CVJ - July 2026, Vol. 67, No. 7
Scientific
Case Reports
Surgical reconstruction using a mucosal graft and temporary nasal stent in a cat with severe nasal stenosis
Natalie L. Leong, William Hawker, Rachel Dobberstein, Bryden J. Stanley, Ameet Singh (page 729)
A 4-year-old spayed female exotic shorthair cat was presented to a tertiary referral center because of chronic, open-mouth breathing resulting from complete nasal stenosis, a complication of revision rhinoplasty surgery for brachycephalic obstructive airway syndrome. Reconstruction to create a new, single naris was done by using a biopsy punch, harvesting a sublingual mucosal graft, and placing the graft with a temporary nasal stent. No major complications were encountered. At 18 d postoperatively, the nasal stent was removed and the neo-nasal orifice appeared healthy and patent. At 40 and 95 d postoperatively, the neo-nasal orifice had decreased in size but remained patent and the cat continued to breathe comfortably.
Key clinical message:
This case report describes the surgical technique for and successful use of a sublingual graft and temporary nasal stent for reconstruction of a nasal passage in a brachycephalic cat. This technique should be considered a viable surgical option for severe nasal stenosis in feline patients for which conventional rhinoplasty is unlikely to be successful.
Perirenal lipoma in a 14-year-old spayed female dog: A rare diagnosis
Xin Ci Ling, Jay Pakhawala, Whitney Phipps (page 737)
Adipose tumors are common in older dogs. Most of these tumors present as benign subcutaneous lipomas; however, intracavitary lipomas, particularly those within the retroperitoneal space, are rarely documented in veterinary medicine. This case report describes a 14-year-old spayed mixed-breed dog with a history of recurrent urinary tract infections, hind-limb weakness, and prior subcutaneous lipomas that was presented because of polyuria, polydipsia, and behavioral changes. Abdominal ultrasound and subsequent computed tomography revealed a left-sided perirenal mass with fat, fluid, and soft-tissue components. Given the mass’s location, vascularity, and associated organ displacement, malignant differential diagnoses were prioritized. Exploratory laparotomy with left nephrectomy and adrenalectomy was completed due to the mass’s indistinct margins. Histopathology revealed a benign perirenal lipoma with necrosis, inflammation, and abscessation. The embedded adrenal gland was histologically normal. Postoperative azotemia developed but later stabilized. This case represents a rare instance of a benign retroperitoneal lipoma closely associated with renal and adrenal structures, mimicking more aggressive pathology on imaging. To the authors’ knowledge, this may be the first reported case of perirenal lipoma in a dog. Although uncommon, intracavitary lipoma should be considered as a differential diagnosis of retroperitoneal masses, to better inform treatment decisions and prognoses.
Key clinical message:
This case highlights the rare occurrence of a perirenal lipoma in a dog, emphasizing the importance of considering benign adipose tumors in the differential diagnosis of retroperitoneal masses, even when imaging suggests malignancy. Early recognition can guide more informed treatment decisions and improve patient outcomes.
Idiopathic thoracic aortic aneurysm in a dog with 2:1 atrioventricular block
Junyoung Kim, Eunji Hur, So-Young Lee, Hyeon Woo Jeong (page 742)
A 14-year-old castrated male spitz dog was presented with intermittent coughing. Physical examination revealed bradycardia and a grade 3/6 left apical systolic murmur. Thoracic radiographs demonstrated severe bulging of the aortic arch with focal dorsal deviation of the trachea. Echocardiography revealed marked dilation involving the sinotubular junction and extending into the ascending aorta without discernible physiologic causes, with moderate aortic regurgitation and mild mitral regurgitation secondary to myxomatous degeneration. Electrocardiography showed a 2:1 second-degree atrioventricular block. Idiopathic thoracic aortic aneurysm was presumptively diagnosed. The dog was managed medically with pimobendan, theophylline, and famotidine. Clinical signs and electrocardiographic abnormalities improved, and the dog remained stable for 13 mo.
Key clinical message:
This case report demonstrates the diagnostic and therapeutic challenges and clinical relevance of idiopathic thoracic aortic aneurysm in dogs.
Medical management of multifocal immune-mediated punctate keratitis in 3 dogs: A case series
Seokmin Go, Seonmi Kang, Kyoungsun Park, Hyunwoo Noh, Jaeho Shim (page 747)
Multifocal immune-mediated punctate keratitis (MIPK) is an uncommon corneal disease in dogs characterized by multifocal anterior stromal opacities with fluorescein retention that may not respond to conventional therapy for superficial corneal ulcers. Clinical decision-making is challenging because concurrent corneal epithelial defects are considered a relative contraindication to topical immunosuppressive therapy. Three dogs were presented with multifocal punctate corneal opacities and positive fluorescein staining; MIPK was diagnosed based on characteristic clinical findings and exclusion of infectious causes. All 3 dogs received topical cyclosporine as the primary immunomodulatory agent; 2 dogs were subsequently treated with topical corticosteroids after infectious and non-immune-mediated causes were excluded, and 1 dog initially received a topical nonsteroidal anti-inflammatory drug that was subsequently replaced with a topical corticosteroid. Adjunctive therapies included temporary tarsorrhaphy in 1 dog and bandage contact lens in another. Corneal epithelial defects and stromal opacities improved within 1 to 5 wk and no clinical recurrence was observed during follow-up periods of 4 to 14 wk, despite tapering of anti-inflammatory therapy. These cases support early initiation of topical cyclosporine combined with carefully selected anti-inflammatory agents for canine MIPK, despite the presence of superficial corneal ulceration, provided infectious or non-immune-mediated causes have been thoroughly excluded.
