Evaluation of platelet function in cats with and without kidney disease: a pilot study.

OBJECTIVES: The aims of this study were to determine if stable chronic kidney disease (CKD) cats and uremic crisis cats have altered platelet function, and to determine the prevalence of positive fecal occult blood in CKD cats. METHODS: Platelet function in normal cats, clinically stable International Renal Interest Society (IRIS) stage 2-4 CKD cats and CKD cats experiencing a uremic crisis were evaluated using impedance aggregometry. Area under the curve (AUC) at 6 mins was calculated for saline, adenosine diphosphate (AUCADP) and arachidonic acid (AUCASPI). The AUC in addition to hematocrit, platelet count and mean platelet volume (MPV) were compared between groups using the Kruskal-Wallis test followed by Dunn's post-hoc analysis. Guaiac fecal occult blood tests were performed on fecal samples and results were compared between groups using a χ2 for trend test. RESULTS: AUCADP (P = 0.04) and AUCASPI (P = 0.05) were significantly higher in uremic crisis cats compared with normal cats at 6 mins. Hematocrit was significantly higher in normal cats when compared with IRIS stage 3 and 4 (P = 0.002) and uremic crisis (P = 0.0008) cats, with no difference among groups for platelet count or MPV. The proportion of cats with positive fecal occult blood samples was significantly different between groups (P = 0.0017); 50% uremic crisis cats, 33% IRIS stage 3 and 4 cats, and 10% IRIS stage 2 cats were positive, while no normal cats were positive. The proportion of cats with platelet clumping was significantly different between groups (P = 0.03). CONCLUSIONS AND RELEVANCE: Platelet hyper-reactivity may be occurring in CKD cats experiencing a uremic crisis. The etiology of positive fecal occult blood samples in CKD cats is unclear and did not appear to be related to decreased platelet function as measured in this study and requires further investigation.

An Inter-Institutional Collaboration to "Make Teaching Matter": The Teaching Academy of the Consortium of West Region Colleges of Veterinary Medicine.

Veterinary medical education is a relatively small community with limited numbers of institutions, people, and resources widely dispersed geographically. The problems faced, however, are large-and not very different from the problems faced by (human) medical education. As part of an effort to share resources and build a community of practice around common issues, five colleges in the westernmost region of the United States came together to form a regional inter-institutional consortium. This article describes the processes by which the consortium was formed and the initiation of its first collaborative endeavor, an inter-institutional medical/biomedical teaching academy (the Regional Teaching Academy, or RTA). We report outcomes, including the successful launch of three RTA initiatives, and the strategies that have been considered key to the academy's success. These include strong support from the consortium deans, including an ongoing financial commitment, a dedicated part-time Executive Coordinator, regular face-to-face meetings that supplement virtual meetings, an organization-wide biennial conference, an effective organizational structure, and a core group of dedicated leaders and RTA Fellows. The western consortium and RTA share these processes, insights, and outcomes to provide a model upon which other colleges of veterinary medicine can build to further leverage inter-institutional collaboration.

Delayed diagnosis of fatal pneumonic canine plague: clinical and pathologic features in two naturally infected Colorado dogs.

BACKGROUND: Plague caused by Yersinia pestis is a highly infectious and potentially fatal zoonotic disease that can be spread by wild and domestic animals. In endemic areas of the northern hemisphere plague typically cycles from March to October, when flea vectors are active. Clinical forms of disease include bubonic, septicemic, and pneumonic plague. All clinical forms are uncommon in dogs and the pneumonic form is exceedingly rare. CASE PRESENTATION: Two mixed breed young-adult male domestic dogs presented to Colorado veterinarians with fever and vague signs that progressed to hemoptysis within 24 h. Case 1 presented in June 2014, while Case 2 occurred in December 2017. Thoracic radiography of Case 1 and 2 revealed right dorsal and right accessory lobe consolidation, respectively. In Case 1 initial differential diagnoses included pulmonary contusion due to trauma or diphacinone toxicosis. Case 1 was euthanized ~ 24 h post presentation due to progressive dyspnea and hemoptysis. Plague was confirmed 9 days later, after the dog's owner was hospitalized with pneumonia. Case 2 was treated as foreign body/aspiration pneumonia and underwent lung lobectomy at a veterinary teaching hospital. Case 2 was euthanized after 5 days of hospitalization when bacterial culture of the excised lobe yielded Yersinia pestis. Both dogs had severe diffuse necrohemorrhagic and suppurative pneumonia at post mortem examination. CONCLUSIONS: Both dogs were misdiagnosed due to the atypical lobar presentation of an extremely rare form of plague in a species that infrequently succumbs to clinical disease. Presentation outside of the typical transmission period of plague was also a factor leading to delayed diagnosis in Case 2. Erroneous identification by automated bacterial identification systems was problematic in both cases. In endemic areas, plague should be ruled out early in febrile dogs with acute respiratory signs, hemoptysis, lobar or diffuse pathology, and potential for exposure, regardless of season. Seasonal and geographic distributions of plague may shift with climate change, so vigilance by primary care veterinarians is warranted. Timely submission of samples to a veterinary diagnostic laboratory could expedite accurate diagnosis and reduce potential for human and domestic animal exposure.

