Retrospective evaluation of the incidence of presumed feline urethral obstruction during a prepandemic year compared to a pandemic year.

OBJECTIVE: To investigate the influence of the coronavirus disease 2019 (COVID-19) pandemic on the incidence of urethral obstruction (UO) in male cats. DESIGN: Retrospective study. SETTING: One veterinary university teaching hospital and 6 private practice veterinary specialty and emergency centers. ANIMALS: A total of 24,937 total feline cases presenting to the emergency room (ER) between March 2019 and March 2021. MEASUREMENTS AND MAIN RESULTS: Out of 24,937 total cases, 1793 male cats met the inclusion criteria for diagnosis of UO. Of those, 327 cases were identified in which an additional diagnosis of either urolithiasis or neoplasia was made and were therefore excluded. The remaining 1466 UO cases were presumed to be idiopathic urethral obstruction (iUO) caused by feline interstitial cystitis (FIC) alone. Of those, 637 cats presented during the prepandemic year and 829 cats presented during the pandemic year. KEY FINDINGS: Incidence of presumptive iUO increased by 30% during the COVID-19 pandemic. Total feline emergency caseload increased by 38%. iUO accounted for 6.08% and 5.73% of total feline emergency cases during the prepandemic and pandemic years, respectively. CLINICAL SIGNIFICANCE: The reported increase in incidence of feline UO is likely due to the increase in overall emergency feline caseload.

A retrospective evaluation of hops ingestion in 177 dogs (2005-2018).

OBJECTIVE: To describe the clinical signs and outcomes observed after Humulus lupulus (hops) ingestion in dogs. A secondary objective was to note any trends in the number of hops-related phone calls made to an animal poison control center over a 13-year period. DESIGN: Retrospective study (2005-2018). SETTING: An animal poison control center. ANIMALS: One hundred and seventy-seven dogs with known or suspected hops ingestion. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 177 calls were made to Pet Poison Helpline between 2005 and 2018 involving hops ingestion in dogs. Outcomes were determined in 83 cases; 79 of 83 (95.2%) survived. Clinical signs associated with hops ingestion were observed in 74.0% (131/177). Commonly observed clinical signs were tachypnea (98/131), hyperthermia (65/131), and vomiting (44/131). Severe hyperthermia (>41.4°C, [>106°F]) developed in 8 dogs and 3 of those dogs did not survive. A fourth nonsurvivor was found deceased at home. The majority of symptomatic dogs developed clinical signs between 2 and 8 hours postingestion. Resolution of clinical signs occurred in less than 24 hours in all survivors except in one. Cases consulted with Pet Poison Helpline related to hops ingestion increased from 2005 to 2018 relative to the total amount of cases managed overall. CONCLUSIONS: The most common clinical signs associated with hops ingestion include tachypnea, hyperthermia, and vomiting; however, not all dogs develop clinical signs. While prognosis is good with 95.2% of dogs in this population surviving, some dogs can develop a severe and fatal hyperthermia.

Reassessment Campaign on Veterinary Resuscitation (RECOVER) Initiative small animal CPR registry report 2016-2021.

OBJECTIVE: To introduce the Reassessment Campaign on Veterinary Resuscitation (RECOVER) CPR registry and report cardiopulmonary arrest (CPA) and CPR event data collected to date. DESIGN: International, multi-institutional veterinary CPR registry data report. SETTING: Veterinary private practice and university teaching hospitals. ANIMALS: Data from 514 dogs and 195 cats undergoing CPR entered in the RECOVER CPR registry between February 2016 and November 2021. INTERVENTIONS: The RECOVER CPR registry is an online medical database created for standardized collection of hospital, animal, arrest, and outcome information on dogs and cats undergoing CPR. Data were collected according to the veterinary Utstein-style guidelines for standardized reporting of in-hospital CPR in dogs and cats. Case records were downloaded, duplicate and incomplete cases were removed, and summary descriptive data were reported. MEASUREMENTS AND MAIN RESULTS: Sixteen hospitals in the United States, Europe, and Australia contributed data on 709 CPR events to the registry. One hundred and forty-two (28%) dogs and 58 (30%) cats attained return of spontaneous circulation (ROSC), 62 (12%) dogs and 25 (13%) cats had ROSC >20 minutes, and 14 (3%) dogs and 4 (2%) cats survived to hospital discharge. The reason for CPR discontinuation was reported as owner choice in 321 cases (63%). The most common suspected causes for CPA were respiratory failure (n = 142, 20%), heart failure (n = 86, 12%), and hemorrhage (n = 76, 11%). CONCLUSION: The RECOVER CPR registry contains the first multicenter data set on small animal CPR. It confirms poor outcomes associated with CPA, emphasizing the need for large-sized studies to gain adequate information on characteristics associated with favorable outcomes.

