Acute Muscle Rigidity Secondary to Tetanus: A Toxicology Simulation Case for Fourth-Year Medical Students.

Introduction: Tetanus is uncommon in the United States secondary to vaccination. However, vaccination hesitancy is increasing. This case challenges medical students to consider tetanus in the differential and understand its complications. Methods: Fourth-year medical students took a pretest on the neurotransmitter glycine and associated disease states. They received two 10-minute lectures on glycine and acid-base abnormalities. Students then participated in a simulation featuring a 27-year-old man bitten by a dog, resulting in tetanus. Required equipment included a mannequin with monitor, a defibrillator, and personal protective equipment. Critical actions consisted of learners dividing up roles amongst each other, using closed-loop communication, placing the patient on a cardiac monitor, choosing to establish IV access and intubate the patient, starting IV fluids, and administering tetanus immunoglobulin. The case ended after 20 minutes. Outcome measurements encompassed performance on a posttest and critical actions. Results: Twenty students participated. Mean pretest and posttest scores were 69.5 and 92.5, respectively (p < .001). All groups completed the items on the critical actions checklist within a 20-minute time frame. Discussion: Rising vaccine hesitancy may increase the likelihood of physicians encountering new cases of tetanus and require them to perform lifesaving management of a patient presenting with muscle rigidity. This simulation provides learners with hands-on experience caring for a patient with tetanus and muscle rigidity. It can improve their knowledge of recognition, assessment, and decision-making toward lifesaving management of tetanus by allowing them to practice their skills in a safe environment.

Emergence of pandrug-resistant carbapenemase-producing Enterobacterales in dogs and cats: a cross-sectional study in Egypt.

One of the most important emerging health problems is the increasing role of animals in the rapid global rise in resistance to last-resort antibiotics, such as carbapenems. However, there is limited information on the role of pet animals in harboring and spreading pandrug-resistant (PDR) carbapenemase-producing Enterobacterales (CPE), especially in Egypt. This cross-sectional study was conducted to screen for CPE in healthy and diseased pets using phenotypic and molecular methods and the NG-Test CARBA 5 immunochromatographic assay. Rectal swabs were collected from 62 dogs and 48 cats, incubated overnight in tryptic soy broth containing 10 µg of meropenem disc and subsequently cultured on MacConkey agar supplemented with meropenem (1 mg/L). Sixty-six isolates (60.6%), including 56 Klebsiella pneumoniae, seven Escherichia coli, and three K. oxytoca isolates, were confirmed to be carbapenem-resistant Enterobacterales (CRE) by the disc diffusion method, broth microdilution test, CNPt-direct, and PCR assay targeting carbapenemase genes. Forty-three (65.2%) dogs and 23 (34.8%) cats carried CPE. Of these, 35 (70.0%) were healthy (including 27 dogs and 8 cats) and 31 (52.5%) were diseased (including 16 dogs and 15 cats). bla OXA-181 was the most common gene detected (42/66, 63.6%), followed by bla IMP (40/66, 60.6%), bla OXA-48-like (29/66, 43.9%), bla KPC and bla VIM (20/66, 30.3% each), and bla NDM (17/66, 25.8%). The identified genotypes were bla KPC-2, bla IMP-1, bla VIM-1, bla NDM-1, and bla NDM-5. The CARBA 5 assay showed higher sensitivity and specificity for the detection of NDM, OXA and KPC than that for VIM and IMP genes. Antimicrobial resistance profiles of CRE isolates revealed 20 PDR, 30 extensively drug-resistant (XDR), and 16 multidrug-resistant (MDR) phenotypes. This study provides evidence of colonization with PDR CPE in dogs and cats. To manage the infection or colonization of pets in veterinary clinical settings, extended surveillance systems should be considered, and the use of critical antibiotics should be strictly controlled.

Comedones and epidermal cysts on the abdominal skin of a dog occurring after a laparotomy.

An 8-year-old neutered male shih tzu dog underwent laparotomy for cystolithectomy. Ten days later, multiple various-sized cystic nodules were observed on the suture line and surrounding abdominal skin, although the surgical incision had healed well. Microscopically, various-sized cysts lined with thin walls of stratified squamous epithelium in the dermis were dilated and filled with keratin. Adnexal differentiation from the wall was not seen. Thus, the abdominal lesions were diagnosed as comedones and epidermal cysts. Herein, we describe the case of a dog with comedones and epidermal cysts on the abdominal skin after a laparotomy. Key clinical message: Multiple various-sized cystic lesions of the follicles are described. The implantation of epidermal fragments into the dermis by surgery may induce epidermal cysts and comedones in the skin of hyperadrenocorticism-affected dogs.

