Urinary tract infections in dogs with spontaneous hypercortisolism - frequency, symptoms and involved pathogens.

INTRODUCTION: Dogs with hypercortisolism are predisposed to developing bacteriuria associated either with clinical signs of cystitis or without clinical signs (subclinical bacteriuria). Based on current guidelines, dogs with subclinical bacteriuria should not be treated with antibiotics because there is no evidence that treatment improves outcome and because unnecessary treatments should be avoided. Before these guidelines were published in 2019, dogs with hypercortisolism and bacteriuria were commonly treated with antibiotics irrespective of clinical signs. Comprehensive data on the frequency of bacterial cystitis, subclinical bacteriuria and the outcome of antimicrobial treatment in dogs with hypercortisolism is sparse. The aims of this study were to investigate dogs with hypercortisolism for the presence of bacterial cystitis and subclinical bacteriuria, to address the pathogens involved, and to assess the outcome of antibiotic treatment. Dogs newly diagnosed with hypercortisolism between 2005 and 2015 from which a urine bacterial culture was available were included. Statistical analysis was performed with non-parametric tests. Of the 161 client-owned dogs included, 29 (18%) showed bacteriuria, which was subclinical in 24 (83%) cases. Escherichia coli was the most commonly isolated pathogen (58%). Bacteriuria was not associated with sex or neutering status. In 14 dogs, follow-up data was available, of which 13 (93%) were treated with antimicrobials for 14 to 28 days. Follow-up bacterial culture (1 to 118 days after cessation of therapy) was negative in 10 (77%) treated dogs; a negative follow-up culture was not associated with gender, age or duration of treatment. Bacteriuria persisted in three treated dogs and the one untreated dog. The prevalence of positive bacterial urinary culture in dogs with hypercortisolism was lower than previously reported. In the majority of dogs, bacteriuria was subclinical. Most dogs had a negative bacterial culture result after antimicrobial treatment; however, more resistant bacteria were detected in persistently positive urine.

INTRODUCTION: Les chiens atteints d'hypercortisolisme ont tendance à développer une bactériurie associée avec ou sans signes cliniques de cystite. Selon les recommandations de traitement actuelles, les chiens atteints de bactériurie subclinique ne doivent pas être traités avec des antibiotiques, car il n'y a aucune preuve d'une amélioration du succès du traitement et des traitements inutiles doivent être évités. Avant la publication de ces lignes directrices en 2019, les chiens atteints de hypercortisolisme et de bactériurie étaient traités de façon standard avec des antibiotiques, quels que soient les symptômes cliniques. Les données sur la fréquence de la cystite bactérienne, de la bactériurie subclinique et du résultat du traitement antimicrobien chez les chiens atteints d'hypercortisolisme sont rares. Le but de cette étude était d'examiner des chiens souffrant d'hypercortisolisme quant à la présence d'une cystite bactérienne et d'une bactériurie subclinique, d'identifier les agents pathogènes impliqués et d'évaluer le succès thérapeutique du traitement antibiotique. Cent soixante et un chiens, diagnostiqués avec hypercortisolisme entre 2005 et 2015 et chez qui une culture bactérienne urinaire était disponible, ont été utilisés. L'analyse statistique a été réalisée avec des tests non paramétriques. Une bactériurie a été diagnostiquée chez 29 (18%) des chiens avec hypercortisolisme, de façon subclinique dans 24 (83%) cas. Escherichia coli était le pathogène le plus fréquemment isolé (58%). Il n'y avait aucune association entre la bactériurie et le sexe ou le statut de castration. Des données de suivi étaient disponibles chez 14 chiens, dont 13 (93%) ont été traités avec des antibiotiques pendant 14 à 28 jours. La culture bactérienne (1 à 118 jours après la fin du traitement) a été négative chez 10 chiens (77%) traités. Il n'y avait aucune différence entre le sexe, l'âge ou la durée du traitement. Une bactériurie persistante a été observée chez trois chiens traités et un chien non traité. La prévalence de la culture bactérienne d'urine positive chez les chiens atteints d'hypercortisolisme était moins fréquente que celle publiée précédemment. Chez la majorité des chiens, la bactériurie était subclinique. La plupart des chiens avaient une culture bactérienne négative après un traitement antimicrobien; cependant, les cultures d'urine positives persistantes ont démontré des germes plus résistants aux antibiotiques.

[Diagnostic utility of creatine kinase elevation in the routine biochemical profile in cats]. / Diagnostischer Nutzen einer Kreatin­kinase Erhöhung im Routine­chemogramm bei Katzen.

INTRODUCTION: Creatine kinase (CK) is a muscle enzyme that is very sensitive to muscle damage. Therefore, serum CK is measured particularly to confirm suspected myopathy. Since 2013, this enzyme has been included in the routine chemistry profile in our hospital. Soon thereafter, the subjective impression developed that its elevation did not correlate to and was not explainable with the actual clinical problem. Therefore, the aim of this retrospective study was to investigate in which clinical cases the CK elevation was adequate and in which cases without clinical evidence of muscle damage the CK was so markedly elevated that it implied a clinically relevant muscle damage. For this purpose, we evaluated the CK values of 1641 cats presented in the years 2013/2014 at our university animal hospital. The CK was comprehensibly elevated in cats with trauma and various diseases with obvious and traceable muscle damage like thrombo-embolic damage or seizures. In addition, the CK was elevated in diseases where concomitant muscle damage is perceivable like in cats with hypertrophic cardiomyopathy. However, the CK also was commonly and sometimes dramatically elevated in cats of essentially any disease group without any comprehensible skeletal muscular lesion. These results confirm the hypothesis that the diagnostic value of this parameter is most questionable. A CK elevation does not allow any conclusion regarding its original diagnostic purpose, i.e. to confirm the presence of a clinically relevant myopathy.

