Effect of sodium-glucose cotransporter 2 inhibitor canagliflozin on interstitial glucose concentration in insulin-treated diabetic dogs.

BACKGROUND: The utility of sodium-glucose cotransporter 2 inhibitors (SGLT2i) has not been reported in insulin-treated diabetic dogs. HYPOTHESIS: Canagliflozin, a PO-administered SGLT2i, decreases interstitial glucose concentration (IG) in insulin-treated diabetic dogs. ANIMALS: Five insulin-treated diabetic dogs. METHODS: Uncontrolled open label longitudinal study. Canagliflozin (2-4 mg/kg/day PO) was added to an unchanged insulin dose for 7 days. Fractional excretion of glucose was calculated by dividing the product of urine glucose and serum creatinine concentrations by the product of serum glucose and urine creatinine concentrations. Hypoglycemia was defined as IG <60 mg/dL. RESULTS: Median IG in 2869 measurements obtained while dogs were treated with insulin and canagliflozin was 87 mg/dL (range, 40-500 mg/dL) and was significantly lower than median IG in 1426 measurements obtained while dogs were treated with insulin alone (212 mg/dL; range, 41-500 mg/dL; P < .001). Median fractional excretion of glucose when dogs were treated with insulin and canagliflozin was 1.1% (range, 0.9%-2.0%), significantly higher than when dogs were treated with insulin alone (0.3%; range, 0.01%-1.0%; P = .04). The frequency of hypoglycemia was higher in dogs treated with insulin and canagliflozin (544 of 2869 IG measurements, 19%) compared with the frequency of hypoglycemia in dogs treated with insulin alone (52 of 1426 IG measurements, 4%; P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: Canagliflozin may have a role in improving glycemic control in insulin-treated diabetic dogs, but the dose of insulin should be decreased when adding canagliflozin to insulin treatment.

Abnormalities detected on digital rectal examinations in dogs are common and influence diagnostic and treatment plans.

OBJECTIVE: To determine the frequency of abnormal findings on digital rectal examination (DRE) performed during physical examinations at a tertiary referral veterinary hospital, to establish what abnormal findings are most common and whether they impact diagnostic and treatment plans, and to assess whether patient signalment or admitting service influences the frequency of abnormalities. ANIMALS: Client-owned dogs (n = 440). METHODS: Veterinarians performed DREs on dogs as part of a physical examination. Patient signalment and DRE findings were recorded in a standardized survey. Findings were deemed normal or abnormal and described. Whether the findings changed the diagnostic or treatment plan was also recorded. RESULTS: Abnormalities were detected on DRE in 160 of 440 (36%) dogs. Changes to the diagnostic plan occurred in 41 of 160 (26%) cases when an abnormality was found. Changes to the treatment plan occurred in 20 of 160 (12.5%) cases when an abnormality was found. Age (P = .2), sex (P = .9), and breed (P = 1) did not significantly influence the frequency of abnormal findings. Abnormal findings were significantly more common in dogs presenting to the emergency service than elective services (P = .005). CLINICAL RELEVANCE: Among dogs presenting to a tertiary veterinary hospital, abnormalities found on DRE are common and change the diagnostic plan in 1 out of 4 dogs and treatment plan in 1 out of 8 dogs. This study supports the continued practice of DREs in dogs, especially in emergency settings, regardless of signalment.

Clinical Differences in Dogs with Enterococcal Bacteriuria Compared with Other Bacteriuria: A Retrospective, Case-Control Study.

A retrospective case-control study was performed to determine the clinical differences between dogs with enterococcal bacteriuria (n = 96 cases) and control dogs with any other bacteriuria (n = 288). More dogs with nonenterococcal bacteriuria demonstrated lower urinary tract clinical signs such as hematuria, pollakiuria, and stranguria (40% versus 27%, P = .02). Recessed vulva (odds ratio [OR] 2.5, 95% confidence interval [CI] 1.4-4.2, P < .001), hyperadrenocorticism (OR 0.149, 95% CI 0.004-0.066, P = .03), chronic kidney disease (OR 2.29, 95% CI 1.14-4.51, P = .01), and myelopathy (OR 5.77, 95% CI 3.07-10.82, P < .001) were more common in dogs with enterococcal bacteriuria. Enterococcus spp. cases were more likely to have polymicrobial growth than controls (OR 28.52; 95% CI 12.63-69.62, P ≤ .001). Pugs (OR 7.4, 95% CI 2.6-19.9, P < .001), bearded collies (OR 24.3, 95% CI 2.9-205.5, P = .003), and Saint Bernards (OR 17.3, CI 1.9-154.4, P = .01) had increased odds of enterococcal growth compared with mixed-breed dogs. In the control (but not the case) population, there was an association between resolution of clinical signs and administration of antimicrobials (P = .01). The signalment, clinical signs, comorbidities, and response to therapy in dogs with enterococcal bacteriuria are different from dogs with other bacteriuria.