Comédons et kystes épidermiques sur la peau abdominale d'un chien survenant après une laparotomie. Un chien shih tzu mâle castré de 8 ans a subi une laparotomie pour cystolithectomie. Dix jours plus tard, de multiples nodules kystiques de différentes tailles ont été observés sur la ligne de suture et sur la peau abdominale environnante, bien que l'incision chirurgicale ait bien cicatrisé. Au microscope, des kystes de différentes tailles bordés de fines parois d'épithélium pavimenteux stratifié dans le derme étaient dilatés et remplis de kératine. Aucune différenciation annexielle par rapport à la paroi n'a été observée. Ainsi, les lésions abdominales ont été diagnostiquées comme des comédons et des kystes épidermiques. Nous décrivons ici le cas d'un chien présentant des comédons et des kystes épidermiques sur la peau abdominale après une laparotomie.Message clinique clé:De multiples lésions kystiques des follicules, de différentes tailles, sont décrites. L'implantation chirurgicale de fragments d'épiderme dans le derme peut provoquer des kystes épidermiques et des comédons dans la peau des chiens atteints d'hypercorticisme.(Traduit par Dr Serge Messier).

Basic triage in dogs and cats: Part III.

Background: Emergency cases can be presented at any time of the day or night. All small animal practitioners need to have the skills to triage and stabilize common emergency cases, even if the ultimate goal is to refer the animal to another facility. Objective and procedure: The third and final part of this 3-part review article series discusses arrhythmias typical in emergency cases and the approach to animals that are presented with an inability to stand up and walk normally. A stepwise method to categorize and stabilize these cases is outlined, along with helpful tips to optimize the referral experience, if indicated. Results: Recognizing and knowing how to treat tachy- and bradyarrhythmias is important in stabilizing a dog's or cat's condition. Understanding how to differentiate the various reasons that a dog or cat is unable to stand on its own allows a veterinarian to both treat and communicate outcome expectations for those animals. Conclusion and clinical relevance: Do not refer emergent cases before basic stabilization is completed. Many emergency cases can either be worked up by the primary veterinarian or sent to a referral clinic on an appointment basis after appropriate stabilization steps have occurred.

Triage de base chez les chiens et les chats : Partie III. Mise en contexte: Les cas d'urgence peuvent être présentés à toute heure du jour ou de la nuit. Tous les praticiens des petits animaux doivent avoir les compétences nécessaires pour trier et stabiliser les cas d'urgence courants, même si le but ultime est de référer l'animal vers un autre établissement. Objectif et procédure: La troisième et dernière partie de cette série d'articles de synthèse en trois parties traite des arythmies typiques des cas d'urgence et de l'approche des animaux présentant une incapacité à se lever et à marcher normalement. Une méthode par étapes pour catégoriser et stabiliser ces cas est décrite, ainsi que des conseils utiles pour optimiser l'expérience de référence, si cela est indiqué. Résultats: Reconnaître et savoir comment traiter les tachy- et bradyarythmies est important pour stabiliser l'état d'un chien ou d'un chat. Comprendre comment différencier les différentes raisons pour lesquelles un chien ou un chat est incapable de se tenir seul permet au vétérinaire de traiter et de communiquer les attentes en matière de résultats pour ces animaux. Conclusion et pertinence clinique: Ne référez pas les cas urgents avant que la stabilisation de base ne soit terminée. De nombreux cas d'urgence peuvent être traités par le vétérinaire initial ou envoyés à une clinique de référence sur rendez-vous après que les mesures de stabilisation appropriées ont été prises.(Traduit par Dr Serge Messier).

Acute kidney injury and liver disease in an American bulldog with suspected leptospirosis.

A 6-year-old spayed female American bulldog was brought to a veterinary clinic with a 3-day history of vomiting, lethargy, anorexia, icterus, hemorrhagic diarrhea, and oliguria. The dog's clinical signs, complete blood (cell) count, serum biochemistry, urinalysis, and diagnostic imaging were indicative of acute kidney injury and acute hepatopathy consistent with leptospirosis. Treatment for leptospirosis was initiated but, due to the dog's lack of response and progression of clinical signs, euthanasia was ultimately elected after 3 d of hospitalization. The dog tested negative for Leptospira spp. on ELISA; urine, blood, and tissue PCRs; and immunohistochemistry. This case demonstrates that confirmation of leptospirosis can be challenging, even in an animal with the expected clinical presentation. Therefore, limitations of the diagnostic tests available, as well as the possibility of other, less likely differential diagnoses such as toxicosis, must be considered.

Lésion rénale aiguë et maladie hépatique chez un bouledogue américain avec leptospirose suspectée. Une femelle bouledogue américain stérilisée âgée de 6 ans a été présenté à une clinique vétérinaire avec une histoire d'une durée de 3 jours de vomissement, léthargie, anorexie, ictère, diarrhée hémorragique et oligurie. Les signes cliniques de la chienne, un comptage cellulaire sanguin complet, une biochimie sérique, une analyse d'urine et de l'imagerie diagnostique étaient indicateur de lésion rénale aiguë et d'hépatopathie aiguë compatibles avec la leptospirose. Un traitement pour la leptospirose a été instauré mais, étant donné l'absence de réponse de l'animal et la progression des signes cliniques, l'euthanasie a finalement été décidée après 3 jours d'hospitalisation. L'animal s'est avéré négatif par ELISA pour Leptospira spp.; l'urine, le sang et les tissus étaient également négatifs par PCR; et par immunohistochime. Ce cas illustre le fait que la confirmation de la leptospirose peut représenter un défi, même chez un animal avec la présentation clinique attendue. Ainsi, les limites des tests diagnostiques disponibles, de même que la possibilité d'autres diagnostics différentiels moins probables, tel qu'une toxicose, doivent être considérés.(Traduit par Dr Serge Messier).

