Prognostic factors during gastric dilatation-volvulus in dogs

La torsione gastrica (GDV) rappresenta una delle più frequenti emergenze chirurgiche nel cane. La mortalità piuttosto elevata giustifica il crescente interesse nella ricerca di indicatori prognostici che indirizzino le scelte del veterinario e tutelino il benessere animale, evitandone sofferenze immotivate. In letteratura veterinaria sono stati segnalati alcuni fattori (lattati, mioglobina, base excess, proteina C-reattiva, fattori della coagulazione, ecc), rivelatisi successivamente non totalmente affidabili dal punto di vista prognostico-predittivo. Scopo del mio progetto di dottorato era cercare di identificare ulteriori markers predittivi e rivalutare quelli più utilizzati tra quelli già descritti, in particolare lattati e proteina C-reattiva (CRP), valutandone l’affidabilità prognostica. Ricercando nuovi indicatori che fossero di pronta reperibilità tra quelli normalmente valutati nella pratica clinica con gli esami ematologici pre-chirurgici standard, l’attenzione si è focalizzata su lipasi pancreatica canina specifica (cPLI) e lipasi sierica, che potrebbero subire alterazioni predittive in relazione al coinvolgimento pancreatico conseguente alla sindrome. Per l’esecuzione di queste ricerche sono stati considerati i cani afferiti presso l’Ospedale Veterinario Universitario di Ozzano dell’Emilia con diagnosi di GDV, per i quali sono stati registrati i valori dei biomarkers scelti. I risultati ottenuti hanno indicato che cPLI, lipasi e CRP hanno una potenzialità per essere usati come fattori prognostici efficaci per GDV, contrariamente ai lattati. La tesi si sviluppa in una prima parte compilativa, impostata come review della letteratura presente, e in una seconda parte sperimentale in cui verranno descritti i risultati degli studi effettuati durante il corso di dottorato. Nella prima parte verranno dunque approfonditi eziopatogenesi, fattori predisponenti, effetti sull’organismo, aspetti clinici e, in particolare, i fattori prognostici-predittivi di necrosi gastrica e di sopravvivenza già valutati nel panorama letterario. Nella seconda parte, invece, verranno illustrati i risultati delle indagini condotte sull’affidabilità di cPLI, lipasi, CRP e lattati plasmatici come fattori prognostici in corso di GDV.Gastric Dilatation Volvulus (GDV) represents one of the most common surgical emergencies in dogs. Mortality is quite elevated and justifies the higher and higher interest in the research of prognostic markers which could help the surgeon’s choices and guarantee animals welfare, avoiding unmotivated suffers. In veterinary literature, several factors have been signaled (i.e. lactates, myoglobin, base excess, C-reactive protein, coagulation factors), although, most of them have proven not to be totally reliable. Aim of my PhD project was trying to identify other predictive markers and reexamining the most frequently utilized amongst the ones already described, focusing particularly on lactates and C-reactive protein (CRP), evaluating their prognostic reliability. Searching new factors amongst the ones normally available in the standard pre-anesthetic blood test panel, attention focused on lipase and canine pancreatic lipase immunoreactivity (cPLI), which could experiment predictive alterations induced by the syndrome. For the execution of these researches, dogs treated for GDV at the “Ospedale Veterinario Universitario” in Ozzano dell’ Emilia have been included. Results indicated that cPLI, lipase and CRP have a good potentiality to be used as reliable prognostic factors during GDV, in opposition to lactates. This thesis is made up of two components: a first part reviewing the available literature (GDV pathogenesis, predisposing factors, effects on the organism, clinical aspects, gastric necrosis and survival prognostic factors) and a second part showing the results of my PhD researches (cPLI, lipase, CRP and lactates reliability as predictive markers during GDV)

Evidence-Based Veterinary Medicine: A Tool for Evaluating the Healing Process After Surgical Treatment for Cranial Cruciate Ligament Rupture in Dogs

This study aims to validate a tool, the Bologna healing stifle injury index (BHSII), for the evaluation of the clinical picture and the healing after surgical treatment for cranial cruciate ligament (CCL) rupture. The study included 158 client-owned dogs with CCL rupture and 20 healthy dogs. The BHSII is a questionnaire made up of 34 multiple-choice questions, divided into a part directed to the clinician and a part for the dog's owners. It was applied twice in the healthy dogs in order to test and retest the device. It was evaluated for reliability, validity, and responsiveness to clinical changes involving the dogs treated at the time of surgery, and 1, 3, and 6 months postoperatively. Statistical analyses were performed and the intraclass correlation coefficient test was ≥0.9 and the Cronbach-α was 0.84 suggesting good stability and good internal consistency of the tool. The area under the curve of the receiver operating characteristic curve was >0.9, indicative of the high accuracy of this tool. The clinician survey correlated with the owner questionnaire. In dogs with CCL rupture, the scores of the BHSII increased significantly postoperatively as compared with baseline. In conclusion, this clinical study proved the reliability, validity, and responsiveness of the BHSII. The results achieved from the BHSII provided an instantaneous, collective complete vision of the healing process of the stifle joints treated. It can be considered a valid tool for collecting data and for assessing successful surgical treatment in clinical practice

