Prevalence and Prognosis of Anemia in Dogs with Degenerative Mitral Valve Disease.

In humans, heart failure (HF) and renal insufficiency (RI) have negative reciprocal effects, and anemia can exacerbate their progression. In this retrospective study, the prevalence and prognostic significance of anemia in 114 dogs with degenerative mitral valve disease (DMVD) was investigated. Pretreatment clinical parameters, prevalence of anemia and azotemia, and survival time were analyzed in relation to HF severity. The prevalence of anemia was highest in dogs with the modified New York Heart Association (NYHA) class IV HF (33.3%), followed by classes III (15.2%) and II (0%; p < 0.001). The presence of anemia was associated with HF severity and blood creatinine > 1.6 mg/dL (both p < 0.001). Anemic dogs had a shorter median survival [13 months; 95% confidence interval (CI): 0.7-19.1] than nonanemic dogs (28 months; 95% CI: 15.3-40.7; p < .001). NYHA class IV (hazard ratio (HR): 3.1, 95% CI: 2.2-4.3; p < 0.001), left atrium/aorta ratio > 1.7 (HR: 2.7, 95% CI: 1.7-4.2; p = 0.001), and presence of anemia (HR: 1.43, 95% CI: 1.1-1.9; p = 0.004) emerged as predictors of mortality. A cardiorenal-anemia syndrome-like triangle was observed and anemia was a prognostic factor for survival in dogs with DMVD.

Association of Renal Resistive Index, Renal Pulsatility Index, Systemic Hypertension, and Albuminuria with Survival in Dogs with Pituitary-Dependent Hyperadrenocorticism.

An increased renal resistive index (RI) and albuminuria are markers of target organ damage secondary to systemic hypertension. This study evaluated associations between systemic blood pressure (SBP), renal RI, pulsatility index (PI), and albuminuria in dogs with pituitary-dependent hyperadrenocorticism (PDH). Predictors of overall mortality were investigated. Twenty client-owned dogs with PDH and 20 clinically healthy client-owned dogs as matched controls were included. Incidence rates of systemic hypertension (SBP ≥ 160 mmHg), albuminuria, and increased renal RI (≥ 0.70) and PI (≥ 1.45) in the control group were 5%, 0%, 5%, and 0%, respectively, compared to 35%, 40%, 50%, and 35%, respectively, in the PDH group (P = 0.001, P < 0.001, P < 0.001, and P = 0.001, resp.). No association between systemic hypertension, renal RI, renal PI, and albuminuria was observed. PDH was the only predictor of albuminuria and increased renal RI. Survival was not affected by increased renal PI, systemic hypertension, or albuminuria. Increased renal RI (≥ 0.70) was the only predictor of overall mortality in dogs with PDH.

Evidence-based veterinary dermatology: a review of published studies of treatments for Otodectes cynotis (ear mite) infestation in cats.

BACKGROUND: Otodectes cynotis (ear mite) accounts for 50-80% of cases of otitis externa in cats. Various treatment options exist but evidence-based reviews on treatments for this parasite have not been conducted. HYPOTHESIS/OBJECTIVES: The purpose of this study was to systematically review the efficacy of treatments for Otodectes cynotis infestation in cats, to provide recommendations for their use and to suggest methodologies for future clinical trials and research. METHODS: Electronic searches were carried out using the PubMed, CAB Direct and Thomson Reuters Web of Science; relevant topics were hand searched. The review was restricted to peer reviewed articles without limitation of language and publication date; only in vivo studies were included. The data were extracted and tabulated, then compared with regard to study design. With only a few randomized and controlled trials (RCTs) available, it was not possible to perform a meta-analysis of the pooled data. RESULTS: A total of 27 trials published between 1978 and 2015 fulfilled the selection criteria; 17 different pharmacological interventions were identified. There were two blinded RCTs and 25 open uncontrolled trials. CONCLUSIONS AND CLINICAL IMPORTANCE: There is fair evidence for recommending spot-on 10% imidacloprid +1% moxidectin or selamectin, once or twice 30 days apart, while there is insufficient evidence for or against recommending all other medications due to the quality of study designs in spite of their high efficacies. Future blinded RCTs, using placebo or appropriate active drugs, are required; outcome measurements on both clinical and microbiological and parasitological improvement, and proper follow-up periods are recommended.

