Breath characteristics and adventitious lung sounds in healthy and asthmatic horses.

BACKGROUND: Standard thoracic auscultation suffers from limitations, and no systematic analysis of breath sounds in asthmatic horses exists. OBJECTIVES: First, characterize breath sounds in horses recorded using a novel digital auscultation device (DAD). Second, use DAD to compare breath variables and occurrence of adventitious sounds in healthy and asthmatic horses. ANIMALS: Twelve healthy control horses (ctl), 12 horses with mild to moderate asthma (mEA), 10 horses with severe asthma (sEA) (5 in remission [sEA-], and 5 in exacerbation [sEA+]). METHODS: Prospective multicenter case-control study. Horses were categorized based on the horse owner-assessed respiratory signs index. Each horse was digitally auscultated in 11 locations simultaneously for 1 hour. One-hundred breaths per recording were randomly selected, blindly categorized, and statistically analyzed. RESULTS: Digital auscultation allowed breath sound characterization and scoring in horses. Wheezes, crackles, rattles, and breath intensity were significantly more frequent, higher (P < .001, P < .01, P = .01, P < .01, respectively) in sEA+ (68.6%, 66.1%, 17.7%, 97.9%, respectively), but not in sEA- (0%, 0.7%, 1.3%, 5.6%) or mEA (0%, 1.0%, 2.4%, 1.7%) horses, compared to ctl (0%, 0.6%, 1.8%, -9.4%, respectively). Regression analysis suggested breath duration and intensity as explanatory variables for groups, wheezes for tracheal mucus score, and breath intensity and wheezes for the 23-point weighted clinical score (WCS23). CONCLUSIONS AND CLINICAL IMPORTANCE: The DAD permitted characterization and quantification of breath variables, which demonstrated increased adventitious sounds in sEA+. Analysis of a larger sample is needed to determine differences among ctl, mEA, and sEA- horses.

Bayesian evaluation of the accuracy of a thoracic auscultation scoring system in dairy calves with bronchopneumonia using a standard lung sound nomenclature.

BACKGROUND: Although thoracic auscultation (AUSC) in calves is quick and easy to perform, the definition of lung sounds is highly variable and leads to poor to moderate accuracy in diagnosing bronchopneumonia (BP). HYPOTHESIS/OBJECTIVES: Evaluate the diagnostic accuracy of an AUSC scoring system based on a standard lung sound nomenclature at different cut-off values, accounting for the absence of a gold standard test for BP diagnosis. ANIMALS: Three hundred thirty-one calves. METHODS: We considered the following pathological lung sounds: increased breath sounds (score 1), wheezes and crackles (score 2), increased bronchial sounds (score 3), and pleural friction rubs (score 4). Thoracic auscultation was categorized as AUSC1 (positive calves for scores ≥1), AUSC2 (positive calves for scores ≥2), and AUSC3 (positive calves for scores ≥3). The accuracy of AUSC categorizations was determined using 3 imperfect diagnostic tests with a Bayesian latent class model and sensitivity analysis (informative vs weakly informative vs noninformative priors and with vs without covariance between ultrasound and clinical scoring). RESULTS: Based on the priors used, the sensitivity (95% Bayesian confidence interval [BCI]) of AUSC1 ranged from 0.89 (0.80-0.97) to 0.95 (0.86-0.99), with a specificity (95% BCI) of 0.54 (0.45-0.71) to 0.60 (0.47-0.94). Removing increased breath sounds from the categorizations resulted in increased specificity (ranging between 0.97 [0.93-0.99] and 0.98 [0.94-0.99] for AUSC3) at the cost of decreased sensitivity (0.66 [0.54-0.78] to 0.81 [0.65-0.97]). CONCLUSIONS AND CLINICAL IMPORTANCE: A standardized definition of lung sounds improved AUSC accuracy for BP diagnosis in calves.

Association between computer-aided lung auscultation and treatment failure risk in calves treated for respiratory disease.

The use of computer-aided lung auscultation (CALA, Whisper Veterinary Stethoscope; Merck Animal Health, Madison, New Jersey, USA) is a relatively new approach to assist in confirming the diagnosis of bovine respiratory disease (BRD). For this prospective cohort study at 1 feedlot in the United States, a CALA score was generated for 2726 feeder cattle (calf-fed Holsteins and mixed-breed beef animals) at the time of the first BRD diagnosis and treatment. All cattle were treated according to the same BRD protocol prescribed for that facility and the protocol was not influenced by the CALA score. Data were collected for 120 d after enrollment. In this study, the risk of BRD retreatment and the risk of BRD mortality were each significantly (P < 0.05) associated with the CALA score at the time of first BRD diagnosis and treatment, and those risks increased (numerically and in some cases statistically) as the CALA score increased.