Development of a requirement for exogenous insulin treatment in dogs with hyperglycemia.

BACKGROUND: It has been suggested that overt diabetes mellitus in dogs be defined based on a persistent fasting blood glucose concentration (BGC) >144 mg/dL. OBJECTIVE: Determine the number of dogs with randomly identified hyperglycemia without insulin-treated diabetes mellitus (ITDM) that later develop a need for exogenous insulin treatment. ANIMALS: A total of 1318 dogs examined at a university teaching hospital without ITDM and with randomly identified hyperglycemia. METHODS: Retrospective longitudinal study. Hyperglycemia was defined as randomly identified BGC above >112 mg/dL, moderate hyperglycemia as BGC >144 mg/dL but <200 mg/dL and pronounced hyperglycemia as BGC ≥200 mg/dL. Dogs were defined as having ITDM if they were treated with insulin. Follow-up was attempted 7 to 12 years after hyperglycemia was documented to determine if over time dogs developed a need for exogenous insulin treatment. RESULTS: Twenty-nine of 824 dogs (3.5%) with hyperglycemia and follow-up information developed ITDM, including 3/824 dogs (0.4%) with moderate hyperglycemia, and 2/824 dogs (0.2%) with pronounced hyperglycemia. Most dogs with hyperglycemia that developed ITDM (24/29, 83%) had BGC ≤144 mg/dL. Among dogs that eventually developed a need for exogenous insulin treatment, no association was found between the degree of hyperglycemia and the time interval between documentation of hyperglycemia and diagnosis of ITDM. Logistic regression determined that BGC is not significantly associated with ITDM. CONCLUSIONS AND CLINICAL IMPORTANCE: Most dogs with randomly identified hyperglycemia did not develop a need for exogenous insulin treatment. Other criteria could be required to augment the definition of overt DM in non-insulin treated dogs.

Evaluation of post-transfusion RBC alloimmunization in dogs using a gel-column crossmatch with and without anti-canine globulin enhancement.

A blood crossmatch is essential to ensure RBC compatibility for previously transfused dogs. There is no gold standard crossmatch method for dogs, although the standards used most commonly by academic institutions and reference laboratories are the tube and gel-column crossmatches. Addition of anti-canine globulin (ACG) has been suggested to increase detection of RBC incompatibilities. Our objective was to determine if there is a correlation between results of a standard and an ACG-enhanced gel-column crossmatch in detecting post-transfusion RBC alloimmunization. Pre- and post-transfusion serum or plasma samples were obtained from 33 dogs for major crossmatches to 1-6 (median: 3) blood donors. Crossmatches were performed with (n = 202) and without (n = 202) ACG, with results scored by 4 observers, 3 of whom were anonymized. Ten of 33 (30%) dogs had major crossmatch incompatibilities post-transfusion. RBC incompatibilities (2-4+ agglutination) were detected only with ACG in 4 dogs, only without ACG in 3 dogs, and with both methods in 3 dogs. There was fair correlation between crossmatch methods for determination of compatibility (ρ = 0.34; p < 0.001) and incompatibility (ρ = 0.35; p < 0.001) scores. Among 4 observers, there was near-perfect agreement in determining compatibility (κ = 0.97; p < 0.001) and substantial agreement in overall scoring of incompatibility (κ = 0.77; p < 0.001). Our results suggest that detection of RBC incompatibilities in dogs can be maximized by performing a gel-column crossmatch both with and without ACG enhancement.

Difficult catheterization and previous urethral obstruction are associated with lower urinary tract tears in cats with urethral obstruction.