Two-dimensional speckle-tracking echocardiographic assessment of left ventricular mechanical synchrony in clinically normal cats.

Ventricular heterogeneity and synchrony are associated with hypertrophic cardiomyopathy in humans. Hypertrophic cardiomyopathy is commonly observed in cats. The aim of this study was to determine the presence and normal range of left ventricular mechanical heterogeneity and synchrony in clinically healthy cats using two-dimensional speckle-tracking echocardiography. Thirty-four clinically healthy cats were included in this prospective study. Two-dimensional echocardiography and two-dimensional speckle-tracking echocardiography were performed on all cats. Echocardiographic parameters, including circumferential, radial, and longitudinal strain and strain rate, heterogeneity, and synchrony, were measured. Segmental heterogeneity values in the circumferential, radial, and longitudinal directions were 13.1%±5.9%, 19.1%±10.3%, and 15.4%±6.8%, respectively. Transmural heterogeneity was -14.3%±4.6% in the circumferential direction. Left ventricular synchrony values in the circumferential, radial, and longitudinal directions were 11.7±4.2, 16.5±13.4, and 19.4±8.5 ms, respectively. Inter-ventricular synchrony was -3.9±13.2 ms. Left ventricular heterogeneity and synchrony were noted in clinically healthy cats; segmental heterogeneity, which is characterized as longitudinal, progressively increased from the apical to the basal segments, while transmural heterogeneity, which is characterized as circumferential, progressively decreased from the endocardium to the epicardium.

Assessment of left ventricular function by two-dimensional speckle-tracking echocardiography in small breed dogs with hyperadrenocorticism.

BACKGROUND: Hyperadrenocorticism (HAC) is associated with an increased prevalence of hypertension. This study investigated the left ventricular function using two-dimensional speckle-tracking echocardiography (2D-STE) in small breed dogs affected with spontaneous HAC. Age-matched healthy controls (n = 9), dogs with pituitary-dependent hyperadrenocorticism (PDH, n = 10), and dogs with adrenal-dependent hyperadrenocorticism (ADH, n = 9) were included in this study. Conventional echocardiography, global longitudinal and circumferential strain, and strain rate were assessed. RESULTS: On group-wise comparison, left ventricular free wall (LVFWd) and interventricular septal thickness in diastole (IVSd) were thickest in the ADH group, followed by the PDH and controls (P = 0.014 and P = 0.001, respectively). Neither LVFWd nor IVSd was correlated with systemic blood pressure (P = 0.238 and P = 0.113, respectively). The values of all variables derived from the global strain and strain rate in longitudinal and circumferential directions followed the same pattern: highest in the controls, followed by PDH and then ADH (all P < 0.05, respectively). On multiple regression analyses, global longitudinal strain, global longitudinal strain rate in systole and early diastole, and global circumferential strain all decreased linearly with increased IVSd (all P < 0.05). CONCLUSIONS: Left ventricular hypertrophy (LVH) was more prevalent in the HAC group compared to the control group. Association between hypertension and development of LVH was not identified. Decreased global longitudinal and circumferential strains were associated with increased IVSd. 2D-STE revealed significant decreases in systolic functions that were undetected using conventional echocardiography in the ADH and PDH groups.

Feline sarcoptic mange in Taiwan: a case series of five cats.