INTRODUCTION: La créatine kinase (CK) est une enzyme musculaire très sensible lors de dommages musculaires. Par conséquent, la CK sérique est mesurée en particulier pour confirmer une myopathie suspectée. Depuis 2013, cette enzyme fait partie du chimiogramme de routine de notre hôpital. Après peu de temps, l'impression subjective s'est développée que son élévation n'était pas corrélée ni explicable avec le problème clinique réel. Par conséquent, le but de cette étude rétrospective était d'étudier dans quels cas cliniques l'élévation de la CK était adéquate et dans quels cas sans signe clinique de lésion musculaire, la CK était si nettement élevée qu'elle impliquait une lésion musculaire cliniquement pertinente. À cette fin, nous avons évalué les valeurs CK de 1641 chats présentés dans les années 2013/2014 à notre hôpital universitaire pour animaux. La CK était sensiblement élevée chez les chats souffrant de traumatismes et de diverses affections avec des lésions musculaires évidentes et traçables comme des dommages thrombo-emboliques ou des convulsions. De plus, la CK était élevée dans les maladies où des lésions musculaires concomitantes étaient décelables comme chez les chats atteints de cardiomyopathie hypertrophique. Cependant la CK était également couramment et parfois considérablement élevée chez les chats de pratiquement n'importe quel groupe de pathologies sans aucune lésion musculaire squelettique explicable. Ces résultats confirment l'hypothèse que la valeur diagnostique de ce paramètre est très discutable. Une élévation de la CK ne permet aucune conclusion concernant son objectif diagnostique d'origine, c'est-à-dire de confirmer la présence d'une myopathie cliniquement significative.

The bovine cumulus proteome is influenced by maturation condition and maturational competence of the oocyte.

In vitro maturation (IVM) of oocytes has still a negative impact on the developmental competence of oocytes. Therefore, this study analysed the cumulus proteome of individual cumulus-oocyte complexes (COCs) with and without maturational competence, matured under in vivo or in vitro conditions (n = 5 per group). A novel, ultrasensitive mass spectrometry (MS) based protein profiling approach, using label-free quantification, was applied. The detected cumulus proteome included 2226 quantifiable proteins and was highly influenced by the maturation condition (479 differentially expressed proteins) as well as maturational competence of the corresponding oocyte (424 differentially expressed proteins). Enrichment analysis showed an overrepresentation of the complement and coagulation cascades (CCC), ECM-receptor interaction and steroid biosynthesis in cumulus of COCs that matured successfully under in vivo conditions. Verification of the origin of CCC proteins was achieved through detection of C3 secretion into the maturation medium, with significantly increasing concentrations from 12 (48.4 ng/ml) to 24 hours (68 ng/ml: p < 0.001). In relation, concentrations in follicular fluid, reflecting the in vivo situation, were >100x higher. In summary, this study identified important pathways that are impaired in IVM cumulus, as well as potential markers of the maturational competence of oocytes.

Investigation of the Status Quo of Veterinary Point-of-Care Laboratories in Switzerland: Availability, Application, and Quality Management.

INTRODUCTION: The extent to which Swiss veterinary practitioners follow the guidelines for quality assurance of the American Society for Veterinary Clinical Pathology (ASVCP) for point-of-care (POC) testing is unknown. Thus, the aim of this study was to assess the availability, application, and quality management of POC analyzers in Swiss veterinary practices/clinics. For this purpose, we created an online questionnaire on laboratory equipment, quality management, and biosafety, which all members of the Society of Swiss Veterinarians (GST) were invited to complete. In total, 192 clinics/practices participated, of which 69% had automated POC analyzers, mainly for clinical chemistry (99%) and/or hematology (86%). Sample analyses and equipment maintenance were mostly performed by veterinary technicians (81% and 68%, respectively). Reference intervals were adopted from manufacturers (80%) or literature (17%). The results showed that most participants perform basic internal quality control (chemistry: 75%; hematology: 86%), and many use at least two levels of quality control material (47%-48%). Controls are mostly run once a month (chemistry: 36%; hematology: 35%) or ≤4 times/year (36% and 25%). Only three clinics/practices reported participation in an external quality assessment program; comparative testing was more common (chemistry: 42%; hematology: 52%). Only one-quarter of the participants stated that they make use of the data generated through internal and external quality control measures. In conclusion, POC analyzers are widely available in Swiss veterinary clinics/practices, and internal quality control is performed to some extent. However, quality assessment and management and biosafety awareness and measures need to be improved, ideally with the support of clinical pathologists.

INTRODUCTION: On ignore dans quelle mesure les vétérinaires suisses respectent les directives d'assurance qualité de l'American Society for Veterinary Clinical Pathology (ASVCP) pour les tests au point de service (Point of Care, POC). Ainsi, l'objectif de cette étude était d'évaluer la disponibilité, l'application et la gestion de la qualité des analyseurs POC dans les cabinets/cliniques vétérinaires suisses. À cette fin, nous avons créé un questionnaire en ligne sur les équipements de laboratoire, la gestion de la qualité et la biosécurité que tous les membres de la Société suisse des vétérinaires (GST) ont été invités à remplir. Au total, 192 cliniques/cabinets ont participé, dont 69% avaient des analyseurs POC automatisés, principalement pour la chimie clinique (99%) et/ou l'hématologie (86%). Les analyses des échantillons et la maintenance de l>équipement ont été principalement effectuées par des assistant(e)s en médecine vétérinaires (81% et 68%, respectivement). Les intervalles de référence ont été fixés sur la base des indications des fabricants (80%) ou de la littérature (17%). Les résultats ont montré que la plupart des participants effectuent un contrôle de qualité interne de base (chimie: 75%; hématologie: 86%) et que beaucoup utilisent au moins deux niveaux de matériel de contrôle de la qualité (47% ­48%). Les contrôles sont principalement effectués une fois par mois (chimie: 36%; hématologie: 35%) ou ≤4 fois / an (36% et 25%). Seules trois cliniques/cabinets ont déclaré avoir participé à un programme externe d'évaluation de la qualité. Les tests comparatifs étaient plus courants (chimie: 42%; hématologie: 52%). Un quart seulement des participants ont déclaré utiliser les données générées par des mesures de contrôle de qualité internes et externes. En conclusion, les analyseurs POC sont largement disponibles dans les cliniques/cabinets vétérinaires suisses et le contrôle qualité interne est effectué dans une certaine mesure. Cependant, l'évaluation et la gestion de la qualité ainsi que la sensibilisation et les mesures en matière de biosécurité doivent être améliorées, idéalement avec le soutien de pathologistes cliniciens.

