[Transient, secondary hypoadrenocorticism after treatment with delmadinone acetate (Tardastrex®) in a two year old male dog]. / Transienter, sekundärer Hypoadrenokortizismus nach Behandlung mit Delmadinonacetat (Tardastrex®) bei einem zwei Jahre alten Rüden.

INTRODUCTION: A two year old male Labrador Retriever was treated with delmadinone acetate because of benign prostatic hyperplasia. Four days after the injection the dog showed gastrointestinal signs and a progressive lethargy. In the hospital for small animals of the Justus-Liebig-University of Gießen an ACTH stimulation test was done and a secondary hypoadrenocorticism was diagnosed. The dog was treated with prednisolone in physiological dose for 14 weeks after the injection. The clinical symptoms stopped immediately. A new ACTH stimulation test some weeks later showed a completely normal adrenal function.

Stimulation of duodenal biopsies and whole blood from dogs with food-responsive chronic enteropathy and healthy dogs with Toll-like receptor ligands and probiotic Enterococcus faecium.

The composition of the microbiome plays a significant role in the pathogenesis of inflammatory bowel disease (IBD) in humans and chronic enteropathies (CE) in dogs. The administration of probiotic micro-organisms is one way of modulating the microbiome, but experiments elucidating mechanisms of action of probiotics in the intestine of healthy and CE dogs are lacking. The aim of our study was to investigate the effects of different Toll-like receptor (TLR) ligands and Enterococcus faecium (EF) on ex vivo cultured duodenal samples and whole blood (WB) from dogs with food-responsive chronic enteropathy (FRE) when compared to healthy dogs. Biopsy stimulation was performed in 17 FRE and 11 healthy dogs; WB stimulation was performed in 16 FRE and 16 healthy dogs. Expression of TLR2, 4, 5 and 9, IL-17A, IL-22, IFNy, TNFα, IL-4, IL-10, TGFß and PPARy was determined in biopsies by quantitative polymerase chain reaction (PCR). In addition, production of TNFα, IL-10, IFNy and IL-17A protein in WB and biopsy supernatants was assessed by ELISA. Treatment with individual TLR ligands or EF induced a variety of changes in the expression of different TLRs and cytokines, but not necessarily a consistent change with a single stimulating agent. Even though cytokine protein could not be detected in supernatants from ex vivo stimulated biopsies, we found TNFα protein responses in blood to be opposite of the transcriptional responses seen in the biopsies. Stimulation of canine duodenal biopsies with TLR ligands can potentially induce anti-inflammatory gene expression, especially in healthy tissue, whereas the effects of EF were limited.

[Usefulness of lactate dehydrogenase concentration in thoracic and abdominal fluid of dogs]. / Interpretation des Laktatdehydrogenasespiegels in Thoraxerguss und Aszites beim Hund.

The aims of this study were to investigate the usefulness of LDH measurement in effusions in dogs to classify the fluid as exudate or transudate and to classify the fluid based on the pathophysiological mechanism. In thoracic (n = 107) and abdominal (n = 199) fluid of dogs cell count, protein and LDH concentrations were measured. The fluid was retrospectively categorized into exudate (group A), protein-poor (B) or protein-rich transudate (C) as well as based on pathophysiology into the following five groups (group 1 - 5): hemorrhagic, chylous, inflammatory, oncotic and congestive. In thoracic and abdominal fluid LDH concentrations were significantly higher in group A compared to group B and C. There was a significant difference of LDH concentration between the groups 1 to 5 in both thoracic and abdominal fluid, however there was a large overlap between the five groups. While fluid LDH measurement in dogs is helpful to distinguish exudate from transudate it is only of little help to elucidate the pathophysiological cause.

Dans ce travail, on étudie la signification de la lactatedéshydrogénase (LDH) dans des épanchements pour les classifier en exsudat ou en transsudat ainsi que pour en différencier la pathophysiologie. On a relevé, dans 306 épanchements thoraciques (n = 107) et abdominaux (n = 199), la numération cellulaire, les protéines totales et la LDH et on les a classé rétrospectivement en exsudats (groupe A), transsudats pauvres en protéines (groupe B) ou transsudats riches en protéines (groupe C) ; on les a également différenciés selon leur origine en hémorragiques, chyleux, inflammatoires, tumoraux ou de stase (groupes 1 à 5). Les valeurs de LDH du groupe A étaient significativement plus élevées que celles des groupes B et C, aussi bien dans les épanchements thoraciques qu'abdominaux. Ces valeurs étaient aussi significativement différentes entre les groupes 1 à 5, mais avec une forte superposition des valeurs entre les divers groupes. Alors que la détermination de la LDH dans un épanchement permet de bien différencier entre exsudat et transsudat, elle n'aide que de façon limitée pour différencier la cause de l'épanchement.

