EFFECTS OF DOXYCYCLINE HYCLATE, ONE PERCENT POLIDOCANOL, AND ABSOLUTE ETHANOL ON THE CUTANEOUS AND SUBCUTANEOUS TISSUES OF CHICKENS (GALLUS GALLUS DOMESTICUS) AND THE POTENTIAL IMPLICATIONS IN TREATING CERVICOCEPHALIC DIVERTICULA RUPTURE.

The objective of this pilot study was to examine the histologic effects associated with three known sclerosing agents and their ability to induce fibrosis in the subcutaneous space between the cervicocephalic air sac and skin. In the future, these drugs may prove useful in treating birds experiencing cervicocephalic diverticula rupture. The agents used were 1% polidocanol, absolute ethanol, and doxycycline hyclate. Twelve healthy adult chickens (Gallus gallus domesticus) were used in this study. The chickens were randomly allocated into three groups denoting day of euthanasia (day 4, 7, or 14). On day 0, all agents were injected (0.2 ml) subcutaneously, in a four-point grid fashion, in both the cervical and pectoral region of each bird. After euthanasia, the skin and subcutaneous tissues corresponding to the injection sites were harvested for histologic assessment. Tissue sections were assessed for fibrosis and lymphocytic and histiocytic inflammation. A scoring system was established to rank sclerosing agents by fibrosing and inflammatory ability. In the cervical region of chickens, 1% polidocanol induced the greatest inflammatory changes by day 7. Data suggest that doxycycline hyclate may produce the greatest cutaneous and subcutaneous fibrosis overall among all groups of birds. No adverse reactions were associated with any injection. Sterile saline produced the least amount of inflammation when assessed with the scoring system. Further investigation is needed to determine the safety of injections of larger volume with these chemicals and whether these findings can be extrapolated to birds with disease.

Validation of the oscillometric blood pressure monitor Vet20 SunTech in anesthetized healthy cats.

OBJECTIVE: To evaluate a veterinary-specific oscillometric noninvasive blood pressure (NIBP) system according to the guidelines of the American College of Veterinary Internal Medicine (ACVIM) Consensus Statement. STUDY DESIGN: Prospective clinical study. ANIMALS: A total of 33 client-owned cats (20 females and 13 males). METHODS: Cats were premedicated with methadone (0.3 mg kg-1) and alfaxalone (2 mg kg-1) intramuscularly. After 15 minutes anesthesia was induced with isoflurane (3%) in 100% oxygen by facemask while breathing spontaneously. A 22 gauge catheter was placed in the median caudal artery and systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures were measured. NIBP measurements were collected by placing the cuff (40% of limb circumference) on the right or left antebrachium. The agreement between the two methods was evaluated with the Bland-Altman methods, and the oscillometric NIBP device was evaluated using the ACVIM guidelines for validation of devices. RESULTS: Data from 30 of the 33 cats were analyzed. Five paired measurements were taken from each cat, totaling 150 paired measurements. Mean bias (limits of agreements) for SAP, DAP and MAP were 2.7 (-22.7 to 28.1), 0.9 (-22.3 to 24.2) and 1.3 (-20.4 to 23.0). The oscillometric NIBP passed all validation criteria, except correlation which was <0.9 for SAP, DAP and MAP. CONCLUSIONS AND CLINICAL RELEVANCE: The Vet20 did not meet all validation criteria by the ACVIM. However, all criteria except correlation were met.

Validation of noninvasive blood pressure equipment: which peripheral artery is best for comparison studies in dogs?

OBJECTIVES: 1) To determine which peripheral artery commonly used for invasive arterial blood pressure (IBP) monitoring yields the least bias when compared with noninvasive blood pressure (NIBP) values obtained at the antebrachium of the dog, and 2) to identify and describe differences in systolic (SAP), mean (MAP) and diastolic arterial pressures (DAP) among different anatomical locations. STUDY DESIGN: Prospective experimental study. ANIMALS: Twenty adult hound dogs weighing 24.5 ± 1.1 kg (mean ± standard deviation). METHODS: Four peripheral arteries-dorsal pedal, median caudal, intermediate auricular and superficial palmar arteries-were catheterized with 20 gauge, 3.8 cm catheters. One NIBP cuff was placed in the middle third of the antebrachium. Four sets of IBP and NIBP measurements were simultaneously collected every 2 minutes. A linear mixed model was performed to analyze the collected data. RESULTS: IBP values varied depending on the arterial catheterization site. The difference was greater for SAP. NIBP measured at the antebrachium had the best agreement with IBP measured at the median caudal artery. CONCLUSION AND CLINICAL RELEVANCE: IBP varies among anatomical locations. The smallest bias and narrowest limits of agreement were obtained at the median caudal artery, providing the best overall agreement with the equipment studied. The median caudal artery may be the preferable anatomical location for clinical comparison studies between IBP and NIBP in dogs when the cuff is on the antebrachium.