Association entre l'auscultation pulmonaire assistée par ordinateur et le risque d'échec du traitement chez les veaux traités pour une maladie respiratoire. L'utilisation de l'auscultation pulmonaire assistée par ordinateur (CALA, Whisper Veterinary Stethoscope; Merck Animal Health, Madison, New Jersey, USA) est une approche relativement nouvelle pour aider à confirmer le diagnostic de maladie respiratoire bovine (BRD). Pour cette étude de cohorte prospective dans un parc d'engraissement aux États-Unis, un score CALA a été généré pour 2726 bovins d'engraissement (veau Holstein et bovins de race mixte) au moment du premier diagnostic et traitement de la BRD. Tous les bovins ont été traités selon le même protocole BRD prescrit pour ce site et le protocole n'a pas été influencé par le score CALA. Les données ont été collectées pendant 120 jours après l'inscription. Dans cette étude, le risque de retraitement pour BRD et le risque de mortalité associée au BRD étaient chacun significativement (P < 0,05) associés au score CALA au moment du premier diagnostic et traitement BRD, et ces risques augmentaient (numériquement et dans certains cas statistiquement) à mesure que le score CALA augmentait.(Traduit par Dr Serge Messier).

Predicting bovine respiratory disease outcome in feedlot cattle using latent class analysis.

Bovine respiratory disease (BRD) is the most significant disease affecting feedlot cattle. Indicators of BRD often used in feedlots such as visual signs, rectal temperature, computer-assisted lung auscultation (CALA) score, the number of BRD treatments, presence of viral pathogens, viral seroconversion, and lung damage at slaughter vary in their ability to predict an animal's BRD outcome, and no studies have been published determining how a combination of these BRD indicators may define the number of BRD disease outcome groups. The objectives of the current study were (1) to identify BRD outcome groups using BRD indicators collected during the feeding phase and at slaughter through latent class analysis (LCA) and (2) to determine the importance of these BRD indicators to predict disease outcome. Animals with BRD (n = 127) were identified by visual signs and removed from production pens for further examination. Control animals displaying no visual signs of BRD (n = 143) were also removed and examined. Blood, nasal swab samples, and clinical measurements were collected. Lung and pleural lesions indicative of BRD were scored at slaughter. LCA was applied to identify possible outcome groups. Three latent classes were identified in the best model fit, categorized as non-BRD, mild BRD, and severe BRD. Animals in the mild BRD group had a higher probability of having visual signs of BRD compared with non-BRD and severe BRD animals. Animals in the severe BRD group were more likely to require more than 1 treatment for BRD and have ≥40 °C rectal temperature, ≥10% total lung consolidation, and severe pleural lesions at slaughter. Animals in the severe BRD group were also more likely to be naïve at feedlot entry and the first BRD pull for Bovine Viral Diarrhoea Virus, Bovine Parainfluenza 3 Virus, and Bovine Adenovirus and have a positive nasal swab result for Bovine Herpesvirus Type 1 and Bovine Coronavirus. Animals with severe BRD had 0.9 and 0.6 kg/d lower overall ADG (average daily gain) compared with non-BRD animals and mild BRD animals (P < 0.001). These results demonstrate that there are important indicators of BRD severity. Using this information to predict an animal's BRD outcome would greatly enhance treatment efficacy and aid in better management of animals at risk of suffering from severe BRD.

Accuracy and inter-rater reliability of lung auscultation by bovine practitioners when compared with ultrasonographic findings.

In practice, veterinary surgeons frequently rely on lung auscultation as a confirmation test for pneumonia. To what extent diagnostic accuracy of lung auscultation varies between different practitioners is currently unknown. In this diagnostic test study, 49 Dutch veterinarians each auscultated between 8 and 10 calves, and communicated whether they would decide to treat the animal with antimicrobials or not. They were not allowed to perform any other aspect of the clinical examination. Their decisions were compared with lung ultrasonography findings. The average sensitivity and specificity of lung auscultation were 0.63 (sd=0.2; range=0.2-1.0) and 0.46 (sd=0.3; range=0.0-1.0), respectively. Of the participants, 8.2 per cent were 100 per cent sensitive, 16.3 per cent were 100 per cent specific, and only 4.0 per cent were perfect. The Krippendorff's alpha was 0.18 (95 per cent confidence interval: -0.01 to 0.38), signifying poor reliability between multiple raters. Regardless of the poor diagnostic accuracy in this study, especially the large variation in a confirmation test between different practitioners could potentially cause professional damage as well as misuse of antimicrobials. This study could be seen as a gentle stimulus to regularly evaluate one's diagnostic skills. Both complementary training and the use of more accurate techniques with less inter-rater variation could improve the situation.

