Further characterization of computed tomographic and clinical features for staging and prognosis of idiopathic pulmonary fibrosis in West Highland white terriers.

Idiopathic pulmonary fibrosis is an interstitial lung disease of unknown etiology resulting in progressive interstitial fibrosis, with a known predilection in West Highland white terriers. In humans, computed tomography (CT) is a standard method for providing diagnostic and prognostic information, and plays a major role in the idiopathic pulmonary fibrosis staging process. Objectives of this retrospective, analytical, cross-sectional study were to establish descriptive criteria for reporting CT findings and test correlations among CT, clinical findings and survival time in West Highland white terriers with idiopathic pulmonary fibrosis. Inclusion criteria for affected West Highland white terriers were a diagnosis of idiopathic pulmonary fibrosis and available CT, bronchoscopy, bronchoalveolar lavage, echocardiography, and routine blood analysis findings. Clinically normal West Highland white terriers were recruited for the control group. Survival times were recorded for affected dogs. The main CT lung pattern and clinical data were blindly and separately graded as mild, moderate, or severe. Twenty-one West Highland white terriers with idiopathic pulmonary fibrosis and 11 control West Highland white terriers were included. The severity of pulmonary CT findings was positively correlated with severity of clinical signs (ρ = 0.48, P = 0.029) and negatively associated with survival time after diagnosis (ρ = -0.56, P = 0.025). Affected dogs had higher lung attenuation (median: -563 Hounsfield Units (HU)) than control dogs (median: -761 HU), (P < 0.001). The most common CT characteristics were ground-glass pattern (16/21) considered as a mild degree of severity, and focal reticular and mosaic ground-glass patterns (10/21) considered as a moderate degree of severity. Findings supported the use of thoracic CT as a method for characterizing idiopathic pulmonary fibrosis in West Highland white terriers and providing prognostic information for owners.

Organ dysfunction and mortality risk factors in severe canine bite wound trauma.

OBJECTIVE: To identify mortality risk factors, determine mortality rate, and to describe the treatment, incidence, and type of organ dysfunction in dogs with severe bite wounds. DESIGN: Retrospective case study from 2000 to 2009. SETTING: University veterinary teaching hospital. ANIMALS: Ninety-four dogs admitted to the intensive care unit (ICU) with bite wounds. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: In all dogs, physical parameters, diagnostic testing, surgery and anesthesia timing, and treatment details were recorded at presentation and during ICU hospitalization. The overall mortality rate was 15%. A majority of dogs (68%) were <10 kg. A majority of the wounds (53%) yielded no growth on bacterial culture. Prolonged time from admission to anesthesia was associated with a need for longer postoperative ICU hospitalization (P = 0.0099). Prolonged anesthesia time was associated with mortality (P = 0.0044). Systemic inflammatory response syndrome (SIRS) occurred in 54.3% of dogs and multiple organ dysfunction syndrome (MODS) occurred in 27.7% of dogs. The presence of SIRS was significantly associated with mortality (P = 0.01), with a mortality rate of 24% in dogs that developed SIRS. MODS was associated with risk of mortality (P < 0.001) with a mortality rate of 67% in dogs with dysfunction of 4 or more organs. Dogs with dysfunction of 1 organ system had a mortality rate of 9%. The body system most commonly affected was the respiratory system (37%). Cardiovascular dysfunction was highly predictive of mortality (odds ratio [OR]: 29). CONCLUSIONS: Patients with extensive bite wounds have a significant risk of developing severe secondary complications such as SIRS, disseminated intravascular coagulopathy, and MODS. Longer time to anesthesia was associated with a longer recovery and longer anesthetic times were associated with mortality, disseminated intravascular coagulopathy, and MODS. Injury to the respiratory system was most commonly encountered and mortality increased with cardiovascular injury, MODS, and SIRS.

Case-control study to evaluate risk factors for the development of sepsis (neutropenia and fever) in dogs receiving chemotherapy.

OBJECTIVE-To identify risk factors for development of sepsis in dogs treated with chemotherapeutics and to evaluate the impact of sepsis on outcome. DESIGN-Case-control study. ANIMALS-Client-owned dogs with various cancers undergoing standard chemotherapeutic treatment at the University of Pennsylvania veterinary hospital. PROCEDURES-39 dogs with sepsis (cases) were identified through a search of the medical record database. Controls (n = 77) were randomly selected from dogs admitted during the same time period. Variables analyzed included patient demographics, tumor type, stage, remission status, treatment phase, chemotherapeutics used, and outcome. RESULTS-Dogs that weighed less and dogs with lymphoma were significantly more likely to become septic, compared with larger dogs or dogs with solid tumors. Septic dogs were also significantly more likely to have received doxorubicin (odds ratio [OR], 12.5; 95% confidence interval [CI], 2.4 to 66.0) or vincristine (OR, 9.0; 95% CI, 1.6 to 52.0) than controls. Of the 39 cases, 28 (71.8%) were in the induction phase of their protocol, and 19 of 39 (48.7%) became septic after receiving the chemotherapeutic drug for the first time. Median survival time of the cases (253 days) was not significantly different from that of the controls (371 days). CONCLUSIONS AND CLINICAL RELEVANCE-Dogs that weighed less were at increased risk for chemotherapy-induced sepsis. Tumor type and chemotherapeutic drug used were also important risk factors. These results may lead to the implementation of prophylactic measures, especially when doxorubicin or vincristine is used in the induction phase in small dogs with lymphoma.

Underlying cause, pathophysiologic abnormalities, and response to treatment in cats with septic peritonitis: 51 cases (1990-2001).

OBJECTIVE: To determine the underlying cause, pathophysiologic abnormalities, and response to treatment in cats with septic peritonitis and identify differences between cats that survived following treatment and cats that did not survive despite treatment. DESIGN: Retrospective study. ANIMALS: 51 cats with septic peritonitis. PROCEDURE: Medical records were reviewed for clinical findings; results of clinicopathologic testing, microbial culture, and radiography; diagnosis; treatment; and outcome. RESULTS: Signs of pain during palpation of the abdomen were reported for only 29 of 47 (62%) cats. Eight (16%) cats had relative bradycardia (heart rate < 140 beats/min). The most commonly isolated organisms included Escherichia coli, Enterococcus spp, and Clostridium spp. The most common cause of peritonitis was gastrointestinal tract leakage (24 cats). No definitive source could be identified in 7 cats. Treatment, including exploratory surgery, was pursued in 23 cats, of which 16 (70%) survived and were discharged. There were no significant differences between survivors and nonsurvivors in regard to heart rate, age, rectal temperature, serum lactate concentration, WBC count, PCV, blood glucose concentration, or serum albumin concentration. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that clinicopathologic abnormalities and outcome in cats with septic peritonitis are similar to those reported for dogs. However, certain features may be unique, including an absence of signs of pain during abdominal palpation, relative bradycardia, and apparent spontaneous peritonitis in some cats.