Oral cavity squamous cell carcinomas in zoo-managed Goeldi's monkeys (Callimico goeldii).

BACKGROUND: Oral cavity squamous cell carcinomas (OCSCCs) are relatively common in multiple non-human primate species but are poorly documented in Goeldi's monkeys. METHODS: Four Goeldi's monkeys with OCSCC, from three zoological collections, underwent necropsy with cytology, histopathology, immunohistochemistry, and pan-herpesvirus PCR analysis. RESULTS: All animals were euthanised and exhibited poor-to-emaciated body condition. Three OCSCCs arose from the maxillary oral mucosa and a single OCSCC was primarily mandibular, with bone invasion evident in three cases. Histologically, one OCSCC in situ was diagnosed, whilst the rest were typically invasive OCSCCs. Neoplastic cells were immunopositive for pancytokeratin and E-cadherin. All examined cases were negative for regional lymph node (RLN) and/or distant metastases, cyclooxygenase-2 (COX-2) immunoexpression, and panherpesvirus PCR expression. CONCLUSIONS: OCSCCs in Goeldi's monkeys may be deeply invasive, but not readily metastatic. No herpesvirus-association or COX-2 expression was evident; the latter suggesting that NSAIDs are unlikely to be a viable chemotherapeutic treatment.

Shewanella xiamenensis-associated ulcerative dermatitis in koi carp (Cyprinus rubrofuscus).

Ulcerative dermatitis (UD) is common in ornamental fish collections and is typically associated with a wide range of bacterial aetiologies. Clinical reports describing Shewanella xiamenensis-associated UD are limited, however, despite growing attention to pathogenic Shewanella species in fish. Two out of 95 koi carp with UD were presented for clinical assessment by a commercial collection (n = 3000 fish) and subsequently killed on welfare grounds for necropsy. Both specimens exhibited extensive cutaneous ulcers and coelomic fat necrosis with petechial haemorrhages on post-mortem examination. Shewanella xiamenensis was cultured from ulcerated skin tissues taken from both fish, with consistent intralesional gram-negative rod-like bacteria seen on skin scrape cytology. Histology also confirmed intralesional gram-negative rod-like bacteria within multiple ulcerative and erosive dermatitis lesions, plus myofibre necrosis and necrotising coelomic steatitis, in both specimens. Features associated with impaired generalised osmoregulation secondary to UD were detected within the striated muscle underlying the ulcers, the gills, and the caudal aspects of the kidneys. Additional histological features suggestive of sepsis were also seen in one of the fish. In the interim period, morbidity had increased from 3.2% to around 30% of the entire stock. Following culture results, increased pond water changes were implemented (q.2-3d) and the remaining stock was treated with florfenicol, resulting in complete resolution of UD in the collection (as per client). This article highlights the first description of S. xiamenensis-associated UD in koi carp/diseased ornamental fish in the United Kingdom.

A retrospective study of pathologic findings in cephalopods (extant subclasses: Coleoidea and Nautiloidea) under laboratory and aquarium management.

This retrospective study examines pathologic findings in 593 captive cephalopods (340 octopuses, 130 cuttlefish, 33 squid, and 90 nautiluses; 22 species in total) submitted to International Zoo Veterinary Group Pathology between May 2003 and August 2022. Common octopus, European common cuttlefish, hummingbird bobtail squid, and chambered nautilus were the most numerous species from the included orders of Octopoda, Sepiida, Sepiolida, and Nautilida, respectively. Commonly identified conditions included coccidiosis and renal dicyemid mesozoan infection in octopuses, amebiasis in squid, bacterial infections in cuttlefish, and idiopathic multisystemic inflammatory disease in nautiluses. Coccidiosis was most frequent in common octopuses, giant Pacific octopuses, and California 2-spot octopuses (present in 68.4%, 46.3%, and 23.8% of these species, respectively) and was the attributed cause of death in 32.3%, 36.0%, and 60.0% of such cases, respectively. Ulcerative dermatitis (UD) was common, affecting squid, cuttlefish, and octopuses, while many nautiluses exhibited black shell disease and/or UD. Notable differences in the prevalence of UD were detected between laboratory and aquaria-housed decapodiforms; 52.2% for laboratory squid versus 20.0% in aquaria; 51.3% in laboratory cuttlefish versus 11.0% in aquaria. All octopuses and nautiluses in the study were derived from aquaria. Semelparity-associated death in Coleoidea species was identified in 22.4% of octopuses, 11.5% of cuttlefish, and 6.1% of squid. This report aims to provide an overview and reassessment of species-specific disease patterns under aquarium and laboratory management as a starting point for future developments in husbandry and disease investigation.

