Journal of Veterinary Internal Medicine

Publications in this journal

• Article: Bradyarrhythmias and Pacemaker Therapy in Dogs with Chagas Disease.

  A B Saunders, S G Gordon, M H Rector, A Demaster, N Jackson, F J Clubb, G T Fosgate, M W Miller
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  ABSTRACT: BACKGROUND: Chagas disease (Trypanosomiasis) is a cause of myocarditis in the southern United States causing cardiac conduction abnormalities, arrhythmias, and heart failure. OBJECTIVES: To report clinical findings and outcome in Chagas positive (CP) dogs requiring pacemaker implantation for bradyarrhythmias. ANIMALS: One hundred and forty-four client-owned dogs requiring pacemaker implantation. METHODS: Retrospective case series. Information regarding history, physical exam, laboratory and diagnostic imaging findings, treatment, and survival were obtained from medical records, with additional follow-up information obtained by contacting referring veterinarians and owners. RESULTS: Of the 144 dogs requiring pacemaker implantation from January 2001 to May 2010, 83 (57.6%) had a Chagas titer performed and 9 (10%) were CP. Concurrent ventricular arrhythmias (odds ratio 1.61, P = .005) or atrioventricular (AV) block (odds ratio 4.18, P < .001) increased the likelihood that a Chagas titer was submitted. Median age for CP dogs was 6.2 years (range, 0.3-10); 7 were male. Bradyarrhythmias included high-grade 2nd or 3rd degree AV block (n = 8) and sinus bradycardia with 1st degree AV block (n = 1); 5 had concurrent ventricular arrhythmias. A positive Chagas titer had a negative impact on survival (hazard ratio 4.04; 95% CI 1.36-12.1, P = .012) with a reported median survival time of 365 days (interquartile range, 84-973 days). CONCLUSIONS AND CLINICAL IMPORTANCE: Bradyarrhythmias can result in clinical signs requiring pacemaker implantation in CP dogs, and although the diagnosis negatively impacts survival, pacemaker therapy is a viable treatment option.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: Phase I Clinical Trial of Vinorelbine in Tumor-Bearing Cats.

  J A Pierro, C L Mallett, C F Saba
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  ABSTRACT: BACKGROUND: Vinorelbine (VRL) has been investigated in dogs, but its use in cats has not been studied. HYPOTHESIS/OBJECTIVES: To determine the maximal tolerated dose (MTD) and dose-limiting toxicity (DLT) of VRL in tumor-bearing cats. ANIMALS: Cats were included in this prospective phase I trial if they had confirmed malignancy, received ≥1 VRL treatment, and had adequate follow-up. Previous treatment was acceptable, but concurrent chemotherapy or radiotherapy was not permitted. METHODS: Using a modified phase I design, cats were enrolled in cohorts of 3 at a starting dosage of 9 mg/m(2) . Cats tolerating the first treatment well were eligible to receive additional VRL treatments at escalating dosages; escalations beyond the perceived MTD were permitted based on individual tolerance. Intended treatment interval was 7 days. Patient histories, physical examinations, and complete blood counts were performed weekly. RESULTS: Nineteen cats were included. Sixty-one VRL treatments were administered. Median number of treatments was 2 (range, 1-9). Starting dosages were 9-12 mg/m(2) . Maximal dosage administered was 15.5 mg/m(2) . The MTD was 11.5 mg/m(2) . Acute DLTs were neutropenia, vomiting, and nephrotoxicity. Other notable toxicities were weight loss and anemia. CONCLUSIONS AND CLINICAL IMPORTANCE: Vinorelbine is tolerated in cats at a weekly interval. Recommended starting dosage is 11.5 mg/m(2) . Neutropenia was transient, lasting <7 days; vomiting was self-limiting in most cases. Although VRL-associated nephrotoxicity has not been reported, potential attribution of this toxicity to VRL must not be discounted. Further investigation of the efficacy of VRL in feline malignancies is warranted.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: Evaluation of Hemostatic Activity of Canine Frozen Plasma for Transfusion by Thromboelastography.

