Treatment of ionized hypercalcemia in 12 cats (2006-2008) using PO-administered alendronate.

BACKGROUND: Long-term treatment of cats with ionized hypercalcemia using alendronate has not been evaluated. HYPOTHESIS/OBJECTIVES: Alendronate is well tolerated in treatment of ionized hypercalcemia in cats. ANIMALS: A total of 12 cats with ionized hypercalcemia. METHODS: Prospective study of 12 cats with ionized hypercalcemia of idiopathic origin was identified by telephone and email communication with a convenience sample of consulting veterinarians. Cats were treated with alendronate at a dose of 5-20 mg per feline PO q7d. Serum ionized calcium concentration (iCa) was measured before beginning treatment with alendronate, and after 1, 3, and 6 months of treatment. Alendronate dosage was adjusted according to iCa. Evaluation included physical examination, CBC, biochemistry profile, and diagnostic imaging. The owners and referring veterinarians were questioned about any observed adverse effects. The Wilcoxon matched-pairs signed rank test was used to compare baseline iCa to iCa at different time periods. RESULTS: Alendronate treatment resulted in a decrease in iCa in all 12 cats. The median percentage change in iCa was -13.2%, -15.9%, and -18.1% (range, -29.6 to +7.6; -30.5 to -1.9; -45.8 to +1.5%) at the 1, 3, and 6 month time points, respectively. Baseline iCa was significantly different from 1 month (P = .0042), 3 months (P = .0005), and 6 months (P = .0015). No adverse effects were reported for any of the cats. CONCLUSIONS AND CLINICAL IMPORTANCE: Alendronate was well tolerated and decreased iCa in most cats for the 6-month period of observation.

Characteristics of dairy calf ranches: morbidity, mortality, antibiotic use practices, and biosecurity and biocontainment practices.

The utilization of farming operations specializing in rearing dairy heifer calves has increased since the early 1990s. However, these operations have not been as well characterized as US dairy operations with respect to demographic and health-related measures, particularly during the preweaning period. The objective of this study was to characterize morbidity, mortality, antibiotic use, and biosecurity and biocontainment practices on operations rearing preweaned heifers only or preweaned heifer and bull calves (mixed) in the United States. A cross-sectional survey was performed using a standardized method that included a preletter, initial survey, postcard follow-up, and second survey delivered by mail. Additional follow-up contacts were attempted by telephone. Descriptive statistics for morbidity, mortality, antibiotic use, and biosecurity and biocontainment practices were computed at both the operation and calf levels. The overall response rate was 50%. Crude yearly mortality averaged 6.9% at the calf level, with the median operation reporting 3.6% mortality. Diarrhea was experienced by 18% of calves, with 73% receiving an antibiotic. The median operation reported 20% diarrhea morbidity with 83% receiving an antibiotic. Respiratory disease was experienced by 9.0% of calves, with 82% receiving an antibiotic. The median operation reported 5.3% respiratory morbidity, with 100% receiving an antibiotic. Heifer-only and mixed operations did not differ in operation median morbidity, mortality, or antibiotic treatment rates. Written antibiotic protocols were available on 65% of operations. Medicated milk replacer was used by 56% of operations. Passive immunity was routinely measured by 46% of operations. Direct contact between calves in housing units was not allowed by 45% of operations. Of all farms informed of disease concerns at the source farm, 76% changed their daily routine as a result. Almost all operations uniquely identified calves and recorded mortality. The heifer-only and mixed operations in this study were similar to US dairy operations for key health, antibiotic use, and biosecurity and biocontainment metrics. This research provides initial estimates of key demographics usable by calf ranches, veterinarians, and other professionals serving this segment of the US dairy industry.

Characterization of advertisements for puppies sold online: determinants of cost and a comparison with parent club breeders.

