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Cortellini S, DeClue AE, Giunti M, Goggs R, Hopper K, Menard JM, Rabelo RC, Rozanski EA, Sharp CR, Silverstein DC, Sinnott-Stutzman V, Stanzani G. Defining sepsis in small animals. J Vet Emerg Crit Care (San Antonio) 2024; 34:97-109. [PMID: 38351524 DOI: 10.1111/vec.13359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To discuss the definitions of sepsis in human and veterinary medicine. DESIGN International, multicenter position statement on the need for consensus definitions of sepsis in veterinary medicine. SETTING Veterinary private practice and university teaching hospitals. ANIMALS Dogs and cats. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Sepsis is a life-threatening condition associated with the body's response to an infection. In human medicine, sepsis has been defined by consensus on 3 occasions, most recently in 2016. In veterinary medicine, there is little uniformity in how sepsis is defined and no consensus on how to identify it clinically. Most publications rely on modified criteria derived from the 1991 and 2001 human consensus definitions. There is a divergence between the human and veterinary descriptions of sepsis and no consensus on how to diagnose the syndrome. This impedes research, hampers the translation of pathophysiology insights to the clinic, and limits our abilities to optimize patient care. It may be time to formally define sepsis in veterinary medicine to help the field move forward. In this narrative review, we present a synopsis of prior attempts to define sepsis in human and veterinary medicine, discuss developments in our understanding, and highlight some criticisms and shortcomings of existing schemes. CONCLUSIONS This review is intended to serve as the foundation of current efforts to establish a consensus definition for sepsis in small animals and ultimately generate evidence-based criteria for its recognition in veterinary clinical practice.
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Affiliation(s)
- Stefano Cortellini
- Department of Clinical Science and Services, The Royal Veterinary College, University of London, Hatfield, UK
| | - Amy E DeClue
- Fetch Specialty and Emergency Veterinary Center, Greenville, South Carolina, USA
| | - Massimo Giunti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | - Kate Hopper
- Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Julie M Menard
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - Deborah C Silverstein
- Department of Clinical Studies and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Gaudette S, Smart L, Woodward AP, Sharp CR, Hughes D, Bailey SR, Dandrieux JRS, Santos L, Boller M. Biomarkers of endothelial activation and inflammation in dogs with organ dysfunction secondary to sepsis. Front Vet Sci 2023; 10:1127099. [PMID: 37520007 PMCID: PMC10372490 DOI: 10.3389/fvets.2023.1127099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 06/09/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction Alteration in endothelial function during sepsis is thought to play a key role in the progression of organ failure. We herein compared plasma concentrations of endothelial activation biomarkers vascular endothelial growth factor (VEGF), hyaluronan (HA), plasminogen activator inhibitor-1 (PAI-1) and von Willebrand factor (vWF), as well as inflammatory mediator concentrations (IL-6, IL-8, IL-10, C-reactive protein and monocyte chemoattractant protein-1) in dogs with sepsis to healthy dogs. Methods This study was a multicenter observational clinical trial conducted at two university teaching hospitals from February 2016 until July 2017. The study included 18 client-owned dogs hospitalized with sepsis and at least one distant organ dysfunction, as well as 20 healthy dogs. Plasma biomarker concentrations were measured using ELISA. Severity of illness in dogs with sepsis was calculated using the 5-variable acute physiologic and laboratory evaluation (APPLEFAST) score. Biomarker concentrations were compared between septic and healthy dogs using linear models. Results Septic peritonitis was the most frequent source of sepsis (11/18; 61%), followed by pneumonia (4/18; 22%). Ten dogs (56%) had only 1 organ dysfunction, whereas 3 dogs (17%) had 2, 3 (17%) had 3, 1 (6%) had 4 and 1 (6%) had 5 organ dysfunctions. The median APPLEFAST score in the septic dogs was 28.5 (Q1-Q3, 24-31). Mean plasma concentrations of all endothelial and inflammatory biomarkers, except vWF, were higher in the sepsis cohort than in controls. The mean endothelial biomarker concentrations in the septic cohort ranged from ~2.7-fold higher for HA (difference in means; 118.2 ng/mL, 95% credible limit; 44.5-221.7) to ~150-fold for VEGF (difference in means; 76.6 pg./mL, 95% credible limit; 33.0-143.4), compared to the healthy cohort. Fifteen dogs with sepsis (83%) died; 7 (46%) were euthanized and 8 (53%) died during hospitalization. Conclusion Dogs with naturally occurring sepsis and organ dysfunction had higher mean concentrations of biomarkers of endothelial activation and inflammation compared to healthy dogs, broadening our understanding of the pathophysiology of sepsis secondary to endothelial dysfunction.
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Affiliation(s)
- Sarah Gaudette
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Lisa Smart
- School of Veterinary Medicine, Murdoch University, Perth, WA, Australia
- Small Animal Specialist Hospital, Tuggerah, NSW, Australia
| | - Andrew P. Woodward
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Claire R. Sharp
- School of Veterinary Medicine, Murdoch University, Perth, WA, Australia
- Center for Terrestrial Ecosystem Science and Sustainability, Harry Butler Institute, Murdoch University, Murdoch, WA, Australia
| | - Dez Hughes
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Simon R. Bailey
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Julien R. S. Dandrieux
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Leilani Santos
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Manuel Boller
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, VIC, Australia
- VCA Canada Central Victoria Veterinary Hospital, Victoria, BC, Canada
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Chee W, Sharp CR, Boyd CJ. Clinical Use of Canine Thawed Refrigerated Plasma: A Historical Case Series. Animals (Basel) 2023; 13:2040. [PMID: 37370550 DOI: 10.3390/ani13122040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
Thawed plasma (TP) refers to defrosted fresh frozen plasma stored refrigerated. TP is used in human medicine for the rapid provision of coagulation factors and resuscitation of haemorrhagic shock, but its use in dogs is poorly described. The objectives of this historical case series were to describe the reasons for TP transfusion, treatment outcomes, and adverse events associated with canine TP transfusions in a veterinary teaching hospital. We hypothesised that TP would be used most commonly for the treatment of haemorrhage secondary to anticoagulant rodenticide intoxication and trauma. Blood bank plasma transfusion logs were searched to identify dogs that received at least one unit of TP between December 2015 and June 2021. Briefly, 166 dogs received a total of 262 units of TP. Anticoagulant rodenticide intoxication (37/166, 22.3%) was the most common reason for transfusion, followed by traumatic haemorrhage (23, 13.9%) and spontaneous haemoperitoneum (22, 13.2%). The majority of dogs received one unit of TP (111/166, 67.1%) and pRBCs were commonly simultaneously transfused with TP (65, 39.2%). Severe prolongations of prothrombin time and activated partial thromboplastin time were reduced following TP transfusions. Allergic reactions were the most common transfusion reaction (19/166, 11.4%). Most dogs survived to discharge (101/166, 60.8%).
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Affiliation(s)
- Weiqin Chee
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia
- Western Australian Veterinary Emergency and Specialty, Success, WA 6164, Australia
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia
| | - Corrin J Boyd
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia
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Claus MA, Smart L, Raisis AL, Sharp CR, Abraham S, Gummer JPA, Mead MK, Bradley DL, Van Swelm R, Wiegerinck ETG, Litton E. Effect of Deferoxamine on Post-Transfusion Iron, Inflammation, and In Vitro Microbial Growth in a Canine Hemorrhagic Shock Model: A Randomized Controlled Blinded Pilot Study. Vet Sci 2023; 10:vetsci10020121. [PMID: 36851425 PMCID: PMC9962370 DOI: 10.3390/vetsci10020121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
Red blood cell (RBC) transfusion is associated with recipient inflammation and infection, which may be triggered by excessive circulating iron. Iron chelation following transfusion may reduce these risks. The aim of this study was to evaluate the effect of deferoxamine on circulating iron and inflammation biomarkers over time and in vitro growth of Escherichia coli (E. coli) following RBC transfusion in dogs with atraumatic hemorrhage. Anesthetized dogs were subject to atraumatic hemorrhage and transfusion of RBCs, then randomized to receive either deferoxamine or saline placebo of equivalent volume (n = 10 per group) in a blinded fashion. Blood was sampled before hemorrhage and then 2, 4, and 6 h later. Following hemorrhage and RBC transfusion, free iron increased in all dogs over time (both p < 0.001). Inflammation biomarkers interleukin-6 (IL6), CXC motif chemokine-8 (CXCL8), interleukin-10 (IL10), and keratinocyte-derived chemokine (KC) increased in all dogs over time (all p < 0.001). Logarithmic growth of E. coli clones within blood collected 6 h post-transfusion was not different between groups. Only total iron-binding capacity was different between groups over time, being significantly increased in the deferoxamine group at 2 and 4 h post-transfusion (both p < 0.001). In summary, while free iron and inflammation biomarkers increased post-RBC transfusion, deferoxamine administration did not impact circulating free iron, inflammation biomarkers, or in vitro growth of E. coli when compared with placebo.
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Affiliation(s)
- Melissa A. Claus
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia
- Perth Veterinary Specialists, Osborne Park, WA 6017, Australia
- Correspondence:
| | - Lisa Smart
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia
- Small Animal Specialist Hospital, Tuggerah, NSW 2259, Australia
| | - Anthea L. Raisis
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia
| | - Claire R. Sharp
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia
| | - Sam Abraham
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia
| | - Joel P. A. Gummer
- Forensic Sciences Laboratory, ChemCentre, Resources and Chemistry Precinct, Bentley, WA 6102, Australia
- School of Science, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Martin K. Mead
- School of Veterinary Medicine, Murdoch University, Murdoch, WA 6150, Australia
| | - Damian L. Bradley
- Intensive Care Unit, Rockingham General Hospital, Cooloongup, WA 6168, Australia
| | - Rachel Van Swelm
- Hepcidinanalysis.com, Department of Laboratory Medicine, Translational Metabolic Laboratory (TML 830), Radboud University Medical Center, 6525 Nijmegen, The Netherlands
| | - Erwin T. G. Wiegerinck
- Hepcidinanalysis.com, Department of Laboratory Medicine, Translational Metabolic Laboratory (TML 830), Radboud University Medical Center, 6525 Nijmegen, The Netherlands
| | - Edward Litton
- Intensive Care Unit, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
- School of Medicine, University of Western Australia, Crawley, WA 6009, Australia
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Robveille C, Kim MW, Stayt J, Sharp CR, Langner KFA. Disseminated T-cell lymphoma with non-epitheliotropic cutaneous involvement in a cat with erythematous patches and regenerative anemia. J Vet Diagn Invest 2023; 35:42-46. [PMID: 36317261 PMCID: PMC9751472 DOI: 10.1177/10406387221133543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A 14-y-old, castrated male, diabetic, domestic longhaired cat was presented for investigation of anemia. General examination revealed widespread cutaneous erythematous macules and patches. Hematology and bone marrow aspiration revealed severe regenerative anemia and marked erythroid hyperplasia, respectively. Low numbers of intermediate-to-large, atypical lymphocytes were observed in the blood smear and bone marrow aspirates. Various imaging modalities demonstrated a diffuse pulmonary bronchial pattern, multifocal mural thickening of the urinary bladder, splenomegaly, and mild tri-cavitary effusion. Skin biopsies and cytologic examination of the pleural effusion demonstrated round-cell neoplasia consistent with lymphoma. Autopsy confirmed disseminated T-cell lymphoma, mostly affecting the urinary bladder, stomach, lymph nodes, and interscapular subcutis and muscles. Angiocentrism and nerve infiltration were present. The cutaneous erythematous patches, characterized by perivascular neoplastic lymphocytic infiltrates and angiodestruction, were a manifestation of the disseminated lymphoma in this cat, similar to the lesions reported in humans affected by angioimmunoblastic T-cell lymphoma.
