Myenteric ganglionitis and intestinal leiomyositis in a Jack Russell terrier.

A 9-year, 6-month old spayed female Jack Russell terrier presented with a 3-week history of intermittent vomiting, diarrhoea and weight loss. Serum biochemistry demonstrated severe panhypoproteinaemia, mild hypocalcaemia and mild hypocholesterolaemia, consistent with protein-losing enteropathy. Full-thickness biopsies obtained from the stomach and different sections of small intestine demonstrated histological features of both myenteric ganglionitis and early intestinal leiomyositis. Complete resolution of clinical signs occurred within 1 week of implementing immunosuppressive therapy. At the time of writing, 9 months following diagnosis, the dog remains in remission.

Relationships between low serum cobalamin concentrations and methlymalonic acidemia in cats.

BACKGROUND: Serum cobalamin concentrations below reference range are a common consequence of gastrointestinal disease in cats. Serum cobalamin 867 nmol/L. Sensitivity and specificity of serum cobalamin concentrations 867 nmol/L were analyzed using a receiver-operator characteristic curve. RESULTS: There was a negative correlation between serum cobalamin and MMA concentrations (Spearman's r=-0.74, P < 0.0001). The prevalence of MMA >or= 867 nmol/L in cats with serum cobalamin 867 nmol/L. No significant difference in serum folate concentrations was detected between affected and unaffected cats. CONCLUSIONS AND CLINICAL IMPORTANCE: Elevated MMA concentrations, suggesting cobalamin deficiency, are common in cats with serum cobalamin

Biological variation of serum canine calprotectin concentrations as measured by ELISA in healthy dogs.

Calprotectin is a useful biomarker of inflammation in dogs. However, the biological variation of serum canine calprotectin is unknown. Indices of biological variation were determined in serial serum samples (n=147) from 11 healthy dogs (males/females: 4/7, median age: 5 years): analytical (3.0%), intra-individual (29.9%), and inter-individual variation (33.2%), reciprocal index of individuality (1.1), and index of heterogeneity (4.9). Serum calprotectin concentrations measured by ELISA and by the previous radioimmunoassay were highly correlated, but a constant and proportional bias exists between both assays. A de novo ELISA-reference interval (RI) for serum calprotectin concentration was established (0.6-11.8mg/L). Moderate changes in serum calprotectin (minimum critical difference: 6.4mg/L) between sequential measurements are needed to be considered relevant, and a population-based RI may or may not be appropriate for serum calprotectin.

Variability of Symmetric Dimethylarginine in Apparently Healthy Dogs.

BACKGROUND: Symmetric dimethylarginine (SDMA) is a screening tool for early kidney dysfunction and monitoring treatment in cases of chronic kidney disease (CKD). There are no current studies describing the suitability of this test for use with published population-based reference intervals. HYPOTHESIS/OBJECTIVES: To determine the components of biological variability, the index of individuality (IOI), the critical difference between sequential measurements (CD ) and the number of measurements required to assess the homeostatic set point (HSP), for both SDMA and serum creatinine (sCr), in apparently healthy dogs. ANIMALS: Twenty apparently healthy adult dogs owned by clients or staff at a veterinary teaching hospital. METHODS: Prospective, observational study. Blood was collected from each dog on 9 occasions, and SDMA and sCr were measured in duplicate using commercially available assays. RESULTS: SDMA and sCr had intermediate and low IOI values of 0.87 and 0.28, respectively. The CD of SDMA and sCr, was 1.34 µg/dL and 0.89 µmol/L, respectively. The sample numbers required for estimation of an individual's HSP (with 90 and 95% CI) for SDMA and sCr were 8 and 45, and 2 and 12 sequential measurements, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Based on our findings, in comparison to sCr, SDMA is better suited for use with population-based reference intervals. False-negative test results could occur when comparing a single test result from an individual to such intervals. Ideally CD should be used with sequential measurements.

Preliminary evaluation of serum total cholesterol concentrations in dogs with osteosarcoma.

