Accuracy of Lumbosacral Pedicle Screw Placement in Dogs: A Novel 3D Printed Patient-Specific Drill Guide versus Freehand Technique in Novice and Expert Surgeons

OBJECTIVE

 The aim of this study was to compare the accuracy of pedicle screw placement at the canine lumbosacral junction using a novel unilateral three-dimensional printed patient-specific guide (3D-PSG) versus a freehand drilling technique. Additionally, accuracy of screw placement between a novice and an experienced surgeon was determined.

STUDY DESIGN

 Preoperative computed tomography images from 20 lumbosacral cadaveric specimens were used to design a novel unilateral 3D-PSG for the L7 and sacral vertebrae which was printed in acryl-nitrile butadiene styrene plastic. A novice and an expert surgeon each placed 3.5mm cortical screws in 10 cadavers; on the left using the unilateral 3D-PSG and by the freehand (anatomic landmark) technique on the right.

RESULTS

 Sixty screws were placed using the unilateral 3D-PSG and 60 using the freehand technique. There was no statistical difference in accuracy for the comparison between methods performed by the expert (p = 0.679) and novice (p = 0.761) surgeon, nor between an expert and novice surgeon overall (p = 0.923). Unexpectedly, the use of a unilateral 3D-PSG increased variability for the expert surgeon in our study (p = 0.0314).

CONCLUSION

 Using a novel unilateral 3D-PSG did not improve the accuracy of screw placement for lumbosacral stabilization by a novice surgeon compared with an expert surgeon in lumbar spine surgery. This may reflect a suboptimal PSG design.

Computed Tomographic Measurement of Trochlear Depth in Three Breeds of Brachycephalic Dog

OBJECTIVE

 The aim of this study was to determine the trochlear sulcus depth of three common brachycephalic breeds at risk of medial patellar luxation.

STUDY DESIGN

 Retrospective blinded clinical study using a previously validated ratio (T/P) of maximal trochlear sulcus depth (T) and maximal patellar craniocaudal thickness (P) measured on computed tomography, to assess trochlear sulcus depth in Pugs, French Bulldogs and English Bulldogs without clinical patellar luxation. The effect of breed on T/P was assessed using one-way linear regression models.

RESULTS

 The mean T/P was affected by breed (p < 0.001). There was significant difference between Pugs (0.45) and French Bulldogs (0.38) and between Pugs and English Bulldogs (0.4). There was no significant difference between Pugs and previously published data for non-brachycephalic and mixed breed dogs (0.46) (p = 0.39). Mean T/P was significantly reduced in the brachycephalic dog breeds combined compared with the previously published data (p < 0.001).

CONCLUSION

 The trochlear sulcus varies by breed and was more shallow in French and English Bulldogs than Pugs, hence a shallow sulcus may be a breed-driven characteristic. The three breeds assessed are at risk of patellar luxation but sulcus depth did not directly correlate with previously published risk factors-the contribution of sulcus depth to the aetiopathogenesis of patellar luxation remains unclear. Trochlear recession to achieve patellar coverage of 50% may be excessive considering maximal breed normal depth.

A retrospective evaluation of complications associated with forkless tibial tuberosity advancement performed in primary care practice

OBJECTIVE

To report postoperative complications associated with forkless tibial tuberosity advancement (TTA) performed in primary care veterinary practice and to compare results with previous publications.

STUDY DESIGN

Retrospective study.

SAMPLE POPULATION

Three hundred seventy-four forkless TTAs in 329 dogs performed by six nonspecialist veterinarians.

METHODS

Medical records of dogs treated with a standard forkless TTA (2013-2016) and with at least 12 months of postoperative follow-up were reviewed. Complications recorded by the referring practice or the operating veterinarian were classified as minor (medically treated) or major (surgically treated).

RESULTS

Complications occurred in 57 of 374 (15.2%) TTAs; 28 (7.5%) complications were major, and 29 (7.7%) complications were minor. Postliminary meniscal injuries were documented in 12 of 374 (3.2%) TTAs (12/57 major complications) and were more common when the ratio of cage size to bodyweight was ≤0.25 (P = .019). Mean TTA (cage size) was greater in this population than what has been previously reported for a lower median bodyweight.

CONCLUSION

The incidence of major complications was low and within the range previously reported for TTA in referral practice after adjusting for study design. The magnitude of advancement was greater, and the incidence of postliminary meniscal injury was lower than what has been previously reported, after accounting for dogs that had a preliminary meniscal injury or medial meniscal release.

CLINICAL SIGNIFICANCE

Forkless TTA may be successfully performed by experienced veterinarians in primary care practice with a low rate of complications. The incidence of postliminary meniscal injury may be reduced by a greater degree of advancement of the tibial tuberosity.

