Oral and maxillofacial dental care professionals in critical care during the COVID-19 pandemic.

At the peak of the COVID-19 pandemic there was a 'call to arms' across the oral and maxillofacial staff. This article reports on the extended role of the department's dental care professionals (DCPs) and the tremendous opportunity and value that temporary redeployment presented.

Comparison of health parameters in normal cats fed a limited iodine prescription food vs a conventional diet.

Objectives The objective was to compare the effect on thyroid function in healthy, adult cats fed a limited-iodine food or conventional diet for 24 months. Methods Cats in the limited-iodine group (n = 14) were fed a commercial, dry food containing 0.2 ppm iodine on a dry-matter basis (DMB). Cats in the conventional diet group (n = 12) were fed an identical diet except that the iodine content was 3.2 ppm on a DMB. Both groups were maintained on their respective diets for 24 months. The median age of the cats at baseline was 3.2 years (interquartile range 2.4-4.3). Diagnostic samples were obtained for measurement of serum biochemistry parameters, thyroid hormone concentrations, complete blood count and urinalysis, and thyroid ultrasound examination was performed at baseline, 6, 12, 18 and 24 months. Results Median serum concentrations of free and total thyroxine and thyroid-stimulating hormone were within respective reference intervals for both test groups at all sampling intervals. Median urine iodine concentrations in the limited-iodine group declined significantly ( P = 0.0001) from baseline and were significantly different than conventional diet ( P ⩽0.0007). Ultrasound examination revealed no significant change in median thyroid height in the limited-iodine group at any time point. Conclusions and relevance Normal serum thyroid hormone concentrations and results of urinalysis and routine biochemical testing confirmed that the limited-iodine food was safely fed for 2 years to healthy, adult cats. Ultrasound examination showing that cats on limited-iodine did not develop a change in thyroid gland height was a further indication of the absence of iatrogenic hypothyroidism in the limited iodine diet group. These results support the lack of obvious side effects associated with feeding a limited-iodine diet for 2 years to healthy, adult cats, a situation that may occur in multi-cat households where healthy cats have access to a limited-iodine diet being used to manage cats with feline hyperthyroidism.

Feline idiopathic cystitis.

While FIC remains a diagnosis of exclusion, studies over the last two decades suggest that it results from complex interactions between the urinary bladder, neuroendocrine system and environmental factors, and stress appears to play a role in the pathogenesis. The self-limiting nature of FIC and importance of environmental factors on recurrence of clinical signs emphasize the need for controlled, prospective, double-blinded clinical studies to determine the best management options. Current best evidence for initial management of acute, non-obstructive FIC supports a specific nutritional recommendation for a therapeutic urinary food proven to reduce recurrent episodes, environmental enrichment and feeding moist food.

Myasthenia gravis in Jamaican children: a 12-year institutional review.

BACKGROUND: Myasthenia gravis is uncommon in children. The clinical characteristics in children of the English-speaking Caribbean have not been documented previously. OBJECTIVE: To describe the clinical characteristics and outcome of children with myasthenia gravis at two tertiary hospitals in Jamaica. METHODS: The case-notes of all children with a diagnosis of myasthenia gravis managed at the University Hospital of the West Indies and Bustamante Hospital for Children between January 1994 and December 2005 were reviewed. RESULTS: There were 34 children; mean age of onset of illness was 7.5 years and mean period of follow-up was 38.5 months. The male-to-female ratio was 1:1.3. Nineteen (59%) presented with ocular manifestations; 47% of these developed signs of generalised involvement. Most were treated with pyridostigmine and prednisone. Eight patients had thymectomy. Four patients (12%) entered remission. There were two deaths. CONCLUSIONS: Myasthenia gravis in Jamaican children is similar to that in other populations. It is more common in female children. Most children present with ocular manifestations and remission occurs infrequently.

Diagnostic utility of abdominal ultrasonography in dogs with chronic vomiting.

