Utility of bronchoscopy combined with surgery in the treatment and outcomes of dogs with intrathoracic disease secondary to plant awn migration.

OBJECTIVE: To evaluate the diagnostic and therapeutic utility of bronchoscopy in dogs undergoing computed tomography (CT) and surgery for intrathoracic disease (pyothorax and pneumothorax) secondary to migrating plant awns (MPA) and to report outcomes in dogs that did and did not undergo bronchoscopy in addition to CT and surgery. STUDY DESIGN: Retrospective case series. ANIMALS: Thirty-seven client-owned dogs. METHODS: Medical records from 2008 to 2017 were reviewed for dogs with documented MPA in the thoracic cavity treated with CT and surgery with or without bronchoscopy. Information regarding diagnostics, treatments, complications, and outcomes relating to hospitalization was evaluated. RESULTS: At least one abnormal lung lobe was identified by CT in all dogs. Bronchial abnormalities were identified with bronchoscopy in 21 of 22 dogs (95.4%) with available reports. Agreement between CT and bronchoscopy findings ranged from 50% to 81.8%, depending on lung lobe. Thirty-six dogs had one or more lung lobes surgically removed. Thirty-seven MPA were retrieved via bronchoscopy in 10 of 27 (37%) dogs, and 39 MPA were retrieved at surgery in 26 of 37 (70.3%) dogs. Actinomyces spp. were cultured from surgical samples in 7 of 33 (21.2%) dogs. Thirty-five of 37 (94.6%) dogs survived to discharge. CONCLUSION: Migrating plant awns were successfully retrieved via bronchoscopy. Agreement between CT findings and bronchoscopy was inconsistent, so there may be roles for both modalities. Short- and long-term survival was excellent in this cohort. CLINICAL SIGNIFICANCE: Bronchoscopy may allow for diagnostic and therapeutic advantages compared with CT in dogs with endobronchial MPA. Actinomyces spp appear to be variably present in surgically acquired bacterial cultures in dogs with MPA.

A novel approach to identifying and quantifying neutrophil extracellular trap formation in septic dogs using immunofluorescence microscopy.

BACKGROUND: Canine neutrophils release neutrophil extracellular traps (NETs) in response to lipopolysaccharide but NETs from clinical septic dogs had not been identified. The primary aim is to describe the methodology of identifying and quantifying neutrophil extracellular traps (NETs) in cytology samples of septic foci in dogs with sepsis using immunofluorescence microscopy. Cytology samples including endotracheal tracheal wash (ETW), bronchoalveolar lavage (BAL), abdominal and pleural effusion collected from 5 dogs (3 septic, 2 non-septic) were fixed, permeabilized and stained for myeloperoxidase (MPO), citrullinated histone H3 (citH3) and cell-free DNA (cfDNA). Fluorescence microscopy was used to identify and quantify NETs in 10 random views at 40× magnification. NETs were identified based on co-localization of MPO, citH3 and cfDNA. NETs were quantified as a ratio (number of NETs: number of neutrophils). Neutrophils were identified based on cytoplasmic MPO, cellular diameter and nuclear morphology. RESULTS: NETs were identified and quantified in all cytology samples collected from septic dogs. A small number of NETs was documented in one dog with sterile chronic bronchitis. No NETs were found in sterile abdominal effusion collected from one dog with congestive heart failure. CONCLUSIONS: Immunofluorescence microscopy could be a useful tool for the study of NETs in dogs with clinical sepsis.

The prevalence of dynamic pharyngeal collapse is high in brachycephalic dogs undergoing videofluoroscopy.

