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In collaboration with the American College of Veterinary Radiology.

A preliminary study comparing the sedative, cardiorespiratory, and histaminic-releasing effects of intramuscular and intravenous administration of pethidine (meperidine) with midazolam in healthy cats.

Pethidine is a synthetic opioid that is widely used in cats. However, the sedative, cardiorespiratory, and histaminic effects following administration of pethidine with midazolam in cats remain unclear. The objectives of this study were to evaluate and compare changes before and after intravenous (IV) and intramuscular (IM) administration of pethidine with midazolam in healthy cats. In this prospective randomized blind study, 12 cats were assigned equally to either the IV or IM treatment group. The IV group received pethidine 3 mg/kg and midazolam 0.1 mg/kg. The IM group received pethidine 6 mg/kg and midazolam 0.2 mg/kg. The sedative effects, heart rate, respiratory rate, non-invasive arterial blood pressures, and behavioral signs were recorded before and at 2, 5, 15, 30, 45, and 60 min after the injection. Blood samples were taken for an ELISA histamine assay at baseline and at 5 and 15 min after treatment. Cats that received IV treatment were rapidly induced a moderate degree of sedation but those received IM treatment were only mildly sedated. There was no significant difference in the cardiorespiratory values within and between the treatments over time. Plasma histamine concentrations increased by 3 and 5 times at 5 and 15 min after IV treatment, respectively, compared to baseline values. IM injections induced minimal changes in the plasma histamine concentration. In summary, intravenous pethidine with midazolam induced potentially superior sedative effects without serious side effects in clinically healthy cats. However, further studies with larger sample sizes are required to validate this finding.

Effect of administering dexmedetomidine with or without atropine on cardiac troponin I level in isoflurane-anesthetized dogs.

We aimed to determine whether dexmedetomidine administration with or without atropine increases cardiac troponin I (cTnI) level in healthy dogs. We hypothesized that 10 µg/kg dexmedetomidine + atropine increases the cTnI level, whereas 5 µg/kg dexmedetomidine + atropine does not. Eighteen healthy, pet dogs that underwent an orthopedic surgery or ovariohysterectomy were included in this study. The dogs were randomly assigned to atropine (0.02 mg/kg)-dexmedetomidine (10 µg/kg), saline-dexmedetomidine (10 µg/kg), and atropine (0.02 mg/kg)-dexmedetomidine (5 µg/kg) groups. Each dog was premedicated with atropine or saline intramuscularly (IM). After 10 min, they were IM injected with dexmedetomidine (10 or 5 µg/kg)-morphine (0.5 mg/kg)-midazolam (0.2 mg/kg). Following this, anesthesia was induced after 10 min with propofol and maintained with isoflurane in 100% oxygen. The median plasma cTnI level at 6, 12 and 24 hr after premedication was significantly higher than that at baseline. The cTnI level in the atropine-dexmedetomidine (10 µg/kg) group was significantly higher than that in the saline-dexmedetomidine (10 µg/kg) and atropine-dexmedetomidine (5 µg/kg) groups at 6 and 12 hr after premedication. The cTnI level returned to normal within 72 hr after premedication in all groups. The administration of atropine in combination with 10 µg/kg dexmedetomidine increased the cTnI level, indicating subclinical myocardial damage.

Relationship between ultrasonographically determined renal dimensions and International Renal Interest Society stages in cats with chronic kidney disease.