OBJECTIVES: To determine if total serum cholesterol concentrations were altered in dogs with osteosarcoma. To evaluate association of total serum cholesterol concentration with clinical outcomes in dogs with appendicular osteosarcoma. MATERIALS AND METHODS: Retrospective, multi-institutional study on 64 dogs with osteosarcoma. Control population consisted of dogs with traumatic bone fractures (n=30) and healthy patients of similar age and weight as those of the osteosarcoma cases (n=31). Survival analysis was done on 35 appendicular osteosarcoma patients that received the current standard of care. Statistical associations were assessed by univariable and multi-variable analysis. Information about age, sex, primary tumour location, total cholesterol concentration, monocytes and lymphocyte counts and alkaline phosphatase were also included. RESULTS: Total cholesterol was elevated above the reference interval (3·89 to 7·12 mmol/L) (150 to 275 mg/dL) in 29 of 64 (45·3%) osteosarcoma-bearing dogs, whereas similar elevations were found in only 3 of 30 (10%) fracture controls (P<0·0001) and 2 of 31 (6·5%) similar age/weight controls (P=0·0002). Elevated total cholesterol was significantly associated with a reduced hazard ratio (0·27, P=0·008) for overall mortality in dogs with osteosarcoma. CLINICAL SIGNIFICANCE: These results suggest that elevated total cholesterol is associated with canine osteosarcoma and may have prognostic significance.

Early biochemical and clinical responses to cobalamin supplementation in cats with signs of gastrointestinal disease and severe hypocobalaminemia.

Domestic cats with small intestinal disease may develop cobalamin deficiency because of reduced small intestinal uptake of this vitamin. This study assessed the impact of cobalamin deficiency on biochemical and clinical findings in cats with intestinal disease. Nineteen pet cats, all with severe hypocobalaminemia (< or =100 ng/L) and histories of gastrointestinal signs, were studied. Cats received cobalamin, 250 microg SC once weekly, for 4 weeks. Biochemical indices of cobalamin availability (e.g., serum methylmalonic acid, homocysteine, and cysteine concentrations), serum feline trypsinlike immunoreactivity (fTLI) and serum folate concentrations, and clinical findings were recorded at the start of the study and after 4 weeks of cobalamin therapy. Serum methylmalonic acid (MMA) concentrations (median; range) decreased after cobalamin supplementation (5373.0; 708.5-29,329.0 versus 423.5; 214.0-7219.0 nmol/L, P < .0001). Serum homocysteine concentrations were not significantly altered (mean +/- SD 8.2 +/- 2.9 versus 10.3 +/- 4.5 micromol/L, P = .1198), whereas cysteine concentrations increased significantly (122.3 +/- 38.8 versus 191.5 +/- 29.4 micromol/L, P < .0001). Mean body weight increased significantly after cobalamin therapy (3.8 +/- 1.1 versus 4.1 +/- 1 kg, P < .01), and the average body weight gain was 8.2%. Significant linear relationships were observed between alterations in serum MMA and fTLI concentrations and the percentage body weight change (P < .05 for both, Pearson r2 = 0.26 and 0.245, respectively). Mean serum folate concentration decreased significantly (mean +/- SD 19 +/- 5 microg/L versus 15.4 +/- 6.2 microg/L, P < .001). Reduced vomiting and diarrhea were observed in 7 of 9 and 5 of 13 cats, respectively. These results suggest that cobalamin supplementation in cats with small intestinal disease and severe hypocobalaminemia is associated with normalization of biochemical test results and improvements in clinical findings in most affected cats.

The effect of ex vivo refrigerated storage and cell preservation solution (Cyto-Chex II) on CD11b expression and oxidative burst activity of dog neutrophils.

The expression of CD11b and oxidative burst activity of dog neutrophils undergoing ex vivo refrigerated storage was studied using flow-cytometry . Additionally, the effect of a proprietary cell stabilization reagent (Cyto-Chex) on the expression of CD11b and oxidative burst activity was studied. Expression of CD11b was very high (>90% positive) on dog neutr ophils isolated from peripheral blood. Dog neutrophils showed a rapid and sustained increase in CD11b antigen density (P<0.01) during refrigerated storage, this increase was prevented by treatment with Cyto-Chex but was not completely blocked on the first day. There were no significant differences in mean antigen density between any days in the non-preserved group or between Days 1 to 4 in the Cyto-Chex treated group. The non-treated group showed significantly greater mean antigen density at all time points when compared to the preservative treated group (P<0.0001). Treatment with Cyto-Chex did not interfere with measurement of oxidative burst function on the first 2 days. Alterations of both resting oxidative activity and stimulated response were observed over time in both treated and untreated blood samples. Cyto-Chex treated samples showed a dramatic, significant decline in stimulated response after the third day of storage (P<0.001), while non-treated cells showed steadily increasing, but non-significant differences in stimulated response. Cyto-Chex was demonstrated to be a useful reagent for stabilization of dog neutrophil membrane antigens during storage, however this reagent is not recommended for preservation of cells for functional assays.

