Surgical intervention for vertebral osteomyelitis in a calf.

OBJECTIVE: To report the surgical treatment and outcome of a non-ambulatory calf with cervical vertebral ostoeomyelitis. STUDY DESIGN: Clinical report. SAMPLE POPULATION: One 3.5-month-old female mixed-breed calf with tetraparesis of 3 months duration. METHODS: After computed tomography-guided bone biopsy, a bacterial osteolytic lesion within the body of the fourth cervical vertebrae (C4) and resultant pathologic compression fracture clinically resulting in full tetraparesis was diagnosed in the calf. Culture results from the lesion within C4 confirmed a diagnosis of Trueperella pyogenes. RESULTS: Poor response to medical management justified surgical debridment of the lesion in C4 and subsequent stabilization of the cervical vertebral column. A three-part procedure was performed including (1) debridement of the C4, (2) bilateral ventral vertebral stabilization from C3 to C5, and (3) placement of ampicillin-impregnated plaster of Paris beads within the body of C4. With postoperative physical rehabilitation, the calf regained full ambulatory function. At 1-month follow-up, the calf remained ambulatory with mild proprioceptive ataxia and no evidence of implant failure. At annual recheck, the calf had gained 208 kg and remained fully ambulatory with no residual neurologic deficits. CONCLUSION: Surgical intervention and use of antibiotic-impregnated implants offered a viable alternative to long-term medical management of vertebral osteomyelitis in the calf reported here. CLINICAL SIGNIFICANCE: This case identifies surgical intervention as a potential means for improving outcomes in a historically fatal condition of production animals.

Severe Disseminated Necrotizing and Granulomatous Lymphadenitis and Encephalitis in a Dog Due to Sporotrichum pruinosum (Teleomorph: Phanerochaete chrysosporium).

A 9-year-old female mixed breed dog presented for an acute onset of anorexia, vomiting, and cough. Initial examination and diagnostics revealed a large multilobular cranial mediastinal mass with unidentified fungal organisms on cytology. The disease progressed in spite of therapy until the dog was euthanized 8 months later. Gross necropsy findings were a large multilobular intrathoracic mass, mild pleuritis, and generalized lymphadenopathy. Histologic evaluation showed granulomatous inflammation and necrosis with numerous 20- to 70-micron, periodic acid-Schiff- and Gomori methenamine silver-positive spherules effacing lymph node parenchyma, as well as severe inflammation within the midbrain. Endosporulation was a common finding, and large numbers of fungal hyphae were also present in affected areas. Ribosomal RNA gene sequencing found 100% identity to published sequences of Phanerochaete chrysosporium, the teleomorph form of Sporotrichum pruinosum. This is the first published report of disease caused by natural infection with this basidiomycete organism in animals.

Changes in symmetric dimethylarginine and glomerular filtration rates in hyperthyroid cats undergoing radioiodine therapy.

OBJECTIVES: The aims of this study were to evaluate concentrations of symmetric dimethylarginine (SDMA) in hyperthyroid cats before and after radioiodine treatment, and to compare results with other variables used to assess kidney function in cats (creatinine, urine specific gravity [USG] and glomerular filtration rate [GFR] measured by renal scintigraphy). METHODS: Thirteen cats diagnosed with hyperthyroidism based on clinical signs and increased serum total thyroxine (TT4) were included in this prospective study. Study design included physical examination, complete blood count, serum chemistry, TT4, urinalysis and SDMA before treatment (T0) and at 1 month (T1) and 3 months post-treatment (T3). GFR was quantified by renal scintigraphy at T0 and T3. RESULTS: Median GFR decreased significantly from baseline (3.18 ml/kg/min; range 1.35-4.87) at T3 (2.22 ml/kg/min; range 1.81-3.42 [P = 0.005]). While median creatinine and serum urea nitrogen increased post-treatment (creatinine: T0 = 0.8 mg/dl [range 0.4-1.1], T1 = 1.3 mg/dl [range 0.9-2]; T3 = 1.65 mg/dl [range 0.8-2.8]; P <0.001; serum urea nitrogen: T0 = 23 mg/dl [range 15-26]; T1 = 27 mg/dl [range 20-40]; T3 = 27.5 mg/dl [range 20-36]; P <0.001), SDMA and USG did not change significantly (SDMA: T0 = 11 µg/dl [range 7-15]; T1 = 12 µg/dl [range 6-16]; T3 = 10.5 µg/dl [range 8-21]; P = 0.789; USG: T0 = 1.030 [range 1.011-1.059]; T1 = 1.035 [range 1.012-1.044]; T3 = 1.030 [range 1.007-1.055]; P = 0.792). CONCLUSIONS AND RELEVANCE: Our data suggest that factors other than GFR may affect serum SDMA in hyperthyroid cats and that SDMA does not offer an advantage over other biomarkers traditionally used to predict changes in renal function following radioiodine therapy.

