Cryptococcosis in ferrets: a diverse spectrum of clinical disease.

Cryptococcosis was diagnosed in seven ferrets (five from Australia; two from western Canada) displaying a wide range of clinical signs. Two of the ferrets lived together. One (5-years-old) had cryptococcal rhinitis and presented when the infection spread to the nasal bridge. Its sibling developed cryptococcal abscessation of the right retropharyngeal lymph node 12 months later, soon after developing a severe skin condition. DNA fingerprinting and microsatellite analysis demonstrated that the two strains isolated from these siblings were indistinguishable. Two ferrets (2- to 3-years-old) developed generalised cryptococcosis: one had primary lower respiratory tract disease with pneumonia, pleurisy and mediastinal lymph node involvement, while in the other a segment of intestine was the primary focus of infection with subsequent spread to mesenteric lymph nodes, liver and lung. The remaining three ferrets (1.75 to 4-years-old) had localised disease of a distal limb, in one case with spread to the regional lymph node. Cryptococcus bacillisporus (formerly C. neoformans var gattii) accounted for three of the four infections in Australian ferrets where the biotype could be determined. The Australian ferret with intestinal involvement and the two ferrets from Vancouver had C. neoformans var grubii infections.

Cardiovascular effects of 3,4-methylenedioxymethamphetamine. A double-blind, placebo-controlled trial.

BACKGROUND: The psychoactive stimulant 3, 4-methylenedioxymethamphetamine (MDMA), also known as "ecstasy," is widely used in nonmedical settings. Little is known about its cardiovascular effects. OBJECTIVE: To evaluate the acute cardiovascular effects of MDMA by using transthoracic two-dimensional and Doppler echocardiography. DESIGN: Four-session, ascending-dose, double-blind, placebo-controlled trial. SETTING: Urban hospital. PATIENTS: Eight healthy adults who self-reported MDMA use. INTERVENTION: Echocardiographic effects of dobutamine (5, 20, and 40 microg/kg of body weight per minute) were measured in a preliminary session. Oral MDMA (0.5 and 1.5 mg/kg of body weight) or placebo was administered 1 hour before echocardiographic measurements in three weekly sessions. MEASUREMENTS: Heart rate and blood pressure were measured at regular intervals before and after MDMA administration. Echocardiographic measures of stroke volume, ejection fraction, cardiac output, and meridional wall stress were obtained 1 hour after MDMA administration and during dobutamine infusions. RESULTS: At a dose of 1.5 mg/kg, MDMA increased mean heart rate (by 28 beats/min), systolic blood pressure (by 25 mm Hg), diastolic blood pressure (by 7 mm Hg), and cardiac output (by 2 L/min). The effects of MDMA were similar to those of dobutamine, 20 and 40 microg/kg per minute. Inotropism, measured by using meridional wall stress corrected for ejection fraction, decreased after administration of dobutamine, 40 microg/kg per minute, but did not change after either dose of MDMA. CONCLUSIONS: Modest oral doses of MDMA increase heart rate, blood pressure, and myocardial oxygen consumption in a magnitude similar to dobutamine, 20 to 40 microg/kg per minute. In contrast to dobutamine, MDMA has no measurable inotropic effects.

Rate of change in aortic valve area during a cardiac cycle can predict the rate of hemodynamic progression of aortic stenosis.