The aim of this retrospective study was to determine the frequency of pharyngeal collapse in a large group of brachycephalic dogs undergoing videofluoroscopic assessment of swallowing or airway diameter. We hypothesized that brachycephalic dogs would have pharyngeal collapse more frequently than dolichocephalic or mesocephalic dogs with or without airway collapse. The medical records database was searched for brachycephalic dogs undergoing videofluoroscopy of swallowing or airway diameter between January 1, 2006 and December 31, 2015. A cohort of dolichocephalic/mesocephalic dogs with videofluoroscopically confirmed airway collapse was age and time matched for comparison. A control group of dolichocephalic/mesocephalic dogs that did not have documented airway collapse was also evaluated. All fluoroscopic studies were assessed by a board certified veterinary radiologist for the presence and degree of pharyngeal collapse. Results demonstrate that pharyngeal collapse was significantly more common in brachycephalic dogs (58/82; 72%) than in nonbrachycephalic dogs with (7/25; 28%) and without (2/30; 7%) airway collapse. Pharyngeal collapse is more prevalent in brachycephalic dogs undergoing videofluoroscopy than in dolichocephalic/mesocephalic dogs with or without airway collapse.

Molecular diagnosis of Pneumocystis pneumonia in dogs.

Pneumocystis pneumonia (PCP) is a life-threatening fungal disease that can occur in dogs. The aim of this study was to provide a preliminary genetic characterisation of Pneumocystis carinii f.sp.'canis' (P. canis) in dogs and thereby develop a reliable molecular protocol to definitively diagnose canine PCP. We investigated P. canis in a variety of lung specimens from dogs with confirmed or strongly suspected PCP (Group 1, n = 16), dogs with non-PCP lower respiratory tract problems (Group 2, n = 65) and dogs not suspected of having PCP or other lower respiratory diseases (Group 3, n = 11). Presence of Pneumocystis DNA was determined by nested PCR of the large and small mitochondrial subunit rRNA loci and by a real-time quantitative polymerase chain reaction (qPCR) assay developed using a new set of primers. Molecular results were correlated with the presence of Pneumocystis morphotypes detected in cytological/histological preparations. Pneumocystis DNA was amplified from 13/16 PCP-suspected dogs (Group 1) and from 4/76 dogs of control Groups 2 and 3 (combined). The latter four dogs were thought to have been colonized by P. canis. Comparison of CT values in 'infected' versus 'colonized' dogs was consistent with this notion, with a distinct difference in molecular burden between groups (CT ≤ 26 versus CT range (26

PROSPECTIVE COMPARISON OF TUMOR STAGING USING COMPUTED TOMOGRAPHY VERSUS MAGNETIC RESONANCE IMAGING FINDINGS IN DOGS WITH NASAL NEOPLASIA: A PILOT STUDY.

Identification of nasal neoplasia extension and tumor staging in dogs is most commonly performed using computed tomography (CT), however magnetic resonance imaging (MRI) is routinely used in human medicine. A prospective pilot study enrolling six dogs with nasal neoplasia was performed with CT and MRI studies acquired under the same anesthetic episode. Interobserver comparison and comparison between the two imaging modalities with regard to bidimensional measurements of the nasal tumors, tumor staging using historical schemes, and assignment of an ordinal scale of tumor margin clarity at the tumor-soft tissue interface were performed. The hypotheses included that MRI would have greater tumor measurements, result in higher tumor staging, and more clearly define the tumor soft tissue interface when compared to CT. Evaluation of bone involvement of the nasal cavity and head showed a high level of agreement between CT and MRI. Estimation of tumor volume using bidimensional measurements was higher on MRI imaging in 5/6 dogs, and resulted in a median tumor volume which was 18.4% higher than CT imaging. Disagreement between CT and MRI was noted with meningeal enhancement, in which two dogs were positive for meningeal enhancement on MRI and negative on CT. One of six dogs had a higher tumor stage on MRI compared to CT, while the remaining five agreed. Magnetic resonance imaging resulted in larger bidimensional measurements and tumor volume estimates, along with a higher likelihood of identifying meningeal enhancement when compared to CT imaging. Magnetic resonance imaging may provide integral information for tumor staging, prognosis, and treatment planning.

Effect of One-Lung Ventilation With or Without Low-Pressure Carbon Dioxide Insufflation on Cardiorespiratory Variables in Cats Undergoing Thoracoscopy.