OBJECTIVE: To retrospectively assess the hospital prevalence and risk factors associated with iatrogenic lower urinary tear in cats with urethral obstruction (UO). ANIMALS: 15 client-owned cats diagnosed with concurrent UO and lower urinary tears and year-matched control population of 45 cats diagnosed with UO. METHODS: University teaching hospital records were reviewed for cats presenting with UO between January 2010 and December 2022. Signalment, anatomic location of tear, experience of the individual passing the urinary catheter, difficulty level of catheter passage, history of previous UO, blood work parameters on presentation, presence of visible grit in urine, and survival to discharge were recorded. In addition, prevalence of lower urinary tears in cats presenting with UO was calculated. RESULTS: The prevalence of lower urinary tears was 0.92% in UO cats. Cats with lower urinary tears were significantly less likely to survive to discharge and had a longer period of hospitalization than cats without tears. In addition, cats with tears were more likely to have a history of previous UO and had more difficult urinary catheter passage than cats in the control group. Cats with tears also had a higher Hct than the control UO cats. CLINICAL RELEVANCE: Cats that develop lower urinary tears are more likely to have a history of previous UO and difficult catheter passage. This group of cats is also more likely to have a longer hospitalization period and lower survival to discharge rates.

Establishment of a reference interval for thiamine concentrations in healthy dogs and evaluation of the prevalence of absolute thiamine deficiency in critically ill dogs with and without sepsis using high-performance liquid chromatography.

OBJECTIVE: To determine the normal reference interval (RI) for thiamine concentrations in healthy dogs and investigate the prevalence of thiamine deficiency in critically ill dogs with and without sepsis. DESIGN: Prospective, observational, multicenter study, conducted between 2019 and 2021. SETTING: Two veterinary university teaching hospitals. ANIMALS: A total of 109 dogs were enrolled into 3 groups: 40 healthy dogs, 33 dogs with suspected or confirmed sepsis and evidence of tissue hypoperfusion (Doppler blood pressure ≤90 mm Hg or plasma lactate ≥3 mmol/L), and 36 dogs with other critical illnesses and evidence of tissue hypoperfusion. INTERVENTIONS: For each dog, CBC, serum biochemistry, plasma lactate concentration, whole-blood thiamine concentration, blood pressure, vital parameters, Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast score, and clinical outcomes were recorded, alongside basic patient parameters and dietary history. Whole-blood thiamine pyrophosphate (TPP) concentrations were measured using high-performance liquid chromatography. MEASUREMENTS AND MAIN RESULTS: The RI for whole-blood TPP in healthy dogs was 70.9-135.3 µg/L. Median TPP concentrations were significantly lower in septic dogs compared to healthy controls (P = 0.036). No significant difference in median TPP concentrations was found between septic dogs and nonseptic critically ill dogs, or between healthy dogs and nonseptic critically ill dogs. TPP concentrations were below the normal RI in 27.3% of septic dogs, compared to 19.4% of nonseptic critically ill dogs (P = 0.57). No correlations were found between TPP concentrations and lactate concentrations, age, body condition scores, time since last meal, RBC count, serum alanine aminotransferase, APPLEfast scores, or patient outcomes. CONCLUSIONS: TPP concentrations were significantly lower in septic dogs compared to healthy controls, with an absolute thiamine deficiency found in 27.3% of septic dogs. The established TPP RI allows for further investigation of thiamine deficiency in critically ill dogs.

Hepatic abscessation in dogs: A multicenter study of 56 cases (2010-2019).

