Comprehensive health assessment of green turtles Chelonia mydas nesting in southeastern Florida, USA

Important indicators of population health needed for large-scale sea turtle population recovery efforts include demographics, disease and mortality trends, condition indices, and baseline blood data. With this comprehensive health assessment of adult female green sea turtles Chelonia mydas nesting on Juno Beach, Florida, USA, we (1) established comprehensive baseline health indices; (2) identified individuals with evidence of infection by chelonid alphaherpesviruses 5 and 6 (ChHV5, ChHV6), which are implicated in fibropapillomatosis and respiratory and skin disease, respectively; and (3) compared measured health indices between turtles that did versus those that did not test positive for ChHV5 and/or ChHV6. All 60 turtles included in the study were in good body condition with no external fibropapillomatosis tumors. Hematological and biochemical reference intervals were established. Via quantitative PCR (qPCR), 5/60 turtles (8%) tested positive for ChHV5, and all turtles were negative for ChHV6. Of 41 turtles tested for antibodies to ChHV5 and ChHV6, 29% and 15% tested positive, respectively, and 10% tested positive for antibodies to both viruses. Notably, there were no statistically significant differences between health variables for nesting turtles that tested positive for ChHV5 DNA versus those that tested negative; and also no differences between turtles that tested positive for ChHV5 or ChHV6 antibodies and those that did not. This suggests that these viruses are enzootically stable in Florida’s adult green turtles. This study provides a health profile of nesting green turtles in southeastern Florida applicable to temporal and spatial investigations of this and other populations.

Histopathologic Changes, Ultrastructure, and Molecular Characterization of an Adenovirus in a Sun Conure (Aratinga solstitialis)

In this case report, we describe the pathologic changes and the ultrastructural and molecular characteristics of an adenovirus in a sun conure (Aratinga solstitialis) that presented with a history of sudden death. On histologic examination, there was multifocal hepatic and splenic necrosis. Within some hepatocytes and unidentified cells in the spleen, renal interstitial fibroblasts, and ovarian stroma were intranuclear amphophilic inclusion bodies. Electron microscopy of affected tissue showed intranuclear icosahedral viral particles with an inner capsid (29.2-33.8 nm in diameter) and an outer capsid (70.2-71.7 nm in diameter). Next-generation sequencing and BLAST analysis of complementary DNA synthesized from RNA extracted from formalin-fixed tissues showed an adenovirus, designated sun conure adenovirus (SCAdv). A DNA in situ hybridization (ISH) probe, constructed from the SCAdv and similar sequences from GenBank, was also positive in the intranuclear inclusion bodies, whereas standard ISH for psittacine adenovirus 1 was negative. These results show that ancillary diagnostic testing, such as next-generation sequencing, even using formalin-fixed, paraffin-embedded tissues, along with ISH, can be useful in identifying additional, unknown viruses that show similar pathology to commonly known viruses but do not show up as positive on routine diagnostic tests.

Spontaneous haemorrhage from a left gastric artery aneurysm as a cause of acute abdominal pain

Visceral artery aneurysms are rare, with a reported incidence of less than 2% in the general population. ^1,2 Aneurysms of the left gastric artery are particularly uncommon, accounting for 4% of all visceral aneurysms. ^3,4 Although the majority are discovered incidentally and can be managed conservatively, prompt treatment of those ruptured or at risk of rupture is crucial to reduce the associated morbidity. Increasing awareness of visceral artery aneurysms as a cause of spontaneous intraperitoneal haemorrhage will improve early recognition and impact on survival. We present a rare case of spontaneous rupture of a left gastric artery aneurysm.

Pharmacokinetics and pharmacodynamics of A77 1726 and leflunomide in domestic cats

The pharmacokinetics and pharmacodynamics of A77 1726 and leflunomide after intravenous (i.v.) and oral (p.o.) administration were evaluated in adult cats. Three treatments were administered: a single i.v. dose of A77 1726 (4 mg/kg), a single oral dose of leflunomide (4 mg/kg), and multiple oral doses of leflunomide (2 mg/kg). Mean pharmacokinetic parameter values after a single i.v. dose of A77 1726 were distribution (A) and elimination (B) intercepts (15.2 μg/mL and 34.5 μg/mL, respectively), distribution and elimination half-lives (1.5 and 71.8 h, respectively), area under the curve (AUC(0 → ∞); 3723 μg*h/mL), mean residence time (MRT; 93 h), clearance (Cl(obs); 1.1 mL/kg/h), and volume of distribution at steady state (Vd(ss); 97 mL/kg). Mean pharmacokinetic parameter values after a single oral dose of leflunomide were absorption and elimination rate constants (0.3 1/h and 0.01 1/h, respectively), absorption and elimination half-lives (2.3 and 59.1 h, respectively), AUC(0 → ∞) (3966 μg*h/mL), and maximum observed plasma concentration (C(max); 38 μg/mL). The bioavailability after a single oral dose of leflunomide was 100%. The mean ± SD A77 1726 concentration that inhibited 50% lymphocytes (EC(50) ) was 16 ± 13.5 μg/mL. The mean ± SD maximum A77 1726 concentration (EC(max)) was 61.0 ± 23.9 μg/mL.

Histopathologic findings and classification of feline renal transplants

Seventy-seven feline transplant kidney specimens, obtained from 1 to 3,183 days (9 years) after transplantation, were reevaluated histologically and classified on the basis of the Banff '97 guidelines for human renal transplant kidneys. Overall, this classification system appeared useful in detecting rejection reactions and confirmed the finding in humans that biopsies can diagnose subclinical rejection and therefore are an important diagnostic tool for the follow up of renal transplants. However, on the basis of serum creatinine values, the severity of the acute or active and chronic lesions was not accurately reflected by this scoring system. This is thought to be due to the significant differences in histologic rejection patterns, especially in acute or active rejection, in cats when compared with humans. Tubulitis, lymphocytic glomerulitis, and vasculitis, which are the main pillars of the Banff '97 acute or active rejection scoring system, are either rare or not found in cats. The presence of significant necrotizing glomerulitis and vasculitis in feline renal transplants might imply that the rejection is complicated by acute antibody-mediated rejection. Alternatively, cyclosporine toxicity also should be considered because some of these kidneys show other signs of cyclosporine toxicity. Finally, the significance of subcapsular and interlobular phlebitis, rarely described in human rejection reactions but a distinct entity in cats, is unknown. From this study, it is clear that there are significant differences in the histology of acute or active rejection between humans and cats and that a better understanding of the histologic appearance of renal allografts will be especially beneficial for treatment and prognostic purposes.