Agreement between two oscillometric blood pressure technologies and invasively measured arterial pressure in the dog.

OBJECTIVES: To compare two commonly used oscillometric technologies for obtaining noninvasive blood pressure (NIBP) measurements and to determine if there is a difference in agreement between these systems and invasive blood pressure (IBP) measurements. STUDY DESIGN: Prospective, experimental study. ANIMALS: Twenty adult laboratory dogs. METHODS: Each dog was anesthetized and its median caudal artery catheterized for IBP monitoring. An NIBP cuff was placed in the middle third of the antebrachium and attached to either monitor-1 or monitor-2. Four pairs of concurrent NIBP and IBP measurements were recorded with each monitor. Agreement between IBP and NIBP measurements was explored using Bland-Altman analysis, as well as the American College of Veterinary Internal Medicine (ACVIM) and Association for the Advancement of Medical Instrumentation (AAMI) guidelines for the validation of NIBP devices. RESULTS: Both NIBP technologies produced results that met the ACVIM and AAMI guidelines for the validation of NIBP devices. For monitor-1, analyses of agreement showed biases of 0.2 mmHg [95% limits of agreement (LoA) -11.8 to 12.3 mmHg] in systolic arterial pressure (SAP) values, -2.6 mmHg (95% LoA -14.4 to 9.1 mmHg) in diastolic arterial pressure (DAP) values, and -2.5 mmHg (95% LoA -12.7 to 7.3 mmHg) in mean arterial pressure (MAP) values. For monitor-2, analyses of agreement showed biases of 3.4 mmHg (95% LoA -8.7 to 15.5 mmHg) in SAP values, 2.2 mmHg (95% LoA -6.6 to 10.9 mmHg) in DAP values, and 1.6 mmHg (95% LoA -5.9 to 8.9 mmHg) in MAP values. CONCLUSIONS AND CLINICAL RELEVANCE: Multi-function monitors can contain components from various manufacturers. Clinicians should consider whether these have been validated in the species to be monitored. Both of the technologies studied here seem appropriate for use in dogs.

Thromboelastography Values in Hispaniolan Amazon Parrots ( Amazona ventralis ): A Pilot Study.

Thromboelastography (TEG) provides a global assessment of coagulation, including the rate of clot initiation, clot kinetics, achievement of maximum clot strength, and fibrinolysis. Thromboelastography (TEG) is used with increasing frequency in the field of veterinary medicine, although its usefulness in avian species has not been adequately explored. The purpose of this preliminary study was to assess the applicability of TEG in psittacine birds. Kaolin-activated TEG was used to analyze citrated whole blood collected routinely from 8 healthy adult Hispaniolan Amazon parrots ( Amazona ventralis ). The minimum and maximum TEG values obtained included time to clot initiation (2.6-15 minutes), clot formation time (4.3-20.8 minutes), α angle (12.7°-47.9°), maximum amplitude of clot strength (26.3-46.2 mm), and percentage of lysis 30 minutes after achievement of maximum amplitude (0%-5.3%). The TEG values demonstrated comparative hypocoagulability relative to published values in canine and feline species. Differences may be explained by either the in vitro temperature at which TEG is standardly performed or the method of activation used in this study. Although TEG may have significant advantages over traditional coagulation tests, including lack of need for species-specific reagents, further evaluation is required in a variety of avian species and while exploring various TEG methodologies before this technology can be recommended for use in clinical cases.

Measuring the level of agreement between a veterinary and a human point-of-care glucometer and a laboratory blood analyzer in Hispaniolan Amazon parrots (Amazona ventralis).

