Use of ultrasonography to facilitate surgical removal of non-enteric foreign bodies in 17 dogs.

Plant material foreign bodies may cause vague clinical signs at the time of initial presentation but can progress to cause persistent or recurrent abscessation, sinus tract formation and debilitating disease, due to migration of the foreign body, severe tissue reaction and secondary infection. Ultrasonography is a non-invasive technique that can be used to identify precisely the presence, location and size of radiolucent foreign bodies. Early identification of foreign bodies using ultrasonography facilitates surgical retrieval before further migration and tissue injury occur. This paper reviews the ultrasonographic findings and outcome in 17 dogs with non-enteric, radiolucent, plant material foreign bodies.

Evaluation of closed pericardial patch grafting for management of severe pulmonic stenosis.

Closed pericardial patch-grafting has been advocated for the treatment of severe pulmonic stenosis. In this study pre- and postoperative echocardiography was used to determine if the transvalvular pressure gradient was successfully lowered by this surgery and whether it remained lowered long term. The valvulotomy-ventriculectomy wire was passed using a blunt needle in four dogs (Bresnock technique1) and via a soft catheter in five dogs (Shores and Weirich modification). Eight of nine patients survived the perioperative period. These dogs were assessed up to 40 months following surgery for clinical and echocardiographic changes. Five cases showed significant decrease in peak pulmonic pressure gradient immediately after surgery (decreasing by 50-81%, P < 0.05), and six cases showed significant decrease 2 to 40 months postoperatively (decreasing by 31-80%, P < 0.005) when compared to preoperative values. There was no significant change in pulmonic pressure gradient from immediately postoperatively to 2 to 40 months postoperatively (P < 0.48). Six dogs showed clinical improvement postoperatively, however persistent right ventricular hypertrophy was observed in all cases. One dog died with symptoms of congestive heart failure 16 months postoperatively. Closed pericardial patch grafting can improve clinical signs in symptomatic patients, however the surgery has significant risks, long term prognosis for these patients is guarded and recurrence of clinical signs and development of congestive heart failure is possible. Cardiac changes can be monitored with Doppler flow echocardiography. Patients with extremely elevated preoperative pressure gradients may be expected to have poorer outcomes.

Type 1B external fixation of a metacarpal fracture in an alpaca.

External skeletal fixation can be used in small ruminants as a successful, economic, alternative to internal fixation. In this case report, a type 1B frame was used on an alpaca to salvage a comminuted metacarpal fracture after failed internal fixation. Positioning the frame on the caudal aspect of the limb allowed full carpal flexion for kneeling and hence normal use of the limb throughout the recovery period. Complete healing occurred without further complications.

Radiographic features of a lateral extracapsular wire suture in the canine cranial cruciate deficient stifle.

Radiographs of 74 dogs (84 stifles) presented with a cranial cruciate ligament rupture and surgically treated using a lateral extracapsular wire (LEW) were reviewed. A strand of orthopaedic wire was surgically placed caudally around the lateral fabella and through a predrilled hole in the tibial crest. At six week follow-up, the LEW was broken at least once in 26 of 33 stifles, predominantly in the area of the lateral fabella. In five stifles, the LEW had slipped off the fabella and was displaced distally along the gastrocnemius muscle. Six months after surgery, the LEW was often broken at several sites. LEW migration was rare. Osteolysis and sclerosis at the site of LEW penetration through the tibial crest occurred in about two-thirds of the stifles examined.

Antimicrobial-resistance trends in bacterial isolates from companion-animal community practice in the UK.

We conducted a longitudinal, retrospective investigation of antimicrobial resistance in bacterial isolates obtained from canine and feline clinical cases in veterinary community practice in UK (1989-1997). Individual-drug resistance was examined using isolates of Escherichia coli and Staphylococcus spp. as Gram-negative and Gram-positive indicator organisms, respectively. The annual prevalence of resistance was calculated for each organism to each of nine (for E. coli) and 11 (for Staphylococcus spp.) selected antimicrobials. The annual prevalence of multiple-drug resistance (MDR) was calculated for E. coli, Proteus spp., Pseudomonas spp., staphylococci and streptococci. Using a chi-square test for trend, significant rising trends were identified in individual resistance of E. coli to clavulanate-amoxycillin and streptomycin, and in MDR of E. coli, Proteus spp. and Pseudomonas spp. Declining trends were identified in individual resistance of Staphylococcus spp. to ampicillin and penicillin. Comparison with previously reported results from a contemporaneous investigation of companion-animal hospital patients indicated that selection pressures acting on the two populations overlapped but were not identical.

Human adult amino acid requirements: [1-13C]leucine balance evaluation of the efficiency of utilization and apparent requirements for wheat protein and lysine compared with those for milk protein in healthy adults.