  R Urban, C Guillermo Couto, M Cristina Iazbik
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  ABSTRACT: BACKGROUND: In humans, fresh frozen plasma (FFP) loses factor V and VIII activities after 1 year. It then becomes frozen plasma (FP), and theoretically is unsuitable for use in patients with coagulopathies. These findings have not been reported for dogs. HYPOTHESIS: Canine FP is hemostatically active after 5 years of storage. ANIMALS: Fresh plasma (Group FsP; n = 15) and 5-year-old FP (Group FzP; n = 10) from blood bank donors. METHODS: Group FsP and Group FzP samples were evaluated by thromboelastography (TEG), one-stage prothrombin time (OSPT), activated partial thromboplastin time (APTT), fibrinogen, and antithrombin. Fresh plasma (n = 6) and a subset of Group FzP (n = 8) were evaluated for clotting factor activities (V, VIII, IX, X). A 2nd experiment using short-term storage of thawed FP under suboptimal conditions (refrigerated [4°C] or refrozen [-20°C]) by TEG was performed to simulate general practice storage capabilities. RESULTS: Group FzP had shorter reaction time (P = .0007) and larger angle (P = .0004) compared with Group FsP by TEG, suggesting hypercoaguability. Factor VIII and X activities were lower in Group FzP (P = .02 and .005, respectively). Fibrinogen, OSPT, and APTT were significantly lower or longer for Group FzP than Group FsP (P < .05), but most values remained within reference intervals for dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: Five-year-old canine FP stored at -30°C is hemostatically active and should be clinically evaluated in patients with coagulopathies. If active, the monetary savings of using older plasma will be substantial.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: A Comprehensive Pathological Survey of Duodenal Biopsies from Dogs with Diet-Responsive Chronic Enteropathy.

  D Walker, A Knuchel-Takano, A McCutchan, Y-M Chang, C Downes, S Miller, K Stevens, K Verheyen, A D Phillips, S Miah, M Turmaine, A Hibbert, J M Steiner, J S Suchodolski, K Mohan, J Eastwood, K Allenspach, K Smith, O A Garden
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  ABSTRACT: BACKGROUND: The detailed pathological phenotype of diet-responsive chronic enteropathy (CE) and its modulation with dietary therapy remain poorly characterized. HYPOTHESIS/OBJECTIVES: Key mucosal lesions of diet-responsive CE resolve with dietary therapy. METHODS: This was a prospective observational study of 20 dogs with diet-responsive CE. Endoscopic duodenal biopsies collected before and 6 weeks after the start of a dietary trial were assessed by means of qualitative and quantitative histopathological, immunohistochemical, and ultrastructural criteria. Control duodenal biopsies were obtained from 10 healthy Beagle dogs on 1 occasion. RESULTS: Compared with control dogs, the CE dogs had higher villus stunting scores and higher overall WSAVA scores, a lower villus height-to-width ratio, and higher lamina propria density of eosinophils. The CE dogs also had ultrastructural lesions of the mitochondria and brush border. In common with other studies in which the disease and control populations are not matched for breed, age, sex, and environment, these comparisons should be interpreted with caution. Comparing biopsies collected at presentation and 6 weeks after starting the dietary trial, mean lamina propria mononuclear cell score and lamina propria densities of eosinophils and mononuclear cells decreased. Dietary therapy also improved ultrastructural lesions of the mitochondria and brush border, eliciting a decrease in intermicrovillar space and an increase in microvillus height. CONCLUSIONS AND CLINICAL IMPORTANCE: In dogs with diet-responsive CE, the remission of clinical signs with dietary therapy is associated with subtle decreases in lamina propria density of eosinophils and mononuclear cells, and resolution of ultrastructural lesions of the enterocyte.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: Evaluation of Methods to Improve the Diagnosis of Systemic Inflammation in Alpacas.

