Correlation of clinical, diagnostic and histopathological parameters in dogs with chronic lymphocytic-plasmacytic enteropathy.

OBJECTIVE: The objective of this study was to correlate clinical signs and diagnostic parameters with duodenal inflammatory and architectural changes in dogs with lymphocytic-plasmacytic enteropathy. MATERIAL AND METHODS: In a retrospective study dogs presented between 2003 and 2014 with chronic gastrointestinal signs (duration > 3 weeks) and histologic evidence of intestinal lymphocytic-plasmacytic inflammation were evaluated. Clinical signs, serum albumin, cobalamin and folic acid concentrations were recorded and a sonographic, endoscopic, histologic and cytological inflammatory score was determined. Furthermore, the presence of lacteal dilation, villus stunting, crypt lesions, epithelial integrity and increased intraepithelial lympho cytes was evaluated. RESULTS: A total of 270 dogs were retrospectively evaluated. No significant correlation was found between clinical signs and sonographic, endoscopic or duodenal inflammatory score. Dogs with histological signs of lacteal dilation (p = 0.001) and increased intraepithelial lymphocytes (p = 0.005) had significantly higher clinical scores compared to dogs without these changes. No correlation was found between clinical score and villous stunting or crypt lesions. Hypoalbuminemia and hypocobalaminemia correlated significantly with lacteal dilation (p = 0.001, p = 0.009) and increased intraepithelial lymphocytes (p = 0.036, p = 0.018). CLINICAL SIGNIFICANCE: Some clinical and diagnostic parameter correlate with histopathologic features whereas others do not. Morphological features seem to be more important than the intensity of the duodenal inflammation in the assessment of the disease.

[Evaluation of sonographic parameters as prognostic risk factors in cats with pancreatitis - A retrospective study in 42 cats]. / Prognostische Bedeutung sonographischer Parameter der Pankreatitis der Katze.

OBJECTIVE: Pancreatitis in cats can have different clinical courses. A range from asymptomatic or mild, unspecific clinical signs to severe disease with multi-organ dysfunction or even death has been described. It is sometimes difficult to evaluate the prognosis of the cat based on clinical findings, laboratory diagnostics and diagnostic imaging. There are only a few studies that have examined the outcome and prognostic factors for cats with pancreatitis. In cats presenting with signs of pancreatitis, the feline pancreatic lipase immunoreactivity (fPLI) and sonography are frequently used for establishing a diagnosis. Different sonographic parameters have been described to be asso ciated with pancreatitis. The aim of this retrospective study was to determine whether certain sonographic parameters correlate with the severity and the outcome of pancreatitis in the cat. MATERIAL AND METHODS: In 42 cats, presented with at least two clinical signs consistent with pancreatitis and increased fPLI-values (> 5.3 µg/l), the following sonographic parameters were examined: thickness, surface and echogenicity of the pancreas, echogenicity of the peripancreatic fat tissue and the presence of ascites. Cats surviving the first 30 days were classified as survivors and those dying within 30 days as nonsurvivors. RESULTS: Sonographic changes were found in 33/42 cats (79 %). The most frequent sonographic abnormalities were hyper-echoic peripancreatic fat (55 %), hypoechoic pancreatic tissue (45 %) and a thickened pancreas (36 %). There was no significant correlation between sonographic changes and the outcome of the cats. No significant differences in the fPLI concentration were found between the two groups. The fPLI concentration correlated significantly with the prognosis. CONCLUSION: Neither the presence nor the intensity of the sonographic changes correlate with the outcome of cats with pancreatitis. Contrary to this, the fPLI value is a negative prognostic factor, as has been described previously.

Correlation between the FCEAI and diagnostic parameters in chronic enteropathies in 147 cats (2006-2012).

OBJECTIVE: The Feline Chronic Enteropathy Activity Index (FCEAI) has been established as a quantitative index for disease activity in chronic enteropathies in cats. A definite diagnosis is aimed at histology with initial exclusion of extraintestinal causes by laboratory examinations, diagnostic imaging and endoscopy. The study aimed to examine diagnostic parameters and FCEAI in chronic gastroenteropathies. MATERIALS AND METHODS: A retrospective case review of 147 cats with chronic enteropathies was performed. In all patients, the FCEAI was established and endoscopy performed including biopsies and duodenal cytology. Histopathologic reports were reviewed for the diagnosis of lymphoma and architectural changes (epithelial integrity, villi/gland atrophy, intestinal crypt atrophy, lymphangiectasia, epitheliotropism/infiltration of intraepithelial lymphocytes). A cytopathologic score (CS) and histopathologic score (HS) regarding lymphocytic intestinal infiltration were assigned. Statistical dependency analysis was used to determine correlations between the FCEAI, lymphoma, architectural changes, CS, HS, serum concentrations of cobalamin, folate and albumin. RESULTS: The 147 cats consisted of predominately European Shorthair cats (n = 126), were mostly castrated (n = 127) and had a mean age of 9.8 (1-17) years. For the proven lymphoma group (12.2%; n = 18) and the non-lymphoma group a mean FCEAI of 7.3 (4-17) and 6.6 (2-13), respectively, was established. The FCEAI showed a low correlation with the CS (p = 0.010; R = 0.22) and intestinal villous atrophy (n = 121; p = 0.035; R = 0.19). Cats with a CS of 0 had a significant lower FCEAI score (p = 0.015) than cats with all other CSs. The histo- and cytopathologic scores were highly related (p < 0.001; R = 0.43). The gastric intraepithelial lymphocytic infiltration (n = 131) was significantly correlated to serum folate (p = 0.014; R = -0.56) and albumin (p = 0,048; R = -0.20). CONCLUSION: The FCEAI showed only a few correlations. Not only the grade of inflammation, but also the histologic architectural changes are of importance.