OBJECTIVE: To investigate the clinical findings, treatment strategies, and outcomes in dogs with confirmed hepatic abscessation. DESIGN: Retrospective cohort study from 2010 to 2019. SETTING: Multicenter study. ANIMALS: Fifty-six client-owned dogs with hepatic abscessation confirmed by culture, cytology, or histopathology. MEASUREMENTS AND MAIN RESULTS: Dogs were presented for lethargy (39/56), hyporexia (31/56), and vomiting (26/56). Abnormal physical examination findings included increased temperature (41/56) and abdominal pain (22/54). CBCs revealed neutrophilia (31/49), toxic changes (25/49), anemia (28/49), and thrombocytopenia (23/49). Biochemical analyses revealed increased alkaline phosphatase (45/50), increased alanine aminotransferase (40/50), hypoalbuminemia (25/48), and hyperbilirubinemia (19/49). Hypoglycemia was found in 13 of 49 dogs. Hepatic abscesses ranging from 0.5 to 15 cm in diameter were identified ultrasonographically in 37 of 48 dogs; 19 of 37 had solitary abscesses, and 18 of 37 had multifocal abscessation. Escherichia coli was the most commonly cultured organism, isolated in 18 of 42 cases. Histopathology revealed underlying hepatic neoplasia in 10 of 47 dogs. Surgical management was performed in 41 of 49 dogs, and 35 of 41 survived to discharge. Medical management was performed in 8 of 49 dogs, and 5 of 8 survived to discharge. With univariate analysis, hypoglycemia and multifocal abscessation were associated with decreased odds of survival (odds ratio [OR]: 0.2, 95% confidence interval [CI]: 0.03-0.9, P = 0.04; OR: 0.07, 95% CI: 0.01-0.6, P = 0.02, respectively). With multivariate analysis, only multifocal abscessation was associated with decreased odds of survival (OR: 0.09, 95% CI: 0.01-0.87, P = 0.04). CONCLUSIONS: Hepatic abscessation, although rare, should remain a differential diagnosis for dogs presenting with nonspecific clinical signs and increase liver enzyme activities, especially with concurrent increased temperature and neutrophilia. Rate of survival to discharge for dogs in this study was consistent with previously reported survival rates, with 40 of 56 (71%) of the total population surviving to discharge. No variables assessed were able to predict survival to discharge; however, hypoglycemia and multifocal abscessation should be assessed in larger populations to determine prognostic significance.

Neutrophil-to-lymphocyte ratio is increased in dogs with acute congestive heart failure secondary to myxomatous mitral valve disease compared to both dogs with heart murmurs and healthy controls.

OBJECTIVE: To retrospectively evaluate neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as a biomarker for severity and short-term outcomes of congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD) in dogs. ANIMALS: 47 dogs with CHF secondary to MMVD, 47 dogs with presumptive preclinical MMVD, and 47 control dogs. METHODS: Medical record data (signalment, physical examination findings, medical treatments instituted, American College of Veterinary Internal Medicine MMVD stage, length of hospitalization, outcome, and hospital re-presentation due to CHF) from March 2012 through March 2022 for each dog were collected. Statistical analyses were performed with Mann-Whitney, Spearman correlation, and Fisher exact tests. RESULTS: NLR (but not PLR) was significantly higher in dogs with CHF secondary to MMVD (6.41) compared to presumptive preclinical MMVD dogs (4.66; P < .001) and control dogs (3.95; P < .001). Dogs with higher NLR and PLR received significantly higher cumulative dosages of loop-diuretic therapy during hospitalization (ρ = 0.3, P = .04; and ρ = 0.4, P = .02, respectively). There was a positive association between NLR and duration of oxygen supplementation within the CHF group (ρ = 0.4; P = .01). CLINICAL RELEVANCE: The increased diuretic dose and time receiving oxygen supplementation may represent increased disease severity for which NLR (and to a lesser extent PLR) may serve as a readily available marker. The data presented provide information regarding some of the systemic inflammatory changes seen in CHF secondary to MMVD in dogs. Future research should include prospective, longitudinal studies to provide insight into the long-term prognostic value of NLR and PLR in dogs with CHF.

Concurrent disorders of cats with diabetes mellitus and arterial systolic hypertension.

OBJECTIVES: The aim of the present study was to report the concurrent disorders and treatment success of cats with diabetes mellitus (DM) and arterial systolic hypertension (SH). METHODS: A retrospective longitudinal study was conducted of 17 cats with DM and SH that were examined at a university teaching hospital between 1 January 2011 and 31 December 2021. The medical records of diabetic cats were searched for the keywords 'hypertension', 'blood pressure', 'amlodipine', 'benazepril' and 'telmisartan' to identify cats with SH, which was defined as systemic arterial blood pressure (SABP) ⩾160 mmHg, documented at least twice, over several days. Comorbidities, including chronic kidney disease and hyperthyroidism, were recorded. Medications used for the treatment of SH and the SABP response to treatment were also noted. RESULTS: Most cats (13/17, 76%) with DM and SH had at least one other documented concurrent illness that could contribute to SH, including chronic kidney disease (12/17 cats, 71%), hyperthyroidism (4/17, 23%) and functional adrenocortical mass secreting either aldosterone alone (1/17, 6%) or glucocorticoids, and possibly also aldosterone (1/17, 6%). Out of 17 cats, 15 (88%) were treated with amlodipine, and none were treated with an angiotensin converting enzyme inhibitor or an angiotensin II receptor blocker. Mean SABP at the time of diagnosis of SH was 210 ± 23 mmHg and was significantly higher than the mean SABP at the first and second follow-up examinations after the introduction of amlodipine treatment (175 ± 33 mmHg, P = 0.008 and 172 ± 26 mmHg, P = 0.01, respectively). CONCLUSIONS AND RELEVANCE: Cats with DM and SH should be evaluated for the presence of chronic kidney disease, hyperthyroidism and functional adrenal masses. Treatment with amlodipine appears to be effective in lowering SABP in cats with DM and SH.