Asymptomatic Enteric Duplication Cyst in a Geriatric Cat: Case Report and Review of the Literature.

An 11 yr old female neutered domestic shorthair presented for an 8 mo history of an asymptomatic abdominal mass. Computed tomography described an irregular, cystic structure closely associated with the duodenum, and focal ultrasonography confirmed the mass shared outer layers with the intestinal wall. Coeliotomy revealed the mass was originating from, and firmly adhered to, the antimesenteric border of the duodenum but was not communicating with the intestinal lumen. En bloc mass resection with omentalization was performed without small intestinal resection. Histopathology confirmed an enteric duplication cyst. The cat made a full recovery and remained asymptomatic postoperatively with no evidence of recurrence. A review of the literature confirms the duodenum to be the most common location of enteric duplication cysts in felines and that subtotal excision is curative in most cases. This differential should be considered in cases of cystic gastrointestinal structures in juvenile and adult felines, with or without associated clinical signs. In cases of luminal involvement or malignant transformation, intestinal resection and anastomosis is more appropriate. This report describes the presentation, investigations, and treatment of an asymptomatic duodenal duplication cyst in an adult feline and summarizes and compares current knowledge of the condition between veterinary and human literature.

COELOMIC STEATITIS IN TENTACLED SNAKES (ERPETON TENTACULATUM).

A retrospective study revealed seven cases of coelomic steatitis in adult tentacled snakes (Erpeton tentaculatum), including two males and five females, between May 2014 and August 2020. Common clinical signs included death after unusual floating, generalized weakness, inappetence, reduced body condition, coelomic distension, and reproductive pathology in females. Hematology of one specimen revealed marked monocytosis and lymphocytosis with mild heterophilia (chronic and active inflammation). Gross examination identified variable degrees of intracoelomic fat necrosis in all snakes. Consistent histopathologic features included necrotic adipocytes, lipid saponification, lipofuscin/ceroid deposition, granulomatous inflammation, and multinucleated giant cells (Langhans type). Three females exhibited intralesional yolk fluid associated with periovarian steatitis. Hepatic lipidosis was the second most frequent pathologic finding. Thawed frozen lesser sand eels (Ammodytes tobianus) were fed during this period, stored in vacuum-sealed or opened packets at -18°C (frozen). After the death of the last specimen, vitamin E concentrations and peroxide values of the diet were analyzed. For the sealed and opened frozen batches, respectively, vitamin E concentrations were 0.71 and 0.49 mg/100 g (compared with 4 to 8 mg/100 g in average, fresh, raw mixed eel species samples) and peroxide values were 62.5 and 48.6 meq/kg (exceeding the acceptable peroxide values of 8 meq/kg for fish oils). This case study represents the first report of coelomic steatitis in tentacled snakes of unconfirmed etiology but with a putative association with feeding a long-term frozen-stored sand eel diet containing low vitamin E concentrations and fish oils with high peroxide values at time of analysis.

Video methods for evaluating physiologic monitor alarms and alarm responses.

False physiologic monitor alarms are extremely common in the hospital environment. High false alarm rates have the potential to lead to alarm fatigue, leading nurses to delay their responses to alarms, ignore alarms, or disable them entirely. Recent evidence from the U.S. Food and Drug Administration (FDA) and The Joint Commission has demonstrated a link between alarm fatigue and patient deaths. Yet, very little scientific effort has focused on the rigorous quantitative measurement of alarms and responses in the hospital setting. We developed a system using multiple temporarily mounted, minimally obtrusive video cameras in hospitalized patients' rooms to characterize physiologic monitor alarms and nurse responses as a proxy for alarm fatigue. This allowed us to efficiently categorize each alarm's cause, technical validity, actionable characteristics, and determine the nurse's response time. We describe and illustrate the methods we used to acquire the video, synchronize and process the video, manage the large digital files, integrate the video with data from the physiologic monitor alarm network, archive the video to secure servers, and perform expert review and annotation using alarm "bookmarks." We discuss the technical and logistical challenges we encountered, including the root causes of hardware failures as well as issues with consent, confidentiality, protection of the video from litigation, and Hawthorne-like effects. The description of this video method may be useful to multidisciplinary teams interested in evaluating physiologic monitor alarms and alarm responses to better characterize alarm fatigue and other patient safety issues in clinical settings.