Evaluation of a modified proportional margin approach for complete surgical excision of canine cutaneous mast cell tumours and its association with clinical outcome

Canine cutaneous mast cell tumours (MCTs) represent a common neoplasm in veterinary practice. Several reported techniques are available to guide surgical excision. Our study examined one hundred cutaneous MCTs that were excised surgically using a modified proportional margin approach. A 2 cm lateral margin upper limit was applied for any tumour diameter that exceeded this size with a deep surgical margin of one fascial plane applied. A retrospective, cross-sectional study with follow-up was used to determine the clinical utility of this excision technique. Associations between explanatory variables of tumour size and grade were compared with outcomes of complete excision and size of histologic tumour-free margins (HTFM) using the appropriate Pearson's χ² and Fisher's exact tests. Follow-up data evaluated tumour recurrence and patient survival. Ninety-five percent of MCTs (95/100) were completely excised. No significant association in the achievement of complete excision between low- and high-grade MCTs (P = .48) was noted. Tumour size was not associated with the rate of complete excision (P = .06). Tumour grade and size did not influence the size of the HTFM (P = .94 and P = .14, respectively). Overall, a recurrence rate of 3% (3/100 tumours) and de novo MCT development rate of 7.7% (5/65 dogs) was noted, with median follow-up period of 593 days (range 180-1460 days). Post-operative metastases were seen in 4.6% of dogs (3/65). Therefore, a modified proportional margin approach with 2 cm lateral margin upper limit is a suitable technique to guide surgical excision of canine cutaneous MCTs.

Feasibility of open-chest cardiopulmonary resuscitation through a transdiaphragmatic approach in dogs

OBJECTIVE

To describe and evaluate the feasibility of a transdiaphragmatic (TD) approach for open-chest cardiopulmonary resuscitation (OCCPR) as an alternative to a traditional lateral thoracotomy (LT) in a canine cadaver model.

STUDY DESIGN

Randomized noninferiority ex vivo study.

ANIMALS

Fourteen canine cadavers weighing 17.4-30.2 kg.

METHODS

An LT and a TD approach to the heart were performed in each cadaver. The order of procedures as well as an assignment to specific operators were randomized before starting the study. Data recorded included the time between incision and initiation of cardiac compressions; time between initiation of the first suture placement and closure of the intrapleural space; time between initiation of the first suture placement and final skin suture; trauma to pulmonary, cardiac, hepatic and neurovascular structures; distance between the caval foramen and diaphragmatic incision; the intercostal space entered during LT; and appropriate closure.

RESULTS

The mean time between incision and initiation of cardiac compressions for the TD approach (85 ± 35 seconds) was noninferior to the LT (84 ± 28 seconds). The pleural space was closed faster after the TD approach (531 ± 276 seconds) than after the lateral approach (817 ± 294 seconds, P = .03). Total duration of closure did not differ between techniques (P = .11). There was no difference between the complication rates of each approach.

CONCLUSION

The TD approach did not prolong the procedure or increase the complication rate compared with an LT.

CLINICAL SIGNIFICANCE

This study provides evidence to support additional investigation of the TD approach for OCCPR to determine its efficacy and safety in live animals.

Risk Factors for Transport-Related Problem Behaviors in Horses: A New Zealand Survey

Simple Summary

Transport-related problem behaviors (TRPBs) are unwanted behaviors exhibited by horses in one or multiple phases of transport contributing to the injury of the horses and their handlers. The aim of this study was to identify risk factors for TRPBs in support of the development of best practices that minimize their incidence, and safeguard horse and handler wellbeing. An online cross-sectional survey was designed and disseminated to New Zealand equine industry members. Respondents were asked whether one of their horses had shown TRPBs during the two previous years, and to describe their equine background and experience, the method or way in which they had trained their horses for loading and travelling, the type of aids they used for loading and the type of vehicle. At least one horse was reported as showing a TRPB by almost one out of four of respondents. The type of vehicle, of training and of aids used for loading and travelling resulted associated with TRPBs. These findings may be useful to enhance horse welfare by educating people in charge of moving horses on appropriate training methods and vehicle selection for road transportation.

