CVJ - January 2022, Vol. 63, No. 1
Duodenal perforation in a puppy with canine parvovirus infection
Dayoung Oh, Kitae Kim, Junghee Yoon (page 23)
A 2-month-old puppy was brought to a veterinary hospital with diarrhea, vomiting, and anorexia. The test for canine parvovirus was positive, and she was hospitalized for supportive care. Her gastrointestinal symptoms initially improved; however, vomiting and lethargy developed again in the second week of hospitalization. Abdominal ultrasonography results were suspicious of a duodenal perforation. Cytology of the abdominal effusion confirmed septic peritonitis; therefore, emergency exploratory laparotomy was performed. The surgery was successful, and the puppy recovered fully. When symptoms recur or deteriorate in patients with parvoviral infection, surgically curable complications may be disregarded if supportive therapy is continued without additional investigative examinations. This report highlights the usefulness of abdominal ultrasound in conjunction with fluid cytology to identify subsequent complications when the clinical signs of parvovirus deteriorate.
Key clinical message: This case report demonstrates duodenal perforation as a complication of parvoviral infection. Abdominal ultrasonography and peritoneal fluid cytology can be crucial for the early recognition of intestinal complications requiring immediate successful perioperative treatment.
Demographic survey of private veterinary practices in western Canada
Murray D. Jelinski, Brittany Schreiner, Alison Neale, Hugh G.G. Townsend (page 27)
A workforce survey of private veterinary practices in western Canada was conducted in 2020. Data were obtained on 526 practices (response rate = 39.5%) and 1445 individual veterinary practitioners. Overall, 68.4% of practitioners identified as female, with 4 times as many females as males comprising the youngest age cohorts (26 to 35 y) of the profession. The majority of practices (67.9%) were companion animal, followed by mixed animal (21.9%) and food animal (10.2%). Most females (77.2%) and males (57.8%) were engaged in companion animal practice, whereas 23.5% of males and 6.0% of females were food animal practitioners. During an average work week, practitioners devoted 77.4% of practice time to small animals, 15.1% to food animals, and 7.5% to equine animals. A greater proportion of males (75.2%) versus females (63.2%) worked on a full-time equivalent basis (P < 0.001). Whereas males were 1.7 times (95% CI = 1.3 to 2.3; P < 0.001) more likely to be practice owners than females, 54.5% of females were owners. Practice ownership was lower than in previous surveys, a trend that may have long-term implications with respect to the corporatization of the veterinary profession.
Increased risk of select glucocorticoid adverse events in dogs of higher body weight
Loren S. Sri-Jayantha, Michael T. Doornink, Bridget K. Urie (page 32)
There are limited data on glucocorticoid treatment in dogs. The purpose of this study was to investigate whether dogs of higher body weight experienced more adverse events when receiving glucocorticoid therapy. Data pertaining to glucocorticoid therapy was abstracted from the records of 61 dogs that were prescribed glucocorticoids for treatment of immune-mediated thrombocytopenia or hemolytic anemia from 2014 to 2019. The odds of developing muscle atrophy and polyphagia during therapy were increased by 30% for each 5 kg of additional body weight. Almost half of the dogs (44.3%) fluctuated > 15% from baseline weight during therapy. Dogs whose body condition scored as above ideal were at increased risk (odds ratio = 4.2) for being diagnosed with urinary tract infection. Our findings suggest that standard linear glucocorticoid dosing may place higher body weight dogs at increased risk of developing adverse events. Accelerated glucocorticoid tapering and/or alternative dosing schemes in dogs with higher body weights may be prudent in efforts to improve tolerance and client compliance.
Clinical effect of buprenorphine or butorphanol, in combination with detomidine and diazepam, on sedation and postoperative pain after cheek tooth extraction in horses
Franziska R. Haunhorst, Klaus Hopster, Marion Schmicke, Astrid Bienert-Zeit, Sabine Kästner (page 39)
The objective of this study was to compare effects of butorphanol (BUT) or buprenorphine (BUP), in combination with detomidine and diazepam, on the sedation quality, surgical conditions, and postoperative pain control after cheek tooth extraction in horses, randomly allocated to 2 treatment groups (BUT: n = 20; BUP: n = 20). A bolus of detomidine (15 µg/kg, IV) was followed by either BUP (7.5 µg/kg, IV) or BUT (0.05 mg/kg, IV). After 20 min, diazepam (0.01 mg/kg, IV) was administered and sedation was maintained with a detomidine IV infusion (20 µg/kg/h), with rate adjusted based on scores to 5 variables. All horses received a nerve block (maxillary or mandibular), and gingival infiltration with mepivacaine. Sedation quality was assessed by the surgeon from 1 (excellent) to 10 (surgery not feasible). A pain scoring system (EQUUS-FAP) was used to assess postoperative pain. Serum cortisol concentrations and locomotor activity (pedometers) were measured.