Assessing gastrointestinal motility in healthy horses comparing auscultation, ultrasonography and an acoustic gastrointestinal surveillance biosensor: a randomised, blinded, controlled crossover proof of principle study.

BACKGROUND: Auscultation and ultrasonography are noninvasive techniques used to assess gastrointestinal motility in horses. Recently, noninvasive acoustic gastrointestinal surveillance (AGIS) biosensors evaluating intestinal motility have been validated in humans. OBJECTIVES: To compare AGIS to auscultation and ultrasonography for detecting decreased motility after xylazine administration. STUDY DESIGN: Randomised, blinded, controlled cross-over proof of principle study. METHODS: Six healthy horses were evaluated under fasted and nonfasted conditions and randomly assigned to receive treatment with 0.4 mg/kg xylazine or an equivalent volume of 0.9% NaCl intravenously. After a 48-h washout period, the process was repeated with the alternate treatment. Motility was assessed pre and posttreatment. Borborygmi were assessed in each abdominal quadrant and graded on a scale of 0-3, with 3 being continuous borborygmi. Duodenal, jejunal and caecal contractions were assessed ultrasonographically in consistent locations. Four AGIS biosensors were applied in standardised locations (duodenum, caecum, ventral midline, right dorsal colon). The biosensors measure acoustic signals and data were recorded in transport metric. Data were analysed using cross-classified multilevel random effects logistic regression including area under the receiver operator characteristic curve (AUC ROC). Sensitivity, specificity and accuracy were calculated for each modality. RESULTS: All three modalities detected a reduction in gastrointestinal motility following xylazine administration with AUC ROC being 0.85, 0.84 and 0.86 for auscultation, ultrasonography and AGIS respectively. The sensitivity, specificity and accuracy for auscultation was 88, 71 and 75%; for ultrasonography was 67, 63 and 64%; and for AGIS was 69, 70 and 70%, respectively. MAIN LIMITATIONS: The study was performed in normal healthy horses and application of this device to clinical patients warrants further investigation. CONCLUSIONS: In this proof of principle study, AGIS was able to discriminate between horses given xylazine from those given 0.9% NaCl with comparable accuracy as auscultation and ultrasonography. The Summary is available in Spanish - see Supporting Information.

Establishment of lung auscultation scoring method and responses of acute phase proteins and heat shock proteins in vaccinated and non-vaccinated goats.

Pneumonic pasteurellosis is an economically important infectious disease in the small ruminant industry which causes sudden death and loss for farmers. Nonetheless, this disease is still a common sight in sheep and goats in Malaysia, probably due to the unpopular usage of pasteurellosis vaccine or inappropriate vaccination practices. The aim of this study was designed to classify the severity of pneumonia via the establishment of auscultation scoring method and to quantify the acute phase proteins and heat shock proteins responses from vaccinated and non-vaccinated goats. Goat farms, consist of vaccinated and non-vaccinated farms, were selected in this study: where 15 clinically normal healthy goats and 9 pneumonic goats were selected from vaccinated farms whereas 15 clinically normal healthy goats and 31 pneumonic goats from non-vaccinated farms were selected for this study. Crackle lung sounds were not detected in both vaccinated and non-vaccinated normal goats. However, vaccinated pneumonic goats showed mild crackle lung sound while non-vaccinated pneumonic goats exhibited moderate crackle lung sound. There were significant increases (p < 0.05) in acute phase proteins and heat shock proteins concentrations for the non-vaccinated pneumonic goats group. In this study, conclusion can be made that the vaccinated goats exhibited very mild clinical responses of pneumonia and non-significant biomarker responses compared to the non-vaccinated goats. Thus, vaccination is an effective preventive measure to control pneumonic pasteurellosis and acute phase proteins and heat shock proteins can be considered as future biomarkers in screening and rapid diagnostic method for this particular disease.

Incremental Value (Bayesian Framework) of Thoracic Ultrasonography over Thoracic Auscultation for Diagnosis of Bronchopneumonia in Preweaned Dairy Calves.