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Affiliation(s)
- Cynthia Robveille
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
- NC State College of Veterinary Medicine, Raleigh, NC, USA
| | - Mark W. Kim
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
- VetAgro Sup, Marcy l’Etoile, France
| | - Jason Stayt
- VetPath Laboratory Services, Ascot, WA, Australia
- NovaVet Diagnostics, Bayswater, WA, Australia
| | - Claire R. Sharp
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
- Centre for Terrestrial Ecosystem Science and Sustainability–Harry Butler Institute, Murdoch University, Murdoch, WA, Australia
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Cooper JL, Sharp CR, Boyd CJ, Claus MA, Rossi G. The hemostatic profile of cold-stored whole blood from non-greyhound and greyhound dogs over 42 days. Front Vet Sci 2023; 10:1135880. [PMID: 36937016 PMCID: PMC10019821 DOI: 10.3389/fvets.2023.1135880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/08/2023] [Indexed: 03/06/2023] Open
Abstract
Objectives To compare the hemostatic characteristics of cold-stored whole blood (CSWB) from non-greyhound dogs (NGD) and greyhound dogs (GD) over 42 days of storage, notably, platelet closure time (PCT) (NGD only), manual platelet count (PLT) (GD only), ellagic acid (INTEM) and tissue factor activated (EXTEM) rotational thromboelastometry, prothrombin (PT) and activated partial thromboplastin time (aPTT), fibrinogen concentration (FIB), and the activities of factors (F) FII, FV, FVII, FVIII, FIX, FX, FXIII antigen (FXIII:Ag), and von Willebrand factor antigen (vWF:Ag). Design Whole blood from 10 NGD and 10 GD, was refrigerated in CPD blood bags at 4°C for 42 days. Blood was analyzed before refrigeration (day 0) and at day 1 (d1), 3, 5, 7, 10, 14, 17, 21, 24, 28, 31, 35, 38, and 42. Multivariate linear mixed effects models were created to evaluate coagulation parameters over time and compare NGD and GD. Data are summarized as estimated marginal means with 95% confidence intervals. Significance was set at P < 0.05. Results The PCT for all NGD CSWB was above the device limit by d7. The PLT for GD CSWB did not change during storage. The mean alpha-angle for INTEM and EXTEM decreased to <50% of baseline at d38 and d31 for NGD, and d31 and d17 for GD CSWB. The mean maximum clot firmness (MCF) for INTEM and EXTEM reduced to <50% of baseline at d42 and d28 for both GD and NGD. PT and aPTT for NGD and GD increased over time. For NGD CSWB, the mean FVIII and vWF:Ag activities decreased to <50% of baseline at d7 and d28, respectively, and FIB reached 0.982 g/dL by d24. For GD CSWB, FVIII, FXIII:Ag and FV activities decreased to <50% of baseline by d3, d38, and d38, respectively, and FIB was 0.982 g/dL at baseline. Alpha-angle and MCF for both INTEM and EXTEM, and activities for FII, FV, FIX, FXIII:Ag were significantly lower, and vWF:Ag was significantly higher overall in GD CSWB compared with NGD. A significant difference in the pattern of change over time was detected between NGD and GD in EXTEM alpha-angle, INTEM and EXTEM MCF, FII, and FVIII activities. Conclusions The in vitro viscoelastic parameters of GD and NGD CSWB declines over 42 days, but numerous hemostatic parameters (INTEM and EXTEM alpha-angle and MCF, activity of FII, FV, FV, FVII, FIX, FX, FXIII:Ag, vWF:Ag, and FIB) remain within 50% of baseline for more than 14 days. CSWB from GD compared to NGD has reduced hemostatic activity overall, but a similar pattern of decline for most parameters over time.
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Affiliation(s)
- James L. Cooper
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
| | - Claire R. Sharp
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
- *Correspondence: Claire R. Sharp
| | - Corrin J. Boyd
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
| | - Melissa A. Claus
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
- Perth Veterinary Specialists, Osborne Park, WA, Australia
| | - Gabriel Rossi
- School of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
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Turner K, Boyd C, Rossi G, Sharp CR, Claus MA, Francis A, Smart L. Allergy, inflammation, hepatopathy and coagulation biomarkers in dogs with suspected anaphylaxis due to insect envenomation. Front Vet Sci 2022; 9:875339. [PMID: 36003410 PMCID: PMC9393546 DOI: 10.3389/fvets.2022.875339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To compare concentrations of biomarkers of; allergy [mast cell tryptase (MCT) and histamine], inflammation [interleukin (IL)-6,-10, and-18, CXCL8, CCL2, keratinocyte chemoattractant (KC), C-reactive protein (CRP)], endothelial glycocalyx shedding (hyaluronan), coagulation [prothrombin time, activated partial thromboplastin time, fibrinogen concentration, and von Willebrand Factor antigen, protein C (PC) and antithrombin (AT) activity], and hepatopathy [alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and total bilirubin] between dogs with anaphylaxis after suspected insect exposure, dogs with critical illness, and healthy dogs. Design This was a single center prospective clinical observational comparative biomarker study that included 25 dogs with anaphylaxis (evidence of insect exposure, acute dermatological signs, and other organ involvement), 30 dogs with other critical illness, and 20 healthy dogs. Differences across groups in biomarker concentrations were tested using one-way ANOVA or Kruskal-Wallis test, with significant P values (<0.05) reported for pairwise differences detected by post-hoc tests. Logistic regression models were used to calculate the area under the receiver operator characteristic curve (AUROC) for discrimination between anaphylaxis and non-anaphylactic illness. Results Histamine concentration was significantly higher in the anaphylaxis group than the healthy (P < 0.001) and critically ill groups (P < 0.001), whereas no differences in MCT were detected amongst groups. Biomarker concentrations that were increased relative to healthy dogs in both the anaphylaxis and critically ill groups included IL-10 (P < 0.001 and P = 0.007, respectively), CCL2 (P = 0.007 and P < 0.001, respectively) and AST (both P < 0.001), whereas only the critically ill group had significantly increased CRP (P < 0.001), IL-6 (P < 0.001), KC (P < 0.001), ALP (P < 0.001), and fibrinogen (P = 0.016) concentrations, compared to the healthy group. Only dogs with anaphylaxis had significantly higher hyaluronan (P = 0.021) and ALT (P = 0.021) concentrations, and lower PC (P = 0.030) and AT (P = 0.032) activities, compared to healthy dogs. Both CRP and histamine concentration showed good discrimination between anaphylaxis and other critical illness, with an AUROC of 0.96 (95% CI 0.91-1) and 0.81 (95% CI 0.69-0.93), respectively. Conclusions This preliminary study in dogs with anaphylaxis after suspected insect exposure, found evidence of an early innate immune response, glycocalyx shedding and anticoagulant consumption. Both CRP and histamine showed potential clinical utility for differentiation between anaphylaxis and other critical illness.
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Affiliation(s)
- Kate Turner
- Emergency and Critical Care Department, School of Veterinary Medicine, Murdoch University, Perth, WA, Australia
| | - Corrin Boyd
- Emergency and Critical Care Department, School of Veterinary Medicine, Murdoch University, Perth, WA, Australia
| | - Gabriele Rossi
- Veterinary Pathology Department, School of Veterinary Medicine, Murdoch University, Perth, WA, Australia
| | - Claire R. Sharp
- Emergency and Critical Care Department, School of Veterinary Medicine, Murdoch University, Perth, WA, Australia
- Harry Butler Institute, Murdoch University, Perth, WA, Australia
| | - Melissa A. Claus
- Emergency and Critical Care Department, School of Veterinary Medicine, Murdoch University, Perth, WA, Australia
| | - Abbie Francis
- Telethon Kids Cancer Centre, Telethon Kids Institute, Nedlands, WA, Australia
- Discipline of Pediatrics, Medical School, The University of Western Australia, Nedlands, WA, Australia
| | - Lisa Smart
- Emergency and Critical Care Department, School of Veterinary Medicine, Murdoch University, Perth, WA, Australia
- Emergency and Critical Care Department, Small Animal Specialist Hospital, North Ryde, NSW, Australia
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Claus MA, Poh D, Smart L, Purcell SL, Boyd CJ, Sharp CR. Effect of leukoreduction on inflammation in critically ill dogs receiving red blood cell transfusions: A randomized blinded controlled clinical trial. J Vet Intern Med 2022; 36:1248-1257. [PMID: 35792764 PMCID: PMC9308429 DOI: 10.1111/jvim.16487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Melissa A. Claus
- Murdoch University, School of Veterinary Medicine Murdoch Western Australia Australia
| | - Denise Poh
- Murdoch University, School of Veterinary Medicine Murdoch Western Australia Australia
| | - Lisa Smart
- Murdoch University, School of Veterinary Medicine Murdoch Western Australia Australia
| | - Sarah L. Purcell
- University of Queensland, School of Veterinary Science Gatton Queensland Australia
| | - Corrin J. Boyd
- Murdoch University, School of Veterinary Medicine Murdoch Western Australia Australia
| | - Claire R. Sharp
- Murdoch University, School of Veterinary Medicine Murdoch Western Australia Australia
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Sharp CR, Blais MC, Boyd CJ, Brainard BM, Chan DL, de Laforcade A, Goggs R, Guillaumin J, Lynch A, Mays E, McBride D, Rosati T, Rozanski EA. 2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 6: Defining rational use of thrombolytics. J Vet Emerg Crit Care (San Antonio) 2022; 32:446-470. [PMID: 35881647 PMCID: PMC9544803 DOI: 10.1111/vec.13227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To systematically review available evidence and establish guidelines related to the use of thrombolytics for the management of small animals with suspected or confirmed thrombosis. DESIGN PICO (Population, Intervention, Control, and Outcome) questions were formulated, and worksheets completed as part of a standardized and systematic literature evaluation. The population of interest included dogs and cats (considered separately) and arterial and venous thrombosis. The interventions assessed were the use of thrombolytics, compared to no thrombolytics, with or without anticoagulants or antiplatelet agents. Specific protocols for recombinant tissue plasminogen activator were also evaluated. Outcomes assessed included efficacy and safety. Relevant articles were categorized according to level of evidence, quality, and as to whether they supported, were neutral to, or opposed the PICO questions. Conclusions from the PICO worksheets were used to draft guidelines, which were subsequently refined via Delphi surveys undertaken by the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) working group. RESULTS Fourteen PICO questions were developed, generating 14 guidelines. The majority of the literature addressing the PICO questions in dogs is experimental studies (level of evidence 3), thus providing insufficient evidence to determine if thrombolysis improves patient-centered outcomes. In cats, literature was more limited and often neutral to the PICO questions, precluding strong evidence-based recommendations for thrombolytic use. Rather, for both species, suggestions are made regarding considerations for when thrombolytic drugs may be considered, the combination of thrombolytics with anticoagulant or antiplatelet drugs, and the choice of thrombolytic agent. CONCLUSIONS Substantial additional research is needed to address the role of thrombolytics for the treatment of arterial and venous thrombosis in dogs and cats. Clinical trials with patient-centered outcomes will be most valuable for addressing knowledge gaps in the field.
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Affiliation(s)
- Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Marie-Claude Blais
- Department of Clinical Sciences, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Corrin J Boyd
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia, USA
| | - Daniel L Chan
- Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Armelle de Laforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, New York, USA
| | - Julien Guillaumin
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Alex Lynch
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Erin Mays
- Veterinary Specialty Services, St. Louis, Missouri, USA
| | | | - Tommaso Rosati
- Department for Small Animals, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA
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Spada E, Jung H, Proverbio D, Perego R, Baggiani L, Ciuti S, Sharp CR, Nash KJ, Westman M, Lait PJP, Davidow EB. Lack of association between feline AB blood groups and retroviral status: a multicenter, multicountry study. J Feline Med Surg 2022; 24:e194-e202. [DOI: 10.1177/1098612x221100082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives The relationship between blood group antigens and disease has been studied in humans. Blood types have been associated with both decreased and increased rates of various infections. In addition, blood group expression has been shown to vary with some cancers and gastrointestinal diseases. The objective of this study was to explore whether there is a relationship between blood type and retroviral infections in cats. Methods Case records from a veterinary research laboratory, veterinary teaching hospitals and veterinary blood banks were retrospectively searched for cats where both blood type and retroviral status (feline leukemia [FeLV], feline immunodeficiency virus [FIV] or both) were listed (part 1). In addition, a sample of 33 cats with confirmed FIV infection was genotyped to determine blood groups (part 2). Results In part 1, 709 cats were identified, 119 of which were positive for retroviral infection. Among all cases, 621 were type A (87.6%), 68 were type B (9.6%) and 20 were type AB (2.8%). There was no relationship between overall retroviral status (positive/negative) and blood type ( P = 0.43), between FeLV status and blood type ( P = 0.86) or between FIV status and blood type ( P = 0.94). There was no difference in the distribution of blood types between cats that were healthy and typed as possible blood donors vs sick cats that were typed prior to a possible transfusion ( P = 0.13). In part 2, of the 33 FIV-infected cats, all blood group genotypes were identified, although this test did not discriminate type A from type AB. Conclusions and relevance No relationship was identified between feline retroviral status and blood type in this study. The relationship between blood type and other disease states requires further study in veterinary patients.
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Affiliation(s)
- Eva Spada
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Lodi, Italy
| | - Hyein Jung
- Veterinary Clinical Sciences, Washington State University, Pullman, WA, USA
| | - Daniela Proverbio
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Lodi, Italy
| | - Roberta Perego
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Lodi, Italy
| | - Luciana Baggiani
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Lodi, Italy
| | - Silvia Ciuti
- Veterinary Transfusion Research Laboratory (REVLab), Department of Veterinary Medicine and Animal Sciences (DIVAS), University of Milan, Lodi, Italy
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Katherine J Nash
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Mark Westman
- Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW, Australia
| | - Philippa JP Lait
- Molecular Diagnostic Unit, Diagnostic Laboratories, Langford Vets, Langford, Bristol, UK
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deLaforcade A, Bacek L, Blais M, Boyd C, Brainard BM, Chan DL, Cortellini S, Goggs R, Hoareau GL, Koenigshof A, Li R, Lynch A, Ralph A, Rozanski E, Sharp CR. 2022 Update of the Consensus on the Rational Use of Antithrombotics and Thrombolytics in Veterinary Critical Care (CURATIVE) Domain 1- Defining populations at risk. J Vet Emerg Crit Care (San Antonio) 2022; 32:289-314. [PMID: 35499966 PMCID: PMC9322658 DOI: 10.1111/vec.13204] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 03/31/2022] [Accepted: 03/31/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To expand the number of conditions and interventions explored for their associations with thrombosis in the veterinary literature and to provide the basis for prescribing recommendations. DESIGN A population exposure comparison outcome format was used to represent patient, exposure, comparison, and outcome. Population Exposure Comparison Outcome questions were distributed to worksheet authors who performed comprehensive searches, summarized the evidence, and created guideline recommendations that were reviewed by domain chairs. The revised guidelines then underwent the Delphi survey process to reach consensus on the final guidelines. Diseases evaluated in this iteration included heartworm disease (dogs and cats), immune-mediated hemolytic anemia (cats), protein-losing nephropathy (cats), protein-losing enteropathy (dogs and cats), sepsis (cats), hyperadrenocorticism (cats), liver disease (dogs), congenital portosystemic shunts (dogs and cats) and the following interventions: IV catheters (dogs and cats), arterial catheters (dogs and cats), vascular access ports (dogs and cats), extracorporeal circuits (dogs and cats) and transvenous pacemakers (dogs and cats). RESULTS Of the diseases evaluated in this iteration, a high risk for thrombosis was defined as heartworm disease or protein-losing enteropathy. Low risk for thrombosis was defined as dogs with liver disease, cats with immune-mediated hemolytic anemia, protein-losing nephropathy, sepsis, or hyperadrenocorticism. CONCLUSIONS Associations with thrombosis are outlined for various conditions and interventions and provide the basis for management recommendations. Numerous knowledge gaps were identified that represent opportunities for future studies.
