Evaluation of meniscal click for detecting meniscal tears in stifles with cranial cruciate ligament disease.

OBJECTIVE: To assess the diagnostic efficacy of palpable meniscal click by evaluating the sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of preoperative palpable meniscal click compared with examination during surgery. STUDY DESIGN: Prospective case series. SAMPLE POPULATION: Dogs (n = 56) with cranial cruciate ligament (CCL) injury. METHODS: Stifles were examined before anesthesia (EBA) and during anesthesia (EDA) before surgery for palpable meniscal click. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were calculated for EBA and EDA using examination during surgery as the gold standard. RESULTS: EBA was 45.8% sensitive and 94.4% specific for meniscal tear. EDA was 58.3% sensitive and 94.4% specific for meniscal tear. Positive predictive value for palpable meniscal click during EBA was 84.6%, negative predictive value was 72.3%, and diagnostic accuracy was 75.0%. Positive predictive value for palpable meniscal click during EDA was 87.5%, negative predictive value was 77.3%, and diagnostic accuracy was 80.0%. EBA and EDA were significantly associated with the presence of intra-operative meniscal injury (P = .0002 and P < .0001, respectively). Meniscal tears were seen more often in stifles with a full CCL tear as compared to partial CCL tears at a ratio of 11:1. CONCLUSIONS: Presence of a palpable meniscal click during physical examination is strongly indicative of a meniscal tear diagnosed at surgery. The meniscus should always be carefully examined at surgery despite preoperative findings, because the absence of a palpable meniscal click is not a strong indicator for a normal meniscus.

Upper thoracic disc disease (T1-T9) in large-breed dogs.

The purpose of this study was to identify large-breed dogs with intervertebral disc disease (IVDD) in the upper thoracic region (thoracic vertebrae 1-9 [T1-T9]). Medical records of all dogs that were diagnosed with IVDD on MRI between February 2008 and September 2011 were reviewed. Of 723 dogs diagnosed with IVDD based on MRI, 527 (72.9%) were small-breed dogs. There were 21 (10.7%) large-breed dogs with IVDD in the T1-T9 region, whereas no small-breed dogs were identified with lesions in that region. The most common upper thoracic lesion sites were T2-T3 (33.3%) and T4-T5 (25.9%). The majority of dogs with T1-T9 lesions were German shepherd dogs (52.4%). Larger, older dogs were more likely to have T1-T9 lesions and more likely to have multiple regions with IVDD, in particular German shepherd dogs (35.1%). Dogs with T1-T9 IVDD were more likely to have IVDD in another region (66.7%). All large-breed dogs presenting with T3-L3 myelopathy should have diagnostic imaging performed of their entire thoracic and lumbar spine.

Retrospective evaluation of lingual tumors in 42 dogs: 1999-2005.

In this retrospective study of 42 cases of lingual tumors in dogs, 27 (64%) were malignant, and 15 (36%) were benign. Median survival time for dogs with benign tumors was >1607 days, compared to 286 days for malignant tumors. Prognostic factors significantly associated with increased survival included complete histological margins (P=0.036), smaller tumor size (P=0.003), and benign tumor type (P=0.011). Smaller tumors were more likely to be completely resected (P=0.008) and were less likely to recur (P=0.001). Partial or subtotal glossectomies were performed in 13 cases. Short-term morbidity associated with glossectomy included ptyalism and dehiscence. Long-term morbidity included minor changes in eating and drinking habits.

Comparison of endoscopic and full-thickness biopsy specimens for diagnosis of inflammatory bowel disease and alimentary tract lymphoma in cats.

OBJECTIVE: To evaluate the accuracy of endoscopic biopsy (EB) specimens for diagnosis of alimentary tract lymphosarcoma in cats. DESIGN: Prospective study. ANIMALS: 22 cats with inflammatory bowel disease (IBD) or alimentary tract lymphosarcoma. PROCEDURES: Endoscopic biopsy specimens were obtained during endoscopy of the stomach and duodenum immediately prior to laparotomy or laparoscopic surgery, during which full-thickness biopsy (FTB) specimens were obtained. Accuracy of histopathologic diagnoses was compared between EB and FTB specimens. RESULTS: Lymphosarcoma was diagnosed in 10 cats on the basis of FTB specimens. Lymphosarcoma was detected in the jejunum and ileum in all 10 cats, in the duodenum in 9 cats, and in the stomach in 4 cats. In the same 10 cats, EB findings indicated a diagnosis of lymphosarcoma in 3 cats and were suggestive but inconclusive for lymphosarcoma in 3 cats. Lymphosarcoma was correctly diagnosed via gastric EB specimens in 3 of the 4 cats with gastric lymphosarcoma but evaluation of EB specimens led to an incorrect diagnosis of IBD in 4 cats with small intestinal lymphosarcoma. CONCLUSIONS AND CLINICAL RELEVANCE: EB specimens were useful for diagnosis of gastric lymphosarcoma but were not adequate for differentiating between IBD and lymphosarcoma in the small intestine. Because the most common sites of alimentary tract lymphosarcoma in cats are the jejunum and ileum, FTB specimens of those sites should be obtained via laparotomy or laparoscopy for accurate diagnosis. Laparoscopy may be a minimally invasive alternative to endoscopy and laparotomy for obtaining diagnostic biopsy specimens.

