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Previous Issue: Issue 29
Atrial Fibrillation as a Prognostic Indicator in Medium to Large-Sized Dogs with Myxomatous Mitral Valvular Degeneration and Congestive Heart Failure
Jung, S.W., Sun, W., Griffiths, L.G. and Kittleson, M.D. (2016) Journal of Veterinary Internal Medicine, 30: 51–57
Atrial fibrillation (AF) in dogs usually occurs secondary to left atrial enlargement, for example with dilated cardiomyopathy or mitral valve disease, and tends to affect larger dogs. This study assessed whether AF is a prognostic indicator in dogs with mitral valve disease and congestive heart failure (CHF). 64 dogs weighing more than 15kg with mitral valve disease and CHF were included in a retrospective review. Thirty three dogs presented with AF or developed AF at a later stage, while 31 remained free of AF until the time of death. Median survival time for dogs with AF was 142 days, compared to 234 days for dogs with out AF. Adequate heart rate control significantly improved survival time. A combination of diltiazem and digoxin decreased heart rate significantly and prolonged survival time compared to dilatiazem alone.
Bottom line: The presence of atrial fibrillation with congestive heart failure is a negative prognostic indicator, but adequate rate control improves survival time.
Central Hypothyroidism in Miniature Schnauzers
Voorbij, A. M.W.Y., Leegwater, P. A.J., Buijtels, J. J.C.W.M., Daminet, S. and Kooistra, H. S. (2016) Journal of Veterinary Internal Medicine, 30: 85–91
Primary hypothyroidism, due to a lack of total T4 because of thyroid gland dysfunction, is a common disease of dogs. However, central hypothyroidism is much less common. This retrospective study described the presentation of central hypothyroidism in Miniature Schnauzers. Diagnosis was based on scinitigraphy and thyroid stimulating hormone (TSH) stimulation test and/or TSH-releasing hormone (TRH) stimulation testing. Computed tomography (CT) of the pituitary region was performed, and DNA analysis was performed. 7 Miniature Schnauzers were diagnosed with central hypothyroidism. Three of these cases had disproportionate dwarfism, and one had both TSH and prolactin deficiency. Disease-causing mutations were not found in the TSHB gene or in the exons of the TRHR gene. The authors believe that central hypothyroidism could be underdiagnosed in Miniature Schnauzers.
Bottom line: There is a breed predisposition to central hypothyroidism in Miniature Schnauzers that may be genetic in origin.
Review of dietary supplements for the management of osteoarthritis in dogs in studies from 2004 to 2014
Comblain F., Serisier S., Barthelemy N., Balligand M., Henrotin Y. Journal of Veterinary Pharmacology and Therapeutics, 39, 1–15.
Dietary supplements or nutraceuticals are recommended for a variety of disease conditions, but are poorly regulated since they are considered foodstuffs rather than drugs. This review summarises the scientific data on the use of dietary supplements in dogs with osteoarthritis. Chondroitin sulphate, glucosamine, undenaturated type II collagen, avocado–soya bean unsaponifiables, curcumin and polyunsaturated fatty acids were all included in the study. Most of these products were found to show anticatabolic and anti-inflammatory effects, but bioavailability was low, and there was little information about phamacokinetics. The authors believe that good clinical trials are needed to assess the impact of new formulations that improve gastrointestinal absorption.
Bottom line: The authors of this review believe that dietary supplements should be considered as part of osteoarthritis management, but that further studies are needed.
A SURVEY OF RADIOLOGISTS AND REFERRING VETERINARIANS REGARDING IMAGING REPORTS
Weissman, A., Solano, M., Taeymans, O., Holmes, S. P., Jiménez, D. and Barton, B. (2016) Veterinary Radiology & Ultrasound, 57: 124–129.
It is becoming more common for radiographs to be reported on by a specialist radiologist. This survey compared the opinions of small animal general practitioners, veterinary specialists and radiologists about the imaging report. 202 veterinary clinicians and 123 veterinary radiologists were included in the report. 89% of practitioners were satisfied with the reports they received, and 92% read the report as soon as it is available. 48% of clinicians believed that it was current standard of care that all imaging studies should be read by a board certified radiologist. Both radiologists and clinicians agreed that a clinical history and a clinical question were important in generating a good report. The majority of clinicians found value in recommendations for further imaging and medical and surgial treatment. However, about a third of specialists who had been in practice for a long time felt they were able to read imaging reports for their own discipline better than radiologists. Late reports and reports lacking a prioritised differential diagnosis list were considered negative factors.