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Affiliation(s)
- Armelle deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachusettsUSA
| | - Lenore Bacek
- Bluepearl Specialty and Emergency Pet HospitalTampaFloridaUSA
| | - Marie‐Claude Blais
- Department of Clinical SciencesUniversity of MontrealSaint‐HyacintheQCCanada
| | - Corrin Boyd
- School of Veterinary MedicineMurdoch UniversityMurdochAustralia
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, Clinical SciencesUniversity of GeorgiaAthensGeorgiaUSA
| | - Daniel L. Chan
- Department of Clinical Science and ServicesThe Royal Veterinary CollegeLondonUK
| | - Stefano Cortellini
- Department of Clinical Science and ServicesThe Royal Veterinary CollegeLondonUK
| | - Robert Goggs
- Department of Clinical SciencesCornell University College of Veterinary MedicineIthacaNew YorkUSA
| | | | - Amy Koenigshof
- Department of Emergency CareTwo by Two Animal HospitalBerrien SpringsMichiganUSA
| | - Ron Li
- Department of Veterinary Surgical and Radiological SciencesSchool of Veterinary MedicineUniversity of California DavisDavisCaliforniaUSA
| | - Alex Lynch
- Department of Clinical SciencesNC State College of Veterinary MedicineRaleighNorth CarolinaUSA
| | | | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary MedicineTufts UniversityNorth GraftonMassachusettsUSA
| | - Claire R Sharp
- School of Veterinary MedicineMurdoch UniversityMurdochAustralia
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12
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Chee W, Sharp CR, Boyd CJ, Claus MA, Smart L. Stability of ex vivo coagulation factor activity in never-frozen and thawed refrigerated canine plasma stored for 42 days. J Vet Emerg Crit Care (San Antonio) 2021; 32:189-195. [PMID: 34766698 DOI: 10.1111/vec.13152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/05/2020] [Accepted: 08/23/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The primary objective of this study was to document coagulation factor activity in canine "NEVER-FROZEN" and "THAWED" refrigerated plasma for the purposes of defining recommended expiration dates. We hypothesized that NEVER-FROZEN and THAWED refrigerated plasma would maintain >50% activity of coagulation factors V (FV), VII (FVII), VIII (FVIII), IX (FIX), X (FX), and von Willebrand factor antigen (vWF) and a concentration of fibrinogen above the lower bound of the reference interval (>0.982 g/L) for greater than 14 days but less than 42 days. DESIGN Prospective laboratory-based study. SETTING University teaching hospital blood bank. ANIMALS Ten canine plasma units derived from healthy client-owned blood donors. INTERVENTIONS Serial sampling (days 0, 1, 3, 5, 7, 10, 14, 17, 21, 24, 28, 32, 35, 39, 42) from NEVER-FROZEN and THAWED refrigerated canine plasma units was conducted for measurement of activities of FV, FVII, FVIII, FIX, FX, vWF, and fibrinogen concentrations using the ACL TOP 300. Plasma was defined as "suitable for transfusion" at a given time point if the entire 95% confidence interval for each factor was above 50% activity and above a fibrinogen concentration of 0.982 g/L. MEASUREMENTS AND MAIN RESULTS The lower bounds of the FVIII and vWF confidence intervals were above 50% up to and including day 32 for NEVER-FROZEN refrigerated plasma and day 28 for THAWED refrigerated plasma. Confidence intervals for FV, FVII, FIX, and FX remained above 50% activity at all time points. The lower bound of the fibrinogen concentration was <0.982 g/L on day 39 for NEVER-FROZEN refrigerated plasma and on day 35 for THAWED refrigerated plasma. CONCLUSIONS Refrigerated canine plasma from these 10 dogs retained coagulation factor activity above the limit that we defined as suitable for transfusion for up to 32 days when NEVER-FROZEN and 28 days when THAWED. Further studies should evaluate the clinical outcomes and effects on coagulation factor activity of dogs receiving refrigerated plasma transfusions.
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Affiliation(s)
- Weiqin Chee
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Corrin J Boyd
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Melissa A Claus
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Lisa Smart
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
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13
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Saarenkari HK, Sharp CR, Smart L. Retrospective evaluation of the utility of blood cultures in dogs (2009-2018): 45 cases. J Vet Emerg Crit Care (San Antonio) 2021; 32:141-145. [PMID: 34606667 DOI: 10.1111/vec.13144] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/04/2020] [Accepted: 07/21/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is no consensus on obtaining blood cultures routinely in companion animals with suspected sepsis, and there is a paucity of evidence concerning their utility. The objectives of this retrospective study were to determine the yield of positive blood cultures from hospitalized dogs, the prevalence of resistant bacteria, and the frequency and nature of changes to antimicrobial therapy once the culture result became available. KEY FINDINGS Forty-five dogs had a blood culture submitted over a 10-year period, of which 9(20%) yielded positive growth and 36 (80%) yielded no bacterial growth. The most frequent reasons for submission of blood culture were pyrexia of unknown origin (n = 14), suspected soft tissue infection (7), and suspected discospondylitis (7). The most frequent final diagnoses were soft tissue infection (n = 11), discospondylitis (7), and unknown (6). No significant difference was found between the culture-positive versus culture-negative groups with regard to the most frequent reasons for blood culture (P = 0.55), final diagnoses (P = 0.80), survival until the blood culture result (P = 0.37), or whether the infection was hospital- or community-acquired (P = 0.99). There were significantly more immunosuppressed dogs in the culture-positive group (P = 0.02). Resistance to one or more antimicrobials was documented in all dogs with susceptibility reported. In the culture-positive dogs, 63% had antimicrobial de-escalation and none had escalation, whereas 19% of the culture-negative dogs had de-escalation and 7% had escalation. CONCLUSION Blood cultures were submitted infrequently, but the proportion of resistance was higher than expected and supports the use of blood cultures in cases of suspected infection resulting in bacteremia.
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Affiliation(s)
- Heidi K Saarenkari
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
| | - Lisa Smart
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, Australia
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14
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Davis J, Raisis AL, Sharp CR, Cianciolo RE, Wallis SC, Ho KM. Improved Cardiovascular Tolerance to Hemorrhage after Oral Resveratrol Pretreatment in Dogs. Vet Sci 2021; 8:vetsci8070129. [PMID: 34357921 PMCID: PMC8310360 DOI: 10.3390/vetsci8070129] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/06/2021] [Accepted: 07/10/2021] [Indexed: 11/21/2022] Open
Abstract
Resveratrol has been shown to preserve organ function and improve survival in hemorrhagic shock rat models. This study investigated whether seven days of oral resveratrol could improve hemodynamic response to hemorrhage and confer benefits on risk of acute kidney injury (AKI) without inducing coagulopathy in a canine model. Twelve greyhound dogs were randomly allocated to receive oral resveratrol (1000 mg/day) or placebo for seven days prior to inducing hemorrhage until a targeted mean blood pressure of ≤40 mmHg was achieved. AKI biomarkers and coagulation parameters were measured before, immediately following, and two hours after hemorrhage. Dogs were euthanized, and renal tissues were examined at the end of the experiment. All investigators were blinded to the treatment allocation. A linear mixed model was used to assess effect of resveratrol on AKI biomarkers and coagulation parameters while adjusting for volume of blood loss. A significant larger volume of blood loss was required to achieve the hypotension target in the resveratrol group compared to placebo group (median 64 vs. 55 mL/kg respectively, p = 0.041). Although histological evidence of AKI was evident in all dogs, the renal tubular injury scores were not significantly different between the two groups, neither were the AKI biomarkers. Baseline (pre-hemorrhage) maximum clot firmness on the Rotational Thromboelastometry (ROTEM®) was stronger in the resveratrol group than the placebo group (median 54 vs. 43 mm respectively, p = 0.009). In summary, seven days of oral resveratrol did not appear to induce increased bleeding risk and could improve greyhound dogs’ blood pressure tolerance to severe hemorrhage. Renal protective effect of resveratrol was, however, not observed.
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Affiliation(s)
- Jennifer Davis
- School of Veterinary Science, Murdoch University, Murdoch, WA 6150, Australia; (A.L.R.); (C.R.S.); (K.M.H.)
- Correspondence:
| | - Anthea L. Raisis
- School of Veterinary Science, Murdoch University, Murdoch, WA 6150, Australia; (A.L.R.); (C.R.S.); (K.M.H.)
| | - Claire R. Sharp
- School of Veterinary Science, Murdoch University, Murdoch, WA 6150, Australia; (A.L.R.); (C.R.S.); (K.M.H.)
- Centre for Terrestrial Ecosystem Science and Sustainability, Harry Butler Institute, Murdoch University, Murdoch, WA 6150, Australia
| | - Rachel E. Cianciolo
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH 43210, USA;
| | - Steven C. Wallis
- University of Queensland Centre for Clinical Research, Brisbane, QLD 4029, Australia;
| | - Kwok M. Ho
- School of Veterinary Science, Murdoch University, Murdoch, WA 6150, Australia; (A.L.R.); (C.R.S.); (K.M.H.)
- Department of Intensive Care Medicine, Royal Perth Hospital, Perth, WA 6000, Australia
- Medical School, University of Western Australia, Perth, WA 6009, Australia
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15
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Kim MW, Sharp CR, Boyd CJ, Twomey LN. A survey of enteric organisms detected by real-time PCR assay in faeces of dogs in Western Australia. Aust Vet J 2021; 99:419-422. [PMID: 34184250 DOI: 10.1111/avj.13101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 03/08/2021] [Accepted: 05/29/2021] [Indexed: 11/27/2022]
Abstract
This retrospective observational study reports the enteric organisms detected in dogs in Western Australia that had a faecal PCR (fPCR) submitted to a commercial veterinary laboratory. Of 2025 fPCR results, Clostridium perfringens alpha toxin gene was most frequently detected (87.2%), followed by Campylobacter spp. (37.8%), canine parvovirus (10.5%), Giardia spp. (9.7%), Salmonella spp. (7.0%), canine enteric coronavirus (2.3%), and canine distemper virus (0.3%). C.perfringens alpha toxin gene and Campylobacter spp. were the most common organisms co-detected. There was no statistically significant seasonal variation. Further studies are required to elucidate the role these organisms play in gastrointestinal disease in dogs.
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Affiliation(s)
- M W Kim
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - C R Sharp
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, 6150, Australia.,Centre for Terrestrial Ecosystem Science and Sustainability, Harry Butler Institute, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - C J Boyd
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - L N Twomey
- Vetpath Laboratory Services, Jandakot, Western Australia, 6164, Australia
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16
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Boyd CJ, Sharp CR, Claus MA, Raisis AL, Hosgood G, Smart L. Prospective randomized controlled blinded clinical trial evaluating biomarkers of acute kidney injury following 6% hydroxyethyl starch 130/0.4 or Hartmann's solution in dogs. J Vet Emerg Crit Care (San Antonio) 2021; 31:306-314. [PMID: 33709516 DOI: 10.1111/vec.13056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/29/2020] [Accepted: 09/09/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To evaluate the effect of 6% hydroxyethyl starch (HES) 130/0.4, compared with a Hartmann's solution control (CRYST), on urine biomarkers of acute kidney injury (AKI) in dogs prescribed a fluid bolus. DESIGN Randomized, controlled, blinded clinical trial January 2018 to February 2019. SETTING University teaching hospital. ANIMALS Forty client-owned dogs. INTERVENTIONS Dogs prescribed a fluid bolus were randomized to receive at least 10 mL/kg of HES or CRYST with clinicians and investigators blinded to fluid type. Study fluid was used for further boluses as required in the following 24 hours, to a limit of 40 mL/kg total, after which fluid administration was open-label. MEASUREMENTS AND MAIN RESULTS Urine was collected prior to and 6, 12, and 24 hours after the first study fluid bolus. Urine concentrations of AKI biomarkers: neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, kidney injury molecule-1 (KIM), clusterin, and osteopontin were measured using a magnetic bead multiplexed assay. Osmolality-indexed biomarker concentrations were compared between groups over time with linear mixed-effects models, with P < 0.05 considered significant. The mean volume of study fluid administered was not significantly different between groups (HES: 23.1 mL/kg, CRYST: 25.9 mL/kg; P = 0.47, t-test). There were no significant differences between groups in change over time of osmolality-indexed urine concentrations of NGAL (P = 0.91), cystatin C (P = 0.95), KIM (P = 0.77), clusterin (P = 0.63), or osteopontin (P = 0.91). The maximum Veterinary Acute Kidney Injury (VAKI) score up to 7 days during hospitalization (P = 1.0) and in-hospital mortality (P = 0.49) were not significantly different between groups, as compared by Fisher's exact test. CONCLUSIONS There were no differences in change over time of urine AKI biomarkers in dogs treated with 10 - 40 mL/kg HES or CRYST over 24 hours. Larger clinical trials with patient-centered outcomes are required to investigate the safety of HES in dogs.