BACKGROUND: Thoracic ultrasonography (TUS) is a specific and relatively sensitive method to diagnose bronchopneumonia (BP) in dairy calves. Unfortunately, as it requires specific training and equipment, veterinarians typically base their diagnosis on thoracic auscultation (AUSC), which is rapid and easy to perform. HYPOTHESIS/OBJECTIVES: We hypothesized that the use of TUS, in addition to AUSC, can significantly increase accuracy of BP diagnosis. Therefore, the objectives were to (i) determine the incremental value of TUS over AUSC for diagnosis of BP in preweaned dairy calves and (ii) assess diagnostic accuracy of AUSC. ANIMALS: Two hundred and nine dairy calves (<1 month of age) were enrolled in this cross-sectional study. METHODS: Prospective cross-sectional study. All calves from a veal calves unit were examined (independent operators) using the Wisconsin Calf Respiratory Scoring Criteria (CRSC), AUSC, and TUS. A Bayesian latent class approach was used to estimate the incremental value of AUSC over TUS (integrated discrimination improvement [IDI]) and the diagnostic accuracy of AUSC. RESULTS: Abnormal CRSC, AUSC, and TUS were recorded in 3.3, 53.1, and 23.9% of calves, respectively. AUSC was sensitive (72.9%; 95% Bayesian credible interval [BCI]: 50.1-96.4%), but not specific (53.3%; 95% BCI: 43.3-64.0%) to diagnose BP. Compared to AUSC, TUS was more specific (92.9%; 95% BCI: 86.5-97.1%), but had similar sensitivity (76.5%; 95% BCI: 60.2-88.8%). The incremental value of TUS over AUSC was high (IDI = 43.7%; 5% BCI: 22.0-63.0%) significantly improving proportions of sick and healthy calves appropriately classified. CONCLUSIONS AND CLINICAL IMPORTANCE: The use of TUS over AUSC significantly improved accuracy of BP diagnosis in dairy calves.

Evaluation of a Computer-aided Lung Auscultation System for Diagnosis of Bovine Respiratory Disease in Feedlot Cattle.

BACKGROUND: A computer-aided lung auscultation (CALA) system was recently developed to diagnose bovine respiratory disease (BRD) in feedlot cattle. OBJECTIVES: To determine, in a case-control study, the level of agreement between CALA and veterinary lung auscultation and to evaluate the sensitivity (Se) and specificity (Sp) of CALA to diagnose BRD in feedlot cattle. ANIMALS: A total of 561 Angus cross-steers (initial body weight = 246 ± 45 kg) were observed during the first 50 day after entry to a feedlot. METHODS: Case-control study. Steers with visual signs of BRD identified by pen checkers were examined by a veterinarian, including lung auscultation using a conventional stethoscope and CALA that produced a lung score from 1 (normal) to 5 (chronic). For each steer examined for BRD, 1 apparently healthy steer was selected as control and similarly examined. Agreement between CALA and veterinary auscultation was assessed by kappa statistic. CALA's Se and Sp were estimated using Bayesian latent class analysis. RESULTS: Of the 561 steers, 35 were identified with visual signs of BRD and 35 were selected as controls. Comparison of veterinary auscultation and CALA (using a CALA score ≥2 as a cut off) revealed a substantial agreement (kappa = 0.77). Using latent class analysis, CALA had a relatively high Se (92.9%; 95% credible interval [CI] = 0.71-0.99) and Sp (89.6%; 95% CI = 0.64-0.99) for diagnosing BRD compared with pen checking. CONCLUSIONS: CALA had good diagnostic accuracy (albeit with a relatively wide CI). Its use in feedlots could increase the proportion of cattle accurately diagnosed with BRD.

Purring in cats during auscultation: how common is it, and can we stop it?

OBJECTIVES: When cats purr during examination it is difficult to perform auscultation. The objective of this study was to determine the prevalence of purring in cats during examination, and identify interventions that could be used to stop purring. METHODS: Cats seen at a first opinion clinic were enrolled in the study and their purring status recorded. Thirty of the purring cats were exposed to up to three different interventions in an attempt to stop purring in a randomised controlled trial including blowing at the ear, use of an ethanol-based aerosol near the cat and proximity to a running tap. RESULTS: The 30 cats in the trial were subjected to a total of 54 attempts to stop purring, proximity to a running tap caused 17 of 21 (81%) cats to stop purring, blowing at the cat's ears worked in 2 of 15 (13%) cats, spraying an aerosol close to the cat was effective in 9 of 18 (50%) cases. In 2 cats (7%), none of the interventions interrupted purring. CLINICAL SIGNIFICANCE: This study provides evidence that placing a purring cat near a running tap and in proximity to the discharge of an ethanol-based aerosol are effective measures to stop purring in order to allow auscultation.