Hair cortisol concentration in clinically healthy slaughter calves with and -without chronic bronchopneumonic -lesions.

INTRODUCTION: The hypothesis of this study was that healthy calves undergo less stress and thus have lower hair cortisol concentrations than calves with chronic bronchopneumonic lesions. Fifty healthy calves (group 1) and 50 calves with chronic bronchopneumonic lesions (group 2) were used immediately after slaughter, at which time hair samples and both adrenal glands were collected. The hair samples and the left adrenal gland were used for cortisol measurement and the right adrenal gland was used for histological and morphometrical examinations. The median hair cortisol concentrations of calves in groups 1 and 2 were 1.6 and 1.9 pg/mg hair, respectively, and did not differ significantly. The same was true for the mean cortisol concentration of the adrenal gland (1.1 and 1.4 µg/g tissue) and for the adrenal cortisol content (3.7 and 4.6 µg). The weights of the cortex (3.3, mean, and 3.5 g, median) and medulla (1.7 and 1.8 g, both median) did not differ significantly between the groups. This study did not detect differences in hair and adrenal cortisol concentrations between clinically healthy slaughter calves with and without chronic bronchopneumonic lesions. In further studies, calves with clinical signs should be taken into account.

INTRODUCTION: L'hypothèse de cette étude était que les veaux en bonne santé sont soumis à moins de stress et ont donc des concentrations de cortisol dans les poils plus faibles que les veaux présentant des lésions broncho-pneumoniques chroniques. Cinquante veaux sains (groupe 1) et 50 veaux présentant des lésions broncho-pneumoniques chroniques (groupe 2) ont été utilisés immédiatement après l'abattage, moment auquel des échantillons de poils et les deux glandes surrénales ont été prélevés. Les échantillons de poil et la glande surrénale gauche ont été utilisés pour la mesure du cortisol et la glande surrénale droite a été utilisée pour des examens histologiques et morphométriques. Les concentrations médianes de cortisol dans les poils des veaux des groupes 1 et 2 étaient respectivement de 1,6 et 1,9 pg/mg de poil et ne différaient pas significativement. Il en a été de même pour la concentration moyenne en cortisol de la glande surrénale (1,1 et 1,4 µg/g de tissu) et pour la teneur en cortisol surrénalien (3,7 et 4,6 µg). Les poids du cortex (3,3, moyenne et 3,5 g, médiane) et de la médulla (1,7 et 1,8 g, médiane) ne différaient pas significativement entre les groupes. Cette étude n'a pas mis en évidence de différences dans les concentrations de cortisol dans les poils et les surrénales entre les veaux abattus cliniquement en bonne santé avec ou sans lésions broncho-pneumoniques chroniques. Dans des études ultérieures, les veaux présentant des signes cliniques doivent être pris en compte.

[Acromegaly due to a pituitary tumor in a dog - diagnosis, therapy and long-term follow-up]. / Akromegalie aufgrund eines Hypophysentumors bei einem Hund ­ Diagnose, Therapie und Verlauf.

INTRODUCTION: Acromegaly due to a pituitary tumor has so far only been described in 3 dogs. The present case report describes a 7-year-old male-castrated Labrador Retriever which was referred because of difficult-to-control diabetes. Physical examination revealed markedly enlarged head, tongue and paws, widened interdental spaces and thickening of the skin in the head and neck area. IGF-1 and GH were increased and the latter continued to be abnormal after somatostatin application. Computed tomography demonstrated a space-occupying lesion in the pituitary gland and the diagnosis of acromegaly due to a GH-producing tumor of the pituitary was made. The dog underwent radiation therapy with a 6MV linear accelerator (3×8Gy) and improved substantially. Two and a half years after radiation therapy the dog developed lethargy and anorexia and was euthanized. Necropsy was not permitted. This case report represents the description of a dog suffering from pituitary-dependent acromegaly which was successfully treated and had a long-term survival.

INTRODUCTION: L'acromégalie due à une tumeur hypophysaire n'a jusqu'à présent été décrite que chez 3 chiens. Le présent rapport de cas décrit un Labrador Retriever de 7 ans mâle castré, qui a été référé en raison d'un diabète difficile à contrôler. L'examen physique a révélé une tête, une langue et des pattes de taille nettement augmentée, des espaces interdentaires élargis et un épaississement de la peau dans la région de la tête et du cou. L'IGF-1 et la GH étaient augmentées et la seconde restait anormale après l'application de somatostatine. La tomodensitométrie a mis en évidence une masse dans la région de l'hypophyse et le diagnostic d'acromégalie due à une tumeur de l'hypophyse productrice de GH a été posé. Le chien a subi une radiothérapie avec un accélérateur linéaire de 6MV (3×8Gy) et son état s'est considérablement amélioré. Deux ans et demi après la radiothérapie, le chien développa une léthargie et une anorexie et fut euthanasié. L'autopsie n'a pas été autorisée. Ce rapport de cas représente la description d'un chien souffrant d'acromégalie dépendant de l'hypophyse, traité avec succès et ayant une survie à long terme.