Fatal Hymenolepis nana-associated visceral larva migrans in captive juvenile white-tailed antsangies (Brachytarsomysalbicauda).

White-tailed antsangies (Brachytarsomys albicauda) are Madagascan rodents uncommonly kept in captivity. Hymenolepis nana is a cestode with an unusual life cycle, incorporating direct, indirect and autoinfective stages. This case series represents the first reported outbreak of H. nana cestodiasis in white-tailed antsangies, summarizing macroscopic and histological findings in four cases. On post-mortem examination (PME), numerous cysticerci were detected consistently throughout the intestinal serosa, liver, mesenteric lymphatic vasculature and mesenteric lymph nodes. Pancreatic cysticerci were observed in one case. Adult tapeworms, larvae and eggs were found only in the small intestine, and faecal egg shedding was a feature. Histopathological examination identified adult, larval and encysted cestodes within the respective gross lesions, with pulmonary, pancreatic and splenic involvement detected in a single case. The cestodes sampled on PME were identified by polymerase chain reaction and DNA sequencing, with H. nana confirmed in all cases. Visceral larva migrans was consistent throughout all specimens, in contrast with the natural infections of standard rodent hosts, and may be considered a likely pathological feature of H. nana infection in white-tailed antsangies.

A Case Series of Five Horses with Superficial Digital Flexor Tendon Lesions in the Carpal Canal.

This case series discusses the clinical presentation, ultrasonographic findings, treatment, and outcome of 5 horses with superficial digital flexor tendon (SDFT) lesions within the carpal canal. The horses' ages ranged from 11-28 years, and presented with an acute, unilateral forelimb lameness which worsened following proximal limb flexion. The presence of a lesion within the SDFT of the carpal canal was accompanied by a mild swelling of the palmar carpal region in most cases. Diagnostic anesthesia of the ulnar nerve, when performed, abolished the lameness. Ultrasound evaluation revealed an increased cross-sectional area (CSA) of the superficial digital flexor tendon compared to the contralateral, sound limb and a loss of tendon fiber architecture within the palmar aspect of the affected tendon, most readily identifiable upon longitudinal ultrasound images. Three out of the five horses returned to their previous level of performance, and two were euthanized. A back at the knee carpal region conformation was associated with a poorer prognosis in these cases. An intratendinous fibroma was identified on histopathological analysis of one-horse following euthanazia, which has been recorded in a complementary short communication.

Intratendinous Fibroma of the Superficial Digital Flexor Tendon within the Carpal Sheath of a Horse.

A 20-year-old British Warmblood gelding was presented for a progressively worsening right forelimb lameness which developed following an intense dressage training session. Initial ultrasound examination revealed a triangular, intrathecal, hypoechoic region within the superficial digital flexor tendon (SDFT) in the proximal, palmar carpal region distal to the accessory carpal bone (ACB), extending 7cm distally into the proximal metacarpal region. No significant improvement in clinical presentation was observed following an eight-week rehabilitation programme. Repeat ultrasound examination revealed an enlarged cross-sectional area of affected tendon. Due to a poor clinical response to conservative treatment, combined with increasingly marked severity of the lameness, the horse was humanely euthanised and the affected SDFT was submitted for macroscopic and histopathological examination at the University of Liverpool. This revealed an approximately 70mm-elongated, focally extensive mass located within the SDFT. On cross-section, the mass was poorly delineated, irregularly triangular, focally haemorrhagic, firm, 15 × 12mm wide and eccentrically placed towards the palmar aspect of the tendon. Histopathological examination identified a moderately to highly cellular, infiltrative, poorly demarcated mesenchymal neoplasm comprised of streams of moderately atypical spindloid cells including bizarre mitoses. Intratendinous fibroma is an uncommonly recorded human neoplasm and this case represents the third reported case of this entity in the horse, the first in an adult horse and the first to be identified in the SDFT.

Evaluation of the Olecranon Bursa: An Anatomical Structure in the Normal Horse.

