CVJ - September 2024, Vol. 65, No. 9
Scientific
Case Reports
Cough-induced severe bradycardia and syncope in a dog
Sool yi Park, Won-Seok Oh, Hyunseon Jeong, Seunggon Lee (page 874)
A 10-year-old spayed female shih tzu dog was brought to the hospital because of recurring syncope that occurred simultaneously with a cough. Physical examination did not reveal an abnormal heart rhythm or abnormal heart sounds. Electrocardiography revealed sinus arrest of 4.7 s with intermittent escape beats during coughing. Additional examinations, including thoracic radiography, clinical pathology, and echocardiography, revealed no abnormalities of concern. Forty-eight-hour Holter monitoring captured 1 syncopal episode following severe coughing, during which the longest sinus arrest lasted 16 s with intermittent escape beats. This observation confirmed our strong suspicion that coughing was the cause of varying degrees of sinus arrest in this dog. Theophylline, codeine, and short-term prednisolone were prescribed to treat the dog’s cough. The daily episodes of syncope ceased and coughing decreased. Subsequent 48-hour Holter monitoring revealed no abnormal pauses, and the owner did not report syncope. Theophylline and codeine were continued for 5 mo, during which time no syncope occurred. To our knowledge, this case provides the first clear evidence of a correlation between cough-induced sinus arrest and syncope in a veterinary patient, as confirmed by Holter monitoring and electrocardiography.
Key clinical message:
Cough-induced severe bradycardia and syncope were identified in a shih tzu dog. After the antitussive medication was adjusted, the signs resolved.
Infrared thermography for detection of blunt-force trauma injuries during animal abuse investigations
Margaret Doyle (page 880)
Detection of bruising in living animal victims of abuse can be challenging due to animal temperament and anatomy. Visual assessment, combined with physical and serum biochemical evaluation, can fail to detect injuries. However, development and validation of a noninvasive, antemortem method for detecting bruising in domestic species could have important medicolegal implications.
Key clinical message:
Thermal imaging utilizing infrared wavelengths can assist in detection of trauma in cases of animal abuse where no visible injuries are apparent, aiding in providing appropriate medical treatment and guidance for the legal system.
Adjunctive intravesical EDTA-tromethamine treatment of a biofilm-associated recurrent Escherichia coli cystitis in a dog
Vincent Leynaud, Nicolas P. Jousserand, Marie-Noëlle Lucas, Laurent Cavalié, Jean-Paul Motta, Éric Oswald, Rachel Lavoué (page 886)
A 15-month-old spayed female greater Swiss mountain dog was brought to our clinic because of relapsing episodes of urinary tract infection, present since her adoption at 2 mo of age. A diagnosis of chronic bacterial cystitis associated with an invasive, biofilm-forming uropathogenic Escherichia coli was made with bladder-wall histology and fluorescent in situ hybridization analysis. Local treatment with EDTA-tromethamine (EDTA-Tris) infusions along with parenteral cefquinome and prophylactic measures (Type-A proanthocyanidins and probiotics) coincided with clinical and bacterial remission. The dog has been free of clinical signs of urinary tract infection for > 4 y. Biofilm-forming uropathogenic E. coli can cause chronic, recurrent cystitis due to low antibiotic efficacy and should be considered in cases of recurrent cystitis in dogs, especially in the absence of identified predisposing factors. This case report describes the diagnostic and therapeutic options that were used to manage a case of this type.
Key clinical message:
Fluorescent in situ hybridization analysis may be considered in the diagnosis of chronic bacterial cystitis in dogs, and intravesical instillations of EDTA-Tris may be helpful in managing such cases.
Kidney sparing during surgical treatment of an adrenocortical carcinoma with renal vein invasion in a cat
Stefano Nicoli, Alessia Vitali, Diego Iannelli, Ludovica Biassoni, Cyndi Mangano, Nicola Iannelli (page 894)
A 15-year-old domestic shorthair cat was presented with gastrointestinal signs, polyuria, polydipsia, and weakness. Abdominal bruit (“whooshing” sound from turbulent blood flow) and hypertension (systolic blood pressure: 200 mmHg) were present. A left adrenal gland mass was detected with abdominal ultrasonography; a subsequent CT examination identified a mass and a thrombus in the ipsilateral renal vein. Adrenalectomy and venotomy were completed but nephrectomy was not necessary. Histological diagnosis was an adrenocortical carcinoma. There were no clinical signs at a follow-up examination 30 mo after surgery.
