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Previous Issue: Issue 3

Association between waste management and cancer in companion animals

L. MARCONATO, C. LEO, R. GIRELLI, S. SALVI, F. ABRAMO, G. BETTINI, S. COMAZZI, P. NARDI, F. ALBANESE, AND E. ZIN (2009)
Journal of Veterinary Internal Medicine 23(3):564–569

Veterinary Clinical Digest Summary
Human waste is thought to be a health hazard to humans, particularly where it is illegally dumped or incinerated. It is known to contain carcinogens, and a high mortality rate from cancers such as lymphoma, leukaemia and lung cancer has been noted in the region around Naples, where waste management is judged inadequate. This paper looked at the incidence of cancer in pets in the Campania region of Italy, comparing cases from areas of high waste dumping to low waste dumping areas. The main finding was that lymphoma was more common in high risk areas in dogs (but not in cats). The authors conclude that waste emission from illegal dumping sites is a risk factor for cancer in dogs, and studying the epidemiology of spontaneous tumours in dogs may predict health hazards for humans.

The use of vasopressin for treating vasodilatory shock and cardiopulmonary arrest
R. D. SCROGGIN JR, AND J. QUANDT (2009)
Journal of Veterinary Emergency and Critical Care 19(2): 145–157

Veterinary Clinical Digest Summary
This paper reviews the evidence regarding the use of vasopressin in human and veterinary patients for treatment of vasodilatory shock and cardiopulmonary arrest. Septic shock is the most common cause of vasodilatory shock, but other causes include haemorrhagic and cardiogenic shock and anaphylaxis. Improved survival and decreased incidence of new tachyarrhythmias have been shown when vasopressin analogues are used in conjunction with low dose catecholamines. If fluid resuscitation was also provided, then improved splanchnic blood flow was also noted in porcine models of endotoxaemia. Improved survival was also seen in haemorrhagic shock models when vasopressin was administered. Improved survival with vasopressin in humans has been seen in small studies looking at ventricular fibrillation, pulseless ventricular tachycardia, and nonspecific cardiopulmonary arrest. However, three larger studies did not see a difference in survival in cardiopulmonary arrest when comparing catecholamines with vasopressin. The authors recommend that vasopressin should be considered in small animal veterinary patients with vasodilatory shock that is unresponsive to fluid resuscitation and catecholamine administration. The paper includes flow charts of suggested guidelines for use of vasopressin in vasolidatory shock and in CPR.

Retrospective analysis of the relationship between time of thoracostomy drain removal and discharge time.
A. I. D. C. MARQUES, J. TATTERSALL, D. J. SHAW AND E. WELSH (2009)
Journal of Small Animal Practice 50(4): 162–166

Veterinary Clinical Digest Summary
Thoracostomy drains are commonly placed for a variety of pleural diseases, such as pyothorax, chylothorax and pneumothorax. However, the optimal time for removal of the drain is uncertain, with conflicting evidence in the human literature, and sparse information in the veterinary literature. This retrospective study examined the use of drains that had been placed postsurgically and in the treatment of pleural effusion or pneumothorax. The authors attempted to ascertain whether the volume of fluid being removed prior to drain removal correlated with time to discharge. No relationship was found between the volume of fluid and the time to discharge, and animals producing fluid at a rate greater than 2ml/kg/day did not have increased hospitalisation times. The authors conclude that drains can be removed when more than 2ml/kg/day is being drained without clinical compromise, despite previous recommendations, but warn that other clinical factors need to be taken into consideration when deciding on drain removal timing.

Outcomes of Heimlich valve drainage in dogs
H. SALCI, A.S. BAYRAM AND O.S. GORGUL (2009)
Australian Veterinary Journal, 87:148-151.