Abstract

Transport-related problem behaviors (TRPBs) are common in horses and can cause injury to both the horses and their handlers. This study aimed to identify possible risk factors for TRPBs to inform approaches to mitigate TRPBs incidence and enhance horse welfare. An online cross-sectional survey was conducted to explore the prevalence of TRPBs and their association with human-, training- and transport management-related factors in New Zealand. The survey generated 1124 valid responses that were analyzed using descriptive statistics, and logistic regression analyses. Having at least one horse with TRPB was reported by 249/1124 (22.2%) respondents during the two previous years. Of these, 21/249 (8.4%) occurred during pre-loading, 78/249 (31.3%) during loading, 132/249 (53.0%) while travelling, and 18/249 (7.3%) during unloading. Our findings indicate that the use of negative reinforcement and positive punishment as training methods, using a whip or food for loading, and travelling in a straight load trailer/float while offering food were associated with a higher likelihood of TRPBs. Cross-sectional studies cannot determine causality and findings should be interpreted with caution, and evaluated in further experimental studies. The authors suggest that education on appropriate training methods for transport, and vehicle selection may mitigate the risk for TRPBs in horses.

Evaluation of the rostral projection of the sacral lamina as a component of degenerative lumbosacral stenosis in German shepherd dogs

OBJECTIVE

To determine the association between a greater rostral projection of the sacral lamina and clinical signs of cauda equina syndrome (CES) in German shepherd dogs (GSD) with presumptive degenerative lumbosacral disease (DLSS).

STUDY DESIGN

Retrospective cohort study.

SAMPLE POPULATION

One hundred forty-three GSD (125 police dogs and 18 pet dogs) presenting for either CES or prebreeding evaluation. Fifty-five were classified as affected by CES and diagnosed with DLSS, and 88 were classified as unaffected on the basis of clinical and imaging findings.

METHODS

The position of the rostral edge of the sacral lamina was measured from radiographs and/or computed tomography (CT) scans. This position was compared between affected and unaffected dogs. In dogs that underwent both radiography and CT scanning, the agreement between sacral lamina localization using each imaging modality was determined. Owners/handlers were contacted to determine whether dogs subsequently developed clinical signs compatible with CES at a mean of 29 months (unaffected).

RESULTS

The sacral lamina did not extend as far rostrally in affected dogs, compared to unaffected dogs (P = .04). Among the 88 dogs unaffected by CES at initial evaluation, 2 developed clinical signs consistent with CES at follow-up.

CONCLUSION

Rostral projection of the sacral lamina, previously proposed as a potential risk factor in dogs with CES due to lumbosacral degeneration, was not associated with a diagnosis of DLSS in this study; the opposite was true.

CLINICAL SIGNIFICANCE

Rostral projection of the sacral lamina may not be a predisposing factor in the development of CES due to DLSS in GSD.

Owner perceptions of their cat's quality of life when treated with a modified University of Wisconsin-Madison protocol for lymphoma

Objectives The objectives of this study were to assess owner perceptions of their cat's quality of life during treatment for lymphoma with a doxorubicin-containing multi-agent chemotherapy protocol, whether various health-related parameters correlated with quality of life scores, and to assess owner satisfaction with the protocol. Methods A postal questionnaire was sent to the owners of 33 treated cats. Owners retrospectively assessed their cat's quality of life using a Likert scale (1-10) before lymphoma was diagnosed, at diagnosis and during chemotherapy. Owners assigned scores to various health-related parameters previously reported to affect quality of life at the three time points, and correlations with quality of life scores were sought. Owners were asked to rate the importance of these health-related parameters. Satisfaction with the protocol was investigated. Results Twenty questionnaires were completed (61% response rate). The median quality of life score before diagnosis (10, range 5-10) was higher than at diagnosis (3, range 1-9) ( P <0.05). The median quality of life score during chemotherapy (7, range 3-9) was lower than before diagnosis ( P <0.05) and higher than at diagnosis, but this was not statistically significant. Quality of life scores did not correlate with individual health-related parameter scores consistently; however, quality of life scores did correlate with appetite scores during chemotherapy. Appetite, vomiting and diarrhoea were parameters perceived as important in affecting quality of life. Most owners (75%) were happy they had treated their cat. Conclusions and relevance The quality of life scores observed were comparable to a previous study using cyclophosphamide, vincristine and prednisolone, employing the same scoring system. Although quality of life scores during chemotherapy were not significantly improved at diagnosis, owner satisfaction with the protocol was high. The factors perceived by owners to determine quality of life in their pets may be different to those previously conjectured, but appetite during chemotherapy remains important.

Effect of dorsal laminectomy and dorsal annulectomy with partial lumbosacral discectomy on the volume of the lateral intervertebral neuroforamina in dogs when the lumbosacral junction is extended

OBJECTIVE

To determine the effect of dorsal annulectomy and partial discectomy on the volume of the lumbosacral lateral intervertebral neurovascular foramina (intervertebral foramina) in canine cadavers during extension of the lumbosacral junction.

STUDY DESIGN

Ex vivo experiment.