The Internet is an increasingly common way for consumers to purchase puppies. Yet very little information is available about the types of puppies sold via the Internet. In addition these sales are not subject to United States Depart of Agriculture (USDA) regulation. The objectives of the study were to describe puppies sold via the Internet, to assess the characteristics that contribute to the cost of a puppy, and to compare puppies sold via the Internet with puppies sold by American Kennel Club (AKC) Parent Club breeders. Over 14 weeks in 2008, Yorkshire Terrier, Shih Tzu, English Bulldog, Boxer, and Labrador Retriever puppies for sale on two large-scale online puppy sales sites were categorized based on their Internet advertisements. Data were collected in three categories: puppy characteristics, health characteristics, and policies (such as spay/neuter requirement, health guarantee, and return policy). After the survey was completed, 25 AKC Parent Club breeders and 25 other breeders who advertised via one of the puppy sales websites were randomly selected and interviewed over the phone. Small breed puppies were most frequently advertised with 35.2% (1228/3485) of advertisements for Yorkshire Terriers and 23.0% (802/3485) for Shih Tzus. Almost one quarter of Internet breeders 768/3474 (22.2%) advertised four or more different dog breeds. Champion bloodlines increased the cost of a puppy of all breeds. AKC Parent Club breeders 21/25 (84%) were more likely to mention breed-specific health screening tests when compared to Internet breeders 7/25 (28%). Consumers should apply the same standards for purchasing from a breeder found through a puppy sales site as they would for purchasing from a local breeder. Breeders who advertise at one of the large-scale puppy sales websites are less knowledgeable about breed-specific health issues compared to an AKC Parent Club breeder. Internet breeders are less likely to perform these screening tests on their breeding dogs and may breed dogs with undesirable heritable health risks.

Prevalence of elevated alanine transaminase activity in dogs treated with CCNU (Lomustine)*.

The purpose of this study was to evaluate prevalence of serum alanine transaminase (ALT) elevation in dogs receiving lomustine (CCNU) and to analyse the pattern of occurrence and potential risk factors. Serum ALT activity in 109 dogs during single-agent CCNU chemotherapy was retrospectively analysed. The median initial dose, dose-intensity and cumulative dose of CCNU were 64 mg m(-2), 21 mg m(-2) week(-1) and 171 mg m(-2), respectively. The overall prevalence of major ALT elevation [> 5-fold upper reference limit (URL)] was 29% (32/109) and developed most commonly after one to three doses of CCNU. These ALT elevations occurred without preceding mild ALT elevation in 53% (17/32) of the cases. Three dogs (2.8%) developed clinical hepatopathy. For severe ALT elevation (>10-fold URL), age < or =5-year-old was associated with higher risk. The findings of this study showed that elevation of ALT is common during CCNU chemotherapy in dogs and severe elevation can develop on a sudden onset.

Pre-weaning morbidity and mortality of llamas and alpacas.

OBJECTIVES: To describe the morbidity and mortality patterns and identify factors associated with morbidity in pre-weaning llamas and alpacas. DESIGN: Cross-sectional observational study of 287 crias born on four farms in Ohio, USA. PROCEDURE: Historical data representing all crias born over a 6-year period were obtained from two llama farms and two alpaca farms in Ohio. Multivariable generalised linear mixed effects regression models were used to identify factors associated with morbidity outcomes. RESULTS: In total, 105 (37%) of the llamas and alpacas had some reported morbidity during the pre-weaning period, and mortality rate was 2.1%. In addition, 51 (18%) of llamas and alpacas experienced morbidity because of infectious disease, and 47 (16%) experienced morbidity during the neonatal period. The three most commonly reported morbidity events were undifferentiated diarrhoea (23%), umbilical hernia (16%) and unspecified infectious disease (15%). Difficult birth was an important risk factor for pre-weaning morbidity in this population. CONCLUSIONS: Camelid veterinarians and their clients can expect that pre-weaning health events are common among crias, although mortality is low. Crias experiencing difficult births may require additional monitoring for health events during the pre-weaning period.

A phase II clinical trial of vinorelbine in dogs with cutaneous mast cell tumors.