Bottom line: Nearly half of all practitioners believe that all imaging studies should be read by a radiology specialist.
Plasmatic l-lactate in pet rabbits: association with morbidity and mortality at 14 days
Ardiaca, M., Dias, S., Montesinos, A., Bonvehi, C., Barrera, S. and Cuesta, M. (2016) Veterinary Clinical Pathology, 45: 116–123.
Lactate measurements have a place in the assessment of critically ill dogs and cats. This study assessed whether plasmatic l-lactate concentration (PLLC) is of clinical relevance in rabbits, since PLLC can reach much higher concentrations in rabbits than other species. 140 healthy rabbits were used as a control group, and 405 ill rabbits were also included in the study, 266 of which survived to day 14 and 108 of which died. A second study assessed the variation of PLLC in 25 healthy boarding rabbits and 99 hospitalised rabbits. The 95% reference interval in healthy controls was 2.1-15.2mmol/l. PLLC in sick rabbits did not differ significantly from healthy controls at presentation, but was significantly lower in the rabbits that died compared to survivors or controls. An increase in PLLC of 3.3mmol/l within 48 hours was associated with a better prognosis.
Bottom line: Unlike in other species, increased morbidity and mortality is associated with a sustained low PLLC, an increase in PLLC is associated with a better prognosis.
Sequence analysis of three canine adipokine genes revealed an association between TNF polymorphisms and obesity in Labrador dogs
Mankowska, M., Stachowiak, M., Graczyk, A., Ciazynska, P., Gogulski, M., Nizanski, W. and Switonski, M. (2016) Animal Genetics, 47: 245–249
Labrador dogs are prone to obesity, and as an owner of several I can testify to their prodigious appetite. However, obesity is linked to a variety of health problems. Adipokines have a role in homeostasis, and variations in the genes encoding them may have an association with a predisposition to obesity. This study looked for polymorphism in three adipokine genes (TNF, RETN and IL6). 260 dogs were included in the study including 109 lean, 88 overweight and 63 obese dogs. 136 of the dogs were Labradors. 24 new polymorphisms were identified. Two polymorphisms in the non-coding part of TNF was associated with obesity in Labradors.
Bottom line: Adipokine genes are highly polymorphic, and there is evidence of a genetic predisposition in Labrador Retrievers to obesity.
Idiopathic Canine Laryngeal Paralysis as One Sign of a Diffuse Polyneuropathy: An Observational Study of 90 Cases (2007–2013)
Bookbinder, L. C., Flanders, J., Bookbinder, P. F., Harvey, H. J., Barry, J. S. and Cheetham, J. (2016) Veterinary Surgery, 45: 254–260.
Idiopathic laryngeal paralysis (ILP) is a common disease of older dogs, causing signs of upper respiratory obstruction. Many dogs with ILP have concurrent neurological signs, such as hind limb ataxia. This study aimed to assess the prognosis and complications of dogs with ILP and to document the neurological problems of the disease. 90 dogs were included in this retrospective observational study. Dogs that underwent surgical treatment of ILP were 2.6 times less likely to die during the study period. Also, quality of life was significantly improved by surgery both immediately post-operatively and up till death or follow up. 35 out of 72 dogs on follow up had other neurologcal comorbidities. Neurological comorbidities increase the risks of complications.
Bottom line: Surgical treatment of laryngeal paralysis reduces mortality rate.
Carboplatin versus alternating carboplatin and doxorubicin for the adjuvant treatment of canine appendicular osteosarcoma: a randomized, phase III trial
Skorupski, K. A., Uhl, J. M., Szivek, A., Allstadt Frazier, S. D., Rebhun, R. B. and Rodriguez, C. O. (2016) Veterinary and Comparative Oncology, 14: 81–87.
Osteosarcoma is an aggressive bone cancer. Treatment involves local resection of disease, but as early metastasis is common, concurrent adjunctive chemotherapy is often recommended. This study compared treatment with carboplatin alone compared to a carboplatin and doxorubicin combination. 50 dogs that had undergone amputation for histologically confirmed osteosarcoma and were free of gross metastasis were randomly assigned to receive either six doses of carboplatin or 3 doses of carboplatin and 3 doses of doxorubicin in an alternating regime. Dogs that received only carboplatin had a signficantly longer disease free interval than those receiving both carboplatin and doxorubicin (425 days versus 135 days respectively). Adverse effects were similar in both groups.