This study aimed to determine whether a true synovial structure exists over the olecranon tuberosity, which could be attributed to a noninflamed olecranon bursa. Contrast radiography, gross anatomical dissection, and histopathology were used to evaluate the olecranon bursa in horses with no previous elbow pathology. The radiographic study revealed that the contrast was positioned subcutaneously, superficial to the long head of the triceps and its insertion on the olecranon tuberosity and did not extend cranial to the triceps tendon. The contrast region was consistent in shape, size, and location. Gross anatomical dissection of the area revealed a potential bursal space overlying the tendons of the lateral and medial heads of the triceps brachii and the tensor fascia antebrachii in the normal horse. Histopathology confirmed a bursal lining, which was of mesenchymal origin and suggestive of a single-cell membrane, lined by fibroblast-like synoviocytes.

Nectarivorous Bird Emphysematous Ingluvitis (NBEI): A Novel Disease in Loriinae Birds Associated With Clostridium perfringens Infection.

A retrospective study revealed ten cases of emphysematous ingluvitis in Loriinae birds from two zoological collections between 2009 and 2020. Common clinical features were sudden death with gas distention of the crop, subcutaneous cervical emphysema and poor body condition, but also included collapse, hypothermia and abandonment. Macroscopic examination revealed moderate crop enlargement, distention and thickening with minimal intraluminal content, and moderate to severe submucosal to transmural gas-filled cysts (emphysema). Histopathology identified widespread transmural multifocal to coalescing empty pseudo-cystic cavities with lytic necrosis, pyo-/granulomatous inflammatory infiltrates, epithelial ulceration, parakeratotic hyperkeratosis, epithelial ballooning degeneration, and occasional intralesional rod-shaped bacteria. The lesion may have impaired the birds' ability to ingest food, resulting in suboptimal body condition. Necrotizing to granulomatous aspiration pneumonia was also a feature in some cases. Anaerobic bacterial culture of four crops identified Clostridium perfringens with associated toxin genes for alpha and occasionally beta2 toxin (cpa and cpb2 genes respectively), by PCR analysis of bacterial isolates cultured from fresh or frozen tissue. C. perfringens was identified as the common etiological agent of emphysematous ingluvitis in crop and/or liver (six out of ten birds), and type A was confirmed in five birds. C. perfringens was not detected in the crop nor liver of two unaffected Loriinae birds. This is the first publication that characterizes nectarivorous bird emphysematous ingluvitis (NBEI), attributes C. perfringens as an etiological agent, and highlights this novel disease as an important cause of death in Loriinae birds, particularly in nestling and fledgling stage of development, but also in older lorikeets and lories.

Association between exposure to nonactionable physiologic monitor alarms and response time in a children's hospital.

BACKGROUND: Alarm fatigue is reported to be a major threat to patient safety, yet little empirical data support its existence in the hospital. OBJECTIVE: To determine if nurses exposed to high rates of nonactionable physiologic monitor alarms respond more slowly to subsequent alarms that could represent life-threatening conditions. DESIGN: Observational study using video. SETTING: Freestanding children's hospital. PATIENTS: Pediatric intensive care unit (PICU) patients requiring inotropic support and/or mechanical ventilation, and medical ward patients. INTERVENTION: None. MEASUREMENTS: Actionable alarms were defined as correctly identifying physiologic status and warranting clinical intervention or consultation. We measured response time to alarms occurring while there were no clinicians in the patient's room. We evaluated the association between the number of nonactionable alarms the patient had in the preceding 120 minutes (categorized as 0-29, 30-79, or 80+ alarms) and response time to subsequent alarms in the same patient using a log-rank test that accounts for within-nurse clustering. RESULTS: We observed 36 nurses for 210 hours with 5070 alarms; 87.1% of PICU and 99.0% of ward clinical alarms were nonactionable. Kaplan-Meier plots showed incremental increases in response time as the number of nonactionable alarms in the preceding 120 minutes increased (log-rank test stratified by nurse P < 0.001 in PICU, P = 0.009 in the ward). CONCLUSIONS: Most alarms were nonactionable, and response time increased as nonactionable alarm exposure increased. Alarm fatigue could explain these findings. Future studies should evaluate the simultaneous influence of workload and other factors that can impact response time.

Acute Cardiac Tamponade: An Unusual Cause of Acute Renal Failure.

We are reporting a case of acute renal failure after cardiac surgery due to acute pericardial effusion. The patient had normal baseline renal function but developed acute oliguric renal failure with a significant increase in serum creatinine postoperatively. Pericardiotomy led to an improvement in blood pressure, immediate diuresis and quick recovery of renal function back to baseline. Pericardial tamponade should be included in the consideration of causes of the cardiorenal syndrome.