Case Report: Trochlear Wedge Sulcoplasty, Tibial Tuberosity Transposition, and Lateral Imbrication for Correction of a Traumatic Patellar Luxation in a Miniature Companion Pig: A Case Report and Visual Description.

The objective of this case report was to describe successful surgical and post-operative management of a medial patellar luxation in a Vietnamese Potbellied Pig. A two-year old, castrated, Vietnamese Potbellied Pig presented to a veterinary teaching hospital for right pelvic limb lameness of 2 weeks duration. Upon physical examination a grade 3 patellar luxation was diagnosed on the right pelvic limb. Surgical repair included a trochlear wedge sulcoplasty, tibial tuberosity transposition, and lateral imbrication as described for canine patellar luxation. The pig was managed post-operatively with meloxicam and a physical therapy regimen of seven weeks duration. At recheck examination the pig was sound, no complications were observed, and the owners were satisfied with the outcome. As miniature companion pigs, such as Vietnamese Potbellied Pigs are currently increasing in popularity as pets, this case demonstrated that comparative techniques from other veterinary species should be considered when considering a treatment plan for a pig with a medial patellar luxation.

Lung ultrasonography findings in dogs with various underlying causes of cough.

OBJECTIVE: To characterize lung ultrasonography (LUS) findings in dogs with a primary clinical complaint of cough. ANIMALS: 100 client-owned coughing dogs. PROCEDURES: A standardized LUS examination was performed for all dogs to quantify the number of B lines and identify subpleural abnormalities at 4 sites on each hemithorax. The final clinical diagnosis (reference standard) was determined by medical record review, and sensitivity and specificity of LUS for the diagnosis of selected causes of cough was determined. RESULTS: Common underlying causes of cough included dynamic airway collapse (n = 37), cardiogenic pulmonary edema (CPE; 12), and bronchitis (10). Compared with dogs with other causes of cough, dogs with bacterial pneumonia (n = 7) were more likely to have subpleural shred signs, whereas dogs with pulmonary neoplasia (4) were more likely to have subpleural nodule signs. Dogs with CPE had higher total B-line scores and higher numbers of LUS sites strongly positive for B lines (> 3 B lines/site) than other dogs. The LUS criteria of total B-line score ≥ 10 and presence of ≥ 2 sites strongly positive for B lines were each 92% sensitive and 94% specific for CPE diagnosis. Notably, 18% (16/88) of dogs with noncardiac causes of cough had been treated previously with diuretics because of prior CPE misdiagnosis. CONCLUSIONS AND CLINICAL RELEVANCE: LUS profiles in dogs with cough differed by the underlying cause. In dogs with a clinical history of cough, this imaging modality could be diagnostically useful, particularly to help exclude the possibility of underlying CPE.

Percutaneous endoscopic gastrojejunostomy tube placement in healthy dogs and cats.

