Readability of postoperative discharge instructions is associated with complication rate in companion animals undergoing sterilisation.

BACKGROUND: Readability of client communications is a commonly overlooked topic in veterinary medical education. In human medicine, it has been advised that the readability of patient materials should be at USA schooling sixth-grade level or below. We hypothesised that student written discharge instructions would be of an inappropriate readability level, and discharges scored with higher reading grade levels would be associated with more complications. METHODS: The cohort comprised 149 dogs and cats presenting for sterilisation. The readability of discharge instructions was assessed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) formulas. Records were examined for evidence of postoperative complications. RESULTS: The mean FRE score of the discharge instructions was 61.97, with 30.87% being classified as 'difficult' or 'fairly difficult', 60.4% as 'standard' and 8.72% as 'fairly easy'. The mean FKGL was 8.64, with 98% being above reading level 6. Overall, there was an association between FKGL and complication occurrence (p = 0.005). Stratification by species demonstrated FRE and FKGL to be associated with complication occurrence in dogs (FRE score, p = 0.038; FKGL, p = 0.002), but not cats (FRE score, p = 0.964; FKGL, p = 0.679). LIMITATIONS: Due to the retrospective nature of the study, there were difficulties associated with extracting relevant complication information from the medical records. CONCLUSION: Only 2% of owner-directed discharge instructions were written at readability levels aligning with the recommendations set forth in the human guidelines.

Fluorescent In Situ Hybridization for the Detection of Intracellular Bacteria in Companion Animals.

FISH techniques have been applied for the visualization and identification of intracellular bacteria in companion animal species. Most frequently, these techniques have focused on the identification of adhesive-invasive Escherichia coli in gastrointestinal disease, although various other organisms have been identified in inflammatory or neoplastic gastrointestinal disease. Previous studies have investigated a potential role of Helicobacter spp. in inflammatory gastrointestinal and hepatic conditions. Other studies evaluating the role of infectious organisms in hepatopathies have received some attention with mixed results. FISH techniques using both eubacterial and species-specific probes have been applied in inflammatory cardiovascular, urinary, and cutaneous diseases to screen for intracellular bacteria. This review summarizes the results of these studies.

Overall good agreement of smartphone-based and standard base-apex electrocardiography in healthy sheep.

OBJECTIVE: To assess and compare the quality of smartphone ECG tracings to standard (base-apex) ECG tracings and assess agreement of ECG parameters between smartphone-based ECG and standard ECG. ANIMALS: 25 rams. PROCEDURES: The rams were consecutively examined with standard ECG and smartphone-based ECG (KardiaMobile; AliveCor Inc) after physical examination. ECGs were compared for quality score, heart rate, and ECG waves, complexes, and intervals. Quality scores were based on the presence or absence of baseline undulation and tremor artifacts using a 3-point scoring system (lowest possible = 0; highest possible = 3). A lower score was indicative of a better-quality ECG. RESULTS: Smartphone-based ECGs were interpretable in 65% of cases, while 100% of standard ECGs were interpretable. Standard ECG quality was superior to smartphone-based ECG quality, with no agreement in the quality between devices (κ coefficient, -0.0062). There was good agreement for heart rate with mean difference 2.86 beats/min (CI, -3.44 to 9.16) between the standard and smartphone ECGs. Good agreement was observed for P wave amplitude with mean difference 0.02 mV (CI, -0.01 to 0.05), QRS duration with mean difference -10.5 ms (CI, -20.96 to -0.04), QT interval with mean difference -27.14 ms (CI, -59.36 to 5.08), T wave duration with mean difference -30.00 ms (CI, -66.727 to 6.727), and T wave amplitude with mean difference -0.07 mV (CI, -0.22 to 0.08) between the 2 devices. CLINICAL RELEVANCE: Our findings indicate good agreement between standard and smartphone ECG for most parameters, although 35% of smartphone ECGs were uninterpretable.