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Affiliation(s)
- Corrin J Boyd
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
| | - Claire R Sharp
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
| | - Melissa A Claus
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
| | - Anthea L Raisis
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
| | - Giselle Hosgood
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
| | - Lisa Smart
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
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17
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Davidow EB, Blois SL, Goy-Thollot I, Harris L, Humm K, Musulin S, Nash KJ, Odunayo A, Sharp CR, Spada E, Thomason J, Walton J, Wardrop KJ. Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS). Part 1: Definitions and clinical signs. J Vet Emerg Crit Care (San Antonio) 2021; 31:141-166. [PMID: 33792171 DOI: 10.1111/vec.13044] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/06/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To use a systematic, evidence-based consensus process to develop definitions for transfusion reactions in dogs and cats. DESIGN Evidence evaluation of the literature was carried out for identified transfusion reaction types in dogs and cats. Reaction definitions were generated based on synthesis of human and veterinary literature. Consensus on the definitions was achieved through Delphi-style surveys. Draft recommendations were made available through industry specialty listservs and comments were incorporated. RESULTS Definitions with imputability criteria were developed for 14 types of transfusion reactions. CONCLUSIONS The evidence review and consensus process resulted in definitions that can be used to facilitate future veterinary transfusion reaction research.
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Affiliation(s)
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada
| | | | | | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Sarah Musulin
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Katherine J Nash
- VetMED Emergency and Specialty Veterinary Hospital, Phoenix, AZ, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, USA
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Eva Spada
- Department of Veterinary Medicine, University of Milan, Lodi, Italy
| | - John Thomason
- Department of Clinical Sciences, Mississippi State University, Mississippi State, MS, USA
| | | | - K Jane Wardrop
- Veterinary Clinical Sciences, Washington State University, Pullman, WA, USA
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18
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Davidow EB, Blois SL, Goy-Thollot I, Harris L, Humm K, Musulin S, Nash KJ, Odunayo A, Sharp CR, Spada E, Thomason J, Walton J, Wardrop KJ. Association of Veterinary Hematology and Transfusion Medicine (AVHTM) Transfusion Reaction Small Animal Consensus Statement (TRACS) Part 2: Prevention and monitoring. J Vet Emerg Crit Care (San Antonio) 2021; 31:167-188. [PMID: 33751789 DOI: 10.1111/vec.13045] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/06/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To systematically review available evidence to develop guidelines for the prevention of transfusion reactions and monitoring of transfusion administration in dogs and cats. DESIGN Evidence evaluation of the literature (identified through Medline searches through Pubmed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. Evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. Evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines for prevention and monitoring were generated based on the synthesis of the evidence. Consensus on the final recommendations and a proposed transfusion administration monitoring form was achieved through Delphi-style surveys. Draft recommendations and the monitoring form were made available through veterinary specialty listservs and comments were incorporated. RESULTS Twenty-nine guidelines and a transfusion administration monitoring form were formulated from the evidence review with a high degree of consensus CONCLUSIONS: This systematic evidence evaluation process yielded recommended prevention and monitoring guidelines and a proposed transfusion administration form. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.
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Affiliation(s)
- Elizabeth B Davidow
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada
| | | | | | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Sarah Musulin
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Katherine J Nash
- VetMED Emergency and Specialty Veterinary Hospital, Phoenix, Arizona, USA
| | - Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Eva Spada
- Department of Veterinary Medicine, University of Milan, Lodi, Italy
| | - John Thomason
- Department of Clinical Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | | | - K Jane Wardrop
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
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19
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Odunayo A, Nash KJ, Davidow EB, Blois SL, Goy-Thollot I, Harris L, Humm K, Musulin S, Sharp CR, Spada E, Thomason J, Walton J, Jane Wardrop K. Association of Veterinary Hematology and Transfusion Medicine (AVHTM) transfusion reaction small animal consensus statement (TRACS). Part 3: Diagnosis and treatment. J Vet Emerg Crit Care (San Antonio) 2021; 31:189-203. [PMID: 33751797 DOI: 10.1111/vec.13043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/06/2021] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To systematically review available evidence to develop guidelines for diagnosis and treatment of transfusion-associated reactions in dogs and cats. DESIGN Standardized and systemic evaluation of the literature (identified through Medline via PubMed and Google Scholar searches) was carried out for identified transfusion reaction types in dogs and cats. The available evidence was evaluated using PICO (Population, Intervention, Comparison, Outcome) questions generated for each reaction type. The evidence was categorized by level of evidence (LOE) and quality (Good, Fair, or Poor). Guidelines, diagnostic, and treatment algorithms were generated based on the evaluation of the evidence. Consensus on the final guidelines was achieved through Delphi-style surveys. Draft recommendations were disseminated through veterinary specialty listservs for review and comments, which were evaluated and integrated prior to final publication. RESULTS Medline via PubMed and Google Scholar databases were searched. There were 14 Population Intervention Comparison Outcome questions identified and corresponding worksheets were developed focusing on the diagnosis and treatment of transfusion-associated reactions in dogs and cats. Fourteen guidelines and four algorithms were developed with a high degree of consensus. CONCLUSIONS This systematic evidence evaluation process yielded recommended diagnostic and treatment algorithms for use in practice. However, significant knowledge gaps were identified, demonstrating the need for additional research in veterinary transfusion medicine.
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Affiliation(s)
- Adesola Odunayo
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, Tennessee, USA
| | - Katherine J Nash
- VetMED Emergency and Specialty Veterinary Hospital, Phoenix, Arizona, USA
| | - Elizabeth B Davidow
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
| | - Shauna L Blois
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Canada
| | | | | | - Karen Humm
- Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Sarah Musulin
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Perth, Australia
| | - Eva Spada
- Department of Veterinary Medicine, University of Milan, Lodi, Italy
| | - John Thomason
- Department of Clinical Sciences, Mississippi State University, Mississippi State, Mississippi, USA
| | | | - K Jane Wardrop
- Veterinary Clinical Sciences, Washington State University, Pullman, Washington, USA
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Poh D, Claus M, Smart L, Sharp CR. Transfusion practice in Australia: an internet-based survey. Aust Vet J 2021; 99:108-113. [PMID: 33442882 DOI: 10.1111/avj.13049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 11/15/2020] [Accepted: 12/05/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe small animal transfusion practices in Australia, including access to blood products and frequency of pre-transfusion compatibility testing and medication administration. METHODS An online survey was disseminated to target Australian veterinarians treating dogs and cats. Information collected included demographics, sources of blood products, blood storage, recipient compatibility testing and administration of medications pre-transfusion. Associations between the use of compatibility tests and premedications were assessed using the χ2 test. Significance was set at P < 0.05. RESULTS A total of 199 Australian veterinarians were included; however, there was some attrition of respondents over the course of the survey. The majority of respondents were in general practice (n = 133/199). Access to fresh whole blood was commonly reported for dogs (n = 179/199) and cats (n = 131/198), whereas blood components were less commonly available (canine red blood cells [RBC], n = 52/199 and plasma, n = 157/199; feline RBC, n = 9/198 and plasma, n = 21/198). Most blood was sourced from the pets of owners affiliated with the veterinary clinic (n = 179/196). The respondents who did not blood type or crossmatch dogs were significantly more likely to use premedication than those who did these tests (both comparisons: P < 0.001). Likewise, the respondents who did not blood-type cats were significantly more likely to use premedication (P = 0.003); however, there was no association between crossmatching and using premedication in cats (P = 0.183). CONCLUSION This is the first survey to describe transfusion practices across a variety of practice types throughout Australia. Future work is needed to determine how representative these results are of current transfusion practices across Australia, and if so, what can be done to optimise them.
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Affiliation(s)
- D Poh
- Comparative Health Research Group, School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - M Claus
- Comparative Health Research Group, School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - L Smart
- Comparative Health Research Group, School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
| | - C R Sharp
- Comparative Health Research Group, School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia
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21
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Verschoor-Kirss M, Rozanski EA, Sharp CR, Oura TJ, Egan A, Bain P, Knoll J. Treatment of naturally occurring asthma with inhaled fluticasone or oral prednisolone: A randomized pilot trial. Can J Vet Res 2021; 85:61-67. [PMID: 33390654 PMCID: PMC7747657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 06/21/2020] [Indexed: 06/12/2023]
Abstract
The objective of this study was to compare inhaled glucocorticoids with oral glucocorticoids for treatment of naturally occurring feline asthma. Secondary goals were to evaluate serum allergy testing results in cats and to quantify the effect of an inhaled glucocorticoid (fluticasone) on glucose homeostasis. Nine cats with asthma were enrolled on the basis of clinical signs, thoracic radiographic findings, and airway eosinophilia. Cats were randomized and 4 cats were treated with oral glucocorticoids and 5 cats with inhaled glucocorticoids, with a 7-day course of oral glucocorticoids overlapping at the start of therapy. Cats were evaluated at baseline and at 8 wk with thoracic radiographs, bronchoalveolar lavage, lung function testing, and fructosamine levels. Serum allergen panels were evaluated. All cats were clinically normal after treatment and had significantly improved airway eosinophilia and decreased nucleated cell count. No improvement was seen in radiographic changes after treatment with either therapy. Oral, but not inhaled glucocorticoids, caused a decrease in airway resistance, although cats in the inhaled group had a higher baseline resistance than those in the oral group. Fructosamine levels did not change with treatment. Fifty percent of cats tested positive for immunoglobulin E (IgE) antibodies. Asthma is a heterogeneous condition; individual cats responded well to both oral and inhaled glucocorticoids. Ongoing evaluation of the potential underlying causes and therapeutic options is warranted with a larger group of cats.
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Affiliation(s)
- Michael Verschoor-Kirss
- Department of Clinical Sciences (Verschoor-Kirss, Rozanski, Sharp, Oura, Egan) and Department of Biomedical Sciences (Bain, Knoll), Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, Massachusetts 01536, USA
| | - Elizabeth A Rozanski
- Department of Clinical Sciences (Verschoor-Kirss, Rozanski, Sharp, Oura, Egan) and Department of Biomedical Sciences (Bain, Knoll), Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, Massachusetts 01536, USA
| | - Claire R Sharp
- Department of Clinical Sciences (Verschoor-Kirss, Rozanski, Sharp, Oura, Egan) and Department of Biomedical Sciences (Bain, Knoll), Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, Massachusetts 01536, USA
| | - Trisha J Oura
- Department of Clinical Sciences (Verschoor-Kirss, Rozanski, Sharp, Oura, Egan) and Department of Biomedical Sciences (Bain, Knoll), Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, Massachusetts 01536, USA
| | - Ashley Egan
- Department of Clinical Sciences (Verschoor-Kirss, Rozanski, Sharp, Oura, Egan) and Department of Biomedical Sciences (Bain, Knoll), Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, Massachusetts 01536, USA
| | - Perry Bain
- Department of Clinical Sciences (Verschoor-Kirss, Rozanski, Sharp, Oura, Egan) and Department of Biomedical Sciences (Bain, Knoll), Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, Massachusetts 01536, USA
| | - Joyce Knoll
- Department of Clinical Sciences (Verschoor-Kirss, Rozanski, Sharp, Oura, Egan) and Department of Biomedical Sciences (Bain, Knoll), Cummings School of Veterinary Medicine, Tufts University, 200 Westboro Road, North Grafton, Massachusetts 01536, USA
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22
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Boyd CJ, Claus MA, Raisis AL, Hosgood G, Sharp CR, Smart L. Corrigendum: Hypocoagulability and Platelet Dysfunction Are Exacerbated by Synthetic Colloids in a Canine Hemorrhagic Shock Model. Front Vet Sci 2020; 7:641. [PMID: 33102561 PMCID: PMC7506514 DOI: 10.3389/fvets.2020.00641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/06/2020] [Indexed: 11/13/2022] Open
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23
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Kang K, Sharp CR, Boyd CJ, Turner K. Intramyocardial haematoma causing right ventricular outflow obstruction after brown snake (
Pseudonaja
species) envenomation in a dog. Aust Vet J 2020; 98:455-461. [DOI: 10.1111/avj.12989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 03/31/2020] [Accepted: 06/02/2020] [Indexed: 11/27/2022]
Affiliation(s)
- K Kang
- School of Veterinary Medicine Murdoch University Murdoch Western Australia Australia
| | - CR Sharp
- School of Veterinary Medicine Murdoch University Murdoch Western Australia Australia
| | - CJ Boyd
- School of Veterinary Medicine Murdoch University Murdoch Western Australia Australia
| | - K Turner
- School of Veterinary Medicine Murdoch University Murdoch Western Australia Australia
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24
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Kim MW, Sharp CR, Boyd CJ, Twomey LN. Faecal PCR panel results and clinical findings in Western Australian dogs with diarrhoea. Aust Vet J 2020; 98:563-569. [PMID: 32839975 DOI: 10.1111/avj.13008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/20/2020] [Accepted: 07/24/2020] [Indexed: 12/01/2022]
Abstract
AIM To describe faecal PCR (fPCR) results and clinical findings of dogs seen at a university teaching hospital for diarrhoea. DESIGN Retrospective case series (April 2015 to July 2018). PROCEDURE Data were collected from the hospital electronic medical records. Data extracted included signalment, history, clinical signs, treatment, fPCR panel results, other faecal diagnostic test results and antimicrobial use. RESULTS One hundred and sixty-eight dogs with diarrhoea had a fPCR panel submitted. Most dogs (115, 68.5%) had diarrhoea of 3 days or less duration. Clostridium perfringens alpha toxin gene was most frequently detected (156, 92.9%) by fPCR, followed by Campylobacter spp. (55, 32.7%), canine parvovirus (CPV) (29, 17.3%), Salmonella spp. (14, 8.3%) and Giardia spp. (9, 5.4%). For the 45 dogs that had a negative point-of-care CPV test, 13 were CPV fPCR positive; some of which were adult dogs with current vaccination status. A total of 94/168 (56%) dogs received antimicrobials at some time during the treatment of diarrhoea. CONCLUSION Faecal PCR panels can identify dogs with enteric organisms in their faeces that traditional faecal diagnostics may miss, thus contributing additional information to the diagnostic process. Nonetheless, fPCR results should be interpreted in light of the clinical findings, and particular consideration given to avoiding inappropriate use of antimicrobials. This study highlights that testing for C. perfringens alpha toxin gene is not likely to be diagnostically helpful, and that adult dogs with diarrhoea might be identified as CPV positive with PCR testing, despite a negative point-of-care CPV test result and a current vaccination status.