Tumor necrosis factor-alpha at presentation in 60 cases of spontaneous canine acute pancreatitis.

Tumor necrosis factor-alpha (TNF) is a pleiotropic cytokine with profound and broad ranging effects on many cell types. There have been few publications investigating the role of TNF in spontaneous disease processes of dogs, particularly the role of this cytokine during endotoxaemia, shock and multiple organ dysfunction syndromes. Plasma samples taken at presentation from 60 dogs with spontaneous acute pancreatitis of varying severity levels (scored 0-4 in ascending severity) were assessed for TNF activity by bioassay and total TNF protein levels through a dot-blot immunoassay. TNF activity by bioassay was detected in 31% (4/13) of dogs presenting with severe disease (>50% expected mortality) as defined using a scoring system for organ compromise, and was not detectable in the remaining animals or healthy controls. TNF activity was detected in 66% (4/6) animals in the highest severity group (Score 4), these animals were showing severe multiple organ dysfunction. Total TNF protein levels, measured by dot-blot immunoassay, exhibited a wide range in all severity groups and healthy dogs. Dogs with detectable TNF activity were not distinguished from the other severity or healthy groups by immunoassay. The absence of detectable differences in total TNF protein levels between the various severity groups suggests that other factors may be crucial in determining the role of TNF in spontaneous canine acute pancreatitis and subsequent endotoxaemia and shock.

Levels of total alpha-macroglobulin and trypsin-like immunoreactivity are poor indicators of clinical severity in spontaneous canine acute pancreatitis.

Trypsin-like immunoreactivity and total alpha-macroglobulin levels were assessed in serum and plasma samples taken at presentation from 60 cases of spontaneous canine acute pancreatitis of varying clinical severity. Total alpha-macroglobulin was significantly decreased in all severity groups when compared to 119 healthy controls, however there were no significant differences between severity groups. Trypsin-like immunoreactivity was significantly elevated above assay reference range in all groups. Trypsin-like immunoreactivity was significantly elevated in dogs with severe disease when compared to those with mild disease. These results suggest that zymogen release and protease activation, while components of the pathology of spontaneous canine acute pancreatitis, are not directly associated with the onset of multiple organ failure seen in the most severe cases.

Detection and measurement of canine alpha-macroglobulins by enzyme immuno-assay.

The alpha-macroglobulins are broad-specificity protease inhibitors important in the regulation and clearance from circulation of biologically active proteases. Inappropriate protease activation may be a feature of canine acute pancreatitis and the ability of the animal to clear these proteases may be important in determining survival. An enzyme immunoassay for the detection and measurement of canine alpha-macroglobulins in plasma samples was developed. A reference range for the canine alpha-macroglobulins of 1.20-2.72 mg ml-1 was established from a panel of canine plasma samples, and the stability of the alpha-macroglobulins in plasma samples stored at 4 degrees C was investigated. Changes in the level of the alpha-macroglobulins during disease states involving increased endogenous protease activity can now be investigated using a rapid, repeatable and quantifiable assay.

Comparison of direct and indirect tests for small intestinal bacterial overgrowth and antibiotic-responsive diarrhea in dogs.

