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Current Issue: Issue 35, December 2017
Canine acute leukaemia: 50 cases (1989–2014)
Bennett, A. L., Williams, L. E., Ferguson, M. W., Hauck, M. L., Suter, S. E., Lanier, C. B. and Hess, P. R. (2017)
Veterinary and Comparative Oncology
Acute leukaemia (AL) is a form of bone marrow neoplasia that is associated with a poor prognosis, even with intensive treatment. However, in humans, dose intense chemotherapy, in which treat-ments are given closer together than standard, has allowed more patients to achieve a longer term survival. To assess the prognosis for dogs receiving chemotherapy for AL, this study reviewed the records of three academic veterinary hospitals, finding fifty dogs with AL. Criteria involved having an excess of circulating or marrow blast cells, a marked cytopenia and no significant lymph node enlargement. 72% of cases received chemotherapy, leading to a complete or partial response for a median of 56 days, with a range of 9-128 days. 14 dogs underwent rescue therapy. The median sur-vival time was only 55 days, with the longest survival 300 days. Dogs treated palliatively, or not treated at all, had a median suvival time of one week. Chemoresistance was found to occur quickly soon after starting chemotherapy treatment.
Bottom line: The survival time for acute leukaemia is short, even with cytotoxic chemotherapy
Veterinary Clinical Digest Summary
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The treatment of canine mast cell tumours with electrochemotherapy with or without surgical exci-sion
Lowe, R., Gavazza, A., Impellizeri, J. A., Soden, D. M. and Lubas, G. (2017)
Veterinary and Comparative Oncology
Electrochemotherapy (ECT) uses an electric pulse and low dose chemotherapy to help the drugs to penetrate cancer cells by increase the permeabilisation and porosity of the cell membranes. This ret-rospective case series looked at the results of using ECT in the treatment of mast cell tumours (MCTs) either as first line therapy or with surgery. 51 dogs with MCTs were included in the study. 15 had ECT only, 11 had intra-surgery ECT, 14 had ECT adjuvant to surgery and 11 had surgery followed by ECT. The MCTs were mainly Patnaik grade 2. The best outcome was achieved by ad-ministering ECT intra-surgery, but good outcomes were also achieved when ECT was used on its own in smaller lesions.
Bottom line: Electrochemotherapy can be used succesfully alone in small mast cell tumours or intra- or post-operatively in larger lesions, with limited toxicity.
Veterinary Clinical Digest Summary
Associations between thoracic radiographic changes and severity of pulmonary arterial hypertension diagnosed in 60 dogs via Doppler echocardiography: a retrospective study
Adams DS, Marolf AJ, Valdés-Martínez A, Randall EK, Bachand AM (2017)
Vet Radiology Ultrasound
Pulmonary arterial hypertension (PAH) can cause severe problems if left untreated, but can be hard to diagnose without ultrasonography or more invasive techniques. Doppler echocardiography can be used to esimate the severity of PAH but this is a technically tricky procedure. This retrospective case control study aimed to assess the significance of radiographic changes in the presence of PAH and their association with severity. Three radiologists blindly scored radiographs for findings such as right ventricular and main pulmonary artery enlargement, and enlargement, tortuousity and blunt-ing of the pulmonary lobar arteries. Right ventricular enlargement (diagnosed by presence of a re-verse D or a change in the 3/5-2/5 cardiac ratio), main pulmonary artery enlargement and caudal lo-bar artery enlargement were all associated with increasing severity of pulmonary hypertension. However, radiographic findings were generally poor at estimating the severity of pulmonary hyper-tension, and the authors recommend that Doppler echocardiography is still used in the diagnosis of suspected PAH.
Bottom line: Radiographic findings are associated with pulmonary hypertension, but Doppler echocardiography is a superior method of diagnosing the severity of this condition.
Veterinary Clinical Digest Summary
Evaluation of T2-weighted versus short-tau inversion recovery sagittal sequences in the identifica-tion and localisation of canine intervertebral disc extrusion with low-field magnetic resonance imag-ing
Housley D, Caine A, Cherubini G, Taeymans O
Vet Radiology Ultrasound
Magnetic resonance imaging (MRI) is the most useful diagnostic technique for intervertebral disc extrusion, with sagittal T2-weighted sequences generally considered to be the best screening series. However, this retrospective diagnostic accuracy study hypothesised that sagittal short-tau inversion recovery sequences (STIR) would achieve a higher sensitivity than T2 weighted sequences to diag-nose intervetebral disc extrusion, and that using both T2 and STIR series together would increase sensitivity further. 110 dogs with surgically confirmed intervertebral disc extrusion were included in the study. No significant difference was found in sensitivity between STIR and T2 series. However, T2 series alone led to a false negative diagnosis. One radiologist found a significant improvement in sensitivity when pairing the T2 and STIR series. The authors conclude that STIR series can identify disc extrusions that are missed by T2 series.
