Multiplate platelet aggregometry in dogs undergoing laparoscopic liver biopsy for diagnosis of chronic hepatopathy.

OBJECTIVES: To assess platelet function via the Multiplate analyser in dogs undergoing laparoscopic liver biopsy for diagnosis of chronic hepatopathy. MATERIALS AND METHODS: Twenty-seven client-owned dogs were prospectively enrolled. Before laparoscopic liver biopsy, whole blood impedance platelet aggregometry via the Multiplate analyser was performed. Buccal mucosal bleeding time was performed in 23 of 27 dogs. Tissue factor-activated thromboelastography was also performed, in addition to plasma-based coagulation testing. Descriptive statistics were calculated and the prevalence of platelet function abnormalities and results of other biochemical and coagulation testing were reported. RESULTS: Seventeen (63%) of 27 dogs had evidence of decreased platelet function as assessed by aggregometry, with all 17 dogs having decreased responsiveness to adenosine diphosphate, and 11 of 17 dogs demonstrating decreased responsiveness to arachidonic acid. Based on maximum amplitude, most dogs were classified as normocoagulable on thromboelastography (15/25; 60%). Other frequent coagulation abnormalities included increased D-dimers (20/27;74%), thrombocytopenia (11/27; 41%), hypofibrinogenemia (4/27; 15%), and decreased antithrombin (4/27; 15%). CLINICAL SIGNIFICANCE: Decreased platelet function as assessed by whole blood impedance aggregometry was common in dogs with chronic liver disease. Further study is necessary to determine whether this finding is repeatable or indicative of increased bleeding risk.

Eubacterial fluorescence in situ hybridisation and histologic features in 25 dogs with gallbladder mucocele.

OBJECTIVES: To detect and localise bacteria in gallbladder mucoceles using fluorescence in situ hybridisation (FISH). To report clinical signs, clinicopathologic abnormalities, sonographic findings and histopathological findings in FISH+ and FISH- dogs with gallbladder mucoceles. MATERIALS AND METHODS: Retrospective review of signalment, clinical signs, clinicopathologic and sonographic findings of 25 cases of histopathologically confirmed gallbladder mucocele. Histopathological sections of gallbladder mucocele were evaluated for cystic mucinous hyperplasia, cystic mucinous hyperplasia with cholecystitis and rupture. The number and spatial distribution of bacteria was determined by eubacterial FISH. Gallbladder contents were cultured in 21 dogs. RESULTS: Bacteria were detected within or adherent to the gallbladder wall in eight of 25 (32%) cases. Bacterial culture was positive in one dog. Cystic mucinous hyperplasia with concurrent cholecystitis was found in 17 of 25 (68%) of dogs with gallbladder mucocele. CLINICAL SIGNIFICANCE: FISH was more sensitive for detection of bacteria in gallbladder mucoceles when compared to bacterial culture of bile. Cholecystitis was common in dogs with gallbladder mucocele. Further study is required to elucidate the relationship of cystic mucinous hyperplasia, bacteria and cholecystitis in the aetiopathogenesis and progression of gallbladder mucocele.

Minimally invasive wireless motility capsule to study canine gastrointestinal motility and pH.

The aim of this study was to describe the feasibility of using a gastrointestinal tract wireless motility capsule (WMC) that measured intraluminal pressure, pH and transit time through the gastrointestinal tract, in dogs in their home environment. Forty-four adult healthy dogs, eating a standard diet, were prospectively enrolled. The WMC was well tolerated by all dogs and provided data from the different sections of the gastrointestinal tract. Median gastric emptying time was 20h (range, 6.3-119h), demonstrating a large range. The gastric pressure pattern and pH depended on the phase of food consumption. The small bowel transit time was 3.1h (range, 1.6-5.4h) with average contraction pressures of 6.5mmHg (range, 1.1-21.4mmHg) and pH 7.8 (range, 7-8.9). The large bowel transit time was 21h (range, 1-69h) with average contractions pressures of 0.9mmHg (range, 0.3-2.7mmHg) and pH 6.4 (range, 5.3-8.2). There was considerable individual variation in motility patterns and transit times between dogs. No difference was observed between the sexes. No relationships between any transit time, bowel pH or pressure pattern and bodyweights were identified. The WMC likely represents movement of a large non-digestible particle rather than normal ingesta. Due to its large size, the WMC should not be use in smaller dogs. The WMC is a promising minimally invasive tool to assess GIT solid phase transit times, pressures and pH. However, further studies are necessary due to the current limitations observed.

Comparison of endoscopy and sonography findings in dogs and cats with histologically confirmed gastric neoplasia.