BACKGROUND: The correlation between renal dimensions and renal function in cats with chronic kidney disease (CKD) is unclear. HYPOTHESIS/OBJECTIVES: To investigate the relationship between renal dimensions and CKD severity in cats using ultrasound examination. ANIMALS: Nineteen healthy cats and 30 cats with CKD. METHODS: Renal ultrasound images obtained between 2012 and 2016 were reviewed. Severity of CKD was determined using the International Renal Interest Society CKD staging system. Renal length, cortical thickness, medullary thickness, and corticomedullary ratio were measured, and the relationship between these renal dimensions and serum creatinine concentrations as well as differences in dimensions between the control and disease groups was investigated. The sensitivity and specificity of the renal dimensions for differentiation of the CKD also were evaluated. RESULTS: The disease group was subdivided into stage I to II (15 cats) and stage III to IV (15 cats) groups. Cortical thickness was significantly decreased in both disease groups and negatively correlated with disease severity. Compared with other renal dimensions, cortical thickness had a stronger linear correlation with the reciprocal of the serum creatinine concentration and superior diagnostic performance (Youden index: left kidney, 90.0% sensitivity and 94.7% specificity for a cutoff of 4.7 mm; right kidney, 83.3% sensitivity and 94.7% specificity for a cutoff of 4.5 mm). CONCLUSIONS AND CLINICAL IMPORTANCE: Decreased renal cortical thickness is observed in cats with loss of renal function. Measurement of cortical thickness using ultrasonography could be a useful method to evaluate the progression of CKD in cats.

Comparison of the neuromuscular blocking effects of cisatracurium during isoflurane or propofol anesthesia in dogs.

OBJECTIVE: To compare the neuromuscular blocking effects of cisatracurium during isoflurane versus propofol anesthesia in dogs. STUDY DESIGN: Prospective, randomized study. ANIMALS: A total of 20 healthy, client-owned dogs (16 females, four males) weighing 12.5-22 kg and aged 1-8 years. METHODS: Dogs undergoing elective surgery were randomized in equal numbers to an isoflurane (ISO) or propofol (PPF) group. Other drugs used during anesthesia were equal between groups. Single-twitch (ST) stimulation was used to monitor neuromuscular response. After recording the baseline ST (T0), cumulative doses of cisatracurium (0.05 mg kg-1) were administered intravenously until ST/T0 ≤5%. Effective doses 50 (ED50) and 95 (ED95) of cisatracurium in each group were calculated from group dose-response curves. Recovery of ST (TR) was defined as spontaneous recovery of ST to 80-120% of T0 remaining stable for 2 minutes. The ST after each dose of cisatracurium, duration 25% (time after the last dose until 25% recovery of TR), recovery index (time to recovery from 25% to 75% of TR) and duration to TR (time after the last dose until recovery of TR) were recorded. RESULTS: Incremental doses of cisatracurium, median (range), were 2 (1-3) in ISO and 4 (2-5) in PPF to achieve ≥95% depression of ST/T0 (p < 0.01). ED50 and ED95 were 20 µg kg-1 and 117 µg kg-1 in ISO and 128 µg kg-1 and 167 µg kg-1 in PPF, respectively. The duration 25%, recovery index and duration to TR, median (range), were longer in ISO [22.6 (10.3-24.3), 5.3 (3.0-7.8) and 36.1 (20.1-49.7) minutes, respectively] than in PPF [10.2 (6.8-16.5), 3.0 (2.0-3.8) and 17.7 (14.2-28.7) minutes, respectively] (p < 0.01). CONCLUSIONS AND CLINICAL RELEVANCE: Cisatracurium-induced neuromuscular blockade was significantly enhanced and prolonged by isoflurane compared with propofol.

Comparison of the effects of morphine-lidocaine-ketamine and fentanyl-lidocaine-ketamine combinations administered as constant rate infusions on postprocedure rectal temperature in dogs.