Pilot study of side effects and serum and urine concentrations of amoxicillin-clavulanic acid in azotemic and non-azotemic cats.

OBJECTIVES: The aims of this study were to determine the side effect frequency and serum and urine drug concentrations of amoxicillin-clavulanic acid in cats with and without azotemic chronic kidney disease (azCKD). METHODS: Owners whose cats had been prescribed amoxicillin-clavulanic acid completed a survey regarding the occurrence and type of side effects, and whether treatment was altered as a result. Cats were defined as azCKD (serum creatinine concentration >2.0 mg/dl, urine specific gravity [USG] <1.035 with a clinical diagnosis of chronic kidney disease) and without azCKD (serum creatinine concentration <2.0 mg/dl). Data were assessed with Fisher's exact test. Serum and urine samples were obtained from client-owned cats with azCKD (n = 6) and without azCKD (n = 6, serum creatinine concentration <1.8 mg/dl, USG >1.035) that were receiving amoxicillin-clavulanic acid. Amoxicillin and clavulanic acid were measured with liquid chromatography coupled to tandem mass spectrometry and compared between groups with a Mann-Whitney test. Correlation between serum creatinine and drug concentrations in urine and serum was determined using Spearman's rank test. RESULTS: Sixty-one surveys were returned (11 azCKD cats and 50 without azCKD cats). No significant difference in the presence of side effects or type of side effects was seen between groups; however, significantly more azCKD cats had more than one side effect (P = 0.02). More owners of azCKD cats reported that an alteration in treatment plan was necessitated by side effects (55% vs 12%; P = 0.008). Urine amoxicillin was significantly lower in cats with azCKD (P = 0.01) and serum amoxicillin trended toward significance (P = 0.07). Serum amoxicillin concentration was positively correlated with serum creatinine (P = 0.02; r = 0.62) and urine amoxicillin concentration was negatively correlated with serum creatinine (P = 0.01; r = -0.65). CONCLUSIONS AND RELEVANCE: The data suggest that cats with azCKD have altered pharmacokinetics of amoxicillin, which may contribute to an increased incidence of multiple side effects.

Disseminated Strongyloides stercoralis infection in a dog following long-term treatment with budesonide.

CASE DESCRIPTION: A 1.5-year-old 1.5-kg (3.3-lb) castrated male Pomeranian was examined because of a 10-month history of diarrhea characterized by hematochezia and weight loss and an acute onset of respiratory distress (ie, tachypnea and dyspnea). A presumptive diagnosis of inflammatory bowel disease had been made previously, and the dog had been treated with budesonide and tylosin but continued to have diarrhea and weight loss. CLINICAL FINDINGS: On initial examination, the dog was weak and slightly obtunded. Thoracic radiography revealed a moderate to severe, diffuse, unstructured interstitial pattern. Serum biochemical abnormalities consisted of mild hypoalbuminemia, hypoglycemia, hypocalcemia, hypomagnesemia, and hypocholesterolemia that were likely secondary to chronic gastrointestinal disease and malnutrition. Pyuria and moderate bacteriuria with a single live larva were found on microscopic evaluation of the urine sediment. Fecal examination revealed numerous nematode larvae; the morphology was consistent with first-stage, rhabditiform larvae of Strongyloides stercoralis. TREATMENT AND OUTCOME: A diagnosis of disseminated S stercoralis infection was made. The dog was treated with fenbendazole and ivermectin but developed respiratory collapse approximately 12 hours later and was euthanized because of the poor prognosis. Postmortem examination revealed S stercoralis in the lungs, small intestine, and kidney. CLINICAL RELEVANCE: Findings illustrated the importance of performing diagnostic testing, including routine fecal examination, to rule out infectious causes of diarrhea before beginning empirical treatment with glucocorticoids such as budesonide. Further, repeated fecal examinations, including Baermann tests, should be considered if a positive response to glucocorticoids is not observed.

Clinical and Laboratory Effects of Doxycycline and Prednisolone in Ixodes scapularis-Exposed Dogs With Chronic Anaplasma phagocytophilum Infection.

