Lidocaine converts acute vagally associated atrial fibrillation to sinus rhythm in German Shepherd dogs with inherited arrhythmias.

BACKGROUND: Lidocaine is most frequently used to treat ventricular arrhythmias. However, lidocaine may have an antiarrhythmic effect for certain supraventricular arrhythmias. HYPOTHESIS: We hypothesized that lidocaine would be effective in converting experimentally induced atrial fibrillation (AF) to sinus rhythm and that a decrease in the dominant frequency (DF) and an increase in the organization as judged by the spectral entropy (SE) would occur over the course of the conversion. ANIMALS: Seven German Shepherd (GS) Dogs. METHODS: Dogs were anesthetized with fentanyl and pentobarbital. AF was induced with standard pacing protocols while left and right atrial monophasic action potentials (MAP) were recorded. The power spectra from the MAP recordings were analyzed to determine DF and SE during treatment with boluses of 2 mg/kg lidocaine. RESULTS: Lidocaine converted AF to sinus rhythm in all dogs and all episodes (n = 19). Conversion time was 27-87 seconds. After atropine, sustained AF was not induced; however, 5 episodes of atrial tachycardia resulted, and 3 were converted with lidocaine. Frequency domain analysis of 12 conversion sequences showed that left and right DF of the MAP signals decreased from the time of injection to conversion to sinus rhythm (P < .001). Mean SE indicated a gradient between the left and right atria (P = .003) that did not change during conversion. CONCLUSIONS AND CLINICAL IMPORTANCE: Vagally associated AF in GS dogs is terminated with lidocaine. Lidocaine is likely an effective treatment in clinical dogs with vagally associated AF.

Differentiation-dependent expression of lectin binding sites on normal and neoplastic keratinocytes in vivo and in vitro.

We used lectins as probes to demonstrate the composition of membrane carbohydrates of canine keratinocytes in various functional stages and various degrees of differentiation. Keratinocytes during normal epidermal turnover were compared by lectin immunohistochemistry to cells of hyperplastic epidermis and neoplastic keratinocytes. Three types of epidermal tumors and oral squamous cell carcinomas were examined. In addition, two in vitro tissue culture systems for keratinocytes were studied and compared with in vivo epithelium. In normal skin, PNA reacted only weakly with basal cells, whereas in hyperplastic skin basal cells bound this lectin strongly, demonstrating increasing expression of PNA binding sites with increasing thickness of the stratified squamous epithelium. ConA bound to basal cell tumors only. In oral squamous cell carcinomas, the expression of distinct lectin binding sites correlated with certain histological growth patterns, e.g., UEA-I reacted with highly invasive tumors but not with tumors showing a solid growth pattern. Using cell surface iodination and polyacrylamide gel electrophoresis, distinct differences in cell membrane protein expression were demonstrated between normal and neoplastic keratinocytes. SDS-polyacrylamide gel electrophoresis of cultured normal and neoplastic keratinocytes revealed several cell surface proteins that are specific for either cell type. Neoplastic cells specifically express a 140 KD lectin binding cell surface glycoprotein. The results of this study show that lectin binding patterns of keratinocytes are dependent on the functional state and the degree of differentiation of the cells and demonstrate correlation of some histological growth patterns with distinct lectin binding phenotypes, suggesting association of expression of cell membrane carbohydrate moieties with growth patterns. In addition, close similarities between "lifted cultures" grown at the air-liquid interface and native tissue demonstrate the value of this culture system as a model for differentiated stratified squamous epithelium.

Surgical options for the treatment of hyperthyroidism in the cat.