Comparison of thoracic auscultation, clinical score, and ultrasonography as indicators of bovine respiratory disease in preweaned dairy calves.

BACKGROUND: The diagnostic tools for bovine respiratory disease diagnosis include clinical inspection, thoracic auscultation, and ultrasonography. HYPOTHESIS: Thoracic auscultation and clinical examination have limitations in the detection of lung consolidation in dairy calves. ANIMALS: Prospective cohort of 106 preweaned calves from 13 different dairy herds (10 with a history of active bovine respiratory disease (BRD) in calves and 3 without suspected BRD problems). METHODS: Each preweaned calf was clinically inspected using the Wisconsin calf respiratory scoring chart (CRSC) and treatment history was noted. Systematic thoracic auscultation and ultrasonography then were performed, the latter focusing on lung consolidation. Mortality was recorded over a 30-day period. RESULTS: A total of 56 of 106 calves had ultrasonographic evidence of lung consolidation. The sensitivity of thoracic auscultation to detect consolidation was 5.9% (range, 0-16.7%). Only 41.1% (23/33) of calves with consolidated lungs had been treated previously by the producers. When adding CRSC and previous BRD treatment by the producer, sensitivity of detection increased to 71.4% (40/56). The area under the receiver operating characteristics curve was 0.809 (95% CI, 0.721-0.879) for the number of areas within the lungs with consolidation and 0.743 (95% CI, 0.648-0.823) for the maximal depth of consolidation as predictors of death within 1 month after examination. These were not significantly different (P = .06). CONCLUSIONS AND CLINICAL IMPORTANCE: This study shows that thoracic auscultation is of limited value in diagnosing lung consolidation in calves. Ultrasonographic assessment of the thorax could be a useful tool to assess BRD detection efficiency on dairy farms.

Microbiota bacteriana e citologia da região traqueobrônquica de bezerros no período neonatal / Bacterial pathogens and cytology or tracheobronchial region in calves during neonatal period

As broncopneumonias são afecções importantes na pecuária mundial, representando uma das principais causas de mortalidade de bezerros nos primeiros meses de vida. As medidas preventivas e terapêuticas adotadas geralmente são baseadas em resultados de estudos internacionais, não se conhecendo as bactérias implicadas nos quadros pneumônicos em animais criados no Brasil. Aliado a isso, no primeiro mês de vida, os bezerros demonstram imaturidade do sistema imune, o que tem sido pouco estudado em quadros pneumônicos. Desta maneira, objetivou-se estudar as broncopneumonias em bezerros neonatos, identificando bactérias do trato respiratório posterior de bezerros sadios e com pneumonias naturalmente adquiridas, bem como analisar citologicamente a resposta pulmonar frente a estes patógenos. Para isso amostras de lavado do trato respiratório foram colhidas por traqueocentese durante o primeiro mês de vida dos animais. Verificou-se que não houve diferença na microbiota traqueobrônquica de bezerros sadios em relação aos doentes, discordando dos relatos da literatura internacional, sendo constituída principalmente por: Staphylococcus sp., Bacillus sp., Streptococcus sp., Pseudomonas aeruginosa e enterobactérias, permitindo inferir que as medidas profiláticas e terapêuticas adotadas internacionalmente possam não ser tão efetivas para as criações brasileiras. Observou-se também que bezerros neonatos têm uma proporção aproximada de 1:1 de macrófagos e neutrófilos na região traqueobrônquica quando saudáveis, atingindo uma relação aproximada de 1:3 durante os quadros de broncopneumonias, sendo estes perfis provavelmente característicos da idade, período conhecido pela imaturidade do sistema imune e agravado por fatores de manejo que favoreçam uma maior inalação de agentes bacterianos.