Persistent infection of Anaplasma phagocytophilum (AP) after treatment and immunosuppression has not been studied in dogs infected with AP after Ixodes scapularis infestation. This descriptive pilot study evaluated 6 laboratory-reared beagles that were persistently positive for AP antibodies after infestation with wild-caught I. scapularis. After 20 weeks, 3 of 6 dogs were administered doxycycline orally for 28 days, and all 6 dogs were then administered prednisolone at 2.2 mg/kg orally for 14 days. Blood was collected from all 6 dogs and evaluated by complete blood count, AP antibodies, and AP DNA at the beginning of the study and on Week 24 through Week 28. Blood was collected from 5 of the dogs on Week 48. No dogs developed recognizable clinical signs of illness or clinically relevant complete blood count abnormalities. During Week 26 through Week 28, all 6 dogs were negative for AP DNA. On Week 48, the 2 doxycycline treated dogs available for testing were negative for AP DNA and antibodies; the 3 untreated dogs were negative for AP DNA but positive for AP antibodies. In this model, the prednisolone protocol used did not activate AP in dogs with chronic, vector-induced infection. Since PCR evidence of AP infection resolved in both groups of dogs, the effect doxycycline had in eliminating AP infection from I. scapularis-exposed dogs will require further study.

Effect of hospitalization on gastrointestinal motility and pH in dogs.

OBJECTIVE To determine the effect of hospitalization on gastrointestinal motility and pH in healthy dogs. DESIGN Experimental study. ANIMALS 12 healthy adult dogs. PROCEDURES A wireless motility capsule (WMC) that measured pressure, transit time, and pH within the gastrointestinal tract was administered orally to dogs in 2 phases. In the first phase, dogs received the WMC at the hospital and then returned to their home to follow their daily routine. In the second phase, dogs were hospitalized, housed individually, had abdominal radiography performed daily, and were leash exercised 4 to 6 times/d until the WMC passed in the feces. All dogs received the same diet twice per day in both phases. Data were compared between phases with the Wilcoxon signed rank test. RESULTS Data were collected from 11 dogs; 1 dog was excluded because the WMC failed to exit the stomach. Median gastric emptying time during hospitalization (71.8 hours; range, 10.7 to 163.0 hours) was significantly longer than at home (17.6 hours; range, 9.7 to 80.8 hours). Values of all other gastric, small bowel, and large bowel parameters (motility index, motility pattern, pH, and transit time) were similar between phases. No change in gastric pH was detected over the hospitalization period. High interdog variability was evident for all measured parameters. CONCLUSIONS AND CLINICAL RELEVANCE Hospitalization of dogs may result in a prolonged gastric emptying time, which could adversely affect gastric emptying of meals, transit of orally administered drugs, or assessments of underlying motility disorders.

Researching Applicants Online in the Veterinary Program Admissions Process: Perceptions, Practices, and Implications for Curricular Change.

As the use of social media websites continues to grow among adults 18-34 years old, it is necessary to examine the consequences of online disclosure to the veterinary admissions processes and to consider the effects on the professional integrity of veterinary schools and on the e-professionalism of DVM graduates. Prior research has shown that employers, across all fields, routinely use information from social media sites to make hiring decisions. In veterinary medicine, a little over one-third of private practitioners reported using online information in the selection of new associates. However, professional academic programs appear to use online information less frequently in the selection processes. The current study examines the behaviors and attitudes of veterinary medical admissions committees toward the use of applicants' online information and profiles in their recruitment and selection process. An online survey was distributed to Associate Deans for Academic Affairs at all AAVMC-affiliated schools of veterinary medicine. A total of 21 schools completed the survey. The results showed that most veterinary schools do not currently use online research in their admissions process; however, most admissions committee members feel that using online social networking information to investigate applicants is an acceptable use of technology. Previous research has suggested that the majority of veterinary student applicants view this as an invasion of their privacy. Given this discordance, future educational efforts should focus on helping veterinary students determine what type of information is appropriate for posting online and how to use privacy settings to control their sharing behaviors.

Recruitment and Hiring Strategies of Private Practitioners and Implications for Practice Management Training of Veterinary Students.