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Affiliation(s)
- M W Kim
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - C R Sharp
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - C J Boyd
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - L N Twomey
- VetPath Laboratory Services, Belmont, Western Australia, Australia
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25
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Boller M, Kelers K, Stevenson MA, Winkel KD, Hardjo S, Heller J, Judge PR, Ong HM, Padula AM, Reddrop C, Santos L, Sharp CR, Smart L, Swindells KL, Tabrett D, Wierenga JR. SnakeMap: four years of experience with a national small animal snake envenomation registry. Aust Vet J 2020; 98:442-448. [PMID: 32743816 DOI: 10.1111/avj.12993] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 06/10/2020] [Indexed: 11/29/2022]
Abstract
SnakeMap is a national cloud-based, veterinary snakebite registry. It was designed to prospectively collect data of the clinical circumstances and temporospatial information on cases of snake envenomation in dogs and cats. We herein introduce the project and summarise the data from the first 4 years of SnakeMap. The registry is a veterinary community-based online database allowing case entry from veterinary hospitals across Australia. Registry data comprise hospital characteristics, patient characteristics, envenoming snake type, treatment and outcome variables, including time and geolocation of the snake bite. We present summative information on select key variables from the SnakeMap registry (1 July 2015 to 30 June 2019). Twenty-eight hospitals from 6 states/territories entered 624 cases into the registry, including 419 dogs (67%) and 205 cats (33%). Bite time was available in 216 animals of which 90 (42%) were reported to be bitten in the 3 hours between 03:00 pm and 05:59 pm; median bite to presentation interval was 60 (interquartile range [IQR] 30, 211) minutes in dogs and 95 (IQR 41, 238) minutes in cats. Bites occurred in the owner's yard in 356 dogs (85%) and 53 cats (26%). A snake venom detection kit was used in 172 cases (28%) and antivenom was administered in 523 cases (85%). Most animals (n = 534, 88%) survived to discharge (median hospitalisation of 25 [IQR 16, 62] hours). SnakeMap effectively collects relevant clinical data from dogs and cats with presumed snake bite and provides locally specific information on the epidemiology of snake envenomation in small animals.
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Affiliation(s)
- M Boller
- Veterinary Hospital, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, 3030, Australia
| | - K Kelers
- Veterinary Hospital, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, 3030, Australia
| | - M A Stevenson
- Veterinary Hospital, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, 3030, Australia
| | - K D Winkel
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - S Hardjo
- UQ VETS Small Animal Hospital, Corner Main Drive and Outer Ring Road, Gatton, Queensland, 4343, Australia
| | - J Heller
- School of Animal and Veterinary Sciences, Charles Sturt University, Wagga Wagga, New South Wales, 2650, Australia.,Graham Centre for Agricultural Innovation, Charles Sturt University, Wagga Wagga, New South Wales, 2650, Australia
| | - P R Judge
- Vet Education Pty Ltd, Douglas, Queensland, 4814, Australia.,JCUVet, James Cook University, Douglas, Queensland, 4811, Australia
| | - H M Ong
- Veterinary Hospital, Melbourne Veterinary School, University of Melbourne, Werribee, Victoria, 3030, Australia
| | - A M Padula
- Australian Venom Research Unit, Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria, Australia
| | - C Reddrop
- Animal Emergency Service, Carrara, Queensland, 4211, Australia
| | - Lcp Santos
- School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia, 5371, Australia
| | - C R Sharp
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - L Smart
- School of Veterinary Medicine, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - K L Swindells
- Western Australian Veterinary Emergency and Specialty, Success, Western Australia, 6164, Australia
| | - D Tabrett
- Animal Referral and Emergency Centre, Broadmeadow, New South Wales, 2292, Australia
| | - J R Wierenga
- School of Veterinary Sciences, Massey University, Palmerston North, 4442, New Zealand
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Abstract
To determine the incidence of ex vivo incompatibility between ovine maternal RBCs and fetal plasma, we performed cross-matching of blood samples from ewes and from lambs delivered by cesarean section. Twenty-one date-mated singleton pregnant Merino ewes were anesthetized for cesarean delivery of the fetus. At the time of delivery, paired maternal and fetal blood samples were collected and subsequently separated for storage as packed red blood cells and fresh frozen plasma. Gel column major cross matching was performed within 2 wk. All fetus-dam crossmatches were major crossmatches, combining fetal (recipient) plasma with dam (donor) RBCs. 172 individual dam-dam cross matches were performed. Two of these tests were incompatible (1.2%). In addition, 19 fetal blood samples collected immediately after cesarean delivery were crossmatched with 21 maternal samples to generate 174 maternal-fetal individual cross matches. No maternal-fetal incompatibility reactions were observed. The results of this study demonstrate that all maternal donors and fetal recipients were compatible. In addition, the incidence of an incompatible crossmatch between adult ewes was 1.2%. These data suggest that lambs may not be born with antibodies against other blood types, but rather may acquire such antibodies at some time during early life. In addition, these data suggest the risk of incompatibility reactions between ewes of a similar breed and from a single farm of origin is very low.
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Affiliation(s)
- Gabrielle C Musk
- Animal Care Services, University of Western Australia, Crawley, Western Australia; Division of Obstetrics and Gynaecology, University of Western Australia, Crawley, Western Australia;,
| | - Haruo Usuda
- Division of Obstetrics and Gynaecology, University of Western Australia, Crawley, Western Australia
| | - Helen Kershaw
- Animal Care Services, University of Western Australia, Crawley, Western Australia
| | - Matthew W Kemp
- Division of Obstetrics and Gynaecology, University of Western Australia, Crawley, Western Australia
| | - Claire R Sharp
- School of Veterinary Medicine, Murdoch University, Murdoch, Western Australia
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27
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Sharp CR, Rozanski EA, Finn E, Borrego EJ. The pattern of mortality in dogs with gastric dilatation and volvulus. J Vet Emerg Crit Care (San Antonio) 2020; 30:232-238. [PMID: 32077192 DOI: 10.1111/vec.12932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 05/01/2018] [Accepted: 05/24/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The primary study objective was to characterize the pattern of in-hospital mortality in dogs with gastric dilatation and volvulus (GDV), with a focus on preoperative nonsurvival. MATERIALS AND METHODS A retrospective review of medical records from a 10-year period was undertaken at a university teaching hospital. Data collected included signalment, physical examination parameters at hospital presentation, blood lactate concentration, and outcome. RESULTS A total of 498 dogs were included. Overall, 319 (64.1%) survived to discharge and 179 (35.9%) were nonsurvivors. Of the nonsurvivors, 149 (31.3% of all dogs) were euthanized and 30 (6%) died. Of those dogs euthanized, the majority (n = 116) were euthanized at the time of hospital presentation prior to surgery (ie, without intent to treat). When dogs that were euthanized prior to surgery were excluded, 83.5% of dogs survived to discharge. Median group age was higher in those euthanized than in the group of dogs that survived to discharge. CONCLUSIONS Preoperative euthanasia and hence nonsurvival without intent to treat accounted for the majority of GDV mortality in this study. Given the high rate of nonsurvival without intent to treat it is likely that efforts focused at disease prevention will ultimately affect a much greater improvement in overall disease mortality than those focused on improving treatment.
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Affiliation(s)
- Claire R Sharp
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Emily Finn
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - E J Borrego
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
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28
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Yam E, Boyd CJ, Hosgood G, Claus MA, Raisis AL, Sharp CR, Smart L. Hydroxyethyl starch 130/0.4 (6%) and succinylated gelatine (4%) interfere with refractometry in dogs with haemorrhagic shock. Vet Anaesth Analg 2019; 46:579-586. [PMID: 31401048 DOI: 10.1016/j.vaa.2019.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/21/2019] [Accepted: 05/03/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine if low molecular weight synthetic colloid fluids administered to dogs interfere with refractometric estimates of total plasma protein (TPPr) and urine osmolality (UOsm). STUDY DESIGN Experimental study. ANIMALS Eighteen healthy Greyhound dogs. METHODS Anaesthetized Greyhounds subjected to haemorrhage for 60 minutes were given 80 mL kg-1 of Plasma-Lyte 148 (CRYST), or 20 mL kg-1 of hydroxyethyl starch 130/0.4 (HES) or succinylated gelatine (GELO) (n = 6 per group) intravenously over 20 minutes. Refractometric (TPPr) and biuret total plasma protein (TPPb) were measured before haemorrhage (Baseline), at end of shock (Shock), immediately (T20), then 40 minutes (T60), 100 minutes (T120) and 160 minutes (T180) after fluid administration. Urine specific gravity (USG) and UOsm were measured at all time points except T20. Estimated UOsm (eUOsm) was calculated from USG. Bias and limits of agreement (LOA) for TPPr versus TPPb, and eUOsm versus UOsm were calculated at each time point. RESULTS For dogs given CRYST and GELO, median TPPr and TPPb decreased in parallel, with a small consistent TPP bias (CRYST range of bias, 0.38-0.67 g dL-1; GELO range of bias, 0.42-0.58 g dL-1). Dogs given HES showed divergence between median TPPr and TPPb after T20, with a peak bias at T20 of 1.62 g dL-1 (LOA 1.29-1.95). Dogs given HES and GELO had markedly increased USG [HES peak median USG at T180 of 1.119 (Q1-Q3 1.103-1.122); GELO peak median USG at T120 of 1.114 (Q1-Q3 1.082-1.119)], with large increases in bias between eUOsm and UOsm [HES peak bias at T60 of 2995 mOsm kg-1 (LOA 2032-3958 mOsm kg-1); GELO peak bias at T120 of 2465 mOsm kg-1 (LOA 940-3990 mOsm kg-1)]. CONCLUSIONS AND CLINICAL RELEVANCE Administration of HES and GELO to dogs with haemorrhagic shock interferes with refractometric measurements for at least 3 hours after administration.
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Affiliation(s)
- Elodie Yam
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Corrin J Boyd
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Giselle Hosgood
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Melissa A Claus
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Anthea L Raisis
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Claire R Sharp
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Lisa Smart
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia.
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29
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Megquier K, Genereux DP, Hekman J, Swofford R, Turner-Maier J, Johnson J, Alonso J, Li X, Morrill K, Anguish LJ, Koltookian M, Logan B, Sharp CR, Ferrer L, Lindblad-Toh K, Meyers-Wallen VN, Hoffman A, Karlsson EK. BarkBase: Epigenomic Annotation of Canine Genomes. Genes (Basel) 2019; 10:E433. [PMID: 31181663 PMCID: PMC6627511 DOI: 10.3390/genes10060433] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 05/29/2019] [Accepted: 06/03/2019] [Indexed: 12/20/2022] Open
Abstract
Dogs are an unparalleled natural model for investigating the genetics of health and disease, particularly for complex diseases like cancer. Comprehensive genomic annotation of regulatory elements active in healthy canine tissues is crucial both for identifying candidate causal variants and for designing functional studies needed to translate genetic associations into disease insight. Currently, canine geneticists rely primarily on annotations of the human or mouse genome that have been remapped to dog, an approach that misses dog-specific features. Here, we describe BarkBase, a canine epigenomic resource available at barkbase.org. BarkBase hosts data for 27 adult tissue types, with biological replicates, and for one sample of up to five tissues sampled at each of four carefully staged embryonic time points. RNA sequencing is complemented with whole genome sequencing and with assay for transposase-accessible chromatin using sequencing (ATAC-seq), which identifies open chromatin regions. By including replicates, we can more confidently discern tissue-specific transcripts and assess differential gene expression between tissues and timepoints. By offering data in easy-to-use file formats, through a visual browser modeled on similar genomic resources for human, BarkBase introduces a powerful new resource to support comparative studies in dogs and humans.