Evaluation of tissue oxygen saturation in naturally occurring canine shock patients.

OBJECTIVE: To measure tissue oxygen saturation (StO2 ) in a population of dogs with naturally occurring shock and to evaluate the relationship of StO2 with an established veterinary severity scoring system (Acute Patient Physiologic and Laboratory Evaluation) and patient survival. DESIGN: Prospective observational study. SETTING: University teaching hospital. ANIMALS: Twenty-five adult dogs presenting in shock, as determined by the presence of hypotension, the calculated shock index, and hyperlactatemia. INTERVENTIONS: StO2 was measured prior to any therapeutic interventions. Blood samples were also collected for measurement of plasma lactate, complete blood count, and a serum biochemical profile. Abdominal and thoracic focused assessment with sonography was also performed. MEASUREMENTS AND MAIN RESULTS: Dogs enrolled in this study had lower mean (±SD) StO2 values (65.12 ± 17.7%) than previously reported in experimental models of canine hemorrhagic shock. There was a moderate correlation between lower StO2 and increasing Acute Patient Physiologic and Laboratory Evaluation scores. A single StO2 value, assessed prior to therapeutic intervention, was not a sensitive predictor of mortality in this population. CONCLUSIONS: Dogs with naturally occurring shock have lower mean StO2 values than those previously reported in dogs with experimentally induced shock. A lower initial StO2 was associated with worse disease severity but was not a significant predictor of survival in this population.

Retrospective comparison of standard clotting tests and novel clot waveform parameters in dogs using the turbidimetric ACL-TOP CTS 300 coagulation analyzer.

Clot waveforms are generated by coagulation analyzers, such as the ACL-TOP, that utilize photo-optical turbidimetric methods to measure prothrombin time (PT) and activated partial thromboplastin time (aPTT), which are standard clotting tests (SCTs). Additional quantitative clot waveform analysis (CWA) parameters include maximum velocity of the PT curve (PT1d), maximum acceleration of the aPTT curve (aPTT2d), and their change in optical density (ODdelta). We explored the potential for CWA to contribute unique information compared to SCTs and quantitative fibrinogen assay (QFA) in dogs with clinical indications for laboratory evaluation of coagulation. We retrospectively evaluated the frequency and agreement between normal, high, and low values of CWA and SCTs for 203 dogs relative to reference intervals (RIs). Most dogs had SCTs within RIs, but most CWA values were high regardless of whether SCT values were within, below, or above the RI. Agreement between SCTs and CWA was slight (kappa <30%). Clinically significant bleeding was noted in 28 of 203 (14%) dogs. SCTs were not different between bleeders and non-bleeders. Median QFA, PT1d, aPTTdelta, and aPTT2d values were statistically significantly higher than RIs in non-bleeders compared to bleeders, whose median values were not below RI. Compared with SCTs, CWA identified differences between the 2 groups. However, wide overlap between the 2 groups limits the use of CWA to clinically discriminate between bleeders and non-bleeders in a heterogeneous population of dogs. Further studies on the diagnostic utility of CWA in coagulopathic dogs are needed.

Pneumatosis of the intestines, colon and liver in a young cat.

To describe a case of naturally occurring pneumatosis intestinalis, pneumatosis coli and emphysematous hepatitis in a cat. A 9-month-old, indoors-only, female spayed, domestic medium hair cat presented for vomiting, open-mouth breathing and acute collapse. The initial physical examination identified moderate to severe hypothermia [35°C (95°F)], obtunded mentation, weak femoral pulses, tachycardia (heart rate 240 beats per min), pale pink mucous membranes and significant splenomegaly on abdominal palpation. Immediate diagnostics performed [packed cell volume and total solids (PCV, TS), venous blood gas and electrolytes] revealed severe anaemia (PCV 12%), hypoproteinaemia (TS = 2.2 g/dl), and severe metabolic acidosis (pH 6.956). Additional diagnostics performed included Feline Leukaemia Virus and Feline Immunodeficiency Virus testing (FeLV/FIV), complete blood count (CBC) with pathology review, serum biochemistry profile, prothrombin time (PT) and partial thromboplastin time (PTT), urinalysis, and abdominal radiographs. Abdominal radiographs were consistent with gas within hepatic and splenic veins and parenchyma, small intestinal walls and colonic wall. Due to the guarded prognosis, euthanasia was elected. Necropsy was performed and the most significant gross and histopathological findings included intra-luminal and intra-mural intestinal haemorrhage and vascular congestion with mild neutrophilic hepatitis, and marked hepatic periportal emphysema. Clostridium perfrigens and Escherichia coli were cultured from the bowel wall; no bacterial growth from the liver or spleen was identified. This case report describes idiopathic emphysematous hepatitis, with concurrent emphysema of the spleen and intestinal wall and intestinal haemorrhage. To the authors' knowledge, this type of pathology in a feline patient has not been previously described.