Although abnormalities in blood glucose concentrations in avian species are not as common as they are in mammals, the inability to provide point-of-care glucose measurement likely results in underreporting and missed treatment opportunities. A veterinary glucometer that uses different optimization codes for specific groups of animals has been produced. To obtain data for a psittacine bird-specific optimization code, as well as to calculate agreement between the veterinary glucometer, a standard human glucometer, and a laboratory analyzer, blood samples were obtained from 25 Hispaniolan Amazon parrots (Amazona ventralis) in a 2-phase study. In the initial phase, blood samples were obtained from 20 parrots twice at a 2-week interval. For each sample, the packed cell volume was determined, and the blood glucose concentration was measured by the veterinary glucometer. The rest of each sample was placed into a lithium heparin microtainer tube and centrifuged, and plasma was removed and frozen at -30 degrees C. Within 5 days, tubes were thawed, and blood glucose concentrations were measured with a laboratory analyzer. The data from both procedures were used to develop a psittacine bird-specific code. For the second phase of the study, the same procedure was repeated twice at a 2-week interval in 25 birds to determine agreement between the veterinary glucometer, a standard human glucometer, and a laboratory analyzer. Neither glucometer was in good agreement with the laboratory analyzer (veterinary glucometer bias, 9.0; level of agreement, -38.1 to 56.2; standard glucometer bias, 69.4; level of agreement -17.8 to 156.7). Based on these results, the use of handheld glucometers in the diagnostic testing of Hispaniolan Amazon parrots and other psittacine birds cannot be recommended.

Magnesium therapy in a hypocalcemic African grey parrot (Psittacus erithacus).

Hypocalcemic-induced seizure activity is a clinical entity that is commonly diagnosed in neurologic African grey parrots (Psittacus erithacus). Plasma calcium levels are typically less than 6.0 mg/dL at the time of seizure activity, and although the underlying cause of the hypocalcemia has not yet been determined, many theories have been proposed. An African grey parrot that had been fed a seed diet for 8 years was presented with hypocalcemia and seizures and exhibited precipitously declining plasma calcium levels, despite aggressive calcium and vitamin A, D, and E supplementation for 4 days. Baseline magnesium levels in this parrot were determined to be 1.9 mg/dL; therefore, magnesium sulfate was administered at a dose of 20 mg/kg IM once. Twenty-four hours after supplementation, the plasma magnesium level was 3.3 mg/dL, and no further seizure activity was observed. We believe that a primary dietary magnesium deficiency may have been present in this African grey parrot, similar to a syndrome in leghorn chicks, which is frequently characterized by progressive hypocalcemia that is unable to be corrected by calcium supplementation alone.

Agreement between directly measured blood pressure and pressures obtained with three veterinary-specific oscillometric units in cats.

OBJECTIVE: To determine whether veterinary-specific oscillometric blood pressure units yield measurements that are in good agreement with directly measured blood pressures in cats. DESIGN: Evaluation study. ANIMALS: 21 cats undergoing routine spaying or neutering. PROCEDURES: A 24-gauge catheter was inserted in a dorsal pedal artery, and systolic, diastolic, and mean arterial pressures were directly measured with a validated pressure measurement system. Values were compared with indirect blood pressure measurements obtained with 3 veterinary-specific oscillometric blood pressure units. RESULTS: There was poor agreement between indirectly and directly measured blood pressures. For unit 1, bias between indirectly and directly measured values was -14.9 mm Hg (95% limits of agreement [LOA], -52.2 to 22.4 mm Hg), 4.4 mm Hg (95% LOA, -26.0 to 34.8 mm Hg), and -1.3 mm Hg (95% LOA, -26.7 to 24.1 mm Hg) for systolic, diastolic, and mean arterial pressures, respectively. For unit 2, bias was -10.3 mm Hg (95% LOA, -52.9 to 32.2 mm Hg), 13.0 mm Hg (95% LOA, -32.1 to 58.0 mm Hg), and 9.1 mm Hg (95% LOA, -32.9 to 51.2 mm Hg) for systolic, diastolic, and mean arterial pressures, respectively. For unit 3, bias was -13.4 mm Hg (95% LOA, -51.8 to 25.1 mm Hg), 8.0 mm Hg (95% LOA, -25.5 to 41.6 mm Hg), and -3.6 mm Hg (95% LOA, -31.6 to 24.5 mm Hg) for systolic, diastolic, and mean arterial pressures, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that none of the 3 veterinary-specific oscillometric blood pressure units could be recommended for indirect measurement of blood pressure in cats.