Controversy exists over the diagnosis of idiopathic small intestinal bacterial overgrowth (SIBO) in dogs and some clinicians use the term antibiotic-responsive diarrhea (ARD) in preference. However, whether such terms are interchangeable is not clear. To examine the relationship between duodenal bacterial numbers and a clinical response to antibiotics, SIBO and ARD were defined by nonoverlapping criteria. Quantitative duodenal juice bacteriology and indirect serum biochemical tests were used to assess small intestinal bacterial populations in 30 dogs with gastrointestinal disorders, including 9 with ARD. Serum total unconjugated bile acid (TUBA) concentrations were measured in all dogs, serum folate and cobalamin concentrations were measured in 29 of 30 dogs, and quantitative culture of duodenal juice was performed in 22 of 30 dogs. Serum TUBA concentrations also were measured in samples from 38 control dogs. Twenty of 22 affected (clinical) dogs in which quantitative bacteriology was performed were classified as having SIBO (>10(5) colony-forming units of total bacteria per milliliter of duodenal juice), but bacterial numbers did not differ significantly between dogs with ARD and dogs with other disorders. Increased folate (19/29), decreased cobalamin (16/ 29), or a combination (9/29) were common, but increased TUBA concentrations were documented in only 5 of 30 clinical dogs. Again, no significant differences were observed between dogs with ARD and those with other disorders, and a similar proportion (5/38) of controls had abnormally high TUBA concentrations. Finally, no significant differences were noted when duodenal bacteriology and TUBA concentrations were assessed before and during antibiotic therapy. These results question the utility of quantitative duodenal juice bacteriology and indirect biochemical marker tests for SIBO in the investigation of canine gastrointestinal disorders.

Metabolism of amino acids in cats with severe cobalamin deficiency.

OBJECTIVE: To validate an automated chemiluminescent immunoassay for measuring serum cobalamin concentration in cats, to establish and validate gas chromatography-mass spectrometry techniques for use in quantification of methylmalonic acid, homocysteine, cysteine, cystathionine, and methionine in sera from cats, and to investigate serum concentrations of methylmalonic acid, methionine, homocysteine, cystathionine, and cysteine as indicators of biochemical abnormalities accompanying severe cobalamin (vitamin B12) deficiency in cats. SAMPLE POPULATION: Serum samples of 40 cats with severe cobalamin deficiency (serum cobalamin concentration < 100 ng/L) and 24 control cats with serum cobalamin concentration within the reference range. PROCEDURE: Serum concentrations of cobalamin were measured, using a commercial automated chemiluminescent immunoassay. Serum concentrations of methylmalonic acid, methionine, homocysteine, cystathionine, and cysteine were measured, using gas chromatography-mass spectrometry, selected ion monitoring, stable-isotope dilution assays. RESULTS: Cats with cobalamin deficiency had significant increases in mean serum concentrations bf methylmalonic acid (9,607 nmol/L), compared with healthy cats (448 nmol/L). Affected cats also had substantial disturbances in amino acid metabolism, compared with healthy cats, with significantly increased serum concentrations of methionine (133.8 vs 101.1 micromol/L) and significantly decreased serum concentrations of cystathionine (449.6 vs 573.2 nmol/L) and cysteine (142.3 vs 163.9 micromol/L). There was not a significant difference in serum concentrations of homocysteine between the 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE: Cats with gastrointestinal tract disease may have abnormalities in amino acid metabolism consistent with cobalamin deficiency. Parenteral administration of cobalamin may be necessary to correct these biochemical abnormalities.

Inflammatory pseudotumour of the nasal cavity and sinuses.

The term inflammatory pseudotumour encompasses a very diverse group of conditions, with different sites, whose only common feature is the absence of a specific histological diagnosis. The histopathological and aetiopathogenic data have been derived from experience in the thoracic, orbital and abdominal forms, which are much more frequent than disease affecting the nasal cavities and sinuses. However, there is no evidence that these data are applicable to sino-nasal pseudotumour. We present a case of inflammatory pseudotumour of the nasal cavity and a review of the literature (19 cases in 30 years) with respect to the clinical and radiological findings, the natural history and the specific management of disease at these sites. Surgery seems to be the best option for this localization. Corticosteroids and radiotherapy may be of value in cases of residual tumour after the histological confirmation of the diagnosis and the exclusion of neoplasia.

A severity score for spontaneous canine acute pancreatitis.