Endotracheal tube cuff rupture during anesthesia in 2 dogs.

A 15-year-old intact male dachshund dog weighing 4.3 kg and a 5-year-old intact male mixed-breed dog weighing 13.6 kg were referred for examination because of paraparesis and facial paralysis, respectively. Magnetic resonance imaging (MRI) of the thoracolumbar region and brain was performed. The dogs were premedicated with IV butorphanol, 0.2 mg/kg body weight (BW) and midazolam, 0.2 mg/kg BW. Anesthesia was induced with IV propofol, 4 to 5 mg/kg BW and maintained with sevoflurane in oxygen. The dachshund was orotracheally intubated with a 5.0-millimeter internal diameter endotracheal (ET) tube. During positioning in the MRI room, intermittent positive pressure ventilation (IPPV) was applied. The mixed-breed dog was orotracheally intubated with a 6.0-millimeter internal diameter ET tube. After inflation of the ET tube cuff, a leaking test was done by applying positive pressure ventilation. In both dogs, a distinct "popping" sound was heard when positive pressure was applied, after which air leakage from the cuff was evident. Failure to inflate the pilot balloon led to suspicion of a ruptured cuff. Reintubation was completed, both dogs remained stable during anesthesia, and no postanesthetic complications were observed. Rupture of both cuffs, which was visually confirmed, was thought to be caused by overinflation of the cuff, repeated sterilization of the ET tubes, and positive pressure ventilation. Repeated sterilization of ET tubes with ethylene oxide can alter the physical integrity of cuffs. Care should be taken not to overinflate ET tube cuffs, especially when they have been repeatedly sterilized, as cuff rupture may result in failure to provide adequate IPPV. Key clinical message: This report describes 2 cases in which ET tube cuff rupture was noted during anesthesia for MRI.

Rupture du ballonnet du tube endotrachéal pendant l'anesthésie chez 2 chiens. Un chien teckel mâle intact de 15 ans pesant 4,3 kg et un chien croisé mâle intact de 5 ans pesant 13,6 kg ont été référés pour examen en raison de paraparésie et de paralysie faciale, respectivement. Une imagerie par résonance magnétique (IRM) de la région thoraco-lombaire et du cerveau a été réalisée. Les chiens ont reçu une prémédication avec du butorphanol IV, 0,2 mg/kg de poids corporel (PC), et du midazolam, 0,2 mg/kg PC. L'anesthésie a été induite avec du propofol IV, 4 à 5 mg/kg de PC et maintenue avec du sévoflurane dans de l'oxygène. Le teckel a été intubé par voie orotrachéale avec un tube endotrachéal (TE) de diamètre interne de 5,0 millimètres. Lors du positionnement dans la salle d'IRM, une ventilation intermittente à pression positive (VIPP) a été appliquée. Le chien de race mixte a été intubé par voie orotrachéale avec un TE de 6,0 millimètres de diamètre interne. Après le gonflage du ballonnet du TE, un test d'étanchéité a été effectué en appliquant une ventilation à pression positive. Chez les deux chiens, un son distinct de « claquement ¼ a été entendu lorsqu'une pression positive a été appliquée, après quoi une fuite d'air du ballonnet est devenue évidente. Le fait de ne pas gonfler le ballon pilote a fait soupçonner une rupture du ballonnet. Une ré-intubation a été effectuée, les deux chiens sont restés stables pendant l'anesthésie et aucune complication post-anesthésique n'a été observée. La rupture des deux ballonnets, confirmée visuellement, aurait été causée par un surgonflage du ballonnet, une stérilisation répétée des TE et une ventilation à pression positive. La stérilisation répétée des TE avec de l'oxyde d'éthylène peut altérer l'intégrité physique des ballonnets. Il convient de veiller à ne pas surgonfler les ballonnets des TE, en particulier lorsqu'ils ont été stérilisés à plusieurs reprises, car la rupture du ballonnet peut entraîner l'incapacité de fournir une VIPP adéquate.Message clinique clé:Ce rapport décrit 2 cas dans lesquels une rupture du ballonnet du TE a été constatée lors d'une anesthésie pour IRM.(Traduit par Dr Serge Messier).

A retrospective study of chemotherapeutic effect without wide-margin surgery or radiation therapy in dogs with oral malignant melanoma.

Background: Effective treatment for canine oral malignant melanoma (e.g., curative-intent surgery) may not be feasible or radiation therapy may be unavailable. However, chemotherapy is usually an option, and more information is needed regarding its use without adequate local treatments. Objective: Our objective was to investigate the efficacy of chemotherapy in canine oral malignant melanoma without adequate local control, using carboplatin with dose reduction in small-breed dogs and metronomic chemotherapy. Animals and procedure: Client-owned dogs with histopathologically diagnosed oral malignant melanoma were retrospectively enrolled from 2016 to 2022. The chemotherapy protocol in each case was determined by the attending clinician. Results: Thirteen dogs were included. The median progression-free interval of all 13 dogs was 42 d (14 to 953 d). The median overall survival time of dogs with chemotherapy as their only systemic treatment was 181 d (50 to 960 d; n = 11). The median dosage of carboplatin was 250 mg/m2. Response to treatment and clinical stage were significant prognostic factors. Conclusion and clinical relevance: As chemotherapy provided a median survival of 6 mo, it could be considered when adequate local control is infeasible. Earlier clinical stages or achievement of at least stable disease during chemotherapy may indicate better survival in dogs.

