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March 2023
JAAHA Abstracts
Abstracts from the latest issue of the Journal of the American Animal Hospital Association.
59.2 MAR/APR 2023
Case Reports
Lung Lobectomy as an Adjunctive Treatment for Refractory Pulmonary Coccidioidomycosis in a Dog
Kaylyn McDaniel, Kristen McDaniel, Jared A. Jaffey, Jason D. Struthers, Natasha Walzthöni, Danielle Gordon
A 5 yr old, castrated male, border collie mixed-breed dog was evaluated for cough and subsequently diagnosed with pulmonary coccidioidomycosis. Baseline serum anti-Coccidioides spp. immunoglobulin M and immunoglobulin G antibody titers were negative and 1:8, respectively. Thoracic computed tomography identified marked gravity-dependent pulmonary consolidation of the right middle lung lobe and marked tracheobronchial lymphadenomegaly. First-line antifungals were prescribed without adequate clinical or radiographic improvement, and a right middle lung lobectomy was subsequently performed 5.5 mo after diagnosis. Clinical signs associated with the respiratory tract resolved postoperatively. Fluconazole was discontinued 204 days after surgery because the dog remained subclinical, the thoracic computed tomography revealed near normal imaging with the exception of changes typical following a lung lobectomy, and the serum anti-Coccidioides spp. immunoglobulin G titer was 1:2. The dog remained subclinical >90 days after cessation of fluconazole. This case report describes the successful treatment outcome in a dog with severe Coccidioides spp. pneumonia following lung lobectomy and oral antifungal therapy. Future studies are warranted to determine the utility of adjunctive lung lobectomy in dogs with coccidioidomycosis who have large fungal burdens localized to a single lung lobe and are refractory to standard first-line oral antifungal therapies.
Case Reports
Successful Resuscitation of Neonatal Kittens Delivered by a Perimortem Cesarean Section Following Maternal Cardiopulmonary Arrest
Molly Racette
A 9 yr old, unknown weight, intact female domestic shorthair presented for evaluation of dystocia with dyspnea. En route to the hospital for treatment, the owners noted the queen stopped breathing. On presentation, cardiopulmonary arrest was confirmed. The exact cause was unknown but suspected to be secondary to acute fulminant congestive heart failure or acute respiratory distress syndrome due to a large volume of serosanguineous fluid within the mouth and nose. Cardiopulmonary resuscitation (CPR) was immediately started. After 2 min of CPR without return of spontaneous circulation, the owners consented to perimortem Cesarean section. Two kittens were removed via emergency hysterotomy within 3–4 min. Both kittens were successfully resuscitated. CPR efforts were continued on the queen for 2 min after delivery of the kittens, at which time the owners elected to stop further resuscitative efforts. Both kittens were discharged from the hospital and were alive at last follow-up, 2 yr and 4 mo after birth. There are no previous reports regarding the use of a perimortem Cesarean section to deliver neonates in small animal medicine. Therefore, this report represents a novel treatment approach that can be considered in the case of maternal arrest during dystocia.
Case Reports
Brevundimonas vesicularis isolation from a Labrador Retriever with Bacteremia, Endocarditis, Spinal Epidural Empyema, and Polyarthritis
Abby Lynn Ostronic, Rebecca Windsor, Amy Dixon-Jimenez
A 7 yr old spayed female Labrador retriever was evaluated for progressive nonambulatory tetraparesis, obtundation, joint pain, and pyrexia. The dog was diagnosed with spinal epidural empyema, bacteremia, endocarditis, and polyarthritis based on magnetic resonance imaging, echocardiography, joint fluid analysis, and blood culture. Blood culture isolated a rare and atypical pathogen, Brevundimonas vesicularis in conjunction with Escherchia coli. The patient was treated with a 10 mo antibiotic course, and clinical signs quickly resolved. This is the first report of B vesicularis in association with bacteremia, endocarditis, spinal empyema, and polyarthritis in a dog.
Original Studies
Complications and Long-Term Outcomes After Prosthetic Capsule Replacement in 15 Dogs with Traumatic Hip Luxation
Giovanna Redolfi, Jean-Guillaume Grand
Complications and long-term clinical outcomes for 15 dogs surgically treated for traumatic craniodorsal hip luxation by prosthetic capsule replacement (PCR) with a prosthetic ligament were retrospectively reviewed. A PCR technique with capsulorrhaphy was performed in all dogs using acetabular screws with washers and a femoral tunnel as anchor points for the polyester prosthetic ligament. A non–weight-bearing sling was not placed. Minimum 1 yr follow-up period was required for study inclusion. Two major complications (13.3%) consisting of craniodorsal hip reluxation (n = 1) and capital physeal fracture (n = 1) were observed. Minor complications (superficial skin necrosis) occurred in one case (6.7 %). The patient with craniodorsal hip reluxation underwent femoral head and neck ostectomy and was excluded from long-term analysis. In the 11 cases that returned for long-term (median, 3.8 yr; range, 19–75 mo) evaluation at the authors’ institution, 10/11 of the dogs were clinically sound. Three dogs did not return for long-term evaluation. However, telephone interview with owners minimum1 yr after surgery indicated normal limb function and absence of complications in all three cases. These results suggest that PCR with polyester prosthetic ligament can be successful in maintaining hip reduction in dogs with craniodorsal hip luxation.
