Laparoscopic drainage of an ovarian haematoma in a Martina Franca jenny (Equus asinus)

An 11-year-old Martina Franca jenny (Equus Asinus), involved in a breed recovery programme organised by the Puglia Region, was referred to the University’s Veterinary Teaching Hospital for a mass formation detected on the surface of the right ovary. The subject had regular oestrous cycles, but gestation loss was reported in the anamnesis. The ovarian mass was monitored by transrectal palpation and ultrasonography. In the differential diagnosis, an ovarian haematoma, a haemorrhagic anovulatory follicle and a granulosa cell tumour were hypothesised; a surgical resolution with laparoscopic access was chosen. During surgery, about 750 ml of haemorrhagic fluid was drained, confirming the suspect of the ovarian haematoma. After resolution, the jenny was inseminated, eventually giving birth to a live and viable foal. Usually, an ovarian haematoma spontaneously regresses, but, in this report, the lesion remained stable for more than two months, leading to the decision of the surgical resolution. Furthermore, to the authors’ knowledge, this lesion has never been reported in donkeys

Guaifenesin-Ketamine-Xylazine Infusion to Maintain Anesthesia in Mules Undergoing Field Castration

Many minor and surgical procedures can be performed in the field under sedation or general anaesthesia. Numerous drug combinations have been used for sedation, induction and maintenance. The purpose of this study was to determine if the combination of guaifenesin, ketamine and xylazine, commonly referred to as “triple drip”, produce safe and satisfactory total intravenous anaesthesia in mules undergoing field castration, premedicated with xylazine and induced with thiopental. Eight healthy adult intact male mules, aged 4 to 6 years and weighing 380 to 490, were anesthetized to performe field castration. Before anaesthesia a 14-gauge, 13–cm catheter was placed percutaneously in the external jugular vein. Mules were premedicated with 1.3 mg/kg xylazine IV and anaesthesia was then inducted with 6 mg/kg IV thiopental within 10 min after premedication, when the animals were at least moderately sedated. Additional xylazine was administered when the mules were inadequately sedated. Sedation was considered good when lowering of the head, drooping of the lower lip and drooping of the ears were present using a 4-point sedation score. Once the mules were recumbent, the infusion of guaifenesin (50 mg/ml) - ketamine (20 mg/ml) - xylazine (0.5 mg/ml) (GKX) was started to maintain general anaesthesia, approximately 1ml/kg/hr (based on monitoring eye signs, muscle relaxation of the neck, respiratory rate and pattern, and the responses to surgical stimulation. The spermatic cord of each testis was infiltrated with 5 ml of lidocaine to achieve local anaesthesia before the scrotum skin incision. The open technique of castration was applied to all mules for postoperative drainage. During anaesthesia heart rate (HR), respiratory rate RR), rectal temperature (RT) and hemoglobin saturation with oxygen (SpO2) were measured every 5 minutes. Times to sternal recumbency, lateral recumbency and standing were recorded. The data recorded were statistically analysed using simple one-way analysis of variance (ANOVA) and a pvalue>0.05 was considered significant. The qualities of anaesthesia were evaluated using induction, maintenance and recovery scores. The resultes suggest that the premedication using 1.3 mg/kg IV xylazine for mules undergoing thiopental anaesthesia was satisfactory and only one animal needed a supplemental dose of xylazine (0.3 mg/kg IV) to induce better sedation. The total IV amount of thiopental for induction was sufficient to achieve lateral recumbency in all animals. Furthermore, GKX provided adequate surgical plane of general anaesthesia to performe castration in all mules, without responses to the manuality or significant modification of HH, RR, RT, and SpO2 in comparison with the basal values and to maintain a satisfactory muscle relaxation. Recovery from anaesthesia was uneventful, smooth and clinically acceptable in all mules

Differential diagnosis of neurodegenerative dementias with the explainable MRI based machine learning algorithm MUQUBIA

Biomarker-based differential diagnosis of the most common forms of dementia is becoming increasingly important. Machine learning (ML) may be able to address this challenge. The aim of this study was to develop and interpret a ML algorithm capable of differentiating Alzheimer's dementia, frontotemporal dementia, dementia with Lewy bodies and cognitively normal control subjects based on sociodemographic, clinical, and magnetic resonance imaging (MRI) variables. 506 subjects from 5 databases were included. MRI images were processed with FreeSurfer, LPA, and TRACULA to obtain brain volumes and thicknesses, white matter lesions and diffusion metrics. MRI metrics were used in conjunction with clinical and demographic data to perform differential diagnosis based on a Support Vector Machine model called MUQUBIA (Multimodal Quantification of Brain whIte matter biomArkers). Age, gender, Clinical Dementia Rating (CDR) Dementia Staging Instrument, and 19 imaging features formed the best set of discriminative features. The predictive model performed with an overall Area Under the Curve of 98%, high overall precision (88%), recall (88%), and F1 scores (88%) in the test group, and good Label Ranking Average Precision score (0.95) in a subset of neuropathologically assessed patients. The results of MUQUBIA were explained by the SHapley Additive exPlanations (SHAP) method. The MUQUBIA algorithm successfully classified various dementias with good performance using cost-effective clinical and MRI information, and with independent validation, has the potential to assist physicians in their clinical diagnosis

Differential diagnosis of neurodegenerative dementias with the explainable MRI based machine learning algorithm MUQUBIA