OBJECTIVE: To compare the effects of morphine-lidocaine-ketamine (MLK) and fentanyl-lidocaine-ketamine (FLK) combinations administered as constant rate infusions (CRIs) during and after veterinary procedures on postprocedure rectal temperature in dogs. ANIMALS: 32 clinically normal client-owned dogs undergoing nonemergent procedures. PROCEDURES: Dogs were randomly assigned to receive an MLK or FLK combination (16 dogs/group). During the procedure, each dog received 2% lidocaine hydrochloride (1 mg/kg/h; both groups), ketamine hydrochloride (0.6 mg/kg/h; both groups), and morphine (0.36 mg/kg/h; MLK group) or fentanyl (4 µg/kg/h; FLK group) via CRI for analgesia; esophageal temperature was maintained at 37° to 39°C. At extubation, each drug dose in each assigned combination was halved and administered (via CRI) for 12 additional hours for postprocedure analgesia. Rectal temperature and other data were recorded at baseline (prior to administration of premedicants), extubation (0 hours), and 0.5, 1.5, 3, 6, and 12 hours thereafter. RESULTS: Mean postprocedure rectal temperature was significantly lower at each postextubation time point for the MLK group, compared with corresponding values for the FLK group. Compared with the baseline value, mean postprocedure rectal temperature was significantly lower at 0, 0.5, 1.5, and 3 hours for the FLK group and at all postprocedure time points for the MLK group. Hypothermia (rectal temperature < 37°C) was detected at ≥ 1 postprocedure time point more often in dogs in the MLK group (9/16) than in the FLK group (1/16). CONCLUSIONS AND CLINICAL RELEVANCE: Dogs that received an MLK combination for analgesia during and after a veterinary procedure developed hypothermia more commonly than did dogs that received an FLK combination under similar conditions.

Ultrasonographic features of insulinoma in six ferrets.

Insulinoma is a functional, insulin-secreting tumor, arising from the beta islet cells of the pancreas. It is one of the most common neoplasms in ferrets and has been associated with clinical signs of hypoglycemia, such as ptyalism, pawing at the mouth, seizures, lethargy, and coma. The ultrasonographic features of insulinoma in ferrets have not been previously reported. The purpose of this retrospective case series study was to describe the ultrasonographic features of confirmed insulinoma in a group of ferrets. Inclusion criteria were abdominal ultrasound examination and histological confirmed insulinoma by surgical biopsy. Six ferrets met the inclusion criteria, all of which had multiple hypoglycemic episodes. Ultrasonographic images were reviewed and the characteristics of the pancreatic nodules were recorded. Twenty-eight pancreatic nodules were observed in the six ferrets and were primarily hypoechoic (89.3%, 25/28) and homogenous (46.4%, 13/28) with a smooth margin (78.6%, 22/28). The distribution of the pancreatic nodules was 46.4% in the left lobe, 50% in the right lobe, and 3.6% in the body of the pancreas. The sizes of the pancreatic nodules varied from 1.5 × 1.5 to 4.1 × 5.6 mm. All of the pancreatic nodules removed from surgery were histopathologically confirmed as insulinoma. The findings indicated that insulinoma in ferrets could be detected through ultrasonography, which may facilitate diagnosis and preoperative surgical planning.

Clinical diagnosis and surgical management of diaphragmatic retroperitoneal perirenal fat and kidney herniation in a pet rabbit.

CASE DESCRIPTION A 6-year-old 2.08-kg (4.58-lb) neutered male Lionhead-mix pet rabbit (Oryctolagus cuniculus) was examined because of sneezing and increased respiratory effort. CLINICAL FINDINGS On the basis of the rabbit's radiographic findings, a diagnosis of diaphragmatic retroperitoneal perirenal fat and kidney herniation was made. Nine months later, physical examination revealed increased respiratory rate and effort and slightly decreased body weight. Thoracic radiography revealed decreased lung aeration and further craniomedial displacement of the right kidney, compared with the initial evaluation findings, suggesting progressive herniation of the retroperitoneal perirenal fat. TREATMENT AND OUTCOME During exploratory celiotomy, a tear in the right dorsal tendinous portion of the diaphragm was noted. The right kidney and perirenal fat were found to be displaced into the thorax. Diaphragmatic herniorrhaphy was performed after replacement of the right kidney and the perirenal fat in the retroperitoneal space. The rabbit recovered uneventfully from anesthesia and surgery. Clinical signs did not recur during the following 16 months. CLINICAL RELEVANCE For rabbits with increased respiratory effort, diaphragmatic retroperitoneal perirenal fat and kidney herniation should be included as a differential diagnosis. As illustrated by the case described in this report, appropriate surgical management can provide a successful outcome for affected pet rabbits.