[Feline leukemia virus infection: importance and current situation in Switzerland]. / Die feline Leukämievirus-Infektion: Bedeutung und aktuelle Situation in der Schweiz.

INTRODUCTION: Feline leukemia virus (FeLV) leads to fatal disease in cats with progressive infection. The aim of this study was to determine the importance of FeLV infection in Switzerland and make a comparison with previous studies. Of 881 blood samples taken from cats living in Switzerland (minimum of 20 samples per Canton), 47 samples were provirus-positive (5.3%; 95% confidence interval (CI) 3.9-7.0%) and 18 samples were antigen-positive (2%; 95% CI 1.2-3.2%). Together with data previously collected in similar studies, these findings demonstrated a decrease in prevalence between 1997 and 2003 followed by a relative constant low prevalence thereafter. Young cats (=2 years) were more frequently infected than older cats, but FeLV-positive cats were up to 15 (antigen-positive) and 19 (provirus-positive) years old. Sexually intact cats were more frequently viremic than neutered cats; purebred cats were somewhat less frequently FeLV-positive than non-purebred cats. In a second study, in which 300 saliva samples were analyzed, samples from 5 cats were FeLV-RNA positive (1.7%; 95% CI, 0.5-3.8%), although one young feral cat had been falsely assumed to be FeLV-negative based on a point-of-care test. Of the 300 cats, only 50% were FeLV tested or vaccinated, although 90% of the cats were at risk of exposure to FeLV. Testing and vaccination of all cats with exposure risk may help further decrease the prevalence of FeLV infection. Moreover, characteristics of FeLV tests should be considered, such as the risk of false negative results in the early phase of infection when performing antigen testing.

INTRODUCTION: Le virus leucémogène félin (FeLV) conduit la plupart du temps à une maladie mortelle chez le chat avec une infection progressive. Le but du présent travail est de mettre en évidence l'importance de l'infection à FeLV en Suisse sur la base de recherches actuelles et de la comparer avec les résultats de recherches antérieures. Afin de répondre à la question de savoir combien de chats présentés à la consultation étaient porteurs du FeLV (positifs au provirus) respectivement excréteurs de FeLV (positifs à l'antigène), on a analysé 881 échantillons sanguins provenant de toute la Suisse (au minimum 20 par canton) : 47 échantillons étaient positifs au provirus (5.3%; 95% intervalle de confiance (CI) 3.9­7.0%) et 18 positifs à l'antigène (2%; 95% CI 1.2­3.2%). Une comparaison avec des recherches semblables faites antérieurement montre que la prévalence du FeLV a diminué entre 1997 et 2003 mais qu'elle stagne depuis lors. Actuellement ce sont plutôt les jeunes chats (=2 ans) qui sont touchés plutôt que les vieux; des chats ont toutefois été trouvés positifs jusqu'à l'âge de 15 ans (positifs à l'antigène) respectivement de 19 ans (positifs au provirus). Les chats non castrés étaient plus souvent virémiques que les castrés et les chats de races étaient aussi, mais un peu moins fréquemment FeLV-positifs. Dans une autre étude suisse, dans laquelle 300 échantillons de salive de chats ont été testés quant à la présence d'ARN-FeLV, 5 chats étaient excréteurs (1.7%; 95% CI 0.5­3.8%). Un jeune chat trouvé, qui avait été testé négatif au test rapide, a été trouvé infecté par le FeLV au moyen de la mise en évidence d'ARN. Sur ces 300 chats, seuls environ 50% avaient été testés quant au FeLV respectivement vaccinés, bien qu'environ 90% aient présenté un risque d'exposition au FeLV. Pour diminuer encore la prévalence du FeLV, il conviendrait de tester et de vacciner tous les chats avec un risque d'exposition au virus. Dans ce contexte, il faut tenir compte des différentes caractéristiques des tests comme la non reconnaissance de la phase d'infection très précoce au moyen du test FeLV rapide.

Investigation of coagulation and serum biochemistry profiles in dairy cattle with different degrees of fatty liver.

INTRODUCTION: Das Ziel der vorliegenden Arbeit war es, Blutgerinnungsprofile, biochemische und hämatologische Parameter bei Kühen mit unterschiedlichen Schweregraden der Leberverfettung zu untersuchen. Der Schweregrad der Leberverfettung wurde mittels histologischer Untersuchung von Leberbiopsien ermittelt. Fünfzig Kühe, die wegen linksseitiger Labmagenverlagerung überwiesen wurden und verschiedene Schweregrade einer Leberverfettung aufwiesen wurden untersucht. Ein Gerinnungsprofil einschliesslich Prothrombinzeit, Thrombinzeit, partieller Thromboplastinzeit und Fibrinogen konnte nicht zwischen Kühen mit oder ohne Leberverfettung unterscheiden. Die Aspartat Aminotransferase (ASAT) war der einzige Parameter, der bei Kühen mit Leberverfettung signifikant verändert war, jedoch nicht verschiedene Schweregrade der Leberverfettung unterscheiden konnte. Die Ergebnisse zeigen, dass Gerinnungsfaktoren durch eine Leberverfettung nicht beeinflusst werden. Die routinemässig gemessenen biochemischen Parameter sind nicht geeignet um den Schweregrad einer Leberverfettung bestimmen zu können.