BACKGROUND: Sarcoptes scabiei infestation is rare in cats. OBJECTIVE: To report the clinical presentations and treatments of cats infested with S. scabiei. ANIMALS: Five cats that presented with progressive and nonresponsive crusting lesions on the concave and convex aspects of the pinnae are included in this series. Other dermatological manifestations recorded were crusts on the bridge of the nose (five of five), crusty pododermatitis (three of five), crusty lesions on the tail (one of five) and pruritic erythematous papules on the arms and/or thighs of the owners (five of five). None of the cats was living in a household with a dog. METHODS: Sarcoptic (S. scabiei) mange was diagnosed based on the identification of S. scabiei in deep skin scrapings. A spot-on application of 1.0% moxidectin and 10% imidacloprid (0.1 mL/kg) was administered every 2 weeks for three applications. All cats were re-evaluated at the time of treatment. RESULTS: All five cats and their owners improved after the first application and reached clinical remission after the third application. Deep skin scrapings from all cats were negative for S. scabiei after the first application. No clinical adverse effects or abnormalities on routine blood tests were noted during the study period. No reinfestation was reported during the follow-up period of 6 months after treatment. CONCLUSION: Although sarcoptic mange is rare in cats, it should be considered as a differential diagnosis for cats presenting with crusting lesions on the pinnae and nose and crusty pododermatitis. A spot-on preparation of moxidectin and imidacloprid was used successfully to treat cats with S. scabiei infestation.

Treatment of canine generalized demodicosis associated with hyperadrenocorticism with spot-on moxidectin and imidacloprid.

BACKGROUND: Canine generalized demodicosis associated with hyperadrenocorticism is often problematic and might be intractable. The aim of this study was to report the efficacy of a weekly application of spot-on moxidectin/imidacloprid in dogs with hyperadrenocorticism and secondary generalized demodicosis. METHODS: Dogs with hyperadrenocorticism and secondary generalized demodicosis were included. The condition of hyperadrenocorticism was treated and stabilized with trilostane before and throughout the study period in all dogs. RESULTS: Average total live adult mite counts before treatment and after four, eight and 12 weeks of spot-on moxidectin/imidacloprid (2.5/10 mg/kg) applications were 20.1±6.3 (range, 13-33), 0.5±0.7 (range, 0-2; 6/11 were negative), 0.2±0.4 (range, 0-1; 9/11 were negative), 0.2±0.4 (range, 0-1; 9/11 were negative) and 0.1±0.3 (range, 0-1; 10/11 were negative) respectively; this difference was significant (P<0.001). Ten of 11 dogs (90.1%) achieved clinical remission, as demonstrated by the absence of demodectic mites at any life stage at monthly scrapings for eight consecutive weeks, and maintained remission throughout the 12-month follow-up period. CONCLUSION: The weekly application of spot-on moxidectin/imidacloprid appeared to be effective and safe against generalized adult onset canine demodicosis associated with hyperadrenocorticism.

Associations among systemic blood pressure, microalbuminuria and albuminuria in dogs affected with pituitary- and adrenal-dependent hyperadrenocorticism.

BACKGROUND: Hypertension and proteinuria are medical complications associated with the multisystemic effects of long-term hypercortisolism in dogs with hyperadrenocorticism (HAC). METHODS: This study investigated the relationships among adrenocorticotropic hormone (ACTH)-stimulation test results, systemic blood pressure, and microalbuminuria in clinically-healthy dogs (n = 100), in dogs affected with naturally occurring pituitary-dependent (PDH; n = 40), or adrenal-dependent hyperadrenocorticism (ADH; n = 30). RESULTS: Mean systemic blood pressure was similar between clinically healthy dogs and dogs with HAC (p = 0.803). However the incidence of hypertension was highest in dogs with ADH (p = 0.017), followed by dogs with PDH, with the lowest levels in clinically healthy dogs (p = 0.019). Presence of microalbuminuria and albuminuria in clinically healthy dogs and dogs affected with HAC was significantly different (p < 0.001); incidences of albuminuria followed the same pattern of hypertension; highest incidence in dogs with ADH, and lowest level in clinically healthy dogs; but microalbuminuria showed a different pattern: clinically healthy dogs had highest incidences and dogs with ADH had lowest incidence. The presence of albuminuria was not associated with blood pressure values, regardless of whether dogs were clinically healthy or affected with ADH or PDH (p = 0.306). CONCLUSIONS: Higher incidence of hypertension and albuminuria, not microalbuminuria was seen in dogs affected with HAC compared to clinically healthy dogs; incidence of hypertension and albuminuria was significantly higher in dogs affected with ADH compared to PDH. However, presence of albuminuria was not correlated with systemic blood pressure.