Disposition of cyclosporine after intravenous and multi-dose oral administration in cats

The aim of this study was to evaluate the disposition of cyclosporine after intravenous (i.v.) and oral administration and to evaluate single sampling times for therapeutic monitoring of cyclosporine drug concentrations in cats. Six adult male cats (clinically intact) were used. Two treatments consisting of a single i.v. cyclosporine (1 mg/kg) and multiple oral cyclosporine (3 mg/kg b.i.d p.o. for 2 weeks) doses. Whole blood cyclosporine concentrations were measured at fixed times by high performance liquid chromatography and pharmacokinetic values were calculated. Mean values for the i.v. data included AUC (7413 ng/mL.h), t1/2 distribution and elimination (0.705 and 9.7 h, respectively), Cmax (1513 ng/mL), and Vd(ss) (1.71 L/kg). Mean values for the oral data included AUC (6243 ng/mL.h), t1/2 of absorption and elimination (0.227 and 8.19 h, respectively), and Cmax (480.0 ng/mL). Bioavailability of orally administered cyclosporine was 29 and 25% on days 7 and 14 respectively. Whole blood comment cyclosporine concentration 2 h after administration (C2) better correlated with AUC on days 7 and 14 than trough plasma concentration (C12). The rate of oral cyclosporine absorption was less than expected and there was substantial individual variation. Therapeutic drug monitoring strategies for cyclosporine in cats should be re-evaluated.

Diagnostic predictors of complications and survival after renal transplantation in cats

OBJECTIVE

To identify preoperative diagnostic results that predict postoperative complications and survival in feline renal-transplant recipients.

STUDY DESIGN

Retrospective clinical study.

ANIMALS

Sixty-one feline renal allograft recipients.

METHODS

Medical records for 61 consecutive cats that underwent renal allograft transplantation between January 1, 1996, and December 1, 1999, were reviewed. Age, diagnosis, body weight, body condition score, preoperative medical treatment, systolic blood pressure, packed cell volume, biochemical parameters at admission and at the time of surgery, postoperative complications, and postoperative survival were recorded. Associations of preoperative data with the occurrence of postoperative complications were determined using logistic regression. Postoperative survival was graphed using a Kaplan-Meier cumulative-survival plot. Associations of covariates with postoperative survival were analyzed using Cox proportional hazards analysis.

RESULTS

Two parameters were significantly associated with occurrence of postoperative central nervous system (CNS) disorders: blood urea nitrogen concentration (odds ratio = 1.083; 95% CI = 1.018 to 1.148) and serum creatinine concentration (odds ratio = 1.8; 95% CI = 1.413 to 2.187) at the time of surgery. Postoperative survival 6 months after transplantation was 59%, though 3-year survival remained at 42%. Of all covariates investigated, only recipient age (relative hazard = 1.183; 95% CI = 1.039 to 1.334) was significantly associated with survival.

CONCLUSION AND CLINICAL RELEVANCE

Standard measures of preoperative renal dysfunction do not predict postoperative survival in cats after renal transplantation, although an increase in the degree of preoperative azotemia is associated with an increased risk of CNS disorders after surgery. Increased recipient age is associated with decreased survival after renal transplantation.

Fluvastatin in combination with rad significantly reduces graft vascular disease in rat cardiac allografts

BACKGROUND

RAD is a potent immunosuppressive agent that has been shown to be effective in preventing acute and chronic allograft rejection in animal models. The HMGCoA reductase inhibitors have been found to reduce the incidence of graft vascular disease (GVD) in heart transplant patients and in animal models. This study was designed to investigate the effects of fluvastatin or pravastatin in a rodent model of GVD produced using low doses of RAD to prevent acute rejection.

METHODS

Hearts from Fisher 344 rats were heterotopically transplanted to Lewis rat recipients. RAD was administered orally at 0.5 mg/kg per day for days 0 to 14 and then 0.25 mg/kg per day for an additional 85 days to prevent acute rejection but allow for the development of GVD. Pravastatin (20 mg/kg per day) or fluvastatin (2 or 6 mg/kg per day) was added to the RAD treatment. At the end of a 100-day treatment period, the hearts were harvested for morphometric and histopathologic examinations.

RESULTS

Rats treated with fluvastatin, at either dose, had a significant (P< or =0.0239) decrease in coronary arterial intimal thickening (GVD) of approximately 43%. Rats treated with pravastatin had a 22% reduction in GVD that did not reach statistical significance. Treatment with fluvastatin, but not pravastatin, decreased the degree of endomyocardial mononuclear cell infiltration seen with RAD administered alone.

CONCLUSIONS

Fluvastatin significantly decreased GVD in a rat model produced using low-dose RAD immunosuppression. To a lesser extent, pravastatin also decreased GVD in this model. These data lend further support for the study of fluvastatin, pravastatin, and other HMG-CoA reductase inhibitors for the prevention of GVD in cardiac transplant patients.

Detection and confirmation of reptilian adenovirus infection by in situ hybridization

Adenovirus infections are documented in at least 12 different species of reptiles. In contrast to their mammalian and avian counterparts reptilian adenoviruses are not well characterized as to their pathogenic potential and their ability to cause primary disease. In the diagnostic setting, fresh tissues are often not available for virus isolation, and the confirmation of reptilian adenovirus infections is dependent largely upon electron microscopy for the identification of intranuclear viral inclusions associated with histopathologic changes. The diagnosis of adenovirus infection in 2 different species of snake was confirmed by the application of DNA in situ hybridization. Using an aviadenovirus specific oligoprobe, adenoviral DNA was observed in the nuclei of hepatocytes, Kupffer cells, endothelial cells, and enterocytes. Electron microscopy of the liver confirmed the presence of intranuclear viral particles morphologically consistent with an adenovirus. DNA in situ hybridization on formalin-fixed tissues can serve as a suitable alternative to electron microscopy in the diagnosis of reptilian adenovirus infections. Both affected snakes had other concurrent diseases, suggesting that the adenovirus may not have been the primary pathogen.