SAMPLE POPULATION

Lumbosacral specimens from 10 large breed dogs euthanatized for reasons unrelated to lumbosacral disease.

METHODS

The lumbosacral specimens were clamped in a wooden jig and scanned using computed tomography (CT) with the lumbosacral junction in a neutral position and loaded in extension using a tensioning device. The 3-dimensional volumes of the lumbosacral intervertebral neurovascular foramina were measured and the extent of any disc degeneration was determined from the CT data. A limited dorsal laminectomy of S1 and a dorsal LS annulectomy and partial discectomy were then performed. The lumbosacral specimens were remounted into the jig and loaded into extension at the same tension and were re-scanned. Measurements of intervertebral foraminal volume were then repeated.

RESULTS

The mean volume of the lumbosacral foramina (n = 20) was 381 mm³ in neutral (unloaded) positioning and 137 mm³ when loaded in extension. Following dorsal annulectomy, the mean volume was significantly reduced by a mean of 28% to 98 mm³ (P < .01). The foraminal volume was reduced in 19/20 lumbosacral foramen, with the post-annulectomy volume ranging from 31% to 97% of the pre-annulectomy volume (3%-69% reduction).

CONCLUSIONS

This study suggests that a dorsal annulectomy with partial discectomy may induce further dynamic collapse of the lumbosacral articulation in the dog.

Investigation of cell-free DNA in canine plasma and its relation to disease

BACKGROUND

DNA is released from dying cells during apoptosis and necrosis. This cell-free DNA (cfDNA) diffuses into the plasma where it can be measured. In humans, an increase in cfDNA correlates with disease severity and prognosis.

OBJECTIVE

It was hypothesized that when DNA in canine plasma was measured by emission fluorometry without prior DNA extraction, the concentration of cfDNA would increase with disease severity.

ANIMALS

The diseased population consisted of 97 client-owned dogs. The clinically normal population consisted of nine client-owned dogs presenting for 'wellness screens', and 15 colony-owned Harrier Hounds.

METHODS

Plasma cfDNA was measured by fluorometry without prior DNA extraction. The effects of ex vivo storage conditions were evaluated in plasma from two clinically normal dogs. In all other dogs, plasma was separated within two hours of collection. The association between the cfDNA concentration in hospitalized dogs and a variety of clinical, clinicopathological and outcome variables was tested.

RESULTS

The concentration of cfDNA was reliably measured when plasma was separated within two hours of blood collection. The diseased dogs had significantly higher cfDNA than clinically normal dogs (P < 0.001), and the more severe the disease, the higher the cfDNA when severity was categorized according to the American Society of Anesthesiologists (ASA) status (P < 0.001). Dogs that did not survive to discharge had significantly higher cfDNA concentrations than survivors (P = 0.02). Conclusions/Clinical Importance: The concentration of cfDNA in the plasma of diseased dogs is associated with disease severity and prognosis. Measurement of canine cfDNA could be a useful non-specific disease indicator and prognostic tool.

ACCURACY OF RADIOGRAPHIC DETECTION OF THE CRANIAL MARGIN OF THE DORSAL LAMINA OF THE CANINE SACRUM

An elongated sacral lamina has been described as one of the contributing factors for dogs with cauda equina syndrome due to degenerative lumbosacral stenosis (DLSS); however, published evidence is lacking on the accuracy of radiographic screening for the presence of this lesion. Objectives of this prospective, cross-sectional cadaver study were to describe the accuracy and repeatability of detection of the cranial sacral lamina margin on plain lateral radiographs of the lumbosacral junction in dogs. Twenty-five medium and large breed canine cadavers were radiographed before and after placement of a radiopaque hook in the cranial margin of the sacral lamina. Three independent evaluators placed digital markers at the perceived margin on preinterventional radiographs. The distance from perceived location to the true location on postinterventional radiographs was recorded for each dog and observer. A discordance threshold (distance between perceived and actual margin) of 1.5 mm was subjectively defined as clinically relevant. The three evaluators demonstrated good repeatability, although the accuracy for margin detection was only fair (mean discordance 1.7 mm). Evaluators demonstrated greater accuracy in identifying the landmark in juveniles (1.4 mm) vs. adults (1.8 mm; P < 0.01). Results of this study indicated that observer repeatability is good and accuracy is fair for correctly identifying the radiographic cranial margin of the sacral lamina in dogs. This should be taken into consideration when interpreting elongation of the sacral lamina in radiographs of dogs with suspected DLSS, especially adults.

