Obesity and Associated Comorbidities in People and Companion Animals: A One Health Perspective.

This article reviews the biology, prevalence and risks for obesity in people and companion dogs and cats, and explores the links between obesity and diabetes mellitus and cancer across these species. Obesity is a major healthcare problem in both human and veterinary medicine and there is an increasing prevalence of obesity in people and pets. In people and animals, obesity is a complex disorder involving diet, level of physical activity, behavioural factors, socioeconomic factors, environment exposures, genetics, metabolism and the microbiome. Pets and people share a number of obesity-related comorbidities. Obesity is a major risk factor for type 2 diabetes mellitus in people and in cats, but this association is not recognized in dogs. Obesity is a recognized risk factor for a number of human cancers, but there are fewer data available describing this association with canine neoplastic disease. One approach to addressing the problem of obesity is by taking a 'One Health' perspective. Comparative clinical research examining shared lifestyle and environmental risk factors and the reasons underlying species differences should provide new perspectives on the fundamental biology of obesity. One Health programmes involving human healthcare professionals and veterinarians could help address obesity with simple interventions at the community level.

Clinical trial design: veterinary perspectives.

Tremendous potential exists for the use of the randomized clinical trial (RCT) in veterinary clinical research. Understanding the fundamentals of RCT design not only benefits clinical researchers, but it can enhance the ability of practitioners to interpret published RCT reports. In this article, the essential components of RCT design and implementation are described using examples from clinical veterinary medicine.

Veterinary randomized clinical trial reporting: a review of the small animal literature.

The randomized clinical trial (RCT) is a valuable research method for the evaluation of new treatment and prevention regimens in veterinary medicine. Reporting of clinical trials in other disciplines has not been complete. Without complete information on the conduct and results of a clinical trial, readers cannot optimize their use of the information presented. This report represents an objective review of randomized clinical trials in the veterinary small animal literature from 1986 to 1990. Results indicate that RCT reports in the small animal veterinary literature are incomplete. The importance of reporting on particular aspects of RCT research is described.

Hypomagnesemia in 188 dogs: a hospital population-based prevalence study.

Magnesium is a divalent cation involved in more than 300 metabolic processes. Magnesium acts as an intracellular regulator of most energy-demanding pathways. Clinical investigation in the human medical field has determined risk factors for hypomagnesemia and its relationship to a number of disease processes. Experimental studies have established the effects of hypomagnesemia in dogs, but little is known of its prevalence, risk factors, or clinical associations in a hospital population of dogs. To study the prevalence, risk factors, and clinical associations of hypomagnesemia in dogs, a retrospective cross-sectional study of dogs admitted to the University of Minnesota Veterinary Teaching Hospital over a 2.5-year period was undertaken. The prevalence of hypomagnesemia in the study population was 6.1% (188 of 3,102 dogs). Using both categorical and continuous variables in a univariate analysis, significant associations with hypomagnesemia were identified and used to construct a multivariate analysis of the relative risk of hypomagnesemia. Results from evaluation of 3,102 dogs indicate that the most significant predictors of hypomagnesemia were albumin (P < or = .0001; odds ratio [OR] = 0.2), potassium (P < or = .0001; OR = 0.5), total CO2 (P < or = .05; OR = 0.9), and blood urea nitrogen concentrations (P < .0001; OR = 0.9), a diagnosis of cardiovascular disease (P < .02; OR = 1.9); and being a Collie (P < .02; OR = 3.9) or German Shepherd Dog (P < .002; OR = 2.2). These results can be used to better understand and predict hypomagnesemia in dogs.

Evaluation of serum and seminal plasma markers in the diagnosis of canine prostatic disorders.

Serum and seminal plasma concentrations or activities of acid phosphatase (AP), prostate specific antigen (PSA), and canine prostate specific esterase (CPSE) were measured in normal dogs, dogs with benign prostatic hyperplasia (BPH), dogs with bacterial prostatitis, and dogs with prostatic carcinoma to determine if these assays would be of value in differentiating dogs with prostatic carcinoma from normal dogs, and dogs with other prostatic disorders. In addition, tissue sections of prostatic adenocarcinomas were stained with antiprostatic AP, anti-CPSE, and anti-PSA antibodies to determine if these would be suitable immunohistochemical markers of prostatic carcinoma. Prostate-specific antigen was not detected in canine serum or seminal plasma. Serum and seminal AP activities did not differ significantly between normal dogs and those with prostatic diseases, or among dogs with different prostatic disorders. Serum CPSE activities were significantly higher in dogs with BPH than in normal dogs. Mean serum CPSE activities in dogs with BPH, bacterial prostatitis, and prostatic carcinoma were not significantly different from each other. Slight to moderate immunohistochemical staining of canine prostatic adenocarcinomas was noted for prostatic AP and PSA; most tumors did not stain for CPSE. These results show that proteins of prostatic origin appear in the serum of dogs as a result of prostatic pathology, especially BPH. Canine prostatic adenocarcinoma does not appear to be associated with significant increases in CPSE or AP activities, possibly because of down-regulation of these enzymes by prostatic carcinoma cells. It is also possible that failure to detect significant differences resulted from limited statistical power for some groups and pairwise analyses because of the small number of dogs evaluated.