Hiring new employees is one of the most important and difficult decisions all veterinary practice managers and owners face. In an effort to improve hiring decisions, many employers are choosing to screen potential employees more thoroughly through the use of interviews, background checks, personality assessments, and online research including social and professional networking websites. The current study reports results from an anonymous online survey created to evaluate practicing veterinarians' attitudes and practices related to the use of recruitment and hiring tools. Results suggest that, compared to those in other professions, veterinarians underutilize these evaluative tools. The profession could benefit from more opportunities for both practitioners and veterinary students to learn how to utilize a broader range of hiring and recruitment techniques. One area of particular and growing concern is the use of Internet social media for evaluation of potential employees. Despite the fairly low number of participants who indicated they currently research applicants online, a significant number plan to implement this practice in the future. Many students are unaware of how their online postings can affect their future job possibilities and career. It is therefore important to designate time within continuing education programs and professional veterinary curricula to educate these populations about hiring and recruitment tool options and about how to manage their personal Internet interactions (especially social media) to enhance and maintain their professional image (e-professionalism).

Corporate influence and conflicts of interest: assessment of veterinary medical curricular changes and student perceptions.

The ethics document of the Association of American Veterinary Medical Colleges provides guiding principles for veterinary schools to develop conflict of interest policies. These policies regulate faculty and student interactions with industry, potentially reducing the influence companies have on students' perceptions and future prescribing practices. This paper examines the implementation of a conflict of interest policy and related instructional activities at one veterinary college in the US. To inform policy and curricular development, survey data were collected regarding veterinary students' attitudes toward pharmaceutical marketing, including their perceptions of their own susceptibility to bias in therapeutic decisions. Responses from this group of students later served as control data for assessing the effectiveness of educational programs in the content area. A conflict of interest policy was then implemented and presented to subsequent classes of entering students. Classroom instruction and relevant readings were provided on ethics, ethical decision making, corporate influences, and the issue of corporate influence in medical student training. Within seven days of completing a learning program on conflict of interest issues, another cohort of veterinary students (the treatment group) were administered the same survey that had been administered to the control group. When compared with the control group who received no instruction, survey results for the treatment group showed moderate shifts in opinion, with more students questioning the practice of industry-sponsored events and use of corporate funds to reduce tuition. However, many veterinary students in the treatment group still reported they would not be personally influenced by corporate gifts.

Microscope use in clinical veterinary practice and potential implications for veterinary school curricula.

Microscopy (skill of using a microscope) and the concepts of cytology (study of cells) and histology (study of tissues) are most often taught in professional veterinary medicine programs through the traditional method of glass slides and light microscopes. Several limiting factors in veterinary training programs are encouraging educators to explore innovative options for teaching microscopy skills and the concepts of cytology and histology. An anonymous online survey was administered through the Colorado Veterinary Medical Association to Colorado veterinarians working in private practice. It was designed to assess their current usage of microscopes for cytological and histological evaluation of specimens and their perceptions of microscope use in their veterinary education. The first part of the survey was answered by 183 veterinarians, with 104 indicating they had an onsite diagnostic lab. Analysis pertaining to the use of the microscope in practice and in veterinary programs was conducted on this subset. Most respondents felt the amount of time spent in the curriculum using a microscope was just right for basic microscope use and using the microscope for viewing and learning about normal and abnormal histological sections and clinical cytology. Participants felt more emphasis could be placed on clinical and diagnostic cytology. Study results suggest that practicing veterinarians frequently use microscopes for a wide variety of cytological diagnostics. However, only two respondents indicated they prepared samples for histological evaluation. Veterinary schools should consider these results against the backdrop of pressure to implement innovative teaching techniques to meet the changing needs of the profession.

Association of Bartonella species, feline calicivirus, and feline herpesvirus 1 infection with gingivostomatitis in cats.

Feline gingivostomatitis (FGS) is a common syndrome in cats; feline calicivirus (FCV), feline herpesvirus 1 (FHV-1), and Bartonella species are common differential diagnoses. In this study, blood from 70 cats with FGS and 61 healthy control cats was tested for Bartonella species antibodies in serum by enzyme-linked immunosorbent assay and Western blot immunoassay and DNA in blood using a conventional polymerase chain reaction assay. Additionally, fresh oral biopsies from cats with FGS (n=42) and 19 healthy controls were tested for FCV RNA, FHV-1 DNA and Bartonella species DNA. The prevalence rates for Bartonella species antibodies and DNA in the blood and the tissues did not differ between the two groups. FHV-1 DNA was also not significantly different between groups. Only FCV RNA was present in significantly more cats with FGS (40.5%) than control cats (0%). The results suggest that FCV was associated with FGS in some of the cats.

Use of pradofloxacin to treat experimentally induced Mycoplasma hemofelis infection in cats.