Perioperative Cefovecin to Reduce the Incidence of Urinary Tract Infection in Dogs Undergoing Hemilaminectomy.

The prevalence of urinary tract infections (UTIs) in dogs with Type I intervertebral disc extrusion has been reported as high as 38% within 6 wk of surgery. Proper treatment of a UTI is important with myelopathy because it is a risk factor for persistent infection and reinfection in dogs. The study authors' investigated the incidence of UTIs in dogs having received either cefovecin or cefazolin as a preoperative prophylactic antibiotic for thoracolumbar hemilaminectomy. Thirty-nine dogs were retrospectively identified and assigned to groups based on preoperative antibiotic administration and postoperative urinary tract management. Urinalysis and urine culture performed preoperatively, at 2 wk, and at 6 wk, were reviewed to determine the incidence of UTIs. Urinary tract management, grade of neurologic deficit, time to ambulation, and time to voluntary urination were identified to evaluate for additional risk factors. No significant prevalence of UTI incidence was appreciated between the cefovecin and cefazolin groups. Patients with higher grades of neurologic deficit and that took longer to regain ambulation and voluntary urination were at significantly greater risk for UTIs throughout the postoperative period. This study reemphasizes the importance of continued surveillance for UTIs in patients with prolonged neurologic recovery.

Lactate as a diagnostic test for septic peritoneal effusions in dogs and cats.

Lactate concentration in peritoneal fluid was evaluated and compared to blood lactate concentration in dogs and cats with septic and nonseptic abdominal effusions. All dogs with septic effusions had a peritoneal fluid lactate concentration >2.5 mmol/L and a peritoneal fluid lactate concentration higher than blood lactate, resulting in a negative blood to fluid lactate difference. In dogs, the diagnostic accuracy of the peritoneal fluid lactate concentration and the blood to fluid lactate difference in differentiating septic peritoneal effusion was 95% and 90%, respectively. Peritoneal fluid lactate concentration and blood to fluid lactate difference were not accurate tests for detecting septic peritoneal effusions in cats.

Comparison of peritoneal fluid and peripheral blood pH, bicarbonate, glucose, and lactate concentration as a diagnostic tool for septic peritonitis in dogs and cats.

OBJECTIVE: To establish a reliable diagnostic tool for septic peritonitis in dogs and cats using pH, bicarbonate, lactate, and glucose concentrations in peritoneal fluid and venous blood. STUDY DESIGN: Prospective clinical study. ANIMALS: Eighteen dogs and 12 cats with peritoneal effusion. METHODS: pH, bicarbonate, electrolyte, lactate, and glucose concentrations were measured on 1- to 2-mL samples of venous blood and peritoneal fluid collected at admission. The concentration difference between blood and peritoneal fluid for pH, bicarbonate, glucose, and lactate concentrations were calculated by subtracting the peritoneal fluid concentration from the blood concentration. Peritoneal fluid was submitted for cytologic examination and bacterial culture. Peritonitis was classified as septic or nonseptic based on cytology and bacterial culture results. RESULTS: In dogs, with septic effusion, peritoneal fluid glucose concentration was always lower than the blood glucose concentration. A blood-to-fluid glucose (BFG) difference > 20 mg/dL was 100% sensitive and 100% specific for the diagnosis of septic peritoneal effusion in dogs. In 7 dogs in which it was evaluated, a blood-to-fluid lactate (BFL) difference < -2.0 mmol/L was also 100% sensitive and specific for a diagnosis of septic peritoneal effusion. In cats, the BFG difference was 86% sensitive and 100% specific for a diagnosis of septic peritonitis. In dogs and cats, the BFG difference was more accurate for a diagnosis of septic peritonitis than peritoneal fluid glucose concentration alone. CONCLUSIONS: A concentration difference > 20 mg/dL between blood and peritoneal fluid glucose concentration provides a rapid and reliable means to differentiate a septic peritoneal effusion from a nonseptic peritoneal effusion in dogs and cats. CLINICAL RELEVANCE: The difference between blood and peritoneal fluid glucose concentrations should be used as a more reliable diagnostic indicator of septic peritoneal effusion than peritoneal fluid glucose concentration alone.