Horses in BUP and BUT required a median detomidine infusion rate of 30.2 µg/kg/h (20 to 74.4 µg/kg/h) and 32.2 µg/kg/h (20 to 48.1 µg/kg/h), respectively (P = 0.22). Horses in the BUP group had better sedation quality (P < 0.05) during surgery and higher step counts (P < 0.001) postoperatively. Buprenorphine combined with detomidine provided a more reliable sedation than butorphanol. However, the EQUUS-FAP pain scale became unreliable because of BUP-induced excitement behavior.
Antimicrobial resistance in bovine respiratory disease: Auction market- and ranch-raised calves
Trent R. Wennekamp, Cheryl L. Waldner, M. Claire Windeyer, Kathy Larson, Anatoliy Trokhymchuk, John R. Campbell (page 47)
This study compared changes in prevalence and antimicrobial susceptibility of Mannheimia haemolytica, Pasteurella multocida, and Histophilus somni in feedlot calves derived from the auction market (AUCT; n = 299) and from a single-ranch source (RANCH; n = 300). In the AUCT calves, the prevalence of Mannheimia haemolytica decreased, whereas Histophilus somni increased over the feeding period. The AUCT calves showed an increase in isolates not susceptible to tulathromycin for all bovine respiratory disease (BRD) pathogens, an increase in Pasteurella multocida and Histophilus somni isolates not susceptible to oxytetracycline, and an increase in Pasteurella multocida isolates not susceptible to florfenicol. In the RANCH calves, the prevalence of all 3 BRD pathogens was high at feedlot entry and decreased significantly during the study period. In RANCH calves, there was a significant increase in Pasteurella multocida isolates not susceptible to oxytetracycline, tulathromycin, and florfenicol. Surprisingly, there was a significant decrease in Mannheimia haemolytica isolates that were not susceptible to oxytetracycline, tilmicosin, and tulathromycin.
A pilot study examining a proprietary herbal blend for the treatment of canine osteoarthritis pain
Mary L. Cardeccia, Lindsay H. Elam, Kelly A. Deabold, Erin L. Miscioscia, Janice L. Huntingford (page 55)
Osteoarthritis is the most common joint disease in dogs. Despite the use of nonsteroidal anti-inflammatory drugs (NSAIDs), many owners seek natural therapies; either to augment the response to NSAIDs, or as a replacement. Substantial research has been directed to investigation of novel therapies. A randomized, double-blinded, controlled study was conducted to assess the efficacy of a herbal remedy for treatment of canine osteoarthritis pain. Client-owned dogs (N = 24) with osteoarthritis were enrolled between 2 veterinary hospitals. Each dog underwent veterinary and owner assessment at 0, 4, and 8 weeks, using the Canine Brief Pain Inventory and Hudson activity scale. Blood was collected for a complete blood (cell) count (CBC) and serum chemistry analysis. The product was deemed to be safe and well-tolerated at the manufacturer recommended dosage, with no significant changes seen in the CBC or serum biochemical analyses. Aside from1 dog that developed gastrointestinal upset, all other dogs tolerated the supplement without complication. The supplement did not statistically improve clinical signs in dogs based on veterinary or owner assessments of lameness. There was a treatment/time effect when assessing veterinary pain scores; however, post-hoc analysis suggests no observable benefit of treatment compared with the placebo group at any time point.
Factors affecting survival in 516 dogs that underwent cholecystectomy for the treatment of gallbladder mucocele
Monty Galley, Jennifer Lang, Mark Mitchell, Jon Fletcher (page 63)
Gallbladder mucocele (GBM) is a commonly diagnosed disease process in dogs that is associated with high morbidity and mortality if not recognized and appropriately managed. Although the exact mechanism of this disease process is not completely understood, previous studies in smaller populations of dogs have identified multiple factors that predispose to the development of GBM and affect survival. The purpose of this cross-sectional, retrospective study was to evaluate the effects of age, breed category, sex, preoperative antibiotic administration, gallbladder rupture, and a positive biliary culture in dogs that had a cholecystectomy performed for the treatment of GBM. The age (median: 11 years) and percentage of dogs that died within 14 days of cholecystectomy (16.7%) are similar to what have been reported in other studies. Gallbladder rupture and a positive biliary culture occurred in 20.4% and 12.5% of dogs, respectively. Dogs with a gallbladder rupture and positive biliary culture were 2.74 and 3.10 times more likely to die within 14 days of cholecystectomy, respectively. This contradicts a recent study that failed to find a significant association between survival and biliary culture result. Interestingly, younger age was associated with an increased occurrence of gallbladder rupture in that population. Because of the potential effect of gallbladder rupture and a biliary tract infection, abdominal imaging, biliary culture, and empirical preoperative antimicrobial therapy are recommended in dogs undergoing cholecystectomy for the treatment of GBM.
