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Previous Issue 12
Incidence of Postoperative Seizures with and without Levetiracetam Pretreatment in Dogs Undergoing Portosystemic Shunt Attenuation
Fryer, K., Levine, J., Peycke, L., Thompson, J. and Cohen, N. (2011), Journal of Veterinary Internal Medicine, 25: 1379–1384.
Congenital portosystemic shunts are often treated by surgical attenuation of the anomalous vessel. One of the possible complications of this procedure is post-ligation seizuring. These can be hard to treat, and can often result in the death of the patient. This paper studied the use of levetiracetam, an anti-convulsant that is commonly used in human patients with liver disease. The cases of 126 dogs that had undergone portosystemic shunt ligation and been treated with either levetiracetam or no anti-convulsant drug were reviewed retrospectively. A number of historical, clinical and clinico-pathological parameters were recorded, including presence of neurological signs prior to surgery, pre-operative bile acid and ammonia concentrations, duration of hospitalisation and post-operative complications. Levetiracetam was given a minimum of 24 hours prior to surgery, to 33% of cases. No dog treated with this drug experienced post-operative seizures, whereas 5% of dogs not treated with the drug did. None of the dogs that experienced post-operative seizures survived to discharge.
Bottom Line: This paper suggests that levetiracetam is a useful drug in prevention of post-operative seizures after surgical ligation of a portosystemic shunt, and it may reduce post-operative mortality rates with this procedure.
Randomized, Blinded Comparison of Epinephrine and Vasopressin for Treatment of Naturally Occurring Cardiopulmonary Arrest in Dogs
Buckley, G., Rozanski, E. and Rush, J. (2011), Journal of Veterinary Internal Medicine, 25: 1334–1340.
Epinephrine (adrenaline) is commonly used during cardiopulmonary resuscitation (CPR) for the treatment of cardiopulmonary arrest (CPA). However, it has the potential for deleterious adverse effects, so this paper looked at the use of vasopressin as an alternative. In a blinded, randomised, prospective clinical study, clinicians in ER or ICU performed CPR on dogs in CPA with either vasopressin or adrenaline. A standardised CPR protocol was performed, during which the drug was administered at 3 minute intervals. 60 dogs completed the study. 60% of cases achieved a spontaneous return of circulation, with 32% of cases surviving to 20 minutes and 18% to one hour. No difference was seen in rate of return to spontaneous circulation between the two groups, but dogs receiving adrenaline were more likely to survive to 1 hour than those receiving vasopressin. The authors conclude that further studies are required to identify a subset of dogs that might benefit from vasopressin.
Bottom Line: This paper found no advantage in using vasopressin over epinephrine in CPR, and a survival advantage was seen at 1 hour in animals that received epinephrine.
Therapeutic efficacy of topical hydrocortisone aceponate in experimental flea-allergy dermatitis in dogs.
Bonneau, S., Skowronski, V., Sanquer, A., Maynard, L. and Eun, H. (2009), Australian Veterinary Journal, 87: 287–291
Severely pruritic disease, such as flea allergic dermatitis (FAD), can sometimes require glucocorticoids to reduce the level of inflammation. However, systemic administration of glucocorticoids can lead to deleterious side effects. This study evaluated the treatment efficacy of a topical spray containing hydrocortisone aceponate (HCA) for dogs with experimentally induced FAD. 16 beagles with mild to moderate clinical signs were randomised to treatment and non-treatment groups and pruritic events were videotaped and scored. Skin signs such as erythema and alopecia were also assessed. Pruritus was reduced by 94% in the treatment group and 24% in the control group as assessed by cumulative time spent performing pruritic behaviour. There was also a significant improvement in overall clinical signs in the treated group compared to the non-treated group. No drug related side effects were noted during the treatment trial.
Bottom Line: This study showed that topical treatment with HCA led to a rapid and potent antipruritic effect in dogs with FAD, and also reduced the severity of skin lesions associated with FAD.
Carriage of Methicillin-Resistant Staphylococcus pseudintermedius in Small Animal Veterinarians: Indirect Evidence of Zoonotic Transmission
Paul, N. C., Moodley, A., Ghibaudo, G. and Guardabassi, L. (2011), Zoonoses and Public Health, 58: 533–539.
Methicillin-resistant Staphylococcus pseudintermedius (MRSP) is a recently emerged but increasingly reported cause of infections in humans and animals. This study investigated the prevalence of MRSP and Methicillin-resistant Staphylococcus aureus (MRSA) among small animal dermatologists attending a conference in Italy. Out of 128 nasals swabs, seven harboured MRSP and 2 harboured MRSA. A follow up study of two carriers of MRSP was performed which showed that the pathogen persisted for at least a month in the nasal cavity. The study also found that 25% of the vets swabbed had methicillin-susceptible Staphylococcus aureus (MSSA) whereas none had methicillin-susceptible Staphylococcus pseudintermedius (MSSP). The authors believe this may suggest MRSP is superior at colonising the human nasal cavity than MSSP. The genotype of one of the two MRSA isolates was of a type frequently reported in dogs and cats, and two of the MRSP isolates had lineages associated with pets. MRSP isolates were resistant to more drugs than MRSA isolates. Staphylococcus pseudintermedius is rare in humans, so the 3.9% carriage rate in small animal dermatologists is concerning. Cases of human MRSP infection have been linked with pets, and the authors conclude that vets should be aware of the potential for zoonotic transmission of MRSP.
Bottom Line: This paper shows that MRSP infection occurs in veterinarians, and recommends that proper preventative measures are taken to avoid the risk of MRSP transmission to humans from animal patients.