BACKGROUND: There is considerable debate about the human lysine requirement and the consequent nutritional value of wheat protein. OBJECTIVE: We used a novel [1-(13)C]leucine balance protocol to examine whether adaptive mechanisms to conserve lysine allow wheat to be utilized more efficiently than expected according to current estimates of lysine requirements and wheat utilization. DESIGN: Wheat and milk proteins were compared in 6 adults infused for 9 h with L-[1-(13)C]leucine in the postabsorptive state (0-3 h), who were fed half-hourly with low-protein (2% of energy, 3-6 h) and isoenergetic higher-protein (12-13% of energy, 6-9 h) meals providing maintenance energy intakes. From acute measurements of [1-(13)C]leucine balance, we predicted nitrogen balance, the metabolic demand for protein, the efficiency of postprandial protein utilization (PPU), and the requirements for wheat protein and lysine. RESULTS: Leucine balance was higher after the milk than after the wheat feeding because of the greater inhibition of proteolysis by milk. PPU, calculated as the ratio of Deltanitrogen balance to Deltanitrogen intake between the low-protein and higher-protein periods, was 0.68 +/- 0.06 for wheat and 1.00 +/- 0.09 for milk (P

Trends of antimicrobial resistance in bacterial isolates from a small animal referral hospital.

A longitudinal, retrospective investigation was made of antimicrobial resistance in bacterial isolates obtained from clinical cases in a small animal hospital between 1989 and 1997. Isolates of Escherichia coli and Staphylococcus species were used as Gram-negative and Gram-positive indicator organisms, respectively, and the annual prevalence of antimicrobial resistance was calculated for each organism to each of nine (for E coli) and 11 (for Staphylococcus species) appropriate antimicrobials, including enrofloxacin. Using a chi-square test for trend, statistically significant, rising trends were identified in the resistance of E coli to amoxycillin (P=0.04), clavulanate-amoxycillin (P<0.01) and streptomycin (P<0.01), and in the resistance of Staphylococcus species to erythromycin (P<0.01). There was an equivocal, rising trend for the resistance of Staphylococcus species to cephalexin. No significant trends were apparent for any of the other 15 organism/drug interactions. The annual prevalence of multiple drug resistance was calculated for E coli, Proteus species, Pseudomonas species, staphylococci and streptococci, but no statistically significant trends were identified.

Value of direct smears of synovial fluid in the diagnosis of canine joint disease.

Assessments of direct smears of synovial fluid by four clinicians were compared with the results obtained with a Coulter counter. Estimates of total white cell counts by the clinicians were inaccurate and generally higher than the Coulter counter results. The method had a low sensitivity and specificity for the identification of degenerative joint disease and normal joints in comparison with the identification of inflammatory joint disease. There were marked variations in the results obtained by the four clinicians for all the analyses in the study.

Variation in the apparent sensitivity of the insulin-mediated inhibition of proteolysis to amino acid supply determines the efficiency of protein utilization.

1. The variability between normal individuals in the efficiency of postprandial protein utilization (PPU), a determinant of the apparent protein requirement, was examined in relation to the relative responses of protein synthesis and proteolysis to protein feeding by means of [1-13C]leucine turnover and balance studies.2. Twenty-five healthy adults were infused intravenously with L-[1-13C]leucine continuously for 9 h. This was started in the postabsorptive state (PA, 3 h) and followed by low-protein feeding (LP, 3 h), and then by isoenergetic high-protein feeding (HP, 3 h). This allowed protein intake to be varied against a constant postprandial insulin level so that the extent of any amino-acid-mediated responses which were additional to those exerted by insulin could be investigated. Leucine oxidation, O, and balance (intake-oxidation), protein synthesis, S, and degradation, D, were calculated from plasma [1-13C]alpha-ketoisocaproic acid enrichment and 13CO2 excretion.3.PPUprotein, calculated as change in leucine balance/change in intake (HP-LP), varied from 0.58 to 0.99 (mean=0. 81+/-0.10), independently of age or sex. PPUprotein varied directly with the inhibition of D and inversely with the increase in leucine concentration and stimulation of O and S.4. Efficient PPU, as demonstrated by the top quintile of individuals categorized in terms of PPUprotein, involves maximal inhibition of D by protein feeding with minimal increases in free amino acid concentrations, O and S. Lesser inhibition of D and greater stimulation of S and O characterized the lower, less efficient quintile. This indicates that the efficiency of protein utilization in individuals, and a component of their apparent protein requirement, is determined by the sensitivity of the insulin-mediated inhibition of proteolysis to amino acid supply.

Malignant articular plasmacytoma in two dogs.

Malignant articular neoplasia in two dogs was diagnosed as plasma cell neoplasia on the basis of radiography and cytology, and was supported by histopathology. Both dogs were euthanased and widespread metastases were identified postmortem.

Protein requirements and ageing: metabolic demand and efficiency of utilization.

