Metabolic alterations in dogs with osteosarcoma.

OBJECTIVE: To evaluate changes in resting energy expenditure (REE) as well as protein and carbohydrate metabolism in dogs with osteosarcoma (OSA). ANIMALS: 15 weight-stable dogs with OSA that did not have other concurrent metabolic or endocrine illness and twelve 1-year-old sexually intact female Beagles (control dogs). PROCEDURES: Indirect calorimetry was performed on all dogs to determine REE and respiratory quotient (RQ). Stable isotope tracers (15N-glycine, 4.5 mg/kg of body weight, IV; 6,6-deuterium-glucose, 4.5 mg/kg, IV as a bolus, followed by continuous-rate infusion at 1.5 mg/kg/h for 3 hours) were used to determine rate of protein synthesis and glucose flux in all dogs. Dual-energy x-ray absorptiometry (DEXA) scans were performed to determine total body composition. RESULTS: Accounting for metabolic body size, REE in dogs with OSA was significantly higher before and after surgery, compared with REE of healthy control dogs. The RQ values did not differ significantly between groups. Dogs with OSA also had decreased rates of protein synthesis, increased urinary nitrogen loss, and increased glucose flux during the postoperative period. CONCLUSIONS AND CLINICAL RELEVANCE: Alterations in energy expenditure, protein synthesis, urinary nitrogen loss, and carbohydrate flux were evident in dogs with OSA, similar to results documented in humans with neoplasia. Changes were documented in REE as well as protein and carbohydrate metabolism in dogs with OSA. These changes were evident even in dogs that did not have clinical signs of cachexia.

Third degree atrioventricular block and acquired myasthenia gravis in four dogs.

Third degree atrioventricular block was diagnosed in 4 dogs with acquired myasthenia gravis (serum acetylcholine receptor antibody titer > 0.6 nmol/L). All 4 dogs had megaesophagus. Two dogs also had mediastinal thymomas, which were resected. One dog with thymoma received a permanent pacemaker at the same time that it underwent thymectomy; the other did not develop third degree atrioventricular block until 3 months after thymectomy. Both dogs with thymoma died of severe aspiration pneumonitis within 3 months after surgery. The third dog received a permanent pacemaker and was treated with pyridostigmine bromide, but also died of aspiration pneumonitis 1 month after the pacemaker was implanted. The fourth dog was treated with prednisolone and pyridostigmine bromide and improved, but did not become clinically normal. Because third degree atrioventricular block as well as myasthenia gravis can cause signs of weakness, acquired myasthenia gravis should be considered in dogs with idiopathic cardiac conduction disturbances. Likewise, an ECG should be evaluated in dogs with acquired myasthenia gravis.

Ventricular tachycardia and myocardial dysfunction in a horse.

Ventricular tachycardia develops less frequently than supraventricular dysrhythmias and generally is more indicative of cardiac disease. The horse in this report had clinical signs of lethargy and hypophagia and was determined to have sustained ventricular tachycardia. Echocardiography was a valuable diagnostic tool and revealed an echodense area in the left ventricle that had subnormal ventricular performance. A primary heart problem of an inflammatory nature was suspected. The horse responded favorably to treatment with lidocaine, antimicrobials, and aspirin, as well as stall rest. The horse was used successfully as a sire and hunter-jumper after treatment, but subsequently died 2.2 years later of massive hemoperitoneum. Necropsy revealed an extensive area in the left ventricle that appeared thin and fibrotic.

Echinocytosis associated with rattlesnake envenomation in dogs.

A retrospective study of 28 cases of rattlesnake bites in dogs indicated an association of envenomation with echinocytosis; 25/28 dogs (89%) had echinocytosis within 24 hours of a rattlesnake bite being reported. Eighteen of the 28 dogs had marked type III echinocytosis (95-100% of mature erythrocytes affected), and seven dogs had moderate echinocytosis (15-30% of mature erythrocytes affected). The echinocytosis was transient, resolving within 48 hours of envenomation in those for which subsequent blood films were available (13/25). Hypokalemia was noted in 14 of 18 dogs for which biochemical data were available. The hypokalemia was not consistently associated with echinocytosis. The observation of echinocytosis in dogs supports a clinical diagnosis of rattlesnake envenomation.

Controversial issues in drug treatment during cardiopulmonary resuscitation.

The goal of advanced life support in CPR must be to restore and maintain respiratory and hemodynamic effectiveness, and to correct the underlying dysrhythmia. Optimal basic life-support techniques must be continued to meet these goals. Many drugs have been suggested in the treatment of cardiac arrest, but unfortunately, drug effects are inconsistent and resuscitation rates remain low. Epinephrine, atropine, lidocaine, bretylium, and naloxone remain important drugs for consideration in CPR in most animals with cardiac arrest. The best chance of survival remains in early recognition of animals susceptible to arrest and in treatment of the underlying cause.

Respiratory and cardiopulmonary arrest in dogs and cats: 265 cases (1986-1991).