Key clinical message:
This report describes successful surgical management of feline adrenocortical carcinoma with renal vein invasion without kidney damage. This case suggests that, after correct diagnosis and in well-selected cases, surgery to remove adrenal tumors and thrombi in cats, despite renal vein invasion, can be done with excellent short- and long-term outcomes.
Diagnosis and successful medical management of a renal corticomedullary abscess in a dog
Carley Johnson, Janis Lapsley, Hunter Piegols, Julie Byron, Eric Green, Laura E. Selmic (page 900)
A 10-year-old spayed female mixed-breed dog was brought to the Ohio State University Veterinary Medical Center because of a suspected mass located to the right kidney. The mass was diagnosed by abdominal ultrasound following a recurrent lower urinary tract infection. Abdominal computed tomography revealed 2 isoattenuating, peripherally hypoattenuating, and centrally non-contrast-enhancing nodules in the right kidney; the larger one measured 1.9 cm. Initial attempts at fine-needle aspiration were unsuccessful. The dog was returned and the mass was aspirated using ultrasound guidance under heavy sedation. Cytology confirmed the presence of septic inflammation, consistent with a renal corticomedullary abscess. The dog was administered oral enrofloxacin (15 mg/kg, q24h) after diagnosis. Ultrasound guidance was used 2 wk later, under general anesthesia, to achieve percutaneous drainage of ~0.25 mL of fluid and instillation of 5.7 mg (0.25 mL) of enrofloxacin into the abscess capsule. Two weeks after percutaneous drainage, ultrasound examination showed complete resolution of the renal corticomedullary abscess. Urine culture confirmed resolution of the urinary tract infection. To the authors’ knowledge, kidney-sparing medical management has never been successfully reported in a dog with a renal corticomedullary abscess.
Key clinical message:
Renal corticomedullary abscesses occur infrequently in dogs. Medical management is feasible and can result in complete resolution of clinical signs and imaging abnormalities.
Ultrasonographic features of a gastric submucosal lipoma in a cat: A case study
Seoyeoun Ji, Hyung-Kyu Chae, Luke Borst, Yeon-Jung Hong (page 906)
A 7-year-old Korean shorthair cat was admitted to our hospital with chronic constipation. Abdominal ultrasonography incidentally revealed a focal asymmetric gastric mass. The mass was submucosal and hypoechoic without loss of wall layering. Histopathological examination revealed a gastric submucosal lipoma (GSL). Although there have been reports of gastric submucosal fat infiltration in cats, there have been no reports regarding GSL. To our knowledge, this is the first report describing the ultrasonographic characteristics of GSL in a cat. Gastric submucosal lipoma should be considered as a differential diagnosis when a focal hypoechoic submucosal mass without loss of wall layering in the stomach is observed on ultrasound images.
Key clinical message:
This case report describes the ultrasonographic characteristics of GSL in a cat and aims to provide useful information for the diagnosis of lipoma occurring in the feline gastrointestinal tract. The ultrasonographic features and histological results we describe should be helpful in diagnosing submucosal lipoma in cats with similar conditions.
Articles
Confidence level of Australian veterinarians with point-of-care ultrasound before and after a training course
Annelies Valcke, Pamela Manning, Soren Boysen, Kris Gommeren (page 910)
Objective
To determine if a short, hands-on, point-of-care course improves confidence of veterinary practitioners (VPs) in performing basic point-of-care ultrasound (POCUS) applications and diagnosing specific POCUS pathologies.
Procedure
A 2-day POCUS course was offered, including 6 h of lectures and 4 h of hands-on training. A self-assessment survey, using a 4-point Likert scale, was administered before and after the course, to study VPs’ confidence in attaining ultrasound skills and diagnosing pathologies.