Une étude rétrospective de l'effet chimiothérapeutique sur le mélanome malin buccal canin dépourvu de chirurgie et de radiothérapie á large marge : le stade clinique et la réponse au traitement prédisent les résultats du patient. Mise en contexte: Des traitements efficaces pour le mélanome malin oral canin, tels que la chirurgie á visée curative, ne sont parfois pas réalisables ou la radiothérapie n'est pas disponible dans certaines régions. La chimiothérapie reste une option de traitement et davantage d'informations devraient être fournies pour les cas qui n'ont pas eu accés á un traitement local adéquat. Objectif: Cette étude visait á étudier l'efficacité de la chimiothérapie dans le mélanome malin oral canin sans contrôle local adéquat, en utilisant le carboplatine avec réduction de dose chez les chiens de petite race et la chimiothérapie métronomique. Animaux et procédure: Treize chiens appartenant á des clients atteints d'un mélanome malin oral diagnostiqué par histopathologie ont été rétrospectivement inscrits de 2016 á 2022. Le protocole de chimiothérapie a été déterminé par le clinicien traitant. Résultats: L'intervalle médian sans progression des treize chiens était de 42 jours (14­953 jours). La durée médiane de survie globale des chiens ayant reçu une chimiothérapie comme seul traitement systémique était de 181 jours (50­960 jours; n = 11). La dose médiane de carboplatine était de 250 mg/m2. La réponse au traitement et le stade clinique étaient des facteurs pronostiques importants. Conclusion et pertinence clinique: La chimiothérapie pouvait encore être envisagée lorsqu'un contrôle local adéquat était impossible. Des stades cliniques plus précoces ou des patients atteignant au moins une maladie stable pendant la chimiothérapie peuvent indiquer une meilleure survie.(Traduit par les auteurs).

Bilateral hibernomas in the femoral regions of a dog.

A 14-year-old intact male Chihuahua dog was presented with masses located between the biceps femoris and adductor muscles in both hind limbs. Based on histopathological, immunohistochemical, and ultrastructural findings, we diagnosed these masses as bilateral hibernomas in the femoral regions. The dog had no evidence of recurrence or metastasis of the hibernomas through a 4-month postoperative follow-up. This is apparently the first report of bilateral hibernomas in the femoral regions of a dog. Key clinical message: Bilateral hibernomas should be considered as a differential diagnosis for masses occurring in the femoral regions of dogs.

Hibernomes bilatéraux dans les régions fémorales d'un chien. Un chien Chihuahua mâle intact de 14 ans a été présenté avec des masses situées entre le biceps fémoral et les muscles adducteurs des deux membres postérieurs. Sur la base des résultats histopathologiques, immunohistochimiques et ultrastructuraux, nous avons diagnostiqué ces masses comme des hibernomes bilatéraux dans les régions fémorales. Le chien n'avait aucun signe de récidive ou de métastases des hibernomes au cours d'un suivi postopératoire de 4 mois. Il s'agit apparemment du premier rapport d'hibernome bilatéral dans les régions fémorales d'un chien.Message clinique clé:Les hibernomes bilatéraux doivent être considérés comme un diagnostic différentiel pour les masses survenant dans les régions fémorales des chiens.(Traduit par Dr Serge Messier).

Comparison of sedation with dexmedetomidine administered subcutaneously at 2 different locations on the head in dogs.

Objective: This study aimed to compare the sedative effects of dexmedetomidine administered to dogs subcutaneously (SC) at the Governing Vessel 20 (GV20) acupuncture point and at another point on the head. Animals and procedure: Ten client-owned dogs were included. Dogs were sedated 2 times, 14 d apart, with 200 µg/m2 of dexmedetomidine, SC, at GV20 and at a point at the base of the ear (SC-head). The sedation was assessed with a sedation scale and a Dynamic and Interactive Visual Analogue Scale (DIVAS). The ease of performing radiographic studies, physiological parameters, and adverse events were recorded. Statistical linear mixed-effect models (ANOVA) were applied. Statistical significance was set at P < 0.05. Results: The time to sedation and sedation scores were similar for both groups. The level of sedation achieved was adequate to perform orthopedic radiographs for 9/10 (90%) cases in the GV20 group and 8/10 (80%) cases in the SC-head group. Heart and respiratory rates decreased significantly over time in both groups (P < 0.001). Adverse events were infrequent and self-limiting. Conclusion: Our study provides evidence that SC administration of dexmedetomidine on the head, at the GV20 point or at the base of the ear, is easy and provides a sufficient level of sedation to obtain orthopedic radiographs in dogs.