OBJECTIVES: To document a technique for one-lung ventilation (OLV) in cats and evaluate the effect of low-pressure carbon dioxide insufflation and OLV (OLV-CDI) on cardiorespiratory variables in cats. STUDY DESIGN: Prospective randomized study. ANIMALS: Cats (n = 6). METHODS: General anesthesia was induced using a standardized anesthetic protocol. A thermodilution catheter was placed into the pulmonary artery using fluoroscopic guidance. Two 6 mm thoracoscopic cannulae were placed at a subxiphoid and intercostal location, respectively, to allow direct observation of all lung lobes. OLV was induced using an endobronchial blocker, which was placed into the right and left main stem bronchi in randomized order using bronchoscopic guidance. Cardiorespiratory variables were measured at 5 and 30 minutes after induction of OLV and subsequently at 5 and 30 minutes after initiation of OLV-CDI at intra-thoracic pressures of 3 mmHg. RESULTS: Left-sided OLV was successful in 5 cats, right-sided OLV was successful in 2 cats, and neither was successful in 1 cat. No significant effects on hemodynamic variables or oxygen delivery were observed after right or left-sided OLV alone. Hemodynamic variables were also well-preserved after OLV-CDI; however, oxygen delivery was significantly lower after left OLV-CDI compared with right OLV-CDI, and in 2 cats, severe desaturation occurred after L-OLV-CDI before the 30 minute time point. CONCLUSIONS: OLV can be used in cats for thoracoscopic interventions. Although right OLV-CDI was tolerated better than left OLV-CDI, the technique requires further investigation before it can be recommended for widespread clinical use.

COMPARISON OF THE RADIOGRAPHIC AND TRACHEOSCOPIC APPEARANCE OF THE DORSAL TRACHEAL MEMBRANE IN LARGE AND SMALL BREED DOGS.

The etiology and clinical significance of increased radiographic opacity along the dorsal margin of the tracheal lumen has long been debated. Most often, this opacity is attributed to redundancy of the dorsal tracheal membrane (DTM), a condition that occurs with tracheal collapse. We hypothesized that the underlying etiology of this radiographic opacity differs between small breed dogs with tracheal collapse and small or large breed dogs without tracheal collapse. The purpose of this prospective, cross-sectional study was to compare the radiographic appearance of an increased opacity within the trachea to tracheoscopy findings in a group of small and large breed dogs. A total of 17 small breed dogs and 16 large breed dogs were included. Of these, only one did not have a radiographically visible DTM. Small breed dogs were divided into groups with tracheal collapse (n = 8) and those without (n = 9) based on tracheoscopy. Tracheal collapse was absent in larger breed dogs, however both large and small breed dogs demonstrated inward invagination of the DTM. In dogs with tracheal collapse, the DTM occupied a larger percentage of the tracheal luminal height on radiographs and a larger percentage of tracheal circumference on tracheoscopy vs. dogs with an invaginated DTM on tracheoscopy and dogs with no collapse and no invagination of the DTM. Findings supported the hypothesis that increased radiographic opacity along the dorsal margin of the trachea arises from different etiologies in dogs with and without tracheal collapse.

Recognition and Diagnosis of Underlying Disease Processes in Bacterial Pneumonia.

Bacterial pneumonia can present in both dogs and cats as either acute or chronic disease, and clinical signs may suggest respiratory or systemic impairment. Aspiration pneumonia, a common form of disease, can be caused by esophageal or laryngeal disease, vomiting, or altered mentation, such as with CNS disease or general anesthesia. Bacterial pneumonia can also develop due to inhaled airway foreign bodies, reduced local immune function, or impaired clearance of respiratory secretions. Rapid identification of the etiology and associated risk factors for pneumonia can help veterinarians develop a targeted therapeutic plan and prevent recurrence of disease.

Platelet hyperresponsiveness and increased platelet-neutrophil aggregates in dogs with myxomatous mitral valve disease and pulmonary hypertension.