Since the first description of feline hyperthyroidism in 1978, numerous treatment options for hyperthyroidism have been reported. Surgical removal of enlarged, autonomously functioning thyroid glands is one of the most commonly used treatment options. Affected cats must have a careful pre-operative evaluation to detect concurrent medical conditions such as renal disease or cardiomyopathy. Since more than 80% of hyperthyroid cats have neoplastic changes in both thyroid glands, bilateral thyroidectomy is necessary for treatment of the majority of hyperthyroid cats. Several different thyroidectomy techniques have been developed in an attempt to minimise potential post-operative complications associated with bilateral thyroidectomy such as hypocalcemia or recurrence of hyperthyroidism. Damage to or removal of all four parathyroid glands during bilateral thyroidectomy causes hypocalcemia, the most common post-operative complication. Recurrence of hyperthyroidism can occur months after initial thyroidectomy if residual adenomatous thyroid tissue is retained in the surgical site. The most effective surgical techniques for bilateral thyroidectomy involve preservation of at least one external parathyroid gland on the surface of the thyroid capsule. Additionally, the majority of the thyroid capsule must be removed to ensure that all neoplastic thyroid tissue is removed. The most recently described feline thyroidectomy techniques involve sequential removal of bilaterally affected thyroid glands. Staging a bilateral thyroidectomy allows time for ipsilateral parathyroid tissue to revascularise before the second thyroid gland is removed and the blood supply to the contralateral parathyroid glands is potentially interrupted. Thyroidectomy is a very effective treatment option for hyperthyroid cats. Surgical treatment of hyperthyroidism in cats offers permanent cure without chronic medical management. No specialised equipment other than standard surgical instrumentation and facilities are necessary. With practice, feline thyroidectomy can become a routine procedure in most veterinary hospitals.

Radioimmunoassay of parathyroid hormone in cats.

A radioimmunoassay for measurement of midmolecule parathyroid hormone (PTH) concentration in serum from dogs was validated for use on serum from cats. The assay detected an increase in serum concentration of PTH after IV infusion of Na2 EDTA in healthy cats. Infusion of calcium chloride caused a decrease in measured PTH. Accuracy of the assay was demonstrated by quantitative recovery of a feline parathyroid gland extract added to pooled feline sera. Mean interassay and intra-assay coefficients of variation were 0.13 and 0.07, respectively. Sensitivity of the assay was 0.1 ng of PTH/ml. The median PTH concentration measured in 40 adult cats was 3.5 ng/ml, with a range of 1.16 to 11.0 ng/ml.

Functional analysis of ectopic parathyroid activity in cats.

The ability of ectopic parathyroid tissue to support calcium homeostasis was evaluated by measuring serum concentrations of calcium, phosphorus, albumin, magnesium, and parathyroid hormone before and for 12 weeks after bilateral thyroparathyroidectomy in 14 cats. During the immediate postoperative period, significant decrease was observed in serum calcium, magnesium, and parathyroid hormone (PTH) concentrations. Serum PTH concentration remained subnormal and did not significantly increase during the 12-week observation period. Despite persistent hypoparathyroidism, serum calcium and magnesium concentrations gradually increased. Ectopic parathyroid tissue is not capable of maintaining normal serum calcium concentration immediately after thyroparathyroidectomy. Serum calcium concentration gradually normalizes after thyroparathyroidectomy, apparently by means of a PTH-independent mechanism.

Evaluation of selected cardiopulmonary and cerebral responses during medetomidine, propofol, and halothane anesthesia for laparoscopy in dogs.

OBJECTIVES: To compare the dose-sparing effect of medetomidine on the propofol induction dose and concentration of halothane for maintenance of anesthesia during laparoscopy and to provide guidelines for effective and safe use of these anesthetics in dogs to ensure desirable perioperative analgesia. ANIMALS: 14 purpose-bred dogs. PROCEDURE: Cardiopulmonary and electroencephalographic responses were determined during 2 anesthesia protocols in dogs scheduled for laparoscopy. Fifteen minutes before anesthesia induction, all dogs received atropine sulfate (0.02 mg/kg of body weight, i.m.). Seven dogs were then given propofol (6.6 mg/kg, i.v.); anesthesia was maintained with halothane in oxygen. The other dogs were given medetomidine hydrochloride (10 micrograms/kg, i.m.) 5 minutes after administration of atropine sulfate; anesthesia was then induced by administration of propofol (2.8 mg/kg, i.v.) and was maintained with halothane in oxygen. RESULTS: The halothane concentration required for laparoscopy was lower in dogs given medetomidine. Anesthetic requirements were significantly increased during abdominal manipulation in both groups. Total amplitude of the electroencephalograph in medetomidine-treated dogs was not significantly lower than that in dogs not given medetomidine. Pulmonary responses were stable throughout all procedures. The primary cardiovascular response was an increase in blood pressure associated with the medetomidine-atropine preanesthetic combination. Significant differences in total amplitude or frequency shifts (spectral edge) of brain wave activity were not associated with surgical stimulation. CONCLUSION: Lack of neurologic changes during laparoscopy supports the efficacy of either medetomidine-propofol-halothane or propofol-halothane combinations at higher concentrations to provide desirable analgesia and anesthesia in this group of dogs.