Emphysematous pyometra secondary to Enterococcus avium infection in a dog.

A 5-year-old female intact Mastiff dog was presented with a history of vaginal discharge for 1 day. Physical examination revealed a sanguineo-purulent vaginal discharge and systemic inflammatory response syndrome. Abdominal radiographs showed several dilated and gas- filled tubular loops. The differential diagnoses included emphysematous pyometra or small intestinal mechanical ileus. Surgical exploration of the abdomen demonstrated a severely dilated and gas-filled uterus, and emphysematous pyometra was confirmed. The patient's clinical signs resolved after ovariohysterectomy. Histopathology revealed mild endometrial cystic hyperplasia with infiltration of inflammatory cells in the superficial endometrial epithelia. Enterococcus avium, an α-hemolytic gram-positive coccus, was isolated from the uterus. This paper highlights the radiographic features of emphysematous pyometra and a pathogen that has never been reported to be associated with canine pyometra previously.

Effects of cranberry extract on prevention of urinary tract infection in dogs and on adhesion of Escherichia coli to Madin-Darby canine kidney cells.

OBJECTIVE: To determine effects of cranberry extract on development of urinary tract infection (UTI) in dogs and on adherence of Escherichia coli to Madin-Darby canine kidney (MDCK) cells. ANIMALS: 12 client-owned dogs (in vivo experiment) and 6 client-owned dogs (in vitro experiment). PROCEDURES: 12 dogs with a history of recurrent UTI received an antimicrobial (n = 6) or cranberry extract (6) orally for 6 months. Dogs were monitored for a UTI. For the in vitro experiment, cranberry extract was orally administered to 6 dogs for 60 days. Voided urine samples were collected from each dog before and 30 and 60 days after onset of extract administration. Urine was evaluated by use of a bacteriostasis assay. An antiadhesion assay and microscopic examination were used to determine inhibition of bacterial adherence to MDCK cells. RESULTS: None of the 12 dogs developed a UTI. The bacteriostasis assay revealed no zone of inhibition for any urine samples. Bacterial adhesion was significantly reduced after culture with urine samples obtained at 30 and 60 days, compared with results for urine samples obtained before extract administration. Microscopic examination revealed that bacterial adherence to MDCK cells was significantly reduced after culture with urine samples obtained at 30 and 60 days, compared with results after culture with urine samples obtained before extract administration. CONCLUSIONS AND CLINICAL RELEVANCE: Oral administration of cranberry extract prevented development of a UTI and prevented E coli adherence to MDCK cells, which may indicate it has benefit for preventing UTIs in dogs.

EFFECTS OF INTRAVENOUS DEXMEDETOMIDINE ON CARDIAC CHARACTERISTICS MEASURED USING RADIOGRAPHY AND ECHOCARDIOGRAPHY IN SIX HEALTHY DOGS.

Dexmedetomidine is a highly specific and selective α2-adrenergic receptor agonist widely used in dogs for sedation or analgesia. We hypothesized that dexmedetomidine may cause significant changes in radiographic and echocardiographic measurements. The objective of this prospective cross-sectional study was to test this hypothesis in a sample of six healthy dogs. Staff-owned dogs were recruited and received a single dose of dexmedetomidine 250 µg/m(2) intravenously. Thoracic radiography and echocardiography were performed 1 h before treatment, and repeated 10 and 30 min after treatment, respectively. One observer recorded cardiac measurements from radiographs and another observer recorded echocardiographic measurements. Vertebral heart score and cardiac size to thorax ratio on the ventrodorsal projection increased from 9.8 ± 0.6 v to 10.3 ± 0.7 v (P = 0.0007) and 0.61 ± 0.04 to 0.68 ± 0.03 (P = 0.0109), respectively. E point-to-septal separation and left ventricle internal diameter in diastole and systole increased from 2.4 ± 1.1 to 6.6 ± 1.9 mm, 32.3 ± 8.1 to 35.5 ± 8.8 mm, and 19.4 ± 6 to 27.0 ± 7.2 mm, respectively (P < 0.05). Fractional shortening and sphericity index decreased from 40.7 ± 5.8 to 24.4 ± 2.9%, and 1.81 ± 0.07 to 1.58 ± 0.04, respectively (P < 0.05). Moderate-to-severe mitral regurgitation and mild pulmonic regurgitation occurred in all dogs after dexmedetomidine administration. Findings indicated that dexmedetomidine could cause false-positive diagnoses of valvular regurgitation and cardiomegaly in dogs undergoing thoracic radiography and echocardiography.

