Table of Contents and Abstracts

A case of postpartum spontaneous hepatic bleeding in a dog is described and compared to a similar condition that occurs in humans (HELLP syndrome). The bitch developed vague symptoms of weakness and anorexia 7 d postpartum. Clinical pathology test identified anemia, thrombocytopenia, and elevated alkaline phosphatase. An ultrasound examination revealed peritoneal effusion with fluid analysis, consistent with a hemoabdomen. Exploratory laparotomy identified hepatic bleeding from multiple liver lobes as well as a friable uterus. No other abnormalities were detected. To the authors’ knowledge, this is the first reported case of postpartum spontaneous hepatic bleeding in a dog.

Key clinical message:
In this report, we describe and compare the findings in this case to a well-described condition (HELLP syndrome) in humans that also causes hepatic bleeding as a severe complication.

An 11-year-old spayed female terrier mix dog weighing 6.38 kg was presented to the emergency department of a large specialty hospital for hyporexia and lethargy. The dog was diagnosed with a perforated duodenal mass. On exploratory laparotomy, a perforated mass along the duodenal flexure was identified, an intestinal resection and anastomosis was performed, and a nasogastric tube was placed. Two days after surgery, the dog erroneously received 16 mL of a commercially formulated liquid diet through a triple-lumen jugular catheter. When the medical error was detected, 4 mL of diet and blood was aspirated from the jugular catheter. The catheter tip and a sample of the diet were submitted for culture. Culture results of the catheter revealed no growth, but the food grew methicillin-resistant staphylococcus. At 5 d following the inadvertent administration, the dog was discharged on clindamycin 11 mg/kg, q12h and cefpodoxime 7.5 mg/kg, PO, q12h for 10 d. Histopathology of small intestinal mass was consistent with large cell lymphoma. The dog was re-evaluated 2 wk following surgery and was doing well.

Key clinical message:
Inadvertent intravenous administration of enteral feed is a serious medical error; however, this case report serves to describe a successful outcome.

An 8-year-old spayed female Chihuahua dog was diagnosed with a suspected primary mast cell tumor (MCT) of the left popliteal lymph node (LN). Physical examination, computed tomography, and focused hind-limb ultrasound failed to identify a primary integumentary MCT. Asymmetry of the ipsilateral medial iliac LN was identified on abdominal ultrasound. Surgical excision of the left popliteal and left medial iliac LN was completed without complication. Histologic assessment confirmed overt MCT effacement of both LN. Postoperatively, the dog received adjuvant chemotherapy (vinblastine and prednisone). The dog was alive 562 d after surgery, without evidence of disease recurrence. To the authors’ knowledge, this is the first report in the veterinary literature documenting a suspected canine primary LN MCT.

Key clinical message:
Albeit rare, primary LN MCT should be a differential diagnosis for lymphadenopathy in the absence of a primary integumentary tumor.

A 15-year-old castrated male beagle-cross dog was presented with neuromuscular, cardiovascular, and gastrointestinal signs 7 h after accidental ingestion of a toxic dose (33 mg/kg) of the amphetamine lisdexamfetamine dimesylate. Clinical and clinicopathological abnormalities noted included dysphoria, mydriasis, hyperesthesia, muscle tremors, tachycardia, tachypnea, hyperthermia, hematochezia, mild hypoglycemia, hemoconcentration, and metabolic acidosis. Initial treatment with intravenous (IV) acepromazine, butorphanol, methocarbamol, and rectal cyproheptadine, along with IV fluids with 5% dextrose added, was inadequate to control clinical signs. The dog was stabilized effectively following administration of IV constant-rate infusions (CRIs) of dexmedetomidine (1 to 3 µg/kg per hour) and butorphanol (0.2 mg/kg per hour). The dog was maintained on this CRI protocol for 20 h and weaned off without redeveloping neuromuscular and cardiovascular signs. Serum biochemical analysis and urinalysis at that time revealed marked elevation of creatine kinase (100-fold), mild to moderate elevation of liver enzymes (ALP: 2.4-fold, ALT: 9.5-fold, GLDH: 4-fold), and the presence of myoglobinuria, indicative of rhabdomyolysis and possible concurrent hepatic injury. The animal recovered with supportive care and was discharged 44 h after presentation. One week after discharge, the dog was clinically normal and serum biochemical analysis and urinalysis confirmed resolution of rhabdomyolysis. No evidence of kidney failure secondary to the rhabdomyolysis was noted. To the best of the authors’ knowledge, this is the first report of survival following lisdexamfetamine intoxication in a dog. Clinical signs resolved completely with supportive and symptomatic therapies mainly consisting of IV fluid therapy and sedative administration. There were no long-term complications reported.