Comparaison de la sédation avec de la dexmédétomidine administrée par voie sous-cutanée à deux sites différents sur la tête de chiens. Objectif: Cette étude a pour but de comparer les effets sédatifs de la dexmédétomidine administrée par voie sous-cutanée (SC) au point d'acupuncture VG20 et à un autre point sur la tête, non lié à la relaxation/sédation, chez le chien. Animaux et procédure: Dix chiens de clients ont été inclus dans cette étude clinique, prospective, croisée, randomisée et à l'aveugle. Les chiens ont été sédatés deux fois, à 14 jours d'intervalle, avec une injection de 200 µg/m2 de dexmédétomidine sous-cutanée au point d'acupuncture VG20 et à un autre point sur la tête, à la base de l'oreille (SC-tête). La durée et la qualité de la sédation ont été évaluées avec une échelle de sédation et une échelle analogue visuelle dynamique et interactive (DIVAS). La facilité de réaliser des études radiographiques, les paramètres physiologiques et les effets secondaires ont été enregistrés. Des modèles statistiques linéaires à effet mixte (ANOVA) ont été réalisés. Les résultats étaient considérés comme significatifs quand P < 0,05. Résultats: Le temps nécessaire pour atteindre un niveau de sédation adéquat et les scores de sédation étaient comparables entre les deux groupes. Le niveau de sédation était adéquat pour réaliser des radiographies orthopédiques chez 9/10 (90 %) des cas dans le groupe VG20 et 8/10 (80 %) des cas dans le groupe SC-tête. Les fréquences cardiaque et respiratoire diminuaient significativement dans le temps pour les 2 groupes (P < 0,001). Les effets indésirables étaient peu fréquents et auto-limitants. Conclusion: Notre étude suggère que l'administration sous-cutanée de dexmédétomidine sur la tête, que ce soit au point VG20 ou à la base de l'oreille, est facile et permet d'obtenir un niveau de sédation suffisant pour réaliser des radiographies orthopédiques chez des chiens sains.(Traduit par les auteurs).

Morphological comparative study of canine and feline diaphragms: Effect of bodyweight, body condition score, gender, age and breed.

The canine diaphragm is a muscular and tendinous dome-like plate and is largely involved in digestive and respiratory functions. Very few studies compared morphology of the diaphragm between dogs and cats and no studies have investigated the effects of individual factors on this morphology. So the aim of this study was to (1) study the effects of individual factors on the morphology of the diaphragm and (2) to compare its morphology between cats and dogs. Surface measurements of 86 diaphragms were performed. The tendinous centre (TC), the lumbar part of the peripheral muscular (LP) and the sternal and costal parts of the peripheral muscular (SCPM) were measured. Measurement ratios (surface of anatomical part of the diaphragm/total surface of the diaphragm) were used for statistical analysis (TC%S, LP%S, SCPM%S). The SCPM%S are significantly lower, and the LP%S are significantly higher when bodyweight increases in dogs and cats. The TC%S are significantly lower when the body condition score of dogs increases. The SCPM%S are significantly higher, and therefore, the TC%S and LP%S lower in brachycephalic animals as opposed to mesocephalic animals. The TC%S are significantly higher in dogs than in cats and the SCPM%S are significantly higher in cats than in dogs. This study proposed a cartography of the diaphragm morphology in cats and dogs taking into account individual animal factors. Significant differences in the diaphragm morphology between cats and dogs and between mesocephalic and brachycephalic animals were found. Further studies are necessary to confirm these results and to investigate the consequences of these variations.

Placement of a subcutaneous ureteral bypass in a Miniature Pinscher with presumed xanthine urolithiasis as a result of allopurinol treatment.

INTRODUCTION: This case report describes the long-term success of a subcutaneous ureteral bypass device in a dog for treatment of a ureteral obstruction. The suspected xanthine urolithiasis was secondary to treatment with allopurinol for leishmaniasis. The dog presented initially with lethargy, anuria and abdominal pain. Mild azotemia was found on biochemical analysis and abdominal ultrasound revealed bilateral ureteral obstruction. A subcutaneous ureteral bypass was subsequently placed using a standard surgical technique. The dog recovered uneventfully and the azotemia resolved within days. Follow-up examinations were performed every trimester for over three years and no complications like obstruction of the bypass tubes, urinary tract infection or azotemia were recognized during this follow-up period. Allopurinol was replaced with domperidone as long-term treatment against Leishmaniasis which resulted in a mild increase of the leishmania serum antibody titer. The subcutaneous ureteral bypass placement was successful and safe in this dog and is a valuable alternative in cases of ureteral obstruction also in dogs.

INTRODUCTION: Ce rapport de cas décrit le succès à long terme d'une dérivation urétérale sous-cutanée chez un chien pour le traitement d'une obstruction urétérale. L'urolithiase xanthique suspectée était secondaire à un traitement à l'allopurinol contre la leishmaniose. Le chien a d'abord présenté une léthargie, une anurie et des douleurs abdominales. L'analyse biochimique a révélé une légère azotémie et l'échographie abdominale a révélé une obstruction urétérale bilatérale. Une dérivation urétérale sous-cutanée a été mise en place selon une technique chirurgicale standard. Le chien s'est rétabli sans incident et l'azotémie a disparu en quelques jours. Des examens de suivi ont été effectués tous les trimestres pendant plus de trois ans et aucune complication telle qu'une obstruction du tube de dérivation, une infection urinaire ou une azotémie n'a été constatée au cours de cette période de suivi. L'allopurinol a été remplacé par de la dompéridone dans le cadre d'un traitement à long terme contre la leishmaniose, ce qui a entraîné une légère augmentation du titre des anticorps sériques contre la leishmaniose. La mise en place d'une dérivation urétérale sous-cutanée s'est avérée efficace et sûre chez ce chien et constitue une alternative intéressante en cas d'obstruction urétérale, y compris chez les chiens.