BACKGROUND: Chronic vomiting is a common problem in dogs that has many causes. Ultrasonographic descriptions of many gastrointestinal (GI) diseases have been published. However, diagnostic utility of ultrasonography in dogs with chronic vomiting has not been investigated. HYPOTHESIS: Diagnostic utility of abdominal ultrasound will be highest in dogs with GI neoplasia and lowest in those with inflammatory disorders. ANIMALS: Eighty-nine pet dogs with chronic vomiting. METHODS: Medical records were reviewed and the contribution of abdominal ultrasound to the clinical diagnosis was subjectively scored. RESULTS: In 68.5% of dogs, the reviewers thought that the same diagnosis would have been reached without performing ultrasonography. In 22.5% of dogs, the ultrasound examination was considered to be vital or beneficial to the diagnosis. Univariable analysis identified that increased diagnostic utility was associated with increasing age, a greater number of vomiting episodes per week, presence of weight loss, a greater percentage of lost body weight, and a final diagnosis of GI lymphoma or gastric adenocarcinoma. However, multivariate analysis only identified increasing age and a final diagnosis of gastric adenocarcinoma or GI lymphoma to be associated with increased diagnostic utility. In 12.4% of dogs, additional benefits of ultrasonography to case management, excluding the contribution to the vomiting problem, were identified. CONCLUSIONS AND CLINICAL IMPORTANCE: The diagnostic utility of abdominal ultrasonography was high in 27% of dogs. The presence of factors that are associated with high diagnostic utility is an indication to perform abdominal ultrasonography in dogs with chronic vomiting.

Association between clinical characteristics, computed tomography characteristics, and histologic diagnosis for cats with sinonasal disease.

The purpose of this retrospective study was to determine the association between clinical characteristics, computed tomography (CT) characteristics, and histologic diagnosis in 43 cats with sinonasal disease. All cats were evaluated with CT and nasopharyngeal endoscopic examination, with histologic diagnosis based on nasal biopsy. Fifteen cats were diagnosed with sinonasal neoplasia and 28 cats were diagnosed with rhinitis. Clinical characteristics determined to be significantly associated with neoplasia were unilateral ocular discharge (odds ratio [OR] 9.6) and the presence of a nasopharyngeal mass during endoscopic examination (OR 18.9). CT characteristics found to be significantly associated with neoplasia included: unilateral lysis of ethmoturbinates (OR 11.0), unilateral lysis of the dorsal (OR 8.3) and lateral maxilla (OR 6.9), lysis of the vomer bone (OR 6.7) and ventral maxilla (OR 28.8), and bilateral lysis of the orbital lamina (OR 4.1); unilateral abnormal soft tissue/fluid within the sphenoid sinus (OR 15.3), frontal sinus (OR 10.4), and/or and retrobulbar space (OR 12.2). Lysis of the maxillary turbinates, nasal septum, nasal bone, palatine bone, and cribriform plate were not significantly associated with sinonasal neoplasia.

Renal biopsy: a retrospective study of methods and complications in 283 dogs and 65 cats.

Renal biopsy often is required to establish a definitive diagnosis in dogs and cats with renal disease. In this retrospective study, we determined the complications of renal biopsy as well as factors that may be associated with development of complications and procurement of adequate renal biopsy specimens in 283 dogs and 65 cats. Data extracted from medical records at 4 institutions were evaluated using logistic regression. Proteinuria was the most common indication for renal biopsy in dogs. Complications were reported in 13.4 and 18.5% of dogs and cats, respectively. The most common complication was severe hemorrhage; hydronephrosis and death were uncommon. Dogs that developed complications after renal biopsy were more likely to have been 4 to < 7 years of age and > 9 years, to weigh < or = 5 kg, and to have serum creatinine concentrations > 5 mg/dL. The majority of biopsies from both dogs (87.6%) and cats (86.2%) were considered to be of satisfactory quality. Biopsies from dogs were more likely to be of high quality if they were obtained when the patient was under general anesthesia and more likely to contain only renal cortex if they were obtained by surgery. We concluded that renal biopsy is a relatively safe procedure, with a low frequency of severe complications. Hospital practices and patient variables have the potential to impact both the quality of the specimen obtained and the rate of complications.

Effect of fenoldopam on renal function after nephrotomy in normal dogs.