Long-term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitus.

BACKGROUND: The long-term clinical and biofhemical effects of basal-bolus insulin treatment with lispro and NPH in dogs with diabetes mellitus are undocumented. OBJECTIVES: To perform a prospective pilot field study of the long-term effects of lispro and NPH on clinical signs and serum fructosamine concentrations (SFC) in dogs with diabetes mellitus. METHODS: Twelve dogs received combined lispro and NPH insulins treatment twice a day and were examined every 2 weeks for 2 months (visits 1-4), and every 4 weeks for up to 4 additional months (visits 5-8). Clinical signs and SFC were recorded at each visit. Polyuria and polydipsia (PU/PD) were scored as absent (0) or present (1). RESULTS: Median (range) PU/PD scores of combined visits 5-8 (0, 0-1) were significantly lower than median scores of combined visits 1-4 (1, 0-1, p = 0.03) and at enrolment (1, 0-1, p = 0.045). Median (range) SFC of combined visits 5-8 (512 mmol/L, 401-974 mmol/L) was significantly lower than SFC of combined visits 1-4 (578 mmol/L, 302-996 mmol/L, p = 0.002) and at enrolment (662 mmol/L, 450-990 mmol/L, p = 0.03). Lispro insulin dose was significantly and negatively, albeit weakly, correlated with SFC concentration during visits 1 through 8 (r = -0.3, p = 0.013). Median duration of follow up was 6 months (range 0.5-6) and most dogs (8, 66.7%) were followed for 6 months. Four dogs withdrew from the study within 0.5-5 months because of documented or suspected hypoglycaemia, short NPH duration or sudden unexplained death. Hypoglycaemia was noted in 6 dogs. CONCLUSIONS: Long-term lispro and NPH combination therapy may improve clinical and biochemical control of some diabetic dogs with comorbidities. Risk of hypoglycaemia should be addressed with close monitoring.

Effect of donor blood storage on gel column crossmatch in dogs.

BACKGROUND: Compared with fresh blood, stored equine donor blood results in spurious tube crossmatch incompatibilities. Interpretation of blood crossmatch results is considered subjective. OBJECTIVES: We aimed to determine if the duration of canine donor blood storage impacts compatibility testing using a standard gel column crossmatch and evaluate interobserver variation in the interpretation of crossmatch results. METHODS: Observational study. Whole blood segments were obtained from 23 canine packed red blood cell (RBC) units for use in crossmatches after storage for 0, 7, 14, 21, 28, and 35 days. Major and minor crossmatches were performed using serum and RBCs, respectively, from two to three healthy "recipient" dogs per unit. All crossmatch results were interpreted by four observers, of whom three were blinded. RESULTS: All major crossmatches (n = 61) were compatible on day 0 and remained compatible through day 35 of storage. All minor crossmatches (n = 69) were compatible at all time points, except for five donor pairs with 1 to 3+ agglutination. Repeat testing of these five donor pairs confirmed crossmatch incompatibilities on days 0 through 35, with no change in the degree of incompatibility over time. There was substantial agreement among four observers in determining compatibility (κ = 0.94) and scoring incompatibility (κ = 0.76). CONCLUSIONS: The current practice of performing canine crossmatches with whole blood segments stored for up to 35 days is acceptable, with no spurious changes in compatibility expected over time. The substantial interobserver agreement suggests that the gel column is suitable for performing canine crossmatches in a laboratory setting with multiple personnel.

Evaluation of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in critically ill dogs.