Veterinary Clinical Digest Summary
Thoracic drainage can be performed continuously or intermittently. Continuous drainage is useful in certain clinical situations such as ongoing pneumothorax or pyothorax. However, continuous drainage equipment is expensive and bulky, restricting the mobility of the animal. The Heimlich valve is used in human and veterinary medicine to provide a continuous negative pressure through a thoracic drain. This retrospective study looked at the use of the Heimlich valve in 34 patients which had thoracic drains placed for a number of reasons, including lung lobectomy, pneumonectomy and traumatic open pneumothorax. In 29 dogs, negative pressure was achieved without complications. In two patients, non-Heimlich valve related complications were encountered. Heimlich valve related complications included failure of the valve diaphragm, open pneumothorax after the valve was chewed, and gastric dilatation-volvulus with diaphragmatic herniation following pneumonectomy. The authors conclude that the Heimlich valve can be used as a continuous drainage device, provided that clinicians are aware of the possible complications.

Pulmonary thromboembolism
R. GOGGS, L. BENIGNI, V. L. FUENTES AND D. L. CHAN (2009)
Journal of Veterinary Emergency and Critical Care 19(1): 30–52

Veterinary Clinical Digest Summary
This paper reviews the pathophysiology, clinical signs, diagnosis, and treatment of pulmonary thromboembolism (PTE) in small animals. PTE refers to the obstruction of a pulmonary vessel by a thrombus either formed locally or transported from elsewhere, although other substances can cause embolism besides a thrombus such as fat, parasites and foreign bodies. Risk factors include a hypercoagulable state, e.g., due to hyperadrenocorticism or endothelial injury from trauma or sepsis, and vascular flow abnormalities such as those due to myocardial disease or neoplasia. Although the prevalence of PTE in post mortem examinations is low, the true figure is likely to be much higher as thrombi lyse quickly post-mortem. PTE causes dyspnoea due to ventilation:perfusion mismatching. Diagnostic aides include arterial blood gases, thoracic radiography, echocardiography, coagulation profiles, thromboelastography and pulmonary angiography. Treatment may consist of thrombolytic therapy, but is controversial. Long term anticoagulant therapy may be indicated, but evidence for efficacy is limited.

Effects of prednisone alone or prednisone with ultralow-dose aspirin on the gastroduodenal mucosa of healthy dogs.
A. H.GRAHAM AND M. S. LEIB (2009)
Journal of Veterinary Internal Medicine 23(3):482–487

Veterinary Clinical Digest Summary
High dose corticosteroids are often required in the treatment of autoimmune and immune-mediated diseases. One of the most common in veterinary practice is autoimmune haemolytic anaemia (AIHA). AIHA has a high morbidity and mortality rate, due in part to the severe anaemia, but also due to thromboembolic events. Some authors advocate the use of ultra-low dose aspirin as an anticoagulant. This paper describes a randomised placebo-controlled trial to assess the safety of this combination of drugs. 18 healthy dogs were divided into three groups – prednisone alone, prednisone plus ultra-low dose aspirin, and placebo. Gastroduodenoscopy was performed at days 5, 14 and 27 after starting treatment, and mucosal lesions scored. There was no significant difference in lesions scores between the groups, showing that ultra-low dose aspirin in conjunction with prednisone does not appear to increase the risk of gastroduodenal mucosal damage. However, there was a slight increase in frequency of mild, self-limiting diarrhoea in the prednisone plus low dose aspirin group.

Cervical vertebral malformation-malarticulation syndrome in the Bernese mountain dog: clinical and magnetic resonance imaging features
J. S. EAGLESON, J. DIAZ, S. R. PLATT, M. KENT, J. M. LEVINE, N. J. H. SHARP AND S. J. SCHATZBERG (2009)
Journal of Small Animal Practice 50(4): 186–193

Veterinary Clinical Digest Summary
Cervical vertebral malformation-malarticulation syndrome (CVMM), also known as Wobbler syndrome, is a common neurological condition of large breed dogs. This paper describes the clinical and MRI features of the condition in seven Bernese Mountain Dogs. MRI revealed multiple extradural compressive lesions of the cervical spinal cord, with intramedullary hyperintensities seen on T2 weighted scans in all cases. Dorsolateral spinal cord compression associated with articular process hypertrophy was the commonest finding. Five cases were managed surgically and two conservatively, with variable results.

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