Bronchopneumonia is important for world livestock production and one of the major causes of calf mortality during the first months of life. The preventive and therapeutic measures adopted for the disease in calves in Brazil are usually based on the results of international studies; however there is not enough known which bacteria are implicated. In the first month of life calves show immaturity of their immune system, what has been little studied in regard to pneumonia. The present investigation sought to study neonate bronchopneumonia in calves, to identify which bacteria are present in the respiratory tract of healthy and, with naturally acquired pneumonia calves, to analyze the pulmonary cytological response against pathogens. For this purpose, samples of the respiratory tract were collected by tracheocenthesis. It was noted that the microflora of the tracheobronchial region of healthy and diseased calves was the same, but they were different from the one reported by international papers. The flora was constituted mainly by Staphylococcus sp., Bacillus sp., Streptococcus sp., Pseudomonas aeruginosa and enterobacteriae, allowing to infer that the prophylactic and therapeutic measures adopted internationally may not be as effective for the Brazilian condition. It was also found that newborn calves have an approximate ratio of 1:1 of macrophages and neutrophils in the tracheobronchial region when they were healthy, reaching a ratio of approximately 1:3 of macrophages and neutrophils when they were with bronchopneumonia. Probably, these profiles are characteristic of the age, a period when exists immaturity of the immune system and influenced by management factors which lead to greater inhalation of bacterial agents.

Thoracic auscultation in captive bottlenose dolphins (Tursiops truncatus), California sea lions (Zalophus californianus), and South African fur seals (Arctocephalus pusillus) with an electronic stethoscope.

Thoracic auscultation is an important diagnostic method used in cases of suspected pulmonary disease in many species, as respiratory sounds contain significant information on the physiology and pathology of the lungs and upper airways. Respiratory diseases are frequent in marine mammals and are often listed as one of their main causes of death. The aim of this study was to investigate and report baseline parameters for the electronic-mediated thoracic auscultation of one cetacean species and two pinniped species in captivity. Respiratory sounds from 20 captive bottlenose dolphins (Tursiops truncatus), 6 California sea lions (Zalophus californianus), and 5 South African fur seals (Arctocephalus pusillus) were recorded with an electronic stethoscope. The sounds were analyzed for duration of the respiratory cycle, adventitious sounds, and peak frequencies of recorded sounds during expiration and inspiration as well as for sound intensity as reflected by waveform amplitude during the respiratory cycle. In respiratory cycles of the bottlenose dolphins' expiring "on command," the duration of the expiration was significantly shorter than the duration of the inspiration. In the examined pinnipeds of this study, there was no clear pattern concerning the duration of one breathing phase: Adventitious sounds were detected most often in bottlenose dolphins that were expiring on command and could be compared with "forced expiratory wheezes" in humans. This is the first report of forced expiratory wheezes in bottlenose dolphins; they can easily be misinterpreted as pathologic respiratory sounds. The peak frequencies of the respiratory sounds reached over 2,000 Hz in bottlenose dolphins and over 1,000 Hz in California sea lions and South African fur seals, but the variation of the frequency spectra was very high in all animals. To the authors' knowledge, this is the first systematic analysis of respiratory sounds of bottlenose dolphins and two species of pinnipeds.

The diagnostic criteria used in bovine bacterial endocarditis: a meta-analysis of 460 published cases from 1973 to 2011.

Bacterial endocarditis (BE) is the most common valvular disease in cattle but diagnosis in the living animal remains a challenge for clinicians. The objective of the study was to report evidence-based veterinary medicine data concerning the clinical presentation and results of ancillary tests of necropsy-confirmed cases of bovine BE. A systematic review and subsequent meta-analysis was performed using Medline and CAB abstracts of every article on bovine BE published in English, Japanese, German and French. The clinical criteria that were specifically assessed for diagnosis of BE were: tachycardia, heart murmur, signs of congestive heart failure, presence of fever, evidence of lameness/polyarthritis, one or more positive blood cultures and positive echocardiograms for BE. A total of 34 studies (460 cases of BE) satisfied the inclusion criteria for the systematic review. The sensitivity (Se), specificity (Sp) and 95% confidence interval (CI) were obtained using a random-effect meta-analysis for studies reporting five or more cases. The Se (95% CI) were 86.9% (39.1-98.6%) for positive haemoculture, 84.3% (60.4-95.0%) for echocardiography, 79.7% (70.1-86.8%) for the presence of tachycardia, 60.3% (51.8-68.3%) for the presence of a murmur, 45.7% (32.5-59.5%) for the presence of fever, 43.5% (25.6-63.3%) for the presence of lameness/polyarthritis, and 37.3% (21.6-57.0%) for the presence of clinical signs of heart failure. The Sp (95% CI) was 95.3% (93.3-96.8%) for lameness, 72.6% (45.8-89.2%) for the presence of a murmur, 67.0% (55.5-76.7%) for the presence of fever, and 27.1% (14.3-45.2%) for the presence of tachycardia. This meta-analysis confirmed that the diagnosis of BE is a difficult process. Echocardiography seems to be a sensitive diagnostic tool despite the absence of any consensus on the ultrasonographic definition of the disease. However, from these results, it was impossible to determine whether multiple positive findings or clinical tests increase the sensitivity for the diagnosis of bovine BE.