OBJECTIVE: To evaluate effects of fenoldopam on renal function in normal dogs subjected to bisection nephrotomy. In addition, effects of bisection nephrotomy on renal function in normal dogs were evaluated. STUDY DESIGN: Controlled, randomized, blinded experiment. SAMPLE POPULATION: Sixteen mixed-breed adult dogs. METHODS: Dogs were paired for sex, body weight, and approximate age and assigned to 1 of 2 groups: fenoldopam (F) or placebo (P). Baseline glomerular filtration rate (GFR) based on quantitative renal scintigraphy using (99m)Tc-DTPA, blood urea nitrogen (BUN), serum creatinine (SCr), urinalysis, and urine culture were performed before surgery. Left nephrotomy was performed via median celiotomy. Group F dogs were administered intravenous (IV) fenoldopam (0.1 microg/kg/min) for 90 minutes, whereas group P dogs were administered an equivalent volume of saline (0.9 % NaCl) solution for 90 minutes. Temperature, heart rate, respiration, direct arterial blood pressure, and urine volume were recorded during anesthesia. Renal function was assessed by measuring SCr, BUN, and GFR at 1, 21, and 42 days after surgery. RESULTS: There was no significant difference between groups in measured physiologic variables. No significant difference in GFR, BUN, or SCr between groups or between operated or control kidneys was detected. CONCLUSIONS: Bisection nephrotomy in normal dogs with renal arterial occlusion of 15 minutes and using a simple continuous capsular closure does not adversely affect renal function. CLINICAL RELEVANCE: Bisection nephrotomy, as described in this study, does not decrease renal function; perioperative administration of renoprotective agents is not necessary in normal dogs.

Chronic vomiting associated with a gastric carcinoid in a cat.

A geriatric domestic shorthair cat was presented for evaluation of chronic vomiting. Chronic renal failure was diagnosed on the basis of physical examination findings and results of a serum biochemical profile and urinalysis. Endoscopically obtained gastric biopsies were suggestive of a carcinoid tumor. Subsequently, an exploratory celiotomy with partial gastrectomy was performed. Histopathological and electron microscopic analysis of surgical biopsy specimens confirmed the diagnosis of a gastric carcinoid, which has not been previously reported in the cat. Following complete excision, the cat remained clinically stable and free of signs of gastrointestinal disease for 4 months before requiring treatment for progressive renal failure.

Smoking behaviour and dietary restraint in young adolescent women: the role of physical self-perceptions.

OBJECTIVE: To investigate the relationship among BMI, smoking consumption, dietary restraint, smoking to control weight, physical self-perception and self-esteem in young female adolescents. METHODS: 702 grade 9 students (14-15 yrs old) completed self-reported validated measures in classroom settings. RESULTS: 26.7% of students had smoked in the last 30 days. Cigarette consumption was low with only 13% smoking one or more cigarettes a day. MANOVA revealed smokers had higher dietary restraint and lower perceptions of physical appearance, conditioning, and self-esteem. A similar pattern emerged for those girls classified as using smoking to control weight. Multiple regression found dietary restraint was predicted by higher BMI, and lower body appearance and self-esteem. CONCLUSIONS: The data provided converging evidence that girls with low self-perceptions are more likely to engage in health-compromising behaviours. Smoking behaviours and dietary restraint were also linked. However, the small effect sizes for smoking behaviours warrants caution.

Detection of feline leukaemia virus in blood and bone marrow of cats with varying suspicion of latent infection.

The purpose of this study was to determine if polymerase chain reaction (PCR) could be used to detect FeLV proviral DNA in bone marrow samples of cats with varying suspicion of latent infection. Blood and bone marrow samples from 50 cats and bone marrow from one fetus were collected, including 16 cats with diseases suspected to be FeLV-associated. Serum enzyme-linked immunosorbent assay (ELISA), blood and bone marrow immunofluorescent antibody test (IFA), and blood and bone marrow PCR were performed on each cat, and IFA and PCR on bone marrow of the fetus. Forty-one cats were FeLV negative. Five cats and one fetus were persistently infected with FeLV. Four cats had discordant test results. No cats were positive on bone marrow PCR only. It appears persistent or latent FeLV infection is not always present in conditions classically associated with FeLV.

Extraskeletal osteosarcoma in the duodenum of a cat.

A three-year-old, male neutered domestic longhair cat was referred for evaluation of icterus, vomiting, and anorexia. Abdominal ultrasonography revealed a proximal duodenal mass obstructing the common bile duct. The mass was surgically resected, and a cholecystoduodenostomy was performed. The histopathological diagnosis was osteosarcoma. Thoracic radiographs showed no evidence of metastasis, and bone scintigraphy revealed no signs of a primary skeletal osteosarcoma. Four months after surgery, the cat had intermittent vomiting, marked weight loss, and died.

Pleural effusion in cats: 82 cases (1987 to 1995).