OBJECTIVE: To compare sonographic and endoscopic findings in a group of dogs and cats with histologically confirmed gastric neoplasia. METHODS: Retrospective analysis of cases with concurrent abdominal ultrasound and endoscopy to evaluate the presence of gastric wall abnormalities, location and tumour appearance between the two examinations. Sonographic findings of the small intestines, liver, spleen and lymph nodes were recorded. Comparison of the findings from each test and assessment of predictive characteristics for neoplasia was evaluated. RESULTS: In total 17 dogs and 5 cats were included, Sonography identified 50% and endoscopy identified 95% of all gastric neoplasms. Lymphoma was the most commonly missed tumour by sonography. There was sonographic and endoscopic tumour location agreement in 36% of cases (Cohen's kappa = 0 · 25). Animals with sonographically normal small intestines had a statistically greater probability of gastric neoplasia (P = 0 · 035). All cats had lymphoma (P < 0 · 001). CLINICAL SIGNIFICANCE: Sonography and endoscopy are useful for the diagnosis of gastric neoplasia. Endoscopy is more accurate in identifying gastric neoplasia; however, sonography can raise the clinical suspicion for gastric neoplasia and may provide a less invasive means of gathering information before endoscopy. Intraluminal gastric gas or fluid may limit diagnostic capabilities of sonographic evaluation.

Computed tomographic angiography under sedation in the diagnosis of suspected canine pancreatitis: a pilot study.

BACKGROUND: Computed tomography (CT) is highly accurate for diagnosing pancreatitis in humans. The diagnosis of pancreatitis in dogs is based on clinical signs, laboratory findings, and ultrasonographic (US) changes. There are, however, inherent limitations in relying on laboratory and ultrasound findings for the clinical diagnosis of pancreatitis in dogs. HYPOTHESIS/OBJECTIVES: We hypothesized that CT angiography would be a rapid and reliable method to confirm pancreatitis in dogs compared to ultrasonography. The aim was to describe the CT characteristics and compare them to ultrasound findings and correlate the CT appearance to the severity of the patients' clinical course. ANIMALS: A prospective pilot case series; 10 dogs with pancreatitis were enrolled if the history, clinical signs, laboratory, and ultrasonographic findings were indicative of pancreatitis. METHODS: A 3-phase angiographic CT was performed under sedation. Afterward, each dog had US-guided aspirates of the pancreas collected and blood drawn for cPLi assay. Images were evaluated for portion of visible pancreas, pancreatic size and margin, pancreatic parenchyma, presence of peripancreatic changes and contrast enhancement pattern. The results were compared with outcome. RESULTS: An enlarged, homogeneously to heterogeneously attenuating and contrast-enhancing pancreas with ill-defined borders was identified in all dogs. CT identified more features characterizing pancreatic abnormalities compared to US. Thrombi were found in 3/10 dogs. Three dogs with heterogeneous contrast enhancement had an overall poorer outcome than those with homogenous enhancement. CONCLUSIONS AND CLINICAL IMPORTANCE: CT angiography under sedation was used in dogs to confirm clinically suspected pancreatitis and identified clinically relevant and potentially prognostic features of pancreatitis in dogs.

Milk thistle and its derivative compounds: a review of opportunities for treatment of liver disease.

Milk thistle extracts have been used as a "liver tonic" for centuries. In recent years, silibinin, the active ingredient in milk thistle extracts, has been studied both in vitro and in vivo to evaluate the beneficial effects in hepatic disease. Silibinin increases antioxidant concentrations and improves outcomes in hepatic diseases resulting from oxidant injury. Silibinin treatment has been associated with protection against hepatic toxins, and also has resulted in decreased hepatic inflammation and fibrosis. Limited information currently is available regarding silibinin use in veterinary medicine. Future study is justified to evaluate dose, kinetics, and treatment effects in domestic animals.

Effect of tissue processing on assessment of endoscopic intestinal biopsies in dogs and cats.

