Table of Contents and Abstracts

This report describes a 2-year-old spayed female domestic shorthair cat presented because of severe, acute respiratory distress and ultimately diagnosed with myocarditis and secondary congestive heart failure associated with Sarcocystis spp. Despite therapy with oxygen, furosemide, and butorphanol, the cat deteriorated rapidly, became moribund, and was euthanized. Lymphohistiocytic myocarditis associated with protozoal organisms with evidence of secondary congestive heart failure was diagnosed based on gross and histological findings. Protozoal cysts were identified within the myocardium and Sarcocystis-containing cysts were also seen in lingual and periocular striated muscles with associated myositis. Immunohistochemical analysis confirmed that the protozoal organisms were Sarcocystis spp. Molecular identification using polymerase chain reaction identified the etiologic agent as S. arctica/caninum. Although Sarcocystis infection has been documented in striated muscles of cats worldwide, this is typically an incidental finding. If disease occurs, it usually leads to neurologic signs from a Sarcocystis-induced encephalomyelitis. To the best of our knowledge, this is the first report of Sarcocystis spp. affecting the cardiac muscle of a domestic cat with a fatal outcome.

Key clinical message:
Sarcocystis spp. is a novel cause of heart failure in cats due to lymphohistiocytic myocarditis.

An 11-year-old fox terrier was presented with bicavitary effusions following a 2-day history of vomiting and panting. After referral for management of the effusions, following radiographic and ultrasonographic imaging, the dog was diagnosed with acute necrotizing pancreatitis. On Day 5 of hospitalization, the dog developed bilateral abdominal-wall ecchymosis, prompting concerns that this was an example of Grey Turner’s sign (GTS), described in human medicine as a subcutaneous manifestation of intra-abdominal hemorrhage presenting as ecchymosis of the flanks and commonly associated with severe acute necrotizing pancreatitis. This is apparently the first time that suspected GTS has been described in a dog with acute necrotizing pancreatitis. Recognizing GTS in dogs may alert clinicians to serious intra-abdominal pathology and prompt immediate further investigations.

Key clinical message:
We describe a case of suspected GTS (bilateral flank ecchymoses) in a dog, apparently for the first time. Grey Turner’s sign may occur in cases of intra-abdominal hemorrhage as well as intra-abdominal inflammation in which hemoabdomen is not present. Recognizing GTS in dogs may alert clinicians to serious intra-abdominal disease and prompt immediate further investigations.

Alpha-2 adrenergic agonist use in the anesthetic management of dogs undergoing partial pancreatectomy has been reported, but only as single-bolus administration of medetomidine in the premedication or low-dose constant-rate infusion (CRI) of dexmedetomidine, without other systemic analgesic drugs. A 10-year-old Boston terrier diagnosed with an insulinoma was presented to the Ontario Veterinary College Health Sciences Centre (Guelph, Ontario). The anesthetic management for partial pancreatectomy included a high-dose dexmedetomidine CRI (4 µg/kg per hour) as well as lidocaine and fentanyl CRIs for additional analgesia and minimum alveolar concentration reduction. A low-dose norepinephrine CRI was used to maintain blood pressure and improve cardiac output. Overall, blood glucose concentration was controlled, no adverse effects were detected, and the dog did not develop pancreatitis postoperatively. Anesthetic management with a high-dose dexmedetomidine CRI along with other systemic analgesia has apparently not been reported for dogs presented for partial pancreatectomy due to insulinoma.

Key clinical message:
A high-dose dexmedetomidine CRI along with other systemic analgesia was successfully used to manage a dog undergoing partial pancreatectomy for an insulinoma.

An 11-year-old spayed female Maltese dog was presented to a teaching hospital due to anorexia, weight loss, and nodular skin lesions. The dog had been diagnosed with small-cell T-cell gastrointestinal (GI) lymphoma 2 wk before presentation and had received long-term medical management for atopic dermatitis. On physical examination, enlarged submandibular, prescapular, and popliteal lymph nodes were detected bilaterally. Erythema, edema, and crusts were also present on the periocular region with alopecia. In addition, multiple erythematous nodules were detected on the body surface. Fine-needle aspirate (FNA) from the lesions showed a population of large, round cells with prominent nucleoli, suggestive of cutaneous lymphoma. Based on the history, physical examination, and FNA cytology, the disease was suspected to be secondary cutaneous lymphoma secondary to small T-cell GI lymphoma with involvement of lymph nodes. The dog died on the day of the hospital visit, and further diagnostic procedures and treatment could not be conducted.

Key clinical message:
Soon after abdominal surgery that incompletely resected a small T-cell GI lymphoma, a dog rapidly developed secondary cutaneous lymphoma with erythematous skin nodules and several enlarged peripheral lymph nodes. Features were acute onset, severe systemic illness, and rapid cutaneous involvement. The diagnosis was confirmed based on FNA of nodules and enlarged lymph nodes supported the diagnosis, but the dog died very soon after referral.