Outcomes of cardiopulmonary arrest and resuscitation in clinically affected dogs and cats have not been adequately studied. We examined the records from 200 dogs and 65 cats that had received cardiopulmonary resuscitation for respiratory or cardiopulmonary arrest; none of the animals had been anesthetized or intubated at the time of arrest, and all had been hospitalized in a veterinary critical care facility. Cardiopulmonary arrest was found to be more common than respiratory arrest in dogs and cats. Hospital discharge rates for animals with cardiopulmonary arrest ranged from 4.1% for dogs to 9.6% for cats, and were consistent with those reported from studies of human beings with cardiopulmonary arrest. Hospital discharge rates for dogs and cats with respiratory arrest were 28% and 58.3%, respectively.

Abnormal bleeding.

Animals with disorders of hemostasis are often presented as emergency patients and, as such, offer a challenge to the attending clinician. This article reviews the basic physiology of hemostasis and laboratory tests used for diagnosis. Guidelines for the evaluation and treatment of patients with bleeding disorders are provided.

Bacterial culture of blood from critically ill dogs and cats: 100 cases (1985-1987).

Of 100 critically ill dogs and cats, 49 (39 dogs, 10 cats) had bacteremia. Gram-negative bacilli were the most common isolates from the bloodstream of dogs with bacteremia (46%), and gram-positive cocci and anaerobic bacteria were isolated from 36% and 31% of positive cultures, respectively; 15% of positive cultures were polymicrobial. In cats, gram-negative bacilli (especially Salmonella enteritidis) and anaerobic bacteria were the most common isolates, and 30% of positive cultures were polymicrobial. Gram-positive cocci were not isolated from the blood-stream of cats. Odds ratios, adjusted for the combined effects of disease status (severe vs nonsevere), results of bacterial culture of blood result (positive vs negative), and species (dog vs cat) were calculated for mortality in animals in the study. In animals with bacteremia, severe disease increased the risk of death 11.6-fold, compared with the risk in animals with nonsevere disease. Bacteremia increased mortality 10-fold in animals with severe disease, compared with mortality in animals with severe disease without bacteremia. Animals with severe disease and bacteremia were 15.6 times more likely to die than were those with nonsevere disease and negative culture results. In animals with nonsevere disease, culture results (positive vs negative) were not related significantly to mortality. Disease status (severe vs nonsevere) in animals without bacteremia also was not significantly related to mortality. There was no significant difference in overall mortality in dogs, compared with that in cats.(ABSTRACT TRUNCATED AT 250 WORDS)

Real-time ultrasonography for determining pregnancy status and viable fetal numbers in ewes.

The reproductive tracts of 26 estrus synchronized, bred ewes were scanned with a portable 5.0 MHz real-time ultrasound unit within 1 to 6 d postbreeding. Intrarectal scanning was performed on alternate days until Days 28 to 30 and twice weekly until Days 50 of gestation. Transabdominal uterine scans were conducted twice weekly from Days 25 to 65 and continued weekly until parturition. A total of 24 ewes (92%) became pregnant. A nonpregnant ewe was recognized 100% of the time by both methods of ultrasonic screening. Correct identification of a gravid ewe as pregnant was 100% from Days 51 to 150 of gestation using transabdominal real-time ultrasonography. There was a significant association (P < 0.005) between the number of lambs born and the number of fetuses observed using transabdominal real-time ultrasonography after Day 25 of gestation. Accurate differentiation of fetal numbers by transabdominal scanning was 100.0% for ewes carrying one lamb and 97.3% for ewes carrying two lambs at Days 51 to 75 of gestation. Fetal attrition was documented in one ewe at Day 49 of gestation. Hydrops allantois was diagnosed in another ewe at 110 d of gestation. A total of 37 lambs were born to 23 ewes in the project flock. No congenital abnormalities were noted in any of the lambs. Transabdominal real-time ultrasonography is a safe, rapid, accurate and practical method for assessing pregnancy status, fetal number and fetal viability in sheep.

M-mode echocardiographs of endurance horses in the recovery phase of long-distance competition.

M-mode echocardiographic structures, and cardiac function indices, PCV, and total plasma protein values were determined for 34 endurance equine athletes before (base line) and after (after race) a 161-km endurance competition and were compared. The PCV (base-line mean, 37%; after-race mean, 46%) and total plasma protein value (base-line mean, 6.9 g/dl; after-race mean, 7.5 g/dl) increased. Compared with base-line echocardiography, after-race echocardiography indicated an increase in heart rate, as determined from the simultaneous ECG recorded on the echocardiograph (base-line mean, 41 beats/min; after-race mean, 54 beats/min), and an increase in interventricular septal diastolic thickness (base-line mean, 28 mm; after-race mean, 33 mm). The septal thickening fraction (base-line mean, 59%; after-race mean, 38%), the left atrioventricular valve E to F slope (base-line mean, 224 mm/s; after-race mean, 175 mm/s), the left ventricular diastolic dimension (base-line mean, 99 mm; after-race mean, 86 mm), the fractional shortening of the left ventricle (base-line mean, 41%; after-race mean, 37%), the aortic root dimension (base-line mean, 63 mm; after-race mean, 58 mm), the caudal aortic wall excursion (base-line mean, 19 mm; after-race mean, 11 mm) and the left atrial diastolic dimension (base-line mean, 46 mm; after-race mean, 39 mm), decreased significantly (P less than 0.05). In base-line echocardiographs, late diastolic left atrioventricular valve motion was evident in 9 horses. The aberrant left atrioventricular valve motion was not evident in after-race echocardiographs. Seemingly, central vascular volume decreased in these horses during the recovery phase of severe strenuous endurance competition.