Evaluation of a portocaval venograft and ameroid ring for the occlusion of intrahepatic portocaval shunts in dogs

OBJECTIVE

To evaluate the use of a portocaval venograft and ameroid constrictor in the surgical management of intrahepatic portosystemic shunts (PSS).

STUDY DESIGN

Prospective, clinical study.

ANIMAL POPULATION

Ten client-owned dogs with intrahepatic PSS.

METHODS

Portal pressure was measured after temporary suture occlusion of the intrahepatic PSS. In dogs with an increase in portal pressure greater than 8 mm Hg, a single extrahepatic portocaval shunt was created using a jugular vein. An ameroid ring was placed around the venograft and the intrahepatic PSS was attenuated. Transcolonic pertechnetate scintigraphy was performed before surgery, 5 days after surgery, and 8 to 10 weeks after surgery. Dogs with continued portosystemic shunting were evaluated further by laparotomy or portography. Clinical outcome and complications were recorded.

RESULTS

Mean (+/- SD) portal pressure increased from 6 +/- 3 to 19 +/- 6 mm Hg with PSS occlusion; in all 10 dogs, the increase in portal pressure was greater than 8 mm Hg. There were no intraoperative complications, and, after creation of the portocaval shunt, the intrahepatic PSS could be completely ligated in 8 of 10 dogs. The final portal pressure was 9 +/- 4 mm Hg. Postoperative complications included coagulopathy and death (1 dog), ascites (3 dogs), and incisional discharge (3 dogs). Five of 8 dogs had continued portosystemic shunting at 8 to 10 weeks after surgery. Multiple extrahepatic PSS were demonstrated in 4 of these dogs. Clinical outcome was excellent in all 9 surviving dogs.

CONCLUSIONS AND CLINICAL SIGNIFICANCE

The surgical technique resulted in a high incidence of multiple extrahepatic PSS. Short-term clinical results were promising, but long-term outcome must be evaluated further.

Comparison of the in vitro antiproliferative effects of five immunosuppressive drugs on lymphocytes in whole blood from cats

OBJECTIVE

To compare the in vitro immunosuppressive effects of cyclosporine and 4 novel immunosuppressive drugs on lymphocytes in whole blood collected from healthy cats.

SAMPLE POPULATION

Whole blood samples collected from 10 healthy adult domestic shorthair cats.

PROCEDURE

Mitogen-stimulated lymphocyte proliferation in whole blood incubated with and without various concentrations of cyclosporine, tacrolimus, sirolimus, mycophenolic acid (MPA), or A771726 was measured by use of [3H]thymidine incorporation. Drug concentrations that resulted in a 50% inhibition of mitogen-induced proliferation (IC50) were calculated. Lymphocyte viability was determined by use of the trypan blue dye exclusion method.

RESULTS

An obvious dose-response relationship for the antiproliferative effects of each drug was detected. Mean IC50 determined with concanavalin A was 46 nM for cyclosporine, 9 nM for tacrolimus, 12 nM for sirolimus, 16 nM for MPA, and 30 mM for A771726, whereas with pokeweed mitogen, mean IC50 was 33 nM for cyclosporine, 5 nM for tacrolimus, 15 nM for sirolimus, 14 nM for mycophenolic acid, and 25 mM for A771726. Mitogen-stimulated and nonstimulated lymphocytes remained viable, regardless of drug evaluated.

CONCLUSIONS AND CLINICAL RELEVANCE

Tacrolimus, sirolimus, MPA, and A771726 inhibited in vitro mitogen-stimulated proliferation of feline lymphocytes in a dose-dependent manner. These novel immunosuppressive drugs may be useful for management of immune-mediated inflammatory diseases and prevention and treatment of rejection in cats that undergo organ transplantation.

A functional model for whole limb transplantation in the rat

To develop a functional model for the study of whole limb transplantation, inbred Lewis rats were used as both donors and recipients. In this model, the recipient biceps femoris muscle was elevated from its distal attachment to preserve part of the adductor function of the limb after surgery. The tibial, peroneal, and sural branches of the sciatic nerve were anastomosed separately to provide faster and more precise functional recovery. For control sensory evaluation, the saphenous branches of the femoral nerve were not reattached. A flat intramedullary pin stabilized with methyl methacrylate was used to rigidly immobilize the femur. The transplanted limbs started bearing weight at 17 to 22 days. Walking on the plantar surface of the hock and adduction of the toes gradually decreased, and the rats developed a normal walking pattern. Sciatic and tibial function indexes, based on walking track analysis, correlated well with clinical observations. In this study, a new model for limb transplantation was developed that provided good and reliable sensory and ambulatory recovery.

Renal transplantation in cats

Feline renal transplantation can offer long-term survival with a normal quality of life for cats with renal failure. However, it is important to remember that renal transplantation is a treatment option and not a cure. Renal transplantation is never performed on an emergency basis or prophylactically. Feline renal transplantation requires special microvascular instruments and an operating microscope. Careful patient selection and perioperative monitoring have improved the success rate. The new microemulsified form of cyclosporine is recommended for immunosuppression. As survival times have steadily improved, long-term complications, such as diabetes and neoplasia, are now being recognized.

Management of hypertension controls postoperative neurologic disorders after renal transplantation in cats

OBJECTIVES

To determine the prevalence and describe the management of hypertension and central nervous system (CNS) complications after renal transplantation in cats. We also compared the prevalence of CNS complications between cats monitored and treated for postoperative hypertension and a previously described, historical control group of cats not monitored or treated for postoperative hypertension.

STUDY DESIGN

Retrospective clinical study.

ANIMALS OR SAMPLE POPULATION

A total of 34 client-owned cats that received renal allografts for the treatment of end-stage renal failure.

METHODS

Medical records were reviewed. Data obtained included preoperative and postoperative systolic blood pressures, antihypertensive therapy, response to treatment, neurologic signs, and clinical outcome. The results were compared with a historical control group of feline renal allograft recipients that were neither monitored nor treated for postoperative hypertension.