Evaluation of the agreement between a point-of-care lactate meter and a handheld laboratory analyzer in cats treated in emergency practice.

OBJECTIVE: The purpose of this study was to determine if there was agreement between a new point-of-care (POC) lactate analyzer and a handheld laboratory analyzer when measuring blood lactate concentration in cats. DESIGN: Prospective observational study. SETTING: University veterinary teaching hospital. ANIMALS: Fifty-four cats that presented to an emergency service. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Lactate concentrations as measured by the handheld laboratory analyzer ranged from 0.3 to 15.4 mmol/L. Agreement analysis of the handheld laboratory analyzer and the POC lactate meter demonstrated a bias, -0.06 and limits of agreement ranging from -0.87 to 0.99 mmol/L. Regression analysis demonstrated a coefficient of determination (R2 ) of 0.98. CONCLUSION: Results of the present study indicate that the POC lactate meter provided results that are in agreement with a handheld laboratory analyzer when measuring lactate in clinically ill patients.

Investigation of the effects of storage with preservatives at room temperature or refrigeration without preservatives on urinalysis results for samples from healthy dogs.

OBJECTIVE: To compare urinalysis results for canine urine samples stored in preservative-containing tubes at room temperature (20°C to 25°C [68°F to 77°F]) or refrigerated at 4°C (39.2°F) in plain glass tubes with results for the same samples immediately after collection. SAMPLES: Urine samples from 20 healthy dogs. PROCEDURES: Urine samples (1/dog) were divided into 6 aliquots (3 in preservative-containing tubes and 3 in plain glass tubes). Preservative-containing tubes were stored at room temperature and plain glass tubes were refrigerated. Urinalysis was performed 0, 24, and 72 hours after collection. Results for both storage conditions were compared with results for a reference sample (the 0-hour [immediate post-collection] aliquot in a plain glass tube) by Spearman correlation analysis with pairwise tests for selected variables. RESULTS: Physical variables (urine color and turbidity with and without centrifugation) for both storage conditions had high (rs = 0.7 to 0.9) or very high (rs = 0.9 to 1.0) degrees of positive correlation with reference sample results at all time points, except for color at 24 hours. Similar results were found for all biochemical variables with storage up to 72 hours. For microscopic characteristics, correlation with reference sample results ranged from low or nonsignificant to very high under both storage conditions. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that if a delay in urinalysis is expected, use of the preservative-containing tubes evaluated in this study may be a viable option for sample storage. Further research is warranted to assess direct comparability of results to those of freshly collected samples and use of these tubes to store samples from dogs with conditions affecting the urinary tract.

Evaluation of the agreement among three handheld blood glucose meters and a laboratory blood analyzer for measurement of blood glucose concentration in Hispaniolan Amazon parrots (Amazona ventralis).

OBJECTIVE: To determine the degree of agreement between 3 commercially available point-of-care blood glucose meters and a laboratory analyzer for measurement of blood glucose concentrations in Hispaniolan Amazon parrots (Amazona ventralis). ANIMALS: 20 healthy adult Hispaniolan Amazon parrots. PROCEDURES: A 26-gauge needle and 3-mL syringe were used to obtain a blood sample (approx 0.5 mL) from a jugular vein of each parrot. Small volumes of blood (0.6 to 1.5 microL) were used to operate each of the blood glucose meters, and the remainder was placed into lithium heparin microtubes and centrifuged. Plasma was harvested and frozen at -30 degrees C. Within 5 days after collection, plasma samples were thawed and plasma glucose concentrations were measured by means of the laboratory analyzer. Agreement between pairs of blood glucose meters and between each blood glucose meter and the laboratory analyzer was evaluated by means of the Bland-Altman method, and limits of agreement (LOA) were calculated. RESULTS: None of the results of the 3 blood glucose meters agreed with results of the laboratory analyzer. Each point-of-care blood glucose meter underestimated the blood glucose concentration, and the degree of negative bias was not consistent (meter A bias, -94.9 mg/dL [LOA, -148.0 to -41.7 mg/dL]; meter B bias, -52 mg/dL [LOA, -107.5 to 3.5 mg/dL]; and meter C bias, -78.9 mg/dL [LOA, -137.2 to -20.6 mg/dL]). CONCLUSIONS AND CLINICAL RELEVANCE: On the basis of these results, use of handheld blood glucose meters in the diagnosis or treatment of Hispaniolan Amazon parrots and other psittacines cannot be recommended.