Echinocytosis in horses: 54 cases (1990).

Retrospective review of CBC and serum chemical data from 124 horses admitted to the veterinary teaching hospital over a 9-month period (Feb 1, 1990 to Oct 31, 1990) indicated that 54 horses had echinocytosis (prevalence = 44%). In horses with echinocytosis, the most frequent diagnosis was colitis (23 horses; 43%). Odds ratios (measure of association) were calculated to determine the association of echinocytosis with specific hematologic and biochemical abnormalities. When evaluated in a multivariate model, low serum sodium concentration (< 136 mEq/L) was the only variable significantly associated with the incidence of echinocytosis. Within the group of 54 horses with echinocytosis, hyponatremia (35 horses; 65%), hypochloremia (35 horses; 65%), low total carbon dioxide concentration (35 horses; 65%), hypoosmolality (30 horses; 55%), and hypocalcemia (22 horses; 41%) were the most common biochemical abnormalities. It was concluded that hyponatremia was associated with increased incidence of echinocytosis. It was suggested that systemic electrolyte depletion might be involved in the induction of echinocyte formation.

Chronic bicipital tenosynovitis in dogs: 29 cases (1985-1992).

Medical records of 23 dogs with unilateral and 3 dogs with bilateral chronic bicipital tenosynovitis were reviewed. Mean age of affected dogs was 4.6 years (SD, 2.0 years), and mean body weight was 32.6 kg (SD, 14.5 kg). Neither a breed nor a gender predilection was detected. All dogs had a history of intermittent or progressive weight-bearing lameness that became worse after exercise. Mean duration of lameness prior to medical or surgical treatment was 6.5 months (range, 0.25 to 24 months). In all dogs, signs of pain were evident during palpation of the biceps tendon within the intertubercular groove. Radiography revealed sclerosis or osteophytosis of the intertubercular groove in all 29 shoulder joints. Mild degenerative joint disease was evident radiographically in 17. Arthrography was performed in 12 joints, and in 11 there were irregularities of or filling defects along the biceps tendon. Arthrocentesis was performed on 17 joints; 14 synovial fluid samples had cytologic abnormalities consistent with degenerative joint disease. Medical treatment, consisting of injection of methylprednisolone acetate into the biceps tendon and its synovial sheath, was attempted in 21 of the 29 affected shoulder joints. Surgery, which consisted of tenodesis of the biceps tendon, was attempted in 14 joints; 8 of these had not been treated medically; the remaining 6 had poor results following medical treatment. Gross and histologic findings consistent with chronic bicipital tenosynovitis were observed in all 14 joints in which surgery was performed. Seventeen of the medically treated shoulders were available for clinical evaluation, and results were excellent or good in 7.(ABSTRACT TRUNCATED AT 250 WORDS)

Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States.

OBJECTIVE: To determine age, breed, sex, body condition score, and diet of dogs and cats examined at private veterinary practices in the United States during 1995, and estimate prevalences of the most common disorders for these animals. DESIGN: Cross-sectional study. ANIMALS: 31,484 dogs and 15,226 cats examined by veterinary practitioners at 52 private veterinary practices. PROCEDURE: Information on age, breed, sex, body condition score, diet, and assigned diagnostic codes were collected electronically from participating practices and transferred to a relational database. Prevalence estimates and frequencies for population description were generated using statistical software. RESULTS: Dental calculus and gingivitis were the most commonly reported disorders. About 7% of dogs and 10% of cats examined by practitioners during the study were considered healthy. Many conditions were common to both species (e.g., flea infestation, conjunctivitis, diarrhea, vomiting). Dogs were likely to be examined because of lameness, disk disease, lipoma, and allergic dermatitis. Cats were likely to be examined because of renal disease, cystitis, feline urologic syndrome, and inappetence. CLINICAL IMPLICATIONS: Results can be used by veterinary practitioners to better understand and anticipate health problems of importance in cats and dogs they examine and to better communicate with clients regarding the most prevalent disorders in cats and dogs.

Clinical features of inflammatory liver disease in cats: 41 cases (1983-1993).