RESULTS

Severe postoperative hypertension occurred in 21 of 34 of cats. Hypertension was treated in all 21 cats with subcutaneously administered hydralazine which reduced systolic blood pressure to less than 170 mm Hg in 15 minutes in 20 of 21 cats; hydralazine produced hypotension in one cat and failed to control hypertension in 1 cat. After transplantation, seizures were observed in one cat and other neurologic complications (stupor, ataxia, and central blindness) were observed in three cats. The prevalence of seizures and neurologic complication-related deaths after transplantation was significantly reduced with treatment of postoperative hypertension.

CONCLUSIONS AND CLINICAL RELEVANCE

Hypertension is a major contributing factor to postoperative seizure activity after renal transplantation in cats; treatment of hypertension reduces the frequency of neurologic complications.

Comparison of two surgical techniques for renal transplantation in cats

OBJECTIVE

To compare two surgical techniques for renal transplantation in cats with respect to graft warm ischemia time, total surgical time, operative and postoperative complications, and return to normal renal function based on measurement of plasma creatinine concentrations.

STUDY DESIGN

Research study using normal cats.

ANIMALS OR SAMPLE POPULATION

Fourteen adult, feline leukemia virus and feline immunodeficiency virus (FELV/FIV) negative, neutered male and spayed female cats.

MATERIALS AND METHODS

Fourteen cats underwent heterotopic renal isograft transplantation with nephrectomy of the contralateral kidney. Renal arterial end-to-end anastomosis to the external iliac artery was performed in eight cats and renal arterial end-to-side anastomosis to the aorta was performed in six cats. Cats were monitored for 14 days after surgery. Renal function was evaluated by daily measurement of plasma creatinine concentrations. The cats' health was assessed by the daily recording of body weight, rectal temperature, postoperative complications, urine production, appetite, packed red blood cell volume, and total serum protein. Ultrasonographic assessment of the isograft was performed every third day. Animals were euthanatized or adopted 14 days after surgery and histopathologic analysis of biopsies or whole isograft tissues was performed.

RESULTS

Nine of fourteen cats survived the 14-day study period. Although not statistically significant, mean total surgical time and graft warm ischemia time was shorter for the arterial end-to-side anastomosis. Mean daily plasma creatinine concentrations were not significantly different between the two groups. Five of eight cats (62%) undergoing the arterial end-to-end technique developed neuropraxia and lameness of the ipsilateral pelvic limb. Five cats died or were euthanatized because of other complications.

CONCLUSIONS AND CLINICAL RELEVANCE

The arterial end-to-side technique appears to be the better method for renal transplantation in cats. Shorter graft warm ischemia and total surgical times, absence of pelvic limb complications, and an adequate return to normal renal function were associated with this technique.

Acute toxoplasmosis following renal transplantation in three cats and a dog

Three cats and 1 dog that had undergone renal transplantation because of end-stage renal disease were examined because of complications 3 to 6 weeks after surgery. One cat died prior to treatment of the complications; Toxoplasma cysts were found in sections of the renal allograft, and Toxoplasma tachyzoites were found in other organs. The other 2 cats and the dog died despite treatment, and protozoal cysts, as well as tachyzoites, were identified in other organs but not within the allografts, suggesting that reactivation of latent infection following immunosuppression was the most likely cause of disseminated toxoplasmosis. These cases illustrate that toxoplasmosis can be a fatal complication in renal transplant recipients. We currently recommend that feline and canine donors and recipients undergo serologic testing for toxoplasmosis prior to surgery. In addition, we suggest that seropositive donors not be used for seronegative recipients and that seropositive recipients and that seropositive recipients be monitored closely after surgery for clinical signs of toxoplasmosis.

Ultrasonographic evaluation of renal autografts in normal cats

The purpose of this study was to determine changes in resistive index (RI) and renal size that occur in normal feline kidney autografts in the immediate post-transplant period. Qualitative changes in renal parenchymal echogenicity and pelvic dilation were also noted, although this was not a major focus of the study. Fourteen domestic short-haired cats underwent bilateral nephrectomies followed by an autograft of the right kidney to either the aorta or external iliac artery. Due to post-operative complications, only nine of these cats completed the study. Ultrasonographic determination of the RI and renal size was made before transplantation and on days 1, 4, 7, 10, and 13 following transplantation. No significant changes in renal RI were identified during the study. Renal size increased significantly, peaking at 63% above baseline on day 7, and stayed elevated at 50% above baseline on day 13. There was no evidence of rejection or other abnormalities found on histologic evaluation of the transplanted kidneys. It was concluded that the RI of normal feline renal autografts does not significantly change in the immediate post-operative period. However, significant renal enlargement, likely due to a combination of post-operative edema and hypertrophy, does occur. This study provides baseline information for comparison with feline allografts in the immediate post-transplant period.

Ionized and total serum magnesium concentrations in feline renal transplant recipients

OBJECTIVE

To measure the blood concentrations of total and ionized serum magnesium in feline renal transplant recipients and to determine if there was a correlation between these concentrations and the development of neurological disorders after renal transplantation.

STUDY DESIGN

Prospective clinical study.

ANIMALS

Fourteen client-owned cats undergoing renal transplantation as a treatment for renal failure. Ten healthy adult cats were used to establish normal electrolyte concentrations.

METHODS

Total and ionized serum magnesium as well as potassium and ionized calcium concentrations were measured in 14 renal transplant recipients at five intervals: preoperatively; immediately postoperatively; and 24, 48, and 120 hours postoperatively. The mean values from all 14 cats over each time interval were compared with the normal range. The serum concentration of these electrolytes, particularly magnesium, was evaluated in relation to the occurrence of neurological complications.

RESULTS

Ninety-four percent of all ionized serum magnesium concentrations measured in clinical patients were below normal. Ninety percent of all total serum magnesium concentrations were within the normal range, and no cats had abnormally low total serum magnesium concentrations at any time. All clinical patients were hypocalcemic at all intervals. Sixty-six percent of all serum potassium concentrations were below normal. One cat in the study group experienced neurological problems, including seizures, in the immediate postoperative period. The signs appeared to be related to hypertension and responded to appropriate therapy. All electrolyte concentrations in this cat, including ionized magnesium, were within the same range of values as other clinical patients.