OBJECTIVE: To evaluate whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are accurate prognostic indicators and correlate with illness severity scores in critically ill dogs. DESIGN: Prospective observational study from December 2016 to May 2017. SETTING: ICU at a veterinary teaching hospital. ANIMALS: Seventy-two client-owned dogs admitted to the ICU with CBCs and abbreviated and complete acute patient physiologic and laboratory evaluation (APPLEfast and APPLEfull ) scores were enrolled. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The NLR, PLR, APPLEfast , and APPLEfull scores were calculated for each patient on the day of admission. Patients were followed from admission to discharge, and diagnosis, survival, and length of hospitalization were recorded. The patient population was assessed as a whole and as subcategories of patients with neoplastic disease, infectious disease, sepsis, and severe hemorrhage. Dogs with nonseptic disease processes (n = 52) that died had a significantly higher median PLR (P = 0.04) of 441 (range: 106-986) compared to those that survived with a median PLR of 217 (range: 28.4-3225). The PLR was strongly predictive of ICU length of stay in dogs with severe hemorrhage (P = 0.03, Spearman's rho = 0.84). The NLR had a poor positive correlation with APPLEfull score (P = 0.04, Spearman's rho = 0.24), and PLR had a poor negative correlation with APPLEfast score (P = 0.02, Spearman's rho = -0.27). CONCLUSIONS: The PLR correlated with ICU length of stay for patients with severe hemorrhage and with survival for patients with nonseptic disease processes. The PLR and NLR correlated with illness severity as measured by APPLE scores. Future studies with larger sample sizes are warranted to further determine the merit of NLR and PLR as indicators of morbidity, mortality, and illness severity.

Clinical differences in enterococcal bacteriuria compared with other bacteriuria in cats.

OBJECTIVES: The clinical differences between Enterococcus species bacteriuria compared with other bacteria has been reported in a small number of cats. The objective of this study was to compare a large number of cats with Enterococcus species bacteriuria to cats with other bacteriuria and determine the clinical differences. It was hypothesized that enterococcal bacteriuria would be associated with subclinical bacteriuria and polymicrobial infections more than other bacteriuria, and that when local or systemic comorbidities were present, enterococcal bacteriuria would be more common. METHODS: This retrospective case-control study compared case cats with enterococcal bacteriuria to control cats with other bacteriuria. Cats with enterococcal bacteriuria were age, year and weight matched with 1-2 control cats with any other bacteriuria. RESULTS: Lower urinary tract clinical signs were statistically significantly more common in controls (n = 38/77 [49%]) compared with Enterococcus cases (n = 12/47 [25%]; P = 0.01). Specifically, control cats (n = 20/77 [26%]) were statistically significantly more likely to have gross hematuria compared with Enterococcus case cats (n = 3/47 [6%]; P = 0.01). Enterococcus cases were statistically significantly more likely to have a polymicrobial infection compared with controls (odds ratio 5.84, 95% confidence interval 1.33-34.70; P = 0.01). CONCLUSIONS AND RELEVANCE: Enterococcus species are associated with subclinical bacteriuria and polymicrobial urinary tract infections in cats vs other bacteriuria.

Clinical findings and patient outcomes following surgical treatment of chronic gastrointestinal foreign body obstructions in dogs and cats: 72 cases (2010-2020).

The objective of this study was to characterize clinicopathologic factors and outcomes for dogs and cats with chronic small intestinal foreign body obstructions (CFBO). Medical records of 72 dogs and cats diagnosed with CFBO between 2010 to 2020 were reviewed for duration of clinical signs, pre-surgical and intraoperative findings, complications, and outcomes. A chronic foreign body was defined as clinical signs, or the observation of foreign material ingestion, at least 7 days prior to presentation. Twenty-two (31%) patients had a small intestinal resection and anastomosis (SIRA) and were more likely to have longer duration of clinical signs (P = 0.01). Eleven (15%) patients developed major post-operative complications. Sixty-eight (94%) patients survived to follow-up. Although all patients that did not survive (n = 4, 100%) had a SIRA, patients with CFBO had a high survival rate. Therefore, clients should not be deterred from pursuing surgical intervention.

L'objectif de cette étude était de caractériser les facteurs clinico-pathologiques et les résultats pour les chiens et les chats atteints d'obstructions chroniques par corps étrangers de l'intestin grêle (CFBO). Les dossiers médicaux de 72 chiens et chats diagnostiqués avec CFBO entre 2010 et 2020 ont été examinés pour la durée des signes cliniques, les résultats pré-chirurgicaux et peropératoires, les complications et les résultats. Un corps étranger chronique était défini comme des signes cliniques ou l'observation d'une ingestion de corps étrangers au moins 7 jours avant la présentation. Vingt-deux (31 %) patients ont subi une résection et anastomose de l'intestin grêle (SIRA) et étaient plus susceptibles d'avoir des signes cliniques de plus longue durée (P = 0,01). Onze (15 %) patients ont développé des complications postopératoires majeures. Soixante-huit (94 %) patients ont survécu jusqu'au suivi. Bien que tous les patients qui n'ont pas survécu (n = 4, 100 %) aient eu un SIRA, les patients avec CFBO avaient un taux de survie élevé. Par conséquent, les clients ne doivent pas être dissuadés de poursuivre une intervention chirurgicale.(Traduit par Docteur Serge Messier).