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Affiliation(s)
- Kate Megquier
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Diane P Genereux
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Jessica Hekman
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Ross Swofford
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Jason Turner-Maier
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Jeremy Johnson
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Jacob Alonso
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Xue Li
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
- Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
| | - Kathleen Morrill
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
- Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
| | - Lynne J Anguish
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
| | - Michele Koltookian
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Brittney Logan
- Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
| | - Claire R Sharp
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University, Perth, Murdoch, WA 6150, Australia.
| | - Lluis Ferrer
- Departament de Medicina i Cirurgia Animals Veterinary School, Universitat Autonoma de Barcelona, 08193 Barcelona, Spain.
| | - Kerstin Lindblad-Toh
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
- Science for Life Laboratory, Department of Medical Biochemistry & Microbiology, Uppsala University, 751 23 Uppsala, Sweden.
| | - Vicki N Meyers-Wallen
- Baker Institute for Animal Health and Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA.
| | - Andrew Hoffman
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
- Cummings School of Veterinary Medicine, Tufts University, Grafton, MA 01536, USA.
| | - Elinor K Karlsson
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
- Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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30
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Sharp CR, deLaforcade AM, Koenigshof AM, Lynch AM, Thomason JM. Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 4-Refining and monitoring antithrombotic therapies. J Vet Emerg Crit Care (San Antonio) 2019; 29:75-87. [PMID: 30654420 DOI: 10.1111/vec.12794] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 12/08/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To systematically review the evidence for therapeutic monitoring of antithrombotic drugs in small animals, develop guidelines regarding antithrombotic monitoring, and identify knowledge gaps in the field. DESIGN First, a standardized, systematic literature review was conducted to address predefined PICO (Population/Patient, Intervention, Control, Outcome) questions, with categorization of relevant articles according to level of evidence and quality. Preliminary guidelines were developed by PICO worksheet authors and the domain chair. Thereafter, a Delphi-style survey was used to develop consensus on guidelines regarding therapeutic monitoring of antithrombotics in dogs and cats. SETTING Academic and referral veterinary medical centers. RESULTS PICO questions regarding the utility of therapeutic monitoring were developed for 6 different antithrombotic drugs or drug classes, including aspirin, clopidogrel, warfarin, unfractionated heparin, the low molecular weight heparins, and rivaroxaban, The majority of the literature pertaining to therapeutic monitoring of antithrombotic drugs was either performed in experimental animal models of disease or involved studies of drug pharmacokinetics and pharmacodynamics in healthy laboratory animals. There was a paucity of high level of evidence studies directly addressing the PICO questions, which limited the strength of recommendations that could be provided. The final guidelines recommend that therapeutic monitoring should be performed when using warfarin or unfractionated heparin in dogs and cats at risk of thrombosis. There is insufficient evidence to make strong recommendations for therapeutic monitoring of aspirin or low molecular weight heparin in dogs and cats at this time. CONCLUSIONS As in other CURATIVE domains, significant knowledge gaps were highlighted, indicating the need for substantial additional research in this field. Ongoing investigation of the role of therapeutic monitoring of antithrombotic therapies will undoubtedly facilitate improved outcomes for dogs and cats at risk of thrombosis.
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Affiliation(s)
- Claire R Sharp
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, WA, Australia
| | - Armelle M deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA
| | - Amy M Koenigshof
- College of Veterinary Medicine, Michigan State University, East Lansing, MI
| | - Alex M Lynch
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - John M Thomason
- Department of Clinical Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State, MS
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Goggs R, Blais MC, Brainard BM, Chan DL, deLaforcade AM, Rozanski E, Sharp CR. American College of Veterinary Emergency and Critical Care (ACVECC) Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines: Small animal. J Vet Emerg Crit Care (San Antonio) 2019; 29:12-36. [PMID: 30654421 DOI: 10.1111/vec.12801] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 12/12/2018] [Accepted: 12/07/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To systematically review available evidence and establish guidelines related to the risk of developing thrombosis and the management of small animals with antithrombotics. DESIGN Standardized, systematic evaluation of the literature (identified by searching Medline via PubMed and CAB abstracts) was carried out in 5 domains (Defining populations at risk; Defining rational therapeutic use; Defining evidence-based protocols; Refining and monitoring antithrombotic therapies; and Discontinuing antithrombotic therapies). Evidence evaluation was carried out using Population, Intervention, Comparison, Outcome generated within each domain questions to address specific aims. This was followed by categorization of relevant articles according to level of evidence and quality (Good, Fair, or Poor). Synthesis of these data led to the development of a series of statements. Consensus on the final guidelines was achieved via Delphi-style surveys. Draft recommendations were presented at 2 international veterinary conferences and made available for community assessment, review, and comment prior to final revisions and publication. SETTINGS Academic and referral veterinary medical centers. RESULTS Over 500 studies were reviewed in detail. Worksheets from all 5 domains generated 59 statements with 83 guideline recommendations that were refined during 3 rounds of Delphi surveys. A high degree of consensus was reached across all guideline recommendations. CONCLUSIONS Overall, systematic evidence evaluations yielded more than 80 recommendations for the treatment of small animals with or at risk of developing thrombosis. Numerous significant knowledge gaps were highlighted by the evidence reviews undertaken, indicating the need for substantial additional research in this field.
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Affiliation(s)
- Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY
| | - Marie-Claude Blais
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA
| | - Daniel L Chan
- Department Clinical Science and Services, The Royal Veterinary College, London, United Kingdom
| | - Armelle M deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Claire R Sharp
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
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Blais MC, Bianco D, Goggs R, Lynch AM, Palmer L, Ralph A, Sharp CR. Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE): Domain 3-Defining antithrombotic protocols. J Vet Emerg Crit Care (San Antonio) 2019; 29:60-74. [PMID: 30654416 DOI: 10.1111/vec.12795] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 12/10/2018] [Accepted: 12/08/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To systematically examine the evidence for use of a specific protocol (dose, frequency, route) of selected antithrombotic drugs, in comparisons to no therapy or to other antithrombotic therapies, to reduce the risk of complications or improve outcomes in dogs and cats at risk for thrombosis. DESIGN Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence (LOE) and quality (Good, Fair, or Poor), and development of consensus on conclusions via a Delphi-style survey for application of the concepts to clinical practice. SETTINGS Academic and referral veterinary medical centers. RESULTS Databases searched included Medline via PubMed and CAB abstracts. Eight different antithrombotic drugs were investigated using a standardized Patient, Intervention, Comparison, Outcome (PICO) question format both for dogs and cats, including aspirin, clopidogrel, warfarin, unfractionated heparin (UFH), dalteparin, enoxaparin, fondaparinux, and rivaroxaban, generating a total of 16 worksheets. Most studies identified were experimental controlled laboratory studies in companion animals (LOE 3) with only four randomized controlled clinical trials in companion animals (LOE 1). CONCLUSIONS Overall, evidence-based recommendations concerning specific protocols could not be formulated for most antithrombotic drugs evaluated, either because of the wide range of dosage reported (eg, aspirin in dogs) or the lack of evidence in the current literature. However, clopidogrel administration in dogs and cats at risk of arterial thrombosis, notably in cats at risk of cardiogenic thromboembolism, is supported by the literature, and specific protocols were recommended. Comparably, aspirin should not be used as a sole antithrombotic in cats with cardiomyopathy. Using the available safety profile information contained in the literature, the panel reached consensus on suggested dosage schemes for most antithrombotics. Significant knowledge gaps were highlighted, which will hopefully drive novel research.
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Affiliation(s)
- Marie-Claude Blais
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Domenico Bianco
- Internal Medicine Department, Metropolitan Animal Specialty Hospital, Los Angeles, CA
| | - Robert Goggs
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY
| | - Alex M Lynch
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC
| | - Lee Palmer
- Lieutenant Colonel, US Army Reserve, Veterinary Corps, Chair K9 Tactical Emergency Casualty Care Working Group, New Orleans, LA
| | | | - Claire R Sharp
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Australia
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Garden OA, Kidd L, Mexas AM, Chang YM, Jeffery U, Blois SL, Fogle JE, MacNeill AL, Lubas G, Birkenheuer A, Buoncompagni S, Dandrieux JRS, Di Loria A, Fellman CL, Glanemann B, Goggs R, Granick JL, LeVine DN, Sharp CR, Smith-Carr S, Swann JW, Szladovits B. ACVIM consensus statement on the diagnosis of immune-mediated hemolytic anemia in dogs and cats. J Vet Intern Med 2019; 33:313-334. [PMID: 30806491 PMCID: PMC6430921 DOI: 10.1111/jvim.15441] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 01/18/2019] [Indexed: 12/21/2022] Open
Abstract
Immune-mediated hemolytic anemia (IMHA) is an important cause of morbidity and mortality in dogs. IMHA also occurs in cats, although less commonly. IMHA is considered secondary when it can be attributed to an underlying disease, and as primary (idiopathic) if no cause is found. Eliminating diseases that cause IMHA may attenuate or stop immune-mediated erythrocyte destruction, and adverse consequences of long-term immunosuppressive treatment can be avoided. Infections, cancer, drugs, vaccines, and inflammatory processes may be underlying causes of IMHA. Evidence for these comorbidities has not been systematically evaluated, rendering evidence-based decisions difficult. We identified and extracted data from studies published in the veterinary literature and developed a novel tool for evaluation of evidence quality, using it to assess study design, diagnostic criteria for IMHA, comorbidities, and causality. Succinct evidence summary statements were written, along with screening recommendations. Statements were refined by conducting 3 iterations of Delphi review with panel and task force members. Commentary was solicited from several professional bodies to maximize clinical applicability before the recommendations were submitted. The resulting document is intended to provide clinical guidelines for diagnosis of, and underlying disease screening for, IMHA in dogs and cats. These should be implemented with consideration of animal, owner, and geographical factors.
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Affiliation(s)
- Oliver A Garden
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Linda Kidd
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California
| | - Angela M Mexas
- College of Veterinary Medicine, Midwestern University, Downers Grove, Illinois
| | - Yu-Mei Chang
- Royal Veterinary College, University of London, London, United Kingdom
| | - Unity Jeffery
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas
| | - Shauna L Blois
- Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Jonathan E Fogle
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Amy L MacNeill
- College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
| | - George Lubas
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Adam Birkenheuer
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina
| | - Simona Buoncompagni
- Internal Medicine Service, Central Oklahoma Veterinary Specialists, Oklahoma City, Oklahoma
| | - Julien R S Dandrieux
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Melbourne, Australia
| | - Antonio Di Loria
- Department of Veterinary Medicine and Animal Production, University of Napoli Federico II, Napoli, Italy
| | - Claire L Fellman
- Cummings School of Veterinary Medicine, Tufts University, Massachusetts
| | - Barbara Glanemann
- Royal Veterinary College, University of London, London, United Kingdom
| | - Robert Goggs
- College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Jennifer L Granick
- College of Veterinary Medicine, University of Minnesota, Saint Paul, Minnesota
| | - Dana N LeVine
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa
| | - Claire R Sharp
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Perth, Australia
| | | | - James W Swann
- Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom
| | - Balazs Szladovits
- Royal Veterinary College, University of London, London, United Kingdom
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Dorsey TI, Monaghan KN, Respess M, Labato MA, Babyak JM, Sharp CR, Rozanski EA, deLaforcade AM. Effect of urinary bladder lavage on in-hospital recurrence of urethral obstruction and durations of urinary catheter retention and hospitalization for male cats. J Am Vet Med Assoc 2019; 254:483-486. [DOI: 10.2460/javma.254.4.483] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Boyd CJ, Claus MA, Raisis AL, Cianciolo R, Bosio E, Hosgood G, Nabity M, Mori T, Barden A, Sharp CR, Smart L. Evaluation of biomarkers of kidney injury following 4% succinylated gelatin and 6% hydroxyethyl starch 130/0.4 administration in a canine hemorrhagic shock model. J Vet Emerg Crit Care (San Antonio) 2019; 29:132-142. [PMID: 30767375 DOI: 10.1111/vec.12814] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/20/2018] [Accepted: 01/24/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To investigate the association between synthetic colloids and biomarkers of acute kidney injury (AKI) in dogs with hemorrhagic shock. DESIGN Experimental interventional study. SETTING University. ANIMALS Twenty-four healthy ex-racing Greyhounds. INTERVENTIONS Anesthetized Greyhounds subjected to hemorrhage for 60 min were resuscitated with 20 mL/kg of fresh whole blood (FWB), 6% hydroxyethyl starch (HES) 130/0.4, 4% succinylated gelatin (GELO), or 80 mL/kg of isotonic crystalloid (CRYST) over 20 min (n = 6 per treatment). Concentrations of biomarkers of AKI were measured at baseline, end of hemorrhage, and at 40 (T60), 100 (T120), and 160 (T180) min after fluid bolus. Biomarkers included neutrophil gelatinase-associated lipocalin in urine and serum (uNGAL; sNGAL), and urine cystatin C (uCYSC), kidney injury molecule-1 (uKIM), clusterin (uCLUST), osteopontin, gamma-glutamyl transferase, monocyte chemoattractant protein-1 (uMCP), interleukin-6, interleukin-8, protein (uPROT), hyaluronan, and F2 -isoprostanes. Renal histology was scored for tubular injury and microvesiculation. Biomarker fold-change from baseline was compared between groups using mixed effects models (Bonferroni-Holm corrected P<0.05). Frequencies of histology scores were compared by Fisher's exact test. MEASUREMENTS AND MAIN RESULTS In dogs treated with GELO, uNGAL fold-change was markedly greater compared with all other groups at T60, T120, and T180 (all P<0.001), and uCYSC was greater at T60 compared with CRYST (P<0.001), and at T120 and T180 compared with all other groups (all P<0.001). Smaller, albeit significant, between-group differences in uKIM, uCLUST, uMCP, and urine protein concentration were observed across the FWB, GELO, and HES groups, compared with CRYST. The GELO group more frequently had marked tubular microvesiculation than the other groups (P = 0.015) although tubular injury scores were comparable. CONCLUSION In dogs with hemorrhagic shock, GELO was associated with greater magnitude increases in urine biomarkers of AKI and more frequent marked tubular microvesiculation, compared with FWB, CRYST, and HES.