CONCLUSIONS

Ionized serum magnesium concentrations are decreased in feline renal transplant recipients in the perioperative period; however, hypomagnesemia would not appear to be directly related to the development of neurological disorders. None of the study patients were hypomagnesemic when total serum magnesium concentrations were measured over the same intervals. In addition, ionized serum calcium concentrations and serum potassium concentrations are below normal in the perioperative period.

CLINICAL SIGNIFICANCE

The specific clinical significance of these abnormalities is unknown. It is possible that the profound weakness and depression that is commonly seen in feline renal transplant recipients in the immediate postoperative period may be improved by supplementation with these electrolytes. Further work is needed to understand the implications of these abnormalities.

Intestinal lesions in a horse associated with eastern equine encephalomyelitis virus infection

The primary lesions of eastern equine encephalomyelitis (EEE) virus infection in the horse are limited to the brain and spinal cord. Intestinal lesions in addition to the changes in the central nervous system were found in a 6-month-old male Tennessee Walking Horse. One week prior to death, this colt was vaccinated for EEE virus, western equine encephalomyelitis virus, influenza virus, equine rhinopneumonitis virus, and tetanus. The clinical signs consisted of ataxia and rear-end weakness, with a body temperature of 102.8 F. Gross lesions consisted of yellowish discoloration, swelling, edema, and hemorrhage of the brain stem and dark discoloration of the gray matter of the spinal cord. Microscopic lesions in the small intestine were mainly in the muscular layer and consisted of multifocal areas of myonecrosis and lymphomonocytic infiltration with a few focal areas of mild fibrous connective tissue proliferation. Occasional focal mild perivascular lymphocytic infiltration was observed in the submucosa. Lesions in the brain and spinal cord consisted of widespread areas of perivascular lymphomonocytic cuffing, focal areas of necrosis, neutrophilic infiltration, hemorrhage, neuronal degeneration, and gliosis. Hepatic changes consisted of periportal lymphocytic infiltration and mild vacuolar degeneration of hepatocytes. EEE virus was isolated from the intestine and detected by DNA in situ hybridization.

Renal transplants in cats: 66 cases (1987-1996)

OBJECTIVE

To document the morbidity and survival time after renal transplants in cats with end-stage renal failure.

DESIGN

Retrospective case series.

ANIMALS

66 cats that had renal transplants.

PROCEDURE

Information regarding signalment, history, diagnostic testing, and postoperative morbidity and mortality was retrieved from medical records of cats with renal failure that had renal transplants at the University of California School of Veterinary Medicine between 1987 and 1996.

RESULTS

47 of 66 (71%) cats that had renal transplants survived until discharge. Nineteen cats died in the perioperative period. Most common causes of death were seizure-related complications (7 cats) and renal pedicle complications (4). One discharged cat was unavailable for follow-up monitoring. Of the 46 cats discharged and available for follow-up monitoring, 28 died. Most common causes of death in these cats were renal complications (9 cats) and death related to immunosuppression (8; mean and median survival times, 15 and 12 months, respectively). Of the 18 cats that were still living at the time this report was written, mean and median survival times were 26 and 22 months, respectively.

CLINICAL IMPLICATIONS

Renal transplantation resulted in long-term survival of many cats that would have otherwise died from, or have been euthanatized as a result of, renal failure. Problems with ureteral obstruction can be minimized. Postoperative CNS disorders were the most prevalent complication.

Selective alterations of cerebrospinal fluid amino acids in dogs with congenital portosystemic shunts

Numerous studies suggest that modifications in concentrations of both excitatory and inhibitory amino acids are implicated in the pathophysiology of portal-systemic encephalopathy (PSE), a neuropsychiatric disorder associated with chronic liver disease in humans. In this study, amino acid levels were measured by High Performance Liquid Chromatography (HPLC) in Cerebrospinal Fluid (CSF) of 10 dogs (age range: 3 mo.- 3 yr 4 mo.) exhibiting a congenital portal-systemic shunt, either intra or extra-hepatic, and 8 age-matched control dogs who showed no signs of hepatic or neurologic disorders. Dogs with congenital shunts manifested signs of encephalopathy such as disorientation, head pressing, vocalization, depression, seizures and coma. CSF from dogs with congenital shunts contained significantly increased amounts of glutamate (2 to 3-fold increase, p<0.01), glutamine (6-fold increase, p<0.05) and aromatic amino acids (phenylalanine, tyrosine and tryptophan) compared to CSF of control dogs. Concentrations of GABA and branched chain amino acids (valine, leucine, isoleucine) were within normal limits. Modifications of brain glutamate (an excitatory amino acid) as well as tryptophan (the precursor of serotonin) could contribute to the neurological syndrome characteristic of congenital PSE in dogs.

Combination leflunomide and cyclosporine prevents rejection of functional whole limb allografts in the rat

Whole rear limbs were transplanted from Brown Norway or Lewis rat donors to Lewis rat recipients (n=6 per group). One group of allograft recipients was treated with leflunomide (10 mg/kg/24 hr/orally) and cyclosporine (5 mg/kg24 hr/orally) starting 2 days before to surgery. Treatment continued for 60 days or until graft rejection. Untreated allografts were rejected over 6-8 days. After isograft transplantation, weight bearing began by day 17-25 after surgery. Sensory function was restored by 50 days after surgery. All allografts in the drug-treated group survived the 60-day period; survival in this group was significantly longer (P=0.0001) than the untreated controls. Weight bearing began by day 30, but was incomplete in two rats at 60 days. Peroneal nerve function was present in half the rats at 60 days after surgery. Leflunomide combined with cyclosporine prevented whole limb allograft rejection across a major histocompatibility barrier.

Central nervous system disorders after renal transplantation in cats

OBJECTIVE

This study describes the incidence and severity of postoperative central nervous system (pCNS) disorders in feline renal transplant recipients.

STUDY DESIGN

A retrospective study based on the medical records of cats that received renal allografts from 1987 to 1996.

ANIMALS OR SAMPLE POPULATION

Fifty-seven client-owned cats received renal allografts for the treatment of renal failure.

METHODS

The frequency, duration, severity, and treatment of episodes of pCNS disorders were recorded from the medical records.