Results
One hundred and thirteen participants answered the surveys: 65 (57.5%) completed pre- and post-practical surveys. Difference in confidence levels was assessed on paired pre-and post-practical surveys. Self-confidence increased significantly for each of the questions and for each field [pleural and lung POCUS (PLUS), abdominal POCUS, cardiac POCUS, and ultrasound-guided IV access] (P < 0.0001). Self-confidence was significantly higher for abdominal POCUS than for PLUS, cardiac POCUS and IV access before (P < 0.0001), but not following, completion of the course (P = 0.81).
Conclusion
A short, 2-day course significantly increased the confidence level of VPs in the realization and interpretation of PLUS, abdominal POCUS, and cardiac POCUS questions, and vascular access procedures. Following completion of the course, there was no significant difference in confidence levels among POCUS fields. This suggests the course allowed practitioners to obtain equal confidence across all POCUS applications.
When veterinarians treat plus-sized pets: Insights for veterinary practice
Valli-Laurente Fraser-Celin, Amberlee Boulton, Kathleen Keil, Melanie J. Rock, Cindy Adams (page 920)
Background
Obesity of companion animals in Canada is becoming a problem in veterinary practice. Cats and dogs, in particular, are increasingly overweight. However, prevention and treatment present challenges. Challenges in treating pet obesity, such as client nonadherence and animal welfare issues arising from obesity, also affect the well-being of veterinarians — especially given the coincident high rates of burnout and compassion fatigue experienced in the profession.
Objective
This study investigated how practicing veterinarians perceive the treatment of overweight companion animals and how treating obese pets affects well-being of veterinarians.
Animals and procedure
We recruited veterinarians who routinely treat companion animals in private practice to participate in focus group interviews. We also interviewed veterinarians who could not attend the focus group sessions, yet still wished to contribute. Through thematic data analysis, we generated key themes that illustrated how treating obese pets negatively affects veterinarian well-being.
Results
Eighteen companion animal veterinarians contributed to this study. We generated 3 themes from the analysis that illustrate negative effects of treating obese pets on veterinarian well-being: i) negative feelings such as frustration and sadness associated with treating obese pets; ii) owners’ lack of comprehension of the effects of obesity on pets, including early euthanasia; and iii) client nonadherence regarding treatment.
Conclusion and clinical relevance
This study contributes to the veterinary literature on companion animal obesity by focusing on how treating pet obesity affects veterinarian well-being, especially given high rates of burnout and compassion fatigue in the profession. As pet obesity increases in society, obesity prevention and treatment is becoming central to companion animal veterinary practice. Our findings suggest that veterinarian well-being is negatively affected in connection with companion animal obesity. We recommend relationship-centered communication, increased nutritional expertise, and a focus on wellness in the workplace to improve veterinarian well-being while treating pet obesity.
Effectiveness of an experimental subunit ovine Mannheimia haemolytica respiratory vaccine in reducing pneumonia in lambs
Joyce Van Donkersgoed, Megan Gardner, Tracy Prysliak, Jose Perez-Casal (page 927)
Background
Pneumonia is the largest cause of mortality in Canadian lambs. Currently there are no licensed ovine vaccines in Canada to reduce economic losses from this production-limiting disease.
Objective, animals, and procedure
The effectiveness of an experimental subunit Mannheimia haemolytica leukotoxin A (LtxA) and transferrin binding protein B (TbpB) vaccine was evaluated in lambs for reduction of clinical disease in an experimental challenge study and in a controlled randomized field trial in a large commercial sheep operation.
Results
Following an experimental challenge of parainfluenza 3 virus and M. haemolytica, the subunit vaccine induced significantly higher LtxA and TbpB antibody titers at 48 d post-challenge compared to the adjuvant and Ovipast Plus bacterin (Merck Animal Health), but there were no significant differences in clinical signs or mortality among vaccine groups. Following vaccination of commercial ewes and their lambs at weaning, the only significant difference in health, growth, and carcass traits between vaccinates and non-vaccinates was a slightly higher pneumonia treatment rate in vaccinated preweaned lambs (25.7%) compared to unvaccinated preweaned lambs (23.4%) (P = 0.04).
