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November 2023
JAAHA Abstracts
Abstracts from the latest issue of the Journal of the American Animal Hospital Association.
59.6 NOV/DEC 2023
Veterinary Practice Guidelines
2023 AAHA Management of Allergic Skin Diseases Guidelines
Julia Miller, Andrew Simpson, Paul Bloom, Alison Diesel, Amanda Friedeck, Tara Paterson, Michelle Wisecup, Chih-Ming Yu
These guidelines present a systematic approach to diagnosis, treatment, and management of allergic skin diseases in dogs and cats. The guidelines describe detailed diagnosis and treatment plans for flea allergy, food allergy, and atopy in dogs and for flea allergy, food allergy, and feline atopic skin syndrome in cats. Management of the allergic patient entails a multimodal approach with frequent and ongoing communication with the client. Obtaining a comprehensive history is crucial for diagnosis and treatment of allergic skin diseases, and the guidelines describe key questions to ask when presented with allergic canine and feline patients. Once a detailed history is obtained, a physical examination should be performed, a minimum dermatologic database collected, and treatment for secondary infection, ectoparasites, and pruritus (where indicated) initiated. The process of diagnosing and managing allergic skin disease can be prolonged and frustrating for clients. The guidelines offer recommendations and tips for client communication and when referral to a dermatologist should be considered, to improve client satisfaction and optimize patient outcomes.
Case Reports
Recurrent Perineal Hernia in a Female Cat Diagnosed by Positive-Contrast Vaginourethrocystogram
Jackie Hansen, Nicky Cassel, Mathew Stewart, Emily Klocke, David Biller
A 9 yr old female spayed domestic shorthair was presented with a 12-day history of stranguria. Six years previously, the cat had a bilateral perineal herniorrhaphy with cystopexy and pubic osteotomy. At presentation, survey radiographs and a positive-contrast vaginourethrocystogram were performed, which revealed cystolithiasis and recurrent bilateral perineal hernias with bladder retroflexion. A cystopexy was repeated, followed by bilateral perineal repairs using the internal obturator muscle flap transposition. To the authors’ knowledge, this is the first reported case of a perineal hernia with recurrent bladder retroflexion after cystopexy diagnosed with positive-contrast vaginourethrocystogram in a female cat.
Case Reports
Successful Medical Management of Bilateral Pneumothorax Due to Nasogastric Tube Misplacement in a Cat
Briana N. Lippert, Charles T. Talbot, Kelly E. Hall
A 7 yr old female spayed domestic shorthair was evaluated for suspected lily ingestion and acute vomiting. The cat had vomited suspected lily plant material before presentation, and a nasogastric tube (NGT) was placed to continue to administer activated charcoal. The NGT was passed with sedation and limited restraint. To confirm placement, a single lateral radiograph was taken, which showed that the tube was in the trachea, bronchus, through the pulmonary parenchyma, and extending into the region of the craniodorsal retroperitoneal space. The tube was subsequently removed, resulting in a tension pneumothorax. Bilateral thoracostomy tubes were placed and attached to continuous suction. The pneumothorax resolved after 2 days, the thoracostomy tubes were removed, and the cat was discharged on day 3 after admission. To the authors’ knowledge, this is the first described pneumothorax complication with successful medical management secondary to routine NGT placement in a cat. This case report underscores the importance of preparedness for thoracostomy tube placement before removal of any NGT that has been confirmed to be placed through the pulmonary parenchyma.
Case Reports
Pancreatic Torsion Resulting in Acute Pancreatic Necrosis in a Young Dog
Rajdeep Multani, Eli B. Cohen, Jason Haas, Luke Borst, Mandy Womble, Sarah Musulin
We report a case of a 7 mo old French bulldog who was referred to North Carolina State University Small Animal Emergency and Triage Services because of acute abdomen, regurgitation, lethargy, and fever. The patient had a history of pulmonic stenosis, which was corrected by balloon valvuloplasty 3 wk before presenting for the current complaint. The patient had nonspecific changes noted on blood work at his referring veterinarian. An abdominal ultrasound examination showed pathological changes that were supportive of a left-limb pancreatic torsion that was confirmed postmortem.