RESULTS

Twelve (21%) of 57 cats had pCNS disorders 1 hour to 5 days after the surgical procedure. Seven cats survived; four had single or multiple seizure episodes, and two had seizure episodes or disorientation followed by a period of coma. One cat became temporarily ataxic and blind after restraint for venipuncture. Five cats died; all had episodes of disorientation or seizures, or both, that progressed to a nonrecoverable comatose state, respiratory arrest or cardiac arrest, or both. There were no significant differences between the two groups in preoperative serum creatinine, blood urea nitrogen, or cholesterol levels, and intraoperative blood pressure measurements. There were no significant differences in the postoperative serum glucose levels, electrolytes levels, or osmolality between the two groups. The cats with pCNS disorders had a mean preoperative trough cyclosporine A (CyA) whole blood level of 429 ng/mL; cats without pCNS disorders had a significantly (P = .0116) higher mean preoperative trough CyA whole blood level of 736 ng/mL.

CONCLUSION

Central nervous system disorders are a common and often fatal complication of renal transplantation in cats.

CLINICAL RELEVANCE

Recognition of pCNS disorders, and possible causes, will help develop hypotheses to investigate the problem.

Surgical excision of soft tissue fibrosarcomas in cats

OBJECTIVE

The purpose of this study was to determine the tumor-free interval and survival times of cats who had one (group 1) or more (group 2) surgeries, or surgery and radiation therapy (RTH) (group 3) for treatment of soft tissue fibrosarcomas (FSA).

STUDY DESIGN

Retrospective study.

ANIMALS OR SAMPLE POPULATION

45 client-owned cats.

METHODS

Medical records of cats with soft tissue FSA were examined. Vaccination and feline leukemia virus (FeLV) status, age, sex, breed, tumor location, number of surgeries, completeness of excision, and histopathological grade were evaluated to correlate with tumor-free interval and survival periods.

RESULTS

Overall median tumor-free interval and survival times were 10 and 11.5 (range, 1 to 40) months. Median tumor-free interval and survival times were more than 16 months each in group 1, more than 5 and 13 months in group 2, and 4.5 and 9 months in group 3. Age, sex, breed, vaccination or FeLV status, tumor location, or histopathological grade did not affect median tumor-free interval or survival times (P > .05). Cats with complete excisions had significantly longer median tumor-free interval (> 16 versus 4 months) and survival time (> 16 versus 9 months) than those with incomplete excisions (P = .008). Radiation therapy did not seem to extend tumor-free interval and survival times (P = .013). However, most group 3 cats had incomplete surgical excisions, resulting in recurrent or progressive disease.

CONCLUSIONS

Complete surgical excision of FSA in cats is possible and can be curative.

CLINICAL RELEVANCE

Aggressive surgical excision with wide margins appears to contribute to extended tumor-free interval and survival times in cats with soft tissue FSA. Controlled prospective studies are needed to determine the efficacy of RTH in treatment.

Malignant chromatophoroma in a canebrake rattlesnake (Crotalus horridus atricaudatus)

An adult female canebrake rattlesnake (Crotalus horridus atricaudatus) at Zoo Atlanta (Atlanta, Georgia, USA) had a subcutaneous mass on the left lateral abdomen. Microscopically, the tumor contained a pleomorphic population of cells with abundant intracytoplasmic brown to gold nonrefractile pigment (chromatophores), large stellate cells resembling neurons, and small stellate cells whose cytoplasmic processes formed a fibrillar matrix. The pigment stained black with the Fontana-Masson technique and was positive with the periodic acid-Schiff technique (prior to and after diastase treatment). Neuron-specific enolase was detected in the large stellate cells using an immunohistochemical staining technique. In addition, glial fibrillary acidic and S-100 proteins were detected in the chromatophores with immunohistochemical staining. The smaller stellate cells were strongly S-100 positive. Ultrastructurally, chromatophores contained intracytoplasmic structures composed of concentric lamellar membranes bordered by a triple-layer outer membrane. The morphology of these structures was compatible with pterinosomes. Three fluorescent pigments were isolated from the neoplasm by one-dimensional chromatography and characterized by spectrophotometry and spectrofluorometry.

Endogenous benzodiazepine activity in the peripheral and portal blood of dogs with congenital portosystemic shunts

OBJECTIVE

The purpose of this study was to determine whether an endogenous benzodiazepine receptor ligand (EBZ) was present in the arterial and portal blood of dogs with congenital portosystemic shunts (CPSS).

STUDY DESIGN

The presence or absence of an EBZ was determined by the collection of systemic and portal blood from dogs with CPSS.

ANIMALS

Fifteen client-owned dogs with a confirmed CPSS. All dogs had historical signs compatible with hepatic encephalopathy. Eight healthy dogs were used as controls.

METHODS

In all dogs, systemic blood samples were collected after they were anesthetized. Portal blood samples were collected intraoperatively. EBZ was measured by radioreceptor assay.

RESULTS

In 10 of 15 dogs, the portal blood concentration of EBZ was significantly elevated compared with normal dogs (mean, 13.2 +/- 18.55 ng/mL). Five dogs had elevated systemic blood EBZ levels (mean, 8.2 +/- 16.08 ng/mL). Eleven of 15 dogs had a higher portal than systemic blood concentration of EBZ. In contrast, control dogs had extremely low EBZ concentrations detected in their portal blood (mean, 0.16 +/- 0.3 ng/mL) and systemic blood (0 ng/mL). The mean portal and systemic blood concentrations in dogs with CPSS were significantly greater than in control dogs (P < .05).

CONCLUSIONS

Elevated blood levels of EBZ were found in dogs with CPSS. The portosystemic gradient noted in 11 dogs suggests the gastrointestinal tract as a possible source for the endogenous ligand.

CLINICAL RELEVANCE

Generalized motor seizures have been reported in dogs after surgical correction of CPSS. If the presence of a CPSS results in stimulation of brain receptors for benzodiazepines, post-CPSS ligation seizures may result from a withdrawal of EBZ after ligation of the portosystemic shunt.