UK dog fighting ring had cross-Channel reach.

Josh Loeb reports on the conviction of a criminal gang involved in dog fighting in the UK and Europe.

Knowledge and perception about the welfare and mistreatment of dogs in Brazil.

Animal welfare encompasses the overall well-being of an animal, spanning both its physical and mental health, assessable through potential measurements. It stands in contrast to mistreatment, which involves actions, direct or indirect, that endanger an animal's well-being. This study sought to appraise the factors influencing the Brazilian population's understanding of dog welfare and mistreatment. The survey questions were adapted from the Animal Welfare Examination Protocol, utilized by veterinarians to evaluate suspected passive abuse cases in dogs. Out of 1377 responses, 1353 were valid and analyzed. Among the 19 assessed indicators, 15 demonstrated an adequate response rate surpassing 90% of all 1353 responses. However, for three questions related to comfort, a smaller yet notable percentage of responses were only minimally adequate. Moreover, in one question within the comfort assessment, 186 participants (13.74%) provided inadequate responses. This implies that these people could potentially subject animals to a state of low Animal Welfare. Lack of knowledge emerged as a potential root of passive abuse, specifically negligence. In the assessment of nutritional indicators, water supply and quality received unanimous adequate responses. In evaluating comfort perceptions, significant associations were noted between gender, dog ownership, family income, and responses regarding resting surface. Regarding health indicators, the majority responded appropriately. Female gender and dog ownership correlated with providing the appropriate response, while not owning a dog was associated with minimally adequate responses. In the context of comfort indicators, "Hitting the Dog" also demonstrated an association with gender, with females tending towards appropriate responses. Given the lack of significant correlation between educational levels and the most suitable responses, it underscores the urgency of implementing environmental education programs in schools with a focus on animal protection.

Successful management of pulmonary edema secondary to accidental electrocution in a young dog.

BACKGROUND: Human records describe pulmonary edema as a life-threatening complication of electric shock. Successful management requires prompt recognition and intensive care. However, in companion animals, electrocutions are rarely reported, even though domestic environments are full of electrical devices and there is always the possibility of accidental injury. Therefore, it is important for veterinarians to know more about this condition in order to achieve successful patient outcomes. CASE PRESENTATION: A 3-month-old male Labrador Retriever was presented with a history of transient loss of consciousness after chewing on a household electrical cord. On admission, the puppy showed an orthopneic position with moderate respiratory distress. Supplemental oxygen via nasal catheter was provided, but the patient showed marked worsening of respiratory status. Point-of-care ultrasound exams suggested neurogenic pulmonary edema due to electrical shock close to the central nervous system and increased B-lines without evidence of cardiac abnormalities. Mechanical ventilation of the patient was initiated using volume-controlled mode with a tidal volume of 9 to 15 ml/kg until reaching an end-tidal carbon dioxide ≤ 40 mm Hg, followed by a stepwise lung-recruitment maneuver in pressure-controlled mode with increases of the peak inspiratory pressure (15 to 20 cm H2O) and positive end-expiratory pressure (3 to 10 cm H2O) for 30 min, and return to volume-controlled mode with a tidal volume of 15 ml/kg until reaching a peripheral oxygen saturation ≥ 96%. Weaning from the ventilator was achieved in six hours, and the patient was discharged two days after admission without neurological or respiratory deficits. CONCLUSIONS: We present a rather unusual case of a neurogenic pulmonary edema subsequent to accidental electrocution in a dog. Timely diagnosis by ultrasound and mechanical ventilation settings are described. Our case highlights that pulmonary edema should be considered a potentially life-threatening complication of electrical shock in small animal emergency and critical care medicine.

Topical Human Mesenchymal Stem Cell-Derived Exosomes for Acceleration of Wound Healing Following Tissue Trauma and Aesthetic Procedures: A Case Series.

BACKGROUND: In the aesthetics practice, measures to accelerate wound healing and minimize downtime following procedures have been largely restricted to topical serums and platelet-rich plasma (PRP), which can have varying levels of success. Here, the authors present a case series of patients treated in clinical practice with cell-free exosomes derived from human placental mesenchymal stem cells (Exovex, Exocelbio, Doylestown, PA). Topical administration of exosomes after either aesthetic treatment or traumatic injury (a dog bite) had a marked effect on healing. Effects were assessed visually, and case-study images are shared. Individuals demonstrated significantly accelerated recovery and wound healing within hours to days, depending on the procedure. Patients who had undergone the same aesthetic procedure prior without exosomes reported satisfaction with reductions in pain, swelling, redness, and post-procedure downtime. No adverse events were reported by patients after treatment. Together, these case series suggest that exosome treatment can accelerate wound healing safely and effectively and support topical use in an office-based setting. These findings also highlight the need for more formal evaluation of the effects of exosomes on wound healing in reducing aesthetic procedure recovery times for surgical and non-surgical interventions. Significant Finding: The case series presented here illustrates the potential for exosomes to be a versatile and important part of clinical care, especially in situations where expedited healing is central to patient safety and/or satisfaction. These results provide strong support for additional research.  Meaning: Topical administration of cell-free exosomes has the potential to improve patient care and satisfaction with aesthetic interventions. Early experience, illustrated by the presented case studies, has been remarkably positive and treatment has the potential to dramatically improve the standard of care.  Online ahead of print.