BACKGROUND: Few effective drugs are available to treat dogs with locally aggressive or metastatic mast cell disease. HYPOTHESIS: Vinorelbine, a semisynthetic derivative of vinblastine, is an effective drug for the treatment of canine mast cell tumors (MCT). ANIMALS: Twenty-four dogs with cutaneous MCT. METHODS: Dogs with at least 1 measurable, cytologically confirmed, and previously untreated cutaneous MCT received a single treatment with vinorelbine at the previously established dosage of 15 mg/m2 IV. Tumor measurements and CBC were evaluated before and 7 days after treatment. Adverse events were graded according to Veterinary Cooperative Oncology Group (VCOG) guidelines. STATISTICS: Data were accrued in accordance with a Simon's 2-stage design with a noninteresting response rate of .05, a target response of .25, and alpha and beta values of .10. RESULTS: Three of 24 dogs (13%) had a response to treatment, including 1 measurable complete response and 1 measurable partial response. The 3rd dog had microscopic complete response to treatment with stable measurable disease. Twenty other dogs (83%) had stable disease and 1 dog (4%) had progressive disease. Neutropenia occurred in 13 dogs (54%) (grade 1, n = 4; grade 3, n = 6; grade 4, n = 3). Gastrointestinal toxicity occurred in 11 dogs (46%) (anorexia: grade 1, n = 3; grade 2, n = 1; grade 3, n = 1; diarrhea: grade 1, n = 2; grade 3, n = 1; vomiting: grade 1, n = 5; grade 3, n = 1). CONCLUSIONS AND CLINICAL IMPORTANCE: Vinorelbine was associated with an overall response rate of 13% and a high prevalence of neutropenia. Additional studies are indicated to determine if repeated dosing of vinorelbine or combination of vinorelbine with other drugs increases the observed biologic activity against canine MCT.

Use of group-randomized trials in pet population research.

Communities invest considerable resources to address the animal welfare and public health concerns resulting from unwanted pet animals. Traditionally, research in this area has enumerated the pet-owning population, described pet population dynamics in individual communities, and estimated national euthanasia figures. Recent research has investigated the human-animal bond and explored the community implications of managed feral cat colonies. These reports have utilized traditional epidemiologic study designs to generate observational data to describe populations and measure associations. However, rigorous scientific evaluations of potential interventions at the group level have been lacking. Group-randomized trials have been used extensively in public health research to evaluate interventions that change a population's behavior, not just the behavior of selected individuals. We briefly describe the strengths and limitations of group-randomized trials as they are used to evaluate interventions that promote social and behavioral changes in the human public health field. We extend these examples to suggest the appropriate application of group-randomized trials for pet population dynamics research.

Management of the patient with short bowel syndrome.

Extensive resection of the small bowel results in impaired digestion of macronutrients and malabsorption of nutrients, fluid, electrolytes, and minerals. Gastric acid hypersecretion and alterations in gut hormonal response further contribute to the problem. Diarrhea, dehydration, electrolyte and acid/base abnormalities, and macronutrient and micronutrient deficiencies ensue, and is termed the short bowel syndrome (SBS). Rare disorders, such as essential fatty acid deficiency and D-lactic acidosis, are a greater concern for the SBS patient. These patients' lives are significantly impacted, and they require close monitoring by a medical team knowledgeable about the disease and its nutritional, metabolic, and psychosocial consequences. Immediate therapies are directed toward fluid resuscitation, wound healing, and initiation of early nutrition support. After medical stabilization, multiple nutritional and medicinal therapies are used to aid bowel adaptation and prevent medical crisis. Advanced practice nurses should be knowledgeable about SBS to educate patients and families about this disease, associated therapies and changes in lifestyle, and how to detect and manage acute changes in medical condition.

Resting rectal temperature of Vietnamese potbellied pigs.

OBJECTIVE: To determine resting rectal temperatures of Vietnamese potbellied pigs. DESIGN: Prospective clinical trial. ANIMALS: 85 potbellied pigs on a single farm and 27 potbellied pigs examined at a veterinary teaching hospital for routine veterinary care. PROCEDURE: Rectal temperatures of the potbellied pigs on a farm were measured during the morning, afternoon, and evening. Rectal temperatures at the time of initial examination were obtained from medical records for the potbellied pigs examined at the hospital. RESULTS: Mean rectal temperatures for both groups of potbellied pigs were the same. Overall unadjusted mean +/- SD rectal temperature was 37.6 +/- 0.8 C (99.7 +/- 1.5 F; range, 35.1 to 39.6 C [95.2 to 103.3 F]). However, diurnal variation in rectal temperature was found among the farm population of potbellied pigs. After adjustment for age and repeated sampling, rectal temperatures recorded during the morning were found to be significantly lower than temperatures recorded during the afternoon and evening (mean difference, 0.5 and 0.9 C [0.9 and 1.6 F], respectively), and rectal temperatures recorded during the afternoon were found to be significantly lower than temperatures recorded during the evening (mean difference, 0.4 C [0.7 F]). There was a significant inverse linear relationship between age and rectal temperature. CONCLUSIONS AND CLINICAL RELEVANCE: Rectal temperatures of Vietnamese potbellied pigs may be lower than the lower limit of the reference range reported for domestic pigs. Because of diurnal variation in rectal temperatures, it is important to compare temperatures obtained at the same time of day when assessing patients.