INTRODUCTION: Le but du présent travail était d'étudier les profils de coagulation ainsi que les paramètres biochimiques et hématologiques chez des vaches souffrant de lipidose hépatique à divers stades. La gravité de l'affection a été déterminée par l'examen histologique de biopsies hépatiques. Cinquante vaches, référées pour un déplacement de la caillette à gauche et qui présentaient des signes de lipidose hépatique à divers stades ont été examinées. Le profil de coagulation, y compris les temps de prothrombine et de thrombine, le temps partiel de thromboplastine et le fibrinogène, n'a pas permis de faire de différence entre les vaches souffrant ou non de lipidose hépatique. L'aspartate aminotransférase (ASAT) était le seul paramètre significativement modifié chez les vaches atteintes de lipidose hépatique, sans toutefois qu'il permette de différencier les stades de l'affection. Ces résultats montrent que les facteurs de coagulation ne sont pas influencés par la lipidose. Les paramètres biochimiques de routine ne sont pas adaptés pour estimer la gravité d'une lipidose hépatique.

Detection of 'Candidatus Neoehrlichia mikurensis' and other Anaplasmataceae and Rickettsiaceae in Canidae in Switzerland and Mediterranean countries.

INTRODUCTION: 'Candidatus Neoehrlichia mikurensis' is an emerging tick-borne zoonotic agent that primarily affects immunocompromised human patients. Dogs and foxes are frequently exposed to ticks, and both species are in close proximity to humans. This is the first study to systematically investigate the occurrence of 'Candidatus Neoehrlichia mikurensis' in Canidae in Europa. We analyzed 1'739 blood samples from dogs in Switzerland, Italy, Spain and Portugal and 162 blood samples from free-ranging red foxes (Vulpes vulpes) in Switzerland. All samples were tested using a previously described multiplex real-time PCR for the Anaplasmataceae family, the 'Candidatus Neoehrlichia' genus and the 'Candidatus Neoehrlichia mikurensis' species. All Anaplasmataceae positive samples were subsequently tested using specific real-time PCRs for Anaplasma phagocytophilum, Anaplasma platys, Ehrlichia canis and Rickettsia helvetica. Among the tested animals, one dog from Zurich tested positive for 'Candidatus Neoehrlichia mikurensis'. The 12-year old West Highland white terrier had been splenectomized 3 months prior to the blood collection and presented with polyuria/polydipsia. Fanconi syndrome was diagnosed based on glucosuria with normoglycemia and hyperaminoaciduria. A. platys and E. canis were detected in 14/249 dogs from Sicily and Portugal; two of the dogs were coinfected with both agents. Four Swiss foxes tested positive for A. phagocytophilium. R. helvetica was detected for the first time in a red fox. In conclusion, 'Candidatus Neoehrlichia mikurensis' infection should be considered in sick dogs, particularly when immunocompromised. The pathogen seems not to be widespread in Canidae in the investigated countries. Conversely, other Anaplasmataceae were more readily detected in dogs and foxes.

INTRODUCTION: 'Candidatus Neoehrlichia mikurensis' est un agent de zoonose transmis par les tiques qui gagne en importance et concerne principalement les patients immunosupprimés. Les chiens comme les renards sont souvent concernés par des morsures de tiques et vivent en contact étroit avec les êtres humains. Dans le présent travail, nous étudions pour la première fois systématiquement la présence de 'Candidatus Neoehrlichia mikurensis' chez les canidés en Europe. Les échantillons sanguins analysés provenaient de 1'739 chiens de Suisse, d'Italie, d'Espagne et du Portugal ainsi que de 162 renards (Vulpes vulpes) de Suisse. Tous les échantillons ont été examinés avec un test de PCR multiplex en temps réel déjà publié quant à la présence d'agents de la famille des Anaplasmataceae, du genre 'Candidatus Neoehrlichia' et de l'espèce 'Candidatus Neoehrlichia mikurensis'. Les échantillons positifs aux Anaplasmataceae ont ensuite été testés avec un test PCR en temps réel spécifique quant à Anaplasma phagocytophilum, Anaplasma platys, Ehrlichia canis und Rickettsia helvetica. Parmi les échantillons examinés se trouvait celui d'un chien de Zürich qui était infecté par 'Candidatus Neoehrlichia mikurensis'. Ce West Highland White Terrier de 12 ans avait été présenté pour polyurie/polydipsie; il avait été splénectomisé trois mois avant la prise de l'échantillon. Au vu d'une glycosurie et d'une hyperaminoacidurie accompagnées d'une glycémie normale, on a posé le diagnostic de syndrome de Fanconi. A. platys et E. canis ont été mis en évidence chez 14/249 chiens provenant de Sicile et du Portugal; deux chiens étaient infectés par les deux agents pathogènes. Quatre renards suisses étaient positifs à A. phagocytophilium et R. helvetica a été trouvé pour la première fois chez un renard. En résumé, on peut dire qu'une infection à 'Candidatus Neoehrlichia mikurensis' chez un chien malade doit être prise en considération comme diagnostic différentiel, particulièrement chez les anomaux immunosupprimés. Toutefois cet agent n'est pas très répandu chez les canidés des pays examinés, contrairement aux autres Anaplasmataceae spp. qui ont été trouvées plus souvent chez les chiens et les renards.

Prognostic Markers in Acute Babesia canis Infections.