Conclusion and clinical relevance
Although vaccination with the experimental subunit M. haemolytica vaccine induced high LtxA and TbpB antibodies, it did not reduce clinical disease in lambs following an experimental challenge study or in a controlled randomized field trial in a commercial sheep operation. Further research is required to identify additional protective antigens for a safe and effective ovine respiratory vaccine to reduce pneumonia losses in commercial sheep flocks.
Cytologic findings in mandibular and superficial cervical lymph nodes of dogs with thyroid carcinoma
Zoe K. Williams, Ashley A. Smith, Noelle S. Bergman, Stephanie E.S. Lindley, Janet A. Grimes, Brad M. Matz (page 941)
Objective
To describe cytologic findings from mandibular and superficial cervical lymph nodes in dogs with thyroid carcinoma and to determine prognostic factors associated with lymph node metastasis.
Animals
A total of 71 client-owned dogs with confirmed thyroid carcinoma that had cytologic results from at least 1 mandibular or superficial cervical lymph node between 2010 and 2020.
Procedure
Medical records from 2 referral veterinary hospitals were retrospectively reviewed. Cytology of lymph nodes was reviewed for presence of metastasis by diplomates of the American College of Veterinary Pathologists. Thyroid tumor diameter and volume, tumor fixation, bilateral location, vascular invasion, and stage were recorded to determine effects on nodal metastasis.
Results
A total of 154 lymph nodes (104 mandibular and 50 superficial cervical lymph nodes) from 71 dogs were cytologically evaluated, and 1/154 (0.6%) and 2/154 (1.3%) lymph nodes were noted to be definitively metastatic or probably metastatic, respectively. Given the infrequent rate of nodal metastasis (1.9% or less), statistical analysis of potential prognostic variables was not completed.
Conclusion and clinical relevance
Routine lymph node cytology of mandibular and superficial cervical lymph nodes appeared to be of low yield when assessing for metastasis of canine thyroid carcinomas. The medial retropharyngeal and deep cervical lymph nodes should continue to be evaluated as they appeared to have higher metastatic rates, based on historic reports. Additional studies are needed to determine prognostic factors associated with lymph node metastasis and effects on patient survival.
Review Article
Cannabis sativa in veterinary medicine: Foundations and therapeutic applications
Karla Pinto, João F. Requicha (page 948)
An increase in products containing phytocannabinoids, particularly cannabidiol, is often observed in human and veterinary markets following the legalization of hemp (cannabis) for industrial purposes. In veterinary medicine, derivatives of Cannabis sativa are used for managing pain (osteoarticular, oncological, and neuropathic), epilepsy, and behavioral disorders, as well as oncological, immune-mediated, cardiovascular, and respiratory diseases. In addition, there is growing interest in incorporating C. sativa into livestock feed. To elucidate the mechanisms of action of phytocannabinoids, a thorough understanding of the endocannabinoid system and its role in maintaining homeostasis is essential. Short-term use of phytocannabinoid products appears generally safe, but further research is required to understand the routes of administration, pharmacokinetics, and pharmacodynamics across various species. Although literature on phytocannabinoids in veterinary patients is limited, the available data suggest significant therapeutic potential.
Quiz Corner
(page 866)
Features
President's Message
Around the world in 80 days
Tim Arthur (page 856)
Veterinary Medical Ethics
(page 862)
Cross Canada Disease Report
First detection of Duck adenovirus 4 (DAdV-4) in Canada
Carl A. Gagnon, Valérie Grenier St-Sauveur, Marika Köszegi, Andrée Bourgault, Danielle Larochelle (page 870)
Commentary
Reflections on 6 decades in the veterinary profession
R. C. (Chas) Povey (page 959)
Veterinary Dermatology
Overview of the diagnosis and treatment of autoimmune skin disorders in horses
Julie Lefrançois, Frédéric Sauvé (page 964)
Diagnostic Ophthalmology
Fiona Lamb, Lynne S. Sandmeyer
(page 970)
Veterinary Practice Management
Comparing registered veterinary technician wages across Canada
Darren Osborne (page 973)
Notices
Book Available For Review
(page 873)
Index of Advertisers
(page 947)
Business Directory
(page 976)