  T Passler, M F Chamorro, K P Riddell, M A Edmondson, E van Santen, C Cray, H S Maxwell, P H Walz
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  ABSTRACT: BACKGROUND: The stoic nature of alpacas and limitations of current diagnostic tests make early recognition of inflammatory diseases in this species challenging. OBJECTIVES: In a model of mild systemic inflammation, this study evaluated the utility of different clinical and clinicopathologic variables as accurate predictors of inflammation in alpacas. ANIMALS: Twelve clinically healthy alpacas were randomly assigned to equal-sized treatment (TG) and control (CG) groups. After collection of initial blood samples (0 hour), lipopolysaccharide (LPS; 20 μg/kg/24 h) or saline was administered by SC osmotic mini-pumps (OMP) for 96 hours. Additional blood samples were collected at 12, 18, 24, 36, 48, 72, 96, 120, 144, and 240 hours and differential leukocyte counts and concentrations of globulin, albumin, iron, haptoglobin, and serum amyloid A were measured. RESULTS: Mild swelling was observed at OMP implantation sites in both groups. Other clinical signs of systemic inflammation were not observed. Total leukocytes, neutrophils, albumin, and globulin concentrations were not significantly different between groups. Compared with CG-alpacas, TG-alpacas had fewer lymphocytes (P = .0322), more band neutrophils (P = .0087), and higher neutrophil/lymphocyte ratios (P = .0295) during the first 96 hours of the study. During LPS administration, serum iron concentrations were significantly decreased in TG-alpacas (P < .0001). Haptoglobin concentrations of TG-animals exceeded those of CG-animals after removal of OMP (P = .0056). Serum amyloid A was not detectable in alpacas in this study. CONCLUSION AND CLINICAL IMPORTANCE: These results indicated that neutrophil/lymphocyte ratios and serum iron concentrations are early indicators of inflammation in alpacas. Additional research is needed to evaluate the acute phase protein responses of alpacas.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: Effects of Diagnostic Test Accuracy and Treatment Efficacy on the Occurrence of Suspected Failure of Heartworm Prophylaxis in Dogs.

  B W Rohrbach, S Patton
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  ABSTRACT: BACKGROUND: Food and Drug Administration Center for Veterinary Medicine (FDA/CVM) cited concern regarding failure of heartworm prophylaxis. The positive and negative predictive value of the heartworm antigen test is an estimate of the probability of adult heartworm infection. HYPOTHESIS/OBJECTIVES: Assess the sensitivity, specificity, and predictive value of heartworm antigen tests. Explore the role of heartworm test accuracy and treatment with immiticide to generate reports of suspected failure of heartworm prophylaxis. METHODS: Literature searches for published information on the accuracy of heartworm antigen tests and efficacy of immiticide for treatment of the adult heartworm. RESULTS: Weighted averages for heartworm antigen test sensitivity and specificity were 78.2 and 97.3%, respectively. Efficacy of immiticide by 2-injection or alternate dose protocols were 88.3 and 89.1%, respectively. Depending on prevalence, the positive predictive value of the heartworm antigen test ranged from 15 to 54% and negative predictive value from 99 to 99.9%. For a hospital testing 1,000 dogs per year, false-positive test results may vary from 24 to 27 dogs. If these dogs were on heartworm preventive, they may undergo treatment and be classified as prophylaxis failures. Ten percent of dogs who were treated and continued or placed on prophylaxis at the time of treatment may have adult heartworms when tested 1 year later and be presumed to represent failure of prophylaxis. CONCLUSIONS: When interpreting heartworm antigen test results, clinical signs, history, and regional prevalence of heartworm disease should be considered in estimating the predictive value of the test result. Limitations of test and treatment should be discussed with clients as part of the decision-making process.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: Clinical and Pathological Analysis of Epidural Inflammation in Intervertebral Disk Extrusion in Dogs.