Effects of body position and ventilation/compression ratios during cardiopulmonary resuscitation in cats.

Eighteen cats were anesthetized and were randomly assigned to 2 groups (9 cats/group). Cardiopulmonary resuscitation (CPR) was performed on each cat, with the cat in dorsal (group 1) or lateral (group 2) recumbency, by administering 5 external cardiac compressions/1 interposed (diastolic) ventilation (American Heart Association [AHA] technique; n = 3 cats/technique), simultaneous compression and ventilation (SCV; n = 3 cats/technique), or SCV with 1 interposed (diastolic) ventilation every tenth compression (SCV/DV; n = 3 cats/technique). Fourteen of the 18 cats were resuscitated. Central aortic and venous pressures were determined concurrently with lead II electrocardiography. Arterial blood samples were collected during the base-line period (after pressure fluctuations had stabilized, with the cats spontaneously breathing room air), 2.5 minutes after the onset of arrest (defined as the cessation of aortic pressure fluctuations), and after 10 minutes of CPR. Arterial blood gas values during the base-line period or during the period of arrest were not significantly different between group-1 and group-2 cats. After CPR, arterial pH and bicarbonate values were not significantly different between groups or between technique categories. The PaCO2 values were significantly lower in cats resuscitated by SCV or by SCV/DV than in cats resuscitated by AHA (P less than 0.05). The PaO2 values were significantly (P less than 0.001) higher in group-2 cats than in group-1 cats and were significantly (P less than 0.001) different between each technique category, with cats resuscitated by AHA having the lowest PaO2 and cats resuscitated by SCV/DV having the highest PaO2. Body position, CPR technique, sex, weight, or arterial blood gas values after CPR were not predictors of successful resuscitation.

Effects of xylazine and ketamine on epinephrine-induced arrhythmia in the dog.

Ten dogs were studied to determine the effects of xylazine, ketamine, and xylazine combined with ketamine on the dosage of epinephrine required to produce ventricular arrhythmia. Untreated dogs required an arrhythmogenic dose (AD) of 5.88 +/- 2.85 micrograms/kg/min. The AD was 4.28 +/- 3.25 micrograms/kg/min in xylazine-treated dogs, 3.05 +/- 2.3 micrograms/kg/min in ketamine-treated dogs, and 2.96 +/- 1.95 micrograms/kg/min in xylazine/ketamine-treated dogs. The latter two dosages were significantly less than that of the controls (p less than 0.025). The duration of increased arrhythmogenicity was also examined. Four hours after drug administration, the AD for xylazine-treated dogs was decreased further to 3.87 +/- 2.52 micrograms/kg/min (p less than 0.05). Ketamine-treated dogs had returned partially to normal with an AD of 4.09 +/- 3.09 micrograms/kg/min, as had xylazine/ketamine-treated dogs, at 4.22 +/- 2.71 micrograms/kg/min.

Atrial fibrillation in a pregnant mare: treatment with quinidine sulfate.

Atrial fibrillation in a pregnant, lactating, 15-year-old mare nursing a 70-day-old foal was converted to normal sinus rhythm, using quinidine sulfate. The maximum concentration of quinidine was 4.3 mg/L in the mare's milk and was 2.6 mg/L in the mare's serum. Treatment with quinidine did not interrupt the pregnancy. Six months after treatment, the mare developed acute volvulus of the large colon and died. At necropsy, the mare did not have macroscopic or microscopic cardiac lesions. The fetus was macroscopically and histologically normal.

Echocardiography for the diagnosis of congenital heart defects in the dog.

Echocardiography utilizing M-mode and real-time techniques is a safe, noninvasive diagnostic technique for use in veterinary cardiology. It provides a means to assess structural sizes and relationships and can be used to provide quantitative data for diagnosis of congenital heart disease. Although its availability is largely limited to veterinary colleges and specialty hospitals, the practicing veterinarian should know of its advantages and disadvantages. He or she is also encouraged to consider the use of ultrasound in the diagnosis and management of heart disease in all species of veterinary patients.

Endocarditis caused by Corynebacterium sp in a dog.

Mitral valve bacterial endocarditis, caused by Corynebacterium sp, was diagnosed in a dog. The bacteria had characteristics unlike those commonly recognized for most species of Corynebacterium. The primary source of bacteremia was suspected to be a pilonidal cyst of the sacrum. The dog was treated with a first-generation cephalosporin for 6 weeks, and the pilonidal cyst was surgically removed. Physical examination 1 year after initial examination revealed no abnormalities other than a cardiac murmur. On echocardiographic examination 1 year after treatment, the vegetative lesion was still present; however, chamber dimensions had returned to normal. Wall thickness and contractility remained increased.