Key clinical message:
Aggressive medical therapies, including IV CRIs of dexmedetomidine and butorphanol, in addition to IV fluids, were effective for managing a dog with severe lisdexamfetamine intoxication. The dog recovered uneventfully following 44 h of hospitalization, with no evidence of long-term complications secondary to the rhabdomyolysis associated with the toxicosis.

A 7-year-old spayed female Corgi dog was presented for care 1.5 h after ingestion of chocolate brownies (theobromine dosage: 88.3 mg/kg, BW). Physical examination revealed mild tachycardia and hyperthermia. Vomiting was induced, and the dog was treated with maropitant and activated charcoal with sorbitol (1.9 g/kg, BW, PO) prior to ER transfer. Tremors and seizures were noted 4.5 h following ingestion. Despite rehydration, treatment with activated charcoal containing no sorbitol (0.9 g/kg, BW, PO) resulted in the dog’s serum sodium concentration quickly elevating [Na: 174 mmol/L; reference range (RR): 144 to 160 mmol/L]. The dog developed neurologic signs and azotemia. Treatment included customized fluid therapy, anticonvulsant medications, positive pressure ventilation, and administration of emergency drugs related to a near-arrest event. With continued care, the dog was discharged 57 h following admission. One month following discharge, the dog had mild vestibular signs remaining that resolved 10 mo after discharge. To the authors’ knowledge, this is the first reported case that documents a dog developing severe hypernatremia following activated charcoal therapy related to chocolate toxicosis. The case details may be helpful to clinicians treating similar complex toxicity, those interested in potential neurologic recovery following severe hypernatremia, and those who are seeking insights into risk factors for developing hypernatremia with activated charcoal therapy.

Key clinical message:
A case of chocolate toxicity and severe hypernatremia following activated charcoal therapy highlights that patients which have ingested an osmotically active toxin, such as chocolate, especially those at risk of dehydration, may be at increased risk for hypernatremia following activated charcoal therapy. If activated charcoal is used in such complex cases, frequent monitoring of patient’s electrolytes and neurologic status is recommended to minimize the risk of development of life-threatening hypernatremia.

Canine oral papillary squamous cell carcinoma is a rare subtype of squamous cell carcinoma with low metastatic potential. This report describes a 6-month-old intact male Labrador retriever dog with a 2.2 × 2.1-centimeter intraoral mass located in the gingiva between the 1st and 2nd right mandibular premolars. Computed tomography revealed an exophytic mass infiltrating the mandible and right mandibular gingiva without evidence of regional lymph node enlargement or distant metastasis. Histopathological evaluation confirmed canine oral papillary squamous cell carcinoma with metastasis to the right mandibular lymph node (surgically removed) and carboplatin was administered postoperatively. At 1404 d post-surgery, no local recurrence or distant metastasis were observed. To the best of the authors’ knowledge, this is the first reported case of canine oral papillary squamous cell carcinoma metastasizing to the lymph nodes. The dog was treated with chemotherapy after surgery and had a good long-term prognosis.

Key clinical message:
Canine oral papillary squamous cell carcinoma has not been reported to metastasize and is usually treated locally with surgery or radiation therapy. However, as in the case reported herein, metastasis to the lymph nodes may occur. In such cases, accurate evaluation of metastasis, including lymph node excision biopsy, and chemotherapy may need to be considered.