Use of a doxycycline-enrofloxacin-metronidazole combination with/without diminazene diaceturate to treat naturally occurring canine babesiosis caused by Babesia gibsoni.

Canine babesiosis is an important worldwide, tick-borne disease caused by hemoprotozoan parasites of the genus Babesia. Babesia gibsoni is the predominant species that causes canine babesiosis in Taipei, Taiwan. It is a small pleomorphic intraerythrocytic parasite that can cause erythrocyte destruction and hemolytic anemia. Efficacy of oral administration of a doxycycline-enrofloxacin-metronidazole combination with and without injections of diminazene diaceturate in the management of naturally occurring canine babesiosis caused by B. gibsoni was evaluated retrospectively. The overall efficacy of this combination of doxycycline-enrofloxacin-metronidazole in conjunction with and without administration of diminazene diaceturate was 85.7% and 83.3%, respectively; with a mean recovery time of 24.2 and 23.5 days, respectively. Concomitant use of intramuscular diminazene diaceturate may not improve the efficacy of a doxycycline-enrofloxacin-metronidazole combination in management of canine babesiosis caused by B. gibsoni.

Field strain feline coronaviruses with small deletions in ORF7b associated with both enteric infection and feline infectious peritonitis.

Feline coronavirus (FCoV) varies greatly from causing subclinical or mild enteric infections to fatal feline infectious peritonitis (FIP). The open reading frame (ORF) 7b of FCoV has been speculated to play a determining role in virulence as deletions were found to be associated with avirulent viruses. To further clarify the correlation between this gene and FIP, clinical samples from 20 cats that had succumbed to wet-type FIP and 20 clinically healthy FCoV-infected cats were analysed. The ORF7b from the peritoneal/pleural effusions of FIP cats and from the rectal swabs of healthy cats was amplified. Of the 40 FCoVs analysed, 32 were found to have an intact 7b gene whereas eight showed deletions of either three or 12 nucleotides. Surprisingly, among the eight viruses with deletions, three were from FIP diseased cats. These results show that deletions in the ORF7b gene are not constrained to low pathogenicity/enteric biotypes but also associated with pathogenicity/FIP biotypes of FCoV.

Histological changes in the external ear canal of dogs with otitis externa.

This study aimed to better characterise the gross anatomy of the normal ear canal, and to compare histological features of the normal ear canal to those affected by chronic otitis externa. In 40 normal ears from 20 dogs, the length of the annular and auricular cartilage was 1.2 +/- 0.2 and 4.1 +/- 0.9 cm, respectively; overall length of the external ear canal was 5.3 +/- 1.0 cm. The maximal internal diameter at the distal end of the external ear canal, the proximal opening of the auricular cartilage and the proximal end of the annular cartilage was 5.8 +/- 1.5, 0.7 +/- 0.2 and 0.5 +/- 0.1 cm, respectively. Body weight correlated positively with the overall length and diameter of the distal end of the ear canal (r = 0.78, P < 0.001; r = 0.42, P < 0.05). Morphometric evaluation was carried in 28 clinically healthy ears of 14 dogs, and 15 otitic ears of 13 dogs. Histological features of this integument revealed that the density and distribution of sebaceous and ceruminous gland tissue exhibits marked variation between individuals. Nevertheless, general patterns were observed; sebaceous tissue increases gradually from the proximal to the distal parts of the ear canal, whilst ceruminous gland tissue by contrast decreases. In otitic canine ears, the distribution of sebaceous and ceruminous glandular tissue was similar to normal ears but the glands became larger and hyperplastic (P < 0.05). Density of hair follicles was not different between healthy and otitic ears (P = 0.16), but the hair follicles became hyperplastic in otitic ears.

Use of ketoconazole to treat dogs with pituitary-dependent hyperadrenocorticism: 48 cases (1994-2007).