Local carbachol application induces oral microvascular recruitment and improves gastric tissue oxygenation during hemorrhagic shock in dogs.

Introduction: Hemorrhagic shock is characterized by derangements of the gastrointestinal microcirculation. Topical therapy with nitroglycerine or iloprost improves gastric tissue oxygenation but not regional perfusion, probably due to precapillary adrenergic innervation. Therefore, this study was designed to investigate the local effect of the parasympathomimetic carbachol alone and in combination with either nitroglycerine or iloprost on gastric and oral microcirculation during hemorrhagic shock. Methods: In a cross-over design five female foxhounds were repeatedly randomized into six experimental groups. Carbachol, or carbachol in combination with either nitroglycerine or iloprost were applied topically to the oral and gastric mucosa. Saline, nitroglycerine, or iloprost application alone served as control groups. Then, a fixed-volume hemorrhage was induced by arterial blood withdrawal followed by blood retransfusion after 1h of shock. Gastric and oral microcirculation was determined using reflectance spectrophotometry and laser Doppler flowmetry. Oral microcirculation was visualized with videomicroscopy. Statistics: 2-way-ANOVA for repeated measurements and Bonferroni post-hoc analysis (mean ± SEM; p < 0.05). Results: The induction of hemorrhage led to a decrease of gastric and oral tissue oxygenation, that was ameliorated by local carbachol and nitroglycerine application at the gastric mucosa. The sole use of local iloprost did not improve gastric tissue oxygenation but could be supplemented by local carbachol treatment. Adding carbachol to nitroglycerine did not further increase gastric tissue oxygenation. Gastric microvascular blood flow remained unchanged in all experimental groups. Oral microvascular blood flow, microvascular flow index and total vessel density decreased during shock. Local carbachol supply improved oral vessel density during shock and oral microvascular flow index in the late course of hemorrhage. Conclusion: The specific effect of shifting the autonomous balance by local carbachol treatment on microcirculatory variables varies between parts of the gastrointestinal tract. Contrary to our expectations, the improvement of gastric tissue oxygenation by local carbachol or nitroglycerine application was not related to increased microvascular perfusion. When carbachol is used in combination with local vasodilators, the additional effect on gastric tissue oxygenation depends on the specific drug combination. Therefore, modulation of tissue oxygen consumption, mitochondrial function or alterations in regional blood flow distribution should be investigated.

Domestic dogs in indigenous Amazonian communities: Key players in Leptospira cycling and transmission?

BACKGROUND: Leptospirosis is the world's most common zoonotic disease. Mitigation and control rely on pathogen identification and understanding the roles of potential reservoirs in cycling and transmission. Underreporting and misdiagnosis obscure the magnitude of the problem and confound efforts to understand key epidemiological components. Difficulties in culturing hamper the use of serological diagnostics and delay the development of DNA detection methods. As a result, especially in complex ecosystems, we know very little about the importance of different mammalian host species in cycling and transmission to humans. METHODOLOGY/PRINCIPAL FINDINGS: We sampled dogs from five indigenous Kichwa communities living in the Yasuní National Park in the Ecuadorian Amazon basin. Blood and urine samples from domestic dogs were collected to assess the exposure of these animals to Leptospira and to identify the circulating species. Microscopic Agglutination Tests with a panel of 22 different serovars showed anti-leptospira antibodies in 36 sampled dogs (75%), and 7 serogroups were detected. Two DNA-based detection assays revealed pathogenic Leptospira DNA in 18 of 19 dog urine samples (94.7%). Amplicon sequencing and phylogenetic analysis of 16S rRNA and SecY genes from 15 urine samples revealed genetic diversity within two of three different Leptospira species: noguchii (n = 7), santarosai (n = 7), and interrogans (n = 1). CONCLUSIONS/SIGNIFICANCE: The high prevalence of antibodies and Leptospira DNA provides strong evidence for high rates of past and current infections. Such high prevalence has not been previously reported for dogs. These dogs live in the peridomestic environment in close contact with humans, yet they are free-ranging animals that interact with wildlife. This complex web of interactions may explain the diverse types of pathogenic Leptospira observed in this study. Our results suggest that domestic dogs are likely to play an important role in the cycling and transmission of Leptospira. Future studies in areas with complex ecoepidemiology will enable better parsing of the significance of genotypic, environmental, and host characteristics.

Validation of the shortened version of the Canine Behavioral Assessment and Research Questionnaire (C-BARQ) using participants from the Dog Aging Project.