BACKGROUND: Canine babesiosis, caused by Babesia canis, is a prevalent and clinically relevant disease in Europe. Severe acute babesiosis is characterized by a high mortality but prognosis is not always correlated with clinical signs nor with the level of parasitemia. OBJECTIVE: This study evaluated prognostic markers associated with poor outcomes in acute Babesia canis infections. ANIMALS AND METHODS: We compared the results of routine laboratory profiles, hand-held lactate and glucose analyzer, and the acute phase response in 2 groups of naturally infected dogs (7 survivors and 8 nonsurvivors). Samples were collected at the time of first admission and before any treatment. Subsequently, the course of prognostic markers was followed in 3 dogs experimentally inoculated with B. canis. RESULTS: Nonsurvivors showed significantly higher concentrations of lactate, triglycerides and phosphate and lower hematocrit, leukocyte counts, total serum protein concentrations, and thrombocyte counts when compared to survivors. All nonsurvivors (8/8) had hyperlactatemia, whereas most survivors (6/7) had values within the reference range. All survivors had leucocyte counts within the reference range, unlike the nonsurvivors, which showed leukopenia. During the course of acute babesiosis, the variables serum lactate, triglyceride, and phosphate concentrations, and thrombocyte count only exceeded a prognostic threshold during acute crisis. CONCLUSIONS AND CLINICAL IMPORTANCE: Poor outcome in acute B. canis infection is indicated by changes in the laboratory profile. Intensive care should be considered for dogs presenting with moderate anemia, severe thrombocytopenia, mild to moderate leukopenia, hyperlactatemia, moderately increased serum phosphate, and triglyceride concentrations, and moderately decreased total serum protein concentrations.

Cortisol Response in Healthy and Diseased Dogs after Stimulation with a Depot Formulation of Synthetic ACTH.

BACKGROUND: The ACTH stimulation test is used to evaluate the adrenocortical reserve. Recently, the availability of the synthetic ACTH formulation was limited, causing major problems in clinical practice. OBJECTIVES: The objective of this study was to evaluate poststimulation peak cortisol concentrations and the duration of the stimulatory effect of a depot ACTH preparation in dogs. ANIMALS: Twenty-two healthy dogs, 10 dogs with suspected hypoadrenocorticism (HA) and 15 dogs with suspected hyperadrenocorticism (HC). METHODS: Prospective study. An ACTH stimulation test using a synthetic depot tetracosactide, administered intramuscularly (5 µg/kg or at least 0.1 mL) was performed. Blood samples for determination of cortisol were taken immediately before and 1, 2, 3, 4, 6, and 24 hours after stimulation. RESULTS: Peak cortisol concentrations were reached after 2-4 hours in all dogs. Cortisol concentrations 1 hour after stimulation were >9 µg/dL in all healthy dogs and >5 µg/dL in all dogs in which HA was excluded. None of the dogs with HA showed a cortisol-increase above the detection-limit of the assay. After 6 hours, cortisol concentrations had decreased in the healthy and HC group and were back to baseline after 24 hours. CONCLUSIONS AND CLINICAL IMPORTANCE: The depot formulation can be used in place of the short-acting ACTH to evaluate the adrenocortical reserve. Blood for peak cortisol concentrations should be drawn 3 hours after stimulation in cases in which HC is suspected; in HA-suspected cases, blood sampling can take place after 1 hour. As the stimulatory effect is gone after 24 hours, interference with other hormonal tests is unlikely after that time.

Evaluation of the Cortisol-to-ACTH Ratio in Dogs with Hypoadrenocorticism, Dogs with Diseases Mimicking Hypoadrenocorticism and in Healthy Dogs.

BACKGROUND: The adrenocorticotropic hormone (ACTH) stimulation test is the gold standard for diagnosing hypoadrenocorticism (HA) in dogs. However, problems with the availability of synthetic ACTH (tetracosactrin/cosyntropin) and increased costs have prompted the need for alternative methods. OBJECTIVES: To prospectively evaluate the cortisol-to-ACTH ratio (CAR) as a screening test for diagnosing canine HA. ANIMALS: Twenty three dogs with newly diagnosed HA; 79 dogs with diseases mimicking HA; 30 healthy dogs. METHODS: Plasma ACTH and baseline cortisol concentrations were measured before i.v. administration of 5 µg/kg ACTH in all dogs. CAR was calculated and the diagnostic performance of ACTH, baseline cortisol, CAR and sodium-to-potassium ratios (SPRs) was assessed based on receiver operating characteristics (ROC) curves calculating the area under the ROC curve. RESULTS: The CAR was significantly lower in dogs with HA compared to that in healthy dogs and in those with diseases mimicking HA (P < .0001). There was an overlap between HA dogs and those with HA mimicking diseases, but CAR still was the best parameter for diagnosing HA (ROC AUC 0.998), followed by the ACTH concentration (ROC AUC 0.97), baseline cortisol concentration (ROC AUC 0.96), and SPR (ROC AUC 0.86). With a CAR of >0.01 the diagnostic sensitivity and specificity were 100% and 99%, respectively. CONCLUSION AND CLINICAL IMPORTANCE: Calculation of the CAR is a useful screening test for diagnosing primary HA. As a consequence of the observed overlap between the groups, however, misdiagnosis cannot be completely excluded. Moreover, additional studies are needed to evaluate the diagnostic reliability of CAR in more dogs with secondary HA.

Urinary and plasma catecholamines and metanephrines in dogs with pheochromocytoma, hypercortisolism, nonadrenal disease and in healthy dogs.

BACKGROUND: Diagnosis of pheochromocytoma (PC) is based on a combination of clinical suspicion, finding an adrenal mass, increased plasma, and urine concentrations of catecholamine metabolites and is finally confirmed with histopathology. In human medicine, it is controversial whether biochemically testing plasma is superior to testing urine. OBJECTIVES: To measure urinary and plasma catecholamines and metanephrines in healthy dogs, dogs with PC, hypercortisolism (HC), and nonadrenal diseases (NAD) and to determine the test with the best diagnostic performance for dogs with PC. ANIMALS: Seven PC dogs, 10 dogs with HC, 14 dogs with NAD, 10 healthy dogs. METHODS: Prospective diagnostic clinical study. Urine and heparin plasma samples were collected and stored at -80°C before analysis using high-pressure liquid chromatography (HPLC) coupled to electrochemical detection or tandem mass spectrometry were performed. Urinary variables were expressed as ratios to urinary creatinine concentration. RESULTS: Dogs with PC had significantly higher urinary normetanephrine and metanephrine:creatinine ratios and significantly higher plasma-total and free normetanephrine and plasma-free metanephrine concentrations compared to the 3 other groups. There were no overlapping results of urinary normetanephrine concentrations between PC and all other groups, and only one PC dog with a plasma normetanephrine concentration in the range of the dogs with HC and NAD disease. Performances of total and free plasma variables were similar. Overlap of epinephrine and norepinephrine results between the groups was large with both urine and plasma. CONCLUSION AND CLINICAL IMPORTANCE: Measurement of normetanephrine is the preferred biochemical test for PC and urine was superior to plasma.

