Development and validation of a multivariate predictive model to estimate serum ionized calcium concentration from serum biochemical profile results in cats.

BACKGROUND: Measurement of serum ionized calcium is not always available in practice. Total calcium (tCa) might not be reliable for determination of calcium status in cats. OBJECTIVES: To predict serum ionized calcium concentration from signalment, biochemistry profile and T4, and compare predicted ionized calcium (piCa) to tCa. ANIMALS: A total of 1701 cats from two hospitals. METHODS: Cross-sectional study. Cats with serum ionized calcium, biochemistry profile and T4 available were screened over 6 years and included in the training set (569 cats) to create a multivariate adaptive regression splines model to calculate piCa. Diagnostic performances of tCa and piCa and its prediction interval (PI) were compared in 652 cats from the same institution (test set) and 480 cats from a different hospital (external set). RESULTS: The final model included tCa, chloride, albumin, cholesterol, creatinine, BUN, body condition score, GGT, age, and potassium. For hypercalcemia, piCa was highly specific (test set: 99.8%; confidence interval [CI]: 99.5-100; external set: 97%; CI: 95.3-98.7) but poorly sensitive (test set: 30.4%; CI: 18.3-42.4; external set: 42.5%; CI: 31.7-53.3). For hypocalcemia, piCa was also highly specific (test set: 81.6%; CI: 78-85; external set: 99.6%; CI: 99-100) but poorly sensitive (test set: 57.6%; CI: 50.6-64.6; external set: 0%). These diagnostic performances were comparable to those of tCa. The upper and lower limits of piCa PI had high sensitivity for detecting ionized hypercalcemia and hypocalcemia, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Predicted ionized calcium is useful to confirm suspected hypercalcemia in cats and screen for hypercalcemia and hypocalcemia.

Utility and Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Dogs with Septic Peritonitis.

Systemic inflammation is known to cause WBC abnormalities, specifically neutrophilia and lymphopenia. The neutrophil-to-lymphocyte ratio (NLR) is a simple and affordable biomarker that has been used in human clinical settings of sepsis but has not been investigated in veterinary species. We evaluated NLR in dogs with septic and nonseptic systemic inflammatory diseases and compared with a healthy dog population. An NLR ≥6 had an 84.39% sensitivity and 86.95% specificity to identify dogs with systemic inflammatory states; however, no ratio distinguished septic and nonseptic causes. The NLR was not associated with length of hospitalization, morbidity based on the acute patient physiologic laboratory evaluation scoring system, or mortality. The disassociation may be due to the retrospective nature of the study, including a restricted population size and acquisition of only a one-time blood sample. NLR is currently of limited use for diagnosis and prognosis in systemic inflammatory states in dogs, and larger, prospective studies are necessary to further evaluate NLR.

Acute surgical intervention for a depressed skull fracture causing a laceration to the brain parenchyma from a bite wound in a dog.

A 5-month-old spayed female mixed breed dog was attacked by another dog causing multiple fractures of the left calvarium with a fragment penetrating through the gray matter of the parietal lobe. Surgery was performed to remove the bone fragment. A 6-month follow-up showed dramatic improvement in neurologic status.

Intervention chirurgicale d'urgence pour une fracture du crâne pénétrante causant une lacération au parenchyme du cerveau suite à une morsure chez une chienne. Une chienne stérilisée de race croisée âgée de 5 mois a été attaquée par un autre chien causant des fractures multiples de la voûte crânienne gauche avec un fragment pénétrant dans la matière grise du lobe pariétal. La chirurgie a été réalisée pour enlever le fragment d'os. Un suivi de 6 mois a démontré une amélioration spectaculaire de l'état neurologique.(Traduit par Isabelle Vallières).