A 3-year-old intact male English bulldog was presented to a veterinary teaching hospital because of respiratory distress secondary to bronchopneumonia and brachycephalic obstructive airway syndrome. Due to severe hypoxemia, the dog was mechanically ventilated. He developed atrial flutter and atrial fibrillation during hospitalization. The arrhythmias were suspected to be secondary to the systemic inflammation, severe brachycephalic obstructive airway syndrome, and high vagal tone without underlying cardiac pathology identified by echocardiography. Considering the hemodynamic instability of the dog, cardioversion was attempted. The arrhythmias were refractory to conventional treatments, discontinuation of pro-arrhythmic medications, and trials of Class I and II antiarrhythmics. Cardioversion occurred 2 h following oral sotalol administration after the dog received a diltiazem infusion for 30 h, and the dog recovered successfully. After the dog was discharged and prescribed sotalol that was subsequently discontinued, he did not experience any recurrence of arrhythmias during follow-up examinations.

Key clinical message:
To the authors’ knowledge, this is the first report of a medical cardioversion of atrial flutter and atrial fibrillation in a mechanically ventilated dog with bronchopneumonia. Clinicians should be aware of the risk of acute cardiac events in dogs with systemic inflammation, such as bronchopneumonia, especially in brachycephalic breeds with high vagal tone.

A 6-year-old castrated male golden retriever dog weighing 32.6 kg was presented for chemotherapy after hemimandibulectomy due to mandibular osteosarcoma. Considering the incomplete surgical excision and metastatic potential, adjuvant chemotherapy was considered. Oral toceranib (2.76 mg/kg, PO, q48h) was initiated after a nodule was palpated at the surgical site 4 wk following hemimandibulectomy. During treatment, the drug dose was decreased due to mildly increased creatinine levels. However, after 1 mo, the dose was increased because creatinine had decreased to previous values. The animal experienced vomiting and diarrhea 7 mo after toceranib initiation; therefore, the drug was stopped for 1 wk. After that point, except for mild neutropenia, no other clinicopathological abnormalities, clinical signs, recurrence, or metastasis occurred. The toceranib therapy provided a durable disease-free interval in this case. Therefore, oral toceranib therapy can be an option for adjuvant chemotherapy for canine mandibular osteosarcoma.

Key clinical message:
In this case, which was characterized by the overexpression of various receptor tyrosine kinase genes, oral toceranib administration provided a durable disease-free interval in a dog. Further studies are warranted to evaluate the general application of toceranib for the management of canine mandibular osteosarcoma.

An 8-year-old neutered male Maltese dog was presented with 6 palpable cutaneous masses on the neck and thorax 1 y after the surgical excision of mast cell tumors (MCT) from the mid-thoracic and right axillary regions. Before chemotherapy, the sum of the masses’ diameters was 19.0 cm. ¹⁸F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) revealed hypermetabolic lesions within the skin overlying the ventral thorax, bilateral prescapular lymph nodes, and right axillary lymph node. The dog was diagnosed with MCT recurrence and treated with combination chemotherapy comprising imatinib, vinblastine, and prednisolone. After completion of 2 16-week chemotherapy regimens, the sum of the masses’ diameters decreased to 3.6 cm. For assessment of the chemotherapy response and guidance for subsequent therapeutic plans, follow-up FDG-PET/CT was undertaken 25 d after completion of the 2nd chemotherapy regimen. It demonstrated a reduction in FDG uptake in all areas compared with that on the initial scan, except for the middle thoracic mass. After follow-up FDG-PET/CT, a 3rd chemotherapy regimen was implemented, and the dog died 416 d after the initiation of chemotherapy. There are no reports of a combination chemotherapy with imatinib, vinblastine, and prednisolone for treating canine cutaneous MCT. This case highlighted the potential therapeutic use of this combination chemotherapy for recurrent canine MCTs. Furthermore, this report indicates that FDG-PET/CT may be useful for assessing malignancy, evaluating chemotherapy responses, and establishing treatment plans for canine cutaneous MCTs.

Key clinical message:
Combination chemotherapy of imatinib, vinblastine, and prednisolone is a potential therapeutic regimen for recurrent cutaneous MCTs in dogs. In addition, FDG-PET/CT may be a potentially useful tool for assessing malignancy, evaluating chemotherapy responses, and guiding further therapeutic decisions.

Objective
To assess the clinical efficacy of treating septic arthritis (SA) with 3 different antimicrobials: oxytetracycline, florfenicol, and tulathromycin.

Animal
The study population comprised fall-placed steer and heifer calves at 4 commercial western Canadian feedlots. All calves received tulathromycin at induction for bovine respiratory disease (BRD).

Procedure
Calves that developed SA were allocated to a randomized clinical field trial over a 2-year period. Arthritic calves (n = 251) were treated with florfenicol, oxytetracycline, or tulathromycin. Morbidity outcomes were SA relapses (1st and 2nd) and BRD. Causes of mortality were categorized as infectious (BRD, Histophilus somni, SA) and SA alone. Additional outcomes were early shipment for salvage slaughter (railer) and the sum of infectious mortality events and railer events (total fallout). Calves were followed for 90 d post-allocation.

Results
The numbers of calves allocated to florfenicol, oxytetracycline, and tulathromycin treatments were 85, 81, and 85, respectively. There were no differences in health outcomes among antimicrobial treatments (P > 0.05).