  A Fadda, A Oevermann, M Vandevelde, M G Doherr, F Forterre, D Henke
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  ABSTRACT: BACKGROUND: Little is known about the pathologic changes in the epidural space after intervertebral disk (IVD) extrusion in the dog. OBJECTIVES: To analyze the pathology of the epidural inflammatory response, and to search for correlations between this process and clinical findings. METHODS: Clinical data from 105 chondrodystrophic (CD) and nonchondrodystrophic (NCD) dogs with IVD extrusion were recorded. Epidural material from these dogs was examined histopathologically and immunohistochemically. Using statistical analysis, we searched for correlations between severity of epidural inflammation and various clinical and pathologic variables. RESULTS: Most dogs exhibited an epidural inflammatory response, ranging from acute invasion of neutrophils to formation of chronic granulation tissue. The mononuclear inflammatory infiltrates consisted mostly of monocytes and macrophages and only few T and B cells. Surprisingly, chronic inflammatory patterns also were found in animals with an acute clinical history. Severity of the epidural inflammation correlated with degree of the epidural hemorrhage and nucleus pulposus calcification (P = .003 and .040), but not with age, chondrodystrophic phenotype, neurologic grade, back pain, pretreatment, or duration. The degree of inflammation was statistically (P = .021) inversely correlated with the ability to regain ambulation. CONCLUSION AND CLINICAL IMPORTANCE: Epidural inflammation occurs in the majority of dogs with IVD extrusion and may develop long before the onset of clinical signs. Presence of calcified IVD material and hemorrhage in the epidural space may be the triggers of this lesion rather than an adaptive immune response to the nucleus pulposus as suggested in previous studies. Because epidural inflammation may affect outcome, further research is warranted.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: A Single Sample Method for Estimating Glomerular Filtration Rate in Cats.

  N C Finch, R Heiene, J Elliott, H M Syme, A M Peters
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  ABSTRACT: BACKGROUND: Validated methods of estimating glomerular filtration rate (GFR) in cats requiring only a limited number of samples are desirable. HYPOTHESIS/OBJECTIVES: To test a single sample method of determining GFR in cats. ANIMALS: The validation population (group 1) consisted of 89 client-owned cats (73 nonazotemic and 16 azotemic). A separate population of 18 healthy nonazotemic cats (group 2) was used to test the methods. METHODS: Glomerular filtration rate was determined in group 1 using corrected slope-intercept iohexol clearance. Single sample clearance was determined using the Jacobsson and modified Jacobsson methods and validated against slope-intercept clearance. Extracellular fluid volume (ECFV) was determined from slope-intercept clearance with correction for the 1 compartment assumption and by deriving a prediction formula for ECFV (ECFVPredicted ) based on the body weight. The optimal single sample method was tested in group 2. RESULTS: A blood sample at 180 minutes and ECFVPredicted were optimal for single sample clearance. Mean ± SD GFR in group 1 determined using the Jacobsson and modified Jacobsson formulae was 1.78 ± 0.70 and 1.65 ± 0.60 mL/min/kg, respectively. When tested in group 2, the Jacobsson method overestimated multisample clearance. The modified Jacobsson method (mean ± SD 2.22 ± 0.34 mL/min/kg) was in agreement with multisample clearance (mean ± SD 2.19 ± 0.34 mL/min/kg). CONCLUSIONS AND CLINICAL IMPORTANCE: The modified Jacobsson method provides accurate estimation of iohexol clearance in cats, from a single sample collected at 180 minutes postinjection and using a formula based on the body weight to predict ECFV. Further validation of the formula in patients with very high or very low GFR is required.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: Chronic Kidney Disease in Dogs in UK Veterinary Practices: Prevalence, Risk Factors, and Survival.

