Treatment of 5 dogs with immune-mediated thrombocytopenia using Romiplostim.

BACKGROUND: Immune thrombocytopenia (ITP) in dogs is analogous to that in humans. Romiplostim, a novel thrombopoietin receptor (TPO-R) agonist, is currently used for the treatment of refractory ITP in humans, but not in dogs. Here, we describe the response to romiplostim in five dogs with refractory ITP. Five dogs with severe and refractory ITP (three primary and two secondary) received romiplostim subcutaneously. Four dogs were administered 3-5 µg/kg and one dog received 10-13 µg/kg body weight once weekly. RESULTS: Romiplostim was well-tolerated and administration was associated with an increase in platelet counts in all five dogs. Four of the five dogs entered remission and relapses were not observed over a follow-up period of 3-10 months. CONCLUSIONS: Romiplostim is effective in the treatment of ITP in dogs at least as well as in humans. This finding may help to develop and use new therapeutics for ITP in dogs and humans.

Diagnostic cut-off values for the urinary corticoid:creatinine ratio for the diagnosis of canine Cushing's syndrome using an automated chemiluminescent assay.

BACKGROUND: Cushing's syndrome is one of the most common endocrinopathies in dogs. The preferred screening test for spontaneous Cushing's syndrome is the low-dose dexamethasone suppression test (LDDST). The diagnostic value of urinary cortisol:creatinine ratios (UCCR) is questionable. OBJECTIVES: The aim of this study was to determine diagnostic cut-off values for UCCR testing in comparison with LDDST as a clinical reference standard and to calculate the sensitivity and specificity. METHODS: Data from 2018 to 2020 were obtained retrospectively from a commercial laboratory. Both LDDST and UCCR were measured by automated chemiluminescent immunoassay (CLIA). The maximum interval between both tests was 14 days. The optimal cut-off value for UCCR testing was calculated by the Youden index. The sensitivity and specificity of these cut-off values for the UCCR test and LDDST were assessed by Bayesian latent class models (BLCMs). RESULTS: This study included 324 dogs with both UCCR test and LDDST results. The optimal UCCR cut-off value, calculated by the Youden index, was 47.4 × 10-6 . Any UCCR <40 × 10-6 was interpreted as a negative result, 40-60 × 10-6 as values in a gray zone, and >60 × 10-6 as positive. Using the cut-off of 60 × 10-6 , BLCM showed 91% (LDDST) and 86% (UCCR test) sensitivity and a specificity of 54% (LDDST) and 63% (UCCR test). CONCLUSIONS: Considering an 86% sensitivity and a 63% specificity, UCCR testing may be considered a first-line investigation to rule out Cushing's syndrome using CLIA analysis. Urine samples can be collected noninvasively at home by the owner, reducing the potential impact of stress.

Successful Treatment of Pneumothorax in a Dog With Sterile Pleural Fibrosis Caused by Chylothorax.

A 2-year-old, 12 kg, intact male crossbreed dog was presented with respiratory distress, exercise intolerance, and gagging. Plain thoracic radiographs revealed severe pleural effusion. Although bilateral needle thoracocentesis and chest tube placement were performed, no re-expansion of the lung lobes occurred. Pleural effusion was of chylous quality and led to lung entrapment. Computer tomography revealed a highly atrophic and atelectatic right middle lung lobe. The remaining lung lobes were only expanded to ~40%. Visceral pleura and pericardium showed a heterogeneous thickening consistent with pleural fibrosis. Partial pericardiectomy with resection of the middle lung lobe through a right lateral thoracotomy was performed. Ligation of the thoracic duct and ablation of the cisterna chyli was achieved through a single paracostal approach. Histopathology revealed chronic-active proliferative beginning granulomatous pleuritis, fibrotic pericarditis, and partial coagulative necrosis with incomplete granulomatous sequestration in the resected middle lung lobe. Chylothorax resolved after surgical intervention. Active pleural effusion resolved, and lung entrapment changed to trapped lung disease. The remaining lung lobes re-expanded to ~80% over the following 6 days. The dog was discharged 10 days later. Mild to moderate pleural effusion of non-chylic quality was present during the following 4 months. Meloxicam was administered for 4 months because of its anti-fibrotic and anti-inflammatory properties. Fifteen months later, thoracic radiographs revealed full radiologic expansion of the lungs with persistent mild pleural fibrosis. To the authors' knowledge, this is the first case report of pneumothorax due pleural fibrosis caused by chylothorax in a dog with an excellent clinical outcome.

Giardia duodenalis in small animals and their owners in Germany: A pilot study.

Giardia duodenalis is a relevant gastrointestinal protozoan pathogen of humans and animals. This species complex consists of eight genetically different assemblages. Assemblages A and B are pathogenic to humans and pets, thus confer zoonotic potential. The risk of zoonotic transmission has been controversially discussed. The aim of this monocentric cross-sectional pilot study was to investigate G. duodenalis assemblages in humans and pets living in common households in Berlin/Brandenburg (Germany). Samples from dogs, cats and humans sharing the same households were screened for Giardia infection by antigen-detecting assays. All human samples were additionally analysed by a Giardia-specific qPCR. Cyst quantification and sequences of different gene loci (triosephosphate isomerase (tpi), glutamate dehydrogenase (gdh), ß-giardin (bg) and for dogs SSUrDNA) were analysed. A total of 38 households (31 households with dogs and seven with cats) with 69 human individuals participated in the study. Initial antigen-detecting assays revealed Giardia-positive results for 13 (39%) canine, one (14%) feline and one human sample. Reanalysis of the human samples by qPCR revealed two more positive specimens (4%). Two of these three samples were identified as assemblage B at all tested loci. Success rate of assemblage typing for pet samples was generally low and comprised mainly the SSUrDNA locus only. Overall, six of 13 Giardia-positive canine samples were typable (2× A, 1× co-infection: A and B, 1× C; 2× D). One pair of samples (dog and human) from the same household had a similar but not identical assemblage B sequence at tpi locus. Assemblage A was also detected in the dog specimen, which hampered sequence analysis. In conclusion, although exhibiting limitations due to the sample size, our study highlights the need for better and standardized typing tools to distinguish G. duodenalis strains with higher resolution in order to perform proper case-control studies for a realistic estimation of zoonotic risk.

[Spontaneous pneumothorax in cats: two case reports and literature review]. / Spontaner Pneumothorax bei der Katze: zwei Fallberichte und Literaturübersicht.

Spontaneous pneumothorax (SP) is a non-traumatic accumulation of air in the pleural cavity. This case report describes a cat with SP as a result of primary pulmonary adenocarcinoma. A second cat was diagnosed with primary pulmonary adenocarcinoma and asthma. A thoracostomy tube was inserted in the first cat while in the second cat a thoracostomy tube was placed and lobectomy of the right cranial and middle lung lobes was performed. Both cats died following treatment. The current literature reviewed here covers the comparative etiologies of SP as well as clinical presentation, diagnostic work-up, therapy and prognosis in cats. A total of 64 cases of cats with secondary spontaneous pneumothorax reported in nine articles are discussed. To our knowledge, there has been no previous description in the literature regarding primary SP in cats. Based on prior case reports, surgery was performed in 16% (10 cats) of SP cases. The current review demonstrates that depending on the underlying lung disease, cats with SP have a careful short-term prognosis because 39 of 64 cats (60%) were discharged.