Bottom line: Sagittal STIR series are a useful addition to T2 weighted series when screening with MRI for interver-tebral disc disease.
Veterinary Clinical Digest Summary
Canine ocular onchocerciasis: a retrospective review of the diagnosis, treatment, and outcome of 16 cases in New Mexico (2011–2015)
McLean, N. J., Newkirk, K. and Adema, C. M. (2017)
Veterinary Ophthalmology
Onchocerca lupi is an emerging zoonotic nemataode parasite with a wide geographical distribution. This study reviewed the records of 16 dogs diagnosed with ocular onchocerciasis in New Mexico between 2011 and 2015. Cases were included if a histological or PCR diagnosis of the disease had been made. Clinical signs noted included conjunctival hyperaemia/episcleral injection in all cases, focal subconjunctival masses in 14, and retinal detachment in 7 cases. 7 cases were unilateral and 9 cases were bilateral. Medical management alone or in combination with surgery was often success-ful, but recurrence was thought to occur in 10 of the dogs.
Bottom line: Onchocerciasis is endemic in New Mexico. Treatment is often successful but the relapse rate is high.
Veterinary Clinical Digest Summary
Treatment of intrahepatic congenital portosystemic shunts in dogs: a systematic review
Tivers, M. S., Lipscomb, V. J. and Brockman, D. J. (2017)
Journal of Small Animal Practice
Intrahepatic congenital portosystemic shunts (CPSS) can be treated with surgical or medical inter-ventions, and numerous studies have been published about the management of this condition. This systematic review was performed to answer the question “Which of the treatment options for intra-hepatic CPSS in dogs offers the best short- and long-term outcome?” Thirty two studies were in-cluded in the review, and were assigned levels of evidence. There were no level 1, 2 or 3 studies. 26 had level four evidence and six had level 5 evidence. All but two studies were case series describing the outcome of one treatment method. One study compared surgical versus medical management and one study compared suture ligation versus ameroid constrictor placement. The overall evidence base was weak.
Bottom line: There is a lack of evidence to aid clinical decision making in the management of congenital intrahe-patic portosystemic shunts.
Veterinary Clinical Digest Summary
Dog Ecology and Barriers to Canine Rabies Control in the Republic of Haiti, 2014-2015
Schildecker, S., Millien, M., Blanton, J. D., Boone, J., Emery, A., Ludder, F., Fenelon, N., Crowdis, K., Destine, A., Etheart, M. and Wallace, R. M. (2017)
Transboundary and Emerging Diseases
Rabies kills tens of thousands of people worldwide every year, with dog bites responsible for the vast majority of these. Haiti has a particularly high rate of animal and human rabies. This epidemio-logical study assessed various factors in the prevention and treatment of rabies in Hiati. Over 2000 surveys were carried out among dog owners attending government-sponsored vaccination clinics. 50% of owned dogs were free roaming. 80% of owners reported difficulties with getting their dogs vaccinated. 18% of the dog population in the study had died in the previous year with signs con-sistent with rabies, and 3% of owners reported they had been bitten by dogs in the previous year. The authors note that low availability of veterinary care, low animal welfare standards and free-roaming dogs contribute to the rabies problem in Haiti.
Bottom line: Haiti and other countries with endemic rabies still have significant challenges to overcome regarding elimination of rabies.
Veterinary Clinical Digest Summary
Use of cabergoline for oestrus induction in multiparous anoestrous Beagle bitches
Shimatsu, Y. (2017)
Australian Veterinary Journal, 95: 350–352
Cabergoline is licensed in the UK for suppression of lactation and treatment of false pregnancy in bitches. This study aimed to assess the use of this drug for induction of oestrus. 20 multiparous Beagle bitches were included in the study. 15 had not been mated at their last oestrus, and 5 had whelped after mating at their last oestrus. The bitches were given cabergoline in early or mid-anoestrus. Oestrus induction occurred more frequently in bitches in mid than early anoestrus, and the rate of induction was higher in the bitches that hadn’t been pregenant after their last oestrus than those that had whelped.