Original Studies
Urine Residual Volume in Normal Dogs Determined by Direct Measurement and Comparison to Two-Dimensional Ultrasonographic Measurement
Lisa M. Anderson, Grayson Cole, Laura J. Hammond
Normal urine residual volume (URV) in dogs has not previously been established by direct measurement. Twenty-two client-owned normal healthy dogs (8 female spayed, 12 male castrated, 2 male intact) without history of urinary abnormalities were included. Dogs were walked outside for 5 min to allow for natural voiding, immediately followed by urinary bladder ultrasound and urinary catheterization. The URV was recorded, and the ultrasound images were used to estimate URV for each dog. There was no significant difference between male and female URV; therefore, all data were pooled. With a 90% confidence interval, URV was 0–0.47 mL/kg with a mean URV of 0.21 mL/kg and a median value of 0.175 mL/kg. There was no significant difference between the measured URV and the ultrasound-determined URV. This case series supports previously established normal URV in the dog; however, a reference interval based on a larger population of dogs with further evaluation of body size/weight, sex, and neuter status is recommended to be established for use in clinical setting to differentiate normal urination from urinary retention in patients.
Retrospective Studies
Retrospective Study Evaluating Surgical Treatment and Outcome in Dogs with Septic Peritonitis Secondary to Neoplasia
Laura E. Selmic, Carolyn L. Chen, Janis Lapsley, Page Yaxley, Megan Brown, Vincent A. Wavreille, Giovanni Tremolada
Septic peritonitis is a life-threatening disease that can be caused by neoplasia, among other disease processes. There is no veterinary literature directly evaluating the outcome of patients with septic peritonitis caused by neoplasia. The objective of this study was to evaluate for differences in survival to discharge and complication rates between septic peritonitis caused by neoplastic and nonneoplastic disease in canine patients. A single-institution retrospective cross-sectional cohort study was performed, identifying dogs who were treated surgically for septic peritonitis between January 1, 2010, and November 1, 2020. A total of 86 patients were included, 12 with a neoplastic cause for septic peritonitis and 74 with another cause. The most common neoplastic lesions associated with septic peritonitis were gastrointestinal lymphoma and hepatocellular adenoma. Presence of neoplasia was not a significant factor for development of intraoperative or immediate postoperative complications, nor did it decrease chances of survival to discharge (P < .09). The diagnosis of a primary, localized, neoplastic lesion alone should not deter clinicians and owners from pursuing treatment for septic peritonitis.
Original Studies
Prospective Evaluation of Low-Fat Diet Monotherapy in Dogs with Presumptive Protein-Losing Enteropathy
Marc Myers, Stephen A. Martinez, Jonathan T. Shiroma, Adam T. Watson, Roger A. Hostutler
For dogs with protein-losing enteropathy (PLE) and evidence of lymphangiectasia, the efficacy of low-fat diet as monotherapy or combined with prednisone remains poorly characterized. In this prospective, observational cohort study of 14 dogs with presumptive PLE and ultrasonographic evidence of lymphangiectasia, subjects were placed on various low-fat diets as monotherapy and prednisone was added if response was deemed inadequate. Dogs were assessed and scored at four recheck examinations across a 6 mo study period, including a final recheck ultrasound. Clinical and clinicopathologic variables were collected and dogs were divided into three outcome groups: clinical remission on dietary monotherapy (LOF); clinical remission on dietary therapy plus immunosuppressive prednisone (LOP); and treatment failure (TXF). Eleven of 14 dogs were in clinical remission at the study end date (6 mo after enrollment): 6 LOF dogs and 5 LOP dogs. LOF dogs achieved a significant reduction in Canine Chronic Enteropathy Clinical Activity Index score and a significant increase in serum albumin within 2 wk of beginning dietary monotherapy. Four of 11 dogs in remission also had ultrasonographic evidence of resolution of linear striations. Low-fat diet appears to be an effective monotherapy in some dogs with presumptive PLE and ultrasonographic evidence of lymphangiectasia.