OBJECTIVE: To evaluate the effectiveness of ketoconazole as a treatment for dogs with pituitary-dependent hyperadrenocorticism (PDH). DESIGN: Retrospective case series. ANIMALS: 48 client-owned dogs in which PDH was diagnosed. PROCEDURES: Medical records of dogs with PDH that were treated with ketoconazole were examined. Data collected from each record included signalment, clinical signs, results of ACTH stimulation tests before and after treatment with ketoconazole, serum alkaline phosphatase (ALP) and alanine aminotransferase (ALT) activities, dosage of ketoconazole, clinical response, and survival time. RESULTS: 43 of 48 (90%) dogs had evidence of clinical improvement during the treatment period. In all dogs, treatment with ketoconazole resulted in significantly lower serum cortisol concentrations as measured before and after ACTH stimulation testing; 69% (33/48) of serum cortisol concentrations measured after ACTH stimulation were within the reference range. Serum ALP and ALT activities significantly decreased after treatment with ketoconazole. Survival time after diagnosis of PDH ranged from 2 to 61 months (mean, 26.9 months; median, 25 months). CONCLUSIONS AND CLINICAL RELEVANCE: Ketoconazole was a safe and effective option for treating dogs with PDH. Additional research is needed to evaluate the effects of long-term treatment with ketoconazole on adrenal glands.

Indirect measurement of systemic blood pressure in conscious dogs in a clinical setting.

The present study compared 2 indirect methods, Doppler sphygmomanometry and oscillometry, for measurement of the systemic blood pressure level in 100 conscious, client-owned dogs in a clinical setting on 2 separate occasions. The mean systemic blood pressure values, measured by Doppler sphygmomanometry on 2 separate occasions, were 156 +/- 38.2 mmHg and 150 +/- 34.1 mmHg, respectively. Using oscillometry, the mean systolic blood pressure values were 138 +/- 36.9 mm Hg and 133 +/- 33.5 mm Hg on 2 separate occasions. There were significant differences between the systemic blood pressure readings for both methods on the same occasion (P<0.001). The coefficients of variance from 5 consecutive measurements in the same dog obtained by Doppler sphygmomanometry on the 2 separate occasions were 4.1 +/- 3.2% and 3.1 +/- 1.7%; that of the oscillometric method on the 2 separate occasions were 18.7 +/- 11.3% and 17.2 +/- 12.5%. The coefficients of variance of these 2 methods were statistically different on each occasion (P<0.001). Five consecutive systemic blood pressure readings were obtained for each dog within 6 min on both occasions using Doppler sphygmomanometry. More than 15 min was required to complete 5 consecutive systemic blood pressure readings by oscillometric sphygmomanometry for all dogs on each occasion. The results of this study indicate that Doppler sphygmomanometry provides more efficient and precise measurements of the systemic blood pressure level than oscillometric testing in conscious dogs in a clinical setting.

Iatrogenic hyperadrenocorticism in 12 cats.

Iatrogenic hyperadrenocorticism is an extremely rare condition in cats. Twelve cats with a medical history of progressive skin lesions and long-term treatment with corticosteroids were retrospectively studied. Noncutaneous signs in the cats were variable and included anorexia, lethargy, polydipsia, polyuria, and atrophy of the thigh muscles. Laboratory abnormalities included leukocytosis, elevated alanine aminotransferase levels, and hyperglycemia. Transient diabetes mellitus was a secondary complication in four cats, and transient hypothyroidism was suspected in four cats. The mean time for regression of signs was 4.9 months after corticosteroid withdrawal.

Systolic blood pressure of clinically normal and conscious cats determined by an indirect Doppler method in a clinical setting.

The purposes of the present study were to determine the systolic blood pressure (SBP) of clinically normal and conscious cats, and to set up reference values of feline SBP for subsequent clinical application. SBPs were measured in 53 healthy cats using an ultrasonic Doppler device. The mean SBP was 133.6 +/- 16.0 mmHg (range, 110.0-180.0 mmHg). The distribution of SBP values was not significantly affected by factors such as breed, body condition score, or age (P>0.05), but SBP values of female cats were significantly lower and more variable than those of males (t test, P=0.004; F test, P<0.001). Feline SBP between 114.3 mmHg and 149.5 mmHg was considered indicative of normotension. SBP values higher than 159.3 mmHg were defined as hypertension, and those less than 104.5 mmHg were determined as hypotension.