Abdominal, thoracic, and pericardial effusions

Vinorelbine as First-Line Treatment in Stage IV Canine Primary Pulmonary Carcinoma

Vinorelbine (VRL), a semi-synthetic vinca alkaloid commonly used in humans with advanced lung cancer, reaches high concentrations in the lung tissue, has proven antineoplastic activity and a low toxicity profile in dogs. Treatment-naïve, client-owned dogs with a cyto/histological diagnosis of advanced pulmonary carcinoma, selected from a laboratory database and previously subjected to imaging, were enrolled in the study. Vinorelbine (15 mg/m2) was administered weekly for 4 weeks and then fortnightly until progressive disease was documented. Staging work-up was repeated by means of diagnostic imaging after the fourth VRL (i.e., 28 days) and monthly thereafter; response to treatment was evaluated according to the RECIST. Toxicity was graded following the VCOGC group. Ten dogs met the inclusion criteria. Partial response was documented in eight dogs. Median time to progression was 88 days (range: 7-112) and median survival time for all dogs was 100 days (range 7-635). The most common side effect was neutropenia. The main limitations of the study were the absence of histological diagnosis in eight cases and the limited number of treated dogs. VRL is well tolerated with an adequate toxicity profile and may be useful in the management of advanced lung tumours if used as a first-line treatment strategy.

Use of selected biochemical indices in blood/peritoneal effusion in diagnostics of gastrointestinal tract damage in dogs

This study evaluated selected biochemical indices in blood/peritoneal fluid in dogs with and without gastrointestinal tract damage. Blood and peritoneal fluid samples of 29 dogs presented to the Small Animal Clinic at the University of Veterinary and Pharmaceutical Sciences Brno were obtained as a part of the diagnostic approach and were subsequently biochemically analysed. The biochemical indices analysed were potassium, total protein, glucose, lactate and creatinine. Effusion-to-blood concentration ratios of selected indices were obtained for higher data validity and this ratio was then compared between two groups: patients with gastrointestinal tract damage and patients without gastrointestinal tract damage. There were 11 dogs in the study group of patients with gastrointestinal tract damage and 18 dogs in the study group of patients without gastrointestinal tract damage. Subsequent statistical data analysis did not show any significant difference between these two groups in any of the selected indices. According to our study results, selected biochemical indices cannot be considered as decisive for diagnosing gastrointestinal tract damage.

Outcomes and Blood Product Use in 89 Surgically Managed and 79 Medically Managed Cases of Acute Spontaneous Hemoperitoneum in the Dog

Objective: To describe a population of dogs with acute spontaneous hemoperitoneum (ASH) that were treated with either surgical or medical management in the first 12 h after presentation, and to perform a preliminary investigation into whether there were differences in achieving cardiovascular stabilization or patterns of red blood cell (RBC) transfusion between patients treated with early (<12 h) surgery vs.medical management. Design: A retrospective multicenter preliminary study performed on 168 dogs presenting with ASH between January 2015 and May 2019. Patients were excluded if they were euthanized or discharged from hospital within the first 12 h, or if clinical records were incomplete. All patients received appropriate medical stabilization efforts. Statistical analysis was performed comparing patients that underwent early (<12 h) surgery and those that did not. Results: Eighty-nine patients were in the early surgical group and 79 patients in the medical group. A significantly higher proportion of medical cases were euthanized (p < 0.001). A significantly higher proportion of early surgical cases were discharged from hospital (p = 0.005). There was no statistically significant difference between groups in achieving cardiovascular stabilization (OR 1.07 p = 0.82). A higher proportion of patients with body-weight over 20 kg achieved stabilization within 12 h than those with body-weight of 20 kg or less (62.7 vs. 41.4%, p < 0.01). A higher proportion of patients with splenic conditions achieved stabilization than patients with non-splenic conditions (56.5 vs. 28.6%, p = 0.05). The odds of receiving an RBC transfusion were higher in the early surgical group than the medical group [OR 3.81 (p < 0.001)]. Conclusions: This preliminary study did not identify a significant difference in the ability to achieve cardiovascular stabilization in the first 12 h in dogs with ASH that underwent early surgical intervention vs. those managed medically. Patients in the early surgical group were more likely to receive a RBC transfusion than those in the medical group. At this time the decision on whether to pursue medical or early surgical management should be made on a case by case basis.