Evaluation of bilateral maxillary nerve block in dogs undergoing surgery for brachycephalic obstructive airway syndrome
Chiara De Gennaro, Enzo Vettorato, Federico Corletto (page 67)
This retrospective study assessed the effect of an intraoral bilateral maxillary nerve block in dogs undergoing surgery for brachycephalic obstructive airway syndrome (BOAS). Records of dogs that underwent BOAS surgery were retrieved. Cases were assigned to Group B or C if a preoperative bilateral maxillary nerve block was performed or not. Type and dose of local anesthetic, inhalant anesthetic minimum alveolar concentration multiples, intraoperative fentanyl and injectable anesthetic use, prevalence of intraoperative hypotension or bradycardia, and postoperative opioids administration, were compared between groups. Sixty-seven cases met the inclusion criteria: 33 were assigned to Group B and 34 to Group C. In Group C, 18 dogs required intraoperative fentanyl (P = 0.005), and 12 needed injectable anesthetic top-ups (P = 0.006). Hypotension, or bradycardia, were not different between groups. Bilateral maxillary nerve block reduces intraoperative fentanyl and injectable anesthetic requirement in dogs undergoing BOAS surgery.
Fragment size is associated with post-operative complications following elective arthroscopy of the tibiotarsal joint of horses
Alejandro Merchán, Judith Koenig, Nathalie Côté, Nicola Cribb, Gabrielle Monteith (page 74)
The objective of this retrospective study was to determine the occurrence of joint-related complications after elective arthroscopy of the tibiotarsal joint (TTJ) in 329 horses, and the association with specific clinical parameters. Data were collected from medical records of horses undergoing elective tibiotarsal joint arthroscopy for fragment removal. Exact conditional univariate regression was used to determine significant risk factors for joint-related post-operative complications.
Of 485 joints, 2 (0.4%) developed surgical site infection, 4 (0.8%) developed septic arthritis, 1 (0.2%) developed synovial fistula. There was a significantly increased odds of having septic arthritis as height and length of the distal intermediate ridge of the tibia (DIRT) lesion increased. The median height and length of the DIRT fragments in affected cases was 13.5 mm and 18.0 mm, respectively. For each unit (1 mm) increase in height, there was a 42% increase in the risk of septic arthritis occurrence (P = 0.0042), and a 15% increase for each unit increase in length (P = 0.035). Horses were significantly less likely to develop septic arthritis when suture smaller than USP 0 was used.
Horses with larger osteochondritis dissecans lesions of the DIRT region have an increased risk of developing septic arthritis following fragment removal.
Management of fluorouracil toxicity in a Labrador retriever-poodle crossbred dog
Heather Ellis (page 81)
A juvenile, neutered male, Labrador retriever-poodle crossbred dog was brought to a veterinary hospital for overnight care after ingesting fluorouracil 5.0% (5-FU) topical solution. The exposure occurred the night before and involved an unknown amount of fluorouracil. The dog survived the acute toxicity but developed status epilepticus requiring control with general anesthesia and spent multiple days hospitalized in a comatose state, eventually waking with sensory deficits in both vision and smell which resolved over time. Blood samples taken at a recheck visit 1 week after ingestion, showed the dog had developed severe thrombocytopenia and moderate leukopenia. Ten days after initial intoxication, the dog developed progressive alopecia which eventually affected the entire body.
Resiliency, hope, and trust
Louis Kwantes (page 11)
Veterinary Medical Ethics
Heather Broughton, Sophie Perreault (page 17)
Cutaneous hyperpigmentation in dogs
Jangi Bajwa (page 85)
Lynne S. Sandmeyer, Stephanie Osinchuk
Veterinary Practice Management
Should they stay or should they go: The cost of keeping versus firing cantankerous clients
Chris Doherty (page 91)
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