Effect of pituitary‐dependent hypercortisolism on the survival of dogs treated with radiotherapy for pituitary macroadenomas

Background: Radiotherapy (RT) is an effective treatment for dogs presented with neurologic signs caused by pituitary tumors. However, its impact on the outcome of concurrent pituitary-dependent hypercortisolism (PDH) is controversial. Objectives: Determine whether dogs with PDH have longer survival after pituitary RT compared with dogs with nonhormonally active pituitary masses and to evaluate whether clinical, imaging, and RT variables affect survival. Animals: Ninety-four dogs divided into 2 groups: PDH and non-PDH, based on the presence of hypercortisolism. Forty-seven dogs were allocated to the PDH group and 47 to the non-PDH group. Methods: Retrospective cohort study in which clinical records of dogs undergoing RT for pituitary macroadenomas between 2008 and 2018 at 5 referral centers were retrospectively evaluated. Results: Survival was not statistically different between PDH and non-PDH groups (median survival time [MST], 590 days; 95% confidence interval [CI], 0-830 days and 738 days; 95% CI, 373-1103 days, respectively; P = .4). A definitive RT protocol was statistically associated with longer survival compared with a palliative protocol (MST 605 vs 262 days, P = .05). The only factor statistically associated with survival from multivariate Cox proportional hazard analysis was total radiation dose (Gy) delivered (P < .01). Conclusions and Clinical Importance: No statistical difference in survival was identified between the PDH and non-PDH groups, and longer survival was associated with higher Gy delivered

The use of high-dose immunoglobulin M-enriched human immunoglobulin in dogs with immune-mediated hemolytic anemia.

BACKGROUND: The IV use of human immunoglobulin (hIVIG) in dogs with primary immune-mediated hemolytic anemia (IMHA) has been described previously, but herein we describe the use of high-dose IgM-enriched hIVIG (Pentaglobin). HYPOTHESIS/OBJECTIVES: Dogs treated with high-dose Pentaglobin will experience shorter time to remission and hospital discharge and have decreased transfusion requirements compared to dogs receiving standard treatment alone. ANIMALS: Fourteen client-owned dogs diagnosed with primary IMHA at specialist referral hospitals in the United Kingdom. METHODS: All prospectively enrolled dogs received prednisolone, dexamethasone or both along with clopidogrel. Patients were randomized to receive Pentaglobin at 1 g/kg on up to 2 occasions, or to serve as controls. No additional immunosuppressive drugs were allowed within the first 7 days of treatment. Remission was defined as stable PCV for 24 hours followed by an increase in PCV. RESULTS: Ten of 11 dogs from the treatment group and 2 of 3 dogs from the control group achieved remission and survived until hospital discharge. Survival and time to remission were not significantly different between groups. The volume of packed red blood cells transfused, normalized for body weight, was not significantly different between groups. Potential adverse reactions to Pentaglobin occurred in 2 dogs, but their clinical signs may have been related to the underlying disease. CONCLUSIONS AND CLINICAL IMPORTANCE: Treatment with high-dose Pentaglobin was well tolerated by dogs with primary IMHA but no significant advantage was found in this small study. Additional studies examining larger groups and subpopulations of dogs with primary IMHA associated with a poorer prognosis are warranted

Causes of thrombocytopenia in dogs in the United Kingdom: A retrospective study of 762 cases

Background: Thrombocytopenia is a common laboratory abnormality in dogs, and numerous diseases have been associated with its development. Estimates for the sensitivity and specificity of the degree of reduction of platelet concentration for the diagnosis of primary immune‐mediated thrombocytopenia (pITP) have not been reported. Objectives: To report the prevalence of different causes of thrombocytopenia in dogs in the United Kingdom and to investigate the utility of platelet concentration to differentiate causes of thrombocytopenia. Methods: Medical records of 762 dogs with thrombocytopenia presented to seven referral hospitals from January 2017 to December 2018 were retrospectively reviewed. Cases were assigned into the following categories: pITP, infectious diseases, neoplasia, inflammatory/other immune‐mediated disorders and miscellaneous causes. The prevalence of the different categories was estimated, and platelet concentrations were compared. Receiver‐operating characteristic (ROC) curves were used to investigate the utility of platelet concentration to differentiate between causes of thrombocytopenia. Results: The most common disease category associated with thrombocytopenia was neoplasia (27.3%), followed by miscellaneous causes (26.9%), pITP (18.8%), inflammatory/immune‐mediated disorders (14.4%) and infectious diseases (12.6%). Dogs with pITP had significantly lower platelet concentrations (median 8 × 109/L, range: 0–70 × 109/L) than dogs in the other four categories. Platelet concentration was useful for distinguishing pITP from other causes of thrombocytopenia (area under ROC curve = 0.89, 95% confidence interval 0.87, 0.92), with a platelet concentration ≤12 × 109/L being 60% sensitive and 90% specific. Conclusions: Severe thrombocytopenia was highly specific for a diagnosis of pITP, which was more prevalent in this UK population of thrombocytopenic dogs compared with previous epidemiological studies. Conversely, the proportion of dogs with infectious diseases was lower than in previous reports from other locations