Key clinical message:
Early initiation of topical cyclosporine combined with carefully selected anti-inflammatory agents effectively managed canine MIPK, even in the presence of superficial corneal ulceration.
Ethylene glycol intoxication: Use of the lactate gap for diagnosis and to determine length of intermittent hemodialysis treatment
Saoirse Murphy, Carsten Bandt (page 752)
An 18-month-old dog was presented to the emergency department with a marked discrepancy in lactate measurements obtained on different analyzers (lactate gap), an elevated anion gap, and a renal azotemia, which raised concern for ethylene glycol intoxication. The dog was treated with intermittent hemodialysis until the lactate gap was normal.
Key clinical message:
It is hypothesized that the lactate gap can be used by veterinary clinicians as both a diagnostic tool and a therapeutic tool to determine when intermittent hemodialysis treatment can be stopped.
Modified bilateral labial/buccal rotational flap with surgical nasal orifice creation following rostral maxillectomy in a dog with nasal planum squamous cell carcinoma
Rahyeon Ahn, William Hawker, Rachel Dobberstein, Danielle Richardson, Ameet Singh (page 758)
An 11-year-old neutered male golden retriever dog was presented with a 2-week history of progressive swelling and ulceration of the left nostril and upper lip. Incisional biopsies confirmed nasal planum squamous cell carcinoma with no evidence of metastasis on thoracic imaging or lymph node cytology. Computed tomography and magnetic resonance imaging identified a locally invasive mass involving the left nasal planum. A radical rostral maxillectomy and nasal planectomy were performed, including bilateral excision of the ventral and dorsal mandibular and medial retropharyngeal lymph nodes. Reconstruction was achieved using a modified bilateral labial/buccal rotational flap, with surgical creation of a nasal orifice. Histopathologic analysis confirmed complete tumor excision with wide margins but identified micrometastasis in the mandibular lymph nodes. The dog recovered uneventfully with restored nasal airflow and maintained cosmetic and functional outcomes. Five cycles of adjuvant carboplatin chemotherapy were administered. No local recurrence was observed 7 mo postoperatively. This case represents a novel adaptation of an established technique enabling single-stage resection and reconstruction of a complex nasal planum tumor, achieving both functional and cosmetic restoration. Importantly, the modified approach accommodated an asymmetrical labial flap design necessitated by tumor extent, demonstrating its versatility in achieving complete oncologic resection without compromising reconstructive integrity.
Key clinical message:
This case demonstrated a practical modification of an established reconstructive technique that enables single-stage oronasal reconstruction with restoration of nasal patency following curative-intent resection of nasal planum squamous cell carcinoma.
Progressive nonambulatory tetraparesis and cerebellar signs in a 6-year-old spayed female Shiba Inu dog with normal brain MRI
Dezirae Leger, Ruby Ng, Emeline Gruget, Rachel Lampe (page 767)
A 6-year-old spayed female Shiba Inu dog was evaluated because of a 2-week history of progressive paraparesis that advanced to nonambulatory tetraparesis with cerebellar signs. The dog was fed a nutritionally unbalanced, commercial, freeze-dried, raw, fish-based diet. Thoracolumbar and brain MRI revealed no abnormalities, and CSF analysis showed albuminocytologic dissociation. Based on dietary history, clinical progression, and response to therapy, a presumptive diagnosis of thiamine deficiency was made. Treatment consisted of dietary modification and oral thiamine (vitamin B1) supplementation, resulting in near-complete neurologic recovery. This report describes an atypical presentation of suspected thiamine deficiency in a dog with normal brain MRI and highlights the importance of dietary assessment in cases of progressive neurologic disease.
Key clinical message:
This case highlights the critical importance of obtaining a thorough dietary history. In this dog, thiamine deficiency was suspected based primarily on consumption of a raw-fish diet that appeared not to be nutritionally complete and balanced, and confirmed retrospectively following a rapid clinical response to dietary correction and thiamine (vitamin B1) supplementation. Recognition of diet-associated neurologic disease is particularly relevant to general-practitioner veterinarians, as timely identification and treatment through diet modification can result in substantial neurologic recovery and may prevent death or euthanasia due to a treatable condition.