Alterations in acid-base balance, blood gases, and hematobiochemical profiles of whole-blood and thoracic fluid in goats with contagious caprine pleuropneumonia

Background and Aim:

Contagious caprine pleuropneumonia (CCPP) is a highly contagious and fatal disease affecting goats and some wild ruminants. It is a cause of major economic losses in the goat industry in Africa, Asia, and the Middle East. This study aimed to investigate the acid-base balance, blood gases, and hematobiochemical profiles of whole-blood and fluid collected from the thoracic cavity in goats with CCPP.

Materials and Methods:

Fifty-five goats suffering from weight loss, anorexia, dyspnea, polypnea, cough, and nasal discharges due to CCPP were studied. Twenty-five healthy goats were used as controls. Diseased animals were enrolled in this study based on a positive serological latex agglutination test (LAT) that confirmed the detection of Mycoplasma capricolum subsp. capripneumoniae. The control goats were enrolled based on a negative result of the LAT.

Results:

Compared with a mean value of 7.38±0.04 in controls, the pH in the diseased group was 7.41±0.05. The blood pressure of carbon dioxide (PCO₂), pressure of oxygen (PO₂), base excess (BE), bicarbonate (HCO₃), total carbon dioxide (TCO₂), and saturation of oxygen (SO₂) were lower in goats with CCPP than in controls. However, the anion gap (AnGap) was higher in the diseased goats than in the healthy ones. Compared with the levels in blood samples, the thoracic fluid PCO₂, PO₂, BE, and SO₂ were higher while pH, HCO₃, TCO₂, and AnGap were lower. Compared with the findings in healthy goats, hematological alterations included significant increases in white blood cells and neutrophils, and a significant decrease in the red blood cell count. In the thoracic fluid, neutrophilic leukocytosis was a remarkable finding. The serum concentrations of globulin, blood urea nitrogen, and glucose, and the activities of aspartate aminotransferase (AST) and g-glutamyl transpeptidase (GGT) increased significantly compared with those in controls. In contrast, serum concentrations of albumin, calcium, and magnesium, and the activity of alkaline phosphatase (ALP) decreased significantly compared with those of healthy animals. The activities of ALP, AST, GGT, and creatine kinase and the concentration of phosphorus were higher in thoracic fluid than the serum values in the diseased group.

Conclusion:

When compared with the healthy controls, goats with CCPP have metabolic acidosis. Compared with the levels in healthy goats, the blood PCO₂, PO₂, BE, HCO₃, TCO₂, and SO₂ are low in goats with CCPP; however, the AnGap is higher in diseased goats.

Anaphylaxis-related hemoperitoneum in 11 dogs

OBJECTIVE

To describe the unique complication of hemoperitoneum associated with anaphylaxis.

DESIGN

Retrospective case series from September 2012 to August 2017.

SETTING

Two private emergency and specialty referral hospitals.

ANIMALS

Eleven client-owned dogs diagnosed with anaphylaxis and hemoperitoneum upon presentation or referral.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Inclusion criteria included clinical signs consistent with anaphylaxis (hypotension, tachycardia, vomiting, diarrhea, weakness, collapse, with or without the presence of dermal signs) due to witnessed or unwitnessed presumed bee sting, an elevated alanine aminotransferase (ALT), performance of abdominal FAST (AFAST) examination with an abdominal fluid score, the sonographic presence of gallbladder wall edema, and hemoperitoneum. All dogs (n=11) were managed medically without surgical intervention. 91% (n=10) of dogs survived to discharge.

CONCLUSIONS

Hemoperitoneum development can be seen with anaphylactic reactions, though the exact mechanism remains to be fully understood. Medical therapy is warranted and can be successful in these patients; surgery is not indicated to address hemoperitoneum.