BACKGROUND: Pulmonary hypertension (PH) in dogs with myxomatous mitral valve disease (MMVD) is caused by increased pulmonary venous pressure. Thrombosis, vascular remodeling, and vasoconstriction mediated by platelets could exacerbate PH. HYPOTHESIS: Dogs with PH will exhibit a hypercoagulable state, characterized by increased platelet activation, platelet-leukocyte, and platelet-neutrophil aggregate formation. ANIMALS: Eleven dogs (≥3.5 kg) diagnosed with MMVD and PH and 10 dogs with MMVD lacking PH. METHODS: Prospective cohort ex vivo study. All dogs underwent echocardiographic examination, CBC, 3-view thoracic radiographs, and heartworm antigen testing. Severity of PH and MMVD were assessed by echocardiography. Viscoelastic monitoring of coagulation was assessed using thromboelastography (TEG). Platelet activation and platelet-leukocyte/platelet-neutrophil interactions were assessed using flow cytometry. Plasma serotonin concentrations were measured by ELISA. RESULTS: Unstimulated platelets from dogs with MMVD and PH expressed more surface P-selectin than MMVD controls (P = .03). Platelets from dogs with MMVD and PH had persistent activation in response to agonists. The number of platelet-leukocyte aggregates was higher in dogs with MMVD and PH compared with MMVD controls (P = .01). Ex vivo stimulation of whole blood resulted in higher numbers of platelet-neutrophil aggregates in dogs with MMVD and PH (P = .01). Assessment of hypercoagulability based on TEG or plasma serotonin concentrations did not differ between groups. CONCLUSION AND CLINICAL IMPORTANCE: Platelet hyperresponsiveness and increased platelet-neutrophil interaction occur in dogs with MMVD and PH, suggesting that platelets play a role of in the pathogenesis of PH. Clinical benefits of antiplatelet drugs in dogs with MMVD and PH require further investigation.

Feline herpesvirus-1-related multiple respiratory eosinophilic nodules in an adult cat receiving long-term oral prednisolone.

Case summary: A 10-year-old male castrated domestic shorthair cat was presented for evaluation of a 3-day history of increased inspiratory effort. The cat had received prednisolone 1 mg/kg PO q24h for 1 year due to chronic diarrhea. On physical examination, the patient exhibited severe stridor, intermittent open-mouth breathing and bilateral mucopurulent nasal discharge. Subcutaneous emphysema was palpated over the dorsal cervical region. Mild hypoventilation (PvCO2 55.1 mmHg; approximate reference interval 35-45 mmHg) was identified. Cervicothoracic radiographs showed marked gas tracking within cervical soft tissues with concurrent laryngeal thickening, pulmonary nodules, a bronchial pulmonary pattern, pneumomediastinum and aerophagia. The cat was hospitalized and treated overnight with oxygen and intravenous fluid therapy before anesthesia the next day. On laryngoscopy, a large tracheal mass was observed arising from the right subglottic region and was removed using biopsy forceps. CT revealed an additional mass at the level of the tracheal bifurcation causing marked luminal narrowing of the trachea and proximal main bronchi. The cat made a good initial recovery, although moderate stridor persisted. Five days later, the cat was re-examined due to recurrence of respiratory distress and orthopnea, and the owner elected euthanasia. Histopathology revealed severe nodular obstructive eosinophilic plasmacytic laryngotracheitis with intranuclear inclusion bodies positive for feline herpesvirus-1 on immunohistochemistry. Relevance and novel information: This report describes the presentation and management of a cat with respiratory distress secondary to intratracheal eosinophilic masses caused by feline herpesvirus-1. Although the outcome was ultimately unsatisfactory, to the authors' knowledge, this clinical presentation has not been previously reported.

Quantitative and qualitative computed tomographic characteristics of bronchiectasis in 12 dogs.