The protein requirements of the elderly were investigated with [13C]leucine balance studies of metabolic demand, the efficiency of postprandial protein utilization (PPU) and the consequent apparent protein requirement. Ten elderly subjects aged 68-91 years (five men and five women) and ten young adult subjects aged 21-31 years (five men and five women) were infused with L-[1-13C]leucine for 9 h commencing in the postabsorptive state (0-3 h), continuing during the half-hourly feeding of low-protein meals (LP; protein 3% energy, 3-6 h), and during similar feeding of isoenergetic higher protein meals (HP; protein 15% energy, 6-9 h). Leucine oxidation and balance were determined from plasma [1-13C]-alpha-ketoisocaproate enrichment and expired 13CO2 excretion measured during the 3rd hour of each 3 h period. The protein intake during the HP phase was similar to the habitual intake estimated in the subjects from 24 h urinary N excretion. Metabolic demand was defined as equal to twice the body-protein equivalent of measured postabsorptive leucine oxidation. The efficiency of PPU was calculated from the increased leucine oxidation observed during feeding, and the apparent protein requirement was defined as metabolic demand/PPU and calculated in relation to both body weight (BW) and fat-free mass (FFM) determined by densitometry or bioimpedance. Metabolic demand in the young adults was 0.83 g protein/kg per d; in both elderly groups it was 36% lower when expressed per kg BW and 30% lower when expressed per kg FFM. The apparent protein requirement calculated from metabolic demand and PPU was 0.99 g protein/kg per d in the young adults and this was also lower in the elderly, although this was only significant in the men (0.66 g per kg BW, P = 0.013; 0.79 g per kg FFM, P = 0.02). The results show that in this group of healthy elderly adults protein requirements as assessed from leucine balance studies were either similar to or less than those of younger adults.

Post-prandial protein metabolism.

Current post-prandial studies of amino acid metabolism and utilization are consistent with a feeding mechanism mediated primarily by insulin and amino acids, with the balance between protein conservation and net deposition dependent on the amino acid supply [1-13C]leucine post-prandial kinetic tracer studies of leucine oxidation, non-oxidative disappearance and endogenous appearance allow study of the regulation of whole-body amino acid oxidation, protein synthesis and proteolysis. On the basis of these studies it appears that for leucine oxidation, the main determinant of the efficiency of protein utilization, the overriding regulatory influence is substrate availability rather than insulin. Such substrate sensitivity is manifest throughout the physiological range of insulin down to the lowest insulin levels observed suggesting that a basal insulin need is not an important part of regulation of this important catabolic pathway. The key protein turnover response is an inhibition of proteolysis sufficient to limit any increases in amino acid levels thus limiting any increase in amino acid oxidation. It appears that the influences of amino acids and insulin on proteolysis are separate and additive and may both be receptor mediated so that extracellular amino acid levels can regulate intracellular levels. It is likely that protein synthesis is regulated by intracellular amino acid levels but post-prandial stimulation through increases in amino acid levels appears to be unhelpful because of parallel increases in amino acid oxidation. Evidence for any influence of insulin on protein synthesis has yet to be unequivocally identified.

Influences of dietary energy and protein on leucine kinetics during feeding in healthy adults.

Ten adult men were infused with L-[1-13C]leucine for 9 h commencing in the postabsorptive state (PA, 0-3 h), during the half-hourly feeding of low-protein meals (LP, protein = 2% calories, 3-6 h), and during feeding isoenergetic high-protein meals (HP, protein = 14% calories, 6-9 h). Leucine oxidation and turnover (protein synthesis and degradation) were determined from plasma alpha-[1-13C]ketoisocaproate enrichment and expired 13CO2 excretion measured during the third hour of each 3-h period. Plasma insulin increased markedly with feeding to a level that was maintained with both diets. The negative postabsorptive leucine balance became less negative during the LP meals (P < 0.01) and was positive with the HP meals (P < 0.01). The significant responses to feeding (all P < 0.01) were for oxidation -13% (PA-LP), +50% (LP-HP), and +29% (PA-HP); for degradation -24% (PA-LP), -30% (LP-HP), and -47% (PA-HP); and for synthesis -14% (PA-LP), +29% (LP-HP), and +11% (PA-HP). These data support a feeding mechanism involving both an insulin-mediated, protein-conserving influence of dietary energy that inhibits degradation, lowers amino acid levels, and reduces oxidation, and amino acid-mediated augmentation of the inhibition of degradation, a stimulation of synthesis, and an increase in oxidation when leucine dietary supply exceeds the capacity for its net deposition.

Body composition measurement in elite heavyweight oarswomen: a comparison of five methods.

The study was designed to evaluate the range of body composition in elite heavyweight oarswomen as well as the level of agreement between various methods used to measure this variable. Percent body fat was determined at the start of the competitive season by densitometry, taken to represent the reference standard, and measurement of total body potassium, skinfold thicknesses, bioelectrical impedance analysis and body mass index. The athletes were studied within a two week period with all measurements in any individual taken during one morning. We demonstrated a surprisingly large range of percent fat between these oarswomen, 13.6 to 29.3% by densitometry, which was a feature common to all methods. Percent body fat by total body potassium was lower (p < 0.05) while from body mass index higher (p < 0.01) than the reference value from densitometry. Similar methodologies generated significantly different estimates of % fat (SFT1 versus SFT2, p < 0.01 and BIAv versus BIAB, p < 0.01) highlighting the potential problems that may arise with the use of different regression equations to convert primary measurements into % fat. The limits of agreement between various methods were wide and reflect the large variability about the estimated mean bias. Practically this negates the correction of "non reference" values by adding or subtracting the mean difference or bias between the techniques in individuals. These methodological problems need to be considered when setting specific body composition targets for an athlete.