Effect of clinical signs, endocrinopathies, timing of surgery, hyperlipidemia, and hyperbilirubinemia on outcome in dogs with gallbladder mucocele

Gallbladder mucocele (GBM) is a common extra-hepatic biliary syndrome in dogs with death rates ranging from 7 to 45%. Therefore, the aim of this study was to identify the association of survival with variables that could be utilized to improve clinical decisions. A total of 1194 dogs with a gross and histopathological diagnosis of GBM were included from 41 veterinary referral hospitals in this retrospective study. Dogs with GBM that demonstrated abnormal clinical signs had significantly greater odds of death than subclinical dogs in a univariable analysis (OR, 4.2; 95% CI, 2.14–8.23; P < 0.001). The multivariable model indicated that categorical variables including owner recognition of jaundice (OR, 2.12; 95% CI, 1.19–3.77; P = 0.011), concurrent hyperadrenocorticism (OR 1.94; 95% CI, 1.08–3.47; P = 0.026), and Pomeranian breed (OR, 2.46; 95% CI 1.10–5.50; P = 0.029) were associated with increased odds of death, and vomiting was associated with decreased odds of death (OR, 0.48; 95% CI, 0.30–0.72; P = 0.001). Continuous variables in the multivariable model, total serum/plasma bilirubin concentration (OR, 1.03; 95% CI, 1.01–1.04; P < 0.001) and age (OR, 1.17; 95% CI, 1.08–1.26; P < 0.001), were associated with increased odds of death. The clinical utility of total serum/plasma bilirubin concentration as a biomarker to predict death was poor with a sensitivity of 0.61 (95% CI, 0.54–0.69) and a specificity of 0.63 (95% CI, 0.59–0.66). This study identified several prognostic variables in dogs with GBM including total serum/plasma bilirubin concentration, age, clinical signs, concurrent hyperadrenocorticism, and the Pomeranian breed. The presence of hypothyroidism or diabetes mellitus did not impact outcome in this study.Supplemental Table S1. Number of dogs included from each institution and years reviewed.Supplemental Table S2. Included breeds.Supplemental Table S3. Distribution of various reasons given for performing cholecystectomy in the 179 subclinical dogs with gallbladder mucocele (GBM).Supplemental Table S4. Distribution of clinical signs associated with systemic illness in 982 dogs with gallbladder mucocele.Supplemental Table S5. Distribution of reasons for death in-hospital (i.e. euthanized and died) in 179 dogs with gallbladder mucocele that underwent cholecystectomy.http://www.elsevier.com/locate/tvjlhj2020Companion Animal Clinical Studie

Serum vitamin D concentration in hospitalized critically ill dogs

DOI of related article: 10.1371/journal.pone.0194062.Citation of related article: Jaffey JA, Backus RC, McDaniel KM, DeClue AE (2018) Serum vitamin D concentrations in hospitalized critically ill dogs. PLoS ONE 13(3): e0194062. https://doi.org/10.1371/journal.pone.0194062Abstract of related article: Hypovitaminosis D has been extensively documented in critically ill humans. However, whether or not critically ill dogs have alterations in vitamin D concentrations remains unconfirmed. The primary aims of our study were to compare serum 25-hydroxycholecalciferol [25(OH)D] concentrations in critically ill dogs with healthy control dogs, determine the prognostic utility of serum 25(OH)D concentration as a biomarker in critically ill dogs, and to assess if serum 25(OH)D concentrations in critically ill dogs are associated with length of stay in the intensive care unit or illness severity. Serum concentrations of 25(OH)D together with a range of other clinical, biochemical, and hematological parameters, were measured in 99 dogs within 24 hours of admission to the Intensive Care Unit (ICU). Critically ill dogs (P = 0.001) and dogs with sepsis (P = 0.002) had significantly lower serum 25(OH)D concentrations compared to healthy control dogs. In addition, serum 25(OH)D concentration was an independent predictor of in-hospital and 30 day survival. Using a cut-off of 33 ng/mL, serum 25(OH)D concentrations had excellent sensitivity (0.94; 95% CI, 0.71–1.00), but poor specificity (0.41; 95% CI, 0.31–0.53) for detection of survival. Serum 25(OH)D concentrations were inversely associated with acute patient physiologic and laboratory evaluation (APPLE) fast score but were not associated with ICU length of stay. Hospitalized dogs with critical illness have decreased serum 25(OH)D concentrations compared to healthy dogs and can be used to predict survival in this cohort