OBJECTIVE: To compare the clinical and clinicopathologic findings in and prognosis for cats with lymphocytic portal hepatitis (LPH) versus cats with acute or chronic cholangiohepatitis (CH). DESIGN: Retrospective study. ANIMALS: 25 cats with LPH; 16 cats with CH (7 acute, 9 chronic). PROCEDURE: Cats with LPH and CH were selected by evaluating records from liver biopsy specimens submitted to the University of Minnesota Veterinary Teaching Hospital during a 10-year period. Clinical and clinicopathologic data were retrieved. RESULTS: Cats with CH had higher segmented and band neutrophil counts, alanine aminotransferase activities, and total bilirubin concentrations than did cats with LPH. Cats with acute CH had higher segmented and band neutrophil counts and lower serum alkaline phosphatase activities and total bilirubin concentrations than did cats with chronic CH. Twelve of 14 cats with LPH or CH had coarse or nodular texture to the liver on ultrasonography, with loss of portal vein wall clarity noticed in 4 of 8 cats with LPH. Sixteen of 23 cats with LPH and 8 of 15 cats with CH survived > 1 year. Of those cats living < 1 year, all cats with LPH and 5 of 7 cats with CH had a serious concurrent illness that may have been responsible for their deaths. CLINICAL IMPLICATIONS: LPH and CH can be detected and tentatively differentiated through evaluation of clinical laboratory test results, but histologic evaluation of liver specimens is necessary for definitive differentiation. Survival time was good regardless of the type of inflammatory liver disease.

Prevalence and risk factors for odontoclastic resorptive lesions in cats.

OBJECTIVE: To determine prevalence of, and risk factors for, odontoclastic resorptive lesions in cats seen in a private veterinary practice population. DESIGN: Population-based cross-sectional study. ANIMALS: 145 cats more than 1 year of age that underwent anesthesia for various procedures. PROCEDURE: Cats were evaluated under anesthesia for odontoclastic resorptive lesions. Lesions were graded, using a published classification system. Clients completed a standardized survey on signalment, indoor-outdoor status, medications, diet during the past year, number of daily feedings, treat feeding, source of water, and oral hygiene practices. RESULTS: 48% of cats had resorptive lesions. Lesions were most commonly mandibular, and premolars were more often affected. Compared with cats without oral lesions, cats with oral lesions were more likely to be older, female, taking medications, drinking city (vs well) water, and playing less often with toys. In addition, cats without oral lesions were more likely to have owners who cleaned their teeth daily or twice a week and to be fed diets with higher magnesium, calcium, phosphorus, and potassium contents. Frequency of teeth cleaning was inversely related to the development of odontoclastic resorptive lesions. Variables significantly associated with oral lesions were age and magnesium content of diet. CLINICAL IMPLICATIONS: Older cats should be examined closely for odontoclastic resorptive lesions. Clients should be advised on methods and frequency of teeth cleaning in cats to prevent lesions. Dietary nutrients may play a role in the development of odontoclastic resorptive lesions in cats.

Epizootiologic evaluation of urolithiasis in cats: 3,498 cases (1982-1992).

OBJECTIVE: to test the hypothesis that breed, sex and age of cats, and anatomic location of uroliths are risk factors for calcium oxalate and magnesium ammonium phosphate urolithiasis. DESIGN: Retrospective case-control study. SAMPLE POPULATION: Records of 3,498 feline urolith accessions submitted between September 1982 and September 1992. PROCEDURE: Mineral composition of feline uroliths was quantitatively analyzed. Odds ratios and 95% confidence intervals were calculated for breed, sex, age, and urolith location as risk factors for calcium oxalate and magnesium ammonium phosphate urolith formation. The population at risk was defined as all cats for which that type of urolith had been submitted. The control population was all cats for which uroliths had been submitted, excluding cats with the type of urolith being evaluated. RESULTS: Burmese, Persian, and Himalayan breeds were at higher risk for developing calcium oxalate uroliths, but at reduced risk for developing magnesium ammonium phosphate uroliths. Compared with females, neutered male cats had a higher risk for developing calcium oxalate uroliths, but a reduced risk for developing magnesium ammonium phosphate uroliths. The risk for calcium oxalate urolith formation increased with age. One- to 2-year-old female cats had the highest risk for magnesium ammonium phosphate uroliths. Uroliths removed from the kidneys were more likely to be composed of calcium oxalate than of magnesium ammonium phosphate. CLINICAL IMPLICATIONS: Breed, sex, and age of cats, and anatomic location of uroliths should be considered when evaluating risk of calcium oxalate and magnesium ammonium phosphate urolithiasis in urolith-forming cats.

Randomized controlled trial of doxorubicin versus dactinomycin in a multiagent protocol for treatment of dogs with malignant lymphoma.