Canine Traditional Laboratory Tests and Cardiac Biomarkers

In small animals, cardiac disease evaluation through laboratory tests can be a challenge. This review will present both historical and updated perspectives on the clinical pathology of cardiac diseases in dogs and demonstrate that laboratory tests are useful tools for the management of patients with cardiac diseases.

Microbiological and cytological characterization of coelomic fluid from three captive endangered amphibian Gastrotheca species with edema syndrome: preliminary analysis

OBJECTIVE

Edema syndrome is highly prevalent but under researched in captive frogs around the world. The objective of the present study was to characterize at a basic microbiological and cytological level of the bacteria of the edema fluid of 20 individuals of the genus Gastrotheca to determine the presence of possible anaerobic and aerobic bacteria.

RESULTS

Fourteen types of bacteria were identified in the edema fluid, 12 of them at the species level (Pasteurella haemolytica, Hafnia alvei, Enterobacter agglomerans, Aeromonas hydrophila, Pseudomonas fluorescens, Burkholderia pseudomallei, Salmonella arizonae, Enterobacter gergoviae, Enterobacter sakazakii, Yersinia enterocolitica, Klebsiella oxytoca, and Klebsiella ozaenae) and two at the genus level (Enterococcus spp. and Streptococcus spp.). The most frequently identified cells were lymphocytes (37.7% in females and 46.4% in males), erythrocytes (23.5% in females and 17.5% in males) and neutrophils (4.2% in females and 2.8% in males). Finally, no relationship was found between the data obtained and the sex of the individuals studied.

Pyogranulomatous pleuropneumonia caused by Nocardia asiatica in a dog coinfected with canine morbillivirus (canine distemper virus)

Nocardia asiatica causing pyogranulomatous pleuropneumonia is reported for the first time in a dog coinfected with canine morbillivirus (CM), diagnosed based on epidemiological, clinical, haematological, images, microbiological, histopathological, polymerase chain reaction and hsp65 gene sequencing findings. The immunosuppression of CM probably favoured the opportunistic behaviour of N. asiatica. Despite the therapeutic measures, the animal died, mainly due to respiratory distress. The association of methods to improve early diagnosis, therapy procedures and prognosis of canine nocardiosis is discussed, as well as the close relationship between pets and their owners, which may favour the transmission of pathogens such as Nocardia from pets‐to‐humans, which poses an emerging public health issue.

Incidence of chyloabdomen diagnosis in dogs and cats and corresponding clinical signs, clinicopathologic test results, and outcomes: 53 cases (1984-2014)

OBJECTIVE To determine the incidence of chyloabdomen diagnosis in cats and dogs and characterize and compare between species the corresponding clinical signs, clinicopathologic test results, and outcomes. DESIGN Retrospective case series. ANIMALS 36 cats and 17 dogs in which chyloabdomen was diagnosed at a veterinary teaching hospital between 1984 and 2014. PROCEDURES Medical records were reviewed, and data retrieved included patient signalment; clinical signs at initial evaluation; results of physical examination, diagnostic tests, and imaging studies; and outcomes. Survival analyses, descriptive statistics, and comparisons between species were completed. RESULTS The incidence of chyloabdomen at the veterinary teaching hospital during the study period was 2.0 cases/100,000 admissions for cats and 2.8 cases/100,000 admissions for dogs. The mean age at diagnosis of chyloabdomen in cats was 11.3 years, compared with 6.9 years in dogs. The most common clinical signs in dogs and cats combined were lethargy (39/51 [76%]) and anorexia (37/51 [73%]), but fewer (23/53 [43%]) had abdominal distention. Chylothorax was a common comorbidity (25/53 [47%]), with malignant neoplasia being the most common underlying diagnosis (24/53 [45%]). Survival analyses included 44 patients; median survival time from diagnosis of chyloabdomen was 31 days overall, 8 days for patients with malignant neoplasia, and 73 days for patients without neoplasia. CONCLUSIONS AND CLINICAL RELEVANCE There were multiple causes of chyloabdomen in dogs and cats of the study, and outcome depended on underlying cause. Because of this and the rarity of chyloabdomen, a multicenter prospective study of disease progression, treatment response, and clinical outcome for dogs and cats with chyloabdomen is needed.