Seasonality and geography of diabetes mellitus in United States of America dogs.

The diagnosis of type 1 diabetes mellitus (DM) in humans is associated with high altitude, few sunshine hours, cold climate, and winter. The goals of this study were to investigate seasonal and geographic patterns of DM diagnosis in United States of America (USA) dogs with juvenile and mature onset DM. Data were collected by means of an online survey widely distributed in the USA through breed clubs, academic veterinary institutions, private veterinary referral practices, social media outlets, and the American Kennel Club. Juvenile DM (JDM) and mature onset DM were defined as DM with an age of onset <365 days and DM with an age of onset ≥365 days, respectively. Meteorological seasons were defined as: winter from December through February, spring from March through May, summer from June through August, and fall from September through November. Four geographic regions were also defined as the West, North, South, and Central regions of the USA. Nonoverlapping 95% confidence intervals (CI) for season, geographic region, and breed specific proportions of dogs with JDM were considered statistically significantly different. The study included 933 dogs with mature onset DM and 27 dogs with JDM. Dogs were diagnosed with DM significantly more in the winter and northern USA compared to all other seasons and all other geographic regions, respectively. The prevalence of JDM among dogs with DM was 2.8%. The proportion of dogs with JDM among pure breeds was not significantly different than the proportion of JDM in mixed breed dogs. It is concluded that winter and cold climate could be shared environmental factors influencing DM expression in dogs and humans. Additionally, pure breed dogs do not appear to be at increased risk for JDM compared to mixed breed dogs, indicating that factors other than genetics could influence spontaneous JDM development in dogs.

Retrospective evaluation of carboxyhemoglobin and methemoglobin levels in dogs and cats with respiratory disease.

OBJECTIVE: To evaluate carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels in dogs and cats with respiratory disease in the ICU. DESIGN: Retrospective study. SETTING: University veterinary teaching hospital. ANIMALS: The ICU census was searched for dogs (n = 466) and cats (n = 97) hospitalized within the ICU between January 2016 and January 2019 in whom blood gas with co-oximetry was performed. Dogs and cats were stratified into those with primary respiratory and nonrespiratory categories; the underlying cause of the disease was also noted. Venous blood gas, co-oximeter, PaO2 /FiO2 (PF ratio), physical examination findings, and outcome were recorded. MEASUREMENTS AND MAIN RESULTS: The median COHb and MetHb in dogs hospitalized in the ICU were 2.6% (0.1%-5.6%) and 1.1% (0.1%-2.9%), respectively. The median COHb and MetHb in cats hospitalized in the ICU were 2.2% (0.1%-5.4%) and 1.0% (0%-2.1%), respectively. Dogs with respiratory disease had a higher COHb than dogs without respiratory disease (median, 2.7% [range, 0.3%-5.0%] vs. 2.5% [0.1%-5.6%]; P = 0.0148). COHb was positively associated with survival in cats (median, 2.2% [range, 0.1%-5.4%] vs. 1.9% [0.1%-3.9%]; P = 0.0433). Both COHb and MetHb were higher in septic dogs than in nonseptic dogs (median COHb, 2.8% [range 0.3%-4.5%] vs. 2.6% [0.1%-5.6%]; P = 0.02 and median MetHb, 1.1% [0.1%-2.9%] vs. 1.1% [0.1%-2.4%]; P = 0.01, respectively). CONCLUSIONS: There may be a positive association between COHb and respiratory disease in dogs; prospective studies are needed to evaluate this further. No association between COHb and respiratory disease in cats or MetHb and respiratory disease in either species was detected. Additional prospective studies are needed to determine whether COHb and MetHb are biomarkers for sepsis in dogs and whether COHb is an indicator of mortality in cats.

The odds of neoplasia in dogs with and without diabetes mellitus.