The problem of a high stillbirth rate on a swine farm was investigated. A review of production records revealed an average litter size of 13 pigs born alive and 1.5 stillborn pigs, with stillbirth rates higher for litters from older sows. However, the average parity of the sows studied was only 2.7, indicating a young herd. Backfat measurements indicated many sows were over-conditioned, but body condition was not associated with stillbirth rate. Sows that farrowed during working hours produced fewer stillbirths compared to sows farrowing when no personnel were in the barn to assist. Induction of parturition using an injection of prostaglandin after gestation Day 114 was commonly practiced and resulted in longer farrowing durations for induced sows compared to non-induced sows (P = 0.001) and a trend toward more stillbirths (P < 0.1). Sows that were induced to farrow were no more likely to farrow during working hours than non-induced sows.

Key clinical message:
It was suggested that, in order to reduce stillbirth rates in this herd, it would be advisable to extend the hours of supervision during the days on which most farrowing was expected to occur.

Thymoma is a common neoplasm of goats; however, literature regarding the best imaging modalities for diagnosis is scarce. In this case, multiple modalities were used during antemortem examination to develop a working diagnosis of a mediastinal mass as the cause of acute respiratory distress in a doe. Computed tomography was subsequently used in conjunction with postmortem examination to fully characterize the mass and confirm metastatic thymoma. This case emphasized how important advanced imaging can be for diagnosis and guiding treatment decisions; furthermore, it highlighted that a combination of alternatives can be used in settings where cross-sectional imaging is not available or feasible.

Key clinical message:
This report highlights alternative imaging modalities, such as thoracic fluoroscopy, available to diagnose thoracic masses in goats when advanced imaging may not be available or feasible.

Objective
This study aimed to evaluate the clinical outcomes of transsphenoidal surgery (TSS) in dogs weighing < 15 kg with pituitary-dependent hypercortisolism (PDH).

Animals
The study included 34 dogs, each weighing < 15 kg, diagnosed with PDH, and undergoing TSS at our facility between 1999 and 2021.

Procedure
Postoperative assessments included fatal complications within 4 wk, the extent of mass resection, the duration of central diabetes insipidus, long-term survival, and duration of remission.

Results
Five dogs died within 4 wk after TSS. Complete resections were completed in 28 dogs, whereas 6 dogs underwent partial resection. Factors associated with partial resection included a higher pituitary-to-brain ratio (odds ratio: 112 705.8; P = 0.014). The median duration of central diabetes insipidus after TSS was 9.5 d. The median long-term postoperative survival was 1228 d. The estimated censored survival rates were 83 and 69% at 1 and 2 y postoperatively, respectively. Recurrence of PDH was observed in 2 dogs, with a median postoperative remission duration of 1188 d. Estimated recurrence-free rates were 90 and 90% at 1 and 2 y postoperatively, respectively.

Conclusion and clinical relevance
Transsphenoidal surgery is an effective treatment for PDH in dogs weighing < 15 kg, particularly when the pituitary gland is small.

Objective
The objective was to measure tear production using Schirmer tear test-1 (STT-1) in dogs with atopic dermatitis, to evaluate for abnormal tear production.

Animals
We evaluated 47 client-owned dogs diagnosed with atopic dermatitis based on history, clinical signs, completion of an elimination diet trial, and fulfillment of at least 5 of Favrot’s diagnostic criteria.

Procedure
Schirmer tear test-1 was conducted on each dog. Values < 15 mm/min were consistent with low tear production and suggestive of keratoconjunctivitis sicca. Values > 25 mm/min were consistent with epiphora due to excess lacrimation.

Results
Twenty-one of 47 atopic dogs had STT-1 values outside the normal range in at least 1 eye. Three had STT-1 values < 15 mm/min and 18 had STT-1 values > 25 mm/min in at least 1 eye.

Conclusion and clinical relevance
These findings suggest atopic dermatitis may be associated with altered tear production. However, the absence of a complete ophthalmic assessment precludes definitive conclusions regarding keratoconjunctivitis sicca and epiphora. Future studies to validate these observations could help determine whether routine screening of atopic dogs using the STT-1 can aid in detecting ocular manifestations of canine atopic dermatitis to optimize animal care.