In dogs with metaldehyde intoxication, are benzodiazepines more effective than methocarbamol in relaxing muscles and reducing tremors?

Question: In dogs with metaldehyde intoxication, are benzodiazepines (e.g. diazepam, midazolam) more effective than methocarbamol in relaxing muscles and reducing tremors? Clinical bottom line: The category of research question was treatment/prognosis/risk/diagnosis/prevalence/incidence Treatment: The number and type of study designs that were critically appraised were… Five papers were critically reviewed. There were 5 retrospective case-series. Critical appraisal of the selected papers meeting the inclusion criteria collectively provide zero/weak/moderate/strong evidence in terms of their experimental design and implementation. Weak. The outcomes reported are summarised as follows. Currently, 5 retrospective case series exist in the literature which discuss metaldehyde intoxication cases treated mainly with benzodiazepines, a few of which had methocarbamol. There is not really any study to compare directly benzodiazepines with methocarbamol. In addition to that, commercial (e.g. the low availability of methocarbamol in the UK market comparing to the US market), administrational (e.g. multiple administration routes of benzodiazepines) and pharmacological (e.g. lack of anticonvulsant function of methocarbamol) factors have played an important role to the treatment choice. Several case reports exist as well. In view of the strength of evidence and the outcomes from the studies the following conclusion is made… Currently, there is insufficient evidence to determine whether benzodiazepines are more effective than methocarbamol in relaxing muscles and reducing occurrence of muscle tremors

Brainstem phaeohyphomycosis due to Curvularia lunata (Cochliobolus lunatus) in a cat

A 13-year-old female neutered domestic short-hair cat was presented with chronic progressive vestibular ataxia, lethargy and anorexia. Clinical examination revealed bilateral mucopurulent nasal discharge. Neurological examination revealed obtundation, a right head tilt, ambulatory tetraparesis, generalised vestibular ataxia, decreased postural reactions in all limbs, right Horner's syndrome, spontaneous conjugate jerk rotatory nystagmus and right positional ventral strabismus. Neuroanatomical localisation was observed in the right central vestibular system. Computed tomography revealed a solitary ill-defined contrast-enhancing mass lesion at the level of the right cerebellopontine angle. Cerebrospinal fluid (CSF) analysis revealed mild mononuclear pleocytosis and fungal elements. CSF culture was positive for Curvularia spp. Further tests for underlying diseases were all negative. The cat was treated with antibiotic and antifungal treatment, but it deteriorated rapidly and was euthanased. Necropsy of the brainstem mass lesion revealed pyogranulomatous inflammation. Panfungal polymerase chain reaction (PCR) targeting the internal transcribed spacer (ITS) region and subsequent sequencing identified Curvularia lunata in the formalin fixed brain tissue. This is the first report of brainstem phaeohyphomycosis by Curvularia lunata (Pleosporales) in a cat. In addition, this is the first report among animal and humans where fungal elements of Curvularia lunata were found in the CSF cytology. Opportunistic fungal pathogens should be always considered within the differential diagnoses list in cats with neurological signs and advanced imaging findings compatible with solitary mass lesions in the brain. In feline patients with pyogranulomatous meningoencephalitis and a suspicion of a fungal aetiology, panfungal PCR for the ITS region and sequencing should be performed regardless of the absence of fungal elements in histopathology

Working people with type 1 diabetes in the Finnish population

Peer reviewe

Feel4Diabetes healthy diet score: Development and evaluation of clinical validity

Background: The aim of this paper is to present the development of the Feel4Diabetes Healthy Diet Score and to evaluate its clinical validity. Methods: Study population consisted of 3268 adults (63% women) from high diabetes risk families living in 6 European countries. Participants filled in questionnaires at baseline and after 1 year, reflecting the dietary goals of the Feel4Diabetes intervention. Based on these questions the Healthy Diet Score was constructed, consisting of the following components: breakfast, vegetables, fruit and berries, sugary drinks, whole-grain cereals, nuts and seeds, low-fat dairy products, oils and fats, red meat, sweet snacks, salty snacks, and family meals. Maximum score for each component was set based on its estimated relative importance regarding T2DM risk, higher score indicating better quality of diet. Clinical measurements included height, weight, waist circumference, heart rate, blood pressure, and fasting blood sampling, with analyses of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Analysis of (co) variance was used to compare the Healthy Diet Score and its components between countries and sexes using baseline data, and to test differences in clinical characteristics between score categories, adjusted for age, sex and country. Pearson''s correlations were used to study the association between changes from baseline to year 1 in the Healthy Diet Score and clinical markers. To estimate reproducibility, Pearson''s correlations were studied between baseline and 1 year score, within the control group only. Results: The mean total score was 52.8 ± 12.8 among women and 46.6 ± 12.8 among men (p < 0.001). The total score and its components differed between countries. The change in the Healthy Diet Score was significantly correlated with changes in BMI, waist circumference, and total and LDL cholesterol. The Healthy Diet Score as well as its components at baseline were significantly correlated with the values at year 1, in the control group participants. Conclusion: The Feel4Diabetes Healthy Diet Score is a reproducible method to capture the dietary information collected with the Feel4Diabetes questionnaire and measure the level of and changes in the adherence to the dietary goals of the intervention. It gives a simple parameter that associates with clinical risk factors in a meaningful manner