  D G O'Neill, J Elliott, D B Church, P D McGreevy, P C Thomson, D C Brodbelt
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  ABSTRACT: BACKGROUND: The prevalence for chronic kidney disease (CKD) in dogs varies widely (0.05-3.74%). Identified risk factors include advancing age, specific breeds, small body size, and periodontal disease. HYPOTHESIS/OBJECTIVES: To estimate the prevalence and identify risk factors associated with CKD diagnosis and survival in dogs. Purebred dogs were hypothesized to have higher CKD risk and poorer survival characteristics than crossbred dogs. ANIMALS: A merged clinical database of 107,214 dogs attending 89 UK veterinary practices over a 2-year period (January 2010-December 2011). METHODS: A longitudinal study design estimated the apparent prevalence (AP) whereas the true prevalence (TP) was estimated using Bayesian analysis. A nested case-control study design evaluated risk factors. Survival analysis used the Kaplan-Meier survival curve method and multivariable Cox proportional hazards regression modeling. RESULTS: The CKD AP was 0.21% (95% CI: 0.19-0.24%) and TP was 0.37% (95% posterior credibility interval 0.02-1.44%). Significant risk factors included increasing age, being insured, and certain breeds (Cocker Spaniel, Cavalier King Charles Spaniel). Cardiac disease was a significant comorbid disorder. Significant clinical signs included halitosis, weight loss, polyuria/polydipsia, urinary incontinence, vomiting, decreased appetite, lethargy, and diarrhea. The median survival time from diagnosis was 226 days (95% CI 112-326 days). International Renal Interest Society stage and blood urea nitrogen concentration at diagnosis were significantly associated with hazard of death due to CKD. CONCLUSIONS AND CLINICAL IMPORTANCE: Chronic kidney disease compromises dog welfare. Increased awareness of CKD risk factors and association of blood biochemistry results with survival time should facilitate diagnosis and optimize case management to improve animal survival and welfare.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: Clinical Evaluation and Endoscopic Classification of Bronchomalacia in Dogs.

  E Bottero, C Bellino, D De Lorenzi, P Ruggiero, A Tarducci, A D'Angelo, P Gianella
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  ABSTRACT: BACKGROUND: Little information is available about the association between bronchomalacia and historical or clinicopathologic data. Also, studies applying an endoscopic classification scheme that differentiates between static and dynamic bronchial collapse and based on a scoring system are lacking. OBJECTIVES: To describe the clinical presentation of bronchomalacia in dogs, to classify endoscopic findings, and to evaluate associations among historical, clinicopathologic data, and endoscopic findings. ANIMALS: Fifty-nine client-owned dogs with an endoscopic diagnosis of bronchomalacia. METHODS: In this retrospective study, medical records were analyzed and video documentation was reviewed to assign a score to endoscopic findings. Univariate analysis was performed on categorical variables organized in contingency tables, and a stepwise logistic regression model was used for multivariate analysis. RESULTS: Of the 59 dogs included in the study, 2 were affected by static bronchial collapse (SBC), 35 by dynamic bronchial collapse (DBC), and 22 by both SBC and DBC. The association between SBC and DBC was more frequently seen in the dogs with higher body weight, pulmonary hypertension, a bronchial type of radiographic pattern, and nodularity at endoscopic examination. Thirty-one dogs were presented with tracheomalacia and bronchomalacia; an association emerged between these concurrent disorders in dogs living indoors. Multivariate analysis of the endoscopic scores showed a correlation between DBC severity and cough duration. CONCLUSION AND CLINICAL IMPORTANCE: Results of this study provide evidence for 2 different types of bronchial collapse. Endoscopic scoring scheme has proved to be promising in the bronchomalacia classification, although further evaluation of its applicability in larger canine populations is needed.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: A Comparison of Hepatic Sonographic Features and Histopathologic Diagnosis in Canine Liver Disease: 138 Cases.