[Hypoadrenocorticism without classic electrolyte abnormalities in seven dogs]. / Hypoadrenokortizismus ohne klassische elektrolytveränderungen bei sieben hunden.

OBJECTIVE: Evaluation of all dogs with hypoadrenocorticism (hAC) without classic electrolyte abnormalities that had been admitted during the previous 3.75 years. MATERIAL AND METHODS: Criteria for inclusion in this study were a confirmed diagnosis of hypoadrenocorticism (cortisol concentration before and after ACTH application <2 µg/dl) accompanied by a normal sodium:potassium ratio (≥ 27). Hyperkalaemic animals or those with a history of glucocorticoid, trilostane or mitotane administration were excluded. Information including signalement, history, physical examination, results of complete blood count, serum biochemical analysis, ACTH stimulation test, other laboratory tests and diagnostic imaging findings as well as information on the therapy were evaluated. Outcome, management and development of electrolyte shifts were assessed by owner telephone contact. RESULTS: Seven dogs (among those two poodles) fulfilled the inclusion criteria. The median age was 3.6 years. The most common clinical signs observed were diarrhoea, vomiting, inappetence and lethargy. The median sodium-potassium ratio was 38 (27-41). One dog developed electrolyte abnormalities after 5 months. Prednisolone was given to five dogs while one dog received fludrocortisone. In one dog repeating of the ACTH stimulation test was recommended before the initiation of therapy. One dog was euthanized because of other problems 21 months after diagnosis. The other patients responded well to therapy and are in a good general condition at present. Two of them occasionally have diarrhoea. CONCLUSION AND CLINICAL RELEVANCE: Atypical hAC is an important disease in dogs with recurrent chronic gastrointestinal signs seen mainly in young animals with non-specific historical and physical findings. Therefore, an ACTH stimulation test should be considered before invasive diagnostic tests like endoscopy are performed in these patients. Since some dogs with primary hAC eventually develop classical electrolyte abnormalities serum electrolyte concentrations should be monitored regularly.

Solid phase gastric emptying times in the dog measured by 13C-sodium-acetate breath test and 99mTechnetium radioscintigraphy.

OBJECTIVE: The aim of the study was to assess solid gastric emptying via non-invasive 13C-sodium acetate breath test and compare this technique to 99mTechnetium scintigraphy in 12 healthy adult dogs. MATERIAL AND METHODS: The dogs were fed a test meal containing either 100mg 13C-sodium acetate or 150-250 MBq 99mTechnetium albumin colloid. Breath test and scintigraphy were performed on two consecutive days; this set of procedures was repeated in all dogs. Breath samples and scintigrams were obtained at baseline and every 15minutes for 4 hours, then every 30 minutes for another 2 hours. 25%, 50% and 75% gastric emptying times for breath test (Gt25%b, Gt50%b, Gt75%b) and scintigraphy (Gt25%s, Gt50%s, Gt75%s) were calculated and compared. RESULTS: The mean (±SD) Gt50%b and Gt50%s were 165 (±28.1) and 71 (±16.6)minutes, respectively. There was a significant correlation at all three gastric emptying times between breath test and scintigraphy. Conclusion and clinical significance: While gastric emptying times between both methods varied considerably, both methods correlated significantly showing that the gastric emptying breath test can be used to assess gastric emptying times in dogs.

Osteosarcoma of the penile bone (os penis) in a dog.