Feline pulmonary hypertension: are we overlooking an important comorbidity?

Pulmonary hypertension (PH) is a potential complication in many disease states, yet it has been largely overlooked in feline medicine. Recently, increased awareness of potential underlying causes has led to a wider understanding of the disease process in humans, with a focus on tailoring therapy to include specific treatment of the underlying etiology. Most of these treatments are not yet available in veterinary medicine, but as they move from the human to the veterinary field, it would be beneficial to better understand the forms of PH encountered in different species. Recently, diagnosis and classification of PH in dogs has been the focus of an American College of Veterinary Internal Medicine consensus statement, yet this condition has received little attention in cats. It is therefore our intention to raise awareness of this condition in cats and to propose a classification system for the types of PH seen in feline patients. As new medications are developed for the treatment of PH, it is important to recognize which forms of PH are seen in feline patients and understand the etiology of the disease. There are many reports of PH (or suspected PH based on echocardiographic assessment) in cats. In this review, we highlight the large number of conditions, and different etiologies, that are associated with PH. Improving understanding of this condition will bring us closer to being able to investigate the benefits of potential new diagnostics and therapies as they become available.

Commercial Extruded Plant-Based Diet Lowers Circulating Levels of Trimethylamine N-Oxide (TMAO) Precursors in Healthy Dogs: A Pilot Study.

Elevations in circulating trimethylamine N-oxide (TMAO) and its precursors are observed in humans and dogs with heart failure and are associated with adverse outcomes in people. Dietary intervention that reduces or excludes animal ingredients results in rapid reduction of plasma TMAO and TMAO precursors in people, but the impact of diet in dogs has not been studied. The objective of the current study was to determine the effect of diet on plasma TMAO and 2 of its precursors (choline and betaine) in dogs fed a commercial extruded plant-based diet (PBD) or a commercial extruded traditional diet (TD) containing animal and plant ingredients. Sixteen healthy adult mixed breed dogs from a university colony were enrolled in a randomized, 2-treatment, 2-period crossover weight-maintenance study. Mean (SD) age and body weight of the dogs were 2.9 years (± 1.7) and 14.5 kg (± 4.0), respectively. Eight dogs were female (3 intact, 5 spayed) and 8 dogs were male (4 intact, 4 castrated). Plasma choline, betaine and TMAO were quantified by LC-SID-MRM/MS at baseline, and after 4 weeks on each diet. Choline and betaine were also quantified in the diets. Plasma choline levels were significantly lower (P = 0.002) in dogs consuming a PBD (Mean ± SD, 6.8 µM ± 1.2 µM) compared to a TD (Mean ± SD, 7.8 µM ± 1.6 µM). Plasma betaine levels were also significantly lower (P = 0.03) in dogs consuming a PBD (Mean ± SD, 109.1 µM ± 25.3 µM) compared to a TD (Mean ± SD, 132.4 µM ± 32.5 µM). No difference (P = 0.71) in plasma TMAO was detected in dogs consuming a PBD (Median, IQR, 2.4 µM, 2.1 µM) compared to a TD (Median, IQR, 2.3 µM, 1.1 µM). Betaine content was lower in the PBD than in the TD while choline content was similar in the diets. Our findings indicate consumption of a commercial extruded PBD for 4 weeks reduces circulating levels of the TMAO precursors choline and betaine, but not TMAO, in healthy adult dogs.

Echocardiographic Findings of a Donkey (Equus asinus) Jenny with Suspected Mitral Valve Dysplasia.