Prevalence of and risk factors for feline hyperthyroidism among a clinic population in Southern Germany. / Prävalenz und Risikofaktoren der felinen Hyperthyreose in einer Klinikpopulation in Süddeutschland.

OBJECTIVES: Feline hyperthyroidism is a common endocrine disorder in older cats. Previous studies have identified nutritional imbalances, thyroid-disrupting compounds, increasing age and being non-purebred as risk factors but the final trigger remains unknown. The purpose of this prospective study was a) to determine the hospital prevalence of hyperthyroidism in a client-owned cat population in Southern Germany, b) to exploit how frequently hyperthyroidism was diagnosed after the initial clinical suspicion and c) to determine putative intrinsic and extrinsic risk factors from the cats' signalment and a questionnaire analysis, respectively. METHODS: Total thyroxine (T4) was measured in sera of 495 cats ≥ 8 years. Prevalence was calculated with a 95% confidence interval (95% CI) Association between signalment and hyperthyroidism was analysed by Student's unpaired-t-test, chi-square test and Mann-Whitney U-test. Level of significance was set at 0.05. Multivariate logistic regression model was used to determine extrinsic risk factors. RESULTS: Sixty-one cats were diagnosed with hyperthyroidism leading to a prevalence of 12.3% (95% CI: 9.7-15.5). Older (p < 0.001) female cats (p = 0.019; odds ratio 1.9) were significantly more often affected. Domestic shorthair and domestic longhair cats were more likely hyperthyroid than purebred cats (p = 0.016). In 164 cats hyperthyroidism was considered a differential diagnosis and was verified in 20.1% (33/164). In 2.4% (12/495) cases the elevated T4 was an incidental finding. Hyperthyroid cats were more likely to be fed with moist cat food from aluminum tins (p < 0.013) compared to non-hyperthyroid cats. CONCLUSION AND CLINICAL RELEVANCE: Older, female non-purebred cats are predisposed to hyperthyroidism which is frequently diagnosed after the initial clinical suspicion leading to a prevalence of 12.3% among the study population. Components of the aluminum tins or the moist food itself or both may play a role in the etiopathogenesis.

Serial serum feline pancreatic lipase immunoreactivity concentrations and prognostic variables in 33 cats with pancreatitis.

OBJECTIVE: To identify factors significantly associated with prognosis in cats hospitalized because of pancreatitis. DESIGN: Prospective case series. Animals-33 cats hospitalized for treatment of pancreatitis (diagnosis determined on the basis of clinical signs and serum feline pancreatic lipase immunoreactivity [fPLI] concentration ≥ 5.4 µg/L). PROCEDURES: Cats were hospitalized (day 1) for 2 to 16 days and observed for 44 days or until they died or were euthanized. Results of physical examination and hematologic and serum biochemical analysis, including measurement of serum fPLI concentration, performed on the day of hospital admission were analyzed to determine whether they were associated with outcome (ie, survival to at least 44 days vs death or euthanasia). RESULTS: On day 1, mean × SD serum fPLI concentration among the 33 cats was 22.0 × 16.4 µg/L. Mean age of the cats was 12.7 × 3.8 years (range, 4 to 19 years). Eleven of the 33 (33%) cats died or were euthanized before day 44. In univariate analyses, dyspnea, hypothermia, hypokalemia, hyperkalemia, and serum fPLI concentration were significantly associated with an adverse outcome. However, in a multivariate analysis, only severe dyspnea, hyperkalemia (potassium concentration > 5.5 mmol/L), and serum fPLI concentration at the time of hospital admission were found to be significantly associated with an adverse outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that dyspnea, hyperkalemia, and serum fPLI concentration at the time of hospital admission were significant prognostic factors for cats hospitalized because of pancreatitis.

Palliative intralesional interleukin-2 treatment in dogs with urinary bladder and urethral carcinomas.

AIM: The investigation of the influence of intralesional interleukin-2 (IL-2) on the clinical course and tumor progression in dogs suffering from urinary bladder and urethral carcinomas. MATERIALS AND METHODS: Medical records of 25 dogs diagnosed with advanced transitional cell carcinomas (TCC) were retrospectively reviewed. In 14 dogs, intralesional IL-2 treatment was performed by transabdominal ultrasound-guided injection. Seven dogs underwent cytoreductive surgery, followed by IL-2 injection into the tumor bed. All dogs received long-term non-steroidal anti-inflammatory drugs. RESULTS: Adverse effects associated with IL-2 treatment were not observed. At re-examination, 17 dogs showed marked clinical improvement and regression of tumor size. Four dogs were in complete remission. CONCLUSION: Intralesional IL-2 application is a safe and minimally-invasive palliative treatment option in dogs suffering from advanced transitional cell carcinoma when surgical cure is impossible. Prognosis depends on tumor localization and feasibility of concomitant cytoreductive surgery.

Dacryops in a red-eared slider (Chrysemys scripta elegans): case report.

Clinical and histologic findings of an orbital lacrimal cyst (dacryops) in a 23-year-old-female red-eared slider (Chrysemys scripta elegans) are described. Main ophthalmologic findings included unilateral exophthalmus, engorged episcleral vessels, periocular swelling superior to the globe, incomplete lid closure, and reduced ocular motility. Based on sonographic and cytologic examination of the tissue, the preliminary diagnosis of an orbital cyst was established. After surgical resection of the cystic structure, the eye remained visual but enophthalmic. Histopathologic diagnosis of the resected tissue was interstitial dacryoadenitis.