BACKGROUND: The ability to predict the rate of hemodynamic progression in an individual patient with valvular aortic stenosis has been elusive. The purpose of the present study was to evaluate whether the rate of change in aortic valve area (AVA) measured during the ejection phase of a cardiac cycle predicts the rate of hemodynamic progression in patients with asymptomatic aortic stenosis. METHODS AND RESULTS: In 84 adults with initially asymptomatic aortic stenosis and a baseline AVA of > or =0.9 cm(2), annual echocardiographic data were obtained prospectively (mean follow-up 2.8+/-1.3 years). With the initial echocardiogram, the ratio of AVA measured at mid-acceleration and mid-deceleration to the AVA at peak velocity was calculated. The primary outcome variable was the annual rate of change in AVA (rate of progression), with rate of progression classified as rapid (a reduction in AVA of > or =0.2 cm(2)/y) or slow (<0.2 cm(2)/y). Rapid progression was significantly associated with an AVA ratio of > or =1.25 (P=0.004, risk ratio 3.1, 95% CI 1.2 to 7.9). The sensitivity, specificity, and positive predictive value of AVA ratio of > or =1.25 for the prediction o rapid progression of valvar aortic stenosis was 64%, 72%, and 80% respectively. The decrease in ejection fraction measured from the initial to final echocardiogram was small but greater for patients with an AVA ratio of > or =1.25 (-4+/-7% versus +2+/-7%, P<0.001). CONCLUSIONS: A flow-dependent change in AVA can be measured during a routine transthoracic echocardiographic study. The rate of change in AVA is an additional measure of disease severity and may be used to predict an individual's risk for subsequent rapid disease progression.

Best method in clinical practice and in research studies to determine left atrial size.

Although the anteroposterior dimension of the left atrium is universally used in clinical practice and research, we hypothesized that it may be an inaccurate surrogate for volume because its use is based on the unlikely assumption that there is a constant relation among atrial dimensions. The following measurements of the left atrium were made at end ventricular systole: (1) M-mode-derived anteroposterior linear dimension from the parasternal long-axis view; (2) digitized planimetry of the left atrial (LA) cavity from the apical 4-chamber view; and (3) digitized planimetry of the LA cavity from the apical 2-chamber view. The following volume calculations were obtained from these digital measurements: (1) volume derived from the M-mode dimension assuming a spherical shape; (2) volume derived from the single plane area-length of apical 4-chamber view, which assumes that LA geometry can be generalized from a single 2-dimensional plane; and (3) volume derived from the biplane method of discs. The correlation coefficient between the M-mode and biplane methods of determining LA volume was r = 0.76. The mean difference (+/-2 SDs) between these methods is -25 +/- 33 ml. The correlation coefficient between the single plane apical 4-chamber and biplane methods of determining LA volume is r = 0.97. The mean difference (+/-2 SDs) between these methods was -5.0 +/- 12 ml, indicating good agreement. The M-mode measure of the left atrium is an inaccurate representation of its size. Two-dimensional-derived LA volumes provide a more accurate measure of the true size of the left atrium and are more sensitive to changes in LA size. When an echocardiographic measure of LA size is made either in an individual patient or as a variable in a research study, the M-mode measure should be avoided.

Two-dimensional echocardiography with a 15-MHz transducer is a promising alternative for in vivo measurement of left ventricular mass in mice.

Murine models of left ventricular (LV) hypertrophy recently have been developed. We tested the accuracy of 2-dimensional (2D) echocardiographic measurement of LV mass with high-frequency imaging in mice. Ten anesthetized mice (weight 20 to 31 g, aged 1 to 5 months) were examined with a 15-MHz transthoracic linear-array transducer. End-diastolic myocardial area (A)(epicardial - endocardial) from the parasternal short-axis view at the midpapillary level and LV length (L) from the parasternal long-axis view were measured to calculate LV mass with the area-length method (1.05 [5/6 x A x L]) and data were compared with LV-mass with the 2D guided M-mode method. Within 3 days of echocardiography, the hearts were removed and weighed after potassium-induced cardiac arrest. Two-dimensional echocardiographic measurement with a 15-MHz transducer was performed in all mice. LV chamber dimensions included end-diastolic septal (0.80 +/- 0.12 mm) and posterior wall thickness (0.76 +/- 0.13 mm), end-diastolic dimension (3.64 +/- 0.28 mm), and end-systolic dimension (2.34 +/- 0.32 mm). Echocardiographic LV mass with the area-length method, 2D guided M-mode method, and autopsy LV weight were 80.8 +/- 16.1 mg, 97.6 +/- 17.8 mg, and 78.8 +/- 13.2 mg, respectively. A strong correlation existed between LV weight (x ) and echocardiographic LV mass (y ) with the area-length method: y = 0.745x + 18.9, r =0.908, standard error of estimate (SEE) = 5.9 mg, P <.0005. This correlation was stronger than that of LV weight (x ) and echocardiographic LV mass (y ) with the 2D guided M-mode method: y = 0.577x + 22.6, r =0.779, SEE = 8.8 mg, P =.008. These data suggest that serial in vivo measurements of LV mass with the 2D area-length method may be more accurate than M-mode methods in experimental murine models of LV pathology.