Ultrasonographic evaluation of renal size in dogs with acute allograft rejection

The purpose of this study was to determine the best method to ultrasonographically monitor renal size changes associated with acute allograft rejection in dogs. Qualitative changes in renal cortical and medullary echogenicity were also evaluated, although this was not a major focus of the study. Four unrelated, mixed-breed dogs underwent bilateral nephrectomies and heterotopic renal allograft transplantation. Ultrasound examinations of transplanted kidneys were initiated at 3 days after surgery and continued at 2-3 day intervals until death (38 +/- 2 days). Ultrasound measurements of kidney length, width, height, cross-sectional area, and estimated volume were used to assess relative changes in renal size associated with transplantation and rejection. Transplanted kidneys had a rapid increase in volume and cross-sectional area that averaged 103% and 83% above baseline levels, respectively, by 17 days after transplantation. The increased size was attributed to a combination of hypertrophy and acute rejection, the latter of which was confirmed at postmortem. Kidney volume decreased to approximately 35% above baseline volume by day 34 as rejection became more advanced. Qualitative changes associated with rejection included medullary enlargement with decreased echogenicity early in the study, followed by increased cortical thickness and echogenicity with poor cortical medullary definition in the latter stages of the survival period. It was concluded that relative changes in renal allograft size can be easily monitored with ultrasound. In regard to linear measurements, changes in renal width were more pronounced than changes in height or length with acute rejection. Therefore measurements that incorporate the width, namely volume or cross-sectional area, appear to be the most sensitive for monitoring changes in allograft size. Renal cross-sectional area measurements are preferred because they are simple to perform using the automated calculation capability of most newer ultrasound units.

Effects of leflunomide and cyclosporine on myocutaneous allograft survival in the rat

The immunosuppressive effects of leflunomide and cyclosporine were evaluated in a rat neurovascularized myocutaneous allograft model. Inbred Brown-Norway and Lewis rats were served as donors and recipients, respectively. All recipients were observed for 60 days or until allograft rejection occurred. All isograft controls (Lewis to Lewis, n=6) survived uneventfully. All control allografts (n=6) were rejected within 6 days. Allograft recipients (n=6) administered leflunomide (10 mg/kg/24 hr) rejected their allografts in 28.50+/-6.12 days, and allograft recipients (n=6), administered cyclosporine (5 mg/kg/24 hr) rejected their allografts in 24.33+/-10.48 days. When allograft recipients were administered a combination of leflunomide and cyclosporine (10 mg/kg/24 hr and 5 mg/kg/24 hr, respectively), all allografts survived to 60 days with only partial rejection of the skin of one graft. The neuromuscular function of the allografts of the rats receiving combination therapy was comparable to that of the isografts. The combination of leflunomide and cyclosporine controlled myocutaneous allorejection despite a strong immunological challenge.

Detection of eastern equine encephalomyelitis virus RNA in formalin-fixed, paraffin-embedded tissues using DNA in situ hybridization

Eastern equine encephalomyelitis (F.EE) virus was detected in infected formalin-fixed horse and emu tissues and in infected chicken embryo fibroblasts. Results of in situ hybridization using a digoxigenin-labeled 40-base DNA probe complementary to a conserved region of the EEE virus RNA compared favorably with results of both virus isolation and serum neutralization tests. This technique may be useful for diagnosis of EEE virus infection in various animal species, especially when fresh tissues are not available for analysis, and also will provide a means for studying the involvement of alphaviruses in pathogenesis studies.

A mucosal apposition technique for ureteroneocystostomy after renal transplantation in cats

Renal transplantation is a successful treatment for terminal renal failure in cats. However, in the initial clinical study, there was a frequent occurrence of obstruction of the implanted ureter at the bladder wall or stoma. This resulted in the use of a modified "drop-in" technique that had proved effective in the prevention of obstruction in five normal cats. When applied to renal transplant recipients, ureteral obstruction was reduced, but continued to occur. The modified "drop-in" technique was abandoned and replaced with a technique that apposed the cut edge of the ureteral mucosa to the torn edge of the bladder mucosa. This technique is recommended as it has prevented ureteral obstruction in six successive cases. Prevention of ureteral obstruction, and the required corrective surgery, markedly reduces patient morbidity and mortality, length of hospitalization, and expense to the client.

Enhanced nitric oxide production induced by the administration of L-arginine does not inhibit arterial neointimal formation after overwhelming alloimmune injury

BACKGROUND

Nitric oxide suppresses proliferation and function of T cells and inhibits proliferation of smooth muscle cells in vitro and in vivo. The purpose of this study was to determine whether nitric oxide, stimulated by means of the oral administration of L-arginine, would reduce the degree of intimal thickening produced by immune injury in rat arterial allografts.

METHODS

Orthotopic femoral artery transplantation was done with Brown Norway donors and Lewis recipients. Seven days before operation, and for 39 additional days, one group received 2.25% L-arginine and one group received 0.01% N-omega-nitro-L-arginine in tap water; one group received tap water only. Forty days after operation, all arterial segments were excised and examined by histopathologic, morphometric, and immunohistochemical assays.

RESULTS

There was no difference in the rejection response or degree of intimal thickening among the three groups. There were no qualitative differences in numbers of T cells, macrophages, or smooth muscle cells in the neointima, media, or adventitia among the untreated and treated groups. Induced nitric oxide synthase was present in the media and adventitia of the allograft vessels, but not in native rat arteries.

CONCLUSIONS

Enhanced production of nitric oxide, via the administration of L-arginine, has been shown to reduce tissue pathologic changes in models of mechanical or dietary injury. Enhanced nitric oxide production did not suppress rejection or inhibit intimal thickening in this model of immune-mediated injury.

Histologic evaluation of the crop for diagnosis of proventricular dilatation syndrome in psittacine birds

Histologic sections of crop tissue were evaluated for the presence of lymphoplasmacytic infiltrates within mesenteric ganglia. All birds with proventricular dilatation syndrome that had lymphoplasmacytic infiltrates in crop ganglia had similar infiltrates in the proventricular and/or ventricular ganglia. False-negative crop biopsy results occurred approximately 24% of the time. More invasive procedures, such as proventricular or ventricular biopsy, may be necessary if the crop biopsy is nondiagnostic in a bird with clinical signs of proventricular dilatation syndrome.