Bovine lactoferrin and piroxicam as an adjunct treatment for lymphocytic-plasmacytic gingivitis stomatitis in cats.

Feline lymphocytic-plasmacytic gingivitis/stomatitis (LPGS) or caudal stomatitis is an inflammatory disease that causes painfully erosive lesions and proliferations of the oral mucosa. The disease is difficult to cure and can affect cats at an early age, resulting in lifetime therapy. In this study, a new treatment using a combination of bovine lactoferrin (bLf) oral spray and oral piroxicam was investigated using a randomized double-blinded clinical trial in 13 cats with caudal stomatitis. Oral lesion grading and scoring of clinical signs were conducted during and after the trial to assess treatment outcome. Oral mucosal biopsies were used to evaluate histological changes during and after treatment. Clinical signs were significantly improved in 77% of the cats. In a 4-week study, clinical signs were considerably ameliorated by oral piroxicam during the first 2 weeks. In a 12-week study, the combined bLf oral spray and piroxicam, when compared with piroxicam alone, exhibited an enhanced effect that reduced the severity of the oral lesions (P = 0.059), while also significantly improving clinical signs (P <0.05), quality of life (P <0.05), and weight gain (P <0.05). The remission of oral inflammation was closely correlated with the decreased number of macrophages (OR = 4.719, P < 0.05). There was no detectable influence on liver or kidney function during a 12-week assessment. It was concluded that combining oral bLf spray and piroxicam was safe and might be used to decrease the clinical signs of caudal stomatitis in cats.

Decreased postoperative C-reactive protein production in dogs with pyometra through the use of low-dose ketamine.

OBJECTIVE: To determine the effects of subanesthetic ketamine in dogs with pyometra on C-reactive protein (CRP) concentrations following surgery. DESIGN: Prospective, nonconcealed, alternating allocation controlled trial. SETTING: Veterinary teaching hospital. ANIMALS: Sixteen dogs diagnosed with pyometra. INTERVENTIONS: The tentative diagnosis of canine pyometra was based on compatible history, physical examination findings, ultrasonographic findings, and hematological evaluation. Two different anesthesia and analgesic protocols with and without low-dose ketamine were used during and following ovariohysterectomy in 16 female dogs (n = 8 per group) that were diagnosed with naturally occurring pyometra. Dogs were sequentially allocated to treatment groups in an alternating fashion without concealment. Serum was collected before, 24, and 48 hours after surgery for CRP measurement. MEASUREMENTS AND MAIN RESULTS: Perioperative physical parameters in the 2 groups of dogs were similar. The serum concentrations of CRP in both groups were essentially the same before surgery, but significantly increased in the control group and decreased in ketamine group at 48 hours after surgery. CONCLUSIONS: Low-dose ketamine attenuated the postoperative concentration of serum CRP in dogs with pyometra compared with dogs that did not receive ketamine in the perioperative period. Further studies are warranted to determine the clinical implications of these findings.

Anesthesia with isoflurane and sevoflurane in the crested serpent eagle (Spilornis cheela hoya): minimum anesthetic concentration, physiological effects, hematocrit, plasma chemistry and behavioral effects.