Evidence-Based Veterinary Medicine: a tool for evaluating the healing process after surgical treatment for cranial cruciate ligament rupture in dogs

This study aims to validate a tool, the Bologna healing stifle injury index (BHSII), for the evaluation of the clinical picture and the healing after surgical treatment for cranial cruciate ligament (CCL) rupture. The study included 158 client-owned dogs with CCL rupture and 20 healthy dogs. The BHSII is a questionnaire made up of 34 multiple-choice questions, divided into a part directed to the clinician and a part for the dog's owners. It was applied twice in the healthy dogs in order to test and retest the device. It was evaluated for reliability, validity, and responsiveness to clinical changes involving the dogs treated at the time of surgery, and 1, 3, and 6 months postoperatively. Statistical analyses were performed and the intraclass correlation coefficient test was ≥0.9 and the Cronbach-α was 0.84 suggesting good stability and good internal consistency of the tool. The area under the curve of the receiver operating characteristic curve was >0.9, indicative of the high accuracy of this tool. The clinician survey correlated with the owner questionnaire. In dogs with CCL rupture, the scores of the BHSII increased significantly postoperatively as compared with baseline. In conclusion, this clinical study proved the reliability, validity, and responsiveness of the BHSII. The results achieved from the BHSII provided an instantaneous, collective complete vision of the healing process of the stifle joints treated. It can be considered a valid tool for collecting data and for assessing successful surgical treatment in clinical practice

Bologna Healing Stifle Injury Index nella rottura del legamento crociato

Black and white 8x10 acetate negativehttps://digitalmaine.com/arc_george_french_photos_f/1125/thumbnail.jp

Military Working Dogs Operating in Afghanistan Theater: Comparison between Pre- and Post-Mission Blood Analyses to Monitor Physical Fitness and Training

The intergovernmental organization known as the United Nations (UN) was born “to maintain international peace and security” through different operations and tasks, including “mine action” and “explosive detection”. Explosives are the most frequent cause of injuries in military personnel and an enormous danger for civilians. The role of explosive detection dogs (EDDs) and mine detection dogs has gained great consideration over time, leading to their intense use in military operations. Literature regarding working injuries reported by EDDs during missions is limited. The aim of the present study is to investigate the hematological changes that occurred between pre- and post-mission blood analyses in military working dogs deployed to Afghanistan in order to evaluate signs of health problems or physical adjustments. Examining the clinical records, only three dogs reported a medical issue, one with gastric dilatation-volvulus (GDV), and two with lameness episodes. Lack of health issues occurring during the missions was reflected by the absence of significant differences between pre- and post-mission blood analyses. Blood results were also examined by dividing the EDDs into groups considering age at departure, sex, breed and mission length. A few categories demonstrated significant changes in some parameters; however, the mean values were always included in the ranges of normality, indicating that their physical fitness and training were adequate for the required tasks

Prognostic value of canine pancreatic lipase immunoreactivity and lipase activity in dogs with gastric dilatation-volvulus.

This study evaluated the association between a selection of candidate predictor variables, including the elevation of specific pancreatic enzymes, and outcome in dogs with gastric dilatation-volvulus (GDV). Twenty-two dogs with gastric dilatation-volvulus were included, being classified as survivors or non-survivors based on the final outcome. Dogs with intestinal obstruction (n = 16) were selected for comparison. Blood samples were collected upon admission (T0) and after 24 hours (T1). Serum lipase activity, canine pancreatic lipase immunoreactivity (cPLI) and other variables (plasma lactate concentration and C- reactive protein -CRP- in particular) were evaluated as predictive variables. T0 cPLI and serum lipase activity were not found to differ significantly between dogs with gastric dilatation-volvulus or intestinal obstruction. Canine pancreatic lipase immunoreactivity values above 400 μg/L were detected in 6/22 dogs with gastric dilatation-volvulus and 4/16 with intestinal obstruction. However, lactate concentration was significantly higher and CRP significantly lower in GDV as compared to IO dogs, and in the GDV group, lipase, cPLI and CRP measured upon admission were significantly associated with a negative outcome. No differences in lipase activity and canine pancreatic lipase immunoreactivity values were detected between T0 and T1. Presurgical cPLI and lipase activity were frequently increased during gastric dilatation-volvulus and were suggestive of the presence of pancreatic damage; while more extensive studies are required, based on this pilot analysis, cPLI has the potential to be a useful predictive variable for outcome in GDV. Further to this, serum CRP was able to predict outcome in this population of dogs with GDV, while blood lactate was not