Bronchiectasis is an irreversible dilatation of the bronchi resulting from chronic airway inflammation. In people, computed tomography (CT) has been described as the noninvasive gold standard for diagnosing bronchiectasis. In dogs, normal CT bronchoarterial ratios have been described as <2.0. The purpose of this retrospective study was to describe quantitative and qualitative CT characteristics of bronchiectasis in a cohort of dogs with confirmed disease. Inclusion criteria for the study were thoracic radiography, thoracic CT, and a diagnosis of bronchiectasis based on bronchoscopy and/or histopathology. For each included dog, a single observer measured CT bronchoarterial ratios at 6 lobar locations. Qualitative thoracic radiography and CT characteristics were recorded by consensus opinion of two board-certified veterinary radiologists. Twelve dogs met inclusion criteria. The mean bronchoarterial ratio from 28 bronchiectatic lung lobes was 2.71 ± 0.80 (range 1.4 to 4.33), and 23/28 measurements were >2.0. Averaged bronchoarterial ratios from bronchiectatic lung lobes were significantly larger (P < 0.01) than averaged ratios from nonbronchiectatic lung lobes. Qualitative CT characteristics of bronchiectasis included lack of peripheral airway tapering (12/12), lobar consolidation (11/12), bronchial wall thickening (7/12), and bronchial lumen occlusion (4/12). Radiographs detected lack of airway tapering in 7/12 dogs. In conclusion, the most common CT characteristics of bronchiectasis were dilatation, a lack of peripheral airway tapering, and lobar consolidation. Lack of peripheral airway tapering was not visible in thoracic radiographs for some dogs. For some affected dogs, bronchoarterial ratios were less than published normal values.

Prospective evaluation of the efficacy of inhaled steroids administered via the AeroDawg spacing chamber in management of dogs with chronic cough.

BACKGROUND: Glucocorticoids are frequently required for management of cough because of inflammatory airway disease (IAD) and airway collapse (AWC). OBJECTIVES/HYPOTHESIS: To determine the efficacy and feasibility of inhaled administration of corticosteroids in controlling cough in dogs with noninfectious airway disease. ANIMALS: Thirty-six client-owned dogs. METHODS: Dogs were prospectively recruited for this placebo-controlled cross-over study. Inflammatory airway disease was diagnosed through bronchoalveolar lavage cytology. Airway collapse was diagnosed through bronchoscopy, or if dogs were unsuitable anesthetic candidates, by crackles on auscultation, radiographic changes in airway diameter, or fluoroscopy. Dogs were randomly assigned to receive placebo or fluticasone propionate for the first 2 weeks of the trial then crossed over to fluticasone. A quality of life (QOL) survey (best score 0, worst score 85) was completed at 0 and 6 weeks. A visual-analog cough survey was submitted at 0, 2, 4, and 6 weeks to assess cough, feasibility, and adverse effects of treatment. RESULTS: For 32 dogs, QOL score at study end (mean 11.3 ± 9.7) was significantly lower (P < .0001) compared to entry (mean 28.1 ± 14.1), with a median change of 69% in QOL score, indicating improved quality of life. Cough frequency, duration, and severity were significantly (P < .0001) decreased at study end. Feasibility of aerosolized delivery improved with continued use (P = .05) with only 1 dog unable to accept inhaled medication. CONCLUSION AND CLINICAL IMPORTANCE: This study supports the utility of fluticasone propionate by inhalation in management of cough in dogs with IAD and AWC.

Etiology and effusion characteristics in 29 cats and 60 dogs with pyothorax (2010-2020).