Osteosarcoma of the penile bone was diagnosed in a 5-year-old neutered male Rottweiler with recurrent dysuria. Imaging and cytological findings raised the suspicion for an osteosarcoma and ablation of the entire penis and scrotal urethrostomy was performed. The diagnosis was confirmed histologically. The dog recovered well and no postoperative signs of dysuria were observed. The dog survived without adjuvant chemotherapy for 12 months when multiple tumours in the thorax and abdomen led to it being euthanased. Penile osteosarcoma is a rare disease, but must be considered as a differential diagnosis in dogs presenting with dysuria. This is the second recorded case of a penile osteosarcoma in a dog, but the first with a detailed description of the diagnosis, treatment and outcome.

Comparison of postprandial and ceruletide serum bile acid stimulation in dogs.

BACKGROUND: Postprandial (PP) serum bile acid (SBA) stimulation is an important test for detecting hepatic dysfunction in dogs. However, this test is influenced by numerous variables, and a standardized approach using an injectable cholecystokinin analog (ceruletide) may be advantageous. HYPOTHESIS: Ceruletide SBA stimulation test is more sensitive than PP SBA stimulation in dogs. ANIMALS: Animals with portosystemic shunt (PSS) (n = 11) and dogs with upper respiratory disease (URD) (n = 9) were investigated. Healthy dogs (n = 13) and dogs with other diseases (n = 17) served as controls. METHODS: All dogs underwent SBA stimulation with food and ceruletide. Stimulation blood samples were drawn at 60/120 minutes and 20/30/40 minutes, respectively. Results were compared statistically, and the sensitivity and specificity were determined with receiver-operating characteristic curves. RESULTS: Stimulated SBA were significantly higher in both study groups than in controls. For dogs with PSS, the sensitivity and specificity (>35 micromol/L) were 100% postprandially (120 minutes) and 91 and 100%, respectively, postceruletide (30 minutes). The difference between these values was not statistically significant. For dogs with URD, the sensitivity and specificity (>22 micromol/L) were 44 and 88% postprandially (120 minutes) and 100 and 88% postceruletide (30 minutes). CONCLUSIONS AND CLINICAL IMPORTANCE: Ceruletide SBA stimulation circumvents exogenous and endogenous influences associated with PP SBA stimulation. The results indicate that ceruletide SBA stimulation performs as well as PP SBA stimulation in dogs with PSS and is more sensitive for the detection of hepatic dysfunction in dogs with URD.

Detection of Mycobacterium avium subspecies paratuberculosis-specific DNA by PCR in intestinal biopsies of dogs.

BACKGROUND: Mycobacterium avium subspecies paratuberculosis (MAP) is the cause of paratuberculosis. MAP infections have not been reliably detected in dogs, but a reemerging debate about the link between MAP and Crohn's disease has renewed interest about the occurrence of MAP in pets. HYPOTHESIS: This study was undertaken to examine canine intestinal biopsies for the presence of MAP-specific DNA. ANIMALS: Forty-two dogs with chronic vomiting, diarrhea, or both; and 14 dogs with no gastrointestinal disease. METHODS: All dogs with signs of gastrointestinal disease had a standard work-up for chronic gastrointestinal disease. Endoscopically obtained intestinal biopsies were submitted for histopathologic and molecular investigations. Biopsies were screened for MAP-specific DNA by 3 polymerase chain reaction (PCR) methods (nested, seminested, and triplex real-time PCR). Samples from control dogs were obtained during necropsy. RESULTS: Histopathology of the biopsies was indicative of inflammatory bowel disease (IBD) in 17 and neoplasia in 6 dogs. Six dogs showing nonspecific changes responded to diet and were classified as having food-responsive enteropathy. In 13 dogs a final diagnosis was not established. MAP-specific DNA was detected and confirmed by sequencing in 8 dogs (19%). These dogs were diagnosed with food-responsive enteropathy (n=3), IBD (n=2), and open diagnosis (n=3). MAP-specific DNA was not detected in dogs with no gastrointestinal disease. CONCLUSIONS AND CLINICAL IMPORTANCE: MAP-specific DNA was detected in approximately one fifth of dogs with chronic gastrointestinal disease and might play a role as a pathogenic agent. Apart from animal welfare, the zoonotic aspect warrants further studies addressing the viability of MAP organism in canine intestinal biopsies by culture.

Low ratios of sodium to potassium in the serum of 238 dogs.