OBJECTIVE: To derive a severity score for spontaneous canine acute pancreatitis applicable to general practice. DESIGN: Cohort study of canine pancreatitis cases. PROCEDURE: Cases (n = 68) of spontaneous canine acute pancreatitis presented to general practitioners were identified among accessions to Veterinary Pathology Services Brisbane. The primary veterinarian was surveyed by telephone to ascertain the outcome of each case. Scores were assigned for extent of hyperamylasaemia, hyperlipasaemia and number of organ systems other than the pancreas compromised. The probability of mortality with each score of each analyte was calculated. The strength of interaction between scores for each analyte and mortality rate was assessed by chi-square analysis where appropriate. Relationships between the organ system score, other physiological variables and likelihood of euthanasia were analysed. RESULTS: Scores derived mathematically from analysis of enzyme activities had poor abilities to predict mortality. The score based upon the number of organ systems compromised showed good ability to predict mortality and the interaction between the organ system score and mortality rate was significant by chi-square analysis (P < 0.01). Distribution of data within the amylase and lipase scores was not compatible with chi-square analysis. CONCLUSION: Assessment of severity of spontaneous canine acute pancreatitis using pancreatic enzyme activities is potentially inaccurate. The use of a severity score based upon organ system compromise was more accurate in determining the likelihood of mortality in spontaneous canine acute pancreatitis. This is compatible with the hypothesis that severe canine acute pancreatitis is a multiple organ failure syndrome.

Fecal alpha1-proteinase inhibitor concentration in dogs with chronic gastrointestinal disease.

BACKGROUND: Fecal alpha(1)-proteinase inhibitor (alpha(1)-PI) clearance is a reliable, noninvasive marker for protein-losing enteropathy in human beings. An assay for use in dogs has been developed and validated. OBJECTIVE: The aim of this study was to evaluate fecal alpha(1)-PI concentration in dogs with chronic gastrointestinal disease, compared with healthy dogs, and to assess its correlation with serum albumin concentration. METHODS: Fecal samples were collected from 2 groups of dogs. Group 1 consisted of 21 clinically healthy client-owned dogs without signs of gastrointestinal disease. Group 2 consisted of 16 dogs referred for investigation of suspected gastrointestinal disease. On the basis of gastric and duodenal biopsies, group 2 was further subdivided into dogs with normal histology (n = 9) and those with histologic abnormalities (n = 7: inflammatory bowel disease, n = 3; lymphangiectasia, n = 4). An ELISA was used to measure alpha(1)-PI concentrations in fecal extracts. RESULTS: Fecal alpha(1)-PI concentrations, expressed as micro g/g of feces, were not significantly different between groups 1 and 2 as a whole. However, fecal alpha(1)-PI concentrations (median, minimum-maximum) were significantly higher in dogs with gastrointestinal diseases associated with histologic abnormalities (60.6 micro g/g, 7.4-201.7 micro g/g) compared with dogs with normal histology (3.8 micro g/g, 0.7-74.0 micro g/g) and control dogs (9.9 micro g/g, 0.0-32.1 micro g/g). There was no significant correlation between fecal alpha(1)-PI and serum albumin concentrations in dogs with gastrointestinal disease. CONCLUSIONS: Increased fecal alpha(1)-PI concentration may signal the need to obtain gastrointestinal biopsies for a final diagnosis. Fecal alpha(1)-PI concentration may be a useful test for early detection of protein-losing enteropathy before decreases in serum albumin concentration can be detected.

Fecal alpha1-proteinase inhibitor concentration in dogs receiving long-term nonsteroidal anti-inflammatory drug therapy.

BACKGROUND: Fecal alpha(1)-proteinase inhibitor (alpha(1)-PI) clearance is a reliable, noninvasive marker for protein-losing enteropathy (PLE) in human beings. An assay for measurement of this protein in the dog has been developed and validated and may be useful for the investigation of gastrointestinal disease in this species. Nonsteroidal anti-inflammatory drugs (NSAIDs) frequently are administered to dogs and may have adverse effects on the gastrointestinal tract, including gastroduodenal ulceration and altered mucosal permeability. The value of fecal alpha(1)-PI measurement in detecting unrelated gastrointestinal disease may be limited in dogs on NSAID therapy, but alpha(1)-PI may be a useful marker for NSAID-induced gastrointestinal damage. OBJECTIVE: The aim of this study was to evaluate the effects of long-term administration of NSAIDs on fecal alpha(1)-PI concentrations in dogs. METHODS: Fecal samples were collected from 2 groups of dogs: 1) 21 clinically-healthy client-owned dogs without signs of gastrointestinal disease and receiving no NSAIDs and 2) 7 dogs referred for investigation and treatment of orthopedic disorders; the dogs had received either meloxicam or carprofen daily for at least 30 days. Fecal alpha(1)-PI concentration was measured by ELISA. RESULTS: Fecal alpha(1)-PI concentrations, expressed as micro g/g of feces, were not significantly different between groups 1 and 2 (median [range], group 1: 9.9 micro g/g [0.0-32.1 micro g/g]; group 2: 5.6 micro g/g [1.1-32.3 micro g/g]; P =.81). CONCLUSIONS: These results suggest that use of cyclooxygenase-2-selective NSAIDs, such as carprofen and meloxicam, does not significantly affect fecal alpha(1)-PI measurements. However, study numbers were small, and larger prospective trials are required to assess more accurately the gastrointestinal effects of NSAIDs in dogs.