BACKGROUND: Pyothorax, an accumulation of inflammatory fluid in the pleural space, is often caused by foreign body inhalation in dogs, whereas the etiology in cats can be more difficult to discern. OBJECTIVE: Compare clinical, microbiologic findings, and etiology in cats and dogs with pyothorax. ANIMALS: Twenty-nine cats and 60 dogs. METHODS: Medical records of cats and dogs diagnosed with pyothorax from 2010 to 2020 were reviewed. Clinical findings, fluid analysis, and microbiologic results were retrieved. RESULTS: Antimicrobials had been administered to equal proportions of cats and dogs before fluid sampling (45% and 47%). Groups did not differ in age or total protein concentration or percentage neutrophils in pleural fluid, but effusion cell count was significantly higher in cats than in dogs (P = .01). Neutrophils containing intracellular bacteria were identified in more cats (27/29, 93%) than dogs (44/60, 73%; P = .05). Penetrating damage to the thorax was implicated as the cause of pyothorax in equal percentages of cats (76%) and dogs (75%). Etiology could not be determined in 2 cats and 1 dog. Cats had higher numbers of bacterial isolates per patient (median, 3) than dogs (median, 1; P = .01) and anaerobes were isolated more often in cats (23/29, 73%) than in dogs (27/60, 45%; P = .003). CONCLUSIONS AND CLINICAL IMPORTANCE: Pyothorax had similar etiologies in cats and dogs. Cats had higher fluid cell counts, higher numbers of bacterial isolates identified per patient, and intracellular bacteria detected more commonly than did dogs.

Antemortem cytologic diagnosis of pulmonary Langerhans cell histiocytosis in a cat.

Feline pulmonary Langerhans cell histiocytosis (FPLCH) is a rare histiocytic proliferative disease of middle-aged to older domestic cats. Langerhans cells in the terminal airways proliferate and infiltrate the interstitium and the airways to a lesser degree, widely effacing normal parenchyma. Historically, definitive diagnosis has required postmortem evaluation where pulmonary lesions have a classic gross and histologic morphology. Here, we present the first documented antemortem diagnosis of FPLCH using bronchoalveolar lavage (BAL) cytology and immunocytochemistry (ICC) in a 9-year-old British shorthair mix. The cat had a 3-month history of respiratory difficulty that was refractory to steroids and antimicrobials. Pulmonary radiographs had marked diffuse changes with a complex bronchointerstitial and micronodular pattern. BAL cytology revealed neutrophilic inflammation and markedly increased histiocytes with morphology distinct from typical pulmonary macrophages. ICC characterized histiocytes as CD1a+ /E-cadherin+ /CD11b- /PanCK- , consistent with a Langerhans cell phenotype. The cat was humanely euthanized due to poor prognosis and presented for necropsy. Gross, histopathologic, immunophenotypic, and ultrastructural findings confirmed a diagnosis of FPLCH. Proliferative cells were E-cadherin+ /Iba-1+ /CD18+ /CD1a+ /CD5+ /MHCII+ /CD204- /CD4- ; transmission electron microscopy identified the presence of Birbeck granules in the proliferating histiocytes, consistent with previous reports of FPLCH.

Oculosystemic pneumocystosis in 2 sibling Chihuahuas.

Sibling female and male Chihuahuas were evaluated for a 9-month history of tachypnea that failed to respond to fenbendazole, doxycycline, amoxicillin-clavulanate, and prednisone. Physical examination identified tachypnea, hyperpnea, and harsh bronchovesicular lung sounds. Fundic examination disclosed diffuse chorioretinitis, manifested as multifocal chorioretinal granulomas in the female dog and occasional chorioretinal scars in the male dog. Thoracic radiographs indicated moderate to severe interstitial to broncho-interstitial infiltrates in both dogs. Serum and urine antigen and antibody testing in the female dog failed to identify infectious agents, but cytologic assessment of hepatic lymph node, liver, and splenic aspirates identified Pneumocystis trophozoites. Infection was confirmed in both dogs by 28S rRNA PCR sequencing from multiple tissue samples. The female dog responded well to trimethoprim-sulfamethoxazole, but the male dog was euthanized because of liver failure, presumably related to antimicrobial treatment.

Quantifiable features of a tidal breathing phenotype in dogs with severe bronchomalacia diagnosed by bronchoscopy.