Characterization of and factors associated with causes of pleural effusion in cats

OBJECTIVE To characterize and investigate potential associations between causes of pleural effusion and various clinical factors in a large cohort of affected cats. DESIGN Retrospective case series with nested cross-sectional study. ANIMALS 380 client-owned cats with a diagnosis of pleural effusion from January 1, 2009, through July 14, 2014, for which the cause of pleural effusion had been fully investigated. PROCEDURES Electronic medical records were reviewed and data collected regarding cat characteristics, clinical signs, cause of pleural effusion, treatment, and survival status at discharge from the hospital. Variables were examined for associations with causes of pleural effusion. RESULTS 87 (22.9%) cats died or were euthanized before discharge from the hospital. Congestive heart failure (CHF) was the most common cause (155 [40.8%]) of pleural effusion, followed by neoplasia (98 [25.8%]). Other causes included pyothorax, idiopathic chylothorax, trauma, feline infectious peritonitis, and nontraumatic diaphragmatic hernia. Cats with trauma or feline infectious peritonitis were significantly younger than those with CHF or neoplasia. Cats with lymphoma were significantly younger than those with carcinoma. Cats with CHF had a significantly lower rectal temperature at hospital admission (mean ± SD, 36.9 ± 1.2°C [98.4 ± 2.2°F]) than did cats with pleural effusion from other causes (37.9 ± 1.2°C [100.2 ± 2.2°F]). CONCLUSIONS AND CLINICAL RELEVANCE Cats with pleural effusion in this study had a poor prognosis; CHF and neoplasia were common causes. Age and hypothermia may be helpful to raise the index of suspicion for certain underlying causes of pleural effusion in cats.

Retrospective analysis of pleural effusion in cats

OBJECTIVES

Pleural effusion is a common presenting cause for feline patients in small animal practice. The objectives of this study were to identify possible correlations between the aetiology of effusion and clinical and laboratory findings.

METHODS

In this retrospective study of 306 cats diagnosed with pleural effusion of established aetiology, cats were divided into six major groups: cardiac disease (CD), feline infectious peritonitis (FIP), neoplasia, pyothorax, chylothorax and miscellaneous. Clinical, laboratory and radiographic parameters were compared between groups.

RESULTS

CD was the most common aetiology (35.3%), followed by neoplasia (30.7%), pyothorax (8.8%), FIP (8.5%), chylothorax (4.6%) and miscellaneous diseases (3.7%). In 26 (8.5%) cats, more than one underlying disease was diagnosed as a possible aetiology for pleural effusion. Cats with FIP were significantly younger than those with CD (P <0.001) and neoplasia (P <0.001). Cats with CD were presented with a significantly lower body temperature compared with cats with FIP (P = 0.022). Cats with CD had significantly higher serum alanine aminotransferase activity compared with all other cats (FIP and pyothorax, P <0.001; neoplasia and chylothorax, P = 0.02) and serum alkaline phosphatase activity compared with the pyothorax (P <0.001) and FIP groups (P = 0.04), and significantly lower protein concentrations (FIP, pyothorax and neoplasia, P <0.001; chylothorax, P = 0.04) and nucleated cell counts in the effusion than all other groups (pyothorax and neoplasia, P <0.001; chylothorax, P = 0.02; FIP, P = 0.04). The glucose level in the effusion of cats with pyothorax was significantly lower than glucose levels in patients with CD, neoplasia and chylothorax (P <0.001). Of 249 cats with a follow-up of at least 10 days, 55.8% died or were euthanased during that time.

CONCLUSIONS AND RELEVANCE

CD and neoplasia were the most common causes for feline pleural effusion. Age, liver enzymes, as well as cell count, protein and glucose levels in the effusion can aid in the investigation of underlying aetiologies.