The relevance of echocardiography heart measures for breeding against the risk of subaortic and pulmonic stenosis in Boxer dogs.

The aims of this study were to investigate the role and relative importance of auscultation and echocardiography traits as risk factors for the diagnosis of subaortic (SubAS) and pulmonic (PS) stenosis and to estimate the heritability (h(2)) of cardiac measurements taken through echocardiography for a random sample of Italian Boxer dogs. The data were cardiovascular examination results of 1,283 Italian Boxer dogs (686 females and 597 males) enrolled in the national screening program for heart defects arranged by the Italian Boxer Club. Examinations were performed during a 6-yr period by a group of 7 veterinary cardiologists following a standard protocol. Occurrence and severity of SubAS and PS were diagnosed, taking into account clinical and echocardiography findings such as the grade of cardiac murmur, direct ultrasound imaging of the anatomic obstructive lesions, and values of aortic or pulmonary blood flow velocities. A Bayesian logistic regression analysis was performed to identify clinical and echocardiography variables related to SubAS and PS diagnosis. Estimation of variance components for clinical and echocardiography traits was performed using a mixed linear animal model, Bayesian procedures, and the Gibbs sampler. Prevalence of SubAS (PS) was 8.4% (2.2) and 10.7% (6.4) for female and male dogs, respectively. Cardiac murmur, peak velocities, and annulus areas behaved as risk factors for SubAS and PS. The risk of a positive diagnosis for SubAS was 3 times greater for dogs with aortic annulus area <2.1 cm(2) relative to dogs with areas >2.37 cm(2), 84 times greater for dogs showing aortic peak velocities >2.19 m/s relative to dogs with peak velocities <1.97 m/s, and 41 times greater for dogs with moderate to severe murmur grades relative to dogs with absent murmur. Similar results were obtained for PS. The estimated h(2) for the occurrence of cardiac defects was 23.3% for SubAS and 8.6% for PS. Echocardiography and cardiac murmur grades exhibited moderate h(2) estimates and exploitable additive genetic variation. The estimated h(2) was 36, 24, and 20% for aortic annulus area, aortic peak velocity, and cardiac murmur score, respectively. For the area of the pulmonary annulus and peak pulmonary velocity, the estimated h(2) were smaller, ranging from 9.5 to 12.8%. These measures are candidate indicator traits that might be effectively used in dog breeding to reduce the prevalence and severity of cardiac defects.

The use of an acoustic device to identify the epidural space in cattle.

Twelve healthy cattle (weighing 188-835 kg) were placed in stocks and sedated with xylazine. Caudal epidural puncture was performed using an acoustic device that indicated a decrease in resistance with a change in pitch. Lidocaine was injected to verify correct needle placement by assessing needle prick stimuli applied on the left and right side of the tail root and the perineal region, and the loss of tail and anal sphincter tone. Pressure measurements were recorded during penetration of the different tissue layers and in the epidural space. A clear and sudden decrease in the pitch of the acoustic signal was audible in all 12 cattle. All cows showed clinical effects indicating successful epidural anaesthesia. The pressure in the epidural space after puncture was -19±10 mm Hg. The device may be of assistance in identifying the epidural space in cattle.

Clinical findings and treatment in 63 cows with haemorrhagic bowel syndrome.

The clinical, haematological and biochemical findings, treatment and outcome of 63 cows with haemorrhagic bowel syndrome are described. The general condition and demeanor were moderately to severely abnormal in all the cows. Signs of colic occurred in 27 cows, decreased rectal temperature in 46 and tachycardia in 44. With the exception of one cow, intestinal motility was decreased or absent. Transrectal palpation revealed dilatation of the rumen in 47 cows and dilatation of the small intestine in 18. Faecal output was markedly reduced or absent, and the faeces were dark brown to black and contained blood. Nine cows were euthanized immediately after physical examination. Conservative medical therapy was instituted in two cows; however, both were euthanized a few days later because of deterioration in condition. Exploratory right flank laparotomy was carried out in 52 cows. Of these, 22 were euthanized intraoperatively because of severe lesions. In 27 cows, intestinal massage to reduce the size of blood clots was carried out; 11 were euthanized several days postoperatively because of deterioration in condition. In three other cows, intestinal resection was carried out and all survived. Of the 63 cows, 19 (30.2%) survived and were healthy at the time of discharge from the clinic.