Suspected tick-borne flavivirus meningoencephalomyelitis in dogs from the UK: six cases (2021)

Objectives: Tick-borne encephalitis virus and louping ill virus are neurotropic flaviviruses transmitted by ticks. Epidemiologically, tick-borne encephalitis is endemic in Europe whereas louping ill's predominant geographical distribution is the UK. Rarely, these flaviviruses affect dogs causing neurological signs. This case series aimed to describe the clinical, clinicopathological, and imaging findings, as well as the outcomes in six dogs with meningoencephalitis and/or meningomyelitis caused by a flavivirus in the UK in 2021. Materials and Methods: Observational retrospective case-series study. Clinical data were retrieved from medical records of dogs with positive serological or immunohistochemical results from three different institutions from spring to winter 2021. Results: Six dogs were included in the study. All dogs presented an initial phase of pyrexia and/or lethargy followed by progressive signs of spinal cord and/or intracranial disease. Magnetic resonance imaging showed bilateral and symmetrical lesions affecting the grey matter of the thalamus, pons, medulla oblongata, and thoracic or lumbar intumescences with none or mild parenchymal and meningeal contrast enhancement. Serology for tick-borne encephalitis virus was positive in five dogs with the presence of seroconversion in two dogs. The viral distinction between flaviviruses was not achieved. One dog with negative serology presented positive immunohistochemistry at post-mortem examination. Three dogs survived but presented neurological sequelae. Three dogs were euthanased due to the rapid progression of the clinical signs or static neurological signs. Clinical Significance: These cases raise awareness of the presence of tick-borne encephalitis as an emergent disease or the increased prevalence of louping ill virus affecting dogs in the UK

In dogs with metaldehyde intoxication, are benzodiazepines more effective than methocarbamol in relaxing muscles and reducing tremors?

Question: In dogs with metaldehyde intoxication, are benzodiazepines (e.g. diazepam, midazolam) more effective than methocarbamol in relaxing muscles and reducing tremors? Clinical bottom line: The category of research question was treatment/prognosis/risk/diagnosis/prevalence/incidence Treatment: The number and type of study designs that were critically appraised were… Five papers were critically reviewed. There were 5 retrospective case-series. Critical appraisal of the selected papers meeting the inclusion criteria collectively provide zero/weak/moderate/strong evidence in terms of their experimental design and implementation. Weak. The outcomes reported are summarised as follows. Currently, 5 retrospective case series exist in the literature which discuss metaldehyde intoxication cases treated mainly with benzodiazepines, a few of which had methocarbamol. There is not really any study to compare directly benzodiazepines with methocarbamol. In addition to that, commercial (e.g. the low availability of methocarbamol in the UK market comparing to the US market), administrational (e.g. multiple administration routes of benzodiazepines) and pharmacological (e.g. lack of anticonvulsant function of methocarbamol) factors have played an important role to the treatment choice. Several case reports exist as well. In view of the strength of evidence and the outcomes from the studies the following conclusion is made… Currently, there is insufficient evidence to determine whether benzodiazepines are more effective than methocarbamol in relaxing muscles and reducing occurrence of muscle tremors

Hypersexuality responsive to phenobarbital in a male neutered domestic shorthair cat