OBJECTIVE: To evaluate the efficacy of the fluoroquinolone pradofloxacin in the treatment of cats experimentally infected with Mycoplasma hemofelis. ANIMALS: 23 young adult specific-pathogen-free cats. PROCEDURES: Cats were inoculated with M hemofelis from a chronically infected donor and assigned to 1 of 4 treatment groups: a doxycycline group, a low-dose-pradofloxacin group, a high-dose-pradofloxacin group, and an untreated control group. Treatment was initiated for 14 days when M hemofelis infection was detected via PCR assay and clinical signs of hemoplasmosis were present. Cats that had negative PCR assay results after treatment were administered a glucocorticoid and monitored via PCR assay for an additional 4 weeks. RESULTS: All cats yielded positive results for M hemofelis via conventional PCR and quantitative PCR assays and developed anemia. The low-dose-pradofloxacin group had significantly lower M hemofelis copy numbers than the doxycycline group. Six cats treated with pradofloxacin yielded negative results during treatment. Of those cats, 4 yielded negative conventional PCR assay results and all yielded negative quantitative PCR assay results for M hemofelis 1 month after administration of high-dose glucocorticoids. CONCLUSIONS AND CLINICAL RELEVANCE: Pradofloxacin had anti-M hemofelis effects similar to those of doxycycline. In addition, pradofloxacin may be more effective at long-term M hemofelis organism clearance than doxycycline.

Effect of short-term sequential administration of nonsteroidal anti-inflammatory drugs on the stomach and proximal portion of the duodenum in healthy dogs.

OBJECTIVE: To evaluate effects of injection with a nonsteroidal anti-inflammatory drug (NSAID) followed by oral administration of an NSAID on the gastrointestinal tract (GIT) of healthy dogs. ANIMALS: 6 healthy Walker Hounds. PROCEDURES: In a randomized, crossover design, dogs were administered 4 treatments consisting of an SC injection of an NSAID or control solution (day 0), followed by oral administration of an NSAID or inert substance for 4 days (days 1 through 4). Treatment regimens included carprofen (4 mg/kg) followed by inert substance; saline (0.9% NaCl) solution followed by deracoxib (4 mg/kg); carprofen (4 mg/kg) followed by carprofen (4 mg/kg); and carprofen (4 mg/kg) followed by deracoxib (4 mg/kg). Hematologic, serum biochemical, and fecal evaluations were conducted weekly, and clinical scores were obtained daily. Endoscopy of the GIT was performed before and on days 1, 2, and 5 for each treatment. Lesions were scored by use of a 6-point scale. RESULTS: No significant differences existed for clinical data, clinicopathologic data, or lesion scores in the esophagus, cardia, or duodenum. For the gastric fundus, antrum, and lesser curvature, an effect of time was observed for all treatments, with lesions worsening from before to day 2 of treatments but improving by day 5. CONCLUSIONS AND CLINICAL RELEVANCE: Sequential administration of NSAIDs in this experiment did not result in clinically important gastroduodenal ulcers. A larger study to investigate the effect of sequential administration of NSAIDs for longer durations and in dogs with signs of acute and chronic pain is essential to substantiate these findings.

Use of enrofloxacin for treatment of large-form Haemobartonella felis in experimentally infected cats.

OBJECTIVE: To compare treatment with enrofloxacin and doxycycline with no treatment in cats experimentally infected with Haemobartonella felis. DESIGN: Prospective case-control study. ANIMALS: 16 cats. PROCEDURE: Cats were inoculated with large-form H. felis from a chronically infected donor. Cats were assigned to 1 of 4 treatment groups: doxycycline (5 mg/kg [2.3 mg/lb], p.o., q 12 h), low-dose enrofloxacin (5 mg/kg, p.o., q 24 h), high-dose enrofloxacin (10 mg/kg [4.5 mg/lb], p.o., q 24 h), and an untreated control group. Clinical signs, Hct, blood smears, and a polymerase chain reaction (PCR) assay were used to monitor progression of the infection. RESULTS: All cats were confirmed to be infected with H. felis via blood smear evaluations and PCR assay results. Treatment had no effect on Hct during the intratreatment period, but Hct values were significantly greater in the low-dose enrofloxacin group, compared with the control group, during the posttreatment period. During the intratreatment period, H. felis organism counts per 1,000 RBC in the doxycycline treatment and the high-dose enrofloxacin treatment groups decreased at a significantly faster rate than those in the control group. In the posttreatment period, organism counts in the doxycycline treatment group and the low- and high-dose enrofloxacin groups decreased at significantly faster rates than counts in the control group. There was no significant effect of treatment on the number of positive PCR assay results. Two cats treated with enrofloxacin and 1 cat treated with doxycycline completely cleared the H. fe is organism despite presumed immunosuppression caused by glucocorticoids. CONCLUSIONS AND CLINICAL RELEVANCE: Results support the hypothesis that enrofloxacin has anti-H. felis effects.