Abdominal trauma in dogs 2. management

Trauma represents a big challenge for emergency doctors both in human and veterinary medicine. There have been great advancements in trauma medicine in people and these often provide an inspiration for veterinary surgeons. However, the vast differences in the facilities and finances available in human and veterinary medicine make the approach to trauma in both fields quite different. This article, the second in a two-part series, describes how to manage canine trauma patients. The first part focused on the initial investigation of canine abdominal trauma. Although this article will mention guidelines in people, these should not be automatically applied to dogs, especially when more relevant evidence for this species exists

Ultrasonography in the diagnosis and management of cats with ureteral obstruction

This was a retrospective cross-sectional study of cats with azotaemia (serum creatinine >180 μmol/l) that had ultrasonography of the urinary tract, ultrasound images available for review and received treatment for azotaemia. Cats with pre-renal azotaemia or urethral obstruction were excluded. Associations between clinical and ultrasonographic results and the dependent variables ‘tentative diagnosis of ureteral obstruction’, ‘pyelography positive for ureteral obstruction’ and ‘death in hospital’ were tested using binary logistic regression

Successful management of fipronil toxicosis in two pet rabbits

Background: Antiparasitic drug toxicosis is commonly described in dogs and cats, but reports on the management of antiparasitic drug toxicities in pet rabbits are scarce. Here, we describe the successful clinical management of two pet rabbits with fipronil toxicosis.Cases Description: The first case was a 5-month-old, intact female, rabbit that presented with the acute onset of seizures, obtunded mentation, and in lateral recumbency, while the second rabbit was a 1-year-old, intact male, rabbit that presented with anorexia and lethargy. In both cases, the owners reported to have administered a 0.5 ml fipronil vial topically on the skin as an antiparasitic drug between 4 and 6 hours prior to presentation. Complete blood count and serum biochemistry were unremarkable and both rabbits tested negative on Encephalitozoon cuniculi serology. Both animals were decontaminated by bathing with tepid water and dishwashing soap. The rabbit with seizures received on admission intravenous midazolam. In both cases, overnight hospitalization, intravenous isotonic crystalloid fluids, and assisted-feeding by oral syringe were provided until voluntary feeding was resumed. Both rabbits rapidly improved approximately 12 hours of initiating supportive care. Complete resolution of clinical signs and return of normal appetite and defecation occurred within 24 hours of hospitalization in both animals. No recurrence of neurological signs was reported in the rabbit presenting with seizures on a follow-up period of 1 month.Conclusion: The outcome of these cases suggests that supportive treatment of fipronil toxicity in pet rabbits can be successful if administered promptly

Description of the use of plasma exchange in dogs with Cutaneous and Renal Glomerular Vasculopathy

Cutaneous and renal glomerular vasculopathy (CRGV) is a rare disease affecting dogs, with a recent apparent increase in prevalence since 2012 in the UK. This disease is characterized by a vasculopathy affecting small vessels of the kidney and skin, leading to thrombotic microangiopathy. The underlying etiology remains unknown although clinicopathological and histological findings resemble features of certain forms of thrombotic microangiopathy in people, for which plasma exchange (PEX) is considered an important component of therapy. The objective of the present study is to describe the use of PEX as adjunctive treatment in dogs diagnosed with CRGV. A retrospective review of dogs diagnosed with CRGV between 2014 and 2016 treated with PEX was performed. Clinical records were reviewed and data relating to signalment, diagnostic tests and management strategies were summarized. Information and complications relating to PEX were recorded. Six dogs were diagnosed with CRGV (n = 2 ante-mortem, n = 4 post-mortem) and underwent PEX as part of their therapy. All dogs had cutaneous lesions and were azotemic with oliguria or anuria. All dogs underwent at least one PEX cycle; one dog had a single cycle PEX, three dogs two cycles PEX, and two dogs had one cycle PEX and one cycle of prolonged intermittent renal replacement treatment. Complications seen during PEX therapy included hypothermia (n = 4), tachycardia (n = 2), hypotension (n = 2), and hypocalcemia (n = 6). Two dogs survived to discharge, the remaining four dogs were euthanized. The positive outcome in two dogs treated with PEX despite the reported high mortality rate once acute kidney injury with oliguria/anuria occurs does not confirm success of this treatment. However, survival in two dogs that were initially oligoanuric highlights that further consideration and evaluation of PEX for this patient group is warranted for this specific disease. Additional studies are urgently needed to identify the underlying etiology of CRGV before more targeted therapies can be developed. Based on our findings, further evaluation of the role of PEX in this specific disease are warranted