Serum sodium:potassium (Na:K) ratios are often reported in biochemical studies of dogs, although their value has not been assessed. The aims of this study were to identify diseases associated with a low Na:K ratio in dogs and to compare their prevalence with the prevalence in dogs from the same referral hospital with normal Na:K ratios. A total of 238 dogs with a Na:K ratio less than 27 were identified from medical records. Sample contamination with edta was suspected in 74 cases (31 per cent) and these and two cases that had been supplemented with potassium were removed from the analysis. The remaining 162 cases and 147 control dogs were divided into five categories depending on the organ system affected. Among the cases there were significantly more in the endocrine category than among the control dogs. Hypoadrenocorticism was the most single common cause of a low Na:K ratio and affected 27 (16.7 per cent) of the cases. Other clinical problems associated with low Na:K ratios included different urogenital, cardiorespiratory and gastrointestinal diseases.

Management of painless mid-trimester cervical dilatation: Prophylactic vs emergency placement of cervical cerclage.

Women with recurrent painless mid-trimester miscarriages are often diagnosed with cervical insufficiency. Presenting symptoms typically include vaginal pressure and minimal bleeding; when the cervix is examined, advanced dilatation is usually detected. Labour is short and the premature fetus is born alive. Women with this history were traditionally considered candidates for the placement of cervical cerclage. Recently, this practice has been called into question. Rather than routine placement of prophylactic cervical cerclage at 12 - 14 weeks, many patients are followed expectantly with serial sonographic assessments of cervical length. The goal of this update is to review the literature regarding management options of mid-trimester cervical dilatation.

The effect of trilostane treatment on circulating thyroid hormone concentrations in dogs with pituitary-dependent hyperadrenocorticism.

OBJECTIVE: To assess thyroid hormone levels in hyperadrenocorticoid dogs before and after therapy with trilostane, a reversible inhibitor of steroidogenesis. METHODS: Serum total thyroxine, free thyroxine and endogenous canine thyroid-stimulating hormone concentrations were measured in 20 dogs with spontaneously occurring hyperadrenocorticism before and six months after successful treatment with trilostane. RESULTS: Fourteen dogs demonstrated an increase in thyroxine following trilostane treatment; however, this was not significant (P=0.108). Fourteen dogs demonstrated an increase in canine thyroid-stimulating hormone concentrations with trilostane therapy (P=0.006). Of the 14 dogs that demonstrated an increase in thyroxine concentrations following therapy, 10 also showed an increase in canine thyroid-stimulating hormone concentrations. Before treatment, free thyroxine values were within, above and below the reference range in 10, six and two dogs, respectively. Sixteen of 18 dogs had free thyroxine values within the reference range after treatment, with 11 dogs showing a decrease in free thyroxine levels following therapy (P=0.029). CLINICAL SIGNIFICANCE: While treatment with trilostane did not induce a significant change of thyroxine concentrations, there was a significant increase in canine thyroid-stimulating hormone concentrations following treatment, a finding that supports thyroid-stimulating hormone suppression as one of the factors that contributes to the effects of glucocorticoids on the hypothalamic-pituitary-thyroid axis. The significant elevation in free thyroxine values following treatment with trilostane was unexpected and did not support the findings of previous studies in this area.

Changes in the glomerular filtration rate of 27 cats with hyperthyroidism after treatment with radioactive iodine.

Hyperthyroidism is a common endocrinopathy of older cats and is associated with an increased glomerular filtration rate (gfr). Renal dysfunction is also common in older cats and may develop after they have been treated for hyperthyroidism. This paper describes the changes in the gfr of 27 hyperthyroid cats in the six months after their treatment with radioactive iodine ((131)I), and evaluates whether any commonly measured pretreatment parameters (serum biochemistry, systolic blood pressure, urine specific gravity) could predict a clinically significant decline in renal function. The gfr of all the cats had decreased one month after treatment, and the mean gfr was significantly lower. There was no further significant change in gfr between one and six months. The only independent variable associated with the final gfr was the pretreatment plasma glucose concentration (P=0.003).

Comparison of a CHOP-LAsp-based protocol with and without maintenance for canine multicentric lymphoma.