Use of plasma renin activity to monitor mineralocorticoid treatment in dogs with primary hypoadrenocorticism: desoxycorticosterone versus fludrocortisone.

BACKGROUND: Measurement of plasma renin activity (PRA) is the gold standard for monitoring mineralocorticoid treatment in humans with primary hypoadrenocorticism (PH). OBJECTIVES: To compare PRA in dogs with newly diagnosed PH, dogs with diseases mimicking PH, and healthy dogs, and evaluate measurement of PRA to monitor therapeutic effects in dogs with PH treated with different mineralocorticoids. ANIMALS: Eleven dogs with newly diagnosed PH (group 1), 10 dogs with diseases mimicking PH (group 2), 21 healthy dogs (group 3), 17 dogs with treated PH (group 4). METHODS: In group 1, PRA was measured before treatment and at different times after initiating treatment. In groups 2 and 3, PRA was measured at initial presentation only. In group 4, no baseline PRA was obtained but PRA was measured once or every 1-6 months during treatment. Mineralocorticoid treatment consisted of fludrocortisone acetate (FC) or desoxycorticosterone pivalate (DOCP). RESULTS: Plasma renin activity before treatment was increased in dogs with PH compared to normal dogs and dogs with diseases mimicking PH with median activity of 27, 0.8, and 1.0 ng/mL/h, respectively. In dogs with PH, PRA decreased and normalized with mineralocorticoid treatment using DOCP but not with FC. In dogs treated with DOCP, PRA was lower than in dogs treated with FC. Plasma sodium concentrations were higher and potassium concentrations were lower with DOCP treatment compared to FC treatment. CONCLUSION AND CLINICAL IMPORTANCE: Plasma renin activity is a reliable tool for monitoring mineralocorticoid treatment. DOCP treatment more effectively suppresses PRA compared to FC in dogs with PH.

Urinary corticoid concentrations measured by 5 different immunoassays and gas chromatography-mass spectrometry in healthy dogs and dogs with hypercortisolism at home and in the hospital.

BACKGROUND: Determination of the urinary corticoid-to-creatinine ratio (UCCR) is an important screening test in the diagnosis of hypercortisolism (HC). However, urinary cortisol metabolites interfere with cortisol measurement in immunoassays, leading to decreased specificity. Gas chromatography-mass spectrometry (GC-MS) is considered the gold standard for steroid hormone analysis, because it provides a high level of selectivity and accuracy. OBJECTIVES: To prospectively compare the UCCR of healthy dogs and dogs with HC determined by 5 different immunoassays and by GC-MS and to evaluate the influence of veterinary care on UCCR. ANIMALS: Twenty healthy dogs; 18 dogs with HC. METHODS: Urine was collected in the hospital and again after 6 days at home. Three chemiluminescence immunoassays (Access 2, Beckmann; Immulite 2000, DPC Siemens, with and without trichloromethane extraction) and 2 RIAs (Utrecht in house; Access Beckmann) were used. GC-MS analyses were performed with Agilent 6890N/5973N. Urinary corticoid concentrations were related to urinary creatinine concentrations. RESULTS: Immunoassay results were significantly higher compared to GC-MS results. Evaluation of bias plots and clinical assessment made on the basis of the assay results of each dog indicated substantial disagreement among the assays. Sensitivity varied from 37.5 to 75% and with selected assays was lower in samples from day 6 compared to day 0. GC-MS was not superior to the immunoassays in discriminating healthy from HC dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: Considerable variation must be anticipated comparing different urinary cortisol assays. Establishing an assay- and laboratory-specific reference range is critical when using UCCR.

Agreement of serum Spec cPL with the 1,2-o-dilauryl-rac-glycero glutaric acid-(6'-methylresorufin) ester (DGGR) lipase assay and with pancreatic ultrasonography in dogs with suspected pancreatitis.

BACKGROUND: Spec cPL is the most sensitive and specific test for diagnosing pancreatitis in dogs. Its results have not been compared to those of the 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) lipase assay or those of abdominal ultrasonography. OBJECTIVES: To investigate agreement of Spec cPL with DGGR lipase activity and pancreatic ultrasonography in dogs with suspected pancreatitis. ANIMALS: One hundred and forty-two dogs. METHODS: DGGR lipase activity (reference range, 24-108 U/L) and Spec cPL were measured using the same sample. The time interval between ultrasonography and lipase determinations was <24 hours. The agreement of the 2 lipase assays at different cutoffs and the agreement between pancreatic ultrasonography and the 2 tests were assessed using Cohen's kappa coefficient (κ). RESULTS: DGGR lipase (>108, >216 U/L) and Spec cPL (>200 µg/L) had κ values of 0.79 (95% confidence interval [CI], 0.69-0.9) and 0.70 (CI, 0.58-0.82). DGGR lipase (>108, >216 U/L) and Spec cPL (>400 µg/L) had κ values of 0.55 (CI, 0.43-0.67) and κ of 0.80 (CI, 0.71-0.9). An ultrasonographic diagnosis of pancreatitis and DGGR lipase (>108, >216 U/L) had κ values of 0.29 (CI, 0.14-0.44) and 0.35 (CI, 0.18-0.52). Ultrasonographically diagnosed pancreatitis and Spec cPL (>200, >400 µg/L) had κ values of 0.25 (CI, 0.08-0.41) and 0.27 (CI, 0.09-0.45). CONCLUSIONS AND CLINICAL IMPORTANCE: Although both lipase assays showed high agreement, agreement between ultrasonography and lipase assays results was only fair. Because lipase results are deemed more accurate, ultrasonography results should be interpreted carefully.