BACKGROUND: Increased risk of neoplasia in humans with diabetes mellitus (DM) is well documented. It is unknown if dogs with DM have increased risk of neoplasia. OBJECTIVE: Determine if dogs with DM have an overall increased risk of neoplasia and risk for specific forms of neoplasia compared to dogs without DM. ANIMALS: Seven hundred dogs with DM and 700 breed, age, and sex-matched dogs without DM, examined during the same years. METHODS: Retrospective case-control study. Odds ratios (OR), corresponding 95% confidence intervals (CI), and P-values were calculated using conditional logistic regression to determine if dogs with DM had increased odds of developing neoplasia compared to dogs without DM. RESULTS: The overall odds of developing neoplasia were not significantly different in dogs with and without DM. However, dogs with DM had significantly higher odds of developing an adrenal mass (OR, 4; 95% CI, 1.1-14.2; P = .03) compared to dogs without DM. The odds of developing a splenic mass in dogs with DM (OR, 1.2; 95% CI, 0.99-1.39) were increased compared to dogs without DM, but this difference was not significant (P = .07). CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with DM may be at increased risk for adrenal neoplasia. Awareness of this risk can facilitate early diagnosis of this life-threatening comorbidity. Larger studies are needed to confirm these findings.

Effectiveness of orally administered maropitant and ondansetron in preventing preoperative emesis and nausea in healthy dogs premedicated with a combination of hydromorphone, acepromazine, and glycopyrrolate.

OBJECTIVE: To compare effectiveness of maropitant and ondansetron in preventing preoperative vomiting and nausea in healthy dogs premedicated with a combination of hydromorphone, acepromazine, and glycopyrrolate. ANIMALS: 88 dogs owned by rescue organizations. PROCEDURES: Dogs received maropitant (n = 29) or ondansetron (28) PO 2 hours prior to premedication or did not receive an antiemetic (31; control). Dogs were evaluated for vomiting, nausea, and severity of nausea (scored for 6 signs) for 15 minutes following premedication with hydromorphone, acepromazine, and glycopyrrolate. RESULTS: A significantly lower percentage of dogs vomited after receiving maropitant (3/29 [10%]), compared with control dogs (19/31 [62%]) and dogs that received ondansetron (15/28 [54%]). A significantly lower percentage of dogs appeared nauseated after receiving maropitant (3/29 [10%]), compared with control dogs (27/31 [87%]) and dogs that received ondansetron (14/28 [50%]), and a significantly lower percentage of dogs appeared nauseated after receiving ondansetron, compared with control dogs. Nausea severity scores for hypersalivation, lip licking, hard swallowing, and hunched posture were significantly lower for dogs that received maropitant than for control dogs, and scores for hypersalivation, lip licking, and hard swallowing were significantly lower for dogs that received ondansetron than for control dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Oral administration of maropitant 2 hours prior to premedication with hydromorphone reduced the incidence of vomiting and the incidence and severity of nausea in healthy dogs. Oral administration of ondansetron reduced the incidence and severity of nausea but not the incidence of vomiting.

Validation of a flash glucose monitoring system in outpatient diabetic cats.

BACKGROUND: Interstitial glucose (IG) concentration measurement using a flash glucose monitoring system (FGMS) is a noninvasive, affordable, and informative method to regulate patients with diabetes mellitus (DM) but has not been fully validated in outpatient cats with DM. OBJECTIVES: To further validate the FreeStyle Libre FGMS in outpatient diabetic cats. ANIMALS: Eight client-owned cats with DM. METHODS: Prospective observational validation study. Tissue glue was used to attach the sensor to the cat. Lin's concordance correlation coefficient (ρc ) was used to compare IG concentrations measured by the FGMS to blood glucose concentrations measured using an automated biochemistry analyzer (ABA) and point-of-care glucometer (POCG). RESULTS: Data from 15 sensor placements in 8 cats were analyzed. Paired IG and ABA glucose concentrations (139 samples) had excellent correlation (ρc  = 0.96) as did IG and POCG glucose concentrations (142 samples, ρc  = 0.92). Sensor failure or displacement were recorded for 12/15 (80%) sensor placements. Median time of sensor activity was 7 days (range, 2-13 days). CONCLUSIONS AND CLINICAL IMPORTANCE: In outpatient cats with DM, the FGMS-measured IG concentration correlated well with ABA-measured blood glucose concentration, but a high rate of sensor failures was observed.