  S D Kemp, D L Panciera, M M Larson, G K Saunders, S R Werre
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  ABSTRACT: BACKGROUND: Ultrasound examination is commonly used in the diagnostic evaluation of liver disease in dogs. HYPOTHESIS/OBJECTIVES: To determine if hepatic sonographic features were predictive of findings on liver histopathology. We hypothesized that there would be a relationship between sonographic features and the category of liver disease based on histologic assessment. ANIMALS: One hundred and thirty-eight dogs in which the liver was evaluated by both abdominal ultrasound examination and histopathologic examination. Twenty-five dogs were included in each of the following categories based on histopathology: normal, degenerative, vascular, inflammatory, and neoplasia. Thirteen dogs had nodular regeneration. METHODS: Retrospective study. Medical records of dogs from 2005 to 2010 were searched for cases in which the liver was evaluated by abdominal ultrasound examination as well as by histopathology. After independent evaluation of ultrasound images, the recorded sonographic features were analyzed to identify abnormalities associated with each histopathologic diagnosis or degree of fibrosis. RESULTS: Sixty-four percent of sonographically unremarkable livers had histologic abnormalities. Both microhepatia and the identification of abnormal vasculature were significantly associated with a histopathologic diagnosis of vascular disease. Hepatic masses were significantly associated with a diagnosis of neoplasia. Dilated common bile duct and thickened gall bladder wall were significantly associated with hepatitis. There were no sonographic findings consistently present with hepatic fibrosis. CONCLUSION AND CLINICAL IMPORTANCE: Although some ultrasonographic findings, including masses, microhepatia, anomalous veins, and biliary changes, are associated with specific histopathologic abnormalities, sonographic findings are inconsistently detected in many disorders. Overall, hepatic ultrasonographic abnormalities have substantial limitations in predicting the underlying disease.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: Phylogenetic Diversity of Bacteria Isolated from Sick Dogs Using the BAPGM Enrichment Culture Platform.

  A C Davenport, P E Mascarelli, R G Maggi, E B Breitschwerdt
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  ABSTRACT: BACKGROUND: Bartonella alpha-Proteobacteria growth medium (BAPGM) enrichment culture has proven useful for documenting Bartonella species infection and has facilitated growth of other fastidious bacteria from human samples. PURPOSE: To report non-Bartonella bacterial isolates obtained from canine samples cultured using BAPGM enrichment culture. ANIMALS: Between 2004 and 2008, 695 specimens from 513 dogs were tested by the NCSU-IPRL using the BAPGM enrichment culture. Over the same period of time, blood samples from 270 dogs were cultured by the NCSU-CML using Bactec-Plus Aerobic/F media. METHODS: BAPGM isolates were characterized using Bartonella genus primers and 16S rDNA primers followed by DNA sequencing. NCSU medical records were retrospectively reviewed. Blood culture results from the NCSU-CML were compared with BAPGM blood culture results. RESULTS: Seventy-nine non-Bartonella isolates were obtained from 69/513 dogs. The most commonly isolated phylum was Proteobacteria (48.1%) with alpha-Proteobacteria being the most commonly isolated class. Staphylococcus and Sphingomonas were the most commonly isolated genera. The majority of the remaining isolates were bacteria that are rarely isolated from canine samples. Comparison of NCSU-CML and IPRL (BAPGM) blood culture isolates showed alpha-Proteobacteria were isolated more often from BAPGM. CONCLUSIONS AND CLINICAL IMPORTANCE: Use of insect cell culture enrichment medium, such as BAPGM, appears to enhance the growth of alpha-Proteobacteria, but also results in isolation of non-alpha-Proteobacteria from sick dogs. Future studies are needed to elucidate the utility of BAPGM and other "nonconventional" growth media and methods for isolation of fastidious organisms and to determine if these organisms play a causal role in disease development.
  Journal of Veterinary Internal Medicine 05/2013;
• Article: Letter to the editor.

  Micah Bishop, Panagiotis Xenoulis, Jörg M Steiner
  Journal of Veterinary Internal Medicine 05/2013; 27(3):427-8.
• Article: Letter to the editor.