The natural history and rate of progression of aortic stenosis.

One of the challenges in clinical cardiology is to determine the optimal time of valve replacement surgery in patients with aortic stenosis. To meet this challenge, one requires an accurate knowledge of the natural history and rate of progression of the disease. This review will summarize the natural history of aortic stenosis in terms of symptoms, mortality, and stenosis progression.

Use of allopurinol to treat visceral leishmaniosis in a dog.

Visceral leishmaniosis was diagnosed in a working sled dog on the basis of history, clinical signs, and identification of amastigotes in a skin biopsy specimen. Allopurinol was administered as sole treatment for the disease. The drug was given for 9 months, and, during this time, clinical signs of disease resolved. Laboratory abnormalities had resolved by 12 months after diagnosis and 3 months after treatment. The dog has been without medications for 19 months and remains free of clinical signs, has sired 2 litters, and functions well as lead sled dog for a team.

Behavioural and cortisol responses of lambs to castration and tailing using different methods.

Lambs at 4-5 weeks of age were studied during the first 4 hours after castration and/or tailing using three methods in various commonly used combinations. The methods were: cutting with a knife, application of constricting rubber rings and using a heated docking iron (tailing only). Behaviour was monitored by quantifying the incidences of restlessness (during the first hour only), normal and abnormal standing/walking, and normal and abnormal lying. Plasma cortisol concentrations were also measured in samples taken at intervals during the 4 hours after treatment. With the knife, abnormal standing/walking predominated throughout the fist 4 hours and beyond, and restlessness was virtually absent. Plasma cortisol concentrations in knife-treated lambs remained above pretreatment values for at least 4 hours. With rings, high restlessness was invariably present during the first 30-45 minutes, and much of the associated standing/walking and lying was abnormal, but all behaviours had returned to control values within 4 hours of treatment, as had the plasma cortisol concentrations. There were no correlations between the incidences of abnormal behaviours and the plasma cortisol concentrations during the first 4 hour after any treatment, except that when abnormal behaviour was present the cortisol concentrations were greater than pretreatment values, and vice versa. Thus, the presence/absence of the abnormal behaviours reported here allowed an assessment of the duration of distress after castration and/or tailing. However, as the behavioural responses to castration and/or tailing were broadly procedure-specific, so that the responses to the knife and rings were not apparently part of the one behavioural continuum, it is argued that the relative intensities of distress caused by the two procedures cannot be assessed from behaviour alone. Rather, reference must also be made to established physiological indices of distress such as plasma cortisol concentration. On that basis, the knife treatments apparently caused greater and more protracted distress responses than did the ring or docking iron treatments, and should therefore be avoided. However, ring-treated lambs, especially those castrated or castrated and tailed apparently experienced distress, so that more benign alternatives to the use of rings should also be sought.

Histopathological evaluation of canine stifle joint synovial membrane collected at the time of repair of cranial cruciate ligament rupture.

Synovial membranes from 54 dogs were collected at the time of surgery to stabilize the stifle joint following rupture of the cranial cruciate ligament. Histological evaluation revealed lymphoplasmacytic synovitis with the formation of distinct, nodular aggregates in 36 synovial membranes. The remainder had evidence of chronic synovitis with variable numbers of diffuse, mononuclear cells. The presence of a potentially immune-mediated synovitis in the majority of cases suggests the need for further study.