Determinination of plasma osmolality and agreement between measured and calculated values in healthy adult Hispaniolan Amazon parrots (Amazona ventralis).

OBJECTIVE: To determine plasma osmolality in healthy adult Hispaniolan Amazon parrots (Amazona ventralis) and validate osmolality equations in these parrots. ANIMALS: 20 healthy adult Hispaniolan Amazon parrots. PROCEDURES: A blood sample (0.5 mL) was collected from the right jugular vein of each parrot and placed into a lithium heparin microtainer tube. Samples were centrifuged, and plasma was harvested and frozen at -30 degrees C. Samples were thawed, and plasma osmolality was measured in duplicate with a freezing-point depression osmometer. The mean value was calculated for the 2 osmolality measurements. RESULTS: Plasma osmolality values were normally distributed, with a mean +/- SD of 326.0 +/- 6.878 mOsm/kg. The equations (2 x [Na(+) + K(+)]) + (glucose/18), which resulted in bias of 2.3333 mOsm/kg and limits of agreement of -7.0940 to 11.7606 mOsm/kg, and (2 x [Na(+) + K(+)]) + (uric acid concentration/16.8) + (glucose concentration/18), which resulted in bias of 5.8117 mOsm/kg and limits of agreement of -14.6640 to 3.0406 mOsm/kg, yielded calculated values that were in good agreement with the measured osmolality. CONCLUSIONS AND CLINICAL RELEVANCE: IV administration of large amounts of hypotonic fluids can have catastrophic consequences. Osmolality of the plasma from parrots in this study was significantly higher than that of commercially available prepackaged fluids. Therefore, such fluids should be used with caution in Hispaniolan Amazon parrots as well as other psittacines. Additional studies are needed to determine whether the estimation of osmolality has the same clinical value in psittacines as it does in other animals.

Canine Incontinence.

Incontinence is a frustrating condition for both pet owners and their veterinarians. Fortunately, most causes are easily diagnosed and most dogs respond to appropriate therapy. This article reviews normal urine storage and voiding, causes of incontinence, typical clinical presentation, diagnostics, and treatment.

Measuring statistical agreement between four point of care (POC) lactate meters and a laboratory blood analyzer in cats.

The use of blood lactate concentrations as a prognostic indicator and therapeutic gauge in feline medicine has been hindered by the inability to obtain values in a timely manner with minimal quantities of blood. Recently, hand-held point-of-care (POC) lactate meters have become commercially available. The objective of this prospective study was to determine if lactate values produced by three commercially available and one medical grade POC meter were in agreement with a laboratory blood analyzer. Blood samples from 47 cats were collected on presentation to an emergency service and processed on four POC meters and a Stat Profile Critical Care Xpress blood analyzer. The results were analyzed using the Bland-Altman method. The blood lactate values produced by the hospital grade POC meter and one of the commercially POC meters were in good agreement with the Critical Care Xpress blood analyzer. Other commercially available POC meters produced acceptable agreement.

Comparison of prothrombin time, activated partial thromboplastin time, and fibrinogen concentration in blood samples collected via an intravenous catheter versus direct venipuncture in dogs.