Mycotic rhinosinusitis in dogs

No abstract availabl

Helicobacter: an exploration of therapeutics, homeostatic mechanisms and the application of the novel diagnostic technique, confocal endomicroscopy

© 2015 Dr. Mellora Jane SharmanStandard endoscopy has improved assessment of gastrointestinal disease in a relatively non-invasive manner. However gross endoscopic examination of the mucosa does not always correlate with histopathology. This has led to development of advanced endoscopic techniques allowing real-time histopathologically-equivalent examination that potentially circumvents the need for biopsy altogether. Confocal endomicroscopy (CEM) has not been established in dogs, but applications in gastroenterology may prove useful. Before abnormalities can be appropriately interpreted, protocols for implementation need to be investigated together with assessment and description of normal mucosal topologic morphology. One described application of CEM is in the identification of Helicobacter pylori and assessment of the severity of associated gastritis in people. Additionally, CEM aids identification of other mucosally associated and intracellular bacteria. In dogs, the role of non-Helicobacter pylori Helicobacters (NHPH) remains undetermined. Despite high infection prevalences, studies fail to demonstrate a significant impact on gastric function, nor a relationship with gastritis or neoplasia. The pathogenic potential of individual NHPH may differ, however discriminating between these can be challenging. Pathogenic potential could reflect differences in adherence or virulence factors between species, therefore distinguishing individual NHPH could be important. Pathogenicity may also relate to capability for invasion of the intracellular space, and this is frequently recognised in dogs. This thesis established the potential usefulness of CEM in dogs, through studies that evaluated the pharmacokinetics of intravenous fluorescein, and that assessed the topographic morphology of the small intestinal and gastric mucosa in clinically healthy dogs. This allowed establishment of fluorophore protocols, and an understanding of normal morphology. In addition change correlating with lymphocytic gastritis was identified. Furthermore, NHPH were able to be seen, but only fluorescent in situ hybridization allowed detection of intracellular organisms. This likely related to depth of examination achievable using CEM. CEM was useful for evaluating spatial distribution of NHPH during therapeutic intervention, outperforming other diagnostic modalities. The two treatment protocols assessed were equally effective at short-term clearance of NHPH, whilst administration of a single, whole H. felis organism vaccination offered no subsequent prophylactic or therapeutic benefit. A further study evaluated the ability of a PCR assay, subjected to high resolution melt (HRM) curve analysis, to differentiate between NHPH based upon predicted curves. This technique did not aid immediate discrimination between NHPH, but it did allow serial assessment throughout therapy and the follow-up period in three dogs with reinfection or recrudescence. Lastly, evaluation of mRNA expression of the homeostatic gastrokine factors provided interesting results where gene expression was down- rather than up-regulated as is seen in people post H. pylori eradication. This could relate to a lack of inflammation in the cases included and could therefore support a role for gastrokines in preventing development of gastritis in NHPH colonization. In all, this thesis supports the usefulness of CEM in evaluating the gastrointestinal mucosa and in identification of mucosally associated bacteria. The role of NHPH in dogs remains undetermined. Further work is required to develop techniques to aid immediate discrimination of species, however up-regulation of the homeostatic gastrokines may limit the development of gastritis in dogs

Acquired Fanconi-like syndrome cases associated with dried chicken and duck meat ingestion

No abstract available

Effect of pituitary-dependent hypercortisolism on the survival of dogs treated with radiotherapy for pituitary macroadenomas.

BACKGROUND: Radiotherapy (RT) is an effective treatment for dogs presented with neurologic signs caused by pituitary tumors. However, its impact on the outcome of concurrent pituitary-dependent hypercortisolism (PDH) is controversial. OBJECTIVES: Determine whether dogs with PDH have longer survival after pituitary RT compared with dogs with nonhormonally active pituitary masses and to evaluate whether clinical, imaging, and RT variables affect survival. ANIMALS: Ninety-four dogs divided into 2 groups: PDH and non-PDH, based on the presence of hypercortisolism. Forty-seven dogs were allocated to the PDH group and 47 to the non-PDH group. METHODS: Retrospective cohort study in which clinical records of dogs undergoing RT for pituitary macroadenomas between 2008 and 2018 at 5 referral centers were retrospectively evaluated. RESULTS: Survival was not statistically different between PDH and non-PDH groups (median survival time [MST], 590 days; 95% confidence interval [CI], 0-830 days and 738 days; 95% CI, 373-1103 days, respectively; P = .4). A definitive RT protocol was statistically associated with longer survival compared with a palliative protocol (MST 605 vs 262 days, P = .05). The only factor statistically associated with survival from multivariate Cox proportional hazard analysis was total radiation dose (Gy) delivered (P < .01). CONCLUSIONS AND CLINICAL IMPORTANCE: No statistical difference in survival was identified between the PDH and non-PDH groups, and longer survival was associated with higher Gy delivered