The recommendation to treat canine lymphoma with a discontinuous protocol is based on small case numbers and mostly historic controls. This study compares duration of first remission (DFR) and overall survival time (ST) with a discontinuous protocol to the same protocol with maintenance phase. 408 dogs were treated with a CHOP-LAsp (C=cyclophosphamide; H=hydroxydaunorubicin; O=Oncovin; P=prednisolone; LAsp=l-asparaginase)-based 28-week induction protocol. In 75 dogs (cohort 1), this was followed by a maintenance phase consisting of vincristine, chlorambucil and actinomycin-D with a total treatment duration of two years. In the subsequent 333 dogs, therapy was discontinued after induction (cohort 2). Median DFR and ST in cohort 1 were 216 and 375 days and 184 and 304 days in cohort 2. 6-Month, 1-year and 2-year survival rates in cohort 1 were 73 per cent, 50 per cent, 24 per cent and 67 per cent, 39 per cent, 21 per cent in cohort 2. There was no significant difference between the two protocols (P=0.291 for ST, P=0.071 for DFR). On multivariate analysis, corticosteroid pretreatment (P=0.005), thrombocytopenia at diagnosis (P=0.019), stage (P=0.009), substage b at relapse (P<0.001), age (P=0.002) and incomplete or unstable remission necessitating intensification of therapy (P=0.004) were negatively correlated with ST in both groups. This study supports the use of a discontinuous protocol for canine multicentric lymphoma.

Applicability of 99m Tc-Labeled Human Serum Albumin Scintigraphy in Dogs With Protein-Losing Enteropathy.

BACKGROUND: Diagnosis of protein loss into the gastrointestinal tract using noninvasive techniques is challenging. In people, scintigraphy not only is a sensitive tool to confirm protein-losing enteropathy (PLE), but it also allows for localization of protein loss. HYPOTHESIS/OBJECTIVES: To investigate the feasibility of 99m Tc-labeled human serum albumin (HSA) scintigraphy in dogs with PLE in comparison with control dogs. ANIMALS: A total of 8 clinically healthy control research dogs and 7 client-owned dogs with gastrointestinal clinical signs and hypoalbuminemia (serum albumin concentration <2.0 g/dL). METHODS: Prospective case-control study. After IV injection of 400 MBq freshly prepared 99m Tc HSA (30 mg/dog), images of the abdomen were obtained 10, 60, 120, and 240 minutes postinjection. Additional images of the salivary and thyroid glands were obtained to rule out free 99m Tc. A scan was considered positive for PLE when radiopharmaceutical exudation was detectable in the intestinal tract. RESULTS: Only 1 control dog showed exudation of the radiopharmaceutical into the intestinal tract. No free 99m Tc was detected in any dog. In dogs with PLE, focal small intestinal and diffuse small intestinal radiopharmaceutical exudation into the bowel was detected in 2 and 3 dogs, respectively, whereas in 2 dogs, there was disagreement about whether radiopharmaceutical exudation was focal or diffuse. CONCLUSION AND CLINICAL IMPORTANCE: 99m Tc-labeled HSA scintigraphy was feasible to diagnose PLE in dogs.

Plasma Symmetric Dimethylarginine Concentration in Dogs with Acute Kidney Injury and Chronic Kidney Disease.

BACKGROUND: Symmetric dimethylarginine (SDMA) is considered a biomarker for early detection of renal dysfunction in human patients with acute kidney injury (AKI). At present, no studies exist analyzing the relevance of SDMA in dogs with AKI. HYPOTHESIS/OBJECTIVES: SDMA would correctly identify dogs with renal disease but would not be able to differentiate between AKI and CKD. ANIMALS: Eighteen healthy control dogs, 48 dogs with AKI, and 29 dogs with CKD. METHODS: Prospective study. Dogs with kidney disease were categorized as having AKI or CKD according to the history, clinical signs, laboratory findings, and results of diagnostic imaging. Plasma SDMA concentration was measured by IDEXX Laboratories. SDMA/creatinine ratio was calculated in dogs with AKI or CKD. RESULTS: Median SDMA concentrations were 8.5 µg/dL (6-12 µg/dL), 39.5 µg/dL (8->100 µg/dL), and 35 µg/dL (12->100 µg/dL), in healthy, AKI, and CKD, respectively. SDMA concentrations were significantly higher in dogs with AKI (P < .0001) or CKD (P < .0001) in comparison with healthy dogs. Median SDMA/creatinine ratio in dogs with AKI and CKD was 6.5 (1.7-20.9) and 10 (2.4-33.9) (P = .0004), respectively. Although there was overlap of the SDMA/creatinine ratio in dogs with AKI or CKD, it was significantly higher in dogs with CKD compared to dogs with AKI (P = .0004). CONCLUSIONS AND CLINICAL IMPORTANCE: In this population, SDMA was suitable for identifying dogs affected by AKI or CKD, but could not differentiate between them.