Treatment of experimentally induced trichinosis in dogs and cats.

Studies were undertaken to determine the efficacy of milbemycin oxime against the enteric adult stages of Trichinella spiralis and of albendazole against the muscle stage larvae in experimentally infected dogs and cats. Specific-pathogen-free Beagle pups (n = 6) and domestic shorthair kittens (n = 6) were inoculated with 7,500 first-stage larvae of Trichinella spiralis. Physical examination (including collection of blood and fecal samples) was performed weekly. During the first week after inoculation, all animals had mild gastrointestinal tract disturbances, but stages of T spiralis were not observed in the feces. Beginning on postinoculation day (PID) 10, 3 pups and 3 kittens were treated with milbemycin oxime (1.25 mg/kg of body weight, PO, q 12 h) for 10 days. Muscle biopsy specimens were taken from dogs and cats on PID 26 and 29, respectively. Mean numbers of larvae per gram of muscle were 30.3 in the control and 37.7 in the treated dogs. Mean numbers of larvae per gram of muscle in the control and treated cats were 318.7 and 89.3, respectively. Two dogs and 2 cats were removed from the study at that time. The remaining animals, 2 each of the control and milbemycin oxime-treated animals, were given albendazole (50 mg/kg, PO, q 12 h) for 7 days starting at PID 31 and 34 in dogs and cats, respectively. Muscle biopsy specimens were again taken at PID 46 and 49, for dogs and cats, respectively; mean numbers of larvae recovered from muscle were 0.6 for dogs and 13.5 for cats.

Quadriceps contracture in a cat.

Quadriceps contracture associated with a healed malunion fracture of the left femur was diagnosed in a 1-year-old cat. The proximal portion of the distal fracture piece protruded through the skin of the thigh. The protruding bone was removed surgically and the area of ulcerated skin was debrided. Because the fracture was stable and the cat was able to bear weight on the affected limb, surgical correction of the malunion was not performed. Quadriceps contracture is uncommon in the cat.

Results of tube gastrostomy as treatment for gastric volvulus in the dog.

The Dragstedt modification of the Stamm tube gastrostomy was used in 29 dogs with gastric volvulus. A total of 17 dogs were monitored for 14 to 40 months after surgery. Volvulus recurred in one dog. All dogs with a presumptive diagnosis of gastric volvulus were treated surgically by gastric derotation and gastrostomy on an emergency basis. Mortality during the first week after surgery was 31%.

Use of a vascular access system for administration of chemotherapeutic agents to a ferret with lymphoma.

Two months after initiation of chemotherapy, a totally implantable vascular access system was used for the continuing administration of chemotherapeutic agents to a ferret with multicentric lymphoma. The subcutaneously located injection port minimized the need for restraint and facilitated repeated IV administration of drugs. Treatment with a combination of L-asparaginase, vincristine sulfate, doxorubicin, cyclophosphamide, methotrexate, chlorambucil, and prednisone failed to induce complete remission. Survival time (interval from histologic diagnosis to euthanasia) was 10 months. The vascular access system remained patent and did not cause infection in the surrounding subcutaneous tissues during the 5-month period that it was in position.

Adjustment of total serum calcium concentration for binding to albumin and protein in cats: 291 cases (1986-1987).