Evaluation of Candida spp. and Other Fungi in Feces from Dogs with Naturally Occurring Diabetes Mellitus

Diabetes mellitus is a common endocrinopathy in dogs and in most cases is analogous to type 1 diabetes mellitus (T1DM) in humans. Candida spp. is a common commensal fungi with higher prevalence and magnitude of growth in humans with T1DM. There is currently no published information about the fungal microbiome in diabetic dogs. Therefore, the objectives of this study were to (i) determine whether diabetic dogs were more likely to have Candida spp. or other types of fungi from feces compared to non-diabetic controls, and (ii) identify variables associated with fungi colonization. Fourteen diabetic dogs and 14 age, sex, and breed matched non-diabetic healthy control dogs were included in this prospective case&ndash;control study. Matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) was used for fungal identification. Diabetic dogs had greater quantitative fungal growth compared to controls (p = 0.004). Moreover, female dogs were more likely to have fungi colonization than males (p = 0.02). All instances of Candida spp. and Aspergillus spp. colonization were exclusively identified in diabetic dogs. Serum fructosamine concentration was higher in diabetic dogs with fecal colonization of Candida spp. compared to diabetic dogs without growth (p = 0.03). Our results indicate that the fungal microbiome in feces is altered in diabetic dogs, which seem to favor an increased prevalence of Candida spp. and higher quantitative fungal growth. Moreover, female sex and glycemic control could affect the intestinal mycobiome

Sensitivity and specificity of serum 25(OH)D concentrations for detection of survival in the ICU using different cutoff values.

<p>Sensitivity and specificity of serum 25(OH)D concentrations for detection of survival in the ICU using different cutoff values.</p

APPLE fast score.

<p>Calculated by adding the values in the upper left corner of each cell for the 5 parameters listed, with a maximum score of 50 [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0194062#pone.0194062.ref037" target="_blank">37</a>]. Adapted from Hayes et al., 2010.</p

Box and whiskers plot comparing serum 25(OH)D concentrations in dogs that stayed ≤ 3 days in the intensive care unit to those that stayed > 3 days.

<p>The boxes represent the 25th and 75th quartiles with the horizontal line representing the median. The whiskers represent the range of the data. There was not a significant difference in serum 25(OH)D concentrations in dogs that stayed ≤ 3 days (n = 42) and those that stayed > 3 days (n = 40, P = 0.14).</p

Box and whiskers plot comparing serum 25(OH)D concentrations in critically ill dogs and healthy control dogs.

<p>The boxes represent the 25th and 75th quartiles with the horizontal line representing the median. The whiskers represent the range of the data. The black circles represent results for individual dogs. Healthy control dogs (n = 17) had significantly greater serum 25(OH)D concentration than critically ill dogs (n = 99).</p

Multivariate logistic regression model for survival 30 days after discharge.

<p>Multivariate logistic regression model for survival 30 days after discharge.</p

Box and whiskers plot comparing serum 25(OH)D concentrations in survivor and non-survivor critically ill dogs.

<p>The boxes represent the 25th and 75th quartiles with the horizontal line representing the median. The whiskers represent the range of the data. The black circles represent results for individual dogs. (A) Dogs that survived (n = 82) to discharge had significantly greater serum 25(OH)D concentration than non-survivors (n = 17). (B) Dogs that were alive (n = 23) 30 days after discharge had significantly greater serum 25(OH)D concentrations than non-survivors (n = 70).</p

Mentation score [37].

<p>Adapted from Hayes et al., 2010.</p