Clinical, laboratory and pathological findings in cats experimentally infected with Aelurostrongylus abstrusus.

Aelurostrongylus abstrusus parasitizes the respiratory tract and can heavily affect the breathing and general condition of cats. Experimental infections of six cats were initiated by intragastric administration with 100 or 800 third-stage larvae (L3) obtained from the terrestrial snail Helix aspersa. First-stage larvae were isolated from faecal samples after 35-41 days post infection (dpi) in five animals and until end of study (84 dpi) in two cats. Cough and respiratory sounds were observed starting from 28 to 41 dpi and dyspnoea and panting starting from 52 dpi. All cats had enlarged lymph nodes and, starting from 56 dpi, reduced body weight, and four cats showed intermittent reduced general condition with apathia and anorexia. Eosinophilia and leucocytosis partially with massive lymphocytosis, and occasional basophilia and monocytosis were observed. Mild anaemia was present in five cats, while alterations in coagulation parameters suggested stimulation of the coagulation cascade with increased consumption of coagulation factors (delayed PT, hypofibrinogenemia). Adult A. abstrusus specimens were isolated from the five patent cats at necropsy and all six cats showed pathological changes in the lungs, including disseminated inflammatory cell infiltrates, often associated with incorporated larvae and eggs. There was some degree of overlap between the severity and the inoculation doses. Infections starting from 100 L3 of A. abstrusus had an impact on the lung tissues and on the health of the cats, despite the presence of only mild haematological abnormalities. Due to the worldwide occurrence of feline lung worms, parasitic infections should be considered in the differential diagnosis of lung diseases regardless of the presence of clinical signs and larval excretion.

Total protein measurement in canine cerebrospinal fluid: agreement between a turbidimetric assay and 2 dye-binding methods and determination of reference intervals using an indirect a posteriori method.

BACKGROUND: In veterinary clinical laboratories, qualitative tests for total protein measurement in canine cerebrospinal fluid (CSF) have been replaced by quantitative methods, which can be divided into dye-binding assays and turbidimetric methods. There is a lack of validation data and reference intervals (RIs) for these assays. OBJECTIVES: The aim of the present study was to assess agreement between the turbidimetric benzethonium chloride method and 2 dye-binding methods (Pyrogallol Red-Molybdate method [PRM], Coomassie Brilliant Blue [CBB] technique) for measurement of total protein concentration in canine CSF. Furthermore, RIs were determined for all 3 methods using an indirect a posteriori method. METHODS: For assay comparison, a total of 118 canine CSF specimens were analyzed. For RIs calculation, clinical records of 401 canine patients with normal CSF analysis were studied and classified according to their final diagnosis in pathologic and nonpathologic values. RESULTS: The turbidimetric assay showed excellent agreement with the PRM assay (mean bias 0.003 g/L [-0.26-0.27]). The CBB method generally showed higher total protein values than the turbidimetric assay and the PRM assay (mean bias -0.14 g/L for turbidimetric and PRM assay). From 90 of 401 canine patients, nonparametric reference intervals (2.5%, 97.5% quantile) were calculated (turbidimetric assay and PRM method: 0.08-0.35 g/L (90% CI: 0.07-0.08/0.33-0.39); CBB method: 0.17-0.55 g/L (90% CI: 0.16-0.18/0.52-0.61). Total protein concentration in canine CSF specimens remained stable for up to 6 months of storage at -80°C. CONCLUSIONS: Due to variations among methods, RIs for total protein concentration in canine CSF have to be calculated for each method. The a posteriori method of RIs calculation described here should encourage other veterinary laboratories to establish RIs that are laboratory-specific.

Agreement of the serum Spec fPL™ and 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester lipase assay for the determination of serum lipase in cats with suspicion of pancreatitis.

BACKGROUND: Serum lipase activities measured by catalytic assays are claimed to be of limited utility for diagnosing pancreatitis in cats. The Spec fPL assay currently is believed the most sensitive test; however, studies comparing different lipase assays are lacking. 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6'-methylresorufin) ester (DGGR) assay for the determination of lipase activity has been evaluated in dogs, but no information is available in cats. OBJECTIVES: To investigate the agreement of DGGR-lipase activity and Spec fPL concentration in cats with clinical signs consistent with pancreatitis. ANIMALS: Two hundred fifty-one client-owned cats. METHODS: DGGR-lipase activity and Spec fPL concentration measured from the same blood sample in cats undergoing investigation for pancreatitis. The agreement between DGGR-lipase and Spec fPL at different cutoffs was assessed using Cohen's kappa coefficient (κ). Sensitivity and specificity were calculated for 31 cases where pancreatic histopathology was available. RESULTS: DGGR-lipase (cutoff, 26 U/L) and Spec fPL (cutoff, >5.3 µg/L) had a κ of 0.68 (standard error [SE] 0.046). DGGR-lipase (cutoff, 26 U/L) and Spec fPL (cutoff, >3.5 µg/L) had a κ of 0.60 (SE, 0.05). The maximum κ at a Spec fPL cutoff >5.3 µg/L was found when the DGGR-lipase cutoff was set >34 U/L and calculated as 0.755 (SE, 0.042). Sensitivity and specificity were 48% and 63% for DGGR-lipase (cut-off, 26 U/L) and 57% and 63% for Spec fPL (>5.3 µg/L), respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Both lipase assays agreed substantially. DGGR assay seems a useful and cost-efficient method compared to the Spec fPL test.