Owner perception of the care of long-term phenobarbital-treated epileptic dogs.

A study was undertaken to evaluate owners' perception of the effect that epilepsy and long-term phenobarbital therapy had on the quality of pet and owner lifestyle. Selected owners who participated in a prospective, longitudinal clinical epilepsy study were sent a questionnaire at the end of the two-year study. Inclusion criteria were dogs with a history of seizures without previous medical attention or therapy by any veterinarian before enrolment, subsequent determination of seizure aetiology using a standardised diagnostic protocol and treatment with phenobarbital for a minimum period of six months. A relatively equal distribution of the respondents' dogs had a determined (secondary, 47 per cent) or undetermined (primary, 53 per cent) seizure aetiology, and the vast majority of owners agreed that they would choose to treat their epileptic pet again rather than opt for other alternatives. Most owners disagreed that their pet was leading a poor quality of life after the start of phenobarbital therapy. A significant negative correlation existed between an owner's perception of the pet's quality of life and the amount of work required to care for the pet during the two-year study period. This study demonstrates that many owners are willing to care for epileptic dogs on long-term phenobarbital treatment, regardless of the underlying cause.

Denial: a conceptual analysis.

The term denial is used in nursing to describe a client's behavior. A random sample of 18 articles published in English from 1990 to 1999 was identified for conceptual analysis using Rogers' methodology. The 2 main definitions identified ranged from an adaptive to maladaptive coping process. Anxiety or perceived threats evolving from situational or maturational crises were antecedents. Events that followed typically resulted in either positive or negative outcomes. Related concepts used most often were avoidance, unrealistic hopefulness, and repression.

In utero varicella-zoster infections.

In utero varicella-zoster infections, though infrequent, may have significant consequences for the affected infant depending on the gestational timing of the infection. We present a case of infantile zoster in a 5-month-old boy after maternal varicella infection. Also, we review the three major disorders resulting from in utero infection with respect to severity and management.

Demographic and needs assessment survey of animal care and control agencies.

OBJECTIVE: To characterize demographic and needs assessment information for animal care and control agencies in Ohio. DESIGN: Mail survey. SAMPLE POPULATION: 222 animal care and control agencies. PROCEDURE: A questionnaire was mailed to animal care and control agencies in Ohio. Data were collected for 1996. RESULTS: Of 222 agencies contacted, 180 (81%) responded. Agencies estimated that they spent $28.4 million ($2.47/person). Approximately 339,207 animals were taken in, comprising 214,143 (63%) dogs, 114,877 (34%) cats, and 10,187 (3%) wildlife or other species. Of these animals, a fourth were adopted, about a tenth were reclaimed by their owners, and two thirds were euthanatized. Approximately 302,589 animal control complaints were received, and 22,053 (7%) citations were issued. One hundred three (57%) agencies reported 25,564 cruelty complaints; criminal charges were filed for 543 (2%) cases, with 445 (82%) resulting in guilty verdicts. Among 155 agencies that provided information, 87 (56%) had spay/neuter policies. Only 69 of 178 (39%) agencies reported an association with a veterinarian. Less than half (64/150; 43%) of the agencies administered vaccinations, and 69 of 152 (45%) treated animals for intestinal parasites. The top 5 things needed by agencies were capital/facility improvements, increased funding, improved legislation for animals, educational needs, and veterinary services. CLINICAL IMPLICATIONS: In Ohio in 1996, 9.9% of dogs and 4.5% of cats received care or assistance from animal care and control agencies. Only 39% of animal care and control agencies have an association with a veterinarian.

Survey of humane organizations and slaughter plants regarding experiences with Vietnamese potbellied pigs.