Bottom line: Cabergoline can be used for oestrus induction in mid-anoestrus bitches.
Veterinary Clinical Digest Summary
Assessment of horse owners’ ability to recognise equine laminitis: A cross-sectional study of 93 veterinary diagnosed cases in Great Britain
Pollard D, Wylie C.E, Verheyen K.L.P, Newton J.R
Equine Veterinary Journal
In this study, the aims were to ascertain whether owner-reported laminitis cases were confirmed as laminitis by the attending vet; and compare owner and veterinary reported information in these cases. Data were obtained from vets and owners of 93 cases of laminitis seen by 25 veterinary practices in 2014 and 2015. Respondents recorded clinical signs, risk factors and un-derlying disease and owners completed their independently from their vets.
Welsh ponies and crosses were the most frequently represented breeds; 62% of cases were overweight. Of the 93 veterinary diagnosed cases, 51 (54.8%) were suspected to have laminitis by their owners. All of these 51 cases were confirmed to be laminitis by the attending vet. However, 45.2% of owners who did not suspect laminitis prior to vet diagnosis either did not know what the problem was or suspected a different condition including foot abscesses, bruised soles, navicular disease and colic.
Divergent growth rings was significantly more commonly reported by veteri-nary surgeons in cases where owners recognised laminitis, compared to cas-es unrecognized by owners. This suggests that owners of these horses either had previous experience of laminitis in their animal or used the presence of these rings as an indicator of laminitis. Difficulty in turning and weight shift-ing were more commonly reported by vets whereas increased hoof tempera-ture and recumbency were more commonly reported by owners. Difficulty in turning was reported in more than 75% of cases, while the classic laminitic stance and divergent growth rings were much less common, highlighting a need for to educate clients to recognise more subtle clinical signs.
Fewer owners reported equine metabolic syndrome compared to vets, but this difference was not apparent for PPID. The horse’s breed was more commonly reported as a risk factor in owner-recognised cases than in those not recognised by owners. Pony breeds were significantly more commonly reported in owner-recognised cases perhaps meaning that owners are not aware of the potential of laminitis in non-pony breeds. Fewer owners re-ported obesity compared to the vets, indicating that owners’ perceptions of their animal’s body condition score are not reliable.
Bottom line: Further owner education is needed, particularly in areas such as the spec-trum of possible clinical signs, equine metabolic syndrome and assessment of body condition.
Veterinary Clinical Digest Summary
Equine atypical myopathy in the UK: Epidemiological characteristics of cases reported from 2011 to 2015 and factors associated with survival
Gonzalez-Medina S, Ireland J.L, Piercy R.J, Newton J.R, Votion D.M
Equine Veterinary Journal
Data was obtained from 224 UK cases over 5 years submitted to the Atypical Myopathy Alert Group website by owners and veterinary surgeons to identi-fy relationships between clinical factors and survival. Most cases (73.3%) oc-curred in autumn, with greatest numbers reported in October and Novem-ber. The majority occurred in England (87.9%), with smaller numbers in Wales (8.5%) and Scotland (2.7 Hampshire, Wiltshire and Gloucestershire reported the highest numbers.
The median age was 6 years. Middle-aged horses were more likely to survive than those <5 years. There were 60% males and 40% females and over two thirds were in good body condition. Almost all horses (98.6%) had access to pasture, with the majority (72.5%) being turned out for 24 hours a day. In 59% of cases, the paddocks of affected horses were used for grazing all year round; this group had decreased odds of survival. Supplementary feeding was being given to 68% of horses. Horses with access to a salt lick and those receiving a vitamin or mineral supplement had significantly increased odds of survival compared to those who did not.
In the vast majority of cases (96%), sycamore seeds were found in the pad-docks; sycamore seedlings were found in 67.6% of cases. In most of these in-stances the sycamore trees were within, or near the paddock. The most common presenting signs were dark urine, stiffness and muscle fascicula-tions. For the 189 cases for which outcome was reported, 74 (38.6%) sur-vived. 14% of cases died or were euthanased within 24 hours of onset of clinical signs. Recumbency was strongly associated with decreased odds of survival. Veterinary treatment with vitamin preparations was significantly associated with increased odds of survival.
Bottom line: Factors associated with decreased odds of survival include full-time turnout and younger age. Vitamin/mineral supplementation in the diet and veteri-nary treatment including vitamin preparations were associated with in-creased odds of survival.
Veterinary Clinical Digest Summary
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