Reports of ante-mortem diagnosis of cardiovascular diseases in donkeys (Equus asinus) are rare. This case report describes the echocardiographic findings of suspected mitral valve dysplasia in a 3-year-old Nevisian donkey jenny presented for evaluation of a grade III/VI left-sided systolic murmur. Pertinent findings on transthoracic echocardiography included double mitral regurgitant jets and a bridge of tissue between the septal and mural mitral leaflets. Based upon the mild degree of cardiac remodeling and absence of clinical signs, therapeutic intervention was deemed unnecessary, and the jenny was returned to the teaching herd. Repeat echocardiography 10 months later revealed no significant progression of mitral regurgitation or cardiac remodeling. This case reinforces the utility of auscultation and echocardiography in detecting structural heart disease in donkeys.

Short-term amino acid, clinicopathologic, and echocardiographic findings in healthy dogs fed a commercial plant-based diet.

Consumer demand for commercially prepared plant-based (PB) dog food is increasing, but studies evaluating the short- or long-term effects of PB diets on canine health are lacking. The objective of this study was to assess the short-term amino acid (AA), clinicopathologic, and echocardiographic findings in 34 client-owned dogs fed a commercial extruded plant-based diet (PBD) in which pea protein was the primary protein source and 4 control dogs fed a commercial extruded traditional diet (TD). Plasma AA and whole blood taurine concentrations were measured in dogs at baseline and after 4 weeks on the PBD or the TD. Hematologic, serum biochemical, and echocardiographic testing were performed at baseline and after 12 weeks on the PBD or the TD. Four dogs in the PBD group did not complete the study. All essential AAs, except methionine, were higher in dogs after 4 weeks on the PBD compared to baseline. Taurine (plasma and whole blood) was also higher after 4 weeks on the PBD compared to baseline. A meaningful difference was detected in whole blood taurine between the PBD group and the control group at 4 weeks (P = .026) with the PBD group being higher. Median hematologic and biochemical results for the PBD group were within normal limits at baseline and at 12 weeks. In the PBD group, left ventricular internal diastolic dimension (LVIDd, P = < .001) and normalized LVIDd (P = .031) were higher 12 weeks post-PBD compared to baseline. There were no meaningful differences in left ventricular internal systolic dimension (LVIDs), normalized LVIDs, or fractional shortening 12 weeks post-PBD. There was no statistical evidence of difference between the 2 groups of dogs for any of the echocardiographic parameters at baseline or at 12 weeks. Essential AA or taurine deficiency was not observed in this cohort of dogs fed a commercial extruded PBD. Additionally, clinically relevant hematologic, serum biochemical and echocardiographic alterations were not detected. Further research is required to determine if long-term static feeding of PB diets can meet and maintain AA and other nutrient targets in dogs.

Measurements of the radiographic cardiac silhouette of ospreys (Pandion haliaetus).

OBJECTIVE: To evaluate and report measurements of the radiographic cardiac silhouette of healthy juvenile and adult ospreys (Pandion haliaetus). ANIMALS: 54 ospreys (22 adults, 19 juveniles, and 13 birds of undetermined age) without clinical signs of cardiac disease and with adequate ventrodorsal radiographic images for cardiac silhouette assessment. PROCEDURES: Radiographs of ospreys were assessed to determine cardiac width at the widest point as well as sternal width and thoracic width at the same level. Two-way mixed-effects models were used to evaluate interrater reliability for mean rating. Multivariable linear regression analysis was used to create predictive models of cardiac width and to establish a theoretical reference range for healthy ospreys. RESULTS: Cardiac width of healthy ospreys was approximately 90% to 92% of sternal width and 67% to 69% of thoracic width. Both sternal width and thoracic width were significant predictors of cardiac width in independent predictive models as well as in a combined model after controlling for age. Thirty-four of 41 (83%) measured cardiac widths were within the theoretical reference range. CONCLUSIONS AND CLINICAL RELEVANCE: Ospreys are sentinels used in monitoring environmental health. Environmental factors may have an impact on the cardiac health of ospreys, but reference values for healthy ospreys have not been established for use in assessing cardiomegaly in this species. The radiographic ratios and predictive model obtained in this study may be useful for objective evaluation of cardiomegaly in ospreys.