Dynamic lower airway obstruction is the primary component of canine bronchomalacia, but the ventilatory function remains underinvestigated. This prospective study analyzed tidal breathing characteristics in 28 dogs, comprising 14 with severe bronchomalacia diagnosed by bronchoscopy versus 14 without respiratory disease. Spirometry was conducted in all dogs. Bronchoscopy with bronchoalveolar lavage or brush under anesthesia was performed in 14 dogs with cough and expiratory effort. Severe bronchomalacia was defined by the severity of collapse and total number of bronchi affected. Ventilatory characteristics were compared between groups. Results revealed that dogs with severe bronchomalacia had lower minute volume (218 vs 338 mL/kg, p = .039) and greater expiratory-to-inspiratory time ratio (1.55 vs 1.35, p = .01) compared to control dogs. The tidal breathing pattern of dogs with bronchomalacia was different from that of normal dogs, and the pattern differed from the concave or flat expiratory curves typical of lower airway obstruction. Compared to control dogs, dogs with severe bronchomalacia had a significantly prolonged low-flow expiratory phase (p < .001) on the flow-time plot and a more exponential shape of the expiratory curve (p < .001) on the volume-time plot. Flow-time index ExpLF/Te (>0.14) and volume-time index Vt-AUCexp (≤31%) had a high ROC-AUC (1.00, 95% confidence interval 0.88 to 1.00) in predicting severe bronchomalacia. In conclusion, the tidal breathing pattern identified here indicates abnormal and complicated ventilatory mechanics in dogs with severe bronchomalacia. The role of this pulmonary functional phenotype should be investigated for disease progression and therapeutic monitoring in canine bronchomalacia.

Evaluation of blind thoracoscopic-assisted placement of three double-lumen endobronchial tube designs for one-lung ventilation in dogs.

OBJECTIVE: To describe a technique for blind thoracoscopic-assisted double-lumen endobronchial tube (DLT) placement for achieving one-lung ventilation (OLV) using 3 different DLT designs and to evaluate whether thoracic auscultation could reliably confirm OLV in dogs. STUDY DESIGN: Prospective randomized study. ANIMALS: Mature female hound dogs (n = 6). METHODS: Physical examination, baseline blood work and thoracic radiography confirmed the absence of preexisting disease in all dogs. Thoracoscopic observation was established through a subxiphoid portal and used for evaluation of differential lung lobe ventilation. Each dog was sequentially intubated using 1 of 3 DLT designs in random order; Robertshaw left-sided tube (RS-L), Carlens left-sided tube (C-L), Dr. White right-sided tube (DW-R). Incidence of initial and overall (after a maximum of 3 DLT manipulations) correct and complete OLV (CC-OLV) was recorded. After each blind thoracoscopic-assisted DLT placement, bronchoscopic evaluation was performed to document correct DLT position. RESULT: Blind DLT placement achieved overall CC-OLV in all dogs using RS-L, 66% using C-L, and all using DW-R. Successful initial left-sided OLV (L-OLV) was statistically more likely when RS-L DLTs were used compared to C-L or DW-R. Of cases where overall CC-OLV was achieved, correct DLT position was present in only 44% of intubations. CONCLUSIONS: Blind DLT placement produced successful CC-OLV in all dogs using at least one DLT design evaluated. Use of thoracoscopic assistance may obviate the need for bronchoscopic observation during DLT placement in dogs. However, bronchoscopic observation may still refine DLT positioning in dogs after blind thoracoscopic-assisted DLT placement.

Assessment of Zoonotic Risk following Diagnosis of Canine Tularemia in a Veterinary Medical Teaching Hospital.

Tularemia is a rare zoonotic disease found worldwide. The agent responsible for disease, Francisella tularensis, is one of the most highly infectious pathogens known, one that is capable of causing life-threatening illness with inhalation of <50 organisms. High infectivity explains concerns of its use in bioterrorism. This case describes a 4-year-old male neutered Australian shepherd presented for evaluation of hyporexia and fever. Physical examination revealed marked enlargement of the right superficial cervical lymph node. Tularemia lymphadenitis was diagnosed by lymph node aspiration cytology and culture. Public health officials were advised of the isolation of this zoonotic pathogen, and contact tracing was instituted. Seven individuals associated with the aspiration event were screened for tularemia and treated with prophylactic ciprofloxacin. All were negative, and none became sick. The dog was treated with doxycycline for 3 weeks, and clinical signs and physical examination abnormalities were resolved fully. The owner, a solid organ transplant recipient, was also screened for disease and received prophylactic doxycycline due to a history of shared exposure. The owner remained well throughout the course of his dog's disease and has heightened awareness of potential zoonoses. This case highlights the importance of animals as a sentinel for human health threats and for coordination of human and veterinary care.