Nasal bone assessment in prenatal screening for trisomy 21.

A small nose is a common facial feature of individuals with trisomy 21. Evidence based on radiologic, histomorphologic, and sonographic studies shows that nasal bone abnormalities are significantly more common in trisomy 21 fetuses than in euploid fetuses. These abnormalities, which include both nasal bone absence and short nasal bone length, can be detected by prenatal ultrasound. In this article we review the evidence and discuss the potential value of assessment of the fetal nasal bone in screening for trisomy 21.

Changes in the threshold of fetal lung maturity testing and neonatal outcome of infants delivered electively before 39 weeks gestation: implications and cost-effectiveness.

OBJECTIVE: To compare the neonatal outcome of infants delivered before 39 weeks' gestation following documentation of fetal lung maturity before and after the lamellar body count (LBC) threshold was increased from 30,000 to 50,000 LB/ul. We discuss the algorithm employed for testing fetal lung maturity, the cost of testing and potential savings. MATERIAL AND METHODS: We studied the outcome of infants delivered electively before 39 weeks' gestation after fetal lung maturity was documented by amniotic fluid analysis. We compared the outcome of neonates born before and after the LBC threshold was increased. RESULTS: Our cohort included 527 neonates who were divided into two groups: 264 who underwent fetal lung maturity studies before the change in LBC threshold and 263 who underwent testing after the change. In the first group, 158 neonates met the criteria of LBC >30,000 LB/ul and were delivered without further testing. The second group included 154 neonates who were mature by LBC >50,000 LB/ul and were delivered. Seven of the neonates born in the first group required admission to the neonatal intensive care unit (NICU), whereas in the second group only two neonates required admission (P = 0.02). Additionally, 16 neonates in the first group required respiratory assistance compared with six in the second group (P = 0.04). The overall neonatal complication rate was significantly higher in the first group (P = 0.001). CONCLUSION: Changing the LBC threshold resulted in a significant decrease in neonatal morbidity. Employing the algorithm, we described for testing fetal lung maturity is cost effective, and more importantly, represents sound evidence-based medical management.

Study of the effects of once daily doses of trilostane on cortisol concentrations and responsiveness to adrenocorticotrophic hormone in hyperadrenocorticoid dogs.

The effects of trilostane, a 3beta-hydroxysteroid dehydrogenase inhibitor on basal cortisol concentrations and the results of ACTH stimulation tests in dogs with pituitary-dependent hyperadrenocorticism were investigated. In eight of nine dogs trilostane suppressed the concentration of cortisol below the lower limit of the reference range (<50 nmol/l) for a mean (sd) of 3.5 (2.3) hours during the day, but for no longer than 13 hours. In another 10 dogs, there was a clear difference between the post ACTH cortisol concentrations observed four and 24 hours after the administration of trilostane. Furthermore, in the six dogs whose clinical signs were poorly controlled the post-ACTH concentrations observed four and 24 hours after the administration of trilostane were always higher than the equivalent cortisol concentrations in the four dogs whose clinical signs were controlled. A short duration of drug action may be responsible for the failure of some dogs to respond adequately to once daily trilostane administration.

[Detection of bocavirus in 4-week-old puppies with acute diarrhea]. / Bocavirus-Nachweis bei 4 Wochen alten Welpen mit akutem Durchfall.

Two 4-month-old female Doberman puppies were presented with clinical signs of acute diarrhea and emesis. They also showed sneezing and nasal discharge. The clinical presentation and neutropenia were suggestive of a parvovirus infection. The puppies were hospitalized for several days and treated symptomatically. Fecal samples tested negative for parasites. Virological examination of feces using polymerase chain reaction (PCR) and immune electron microscopy failed to confirm a parvovirus infection. With a recently developed PCR, bocavirus could be identified, thus making an infection with this virus a possible diagnosis. This case report presents a less well-known viral puppy disease and its successful therapy.