  Eva Furrow, P Jane Armstrong, Ned E Patterson
  Journal of Veterinary Internal Medicine 05/2013; 27(3):429.
• Article: Letter to the editor.

  B McKenzie
  Journal of Veterinary Internal Medicine 05/2013; 27(3):425.
• Article: A potential role for substance p and interleukin-6 in the cerebrospinal fluid of cavalier king charles spaniels with neuropathic pain.

  M J Schmidt, J Roth, N Ondreka, M Kramer, C Rummel
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  ABSTRACT: Neuropathic pain can be a clinical sign in Cavalier King Charles Spaniels (CKCS) with syringomyelia. The pathophysiology of this pain is not fully understood. Neuropathic pain in CKCS is a result of a neuroinflammatory process. Twenty-six client-owned dogs: 15 dogs with clinical signs of cervical hyperesthesia (group 1), and 11 dogs without of clinical signs (group 2). Dogs were examined by magnetic resonance imaging (MRI). Interleukin-6, tumor necrosis factor alpha, and substance P were measured in CSF and compared with morphological findings on MRI and clinical pain scores. All dogs without clinical signs had symmetrical syringomyelia, whereas in the group with pain, 6 dogs had symmetrical and 9 dogs had asymmetrical syringomyelia. Pain and syringomyelia asymmetry were correlated, and a strong association between pain and dorsal horn involvement of syringomyelia was observed. There was no significant difference between the mean width of the syringomyelia in dogs with or without pain. The concentrations of interleukin-6 and substance P were significantly higher in dogs with neuropathic pain. Tumor necrosis factor alpha was not detected in either group. Concentrations of substance P were significantly higher in dogs with asymmetrical syringomyelia or dorsal horn involvement, whereas interleukin-6 concentrations were not significantly different between groups. Release of interleukin-6 and substance P may initiate proinflammatory effects leading to development of persistent pain in CKCSs with syringomyelia.
  Journal of Veterinary Internal Medicine 05/2013; 27(3):530-5.
• Article: Comparison of 2 Retrieval Devices for Heartworm Removal in 52 Dogs with Heavy Worm Burden.

  W K Yoon, R Choi, S G Lee, C Hyun
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  ABSTRACT: BACKGROUND: For treating dogs with heavy heartworm infection, mechanical removal using various retrieval devices is useful. However, the efficacy and safety of retrieval devices have rarely been studied. HYPOTHESIS: Catheter-based heartworm removal using 2 retrieval devices (basket and tripod grasping forceps) is efficient and safe for treating dogs with heavy worm burden. ANIMALS: Fifty-two client-owned dogs with heavy (Class III and IV) worm burden. METHODS: A retrospective study was performed on 52 dogs, using a catheter-based heartworm removal approach using 2 types of retrieval devices (ie, the basket and the tripod grasping forceps). The efficacy and complications associated with the 2 devices were assessed. RESULTS: The basket device was used on 22 of the study group dogs, and the tripod grasping forceps was used on 30 of the dogs. The postoperative survival rate was 95.5% for the basket device and 80% for the tripod grasping forceps, but the difference was not statistically significant. The worm number captured per attempt was 3.5 ± 1.7 using the basket device and 1.9 ± 0.85 for the tripod grasping forceps (P < .05). Various complications associated with heartworm removal were noticed with both retrieval devices. CONCLUSIONS AND CLINICAL IMPORTANCE: This study suggests that catheter-based heartworm removal is not only a relatively safe and efficient therapeutic method in dogs with heavy worm burden, but more efficient using the basket device. Our data do not indicate a clear safety advantage between the 2 devices evaluated, although the survival rate was numerically higher in dogs undergoing a basket intervention.
  Journal of Veterinary Internal Medicine 04/2013;
• Article: NOD2 mRNA Expression and NFkappaB Activation in Dogs with Lymphocytic Plasmacytic Colitis.