Bone volume and regional density of the central tarsal bone detected using computed tomography in a cross-sectional study of adult racing greyhounds

AIMS

To determine whether left-to-right asymmetry of the central tarsal bone (CTB) of racing greyhounds was detectable using computed tomography (CT) in live dogs; to quantify the asymmetry in terms of average bone volume, volumetric bone mineral density (vBMD), and dorsal cortical shape, and to determine if age, gender, bodyweight, number of starts or history of tarsal injury were significant covariates.

METHODS

One trainer supplied 11 male and seven female, unrelated, skeletally mature, actively racing greyhounds, including dogs with a history of tarsal injury diagnosed by the trainer and/or track veterinarian (n=8), and dogs without a history of tarsal injury (n=10). Using CT, standardised parameters of the CTB were measured including volume and average vBMD of the left and right CTB, vBMD of regions within the CTB, and bone shape.

RESULTS

There was no difference in the volumes of the left and right CTB and no association with number of racing starts. Volume of CTB in dogs with a history of tarsal injury was greater than in dogs with no history of injury (p<0.001). Mean vBMD of the right was greater than the left CTB (p=0.004), and was independent of history of injury, gender, bodyweight, and number of starts. Males with a history of injury weighed more than those with no history of injury (p=0.004). The region of greatest difference in vBMD between right and left limbs was the centrodorsomedial aspect of the CTB. Middle plantar ligament enthesiopathies and fractures of tarsal bones other than the central tarsal bone were identified in dogs with and without a history of tarsal injury.

CONCLUSIONS

Significant left-to-right asymmetry of the CTB in racing greyhounds was detected using CT. Contrary to previous suggestions, the asymmetry was not associated with the number of racing starts. We propose that the majority of the adaptive modelling of the CTB occurred rapidly following the onset of counter-clockwise training, with little further modelling throughout the racing career of the dog, however further investigation is warranted.

CLINICAL RELEVANCE

This study described a technique using CT for imaging the CTB in live dogs, which opens the way for a longitudinal study of bone modelling of the CTB in response to training and racing in a counter-clockwise direction.

Seasonal variation in the hip score of dogs as assessed by the New Zealand Veterinary Association hip dysplasia scheme

AIM

To determine whether there is a seasonal variation in the phenotypic hip score of dogs born in New Zealand as assessed by the New Zealand Veterinary Association (NZVA) canine hip dysplasia (CHD) scheme.

METHODS

Data from dogs born in New Zealand between 1988 and 2009 that have been scored for CHD were retrospectively evaluated for the effect of month of birth on radiographic phenotype. Data included both the total score and the subtotal score, comprising Norberg's angle, the subluxation score and changes to the cranial acetabular edge, for each dog. Datasets were created for all breeds combined and for the four most populous breeds using the scheme (German Shepherd dog, Labrador Retriever, Golden Retriever and Rottweiler) and stratified according to month of birth and season. Due to the skewed nature of the data, a Kruskal-Wallis Rank Sum test was used to test for statistical significance. Additionally, χ² analysis was performed using the median of each dataset (proportion above/below the median). The null hypothesis was that there would be no effect of month of birth, and hence seasonality, on hip phenotype for dogs born and scored in New Zealand by the NZVA.

RESULTS

For all breeds combined, month of birth had an effect on total and subtotal NZVA CHD scores (p<0.001) with a lower total hip score in the autumn months of March and April than other months. When individual large breed data were analysed, there was an effect of month of birth on total and subtotal scores for the Labrador Retriever and the Rottweiler (p ≤ 0.05), but not the German Shepherd dog or Golden Retriever breeds.

CONCLUSIONS

Being born in the autumn was associated with a protective effect on hip phenotype in some breeds. These results suggest that weather and/or another seasonal factor may have a significant environmental effect on the phenotype of the coxofemoral joint.

CLINICAL RELEVANCE

The protective effect of being born in autumn suggests that a decreased level of exercise during subsequent development over winter may positively impact on final coxofemoral joint conformation. Whilst statistically significant, the magnitude of the sparing effect is not likely to be clinically relevant. However, this study, in concert with other studies, may suggest that the effects of exercise can be manipulated to improve hip phenotype.

Long-term outcomes after partial tarsal arthrodesis in working farm dogs in New Zealand

AIM

To report the long-term outcome (return to work and owner satisfaction) for working farm dogs in New Zealand after partial tarsal arthrodesis for proximal intertarsal and/or tarsometatarsal tarsal joint injury.

METHODS

Working farm dogs that underwent partial tarsal arthrodesis were identified by diagnosis and breed code via a search of the medical records of Massey University Veterinary Teaching Hospital (MUVTH) and Veterinary Specialist Orthopaedic Services (VetSOS). Fourteen dogs fulfilled the selection criteria and were all actively in work on farms at the time of injury. Data from case files were analysed, and the ability of the dog to work after surgery and owners' satisfaction were assessed using a questionnaire sent to owners at a median follow-up interval of 57 months.