Pericardial effusion associated with systemic inflammatory disease in seven dogs (January 2006 - January 2012)

Pericardial effusion (PE) is reported in dogs as a consequence of neoplasia, primary cardiac disease or as an idiopathic condition. We describe seven dogs with systemic inflammatory disease, PE without tamponade and increased cardiac troponin I concentrations. Echocardiographic findings and adjunctive testing did not identify other known causes of PE. Resolution of the PE was documented in five of seven dogs in which follow-up echocardiography was performed, often after anti-inflammatory therapy. Resolution of PE was associated with normalisation of cardiac troponin I levels. Clinical signs had not recurred in six dogs with follow-up for more than 12 months and up to 7 years. These findings suggest an association between systemic inflammation and PE in dogs.

An analysis of pH, pO2 and pCO2 in the peritoneal fluid of dogs with ascites of various etiologies

The aim of the study was to assess pH, pO2 and pCO2 in peritoneal fluid. The study was conducted on a group of 22 dogs with symptoms of ascites. Group 1 consisted of 4 dogs with adenocarcinoma, group 2--of 6 dogs with glomerulonephritis, group 3 of 8 dogs with hepatic cirrhosis and group 4 of 4 dogs with bacterial peritonitis. An abdominal cavity puncture was performed in all dogs and the fluid was drawn into a heparinized syringe in order to assess pH, pO2 and pCO2 . The analysis of pH in the peritoneal fluid revealed statistically significant differences between group 4 and groups 1 (p=0.01), 2 (p=0.01), and 3 (p=0.01). The lowest pH value compared to the other studied groups was recorded in group 4. In group 4, the pO2 was the lowest compared to the other groups (group 1 p=0.01, group 2 p=0.01, group 3 p=0.01). The value of pCO2 was the highest in group 4 compared to groups 1, 2, and 3. The study found statistically significant differences in pH, pCO2 and pCO2 between group 4 (the group of dogs with bacterial peritonitis) and the other groups of dogs. This was probably linked to the pathogenesis of peritonitis. As a result of an inflammatory reaction within the peritoneal cavity, there is an increase in fibrin accumulations leading to a decreased oxygen supply causing the oxidative glucose metabolism to change into a non-oxidative glucose metabolism. This, in turn, causes a decrease in pH, acidosis, and a low oxidoreduction potential. It also impairs phagocytosis and activates proteolytic enzymes which create ideal conditions for the growth of anaerobic bacteria. The obtained results indicate that the pH, pO2 and pCO2 may be used to differentiate bacterial peritonitis from ascites of other etiologies.

Influência do parasitismo intestinal sobre os parâmetros hematológicos e de líquido peritoneal em equinos de tração

O objetivo do presente estudo foi avaliar a influência do parasitismo intestinal crônico sobre parâmetros hematológicos e de líquido peritoneal por meio da comparação dessas características em equinos naturalmente parasitados e após administração de anti-helmíntico. Utilizaram-se 21 cavalos de tração urbana, entre dois e 19 anos, sem raça definida e com resultado de exame parasitológico superior a 300 ovos por grama de fezes. Foi realizada avaliação física e coleta de fezes, de líquido peritoneal e de sangue em dois momentos do experimento (D0 e D15), sendo efetuado tratamento antiparasitário no D0. No fluido peritoneal foram avaliadas características físicas, bioquímicas, bem como contagem de células nucleadas (CTCN) e diferenciação celular. No sangue foram determinados valores eritrocitários, leucocitários, proteínas plasmáticas totais, glicose e fibrinogênio plasmáticos, além de fosfatase alcalina (FA) sérica. A análise dos parâmetros avaliados não demonstrou diferença significativa entre animais parasitados e após administração de anti-helmíntico, exceto para valores de CTCN, contagem de neutrófilos segmentados e grau de turbidez do líquido peritoneal. As médias se mantiveram dentro dos intervalos de referência, com exceção da CTCN do líquido peritoneal no D0. No líquido peritoneal, houve predomínio de neutrófilos segmentados, seguidos por macrófagos, linfócitos e eosinófilos em ambos os momentos de avaliação. Observaram-se tendência do quadro eritrocitário em manter-se próximo aos limites inferiores e leve leucocitose no D0. A infecção parasitária nos animais estudados foi predominantemente moderada, o que oferece poucos riscos clínicos. Nessas condições, pode-se afirmar que a CTCN, a contagem absoluta de neutrófilos segmentados e o grau de turbidez do líquido peritoneal são influenciados e podem ser considerados ferramentas diagnósticas e prognósticas úteis nas parasitoses intestinais crônicas.

