudate and histopathology was consistent with a subacute to chronic torsion with no evidence of neoplasia or infection. The patient recovered without complication. Lung lobe torsion is an uncommon presentation across all species and is especially rare in cats. To the authors' knowledge, bilateral lung lobe torsion has not been previously reported in small animals.

Torsions bilatérales de lobes pulmonaires chez un chat. Une chatte domestique à poils longs âgées de 13 ans fut présentée pour tachypnée et on identifia une diminution des bruits respiratoires du côté de l'hémithorax gauche. Une échographie thoracique et un examen par tomodensitométrie (CT) identifièrent des changements compatibles avec une torsion bilatérale de lobes pulmonaires. Une sternotomie médiane confirma la torsion des portions crâniales du lobe pulmonaire crânial gauche et du lobe pulmonaire moyen droit. Les lobes affectés furent excisés. L'analyse du liquide pleural était indicatrice d'un transsudat modifié et l'histopathologie était compatible avec une torsion subaigüe à chronique sans évidence de néoplasie ou d'infection. La chatte récupéra sans complication. La torsion des lobes pulmonaires est une présentation peu commune chez toutes les espèces et est spécialement rare chez les chats. Selon les auteurs, une torsion bilatérale des lobes pulmonaires n'a pas encore été rapportée chez les petits animaux.(Traduit par Dr Serge Messier).

Markers of tissue perfusion and their relation to mortality in dogs with blunt trauma.

OBJECTIVE: To evaluate admission Animal Trauma Triage (ATT) score, shock index (SI), and markers of perfusion, including base excess (BE), plasma lactate, and lactate clearance in dogs with blunt trauma. DESIGN: Prospective observational clinical study from 2013 to 2015. SETTING: Private veterinary referral and emergency center. ANIMALS: Forty-four client-owned dogs hospitalized following blunt trauma. INTERVENTION: Within 1 hour of presentation and prior to fluid administration an initial hematocrit, total plasma protein, blood glucose, plasma lactate, blood gas, and electrolytes were obtained for analysis. Plasma lactate concentrations were also measured 4 and 8 hours following initial measurement, and a 4-hour lactate clearance was calculated if patients had an increased admission plasma lactate. ATT score and SI were calculated for each patient based on admission data. Outcome was defined as survival to hospital discharge. MEASUREMENTS AND MAIN RESULTS: Twenty-nine dogs survived, 14 were euthanized, and 1 died. Nonsurviving dogs had a lower mean pH (7.28 ± 0.03 vs 7.36 ± 0.01, P = 0.006), lower median HCO3 (15.7 vs 18.8 mmol/L, P = 0.004), lower median admission BE (-11.0 vs -7.0 mmol/L, P = 0.004), and higher median admission lactate (3.1 vs 2.4 mmol/L, P = 0.036) than those who survived. Median ATT was significantly higher in nonsurvivors (5 vsF 2, P < 0.001). The SI was not significantly different between survivors and nonsurvivors (P = 0.41). There was no difference in median 4-hour lactate (P = 0.34), median 8-hour lactate (P = 0.19), or 4-hour lactate clearance (P = 0.83) in survivors compared to nonsurvivors. No other statistically significant differences were noted between groups. CONCLUSION: Dogs hospitalized following blunt trauma with a lower admission pH, HCO3 , and BE and a higher admission plasma lactate were less likely to survive to hospital discharge. Median ATT score was also significantly higher in nonsurvivors. Although lactate clearance was not predictive of survival, the sample size was small, and additional studies with a larger study population are warranted.

The effect of fasting on gastrointestinal motility in healthy dogs as assessed by sonography.

OBJECTIVE: To evaluate the effect of fasting on gastrointestinal (GI) motility in healthy dogs, as detected by 2D ultrasound. DESIGN: Prospective observational study. SETTING: University Distributed Veterinary Learning Community. ANIMALS: Ten healthy client-owned dogs. INTERVENTIONS: Dogs were fasted 24 hours following regular feeding. After this first feeding and during the 24 hour fasting period, 2D ultrasound was performed to detect sonographically visible GI contractions of the stomach, duodenum, and jejunum/ileum at T = 30 minutes, 6 hours, 12 hours, and 24 hours. Dogs were then fed a second meal after the 24-hour fast and ultrasound was repeated 30 minutes later (T = 24.5 h). Each site was scanned twice at each time point. Each scan lasted 3 minutes. The results were averaged and then divided by 3 to determine contractions per minute. One-way repeated measures ANOVA with post hoc Tukey's comparison test was used to detect statistical differences over time for each site examined. MEASUREMENTS AND MAIN RESULTS: The mean GI contraction rates in the stomach, duodenum, and jejunum/ileum at T12 and T24 were significantly lower than the GI contraction rates at T30, T3, T6, and T24.5 (P < 0.05). The mean GI contraction rates in the stomach, duodenum, and jejunum/ileum at T30, T3, T6, and T24.5 were not statistically different from each other. CONCLUSIONS: Results of this study show that 2D sonography can be used to evaluate GI motility in dogs and that GI contraction rate decreases significantly in the stomach, duodenum, and jejunum/ileum after 12-24 hours of fasting.