Prospective evaluation of pericardial catheter placement versus needle pericardiocentesis in the management of canine pericardial effusion

Objective To compare the safety and efficacy of pericardial catheter placement with needle pericardiocentesis in dogs with pericardial effusion (PE) Design Prospective, randomized clinical trial. Setting University teaching hospital. Animals Thirty client‐owned dogs requiring pericardiocentesis between January 2017 and August 2019. Interventions Dogs were randomized to undergo PE drainage via indwelling pericardial catheter placement (catheter group) followed by elective drainage every 4–6 hours or needle pericardiocentesis (needle group) repeated as necessary. Measurements and main results Fifteen dogs were allocated to the catheter group and 15 to the needle group. Data collected included signalment, cause of effusion, occurrence of arrhythmias pre‐, during, and post‐pericardiocentesis, procedural length, and details of repeated drainages. There was no significant difference between mean procedural times for pericardial catheter placement (17.7 min [±11.8]) and needle pericardiocentesis (12.1 min [±8.6]) (P = 0.192) or the rate of new arrhythmias in the catheter (36%) and needle (64%) groups (P = 0.24). Pericardial catheters were kept in situ for a median of 21 hours (range, 14–85). Three of 15 (20%) dogs in the needle group required repeated pericardiocentesis within 24 hours of initial pericardiocentesis. Pericardial catheters enabled repeated large volume PE drainage in 4 cases (median, 10.6 mL/kg; range, 8‐5–10.6). Conclusions Pericardial catheters appear to offer a safe alternative to needle pericardiocentesis. Minimal sedation is required for placement, and they can be placed quickly. Their indwelling nature and use was not associated with a higher rate of arrhythmia compared to that of needle pericardiocentesis alone, and may be beneficial in the event that clinically significant PE recurs

Application of alternative fixatives to formalin in diagnostic pathology

Fixation is a critical step in the preparation of tissues for histopathology. The aim of this study was to investigate the effects of different fixatives vs formalin on proteins and DNA, and to evaluate alternative fixation for morphological diagnosis and nucleic acid preservation for molecular methods. Forty tissues were fixed for 24 h with six different fixatives: the gold standard fixative formalin, the historical fixatives Bouin and Hollande, and the alternative fixatives Greenfix, UPM and CyMol. Tissues were stained (Haematoxylin-Eosin, Periodic Acid Schiff, Trichromic, Alcian-blue, High Iron Diamine stainings), and their antigenicity was determined by immunohistochemistry (performed with PAN-CK, CD31, Ki-67, S100, CD68, AML antibodies). DNA extraction, KRAS sequencing, FISH for CEP-17, and flow cytometry analysis of nuclear DNA content were applied. For cell morphology the alternative fixatives (Greenfix, UPM, CyMol) were equivalent to formalin. As expected, Hollande proved to be the best fixative for morphology. The morphology obtained with Bouin was comparable to the one with formalin. Hollande was the best fixative for histochemistry. Bouin proved to be equivalent to formalin. The alternative fixatives were equivalent to formalin, although with greater variability in haematoxylin-eosin staining. It proved the possibility to obtain immunohistochemical staining largely equivalent to that following formalin-fixation with the following fixatives: Greenfix, Hollande, UPM and CyMol. The tissues fixed in Bouin did not provide results comparable to those obtained with formalin. The DNA extracted from samples fixed with alternative fixatives was found to be suitable for molecular analysis

Comparison of ultrasonographic findings in cats with and without azotaemia

US findings in 238 cats with (serum creatinine >180 μmol/l) and 270 cats without azotaemia were compared in a retrospective case-control study. Cats with pre-renal azotaemia or urethral obstruction were excluded. Data extracted from the medical records included age, body weight and body condition score (BCS). Quantitative and subjective US findings were extracted from archived ultrasound images and contemporaneous reports