RESULTS

Following partial tarsal arthrodesis, 7/14 (50%) dogs could perform normal work duties required while 4/14 (29%) dogs could perform most of the duties they had undertaken before injury, though some allowance had to be made for reduced performance. Thirteen owners were satisfied or very satisfied with the outcome of surgery and 12/14 thought the financial investment required for the surgery was worthwhile. Of the three dogs that did not return to work, infection requiring implant removal (one dog) and less than optimal post-operative limb alignment (two dogs) were assessed to contribute to the poor outcome. Two other dogs that required implant removal due to infection did successfully return to work.

CONCLUSIONS

In this limited cases series, partial tarsal arthrodesis in working dogs had a good prognosis for return to work. Any conclusion regarding the benefit of a particular surgical technique requires a prospective evaluation with a larger number of animals. It is important to minimise the risk of infection and optimally align the tarsus to avoid a poor outcome.

CLINICAL RELEVANCE

New Zealand veterinarians can now provide more accurate prognostic information to owners whose working dogs suffer tarsal trauma requiring partial arthrodesis.

A survey of diseases of working farm dogs in New Zealand

AIMS

To record the incidence of specific diseases affecting working farm dogs; identify any apparent breed predispositions; determine the most important causes of loss from death, euthanasia, or retirement of the dog; and identify potential interventions that could reduce the incidence of disease.

METHODS

A national questionnaire-based cross-sectional study was conducted to identify the incidence of specific diseases, and circumstances of trauma affecting working farm dogs that presented to rural veterinary practices over a 12-month period, between April 2008 and April 2009. The practices were convenience-sampled on the basis of geography and size.

RESULTS

Sixty-six practices were approached, and veterinarians from 30 practices agreed to participate, with representation from all major rural regions of New Zealand. Data were provided on 2,214 presentations, excluding revisits, of which 51% were for Huntaways and 39% Heading dogs. Trauma was identified as a cause of injury in 848 (38%) visits. Huntaways were apparently over-represented in cases of constipation, gastric dilatation-volvulus (GDV), theriogenological problems, laryngitis, hip dysplasia, and degenerative lumbosacral disease. In contrast, Heading dogs were over-represented among cases of multiple ligamentous injury of the stifle, disruption of the gastrocnemius or Achilles tendon, tarsal injuries, and hip luxation. Traumatic injury involved injury by stock (20%), automotive incidents (19%), transit across fence lines (16%), and dog bites (12%). Loss occurred following 10% of visits, of which trauma was known to be involved in 32%. The most important non-traumatic causes of loss were GDV, degenerative joint disease, mammary neoplasia and diseases involving the female reproductive tract, cardiac disease, and poisoning.

CLINICAL RELEVANCE

Several important diseases appear amenable to intervention through nutrition, neutering, or behavioural modification, including constipation, GDV, theriogenological problems, dog-bite injuries, and laryngitis. Altering modes of transit across fence lines has the potential to reduce large numbers of serious orthopaedic injuries to working farm dogs.

Effects of corticosterone treatment on growth, development, and the corticosterone response to handling in young Japanese quail (Coturnix coturnix japonica)

Corticosterone, a glucocorticoid secreted during stress responses, has a range of actions that help birds respond to stressors. Although effects of corticosterone treatment have been described in several avian species, the impacts of defined increases in plasma corticosterone on early development and on corticosterone stress responses are little known. These issues were addressed by providing quail with different doses of corticosterone in drinking water from days 8 to 38 post-hatch. The corticosterone dose consumed by each bird during treatment days 15-30 was calculated by measuring water intake. The corticosterone dose was inversely, but weakly, correlated with weights of the bursa, thymus, spleen, liver, testes, oviduct, muscle, and body, and positively correlated with peritoneal fat deposition. When birds were divided into groups based on their corticosterone intake, weights of the spleen, thymus, bursa, muscle, testes, and oviduct were significantly reduced in birds receiving the highest doses; with the exception of muscle, similar reductions were also observed in birds receiving medium doses, and thymic growth was inhibited in birds receiving low doses. The acute corticosterone stress response was measured by handling birds for 15 min. Plasma corticosterone was transiently increased at 15 min in control birds in response to the handling stressor. Some birds consuming low doses of corticosterone had corticosterone responses similar to control birds. Initial corticosterone concentrations were elevated in birds consuming higher doses of corticosterone. Plasma corticosterone in these birds decreased from 0 to 15 min, then increased from 15 to 30 min. The initial decrease could be due to corticosterone clearance, whilst the increase could indicate that the birds had a greater response than control birds to isolation as a stressor. Corticosterone treatment may have reduced the strength of corticosterone negative feedback within the hypothalamo-pituitary-adrenal axis. The results indicate that individuals and organs differ in their sensitivity to corticosterone. Moreover, elevated plasma corticosterone may disrupt the acute corticosterone stress response, and may thus reduce the ability of birds to cope with stressors.