[Inverted papilloma of the nose and paranasal sinuses. Apropos of 10 cases]. / Papillomes inverses naso-sinusiens. A propos de dix cas.

Authors report a retrospective study of 10 new cases of inverted papilloma of the nose and paranasal sinuses, observed during a 26 years period, with a 6.1 years average follow up. This group is marked by 2 cases of directly carcinomatous association, 4 cases of recurrence and 2 cases of later malignant transformation. The responsibility of different types of human papillomavirus in the origin of this tumor and its malignant transformation is suspected. Preoperative evaluation is based on clinical examination, CT scan and endoscopic method while diagnosis and prognosis depend on histopathologic finding of the whole tumor. The aim of surgical treatment is the most complete removal of the tumor with as limited after effects as possible. Lateral rhinotomy is the most favoured surgical approach versus mid facial degloving and intranasal endoscopy. No surgical patient, no removal tumor, inadequate limits, malignant papilloma and early recurrence are indications for external radiotherapy.

[Facial nerve involvement after surgery of the parotid gland]. / Atteinte motrice faciale après chirurgie de la parotide.

The authors report a retrospective study of 351 parotidectomies observed during a 28 years period. The average follow-up is 28 months. Preoperative and postoperative facial nerve function, type of parotidectomy, surgical management of facial nerve, and histologic diagnosis according to the revised WHO classification (1990) are presented. Type of parotidectomy and degree of tumor malignancy are statistically analyzed. It seems that occurrence of post-operative facial nerve dysfunction depends on radical parotidectomy, whereas long term dysfunction is determined by tumor malignancy. Malignant epithelial tumors of the major salivary glands proved to be radiosensitive. Apart from preoperative dysfunction, clinical involvement and impossible facial nerve dissection, the authors insist upon sparing the facial nerve, even in the case of microscopic residual tumors, and prefer postoperative radiotherapy.

[Malformation of the internal ear and recurrent meningitis: radio-surgical correlations]. / Malformation de l'oreille interne et méningites à répétition: corrélations radio-chirurgicales.

Authors report one case of bilateral inner ear malformation in a 3 years-old child with congenital sensorineural hearing loss, recurrent meningitis and cerebro-spinal fluid leakage. This anomaly is a pseudo-Mondini's malformation with a meningocele through the oval window and a fistula of C.S.F. of the round window. A close radiological and surgical correlation support some physiopathological hypothesis about fistula between sub arachnoid space and middle ear. Authors discuss the place of high resolution computed tomography in case of congenital sensorineural learning loss.

[Multiple localization and lymphatic involvement of papillary micro-carcinoma of the thyroid. Results of total thyroidectomy with bilateral lymph node excision. Apropos of 38 patients]. / Multifocalité et lymphophilie des micro-carcinomes papillaires thyroidiens. Résultats de la thyroïdectomie totale avec évidement bilatéral, à propos de 38 patients.

This study involved 38 patients with occult papillary carcinoma of the thyroid gland treated by total thyroidectomy and bilateral prophylactic neck dissection. The histological results show the glandular multicentricity on either side, both in single nodule (65%) and in multinodular goiter (73.3%). High risk of cervical spreading clearly appears in papillary carcinoma (18.4% of the patients) even in these small foci (lower than 10 mm). Topography of involvement brings into prominence two main territories: paratracheal, mid and lower jugularly nodes (involved in 92.8% of the positive dissections).