A 6-year-old, vaccinated, male neutered domestic shorthair cat was presented due to polyphagia and hypersexuality manifested since he had been adopted one year prior. Clinical and neurological examination was unremarkable, including absence of scrotal testicles and penile spines, indicative of testosterone absence. Differential diagnoses included inadequate neutering and residual testicular tissue, cryptorchidism, adrenal hyperplasia/neoplasia (sex steroid–producing), urinary bladder neoplasia, infectious myelopathy/neuropathy (e.g., feline infectious peritonitis [FIP]), temporal lobe epilepsy, or primary behavioral disorder. Hematology, biochemistry, and thyroid profile were almost unremarkable. Serology for Feline Immunodeficiency Virus, Feline Leukemia Virus, and Feline Coronavirus was negative. Serum pre- and post-human chorionic gonadotropin hormone stimulation Serum pre- and post-human chorionic gonadotropin hormone (hCG) stimulation testosterone ruled out cryptorchidism. Abdominal ultrasound revealed mildly enlarged colonic lymph nodes, the cytology of which revealed mild reactive hyperplasia. Urinalysis and culture were positive to Enterococcus spp. Magnetic resonance imaging of the brain and spinal cord and cerebrospinal fluid analysis was unremarkable. polymerase chain reaction in the cerebrospinal fluid for Toxoplasma gondii, FPV, FCoV, and bornavirus was negative. Attempts to treat hypersexuality as a behavioral disorder, urinary tract infection (amoxicillin clavulanic acid), pain (meloxicam and diazepam), and anxiety (diazepam) were unsuccessful. Thus, phenobarbital was prescribed in a low dose (1 mg/kg PO q 12h) which eliminated the episodes of polyphagia and hypersexuality without sedating the cat. Phenobarbital withdrawal resulted in hypersexuality re-establishment. Two years later, the cat remained episode-free on phenobarbital. Hypersexuality in male cats is characterized mainly by biting the nape, mounting, pelvic thrusting, penile erection, coital intermission, ejaculation, and/or masturbation. Temporal limbic structures play a significant role in the regulation of sexual arousal independently of testosterone. Hypersexuality has been associated with temporal lobe epilepsy in cats experimentally, while along with other clinical signs such as polyphagia, it is an established condition in humans called Klüver-Bucy syndrome. This is the first report to describe phenobarbital as a successful treatment of hypersexuality and polyphagia in a male neutered cat, raising a suspicion of feline Klüver-Bucy syndrome and temporal lobe epilepsy origin of these signs

Response to: was the “alternating head tilt” “positioning head tilt”?

No abstract available

Veterinary Students of the World Within One Health: Projects and Reach of the IVSA Standing Committee on One Health (SCOH)

International Veterinary Students’ Association (IVSA) is the biggest veterinary students’ association worldwide, founded in the 1950’s in Europe. Its Standing Committee on One Health (SCOH) was formed in August 2013 in the Netherlands to promote the interdisciplinary collaboration, as well as educate and inform veterinary students on the concept and importance of One Health. SCOH established a Local Veterinary Public Health Network which aims to urge the member organizations (MO’s) of IVSA to add to their boards a position relating to Public/One Health. Consequently, every member organization (MO) have a representative who will carry out global one health projects of the committee or will invent new ones locally. So far, 23 out of the 60 active MO’s have embraced the idea, and represent 19 countries. So far, the committee organized 2 global Awareness Campaigns; “IVSA Campaign at World Rabies Day 2013” and “IVSA Stop TB Campaign 2014”. At the first campaign, dogs’ vaccination, lectures, street actions and school visits were organized in order to make people aware about the hazards of Rabies. A second campaign, similar to the awareness events were organized with the major goal of informing people and farmers about Bovine TB; Moreover, the committee turned to more practical methods by organizing two One Health Workshops. The first was a “Stimulation Game” held in Karditsa (Greece) within the 2nd Hellenic Veterinary Students’ Congress 2014 (30 people attended), while the second was a “One Health management at a local level” seminar held in Yogyakarta (Indonesia) during the 63rd IVSA World Congress (13 people attended). The evaluation of these workshops concluded that the majority of veterinary students liked both the knowledge game and the tips provided for local management of one health filed at the local MOs. Also, another trend that people endorsed is the Interdisciplinary Collaborations within One Health. Looking at a survey the committee did, 100% of the students evaluated (35) were in favor of these collaborations below. Firstly, IVSA for the first time ever will participate in the upcoming World Healthcare Students’ Symposium (WHSS) 2015 which is organized by medical, veterinary, dental, pharmaceutical, and physical therapy students throughout the world. In addition to this, IVSA signed a formal MoU with the International Federation of Medical Students’ Associations (IFMSA), as well as started to collaborate with the International Pharmaceutical Students’ Federation (IPSF). Finally, the highest achievement so far is the Global One Health Challenge, a joint project of IVSA, IFMSA and Global Alliance for Rabies Control (GARC). This is a worldwide contest dedicated to World Rabies Day 2014 and Rabies awareness, which calls IFMSA and IVSA MOs to collaborate and make an event for rabies. However, this project is still in progress. In conclusion, IVSA through SCOH is promoting Public Health by creating awareness about the need to fight zoonosis and making the concept of One Health (the collaborative effort of multiple disciplines to obtain optimal health for people, animals, and our environment ) more popular