OBJECTIVE: To determine to what extent humane organizations are receiving requests to take unwanted Vietnamese potbellied pigs and to determine whether owners of potbellied pigs are selling them for slaughter. DESIGN: Mail survey. SAMPLE POPULATION: 1,178 humane organizations in 7 states and 978 slaughter plants in 4 states. RESULTS: 802 (68%) humane organizations and 787 (81%) slaughter plants responded. Of the humane organizations that responded, 479 (60%) stated they were willing to accept potbellied pigs. Humane organizations received 4,380 requests from owners to accept potbellied pigs during the study period and accepted 3,149 (72%) of these pigs. Six hundred fifteen (20%) of the potbellied pigs accepted were strays. Of the 437 humane organizations that provided reasons why owners relinquished their potbellied pigs, 255 (58%) reported larger than expected size, 148 (34%) reported zoning restrictions and 82 (19%) reported aggression. Of 485 slaughter plants that normally slaughtered hogs, 255 (53%) had received requests to slaughter potbellied pigs. These plants slaughtered 2,640 and refused 1,407 potbellied pigs during the study period. CLINICAL IMPLICATIONS: Problems with larger than expected size, zoning restrictions, and aggressive behavior caused owners of Vietnamese potbellied pigs to relinquish their pets to humane organizations and slaughter plants.

Enteral access devices.

When the mode of nutrition support therapy is decided, it is generally accepted that the gastrointestinal (enteral) route be considered before the intravenous (parenteral) route. Currently, there are a plethora of enteral devices available and as many techniques for device insertion. This article will help the health care practitioner differentiate among the various enteral access devices available and provide care aimed at minimizing device related complications. Many complications can be prevented by keeping the devices secure, noting any migration inward or outward, and providing good site care and proper flushing. With careful selections of the type of enteral feeding device and tube tip location, most patients can be fed successfully by the enteral route.

Adult tube feeding formulas.

Adult tube feeding formulas vary considerably with respect to composition, administration, and cost. Selecting the best product for patients requires a careful analysis of specific patient requirements and resources.

The role of the gut in critical illness.

The gastrointestinal tract is a major immunologic organ that must be maximally supported during critical illness. Gastrointestinal tissues require direct contact with nutrients to support their own rapid cellular turnover rate and carry out the multitude of metabolic and immunologic functions needed for successful adaptation to stress. Disruption in the ecologic equilibrium of the gastrointestinal tract often occurs during critical illness and the therapies provided. Problems encountered include stress ulcers, intestinal ischemia, bacterial overgrowth, aspiration pneumonia, bacterial translocation, sepsis, and the systemic inflammatory response syndrome. Early enteral nutrition has been shown to be a viable, economic, and physiologically beneficial way to support the gastrointestinal tract during critical illness. The fortification of enteral formulas with glutamine, arginine, or fiber is being studied to determine each one's unique role in the gut and immunologic changes that occur with severe stress.

Comparison of weighted vs unweighted enteral feeding tubes for efficacy of transpyloric intubation.

Routine transpyloric placement of feeding tubes reduces aspiration in intensive care unit patients. Spontaneous passage eliminates the need for radiologic or endoscopic intervention. It is unclear whether the addition of a weight to the end of the tube or the use of the prokinetic agent metoclopramide in the conventional dose (10 mg) improves spontaneous transpyloric placement. In a randomized, prospective trial, 39 intensive care unit patients (age > 2 years) had a total of 50 nasoenteral tubes placed after intravenous metoclopramide (20 mg in adults, 0.2 mg/kg in children). The tubes were 8 French in diameter with either a weighted end or an unweighted bullet tip. Tip position was confirmed radiographically within 4 hours after blinded placement and at 1 and 2 days if spontaneous passage had not occurred. At 4 hours, 36% of the weighted tubes and 84% of the unweighted tubes (p < .002) had passed through the pylorus. At 1 day, 48% of the weighted tubes and 86% of the unweighted tubes (p < .007) had achieved transpyloric position. At 2 days, 56% and 92% of the weighted and unweighted tubes, respectively, had passed through the pylorus (p < .009, chi 2). The occurrence of transpyloric passage and the rapidity at which it occurred was significantly greater for the unweighted tube during all time periods. A poststudy trial was conducted to evaluate the effect of the normal dose of metoclopramide (10 mg in adults and 0.1 mg/kg in children) and the transpyloric passage of the unweighted feeding tube. Twenty-five patients received 10 mg of metoclopramide before the insertion of the unweighted tube.(ABSTRACT TRUNCATED AT 250 WORDS)