BACKGROUND: Prior studies failed to detect significant association between hypoalbuminemia and small intestinal lesions. HYPOTHESIS: Use of pictorial templates will enhance consistency of interpathologist interpretation and identification of intestinal lesions associated with hypoalbuminemia. ANIMALS: Tissues from 62 dogs and 25 cats examined as clinical cases at 7 referral veterinary practices in 4 countries. METHODS: Retrospective, observational study. Histopathology slides from sequential cases undergoing endoscopic biopsy were examined by 4 pathologists by pictorial templates. Changes for 9 microscopic features were recorded as normal, mild, moderate or severe, and 2- and 4-point scales were tested for consistency of interpretation. Logistic regression models determined odds ratios (OR) of histologic lesions being associated with hypoalbuminemia while kappa statistics determined agreement between pathologists on histologic lesions. RESULTS: There was poor agreement (kappa = -0.013 to 0.3) between pathologists, and institution of origin of slides had effect (kappa = 1.0 for 3 of 4 lesions on slides from Institution 5) on agreement between pathologists on selected histologic features. Using 2 point as opposed to 4-point grading scale increased agreement between pathologists (maximum kappa = 0.69 using 4-point scale versus maximum kappa = 1.0 using 2-point scale). Significant association (P = .019- .04; 95% OR = 3.14-10.84) between lacteal dilation and hypoalbuminemia was found by 3 pathologists. CONCLUSIONS AND CLINICAL IMPORTANCE: Substantial inconsistency between pathologists remains despite use of pictorial template because of differences in slide processing. Distinguishing between mild and moderate lesions might be important source of the disagreement among pathologists.

Effect of sample quality on the sensitivity of endoscopic biopsy for detecting gastric and duodenal lesions in dogs and cats.

BACKGROUND: The quality of histopathology slides of endoscopic biopsies from different laboratories varies, but the effect of biopsy quality on outcome is unknown. HYPOTHESIS: The ability to demonstrate a histologic lesion in the stomach or duodenum of a dog or cat is affected by the quality of endoscopic biopsy samples submitted. More endoscopic samples are needed to find a lesion in poor-quality tissue specimens. ANIMALS: Tissues from 99 dogs and 51 cats were examined as clinical cases at 8 veterinary institutions or practices in 5 countries. METHODS: Histopathology slides from sequential cases that underwent endoscopic biopsy were submitted by participating institutions. Quality of the histologic section of tissue (inadequate, marginal, adequate), type of lesion (lymphangiectasia, crypt lesion, villus blunting, cellular infiltrate), and severity of lesion (normal, mild, moderate, severe) were determined. Sensitivity of different quality tissue samples for finding different lesions was determined. RESULTS: Fewer samples were required from dogs for diagnosis as the quality of the sample improved from inadequate to marginal to adequate. Duodenal lesions in cats displayed the same trend except for moderate duodenal infiltrates for which quality of tissue sample made no difference. Gastric lesions in dogs and mild gastric lesions in cats had the same trend, whereas the number of tissue samples needed to diagnose moderately severe gastric lesions in cats was not affected by the quality of tissue sample. CONCLUSIONS AND CLINICAL IMPORTANCE: The quality of endoscopically obtained tissue samples has a profound effect on their sensitivity for identifying certain lesions, and there are differences between biopsies of canine and feline tissues.

S-adenosylmethionine (SAMe) in a feline acetaminophen model of oxidative injury.

S-adenosylmethionine (SAMe) is reported to have hepatoprotective and antioxidant functions. Acetaminophen (paracetamol) was used to induce oxidative damage in cats, and to then determine the effect of SAMe treatment on erythrocyte morphology, PCV, liver histopathology, thiobarbituate reacting substances (TBARS), reduced glutathione (GSH), and oxidised glutathione (GSSG). Cats receiving acetaminophen had a significant increase in methemoglobin and Heinz body production. A significant effect for the interaction of time and treatment was found for Heinz body production and changes in PCV. No significant changes were found in blood or hepatic TBARS. Blood GSH increased significantly in all cats, while the blood GSH:GSSG ratio tended to increase the most in cats given acetaminophen only. The hepatic GSH:GSSG ratio tended to increase in cats given SAMe and decrease in cats given acetaminophen, but this effect was not significant. SAMe protected erythrocytes from oxidative damage by limiting Heinz body formation and erythrocyte destruction and maybe useful in treating acetaminophen toxicity.

Thoracoscopic correction of persistent right aortic arch in a dog.

A 15-week-old, male intact, miniature schnauzer presented for signs consistent with persistent right aortic arch (PRAA). Esophagram and esophagoscopy confirmed this diagnosis. Following selective intubation, the constricting ligamentum arteriosum was visualized and completely resected via thoracoscopy. No complications were noted with this procedure. Advantages of thoracoscopy for management of persistent right aortic arch observed in this case were better visualization of the ligamentum arteriosum, minor postoperative discomfort, and minimal intraoperative hypothermia. Therefore, thoracoscopy is a potential alternative to intercostal thoracotomy for correction of PRAA.

Evaluation of esophageal transit of tablets and capsules in 30 cats.