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Affiliation(s)
- Corrin J Boyd
- School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - Melissa A Claus
- School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - Anthea L Raisis
- School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - Rachel Cianciolo
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH, USA
| | - Erika Bosio
- Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, WA, Australia.,Emergency Medicine, University of Western Australia, WA, Australia
| | - Giselle Hosgood
- School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - Mary Nabity
- Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, USA
| | - Trevor Mori
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, WA, Australia
| | - Anne Barden
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, WA, Australia
| | - Claire R Sharp
- School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia
| | - Lisa Smart
- School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia.,Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, WA, Australia.,Emergency Medicine, University of Western Australia, WA, Australia
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Sharp CR, Goggs R, Blais MC, Brainard BM, Chan DL, deLaforcade AM, Rozanski E. Clinical application of the American College of Veterinary Emergency and Critical Care (ACVECC) Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines to small animal cases. J Vet Emerg Crit Care (San Antonio) 2019; 29:121-131. [PMID: 30729652 DOI: 10.1111/vec.12804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 12/27/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To illustrate the application of the Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines to the management of dogs and cats at risk of developing thrombosis using a case-based approach. ETIOLOGY Dogs and cats become at risk of developing thrombosis from a wide range of conditions. These conditions often involve a specific insult followed by an inflammatory response and when combined with other contributing factors (eg, hypercoagulability, vascular endothelial injury, hemodynamic changes) create favorable conditions for thrombosis. DIAGNOSIS Development of thrombosis in small animals remains challenging to demonstrate. Compatible clinical signs, the presence of known risk factors, and supporting diagnostic tests may be highly suggestive of the development of thrombosis. THERAPY Therapeutic recommendations in accordance with the CURATIVE guidelines for dogs and cats are described in specific case vignettes presented. Discussion is centered on antithrombotic drug choices and dosing protocols, as outlined in Domains 2 and 3 of the CURATIVE guidelines. Where appropriate, guidelines related to therapeutic monitoring (Domain 4) and discontinuation of antithrombotics (Domain 5) were included. PROGNOSIS In small animals at risk of developing thrombosis, overall prognosis may be improved by following consensus-based recommendations on the use of antithrombotics as outlined in the CURATIVE guidelines. Whether such interventions have any impact on outcome requires further investigation.
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Affiliation(s)
- Claire R Sharp
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University, Murdoch, Australia
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY
| | - Marie-Claude Blais
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA
| | - Daniel L Chan
- Department Clinical Science and Services, The Royal Veterinary College, North Mymms, UK
| | - Armelle M deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
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Chan DL, Goggs R, Brainard BM, Blais MC, Sharp CR, deLaforcade A, Rozanski E. Safe and effective anticoagulation in small animals - Is that too much to ask? Long-awaited first steps. J Vet Emerg Crit Care (San Antonio) 2019; 29:9-11. [PMID: 30654414 DOI: 10.1111/vec.12803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 12/22/2019] [Accepted: 12/22/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Daniel L Chan
- Department of Clinical Science and Services, The Royal Veterinary College, London, United Kingdom
| | - Robert Goggs
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY
| | - Benjamin M Brainard
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, GA
| | - Marie-Claude Blais
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Claire R Sharp
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
| | - Armelle deLaforcade
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
| | - Elizabeth Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA
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Abstract
PRACTICAL RELEVANCE Prior to 1990 papillomaviruses (PVs) were not recognised to infect or cause disease in domestic cats. Since this time, the use of histology, immunohistochemistry and, more recently, molecular techniques has revealed that PVs almost certainly cause feline viral plaques and Bowenoid in situ carcinomas, oral papillomas and feline sarcoids. In addition, there is increasing evidence that PVs play a significant role in the development of feline cutaneous squamous cell carcinomas, one of the most common skin cancers of cats. Recent studies have also revealed that most cats are asymptomatically infected with PVs. This raises a critical question that is currently unanswered: why do only a small proportion of infected cats develop disease? In the future it may be possible to prevent PV-induced diseases by using a vaccine to prevent PV infection. Alternatively, novel therapies may be developed that prevent PVs from causing clinical disease by stimulating the host immune response. CLINICAL CHALLENGES A recognition of the skin diseases caused by PVs is important to more accurately predict disease progression. Unfortunately, there are currently no non-surgical treatments that have been proven to be beneficial in cats and clinical management of PV-induced skin disease in cats can be challenging. GLOBAL IMPORTANCE PVs have a worldwide distribution and negatively impact feline health and welfare globally. AUDIENCE This review is aimed at clinicians, especially those who regularly treat cats with skin disease. The review will also be useful to oncologists and researchers who have an interest in how cancer develops in cats. EVIDENCE BASE In producing this update the authors have drawn on recently published peer-reviewed literature.
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Affiliation(s)
- John S Munday
- School of Veterinary Science, Massey University, Palmerston North, 4410 New Zealand
| | - Claire R Sharp
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Australia
| | - Julia A Beatty
- University of Sydney, Faculty of Science, Sydney School of Veterinary Science, NSW 2006, Australia
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Abstract
PRACTICAL RELEVANCE New technologies capable of sequencing the genetic material in any given biological sample, combined with computer-based algorithms for sequence assembly and analysis, have revolutionised infectious disease research. The rate at which novel viruses are being discovered now exceeds our understanding of their clinical relevance. Novel viruses may contribute to diseases that are major causes of feline morbidity and mortality, including cancer and chronic kidney disease. The identification of new viral pathogens raises the prospect of not only improved patient outcomes through specific treatment but even disease prevention through viral control measures. CLINICAL CHALLENGES It can be difficult to determine the role of a novel virus in disease development. Disease may be an occasional outcome, often years after infection. A high prevalence of infection in the general population can make disease associations harder to identify and almost impossible to rule out. Host cofactors such as immune dysfunction, genetic background or coinfections may be required for manifestation of disease, and one virus species may be linked to a range of pathological sequelae. Establishing causality relies on evaluating accumulating evidence from multiple investigations, which is often hard to access by practitioners. GLOBAL IMPORTANCE The worldwide distribution of gammaherpesvirus and morbillivirus infections in domestic cats underlines the potential of these viruses to negatively impact feline health and welfare globally. EVIDENCE BASE This review relies on grade la-III evidence.
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Affiliation(s)
- Julia A Beatty
- 1 University of Sydney, Faculty of Science, Sydney School of Veterinary Science, NSW 2006, Australia
| | - Claire R Sharp
- 2 College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Australia
| | - W Paul Duprex
- 3 Department of Microbiology, Boston University School of Medicine, National Emerging Infectious Diseases Laboratories, Boston University, 620 Albany Street, Boston, Massachusetts, 02118, USA
| | - John S Munday
- 4 School of Veterinary Science, Massey University, Palmerston North, 4410, New Zealand
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Boyd CJ, Claus MA, Raisis AL, Hosgood G, Sharp CR, Smart L. Hypocoagulability and Platelet Dysfunction Are Exacerbated by Synthetic Colloids in a Canine Hemorrhagic Shock Model. Front Vet Sci 2018; 5:279. [PMID: 30483517 PMCID: PMC6243100 DOI: 10.3389/fvets.2018.00279] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/22/2018] [Indexed: 12/20/2022] Open
Abstract
Background: Hemorrhagic shock and volume replacement can alter coagulation. Synthetic colloids, hydroxyethyl starch (HES), and gelatin, may enhance hypocoagulability. Our primary objective was to describe the effect of four fluid products on coagulation in canine hemorrhagic shock. Our secondary objective was to compare measurements of coagulation during shock to baseline in all dogs. Methods: Anesthetized greyhounds subjected to atraumatic hemorrhage for 60 min were administered 20 mL kg−1 of either fresh whole blood (FWB), 6% HES 130/0.4, 4% succinylated gelatin (GELO), or 80 mL kg−1 of isotonic crystalloid over 20 min (n = 6 per group). Platelet closure time (PCT), rotational thromboelastometry (ROTEM) and plasma coagulation assays were measured at baseline, end of hemorrhage (shock), and 40 (T60), and 160 (T180) min after study fluid. ROTEM parameters included clotting time (CT), clot formation time (CFT), alpha angle, maximum clot firmness (MCF), lysis index at 60 min (LI60), and thrombodynamic potential index (TPI) for INTEM, EXTEM, FIBTEM (MCF only), and APTEM (LI60 only) profiles. Plasma coagulation assays included prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen concentration and activities of factor VII (FVII), factor VIII (FVIII), and von Willebrand Factor antigen (vWF). Between-group differences were tested using linear mixed models with post-hoc between-group comparisons (Bonferroni-Holm corrected). Differences between baseline and shock were tested using paired t-tests. Significance was set at P < 0.05. Results: GELO showed longer PCT at T60, compared with FWB and CRYST, and at T180, compared with all other groups. HES showed longer EXTEM CT at T60, compared with all other groups. HES showed lower INTEM and EXTEM MCF at T60 and lower INTEM MCF at T180, compared with FWB. Some plasma coagulation assays showed greater hypocoagulability with HES. Comparing shock to baseline, EXTEM CT, INTEM CFT, EXTEM CFT, PT, and FVIII significantly increased and PCT, INTEM CT, INTEM MCF, EXTEM MCF, EXTEM LI60, EXTEM TPI, FIBTEM MCF, APTT, fibrinogen, FVII, and vWF significantly decreased. Conclusions: In dogs with hemorrhagic shock, volume replacement with GELO caused mild platelet dysfunction and HES was associated with coagulation changes consistent with hypocoagulability, beyond effects of hemodilution. Shock alone produced some evidence of hypocoagulability.
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Affiliation(s)
- Corrin J Boyd
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University Perth, WA, Australia
| | - Melissa A Claus
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University Perth, WA, Australia
| | - Anthea L Raisis
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University Perth, WA, Australia
| | - Giselle Hosgood
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University Perth, WA, Australia
| | - Claire R Sharp
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University Perth, WA, Australia
| | - Lisa Smart
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University Perth, WA, Australia
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Hall KE, Boller M, Hoffberg J, McMichael M, Raffe MR, Sharp CR. ACVECC-Veterinary Committee on Trauma Registry Report 2013-2017. J Vet Emerg Crit Care (San Antonio) 2018; 28:497-502. [PMID: 30294833 DOI: 10.1111/vec.12766] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/12/2018] [Accepted: 09/10/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To report summative data from the American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma (VetCOT) registry. DESIGN Multi-institutional veterinary trauma registry data report. SETTING VetCOT identified veterinary trauma centers (VTCs). ANIMALS Dogs and cats with evidence of trauma presented to VTCs with data entered in the VetCOT registry September 1, 2013-March 31, 2017. INTERVENTIONS VetCOT created a standardized data collection methodology for dog and cat trauma. Data were input to a web-based data capture system (REDCap) by data entry personnel trained in data software use and operational definitions of data variables. Data on demographics, trauma type (blunt vs penetrating), preadmission care, hospitalization and intensive care requirement, trauma severity assessment at presentation (eg, modified Glasgow coma scale and animal trauma triage score), key laboratory parameters, necessity for surgical intervention, and case outcome were collected. Summary descriptive data for each species are reported. MEASUREMENTS AND MAIN RESULTS Twenty-nine VTCs in North America, Europe, and Australia contributed information from 17,335 dog and 3,425 cat trauma cases during the 42-month reporting period. A large majority of cases presented directly to the VTC after injury (80.4% dogs and 78.1% cats). Blunt trauma was the most common source for injury in cats (56.7%); penetrating trauma was the most common source for injury in dogs (52.3%). Note that 43.8% of dogs and 36.2% of cats were reported to have surgery performed. The proportion surviving to discharge was 92.0% (dogs) and 82.5% (cats). CONCLUSIONS The VetCOT registry proved to be a powerful resource for collection of a large dataset on trauma in dogs and cats seen at VTCs. While overall survival to discharge was quite high, further evaluation of data on subsets of injury types, patient assessment parameters, interventions, and associated outcome are warranted.
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Affiliation(s)
- Kelly E Hall
- American College of Veterinary and Emergency Critical Care Veterinary Committee on Trauma (ACVECC-VetCOT) (Chair), Stillwater, MN, 55082
| | - Manuel Boller
- the Faculty of Veterinary and Agricultural Sciences and the Translational Research and Clinical Trials (TRACTS) Group, University of Melbourne, Werribee, VIC, Australia
| | - Jayme Hoffberg
- Department of Emergency and Critical Care, MedVet Chicago, Chicago, IL, 60618
| | - Maureen McMichael
- Department of Biomedical & Translational Sciences, College of Veterinary Medicine, Carle-Illinois College of Medicine, University of Illinois, Urbana, IL, 61802
| | | | - Claire R Sharp
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University, Western Australia, Australia
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- American College of Veterinary and Emergency Critical Care Veterinary Committee on Trauma (ACVECC-VetCOT) (Chair), Stillwater, MN, 55082
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Abstract
We investigated the incidence of ex vivo incompatibility between ovine maternal RBC and fetal plasma. Time-mated singleton pregnant ewes (n = 8) underwent cesarean delivery of the fetus; at the time of delivery, paired maternal and fetal blood samples were collected and subsequently separated for storage as packed RBC and fresh frozen plasma. Gel column crossmatching was performed 3 to 4 wk later. All fetus-dam crossmatches were considered major crossmatches, combining fetal (recipient) plasma with dam (donor) RBC. The plasma of 8 fetuses was cross-matched with RBC from 5 dams; all autologous controls were negative, and all but one crossmatch (1 of 40, 2.5%) were considered compatible. In addition, the plasma of 3 dams was crossmatched with RBC from 5 dams; all autologous controls were negative; however, significant incompatibility was noted. In total, 4 of 13 (30.8%) dam-dam crossmatches were considered incompatible. The results of this initial study suggest that when a single animal receives multiple blood-product transfusions, the risk of an immunologic transfusion reaction can be reduced by ensuring that the blood products are obtained from a single donor, performing a crossmatch prior to transfusion, and the use of synthetic products to increase the oxygen carrying capacity of fetal blood.