[Prevalence of heart murmurs, aortic and pulmonic stenosis in boxers presented for pre-breeding exams in Switzerland]. / Prävalenz von Herzgeräuschen, Aorten- und Pulmonalstenosen bei Zuchtuntersuchungen von Boxern in der Schweiz.

Boxer are predisposed to subaortic (SAS) and pulmonic stenosis (PS). To decrease the prevalence, pre-breeding cardiologic exams were performed in the last years. In our study the results of 309 pre-breeding exams of boxers presented between 1999 and 2008 were evaluated retrospectively. The overall prevalence of heart murmurs was 26.5 %. A SAS was diagnosed in 25 (8.1 %) and a PS in 10 (3.3 %) dogs. A combination of both defects was found in 7 (2.3 %) Boxers. Animals with a heart murmur of at least grade 3/6 had a significantly higher peak aortic flow velocity (VmaxAo) than animals without or only soft heart murmurs. Over the study period both the frequency of heart murmurs and diagnosis of SAS and PS decreased.

Relationship between thoracic auscultation and lung pathology detected by ultrasonography in sheep.

The utility of routine auscultation to detect and characterise the nature of a range of superficial lung and pleural pathologies in domestic sheep was assessed using ultrasonographic examination to indicate and localise pathologies pre-mortem. Necropsy examination was then used to fully characterise the nature and extent of the lesions. Auscultation recordings were made from 10 normal sheep with no clinical evidence of respiratory disease and with absence of significant superficial lung pathology, which was confirmed initially by ultrasound examination and subsequently at necropsy examination. A further two sheep with endotoxaemia and 30 sheep with well-defined lung lesions were also examined. Increased audibility of normal lung sounds in 4/10 normal sheep was associated with tachypnoea as a consequence of handling and transport during hot weather and was also observed in the two sheep with endotoxaemia. Moderate to severe coarse crackles detected in all advanced cases of ovine pulmonary adenocarcinoma (n=16) were audible over an area larger than the lesion distribution identified during ultrasound examination, and confirmed later at necropsy. Auscultation did not detect abnormal sounds in any of the five sheep with focal pleural abscesses (up to 10 cm diameter). Unilateral pyothorax caused attenuation of sounds relative to the contra-lateral normal lung in all three sheep with this condition. Marked fibrinous pleurisy caused attenuation of sounds relative to normal areas of lung in six sheep. No sounds resembling the description of pleural frictions rubs were heard in the sheep with marked fibrinous pleurisy (n=6) or associated with focal pleural abscesses (n=5). Routine interpretation of auscultated sound did not allow the presence of superficial lung pathology or its distribution to be accurately defined in the respiratory diseases represented in this study.

The use of an acoustic device to identify the extradural space in standing horses.

OBJECTIVE: To determine the usefulness of an acoustic device to confirm correct placement of extradural needles in horses. STUDY DESIGN: Prospective experimental study. ANIMALS: Twelve adult healthy horses weighing between 434 and 640 kg. MATERIALS AND METHODS: Horses were sedated, placed in stocks and subjected to caudal extradural anaesthesia using lidocaine 2%. For extradural puncture an 18 gauge Tuohy needle connected to an acoustic device via an electronic pressure transducer was used. This device allowed recording of the extradural pressure profile and the transformation of pressure changes into an audible signal. Extradural needle advancement was stopped and the local anaesthetic administered when either a sharp decrease in sound pitch occurred or a 'pop' sensation was felt. Correct needle placement was assessed clinically by the degree of extradural anaesthesia present using needle prick stimuli, loss of tail tone and occurrence of localized sweating. Descriptive statistical analysis was used for evaluation of the data. RESULTS: Extradural anaesthesia was successful in nine of 12 horses. In these horses during extradural needle advancement the pitch of the audible signal first increased and abruptly changed to a constant low pitched sound. In the three horses with unsuccessful punctures only a slight decrease of the pitch was noted. A 'pop' was clearly distinguished in five of nine horses with successful extradural puncture. In four horses a 'pop' was not present despite correct extradural needle placement. In three horses with incorrect needle placement a 'pop' was present. In the horses with correct needle positioning the median extradural pressure after the puncture was -0.8 kPa (-6 mmHg). CONCLUSION AND CLINICAL RELEVANCE: The acoustic device is useful to assist in the identification of successful or unsuccessful extradural needle placement in the horse.