The Canine Behavioral Assessment and Research Questionnaire (C-BARQ) is a 100-item owner-completed survey instrument used for assessing behavior and temperament of companion dogs. The shortened version of the C-BARQ (C-BARQ(S)) consists of 42 items of the long C-BARQ. We aimed to validate the shortened C-BARQ(S) by comparing it with the long questionnaire in the same human-dog pair. We examined data from a nationwide cohort of companion dogs enrolled in the large-scale longitudinal Dog Aging Project (DAP) study. Among 435 participating owners who completed both the long and shortened versions of the C-BARQ within 60 days of each other, agreement between individual questions of the long and shortened C-BARQ using an unweighted kappa statistic and percent agreement was examined. Associations between the two questionnaires for mean behavior and temperament domain scores and mean miscellaneous category scores were assessed using Pearson correlation coefficients. Of 435 dogs in the study, the mean (SD) age was 7.3 (4.3) years and 216 (50%) were female. Kappa values between the long and shortened C-BARQ for individual questions within the 14 behavior and temperament domains and a miscellaneous category ranged from fair to moderate (0.23 to 0.40 for 21 items and 0.41 to 0.58 for 26 items, respectively). Pearson correlation coefficients above 0.60 between both questionnaires for 12 of the 14 mean behavior and temperament domain scores and a category of miscellaneous items were observed. Kappa values for individual questions between the long and shortened C-BARQ ranged from fair to moderate and correlations between mean domain scores ranged from moderate to strong.

[Surveillance of echinococcosis in Bayingolin Mongol Autonomous Prefecture, Xinjiang Uygur Autonomous Region from 2017 to 2022].

OBJECTIVE: To analyze the echinococcosis surveillance results in Bayingolin Mongol Autonomous Prefecture, Xinjiang Uygur Autonomous Region from 2017 to 2022, so as to provide insights into formulation of echinococcosis control measures in the prefecture. METHODS: Villagers were randomly sampled using a multistage sampling method from class I and II echinococcosis endemic counties in Bayingolin Mongolian Autonomous Prefecture from 2017 to 2022 for detection of human echinococcosis, while all patients undergoing ultrasound examinations in medical institutions in class III endemic counties received active echinococcosis screening. In addition, livestock in centralized slaughterhouses or slaughtering sites were screened for echinococcosis using the palpation and necropsy method, and fresh domestic dog feces samples were collected from randomly selected dog owners in each administrative village for detection of Echinococcus copro-antigen in domestic dogs. The trends in detection of human and livestock echinococcosis, detection of newly diagnosed human echinococcosis cases and detection of Echinococcus coproantigen in domestic dogs were analyzed in Bayingolin Mongol Autonomous Prefecture from 2017 to 2022. RESULTS: The mean detection rate of human echinococcosis was 0.13% (540/407 803) in Bayingolin Mongol Autonomous Prefecture from 2017 to 2022, which appeared a tendency towards a decline over years (χ2trend = 1 217.21, P < 0.001), and the highest detection of newly diagnosed echinococcosis cases was seen in Hejing County (0.28%, 191/67 865). The detection of livestock echinococcosis appeared a tendency towards a decline over years from 2017 to 2022 (χ2trend = 147.02, P < 0.001), with the highest detection rate seen in Hejing County (3.44%, 86/2 500), and the detection of Echinococcus copro-antigen in domestic dogs appeared a tendency towards a decline over years from 2017 to 2022 (χ2trend = 302.46, P < 0.001), with the highest detection rate in Qiemo County (2.74%, 118/4 313). CONCLUSIONS: The detection of human and livestock echinococcosis and dog feces antigens Echinococcus copro-antigen in domestic dogs all appeared a tendency towards a decline in Bayingolin Mongol Autonomous Prefecture, Xinjiang Uygur Autonomous Region from 2017 to 2022; however, there is still a high echinococcosis transmission risk in local areas. Sustainable integrated echinococcosis control is required in Bayingolin Mongol Autonomous Prefecture.

A new look at the fluorescent protein-based approach for identifying optimal coding sequence for recombinant protein expression in E. coli.

Due to the degeneracy of the genetic code, most amino acids are encoded by several codons. The choice among synonymous codons at the N-terminus of genes has a profound effect on protein expression in Escherichia coli. This is often explained by the different contributions of synonymous codons to mRNA secondary structure formation. Strong secondary structures at the 5'-end of mRNA interfere with ribosome binding and affect the process of translation initiation. In silico optimization of the gene 5'-end can significantly increase the level of protein expression; however, this method is not always effective due to the uncertainty of the exact mechanism by which synonymous substitutions affect expression; thus, it may produce nonoptimal variants as well as miss some of the best producers. In this paper, an alternative approach is proposed based on screening a partially randomized library of expression constructs comprising hundreds of selected synonymous variants. The effect of such substitutions was evaluated using the gene of interest fused to the reporter gene of the fluorescent protein with subsequent screening for the most promising candidates according to the reporter's signal intensity. The power of the approach is demonstrated by a significant increase in the prokaryotic expression of three proteins: canine cystatin C, human BCL2-associated athanogene 3 and human cardiac troponin I. This simple approach was suggested which may provide an efficient, easy, and inexpensive optimization method for poorly expressed proteins in bacteria.