Pulmonary abnormalities in dogs with renal azotemia

BACKGROUND

Clinical signs associated with respiratory tract disease are regularly encountered in people with kidney failure, and have been anecdotally reported in dogs.

OBJECTIVES

To compare clinical signs indicative of pulmonary disease, clinicopathologic findings, radiographic abnormalities, and histologic findings in dogs with acute kidney injury (AKI) or International Renal Interest Society Stage 3 or 4 chronic kidney disease (CKD) to nonazotemic dogs. To determine associations between abnormalities indicative of pulmonary disease and outcome in azotemic dogs.

ANIMALS

One hundred sixty-seven pet dogs (54 AKI dogs, 50 CKD dogs, 63 nonazotemic control dogs diagnosed with intracranial disease).

METHODS

Retrospective cohort study comparing signalment, clinical signs, clinicopathologic variables, prevalence, and severity of pulmonary radiographic patterns, histopathologic findings, and survival times in AKI, CKD, and control dogs.

RESULTS

Clinical signs of pulmonary disease were significantly more common in AKI dogs. Prevalence of an alveolar lung pattern was greater in AKI and CKD dogs. Alveolar mineralization was the most common pulmonary histologic lesion in AKI dogs (6 of 8 dogs), with concurrent alveolar concretions or mineralization of pulmonary vessels or bronchioles noted in 1 dog each; mineralization of lung tissues was not noted in control dogs. Neither clinical signs nor presence of an alveolar pattern were associated with likelihood of survival to discharge or median number of days from discharge until death.

CONCLUSIONS AND CLINICAL IMPORTANCE

Abnormalities indicative of pulmonary disease are more common in azotemic dogs than in control dogs; however, prognosis is not associated with presence of clinical or radiographic pulmonary dysfunction.

Pleural Effusion in the Cat: A Practical Approach to Determining Aetiology

Practical relevance Diverse disease processes result in sufficient fluid accumulation within the pleural space to cause respiratory compromise. Determining the underlying aetiology is key to appropriate management. This review outlines a practical approach to cases of pleural effusion, focusing on early recognition and confirmation of pleural space disease, stabilisation of the patient and logical diagnostic investigation. It emphasises the importance of a holistic approach, incorporating fluid analysis with other clinical data to determine the underlying aetiology.

Clinical challenges Cats with pleural effusion often have severe respiratory compromise at presentation. Careful handling and prompt and adequate stabilisation, incorporating supplemental oxygen and therapeutic thoracocentesis, is essential to avoid respiratory failure. The typical, stepwise approach to the case must be adapted and the clinician may have to proceed, at least initially, without the luxury of information gained from a full history and physical examination. The challenge is to juggle stabilisation, localisation and confirmation of pleural effusion, owner communication and minimally invasive examination while remaining vigilant for clues that allow ranking of the differentials to formulate a diagnostic plan.

Evidence base Appropriately designed studies to determine the utility of diagnostic techniques in cases with confirmed aetiology are limited. The evidence supporting this review is grade II, III and IV, comprising a small number of prospective studies, several case series, reviews, extrapolation from other species, pathophysiological justification and combined clinical experience of those working in the field.

Mucinous Cholangiocarcinoma in a Cat

Mucinous cholangiocarcinoma was diagnosed in a 14-year-old, castrated male, domestic shorthaired cat with marked peritoneal effusion. Cytological confirmation of malignancy by fluid analysis and fine-needle, ultrasound-guided aspiration of the liver was followed by histological examination of tissue samples obtained at surgery and necropsy. No observed response followed chemotherapy with doxorubicin and carboplatin. Electron microscopy and immunohistochemistry helped to further characterize this unusual tumor.

Cytologic diagnosis of diseases in reptiles

The cytologic evaluation of samples obtained from reptile patients may provide invaluable diagnostic information to the clinician. The following article is directed toward providing information regarding the techniques used to obtain samples, discussion of sample types, and guidelines for the cytologic classification of the materials collected from tissue lesions and body fluids.