We have reported tablet-induced focal esophagitis and esophageal stricture formation in cats. The proposed mechanism is thought to be abnormal esophageal tablet retention resulting in focal esophagitis with subsequent stricture formation. The objective of this study was to evaluate the passage of tablets and capsules when given alone (dry swallow) and when followed by a water bolus (wet swallow) to determine if this could, in part, explain the esophageal stricture formation we have observed in cats. Fluoroscopy was used to evaluate tablet or capsule passage after administration. The percentage of dry tablet swallows that successfully passed into the stomach was 0.0% at 30 and 60 seconds, 6.7% at 90 seconds, 13.3% at 120 seconds, 26.7% at 180 and 240 seconds, and 36.7% at 300 seconds. Wet tablet swallows successfully passed 90.0% of the time at 30 seconds, 93.3% of the time at 60 seconds, and 100.0% of the time thereafter. The percentage of dry capsule swallows that successfully passed was 16.7% at each time interval. Wet capsule swallows successfully passed 96.7% of the time at 30 seconds and 100% of the time thereafter. For each time interval, wet swallows achieved significantly greater percentage passage into the stomach when compared to dry swallows (P < .05). This study shows that tablets or capsules given by dry swallow have prolonged retention in the esophagus compared to those given by wet swallow. On the basis of this study, we recommend the routine administration of a water bolus to cats receiving tablets or capsules PO to facilitate esophageal clearance. This practice may help prevent medication-associated esophagitis or stricture formation.

Parenteral nutrition in the management of a dog with lymphocytic-plasmacytic enteritis and severe protein-losing enteropathy.

Management of lymphocytic-plasmacytic enteritis in a dog with whipworm infestation, hypoproteinemia, and ascites is described. Short-term parenteral nutrition hastened normalization of serum proteins, resolution of diarrhea, and weight gain. A description of the potential benefits, limitations, and possible complications of parenteral nutrition in refractory inflammatory bowel disease is given.

Effect of acute gastric dilatation on gastric myoelectic and motor activity in dogs.

OBJECTIVE: To investigate the effects of experimentally induced acute gastric dilatation on electrical and mechanical activities of the stomach in dogs. ANIMALS: 7 healthy dogs. PROCEDURE: Electrodes and strain-gauge force transducers were implanted on the serosal surface of the antrum and pylorus. Eight days later, baseline gastric electrical and contractile activities were recorded. The dogs were anesthetized and mechanically ventilated to maintain normocapnia while the stomach was distended (intragastric pressure, 30 mm Hg) for 180 minutes, using a thin compliant bag. Gastric electrical and contractile activities were recorded again on days 1 and 10 after dilatation. Recordings were analyzed to determine gastric slow-wave frequency, slow-wave dysrhythmia, propagation velocity of slow-waves, coupling of contractions to slow waves, motility index on the basis of relative contractile amplitudes, and onset of contractions after a standardized meal. RESULTS: Electrical or contractile activities were not significantly different 18 hours after acute gastric dilatation (day 1). Arrhythmias were evident before and after gastric dilatation in dogs from which food was withheld and in dogs after consumption of a meal. CONCLUSIONS: Variables for assessing gastric electrical and contractile activities were unaffected 18 hours after acute gastric dilatation. CLINICAL RELEVANCE: Analysis of results of this study indicated that altered electrical and contractile activities in dogs with short-term gastric dilatation are not likely to be secondary to the process of acute gastric dilatation.

Clinical evaluation of cimetidine, sucralfate, and misoprostol for prevention of gastrointestinal tract bleeding in dogs undergoing spinal surgery.

OBJECTIVE: To determine the incidence of gastrointestinal (GI) tract bleeding in dogs undergoing spinal surgery with adjunct corticosteroid treatment, and to determine the protective efficacy of cimetidine, sucralfate, and misoprostol against such bleeding in these dogs. ANIMALS: 40 dogs that underwent spinal surgery. PROCEDURES: Myelography and surgery were performed on the first or second day of hospitalization. Methylprednisolone sodium succinate was given at a dosage of 30 mg/kg of body weight prior to myelography, followed by a second full or half dose 2 to 4 hours later at clinician discretion. Spinal surgery was performed in conventional manner, postoperative administration of analgesics was done, and dogs were fed a diet lacking red meat. Dogs were assigned at random to 1 of the 3 treatment groups or to the control group. Dogs of the treatment groups received cimetidine, sucralfate, or misoprostol. Physical examination and determination of PCV and serum total protein values were performed daily. A fecal sample was examined daily for gross and occult blood. RESULTS: 36 of 40 dogs had GI tract bleeding during a hospitalization period of 3 to 6 days. There was no significant difference in development of bleeding between the control group and any of the treatment groups. CONCLUSIONS: Gastrointestinal tract bleeding occurred in 90% of dogs undergoing spinal surgery combined with administration of methylprednisilone sodium succinate, a higher rate than that found in previous studies. This bleeding was not life-threatening. Prophylactic benefit from any of the GI protectants tested was not found.