Conclusion
This clinical field trial identified no health outcome differences when comparing florfenicol, oxytetracycline, and tulathromycin for the 1st treatment of SA in feedlot calves.

Clinical relevance
Practitioners can use these results when creating treatment protocols for SA cases. Since results indicated similar health outcomes among the 3 antimicrobials, the lowest-priced antimicrobial may be the most cost-effective option. Perhaps antimicrobial treatment does not affect SA outcomes, but this could not be determined as negative controls were not included in this study.

Objective
To determine if the Kidney-Chek salivary test (SN Biomedical) could accurately detect azotemia in cats with urethral obstruction.

Animals
Cats included in the study were adult male cats > 1 y of age, each with an inexpressible bladder > 4 cm in diameter as visualized on ultrasound examination.

Procedure
Twenty-one cats meeting these criteria were admitted to a veterinary hospital. Each cat had salivary urea nitrogen (SUN) assessed with a Kidney-Chek test, following the Kidney-Chek protocol. Blood urea nitrogen (BUN) and creatinine were also assessed.

Results
Twenty-one cats were included in the study. One cat was excluded due to dry saliva sample collection. Final results showed that the SUN test strips were 84% accurate in identifying azotemia or non-azotemia. Azotemia was correctly identified in 78.57% of cats and non-azotemia was correctly identified in 90.9% of cats. Positive correlations were noted between SUN and BUN and SUN and creatinine. There was a negative correlation between SUN and urine specific gravity. No correlation was identified between hydration level and SUN. Hydration had no effect on test results.

Conclusion
Salivary urea nitrogen results from the Kidney-Chek salivary test were correlated to BUN and creatinine results. This test can be used to detect azotemia in selected cases of feline urethral obstruction.

Clinical relevance
This study demonstrated that SUN may be used to detect azotemia in cats at risk of urinary tract obstruction. This test may be useful for clients to use at home, before bringing their animals to the clinic, or as a cost-saving alternative in a clinic setting. Access to an immediately available azotemia reading can help practitioners make guided treatment recommendations and determine if cats are good candidates for outpatient treatment.

Background
Collection of medical history is essential for making informed clinical decisions in veterinary medicine. In veterinary dermatology, historical patterns may alter a clinician’s diagnostic and therapeutic recommendations. Veterinary patient reporting has similarities to reporting in human pediatric medicine, in which clinician history is collected from caretakers instead of patients themselves. Informant discrepancy between medical histories taken from co-parents has been observed in human pediatric medicine but has not been assessed in veterinary medicine.

Objective
The objective of this questionnaire-based, prospective, descriptive study was to investigate informant agreement among caretakers of veterinary dermatology patients.

Participants and procedure
A caretaker history questionnaire was designed to assess the primary concern of the caretaker, seasonality and duration of clinical signs, pruritus score, areas of the body affected, dietary history, and medication history. At initial dermatology consultations, caretakers completed the questionnaire in separate rooms, as anonymized pairs. Agreement proportion was analyzed by calculating the proportion of pairs, among all pairs, in which both caretakers agreed.

Results
Fifty-three paired responses (106 caretakers) volunteered for the study. Agreement was highest for histories of gastrointestinal signs (94.1%), skin disease exacerbation by diet (84.3%), and duration of disease (80.4%). Caretakers reported pruritus visual analogue scores within 2 score units of one another for 61.5% of patients. “Individual affected body part” agreement and “individual protein consumed” agreement proportions were 53.5 and 55.7%, respectively. The lowest agreement was seen for seasonality of disease (38.5%) and individual medication use (38.7%).

Conclusion and clinical relevance
Our findings supported the concept that informant discrepancy exists between caretaker histories reported in veterinary dermatology, suggesting that all caretakers’ histories should be taken into consideration.

Background
The raccoon roundworm, Baylisascaris procyonis, is a gastrointestinal parasite with zoonotic implications.

Objective
To identify and describe available evidence pertaining to clinical B. procyonis infections in humans.

Procedure
A scoping review of the MEDLINE (via OVID), Web of Science, and CAB Abstracts databases.

Results
Sixty infections were identified. Most (38, 75%) were in males and the median age was 2.9 y (range: 9 mo to 73 y). Forty-seven (78%) individuals had neurological disease (9 with concurrent ocular disease), 11 had ocular disease alone, 1 had eosinophilic cardiac pseudotumor, and 1 was an incidental autopsy finding. Clinical signs of neurological disease were highly variable and progressive, with vague initial signs and symptoms. Ocular disease was most often manifested as diffuse unilateral subacute neuroretinitis, retinal lesions, and painless loss of vision and visual acuity. Outcomes were reported for 42 individuals with neurological disease: 8 (19%) died, 4 (10%) fully recovered, and the remaining 30 (71%) had mild to significant neurological residual deficits. Most (7/10, 70%) individuals with solely ocular disease had permanent vision loss.

Conclusion and clinical relevance
The severity of the disease, poor response to treatment, and widespread presence of the parasite in areas where raccoons are endemic indicate a need for awareness among the public, healthcare providers, and veterinarians.