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Affiliation(s)
- Gabrielle C Musk
- Animal Care Services, University of Western Australia, Crawley, Western Australia, Australia.
| | - Murray J Adams
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
| | - Haruo Usuda
- Division of Obstetrics and Gynaecology, University of Western Australia, Crawley, Western Australia, Australia
| | - Matthew W Kemp
- Division of Obstetrics and Gynaecology, University of Western Australia, Crawley, Western Australia, Australia
| | - Claire R Sharp
- School of Veterinary and Life Sciences, Murdoch University, Murdoch, Western Australia, Australia
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Martin EP, Mukherjee J, Sharp CR, Sinnott-Stutzman VB. Evaluation of the sterility of single-dose medications used in a multiple-dose fashion. Can Vet J 2017; 58:1187-1190. [PMID: 29089656 PMCID: PMC5640284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Bacterial proliferation was evaluated in single-dose medications used in a multi-dose fashion and when medications were intentionally inoculated with bacteria. Of 5 experimentally punctured medications, 1 of 75 vials (50% dextrose) became contaminated. When intentionally inoculated, hydroxyethyl starch and heparinized saline supported microbial growth. Based on these findings, it is recommended that hydroxyethyl starch and heparinized saline not be used in a multi-dose fashion.
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Abstract
We investigated the effect of pyometra on kaolin-activated thromboelastography (TEG). Eighteen client-owned dogs with pyometra and 8 healthy spayed dogs were recruited. TEG parameters and packed cell volume were determined. Results from spayed females and from intact females with pyometra were compared using a Student t-test and Wilcoxon rank sum test. Bitches with pyometra were hypercoagulable compared to spayed bitches as evidenced by elevated maximum amplitude, G, and alpha angle. There were no significant group differences in R time, K time, or clot lysis at 30 or 60 min. Dogs with pyometra should be anticipated to have hypercoagulable TEG variables, and this should be addressed when planning surgical and medical therapy.
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Affiliation(s)
- Tovah I Dorsey
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA (Dorsey, Rozanski, Babyak, de Laforcade)
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch, Australia (Sharp)
| | - Elizabeth A Rozanski
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA (Dorsey, Rozanski, Babyak, de Laforcade)
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch, Australia (Sharp)
| | - Claire R Sharp
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA (Dorsey, Rozanski, Babyak, de Laforcade)
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch, Australia (Sharp)
| | - Jonathan M Babyak
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA (Dorsey, Rozanski, Babyak, de Laforcade)
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch, Australia (Sharp)
| | - Armelle M de Laforcade
- Department of Clinical Sciences, Tufts Cummings School of Veterinary Medicine, North Grafton, MA (Dorsey, Rozanski, Babyak, de Laforcade)
- College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch, Australia (Sharp)
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Aona BD, Rush JE, Rozanski EA, Cunningham SM, Sharp CR, Freeman LM. Evaluation of echocardiography and cardiac biomarker concentrations in dogs with gastric dilatation volvulus. J Vet Emerg Crit Care (San Antonio) 2017; 27:631-637. [PMID: 28960715 DOI: 10.1111/vec.12667] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 02/07/2016] [Accepted: 03/30/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess abnormalities in concentrations of cardiac troponin I (cTnI), lactate, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in relation to arrhythmias, echocardiographic measurements, and survival in dogs with gastric dilatation volvulus (GDV). DESIGN Prospective observational study. SETTING University hospital. ANIMALS Twenty-two dogs with naturally occurring GDV. SAMPLES Concentrations of cTnI, plasma lactate, and NT-proBNP were recorded at presentation to the emergency room, the time closest to echocardiography, and the highest recorded concentrations during hospitalization. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Cardiac rhythms were categorized on a 0-4 scale (0 = no ventricular premature complexes [VPCs], 1 = single VPCs, 2 = bigeminy or trigeminy, 3 = couplets or triplets, and 4 = R-on-T phenomenon or ventricular tachycardia). Echocardiography was performed 6-18 hours postoperatively. Fifteen dogs had ventricular arrhythmias during hospitalization (Grade 1 [n = 9], Grade 4 [n = 6]). The highest recorded cTnI concentration was significantly higher in the dogs with Grade 4 (P = 0.002) or Grade 1 (P = 0.001) arrhythmias compared to dogs without arrhythmias. Plasma lactate was significantly correlated with left ventricular internal diameter in diastole (r = -0.52, P = 0.01) and systole (r = -0.57, P = 0.006), left ventricular free wall in diastole (LWDd, r = 0.59, P = 0.004), and interventricular septal thickness in diastole (IVDs, r = 0.65, P = 0.001). Dogs that did not survive to 1 week postdischarge (3/22) had a significantly thicker LVWd (P = 0.04) and IVSd (P = 0.05), and received significantly less fluids in the first 24 (P = 0.02) and 48 hours (P = 0.03) of hospitalization. CONCLUSIONS Concentrations of cTnI and NT-proBNP increased during hospitalization, but only cTnI concentrations were significantly higher in dogs with a higher arrhythmia grade. Additional research on the potential role of serial measurement of biomarkers in dogs with GDV is warranted.
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Affiliation(s)
- Brent D Aona
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536
| | - John E Rush
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536
| | - Elizabeth A Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536
| | - Suzanne M Cunningham
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536
| | - Claire R Sharp
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536
| | - Lisa M Freeman
- Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, 200 Westboro Road, North Grafton, MA, 01536
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Babyak JM, Weiner DE, Noubary F, Sharp CR. Prevalence of Elevated Serum Creatinine Concentration in Dogs Presenting to a Veterinary Academic Medical Center (2010-2014). J Vet Intern Med 2017; 31:1757-1764. [PMID: 28891088 PMCID: PMC5697188 DOI: 10.1111/jvim.14823] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 06/22/2017] [Accepted: 08/03/2017] [Indexed: 12/16/2022] Open
Abstract
Background The epidemiology of kidney disease is not extensively described in dogs. Hypothesis/Objectives To better understand the prevalence of elevated serum creatinine concentration in dogs. Animals Client‐owned dogs. Methods A retrospective, observational cross‐sectional study design was used. We made a dataset of 115,631 hospital visits of all dogs presenting from October 2010 to October 2014. We estimated the prevalence and risk of elevated serum creatinine, defined as >1.6 mg/dL, in evaluated dogs. Results Of 115,631 visits, 98,693 were outpatient visits and 16,938 were hospital admissions. Among outpatient visits, 9,983 (10.1%) had serum creatinine assessment (4,423 [44.3%] visits were first visits), whereas, among hospital admissions, 12,228 (60.0%) had at least 1 serum creatinine (7,731 [75.6%] admissions were first admissions). The prevalence of elevated serum creatinine concentration in all evaluated dogs was 11.5% (95% CI: 11.0%, 11.9%); 10.2% (95% CI: 9.6%, 10.8%) of inpatients and 12.9% (95% CI: 12.1%, 13.8%) of outpatients had elevated serum creatinine concentration. The relative risk (RR) of elevated serum creatinine concentration was significantly higher in geriatric dogs (outpatient RR 1.45 [95% CI: 1.23, 1.70], inpatient RR 1.43 [95% CI: 1.16, 1.76]) and lower in young dogs (outpatient RR 0.39 [95% CI: 0.26, 0.59], inpatient RR 0.44 [95% CI: 0.32, 0.62]) when compared to the measured population risk. Conclusions and Clinical Importance When selected for laboratory evaluation, the proportion of dogs presenting to an academic medical center with evidence of kidney injury is high compared to previous reports and might reflect a population of sicker dogs.
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Affiliation(s)
- J M Babyak
- Tufts Cummings School of Veterinary Medicine, North Grafton, MA
| | - D E Weiner
- Tufts University School of Medicine, Boston, MA.,Tufts Medical Center, Boston, MA.,Tufts Clinical and Translational Institute, Boston, MA
| | - F Noubary
- Tufts Clinical and Translational Institute, Boston, MA.,Tufts Sackler School of Biomedical Sciences, Boston, MA
| | - C R Sharp
- College of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
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Babyak JM, Sharp CR. Epidemiology of systemic inflammatory response syndrome and sepsis in cats hospitalized in a veterinary teaching hospital. J Am Vet Med Assoc 2017; 249:65-71. [PMID: 27308883 DOI: 10.2460/javma.249.1.65] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the epidemiology of the systemic inflammatory response syndrome (SIRS) and sepsis in cats hospitalized in a veterinary teaching hospital. DESIGN Observational study. ANIMALS 246 client-owned cats. PROCEDURES During a 3-month period, daily treatment records were evaluated for all hospitalized cats. Information extracted included signalment, temperature, heart rate, respiratory rate, diagnostic test results, diagnosis, duration of hospitalization, and outcome (survival or death). Cats were classified into 1 of 4 disease categories (sepsis [confirmed infection and SIRS], infection [confirmed infection without SIRS], noninfectious SIRS [SIRS without a confirmed infection], and no SIRS [no SIRS or infection]). RESULTS Of the 246 cats, 26 and 3 were hospitalized 2 and 3 times, respectively; thus, 275 hospitalizations were evaluated. When SIRS was defined as the presence of ≥ 2 of 4 SIRS criteria, 17 cats had sepsis, 16 had infections, 81 had noninfectious SIRS, and 161 were classified in the no SIRS category at hospital admission. The prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. Four cats developed sepsis while hospitalized, resulting in a sepsis incidence rate of 1.5 cases/100 hospital admissions. Four of 17 cats with sepsis at hospital admission and 3 of 4 cats that developed sepsis while hospitalized died or were euthanized, resulting in a mortality rate of 33.3% for septic cats; 239 hospitalizations resulted in survival, 28 resulted in euthanasia, and 8 resulted in death. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that many hospitalized cats have evidence of SIRS and some have sepsis. In cats, sepsis is an important clinical entity with a high mortality rate.
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Sharp CR, Nambulli S, Acciardo AS, Rennick LJ, Drexler JF, Rima BK, Williams T, Duprex WP. Chronic Infection of Domestic Cats with Feline Morbillivirus, United States. Emerg Infect Dis 2016; 22:760-2. [PMID: 26982566 PMCID: PMC4806961 DOI: 10.3201/eid2204.151921] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Cummings KA, Abelson AL, Rozanski EA, Sharp CR. The effect of storage on ammonia, cytokine, and chemokine concentrations in feline whole blood. J Vet Emerg Crit Care (San Antonio) 2016; 26:639-45. [DOI: 10.1111/vec.12510] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 12/12/2014] [Accepted: 01/22/2015] [Indexed: 02/04/2023]
Affiliation(s)
- Katherine A. Cummings
- Department of Clinical Sciences, Cummings School of Veterinary Medicine; Tufts University; North Grafton MA 01536
| | - Amanda L. Abelson
- Department of Clinical Sciences, Cummings School of Veterinary Medicine; Tufts University; North Grafton MA 01536
| | - Elizabeth A. Rozanski
- Department of Clinical Sciences, Cummings School of Veterinary Medicine; Tufts University; North Grafton MA 01536
| | - Claire R. Sharp
- Department of Clinical Sciences, Cummings School of Veterinary Medicine; Tufts University; North Grafton MA 01536
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Redavid LA, Sharp CR, Mitchell MA, Beckel NF. Hyperlactatemia and serial lactate measurements in sick cats. J Vet Emerg Crit Care (San Antonio) 2016; 26:495-501. [PMID: 27305468 DOI: 10.1111/vec.12496] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 02/26/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To document the incidence of hyperlactatemia in sick cats hospitalized for emergency care and to evaluate the prognostic utility of serial lactate measurements in cats with hyperlactatemia. DESIGN Prospective observational study over a 10-month period (July 2010-May 2011). SETTING Private veterinary referral center with 24-hour hospital care. ANIMALS One hundred and twenty-three privately owned cats admitted to a private referral center. INTERVENTIONS Blood was collected by direct venipuncture from the jugular or medial saphenous vein at the time of hospital admission and at 6 and 24 hours following admission. MEASUREMENTS AND MAIN RESULTS The median plasma lactate concentration for all cats at admission (T0) was 1.89 mmol/L (17.0 mg/dL) (range: 0.3-12.48). Twenty-three percent (28/123) of cats admitted were hyperlactatemic (ie, >2.87 mmol/L; >25.86 mg/dL) upon admission. Lactate concentration at presentation and serial lactate measurements were not found to be related with survival to discharge or correlated with duration of hospitalization. The overall survival rate of all cats in this study was 81%. CONCLUSIONS This study demonstrated that the incidence of hyperlactatemia in sick cats being admitted for hospitalization in a private referral center was 23%, and that lactate concentration on admission and serial lactate measurements over time were not prognostic in this group of hospitalized cats. Future studies are needed to evaluate the prognostic utility of lactate and serial lactate measurements in specific disease states and in a larger population of critically ill cats.
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Affiliation(s)
- Lesleigh A Redavid
- Emergency and Critical Care Service, New England Animal Medical Center, 595 West Center Street, West Bridgewater, MA, 02379
| | - Claire R Sharp
- Section of Emergency and Critical Care, Department of Veterinary Clinical Sciences, Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, MA, 01536
| | - Mark A Mitchell
- Department of Veterinary Clinical Sciences, University of Illinois College of Veterinary Medicine, 1008 W. Hazelwood Drive, Urbana, IL, 61802
| | - Nicole F Beckel
- Emergency and Critical Care Service, New England Animal Medical Center, 595 West Center Street, West Bridgewater, MA, 02379
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