OBJECTIVE: To compare prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen concentration in canine blood samples collected via an indwelling IV catheter and direct venipuncture. ANIMALS: 35 dogs admitted to an intensive care unit that required placement of an IV catheter for treatment. PROCEDURES: Blood samples were collected via IV catheter and direct venipuncture at the time of catheter placement and 24 hours after catheter placement. Prothrombin time, APTT, and fibrinogen concentration were measured. RESULTS: 5 dogs were excluded from the study; results were obtained for the remaining 30 dogs. Agreement (bias) for PT was -0.327 seconds (limits of agreement, -1.350 to 0.696 seconds) and 0.003 seconds (limits of agreement, -1.120 to 1.127 seconds) for the 0- and 24-hour time points, respectively. Agreement for APTT was -0.423 seconds (limits of agreement, -3.123 to 2.276 seconds) and 0.677 seconds (limits of agreement, -3.854 to 5.207 seconds) for the 0- and 24-hour time points, respectively. Agreement for fibrinogen concentration was -2.333 mg/dL (limits of agreement, -80.639 to 75.973 mg/dL) and -1.767 mg/dL (limits of agreement, -50.056 to 46.523 mg/dL) for the 0- and 24-hour time points, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Agreement between the 2 techniques for sample collection was clinically acceptable for PT, APTT, and fibrinogen concentration at time 0 and 24 hours. It is often difficult or undesirable to perform multiple direct venipunctures in critically ill patients. Use of samples collected via an IV catheter to monitor PT and APTT can eliminate additional venous trauma and patient discomfort and reduce the volume of blood collected from these compromised patients.

Effects of ultraviolet radiation on plasma 25-hydroxyvitamin D3 concentrations in corn snakes (Elaphe guttata).

OBJECTIVE: To determine whether corn snakes exposed to UVB radiation have increased plasma 25-hydroxyvitamin D3 concentrations, compared with control snakes. ANIMALS: 12 corn snakes (Elaphe guttata). PROCEDURES: After an acclimation period in individual enclosures, a blood sample was collected from each snake for assessment of plasma 25-hydroxyvitamin D3 concentration. Six snakes were provided with no supplemental lighting, and 6 snakes were exposed to light from 2 full-spectrum coil bulbs. By use of a radiometer-photometer, the UVA and UVB radiation generated by the bulbs were measured in each light-treated enclosure at 3 positions at the basking surface and at 2.54 cm (1 inch) below each bulb surface; the arithmetic mean values for the 3 positions at the basking surface and each individual bulb surface were calculated immediately after the start of the study and at weekly intervals thereafter. At the end of the study (day 28), another blood sample was collected from each snake to determine plasma 25-hydroxyvitamin D3 concentration. RESULTS: Mean +/- SD plasma concentration of 25-hydroxyvitamin D3 in snakes that were provided with supplemental lighting (196 +/- 16.73 nmol/L) differed significantly from the value in control snakes (57.17 +/- 15.28 nmol/L). Mean exposure to UVA or UVB did not alter during the 4-week study period, although the amount of UVA recorded near the bulb surfaces did change significantly. CLINICAL RELEVANCE: These findings have provided important insight into the appropriate UV radiation requirements for corn snakes. Further investigation will be needed before exact husbandry requirements can be determined.

Agreement between direct and indirect blood pressure measurements obtained from anesthetized Hispaniolan Amazon parrots.

OBJECTIVE: To determine the level of agreement between direct and indirect blood pressure measurements obtained from healthy Hispaniolan Amazon parrots (Amazona ventralis) anesthetized with isoflurane. DESIGN: Validation study. ANIMALS: 16 healthy adult Hispaniolan Amazon parrots. PROCEDURES: Parrots were anesthetized, and a 26-gauge, 19-mm catheter was placed percutaneously in the superficial ulnar artery for direct measurement of systolic, mean, and diastolic arterial pressures. Indirect blood pressure measurements were obtained with a Doppler ultrasonic flow detector and an oscillometric unit. The Bland-Altman method was used to compare direct and indirect blood pressure values. RESULTS: There was substantial disagreement between direct systolic arterial blood pressure and indirect blood pressure measurements obtained with the Doppler detector from the wing (bias, 24 mm Hg; limits of agreement, -37 to 85 mm Hg) and from the leg (bias, 14 mm Hg; limits of agreement, -14 to 42 mm Hg). Attempts to obtain indirect blood pressure measurements with the oscillometric unit were unsuccessful. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that there was substantial disagreement between indirect blood pressure measurements obtained with a Doppler ultrasonic flow detector in anesthetized Hispaniolan Amazon parrots and directly measured systolic arterial blood pressure.

Treatment of carprofen overdose with therapeutic plasma exchange in a dog.