Coxiella burnetii abortion in farmed plains bison (Bison bison bison) in western Canada
Lindsey A. Hampton, Dayna A. Goldsmith, Hugh Y. Cai, Beverly J. Morrison, Erin K. Zachar, Evan Lowe, Jennifer L. Davies (page 773)
Coxiella burnetii is a zoonotic bacterium that affects human and animal health globally and has detrimental socioeconomic effects on the livestock industry. This organism is known to cause abortion in sheep, goats, and cattle that is characterized by placentitis with minimal to no fetal lesions. In April 2025, the Diagnostic Services Unit at the University of Calgary Faculty of Veterinary Medicine (Alberta) received 11 aborted fetuses from a single herd of farmed plains bison (Bison bison bison). Initial submissions lacked placenta, delaying diagnosis. The 5th submission, which included placenta, revealed a necrotizing placentitis with intracellular bacteria within trophoblasts, highly suggestive of coxiellosis. In 4 of 11 cases, a definitive diagnosis of C. burnetii abortion was made, based on compatible histopathologic lesions in the placenta and detection of high numbers of organisms as evidenced by qPCR values. Coxiella burnetii was suspected in the remaining cases but could not be confirmed due to the absence of placenta. This report documents the first association of C. burnetii with abortion in plains bison and describes the histopathology and qPCR results observed during this outbreak. These cases underscored diagnostic challenges posed by incomplete submissions in abortion investigations.
Key clinical message:
This report highlights diagnostic challenges associated with abortion cases and the need for submission of both fresh and formalin-fixed placenta. Clinicians and diagnosticians should now include C. burnetii as a differential diagnosis for fetal loss in bison and ensure that appropriate biosafety measures are in place when handling specimens from ruminant abortions.
Articles
Influences of measurement environment and owner presence on in-clinic blood pressure in dogs
Hiroshi Sunahara, Melpa Susanti Purba, Takuya Itamoto, Harumichi Itoh, Kazuhito Itamoto, Yuki Nemoto, Munekazu Nakaichi, Kenji Tani (page 780)
Objective and animals
The objective of this study was to evaluate effects of measurement environment and owner presence on oscillometric blood pressure (BP) values in 14 clinically healthy dogs.
Procedure
Without removing the cuff, noninvasive BP measurements were taken in 3 consecutive in-clinic situations: Situations 1) a quiet waiting room with only the owner present, 2) an examination room with the owner and veterinary personnel present, and 3) an examination room without the owner present. Only measurements with bell-shaped oscillograms were considered valid. Systolic, diastolic, and mean BP; pulse pressure; pulse rate; percentage of valid measurements; and success rate were compared among situations.
Results
Systolic and mean BP were significantly higher in the absence of the owner, whereas no significant differences were observed among other parameters. The overall success rate of obtaining 5 consecutive valid measurements was low (26.2%).
Conclusion and clinical relevance
We concluded that owner absence was associated with higher in-clinic BP values and may influence BP assessment in dogs. Results supported measuring BP with the owner present under standardized conditions in clinical practice.
Apramycin resistance in bacteria isolated from animals: A systematic review and meta-analysis
J. Scott Weese, Heather E. Weese (page 788)
Objective
To identify and assess published data pertaining to apramycin resistance in bacteria isolated from animals, in order to inform discussions related to the potential repurposing of apramycin for use in humans.
Animals and procedure
We conducted a systematic review and meta-analysis of studies that reported apramycin susceptibility testing in bacteria from animals.
Results
Seventy-three references were included. Apramycin resistance was uncommon in Escherichia coli and Salmonella from healthy pigs, poultry, and cattle, with overall pooled prevalences of 7% (95% confidence interval: 2 to 13%) for E. coli and 4% (1 to 17%) for Salmonella. In diseased animals, apramycin resistance was 27% (20 to 33%) in E. coli and 7% (4 to 11%) in Salmonella. Apramycin exposure was associated with a relative risk of apramycin resistance of 3.22 (95% confidence interval: 1.79 to 5.78).
Conclusion and clinical relevance
The low overall resistance rates, despite decades of apramycin use, are encouraging. However, the apparent increase over time for E. coli and the limited available data regarding the effect of apramycin use on apramycin resistance highlight the gaps in evidence and challenges in interpreting the role of apramycin use in apramycin resistance of human or animal pathogens.
Quiz Corner
(page 725)
Features
PRESIDENT’S MESSAGE
Veterinary medicine and One Health in the age of AI/La+
Tracy Fisher (page 718)
VETERINARY MEDICAL ETHICS
(page 722)
CLINICAL ONCOLOGY
Aggressive versus non-aggressive bone lesions
Ayano Masuyama, Monique N. Mayer, Sally L. Sukut (page 806)
VETERINARY DERMATOLOGY
Canine pyoderma in the era of multidrug resistance: Diagnosis and treatment
Rehna Curran, Robert Ward (page 813)
DIAGNOSTIC OPHTHALMOLOGY
Thamires F.R. Marques, Liang-Jun Tseng, Nida Chornarm, Marina L. Leis (page 819)
VETERINARY PRACTICE MANAGEMENT
Is there a difference between locum and employed veterinarians?
Amy Noonan, Darren Osborne (page 823)
Notices
INDEX OF ADVERTISERS
(page 812)
BUSINESS DIRECTORY
(page 827)