BACKGROUND: Pancreatitis, hepatobiliary disease, and proximal gastrointestinal tract disorders are clinical situations where delivery of nutrients via jejunostomy tube is preferable to a feeding gastrostomy. A thorough description of the percutaneous endoscopic gastrojejunostomy (PEG-J) technique and practical guidelines for its use in small animals have not been reported. HYPOTHESIS: That a simple technique of PEG-J tube placement in humans would be useful and safe in healthy dogs and cats. ANIMALS: Twelve healthy dogs and 5 healthy cats were included in the study. MATERIALS AND METHODS: Commercially prepared PEG-J tubes were modified for use in animals and positioned in the small intestine by endoscopic guidance. Eight dogs and 5 cats were bolus fed enteral diets for 14 days. Complications associated with the use of the PEG-J tube and responses to bolus feedings were assessed. RESULTS: Jejunostomy tubes were placed distal to the caudal duodenal flexure in all dogs and cats. Complications associated with PEG-J tubes occurred in 5/12 dogs and 4/5 cats and included J-tube removal, local pain/inflammation, retrograde tube migration, and diarrhea. Bolus feeding (daily maintenance energy requirement [MER] divided q8h) through the jejunostomy catheter was well tolerated, maintained normal body weight, and was not associated with adverse gastrointestinal signs. CONCLUSIONS AND CLINICAL IMPORTANCE: Placement of a PEG-J tube is an effective, noninvasive technique for providing enteral nutritional support of healthy dogs and cats. Bolus-feeding techniques via PEG-J tubes maintain normal nutritional status in healthy dogs and cats. This procedure for jejunostomy feeding may be easily adapted for use in clinical practice outside of an intensive care facility.

Effect of hyperimmune plasma on the severity of pneumonia caused by Rhodococcus equi in experimentally infected foals.

This study evaluated the prophylactic effectiveness of hyperimmune plasma (HIP) as an aid in the prevention of pneumonia caused by experimental infection with Rhodococcus equi. Thirty neonatal foals were administered R. equi HIP or saline at 2 days of age and were infected with virulent R. equi at 7 days. All foals developed signs or symptoms of respiratory disease. Radiographic scores on day 28 and neutrophil concentrations on day 49 were significantly greater in control foals, and time to respiratory effort score of 2 or higher was significantly shorter for control foals. Three foals, all in the principal group, died or were euthanized before the end of the study, but there was no significant difference in mortality between groups. VapA titers were significantly greater in principal foals. Administration of R. equi HIP decreased the severity of radiographic lesions and prolonged time to increased respiratory effort due to R. equi-induced pneumonia.

Effect of sedation protocol on glomerular filtration rate in cats as determined by use of quantitative renal scintigraphy.

OBJECTIVE: To evaluate the effect of several sedation protocols on glomerular filtration rate (GFR) in cats as measured by use of quantitative renal scintigraphy and to analyze interobserver differences in GFR calculation. ANIMALS: 5 cats (1 sexually intact male, 1 neutered male, and 3 sexually intact females). PROCEDURES: Effects on GFR of 3 sedation protocols commonly used at the Iowa State University College of Veterinary Medicine were evaluated. The protocols were medetomidine (11 µg/kg) and butorphanol tartrate (0.22 mg/kg) administered i.m.; ketamine hydrochloride (10 mg/kg) and midazolam (0.5 mg/kg) administered i.v.; and ketamine (10 mg/kg), midazolam (0.5 mg/kg), and acepromazine maleate (0.05 mg/kg) administered i.m.. Results for the 3 protocols were compared with results of GFR measurements obtained in these same cats without sedation (control protocol). RESULTS: No significant difference between GFR measurements was associated with the 3 sedation protocols, compared with GFR measurements for the control protocol. The greatest mean GFR values were for the medetomidine-butorphanol and ketamine-midazolam protocols. There were no significant differences between observers for calculation of GFR. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that none of the 3 sedation protocols had significant effects on GFR calculated by use of quantitative renal scintigraphy, compared with results for GFR evaluations performed in the cats when they were not sedated. No significant interobserver error was evident. However, the statistical power of this study was low, and the probability of a type II error was high.