Eighty-two cases of feline pleural effusion were identified and reviewed to assess the type of fluid, underlying disease process, predisposing conditions, historical and physical examination findings, laboratory and cytology data, response to treatment and outcome. Pertinent findings included a high occurrence of pleural effusion with mediastinal lymphoma (and other types of intrathoracic neoplasia), pyothorax, cardiomyopathy and feline infectious peritonitis virus infection. Sixteen cases, eight with chylous effusion, had no underlying disease identified. Cats with pyothorax and effusion secondary to trauma had the best prognosis for complete recovery. Otherwise, the outcome was variable and the prognosis was guarded to poor.

Chylothorax associated with constrictive pericarditis in a dog.

Chylothorax was associated with constrictive pericarditis in a 6-year-old mixed-breed dog. Clinical signs included hepatomegaly, bilateral jugular pulses, muffled heart sounds, and dyspnea. Pleural effusion was identified on thoracic radiographs. Thoracentesis yielded 3 L of chylous effusion, confirmed by the cholesterol/triglyceride ratio (0.14). Echocardiography revealed a thickened pericardium, with numerous fibrin tags, which was suggestive of constrictive pericarditis. Central venous, right atrial, and right ventricular pressures were high and on right ventricular diastolic pressure tracings, the square-root sign, which is indicative of constrictive pericarditis, was evident. Exploratory thoracotomy and pericardiectomy were performed. Histopathologic findings were consistent with chronic non-suppurative pericarditis. The dog's condition improved after surgery. On reevaluation 11 months later, central venous pressure and results of physical examination and thoracic radiography were normal. On the basis of these findings, we concluded that chylothorax was caused by constrictive pericarditis in this dog. Chylothorax is often associated with disorders that have a poor prognosis, but if constrictive pericarditis can be identified as the cause of the chylothorax, exploratory thoracotomy and pericardiectomy can provide a cure.

Severe bilateral fibrosing pleuritis associated with chronic chylothorax in five cats and two dogs.

Severe bilateral fibrosing pleuritis was diagnosed in 5 cats and 2 dogs with chronic chylothorax. All animals were dyspneic on initial examination and remained moderately to severely dyspneic after thoracentesis. Radiographic evidence of fibrosing pleuritis included rounded lung lobes and failure of the lungs to reexpand following effective pleural drainage. Fibrosing pleuritis was also suggested in several animals with radiographic evidence of pleural fluid, in which pleural fluid could not be retrieved. Macroscopically, the lung lobes of all animals were compressed and atelectatic to various degrees, and the pleura appeared to be diffusely thickened and roughened. In several animals, fibrous adhesions were found between the parietal and visceral pleura of some lobes. Lung lobes were markedly constricted and appeared as small, smooth, rounded hilar masses in 4 animals. Mild to moderate pulmonary edema was evident in 3 animals at necropsy. Six of the 7 animals died (2) or were euthanatized (4) within 72 hours after the diagnosis of fibrosing pleuritis. The fibrosing pleuritis developed in 1 animal with lymphoblastic lymphosarcoma and chylothorax after treatment via passive pleuroperitoneal drainage; this animal was euthanatized because of underlying neoplasia. One cat, in which decortication was performed and resulted in marked reexpansion of the lung lobes, died 4 hours after surgery with signs compatible with pulmonary edema. On the basis of our findings, we suggest that animals with chronic chylothorax are at risk to develop fibrosing pleuritis. Furthermore, animals with severe bilateral fibrosing pleuritis should be given extremely guarded prognoses.

Serum hyperviscosity syndrome associated with multiple myeloma in two cats.

Serum hyperviscosity syndrome was diagnosed in 2 cats with multiple myeloma. Clinical signs included pale mucous membranes, dehydration, retinal hemorrhages, dilated and tortuous retinal vessels, seizures, head-tilt, nystagmus, systolic murmur, and gallop rhythm. Laboratory abnormalities included hyperglobulinemia, azotemia, hyperphosphatemia, nonregenerative anemia, and thrombocytopenia. Both cats had IgG monoclonal gammopathy, Bence Jones proteinuria, increased numbers of bone marrow plasma cells, and high values for relative serum viscosity. Renal disease was suspected in both cats. Cardiac hypertrophy was documented in 1 cat and was suspected in the other cat. Chemotherapy, using melphalan, prednisone, and vincristine, caused short-term remission in both cats, and plasmapheresis was used to lower serum protein concentration in 1 cat. Serum hyperviscosity syndrome rarely develops in cats, but should be suspected when monoclonal gammopathy exists with signs of neurologic, cardiac, or retinal disease.