Surfactant lipid peroxidation damages surfactant protein A and inhibits interactions with phospholipid vesicles

The goal of these studies was to examine the effect of lipid peroxidation (LPO) on the function of surfactant protein A (SP-A). First, the optimal dialysis conditions for quantitative removal of EDTA and redoxactive metals from reagents were established. Surfactant phospholipids were incubated with free radical generators in the absence or presence of the SP-A or with BSA as a control. We found that SP-A inhibited copper-initiated LPO to an extent similar to BSA (P < 0.05). Exposure of SP-A to LPO was associated with an increase in the level of SP-A-associated carbonyl moieties and a marked reduction in SP-A-mediated aggregation of liposomes. LPO initiated by an azo-compound also resulted in enhanced protein oxidation and markedly inhibited SP-A-mediated liposome aggregation. The kinetics of aggregation of auto-oxidized and nonoxidized liposomes by nonoxidized SP-A was similar, suggesting that SP-A has similar affinities for oxidized and nonoxidized lipids. Oxidative inactivation of SP-A did not occur upon direct incubation of the protein with malondialdehyde alone. We conclude that exposure of SP-A to LPO results in oxidative modification and functional inactivation of SP-A by phospholipid radicals.

Secretion of surfactant protein C, an integral membrane protein, requires the N-terminal propeptide

Proteolytic processing of surfactant protein C (SP-C) proprotein in multivesicular bodies of alveolar type II cells results in a 35-residue mature peptide, consisting of a transmembrane domain and a 10-residue extramembrane domain. SP-C mature peptide is stored in lamellar bodies (a lysosomal-like organelle) and secreted with surfactant phospholipids into the alveolar space. This study was designed to identify the peptide domain of SP-C required for sorting and secretion of this integral membrane peptide. Deletion analyses in transiently transfected PC12 cells and isolated mouse type II cells suggested the extramembrane domain of mature SP-C was cytosolic and sufficient for sorting to the regulated secretory pathway. Intratracheal injection of adenovirus encoding SP-C mature peptide resulted in secretion into the alveolar space of wild type mice but not SP-C (-/-) mice. SP-C secretion in null mice was restored by the addition of the N-terminal propeptide. The cytosolic domain, consisting of the N- terminal propeptide and extramembrane domain of mature SP-C peptide, supported secretion of the transmembrane domain of platelet-derived growth factor receptor. Collectively, these studies indicate that the N-terminal propeptide of SP-C is required for intracellular sorting and secretion of SP-C.

Pulmonary surfactant proteins A and D are potent endogenous inhibitors of lipid peroxidation and oxidative cellular injury

The lung is composed of a series of branching conducting airways that terminate in grape-like clusters of delicate gas-exchanging airspaces called pulmonary alveoli. Maintenance of alveolar patency at end expiration requires pulmonary surfactant, a mixture of phospholipids and proteins that coats the epithelial surface and reduces surface tension. The surfactant lining is exposed to the highest ambient oxygen tension of any internal interface and encounters a variety of oxidizing toxicants including ozone and trace metals contained within the 10 kl of air that is respired daily. The pathophysiological consequences of surfactant oxidation in humans and experimental animals include airspace collapse, reduced lung compliance, and impaired gas exchange. We now report that the hydrophilic surfactant proteins A (SP-A) and D (SP-D) directly protect surfactant phospholipids and macrophages from oxidative damage. Both proteins block accumulation of thiobarbituric acid-reactive substances and conjugated dienes during copper-induced oxidation of surfactant lipids or low density lipoprotein particles by a mechanism that does not involve metal chelation or oxidative modification of the proteins. Low density lipoprotein oxidation is instantaneously arrested upon SP-A or SP-D addition, suggesting direct interference with free radical formation or propagation. The antioxidant activity of SP-A maps to the carboxyl-terminal domain of the protein, which, like SP-D, contains a C-type lectin carbohydrate recognition domain. These results indicate that SP-A and SP-D, which are ubiquitous among air breathing organisms, could contribute to the protection of the lung from oxidative stresses due to atmospheric or supplemental oxygen, air pollutants, and lung inflammation.