A clinical review of the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats.

OBJECTIVE: To review the current literature in reference to the pathophysiology, diagnosis, and treatment of pyothorax in dogs and cats. ETIOLOGY: Pyothorax, also known as thoracic empyema, is characterized by the accumulation of septic purulent fluid within the pleural space. While the actual route of pleural infection often remains unknown, the oral cavity and upper respiratory tract appear to be the most common source of microorganisms causing pyothorax in dogs and cats. In human medicine, pyothorax is a common clinical entity associated with bacterial pneumonia and progressive parapneumonic effusion. DIAGNOSIS: Thoracic imaging can be used to support a diagnosis of pleural effusion, but cytologic examination or bacterial culture of pleural fluid are necessary for a definitive diagnosis of pyothorax. THERAPY: The approach to treatment for pyothorax varies greatly in both human and veterinary medicine and remains controversial. Treatment of pyothorax has classically been divided into medical or surgical therapy and may include administration of antimicrobials, intermittent or continuous thoracic drainage, thoracic lavage, intrapleural fibrinolytic therapy, video-assisted thoracic surgery, and traditional thoracostomy. Despite all of the available options, the optimal treatment to ensure successful short- and long-term outcome, including the avoidance of recurrence, remains unknown. PROGNOSIS: The prognosis for canine and feline pyothorax is variable but can be good with appropriate treatment. A review of the current veterinary literature revealed an overall reported survival rate of 83% in dogs and 62% in cats. As the clinical presentation of pyothorax in small animals is often delayed and nonspecific, rapid diagnosis and treatment are required to ensure successful outcome.

Admission base excess as a predictor of transfusion requirement and mortality in dogs with blunt trauma: 52 cases (2007-2009).

OBJECTIVE: To evaluate the ability of admission base excess (ABE) to predict blood transfusion requirement and mortality in dogs following blunt trauma. DESIGN: Retrospective study 2007-2009. SETTING: University Veterinary Teaching Hospital. ANIMALS: Fifty-two dogs admitted to the intensive care unit for treatment following blunt trauma. MEASUREMENTS AND MAIN RESULTS: Animals requiring red blood cell transfusion (N = 8) had significantly lower ABE than those not requiring transfusion (N = 44; median base excess [BE] = -8.4 versus -4.7, P = .0034), while there was no difference in admission packed cell volume (PCV) or age. Animals that died or were euthanized due to progression of signs (N = 5) had lower median ABE than those that survived (N = 47; median BE = -7.3 versus -4.9, P = 0.018). Admission PCV and age were not significantly different between survivors and nonsurvivors. Receiver operator characteristic curve analysis showed an ABE cutoff of -6.6 was 88% sensitive and 73% specific for transfusion requirement (P < 0.001), and a cutoff of -7.3 was 81% sensitive and 80% specific for survival (P < 0.001). Multivariate logistic regression analysis demonstrated that ABE was a predictor of transfusion requirement that was independent of overall severity of injury as measured by the Animal Triage Trauma (ATT) score, but a similar analysis showed that only ATT was an independent predictor of survival. CONCLUSIONS: The ABE in dogs with blunt trauma was a predictor of mortality and blood transfusion requirement within 24 hours.

Renal secondary hyperparathyroidism in dogs.

The parathyroid glands secrete parathyroid hormone (PTH), which is important for maintaining calcium homeostasis. Parathyroid gland hyperplasia and subsequent hyperparathyroidism can occur secondary to chronic renal failure in dogs, resulting in significant alterations in calcium metabolism. Renal secondary hyperparathyroidism is a complex, multifactorial syndrome that involves changes in circulating levels of calcium, PTH, phosphorus, and 1,25-dihydroxycholecalciferol (calcitriol). An increased PTH level can have deleterious effects, including soft tissue mineralization, fibrous osteodystrophy, bone marrow suppression, urolithiasis, and neuropathy. Dietary phosphorus restriction, intestinal phosphate binders, and calcitriol supplementation may slow the progression of renal disease and decrease PTH concentrations in animals with secondary hyperparathyroidism; however, the prognosis for these animals is guarded to poor.