Bottom line: Six doses of carboplatin allows a longer disease free interval in the treatment of osteosarcoma, than alternating 3 doses of carboplatin with 3 doses of doxorubicin.
Bodyweight change aids prediction of survival in chronic equine grass sickness Jago R.C, Handel I, C. N. Hahn C.N, Pirie R.S, Keen J.A, Waggett B.E and McGorum B.C Equine Veterinary Journal
This retrospective observational study aimed to identify an objective predictor of survival in chronic equine grass sickness. The records of 213 cases were reviewed: minimum weight, time from first weight to minimum weight, duration of disease on admission and duration of hospitalisation were compared in both survivor and non-survivor groups.
There were 114 (53.5%) survivors and 99 (46.5%) non-survivors. The most common indication for euthanasia was recumbency and inability to stand. There was no significant difference in age or duration of disease prior to hospitalisation between survivors and non-survivors: 50% of nonsurvivors were euthanased by 21 days and 75% by 32 days from disease onset. Survivors were hospitalised for longer than nonsurvivors, with 50% being discharged by day 42.
Survivors had lower maximum bodyweight loss (as percentage of initial weight) compared to nonsurvivors. Survivors also had a significantly earlier day of minimum weight and lower weight loss than nonsurvivors at all time points. All nonsurvivors lost weight during hospitalisation, where as some survivors rapidly reached their lowest weight with some even gaining weight during hospitalisation. The greatest % bodyweight loss occurred between 0 and 7 days of hospitalisation in both groups. This figure was similar in individuals from both groups, indicating that cases can survive despite significant weight loss and that this alone is not an indicator for euthanasia. Survival prediction curves were compiled against which a horse’s bodyweight change between any time intervals can be compared to predict survival rate.
Bottom line: In chronic grass sickness, bodyweight change is a significant predictor of survival.
Does oral prednisolone treatment increase the incidence of acute laminitis?
Jordan V.J, Ireland J.L and Rendle D.I Equine Veterinary Journal
There is concern that the use of oral prednisolone in horses and ponies potentially increases the risk of laminitis. This retrospective case-control study set out to determine whether there was evidence to support this. Clinical records from ambulatory practice over a period of 13 years were analysed. Horses that had received treatment with oral prednisolone (total 416) were compared against two time-matched controls (total 814) that had not received prednisilone treatment and had been seen by the same veterinary surgeon before and after the horse which had been given prednisolone. The median age in both groups was 13 years and there was no significant difference in breed or sex distribution between the groups. Overall laminitis incidence rate and laminitis rate during prednisolone treatment were calculated and where more than one episode of laminitis occurred in the same horse, only the first was included.
There was no statistically significant difference between prednisolone treated and non-treated groups in overall incidence of laminitis or incidence during the treatment period. In total, there were 62 cases of laminitis, giving an overall incidence of laminitis of 3.19 per 100 horse years at risk. Horses had been treated with prednisolone for a variety of disease conditions and there was no association between reason for treatment and risk of laminitis. In the non-prednisilone treated group, 32 episodes of laminitis occurred over the study period, giving an incidence of 3.46 per 100 horse years at risk. In the prednisolone treated group, 16 laminitis cases occurred, giving an incidence of 2.6 per 100 horse years at risk. Seven of these laminitis episodes occurred during the prednisolone treatment period, giving an incidence of 20.84 per 100 horse years at risk during the period prednisolone was being given. The time at which the laminitic episode occurred in relation to prednisolone treatment was variable (median 34 days after commencement of treatment), with 3 cases developing laminitis more than one month after the end of prednisolone treatment.
Of the 16 cases of laminitis in the prednisolone group, 6 were investigated for underlying endocrine disease and all 6 were confirmed to have either PPID or equine metabolic syndrome. There was no significant difference in the prevalance of these endocrine conditions between the treated and non- treated groups, but across both groups horses with PPID or EMS had a significantly higher incidence of laminitis compared with horses without endocrine disease although within the prednisolone group, laminitis rates during treatment were not different in those with and without endocrine disorders. Previous history of laminitis and increasing age were associated with increased risk of laminitis. Of the 15 horses euthanased because of laminitis during the study, 3 were from the prednisolone group and 12 from the control group, with no association between prednisolone treatment and mortality due to laminitis.
Bottom line: Oral prednisolone treatment did not increase the risk of laminitis in this study.