Evaluation of topical nalbuphine or oral tramadol as analgesics for corneal pain in dogs: a pilot study
Clark, J. S., Bentley, E. and Smith, L. J. (2011), Veterinary Ophthalmology, 14: 358–364.
Eye disease and eye surgery can be severely painful, and optimal analgesia is vital. This pilot study evaluated the effectiveness of topical nalbuphine or oral tramadol in the treatment of corneal pain in dogs. Fourteen male Beagle dogs were divided into three treatment groups, and under sedation, a small corneal wound was created. Post-operatively, treatment consisted either of topical nalbuphine plus oral placebo, topical placebo plus oral tramadol, or oral and topical placebo. Pain scoring was performed until the corneal wounds had healed. If cumulative pain scores exceeded a minimum threshold, rescue analgesia with morphine was provided. Four dogs in the nalbuphine treatment group required rescue analgesia, compared to two in the tramadol group and two in the placebo group. Although no significant difference was detected in the incidence of treatment failure, the authors suggest that tramadol should be investigated as possibly a superior analgesic than nalbuphine in the treatment of corneal pain.
Bottom Line: Oral tramadol may be a superior analgesic to topical nalbuphine in the treatment of corneal pain, but further studies are required.
Angiofibroma of the nasal cavity in 13 dogs
Burgess, K. E., Green, E. M., Wood, R. D. and Dubielzig, R. R. (2011), Veterinary and Comparative Oncology, 9: 304–309.
This study describes a case series of 13 dogs with nasal angiofibroma, a rare tumour. All dogs showed clinical signs and radiographic changes suggestive of a locally invasive neoplasm. In five cases, cytological criteria of malignancy was present. However, histopathology on core biopsy samples showed benign vascular proliferation with secondary inflammation.
Bottom Line: Although rare, nasal angiofibroma should be considered as a differential diagnosis for dogs presenting with clinical signs consistent with a malignant nasal tumour.
Evaluation of coagulation status in dogs with naturally occurring canine hyperadrenocorticism
Klose, T. C., Creevy, K. E. and Brainard, B. M. (2011), Journal of Veterinary Emergency and Critical Care, 21: 625–632.
Hyperadrenocorticism (HAC) has been considered to be associated with hypercoagulability, which can lead to serious sequelae such as cerebrovascular accidents and aortic thromboembolism. This prospective, observational study looked at various coagulation parameters in dogs with naturally occurring HAC and compared them to dogs with HAC which were being treated medically, and dogs without HAC. 46 dogs which had undergone adrenal function testing were included, 9 of which had newly diagnosed HAC, 19 were undergoing therapeutic monitoring of previously diagnosed HAC, and 18 did not have HAC. Various clinical and clinicopathological parameters were compared, including thromboelastography parameters, PT, aPTT, fibrinogen and antithrombin levels. The results did not support the contention that there is a significant different in coagulation tendency between dogs with HAC, dogs with HAC being medically managed, and dogs without HAC. The authors speculate this may be due to there being a weaker effect of HAC on coagulation than was previously thought, or due to a small sample size or even the use of coagulation assays that are insensitive to the effects of HAC on haemostasis.
Bottom Line: This paper throws doubt on the previously held thought that HAC causes hypercoagulability, but further studies would be required to confirm these findings.
Use of ethanol in the treatment of distal tarsal joint osteoarthritis: 24 cases
L.P.Lamas, J.Edmonds, W.Hodge, L.Zamora-Vera, J.Burford, R.Coomer and G.Munroe Equine Veterinary Journal
This study analyses the response to treatment of osteoarthritis of the distal tarsal joints with intra-articular ethanol. This treatment is used to promote ankylosis and the authors emphasise the importance of accurate needle placement. The inclusion criteria were horses which have chronic hindlimb lameness, localised to the tarso-metatarsal joint with the use of diagnostic analgesia, radiographic changes of distal hock osteoarthritis and which have failed to respond to intra-articular corticosteroids. The injection was performed under standing sedation with either 70% or 100% ethanol following a contrast study to establish if communication with additional synovial structures was present. Of the treated limbs 66% had improved at 6-12 weeks (9% deterioration) and 60% improved at 6-9 months (14% deteriorated). This article presents an interesting treatment option for distal tarsal osteoarthritis which is unresponsive to corticosteroids, and intra-articular ethanol may prove to be an appropriate treatment option in selected cases.
Bottom Line: This report describes an alternative treatment approach which may help some horses with chronic distal tarsal joint osteoarthritis.
Epilepsy in horses: Aetiological classification and predictive factors
V.A Lacombe, M.Mayes, S.Mosseri, S.M.Reed, W.R.Fenner and H.T. Ou Equine Veterinary Journal
This retrospective observational study had two objectives: to classify seizures in horses in accordance with current human and small animal criteria and to identify clinical factors of equine epilepsy in order to assist future diagnosis. The medical records of 104 horses, which presented to Ohio state university with a history of seizures were analysed. Recurrent seizures (i.e. epilepsy) were distinguished from those horses having a single seizure episode. Epilepsy could be categorised into symptomatic seizures (those occurring due to a structural brain lesion), cryptogenic seizures (unknown cause of recurrent seizures- no abnormalities on diagnostic tests) or idiopathic (no abnormalities on diagnostic tests and a suspected genetic disposition). Of the 73 horses presented with recurrent seizures, 26 were defined as symptomatic, 40 as cryptogenic, 2 as idiopathic and 5, which remained unclassified. The assessment of clinical factors in epileptic horses makes interesting reading and is a useful resource for clinicians when presented with a horse with a history of seizures.
Bottom Line: This paper is both clinically useful and an important step towards understanding equine epilepsy.