OBJECTIVE: To compare efficacy and toxicity of 2 multiagent chemotherapeutic protocols similar in all respects except that 1 incorporated dactinomycin and the other incorporated doxorubicin for treatment of dogs with malignant lymphoma. DESIGN: Randomized controlled trial. ANIMALS: 45 dogs with malignant lymphoma. PROCEDURE: Dogs were randomly assigned to a doxorubicin or dactinomycin treatment group. Time to first remission, duration of first remission, survival time, and prevalence of toxicoses, particularly number of episodes of dose-limiting neutropenia and gastrointestinal toxicoses, were compared between groups. RESULTS: 37 dogs received at least 1 dose of doxorubicin (21 dogs) or dactinomycin (16). Median time to first remission was not significantly different between groups, but median duration of first remission and median survival time were significantly longer for dogs in the doxorubicin treatment group than for dogs in the dactinomycin treatment group. Number of dogs that died, number of episodes of dose-limiting neutropenia, and number of episodes of gastrointestinal toxicoses were not significantly different between groups. CLINICAL IMPLICATIONS: A multiagent chemotherapeutic protocol incorporating doxorubicin was significantly more effective in dogs with malignant lymphoma than a similar protocol incorporating dactinomycin. Despite the lower cost and lack of cardiotoxicity, dactinomycin is not an equivalent substitute for doxorubicin in the initial treatment of dogs with malignant lymphoma.

A quantitative study of the effects of Tribrissen on canine tear production.

The effect of trimethoprim-sulfadiazinea on Schirmer tear test (STT) values was studied in a population of dogs treated with the drug for a variety of medical and postsurgical conditions. The objectives of the study were to determine the incidence of keratoconjunctivitis sicca (KCS) secondary to trimethoprim-sulfadiazine therapy; to determine if such incidence was related to dose, duration, or both; and to identify any other factors that increased patient risk. The package insert accompanying Tribrissen states that "Dogs can tolerate up to ten times the recommended therapeutic dose without exhibiting ill effects." The results of this study indicated a 15.2% (5/33) incidence of KCS in the population of treated dogs.

Intestinal absorption of calcium from three commerical calcium preparations in man.

Intestinal 47Ca absorption was determined from blood and stool radioactivity after oral administration of 150 ml saline containing the isotope (as 47CaCl2) and 500 mg of elementary calcium in the form of one of three commercial calcium preparations from "NAF" or "Collett" (containing calcium carbonate) or from "Sandoz" (containing mainly calcium lactogluconate). 51CrEDTA was used as unabsorbable marker to allow corrections for incomplete faecal collection. The calcium carbonate preparations were only partially dissolved when administered, but the calcium absorption from these preparations was found to be no less than that from the completely soluble calcium "Sandoz" preparation. The calculated minimal absorption of calcium was, on an average, about 100 mg from all three calcium preparations in subjects without known intestinal calcium absorption defects.

Factors associated with late smoking initiation in Minnesota women.

This case-control study investigated factors associated with late initiation (i.e., initiation after the age of 17 years) of smoking among young women. The most significantly elevated odds ratios for late initiation were having a significant other who smoked and having friends who found smoking acceptable at initiation. Peers, especially significant others, played an important role in smoking initiation among young women. Prevention efforts should focus on strategies that reduce the acceptability of smoking in the social environment.

Apolipoprotein AI-derived pulmonary vascular amyloid in aged dogs.

Our studies confirm the common occurrence of a unique form of apolipoprotein AI (apoAI)-derived vascular amyloidosis in dogs that appears to be unrelated to other disease conditions, but is associated with aging. Vascular amyloid deposits were most frequently located within the intima and media of medium-sized pulmonary arteries, and were not confirmed in any other tissues. Pulmonary vascular amyloid immunoreactive with antiserum to purified N-terminal (1-71) canine apoAI amyloid protein was demonstrated retrospectively in 12.8% of necropsied dogs (N = 243) 10 years of age or older. In a subsequent expanded 1-year prospective study of necropsied dogs (N = 231) of all ages, apoAI-derived pulmonary vascular amyloid deposits were demonstrated in 0.7% of dogs < 10 years of age and in 22% of dogs 10 years of age or older. The incidence of this form of amyloid in dogs 10 years of age or older was significantly associated with advancing age (P < 0.00001). However, significant differences regarding gender, breed, or the frequency of selected common disease conditions were not observed when the dogs with apoAI-derived amyloid were compared with control dogs. The possibility that this new form of senile apoAI-derived amyloidosis is a manifestation of an age-associated aberration in apoAI metabolism or is related to a mutant form of apoAI is the subject of ongoing investigations.