Effects of growth factors and L-arginine on ischemic skin flaps in rats

This study determined the effect of the polypeptide growth factors transforming growth factor-beta (TGF-beta), insulin-like growth factor-I (IGF-I), and growth hormone (GH) alone and in combination with dietary L-Arginine HCL (ARG) on skin flap survival in rats. Caudally based dorsal skin flaps were created in 110 Sprague-Dawley rats. The rats were randomly assigned into three treatment groups, based on drinking water supplementation. Group 1 (n = 50) received ARG in their drinking water, group 2 (n = 50) received tap water alone, and group 3 (n = 10) received N-omega-nitro-L-arginine (L-NA) and hydralazine. Groups 1 and 2 were divided into subgroups of 10 rats each based on treatment with either: TGF-beta, IGF-I, GH, or IGF-I + GH. All subgroups that received GH had significantly greater (P < .0001) median body weight gains when compared with subgroups not receiving GH. L-arginine HCL when added to IGF-I negated the positive effects of IGF-I on both flap survival and weight gain. Although the rats in all subgroups from groups 1 and 2 had an increase in mean percent skin flap survival when compared with the water alone subgroup, only rats receiving IGF-I, or the combination of ARG with either TGF-beta or GH, had statistically significant enhanced skin flap survival. Rats in group 3 did not show an increase in skin flap survival when compared with the control subgroup.

Long-term renal and hematologic effects of uninephrectomy in healthy feline kidney donors

To assess long-term hematologic and renal effects associated with a solitary kidney, 16 healthy cats undergoing uninephrectomy for kidney donation between May 1987 and January 1991 were evaluated by use of physical examination, CBC, serum biochemical analysis, urinalysis, and urine protein:creatinine ratio. Results of preoperative CBC, serum biochemical analysis, and urinalysis were within reference limits in all donors. Median age at surgery and at follow-up evaluation was 34 and 72 months, respectively. Mean (+/- SEM) interval between follow-up and uninephrectomy was 39.3 +/- 14.6 months. Postuninephrectomy hematocrit and RBC indices were within reference limits in 15 donors. One cat with chronic renal insufficiency had normocytic, normochromic, nonregenerative anemia. In 15 clinically normal donor cats, mean (+/- SEM) serum creatinine concentrations pre- and post-uninephrectomy were 1.36 +/- 0.20 and 1.71 +/- 0.33 mg/dl, respectively (P = 0.0002); however, the clinical relevance of this statistical difference in serum creatinine is uncertain, because all values were within reference limits. In addition, urine-concentrating ability was maintained in 14 donors, with urine specific gravity > or = 1.040. Two donors, including the cat with chronic renal insufficiency, produced dilute urine (specific gravity < or = 1.020) and had substantial proteinuria, with urine protein:creatinine ratios of 2.16 and 3.62, respectively. Mean urine protein:creatinine ratio in donor cats was not significantly different from that in an age- and sex-matched comparison group. Renal and erythropoetic function was clinically preserved in the group of donor cats within 2 to 5 years after uninephrectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Infectious pericardial effusion in five dogs

The medical records of five dogs diagnosed with infectious pericardial effusion were reviewed. Clinical signs included anorexia, depression, respiratory distress, abdominal distension, collapse, coughing, and vomiting. Anemia and leukocytosis were present in three dogs. Grass awn migration was confirmed as the cause of the pericardial effusion in two dogs and suspected in the other three. Surgery, followed by continuous chest drainage, and appropriate antibiotic therapy was the treatment in four dogs. Chest drains were removed within 4 days of surgery. One dog did not have chest drainage after surgery. Antibiotic treatment was continued for up to 6 months. The dogs were monitored postsurgically for a period ranging from 3 to 24 months. All dogs recovered well without apparent complications.

Treatment with rapamycin and mycophenolic acid reduces arterial intimal thickening produced by mechanical injury and allows endothelial replacement

Rapamycin (RPM) and mycophenolic acid (MPA) inhibit immune responses by antagonizing IL-stimulated lymphocyte activation. These 2 drugs, used alone or preferably in combination, also significantly reduced the response of vascular cells to balloon-catheter arterial injury in rats. When rats were treated for 2 weeks with both drugs starting the day of injury, intimal thickening was significantly reduced (P < 0.001) 14 days after injury; however, by 44 days after injury, intimal thickening had progressed to the extent measured in arteries of untreated control rats. When RPM and MPA were administered for 3 days before and 13 days after injury, arterial intimal thickening was significantly (P = 0.024) reduced and endothelium had regrown in vessels analyzed 44 days after injury. Compared with initiation of treatment on the day of injury, starting the administration of RPM plus MPA before injury appears to limit the activation of cells or actions of factors responsible for the progression of intimal thickening that occurred after the administration of the drugs was terminated. RPM and MPA prevented the development of arterial intimal thickening in a model not dependent upon a rejection response. This direct antiproliferative action on smooth muscle cells by RPM and MPA, in vivo, may prevent the development of arterial intimal thickening associated with chronic rejection.

Cystourethropexy to correct refractory urinary incontinence due to urethral sphincter mechanism incompetence. Preliminary results in ten bitches

Cystourethropexy was performed in 10 bitches with refractory urinary incontinence due to urethral sphincter mechanism incompetence. All animals had an abnormally shaped vesicourethral junction. The bladder neck was located in the pelvic canal in nine dogs (pelvic bladder). Surgery alone restored urinary continence in two cases and markedly improved incontinence in two cases. Surgery combined with medical therapy (phenylpropanolamine, 1.5 mg/kg orally once or twice a day, using a sustained-action preparation) restored urinary continence in four cases and markedly improved continence in one case. Surgery, with medical therapy, was completely ineffective in one case. No major complications were encountered in any dogs. In four cases, histopathologic evaluation of the dorsal bladder wall and neck revealed the presence of a single, perinuclear, clear vacuole in the cytoplasm of smooth muscle fibers. Electron microscopic examination showed that the vacuoles represented a dilatation of normal membrane organelles. Such abnormalities have the potential to alter the smooth muscle motility. This study indicates that cystourethropexy alone restored urinary continence only temporarily in the majority of the patients. The significance and frequency of the histopathologic findings requires further investigation.