  H Okanishi, K Hayashi, Y Sakamoto, T Sano, H Maruyama, Y Kagawa, T Watari
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  ABSTRACT: BACKGROUND: Nucleotide Oligomerization Domain Two (NOD2) is suggested to be an intracellular pathogen-associated molecular pattern recognition molecule. NOD2, plays a key role against bacteria by triggering a host defense response through activation of the transcription factor NFkappaB and subsequent proinflammatory cytokine production. NOD2 recently was reported to be overproduced in inflamed colonic mucosa in Crohn's disease, and to be accompanied by a significant increase in NFkappaB activity. However, few studies to date have investigated intercellular signaling molecules in dogs with lymphocytic plasmacytic colitis (LPC). HYPOTHESIS: NOD2 mRNA expression and NFkappaB activation are increased in mucosal biopsies of LPC dogs as compared with control dogs. ANIMALS: Five healthy dogs and 19 dogs with LPC. METHODS: Descending colon biopsies were obtained endoscopically. Expression of NOD2 mRNA was evaluated by semiquantitative RT-PCR in the colonic mucosa. NFkappaB binding activity was assessed by electrophoretic mobility shift assay. RESULTS: NOD2 mRNA expression was approximately 63% greater in LPC dogs than in healthy controls (P = .019). NFkappaB binding activity was approximately 45% higher in the inflamed colonic mucosa of the LPC dogs, as compared with healthy controls (P = .011). No correlations were observed among NOD2 mRNA expression levels, NFkappaB binding activity, and CIBDAI in LPC dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: NOD2 mRNA and NFkappaB activity were significantly higher in the inflamed colon of dogs with LPC, as compared with healthy controls. Our data suggest that NOD2 and NFkappaB play an important role in the pathogenesis of LPC.
  Journal of Veterinary Internal Medicine 04/2013;
• Article: Identification and Surgical Ligation of Aortopulmonic Vascular Malformation Causing Left Heart Volume Overload in 4 Dogs.

  G J Culshaw, T Wagner, V Luis Fuentes, T Schwarz, D A Yool, A T French, D J Brockman
  Journal of Veterinary Internal Medicine 04/2013;
• Article: Prospective Evaluation of Biweekly Streptozotocin in 19 Dogs with Insulinoma.

  N C Northrup, K M Rassnick, T L Gieger, C E Kosarek, C W McFadden, M P Rosenberg
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  ABSTRACT: BACKGROUND: Administration of streptozotocin (STZ) at a 21-day interval has been described in dogs with stage II and III insulinoma. Myelosuppression was not observed, suggesting the possibility of increasing dose intensity by decreasing the interval between doses. OBJECTIVE: To describe the tolerability of a biweekly STZ protocol. A secondary objective was to describe the outcome of dogs treated with this protocol. ANIMALS: Nineteen dogs with residual local, metastatic, or recurrent insulinoma. METHODS: After surgery for insulinoma, or at the time of recurrence, dogs were treated with a previously described STZ and saline diuresis protocol. Treatments were administered every 14 days. All dogs received antiemetic treatment. Adverse events (AEs) were recorded and graded. Outcome endpoints assessed were progression-free survival (PFS) and survival. RESULTS: None of the dogs experienced neutropenia or thrombocytopenia. Mild to moderate gastrointestinal toxicity was the most common AE. Diabetes mellitus was observed in 8 dogs and, in 6, resulted in euthanasia or death. Two dogs developed nephrotoxicity manifested as Fanconi syndrome in 1 and nephrogenic diabetes insipidus in the other. Six dogs developed increased alanine amino transferase activity. Hypoglycemia at the end of the STZ infusion, resulted in collapse in 1 dog and a generalized seizure in another. The median overall PFS and survival time were 196 and 308 days, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Streptozotocin can be safely administered to dogs with insulinoma, but serious AEs are possible. Additional investigation is required to better define the role of STZ in managing dogs with insulinoma.
  Journal of Veterinary Internal Medicine 04/2013;