The relationships between total serum calcium and serum albumin and total serum calcium and serum protein concentrations were examined in 291 cats. There was a significant (P less than 0.001) linear relationship between serum calcium and serum albumin concentrations. Because of extreme variability among the calcium and albumin concentrations (R2 = 0.18), however, a dependable formula to adjust total serum calcium values for albumin or protein binding in the cat could not be constructed. An adjustment formula could not be based on the relationship between calcium and total protein concentrations because of the lack of a significant relationship (P = 0.21). The association between serum calcium and serum albumin or serum calcium and total protein concentrations is weaker in cats than in dogs or man.

Unilateral adrenalectomy as a treatment for adrenocortical tumors in ferrets: five cases (1990-1992).

Adrenocortical tumors were diagnosed in 5 adult spayed ferrets. Four ferrets had bilaterally symmetrical alopecia of the caudal femoral region, abdomen, and tail, and 1 had alopecia of the distal limbs and feet. All 5 ferrets had vulvar swelling. During abdominal ultrasonography, irregular masses, believed to involve the adrenal glands, were seen in all 5 ferrets. Unilateral adrenalectomy was performed successfully in each ferret by use of ventral midline celiotomy. On histologic examination of biopsy samples, 4 ferrets were found to have adrenocortical adenomas, and 1 ferret was found to have an adrenocortical adenocarcinoma. All clinical signs resolved after adrenalectomy, suggesting that the adrenocortical tumors had been secreting adrenocortical hormones.

Introduction of an endocardial pacing lead through the costocervical vein in six dogs.

Lead dislodgement is one of the most common complications of endocardial pacing lead implantation in dogs. Incidence of lead displacement appears to be higher in large-breed, compared with small-breed, dogs, suggesting that excessive neck movements may be a contributing factor. To avoid introducing pacing leads through a vein in the neck, we developed a technique for implantation of endocardial pacing leads through the right costocervical vein. A right second intercostal space thoracotomy was performed to expose the vein, and the pacing generator was placed in the musculature over the lateral aspect of the thorax. The technique was performed in 6 dogs, 5 of which had had an endocardial pacing lead dislodge. None of the dogs had problems with lead dislodgement during follow-up periods of 15 to 20 months. Implantation of endocardial pacing leads through the costocervical vein should not be considered a replacement for implantation through the jugular vein. However, we believe that this technique is indicated for large dogs in which endocardial pacing leads implanted through the jugular vein have dislodged.

Attitudes of owners regarding tendonectomy and onychectomy in cats.

OBJECTIVE: To compare the incidence of behavior problems following tendonectomy or onychectomy in cats, as well as attitudes of owners following these procedures. DESIGN: Nonrandomized clinical trial. ANIMALS: 18 cats that underwent tendonectomy and 39 cats that underwent onychectomy. PROCEDURE: Owners of cats that underwent tendonectomy or onychectomy between February 1993 and May 1998 were contacted by telephone and asked several questions regarding reasons for surgery as well as complications and behavioral changes in cats following surgery. RESULTS: The most common reason for considering tendonectomy or onychectomy was to avoid damage caused by the cat scratching household materials. Avoidance of injury to humans or animals was chosen more often by owners whose cats underwent onychectomy than those that underwent tendonectomy. Tendonectomy was more likely to have been recommended by veterinarians than onychectomy. Significantly more cats that underwent tendonectomy (67%) than onychectomy (44%) returned to normal activity within 3 days after surgery. Significant differences were not detected regarding behavior problems after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Although tendonectomy and onychectomy involved some medical complications and behavior changes following surgery, owners had positive attitudes regarding both surgeries after the immediate postoperative period. Tendonectomy may be a humane alternative to onychectomy, although owners need to be advised that nail trimming is still necessary in cats after surgery.

Surgical therapy of the thyroid.

The surgical treatment of thyroid cancer in the cat involves excision of one or both thyroid glands while sparing at least one parathyroid gland. The most common postoperative complication of bilateral thyroidectomy is transient hypocalcemia. Most feline thyroid tumors are benign, hyperfunctional thyroid adenomas. Surgical excision is usually curative. Canine thyroid cancer is most commonly malignant and nonfunctional. Successful surgical treatment of canine thyroid cancer depends on histologic and early diagnosis prior to metastasis or invasion of the cancer into adjacent structures within the neck.