Outcome and prognostic factors in infective endocarditis in dogs: 113 cases (2005-2020).

BACKGROUND: Factors associated with outcome in dogs diagnosed with infective endocarditis (IE) are not well characterized. OBJECTIVES: Evaluate outcome and prognostic factors in dogs with IE. ANIMALS: One hundred and thirteen dogs with IE. METHODS: Medical records for dogs that fulfilled the modified Duke criteria between 2005 and 2020 were retrospectively reviewed. Signalment, preexisting conditions, clinicopathologic findings, treatment regimen, and outcomes were recorded. Univariate logistic regression was performed to identify categorical factors associated with mortality, and then multivariate analysis was performed. RESULTS: Dogs were categorized as survivors (n = 47), non-survivors (n = 57), or lost to follow-up (n = 9). Survival to discharge and at 1 month was documented in 79 (70%) of 113 and 56 (54%) of 104 dogs, respectively, with median survival time (MST) of 72 days. Risk factors associated with mortality included development of congestive heart failure (odds ratio [OR], 11.8; 95% confidence interval [CI], 1.4-97.8), thromboembolic events (OR, 5.7; 95% CI, 2.3-14.4), and acute kidney injury (OR, 6.2; 95% CI, 2.0-18.8). Administration of antithrombotic medications was associated with survival (OR, 0.35; 95% CI, 0.13-0.97). Dogs that were not treated with antithrombotics had MST of 92 days, whereas dogs treated with antithrombotics did not reach MST during the study period. The heart valves involved and etiologic agent identified did not correlate with outcome. CONCLUSION AND CLINICAL IMPORTANCE: Dogs with IE that had thromboembolic events, acute kidney injury, or congestive heart failure had higher risk of mortality. Administration of antithrombotics was associated with prolonged survival time.

Results of owner questionnaires describing long-term outcome in Norwich terriers with upper airway syndrome: 2011-2018.

BACKGROUND: Norwich terriers are affected by an upper airway syndrome (NTUAS) but little is known about outcome in affected dogs. OBJECTIVE: To determine outcome in dogs with NTUAS using owner questionnaires. ANIMALS: Thirty-four client-owned dogs. METHODS: At initial assessment, owners were questioned about respiratory noises and exercise tolerance. A NTUAS score was prospectively constructed based on the number and severity of obstructive lesions detected endoscopically (range, 0-25). Owner questionnaires on respiratory noises, exercise tolerance, and quality of life (QOL) were obtained 2.2-9.3 years (median, 4.2 years) after endoscopy. RESULTS: Dogs ranged from 0.5 to 10.7 years of age (median, 4.75 years) at initial examination and no correlation was found between age and NTUAS score (median, 13; range, 1-25). Of 5 possible laryngeal abnormalities, 7 dogs had 1-2, 10 dogs had 3, and 17 dogs had 4-5 abnormalities (median, 3.5). Surgery was performed in 15 dogs, which had higher NTUAS scores (18.5 ± 6.3) than dogs that did not have surgery (7.7 ± 4.7, P < .0001). Scores for QOL ranged from 0 to 31 out of 40, with higher scores indicating worse QOL. Owner surveys resulted in QOL scores of ≤3 in 25/31 dogs (81%), with worse scores in dogs that had surgery performed (median 5, vs 0; P = .003). No correlation was noted between NTUAS and QOL scores, but age at follow-up was weakly associated with worse QOL. CONCLUSIONS AND CLINICAL IMPORTANCE: Despite variable severity of NTUAS scores, owners reported excellent QOL for most Norwich terriers examined.