Cortisol responses of young lambs to castration and tailing using different methods.

Lambs at 4-5 weeks of age were studied during the first 4 hours after castration and/or tailing using three methods in various commonly used combinations. The methods were cutting with a knife, application of constricting rubber rings and using a heated docking iron (tailing only). The integrated cortisol response (area under the cortisol curve) was determined for each lamb during the first 4 hours after treatment and was considered to reflect the overall magnitude of the lamb's acute distress response. On that basis, cut lambs (tailing only, castration only, castration plus tailing) experienced more distress than any other groups. Also the distress response (indicated by elevated plasma cortisol concentrations) lasted longer than 4 hours in cut lambs, unlike all other groups. The use of rings apparently caused similar distress when lambs were castrated only, were castrated plus tailed, or were short-scrotumed (testes pressed against the abdominal wall by a distally located scrotal ring) plus tailed. The magnitudes of distress apparently caused by tailing alone with a ring or a docking iron were similar and were lower than the distress caused by any other castration and/or tailing procedure. It is concluded that acute distress responses to these husbandry procedures would be minimised in lambs of this age if rings and/or a docking iron were used in preference to a knife.

Effects of repeated handling on the cortisol responses of young lambs castrated and tailed surgically.

Changes in the plasma concentrations of cortisol were recorded in 5-6 weeks-old lambs during the first 480 minutes after surgical castration and tailing in order to define the full post-treatment cortisol response and to determine whether or not the handling associated with repeated blood sampling delayed the return of cortisol concentrations to pretreatment values. Four groups of six or seven lambs were studied: One group was bled regularly throughout the 480 minutes of the study, and in the other three post-treatment blood sampling began at 90, 240 or 480 minutes. Plasma cortisol concentrations increased after treatment and returned to or approached pretreatment values by 480 minutes. No significant differences in mean cortisol concentrations were observed between the groups at any stage. It is concluded that the acute distress response of these lambs to surgical castration and tailing lasted about 8 hours and that repeated handling for blood sampling did not contribute significantly to this distress.

Hematologic abnormalities preceding apparent recovery from feline leukemia virus infection.

A 5-month-old domestic short-haired cat was referred to the Western College of Veterinary Medicine because of hemorrhage from the mouth. Neutropenia and bone marrow dyscrasia developed within 2 weeks, and results of a fluorescent antibody test for feline leukemia virus (FeLV) were positive. During the next 6 months, the feline oncornavirus cell membrane-associated antibody titer increased, the hematologic abnormalities regressed, and the cat became negative to the FeLV fluorescent antibody test (FeLV test). The results of 3 consecutive FeLV tests were negative, and the cat has been clinically normal for the past 18 months.

A solitary plasmacytoma in a dog with progression to a disseminated myeloma.

Solitary plasmacytomas are rare occurrences in dogs, consequently their potential for malignancy is undetermined. A solitary plasmacytoma was removed from the perianal region of a dog. The dog was clinically normal at that time, but was killed one year later as a result of hind limb stiffness and uremia. At the postmortem examination a disseminated myeloma was found, involving the vertebral column, liver, spleen, bone marrow and visceral lymph nodes.

Chemoreceptor tumors diagnosed at the Western College of Veterinary Medicine 1967-1979.

Twenty-nine chemoreceptor tumors submitted to the Western College of Veterinary Medicine, Saskatoon, Saskatchewan between 1967 and 1979 were compared with those previously reported. The prevalence was low, with 28 cases occurring in dogs while only one was diagnosed in a cat. Old male dogs and the Boxer, Boston bull terrier and Collie breeds were affected most commonly. The prevalence in Collies (five of 28 dogs) was unexpected but may have been coincidental in this size of sample. The chemoreceptor tumor was often of clinical significance because in two-thirds of the cases it was either the presenting complaint or considered at necropsy to have caused illness or death.