The initial goal of this study was to determine the minimum anesthetic concentration (MAC) for isoflurane (ISO) and sevoflurane (SEVO) for the crested serpent eagle. Next, we compared the anesthetic effects of each on the physiological effects, hematocrit, plasma chemistry values and behavior in spontaneously breathing captive adult crested serpent eagles. Sixteen eagles were randomly allocated to two groups for anesthesia with ISO (n=8) or SEVO (n=8). First, we measured the MAC values of ISO and SEVO, and four weeks later, we investigated the effect of each on the physiological effects, hematocrit (HCT) and plasma chemistry values. The MAC values of ISO and SEVO for crested serpent eagles were 1.46 ± 0.30 and 2.03 ± 0.32%, respectively. The results revealed no significant differences between the two anesthetics in induction time, while time of extubation to recovery was significantly shorter with SEVO. A time-related increase in end-tidal CO2 and decreases in body temperature and respiratory rates were observed during anesthesia with each anesthetic. There were no significant differences between the effect of the two anesthetics on heart rate, hematocrit, plasma chemistry values or respiration, although each caused minor respiration depression. We concluded that SEVO is a more effective inhalant agent than ISO for use in eagles, showing the most rapidest induction and recovery from anesthesia.

Effect of topical administration of 0.8% nalbuphine on the cornea in dogs after phacoemulsification.

It is suggested that topical application of opioids may provide localized analgesia without delay in corneal wound healing. This study was designed to evaluate the effect of topical application of 0.8% nalbuphine on post-operative ocular pain in dogs. Twelve eyes from 11 dogs undergoing phacoemulsification cataract surgery were divided into a nalbuphine group (n=6) and saline group (n=6). Postoperatively, the nalbuphine group received 0.1 ml of topical 0.8% alkalinized nalbuphine (pH 5.6) every 8 hr, and the saline group received 0.1 ml of topical saline (pH 5.9) as a placebo. All dogs received systemic postoperative pain managements with oral tramadol (4 mg/kg) and prednisolone (0.5 mg/kg) every 8 hr. All dogs received pre- and post-ophthalmic examinations. Pain was scored in the dogs using a pain scoring system modified from the University of Melbourne pain scale at 15, 30 and 60 min following the topical treatment on days 1 and 2 (24 and 48 hr after surgery). Eye blink frequency and corneal touch threshold (CTT) were recorded at the same time. There was no statistical difference in the pain score between groups. Significant decreases in CTT, blepharospasm and eye blink frequency were observed after the topical nalbuphine treatment. This indicated that topical application of 0.8% nalbuphine solution can produce a rapid reduction of corneal discomfort in dogs.

Hematocrit and plasma chemistry values in adult collared scops owls (Otus lettia) and crested serpent eagles (Spilornis cheela hoya).

In this study, we report hematocrit and plasma chemistry values for adult captive collared scops owls (Otus lettia) and crested serpent eagles (Spilornis cheela hoya). In particular, we address the gender-specific differences within these values. We measured hematocrit (HCT) and plasma chemistry values for uric acid (UA), plasma urea nitrogen (BUN), total protein (TP), albumin (ALB), glucose (GLU), cholesterol (CHO), triglyceride (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), total bilirubin (TBIL), creatine (CRE), creatine phosphokinase (CPK), amylase (AMY), calcium (CA), ionic phosphorous (IP) and sodium (NA), potassium (K) and chloride ions (CL) in 37 adult captive collared scops owls and 39 adult captive crested serpent eagles. Significant differences between the sexes were found for UA, GLU and CPK in the collared scope owls. UA and GLU concentrations were significantly higher (P<0.01 and P<0.05) among males than females, while the CPK concentration was significantly lower (P<0.05) in males. There were no significant differences in of all of the measured parameters between male and female eagles. These finding suggested that HCT and plasma chemistry values of raptors vary individually according to species and sex. Our results provide the 1st available reference data for ranges of plasma values in adult captive collared scops owls and crested serpent eagles, making them a potentially useful complementary diagnostic tool for veterinary care of individuals for both species in captivity.