OBJECTIVE: To report the use of therapeutic plasma exchange (TPE) in a dog with carprofen toxicosis. SUMMARY: A 6-year-old female neutered Bichon Frise weighing 6.9 kg was examined after it had ingested 72 mg/kg carprofen. Mild dehydration without azotemia and with a urine specific gravity of 1.050 was noted at presentation. Treatment consisted of induction of emesis, symptomatic medical therapy, and TPE. The TPE achieved 1.5 plasma volume exchanges over 3 hours. Blood samples and effluent samples were collected every 30 minutes during TPE and additional blood samples were collected 11 and 35 hours after treatment. Carprofen concentrations in these samples were determined by high-pressure liquid chromatography. A 51% reduction in serum carprofen concentration was achieved following TPE. NEW OR UNIQUE INFORMATION PROVIDED: This report describes the successful reduction of plasma carprofen concentration in a dog using TPE. Although recent studies suggest that this particular dog may not have received a toxic dose, a 51% reduction of plasma carprofen concentration was achieved over 180 minutes, and TPE may be beneficial for treatment of dogs that have ingested higher doses.

Effects of therapeutic plasma exchange on serum immunoglobulin concentrations in a dog with refractory immune-mediated hemolytic anemia.

CASE DESCRIPTION A 9-year-old 8.3-kg (18.3-lb) neutered male Miniature Schnauzer was referred for diagnosis and treatment of a sudden onset of lethargy, anorexia, vomiting, and pallor. CLINICAL FINDINGS On physical examination, the dog was lethargic with pale mucous membranes and a capillary refill time ≥ 2 seconds. Skin and sclera were mildly icteric. Signs of pain were elicited during abdominal palpation, and an enlarged spleen was noted. Results of agglutination testing and cytologic findings were consistent with immune-mediated hemolytic anemia (IMHA). No contributing factors for development of IMHA were identified. TREATMENT AND OUTCOME Initial treatment included management with immunosuppressant medications. Three packed RBC transfusions were administered, but clinical signs continued to progress. Therefore, therapeutic plasma exchange (TPE) was performed 5 and 9 days after admission. Following each TPE procedure, the dog had an appreciable clinical improvement and decrease in RBC autoagglutination, and the Hct stabilized. Serum IgG and IgM concentrations were measured during and after both TPE procedures. Despite anticoagulative treatment, the dog developed a thrombus in the splenic vein, necessitating a splenectomy. CLINICAL RELEVANCE The decrease and rebound in serum IgG and IgM concentrations following TPE provided evidence that TPE may have the same immunomodulatory effects in dogs as have been proposed to occur in people. Further, findings suggested that TPE may be a useful alternative in dogs with refractory IMHA when traditional treatments fail.

Effect of refrigeration of clinical canine urine samples on quantitative bacterial culture.

OBJECTIVE To examine the effect of 24 hours of refrigeration on urine samples collected from dogs with signs of urinary tract infection (UTI). DESIGN Prospective cross-sectional study. ANIMALS 104 dogs with signs consistent with UTI that had a urine sample collected via cystocentesis as part of their diagnostic workup. PROCEDURES A 1-mL aliquot of each urine sample was refrigerated at 5°C for 24 hours in a plain glass tube, then processed for quantitative bacterial culture (QBC). A 0.5-mL aliquot was added to 3 mL of tryptic soy broth (TSB) and refrigerated at 5°C for 24 hours, then processed for QBC. The remaining portion was immediately processed for QBC, with results reported as numbers of bacterial colony-forming units (CFUs). Sensitivity of the QBC for detection of bacteria (and therefore UTI) was determined for sample refrigeration in the 2 conditions, compared with immediate processing (reference standard). RESULTS Bacterial growth was identified in 35.6% (n = 37), 33.7% (35), and 31.7% (33) of the immediately processed, refrigerated, and refrigerated-in-TSB urine samples, respectively. Sample refrigeration without TSB resulted in no significant difference in CFU counts relative to immediate processing; however, the sensitivity of this method was 95% (35/37). Sample refrigeration with TSB resulted in significantly lower CFU counts, and sensitivity was only 89% (33/37). CONCLUSIONS AND CLINICAL RELEVANCE Canine urine samples collected for bacterial culture should be immediately submitted for testing. Although CFU counts for refrigerated and immediately processed samples were statistically similar in this study, sample refrigeration in enrichment broth resulted in imperfect sensitivity for UTI detection and is not recommended.