Segmental regulation of pulmonary vascular permeability by store-operated Ca2+ entry

An intact endothelial cell barrier maintains normal gas exchange in the lung, and inflammatory conditions result in barrier disruption that produces life-threatening hypoxemia. Activation of store-operated Ca2+ (SOC) entry increases the capillary filtration coefficient (Kf,c) in the isolated rat lung; however, activation of SOC entry does not promote permeability in cultured rat pulmonary microvascular endothelial cells. Therefore, current studies tested whether activation of SOC entry increases macro- and/or microvascular permeability in the intact rat lung circulation. Activation of SOC entry by the administration of thapsigargin induced perivascular edema in pre- and postcapillary vessels, with apparent sparing of the microcirculation as evaluated by light microscopy. Scanning and transmission electron microscopy revealed that the leak was due to gaps in vessels >/= 100 micrometer, consistent with the idea that activation of SOC entry influences macrovascular but not microvascular endothelial cell shape. In contrast, ischemia and reperfusion induced microvascular endothelial cell disruption independent of Ca2+ entry, which similarly increased Kf,c. These data suggest that 1) activation of SOC entry is sufficient to promote macrovascular barrier disruption and 2) unique mechanisms regulate pulmonary micro- and macrovascular endothelial barrier functions.

Ca(2+)-inhibitable adenylyl cyclase and pulmonary microvascular permeability

Intracellular mechanisms responsible for endothelial cell disruption are unknown, although either elevated cytosolic Ca2+ ([Ca2+]i) or decreased adenosine 3',5'-cyclic monophosphate (cAMP) promotes permeability. Recent identification that Ca(2+)-inhibitable adenylyl cyclase establishes an inverse relationship between [Ca2+]i and cAMP in macrovascular endothelial cells provided a possible mechanism of development of permeability. However, these data utilized an in vitro model; lacking was evidence supporting 1) expression of Ca(2+)-inhibitable adenylyl cyclase in pulmonary microvascular endothelium and 2) Ca2+ inhibition of adenylyl cyclase and cAMP content as a paradigm for inflammatory mediator-induced permeability in the intact circulation. We therefore addressed these issues in microvascular endothelial cells derived from rat lung and in an isolated perfused rat lung preparation. Results demonstrate expression of a Ca(2+)-inhibitable adenylyl cyclase in microvascular endothelial cells. Furthermore, data suggest that Ca2+ inhibition of adenylyl cyclase is necessary for development of microvascular permeability in the intact circulation. We conclude Ca2+ inhibition of cAMP represents a critical step in genesis of microvascular permeability in the intact pulmonary circulation.

Inhaled nitric oxide pretreatment but not posttreatment attenuates ischemia-reperfusion-induced pulmonary microvascular leak

BACKGROUND

Ischemia-reperfusion (I/R) pulmonary edema probably reflects a leukocyte-dependent, oxidant-mediated mechanism. Nitric oxide (NO) attenuates leukocyte-endothelial cell interactions and I/R-induced microvascular leak. Cyclic adenosine monophosphate (cAMP) agonists reverse and prevent I/R-induced microvascular leak, but reversal by inhaled NO (INO) has not been tested. In addition, the role of soluble guanylyl cyclase (sGC) activation in the NO protection effect is unknown.

METHODS

Rat lungs perfused with salt solution were grouped as either I/R, I/R with INO (10 or 50 ppm) on reperfusion, or time control. Capillary filtration coefficients (Kfc) were estimated 25 min before ischemia (baseline) and after 30 and 75 min of reperfusion. Perfusate cell counts and lung homogenate myeloperoxidase activity were determined in selected groups. Additional groups were treated with either INO (50 ppm) or isoproterenol (ISO-10 microM) after 30 min of reperfusion. Guanylyl cyclase was inhibited with 1H-[1,2,4]Oxadiazolo[4,3-a]quinoxalin-1-one (ODQ-15 microM), and Kfc was estimated at baseline and after 30 min of reperfusion.

RESULTS

(1) Inhaled NO attenuated I/R-induced increases in Kfc. (2) Cell counts were similar at baseline. After 75 min of reperfusion, lung neutrophil retention (myeloperoxidase activity) and decreased perfusate neutrophil counts were similar in all groups. (3) In contrast to ISO, INO did not reverse microvascular leak. (4) 8-bromoguanosine 3',5'-cyclic monophosphate (8-br-cGMP) prevented I/R-induced microvascular leak in ODQ-treated lungs, but INO was no longer effective.

CONCLUSIONS

Inhaled NO attenuates I/R-induced pulmonary microvascular leak, which requires sGC activation and may involve a mechanism independent of inhibition of leukocyte-endothelial cell interactions. In addition, INO is ineffective in reversing I/R-induced microvascular leak.