A systematic review of human and veterinary applications of noninvasive tissue oxygen monitoring.

OBJECTIVE: To describe the methodology for and utilization of tissue oxygen monitoring by near infrared spectroscopy, and to review the current literature on the use of this monitoring modality in human and veterinary settings. DATA SOURCES: Scientific reviews and original research found using the PubMed and CAB Abstract search engines with the following keywords: "tissue oxygen monitoring," "near-infrared tissue spectroscopy," and "tissue oxygen saturation (StO2 )." HUMAN DATA SYNTHESIS: Tissue oxygen monitors have been evaluated in a wide variety of human clinical applications including trauma and triage, surgery, sepsis, and septic shock, and early goal-directed therapy. StO2 more rapidly identifies occult shock in human patients compared to traditional methods, which can lead to earlier intervention in these patients. VETERINARY DATA SYNTHESIS: Veterinary studies involving tissue oxygen monitoring are limited, but the technology may have utility for identification of hemorrhagic shock earlier than changes in base excess, blood lactate concentration, or other traditional perfusion parameters. CONCLUSION: Tissue oxygen monitoring is most commonly performed utilizing a noninvasive, portable monitor, which provides real-time, continuous, repeatable StO2 measurements. A decline in StO2 is an early indicator of shock in both human and veterinary patients. Low StO2 values in human patients are associated with increased morbidity, mortality, and length of hospitalization, as well as the development of multiple organ system dysfunction and surgical site infections.

4-Methylpyrazole as a treatment in naturally occurring ethylene glycol intoxication in cats.

OBJECTIVE: To describe the clinical experience and therapeutic use of fomepizole (4-methylpyrazole [4-MP]) in 3 cats with naturally occurring ethylene glycol (EG) toxicity. CASE OR SERIES SUMMARY: All cats were documented to be EG positive by an ethylene glycol test kit. This report describes the dose of 4-MP used, available clinicopathological data, and clinical progression during hospitalization. All patients survived to discharge. NEW OR UNIQUE INFORMATION PROVIDED: IV use of 4-MP at 125 mg/kg as an initial dose and 31.25 mg/kg at 12, 24, and 36 hours is safe and effective for treatment of naturally occurring EG toxicity in cats. Increased HCO3 concentrations were noted after IV use of 4-MP. This is the first report documenting the successful treatment of naturally occurring EG intoxication in cats with 4-MP.

Potential risks, prognostic indicators, and diagnostic and treatment modalities affecting survival in dogs with presumptive aspiration pneumonia: 125 cases (2005-2008).

OBJECTIVE: To evaluate a clinical population of dogs diagnosed with presumptive aspiration pneumonia (AP) and determine diagnostic and treatment modalities contributing to survival. DESIGN: Retrospective study. SETTING: A university veterinary teaching hospital in an urban setting. ANIMALS: One hundred and twenty-five dogs with presumed AP treated from 2005 to 2008. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Dogs with presumptive AP identified by a review of medical records had an overall survival of 81.6% (102/125). Male large-breed dogs (mean 24.9 kg; 82/125) were overrepresented and were more likely to develop AP in this study population. Recent anesthesia had been performed in 16% (20/125), and vomiting was reported in 64% (80/125). The most common radiographic findings were a predominantly alveolar pattern (187/272, [68.8%] total lung lobes) in the right middle lung lobe (80/115, [69.6%]). A mean of 2 lung lobes were involved radiographically, and the relationship between survival and the number of lung lobes affected was statistically significant (P=0.04). Neutrophilia with a left shift was common with no significant change on consecutive daily evaluations. The mean PaO(2) was 77.7 mm Hg (SD, 17.5 mm Hg) (range, 40.7-100 mm Hg) with a median alveolar-arterial gradient of 41.1 mm Hg (range, 8.1-81.8 mm Hg). In this study population, 37.6% (47/125) of dogs had microbial cultures performed and of these, 76.6% (36/47) were positive for growth; Escherichia coli (38.8%), Mycoplasma spp. (21.3%), Pasturella spp. (19.1%), and Staphylococcus spp. (17%) were the most common isolates in either single or multiagent infections. No treatment modality was statistically associated with increased survival. Colloid therapy was a negative prognostic indicator. CONCLUSIONS: In this study the overall prognosis for AP was good. Patients with only 1 affected lung lobe appeared more likely to survive. Supportive treatment modalities are warranted for the hospitalized patient, although no individual treatment method was found to be clearly superior to others.