Biomarker-based differential diagnosis of the most common forms of dementia is becoming increasingly important. Machine learning (ML) may be able to address this challenge. The aim of this study was to develop and interpret a ML algorithm capable of differentiating Alzheimer’s dementia, frontotemporal dementia, dementia with Lewy bodies and cognitively normal control subjects based on sociodemographic, clinical, and magnetic resonance imaging (MRI) variables. 506 subjects from 5 databases were included. MRI images were processed with FreeSurfer, LPA, and TRACULA to obtain brain volumes and thicknesses, white matter lesions and diffusion metrics. MRI metrics were used in conjunction with clinical and demographic data to perform differential diagnosis based on a Support Vector Machine model called MUQUBIA (Multimodal Quantification of Brain whIte matter biomArkers). Age, gender, Clinical Dementia Rating (CDR) Dementia Staging Instrument, and 19 imaging features formed the best set of discriminative features. The predictive model performed with an overall Area Under the Curve of 98%, high overall precision (88%), recall (88%), and F1 scores (88%) in the test group, and good Label Ranking Average Precision score (0.95) in a subset of neuropathologically assessed patients. The results of MUQUBIA were explained by the SHapley Additive exPlanations (SHAP) method. The MUQUBIA algorithm successfully classified various dementias with good performance using cost-effective clinical and MRI information, and with independent validation, has the potential to assist physicians in their clinical diagnosis

Effectiveness of a Modified Administration Protocol for the Medical Treatment of Feline Pyometra

Simple Summary Pyometra is a common reproductive disorder traditionally managed by ovariohysterectomy, although in selected cases (such as breeding subjects or patients with anesthesiologic risk) medical treatment is preferable. This paper aimed to describe the effectiveness of a modified aglepristone administration protocol. Five intact queens were referred for pyometra and were treated with 15 mg/kg of aglepristone on Day 0 (D0), D2, D5, and D8, along with antibiotic treatment (marbofloxacine, 3 mg/kg). Regular ultrasonographic exams confirmed the complete resolution of the infection. After treatment, 3 out of 4 mated cats had an uneventful pregnancy. The results obtained, although limited to a small group, are promising. Further studies are planned to verify its effectiveness in the long-term prevention of recurrence. Pyometra is a common uterine disease of dogs and cats, typical of the luteal phase. Traditionally, ovariohysterectomy was considered the elective treatment for pyometra, but in some cases, such as breeding subjects or patients with a high anesthesiologic risk, medical treatment is preferred. Aglepristone is a progesterone receptor blocker and its use proved to be effective for the medical treatment of pyometra in bitches and queens. The aim of this work is to report the effectiveness, in the feline species, of a modified aglepristone administration protocol. Five intact queens were referred to veterinary care centers for pyometra. Aglepristone (15 mg/kg) was administered at D0, D2, D5, and D8, as described by Contri and collaborators for dogs. An antibiotic treatment (marbofloxacin, 3 mg/kg) was associated, and uterine conditions were checked with regular ultrasonographic exams. The uterus returned to its normal condition 10 days after starting the treatment and no adverse effects were reported. After treatment, three queens had an uneventful pregnancy. Even if the treated group was restricted and homogeneous, the proposed modified protocol proved to be useful and promising for the medical treatment of pyometra in cats; further studies are planned to verify its effectiveness in the long-term prevention of recurrence

Treatment of a Recurrent Pyometra by Surgical Uterine Drainage in a Main Coon Cat

: Pyometra is a uterine disease typical of the luteal phase of the estrus cycle. For selected patients, such as breeding subjects, ovariohysterectomy is not a valid resolutive option. Medical treatments involving cloprostenol and aglepristone have been developed for the cats, but they can be ineffective in rare cases. Transcervical drainage and flushing have been described for the dogs, as well as for large wild cats. However, to the author's knowledge, there are no report of uterine drainage in cats. The present case describes an alternative treatment of pyometra in a 3-year-old Main Coon previously treated with aglepristone. The patient underwent a laparotomy: the uterus was exposed, and a sterile urinary catheter was inserted into each horn, through the wall of the uterus, to allow the drainage of pathological collection and a subsequent lavage with lukewarm sterile saline. Medical treatment with aglepristone and marbofloxacin was associated. After treatment, no recurrence was reported, and the cat had an uneventful pregnancy. Although it is a unique case report, the results presented are promising, as the technique appears to have provided healing and preserved fertility. Further studies are needed to confirm its efficacy in the long-term prevention of recurrence

Treatment of a Recurrent Pyometra by Surgical Uterine Drainage in a Main Coon Cat

Pyometra is a uterine disease typical of the luteal phase of the estrus cycle. For selected patients, such as breeding subjects, ovariohysterectomy is not a valid resolutive option. Medical treatments involving cloprostenol and aglepristone have been developed for the cats, but they can be ineffective in rare cases. Transcervical drainage and flushing have been described for the dogs, as well as for large wild cats. However, to the author’s knowledge, there are no report of uterine drainage in cats. The present case describes an alternative treatment of pyometra in a 3-year-old Main Coon previously treated with aglepristone. The patient underwent a laparotomy: the uterus was exposed, and a sterile urinary catheter was inserted into each horn, through the wall of the uterus, to allow the drainage of pathological collection and a subsequent lavage with lukewarm sterile saline. Medical treatment with aglepristone and marbofloxacin was associated. After treatment, no recurrence was reported, and the cat had an uneventful pregnancy. Although it is a unique case report, the results presented are promising, as the technique appears to have provided healing and preserved fertility. Further studies are needed to confirm its efficacy in the long-term prevention of recurrence