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Background: Hormone assessment is typically recommended for awake, unsedated dogs. However, one of the most commonly asked questions from veterinary practitioners to the endocrinology laboratory is how sedation impacts cortisol concentrations and the adrenocorticotropic hormone (ACTH) stimulation test. Butorphanol, dexmedetomidine, and trazodone are common sedatives for dogs, but their impact on the hypothalamic-pituitary-adrenal axis (HPA) is unknown. The objective of this study was to evaluate the effects of butorphanol, dexmedetomidine, and trazodone on serum cortisol concentrations., Methods: Twelve healthy beagles were included in a prospective, randomized, four-period crossover design study with a 7-day washout. ACTH stimulation test results were determined after saline (0.5 mL IV), butorphanol (0.3 mg/kg IV), dexmedetomidine (4 µg/kg IV), and trazodone (3-5 mg/kg PO) administration., Results: Compared to saline, butorphanol increased basal (median 11.75 µg/dL (range 2.50-23.00) (324.13 nmol/L; range 68.97-634.48) vs 1.27 µg/dL (0.74-2.10) (35.03 nmol/L; 20.41-57.93); P < 0.0001) and post-ACTH cortisol concentrations (17.05 µg/dL (12.40-26.00) (470.34 nmol/L; 342.07-717.24) vs 13.75 µg/dL (10.00-18.90) (379.31 nmol/L; 275.96-521.38); P ≤ 0.0001). Dexmedetomidine and trazodone did not significantly affect basal (1.55 µg/dL (range 0.75-1.55) (42.76 nmol/L; 20.69-42.76); P = 0.33 and 0.79 µg/dL (range 0.69-1.89) (21.79 nmol/L; 19.03-52.14); P = 0.13, respectively, vs saline 1.27 (0.74-2.10) (35.03 nmol/L; 20.41-57.93)) or post-ACTH cortisol concentrations (14.35 µg/dL (range 10.70-18.00) (395.86 nmol/L; 295.17-496.55); (P = 0.98 and 12.90 µg/dL (range 8.94-17.40) (355.86 nmol/L; 246.62-480); P = 0.65), respectively, vs saline 13.75 µg/dL (10.00-18.60) (379.31 nmol/L; 275.86-513.10)., Conclusion: Butorphanol administration should be avoided prior to ACTH stimulation testing in dogs. Further evaluation of dexmedetomidine and trazodone's effects on adrenocortical hormone testing in dogs suspected of HPA derangements is warranted to confirm they do not impact clinical diagnosis., Competing Interests: The authors declare that they have no competing interests., (© 2024 Hunt et al.)

Simulation in veterinary education provides a safe and ethical alternative to using live animals, but most simulators are single purpose and unvalidated. In this study, canine training manikins were created using readily available materials to teach fine needle aspiration (FNA) of peripheral lymph nodes, jugular venipuncture, cephalic venipuncture, intravenous catheterization, and cystocentesis. Undergraduate subjects were prospectively enrolled and stratified by veterinary experience prior to randomization into two groups. Students were taught a new skill each week through a written description of the technique, video training, and hands-on practice (live animal vs. manikin). The following week, participants were scored on the performance of the previous week's skill on a live animal using a standardized rubric by reviewers blinded to the training group. Six weeks later, the assessment was repeated for all skills. Scores were compared between groups and time points using repeated-measures ANOVA after logarithmic transformation. p < .05 was significant. There were no significant differences in scores for any of the skills between the groups immediately following or 6 weeks after training. Initial proficiency and short-term retention of clinical skills do not differ for students trained using a manikin versus a live dog.

Background: The efffect of administering of probiotics or twice-daily omeprazole on glucocorticoid-induced gastric bleeding in dogs is unknown., Hypothesis: Compare gastrointestinal bleeding among dogs administered placebo, prednisone (2 mg/kg q24h), prednisone with omeprazole (1 mg/kg q12h), or prednisone with probiotics (Visbiome, 11.2-22.5 billion CFU/kg q24h) for 28 days., Animals: Twenty-four healthy research dogs., Methods: Double-blinded, placebo-controlled randomized trial. Clinical signs and endoscopic gastrointestinal mucosal lesion scores at baseline (t 1 ), day 14 (t 2 ), and day 28 (t 3 ) were compared using split-plot repeated-measures mixed-model ANOVAs., Results: Fecal score differed by treatment-by-time (F[6,40] = 2.65, P < .03), with higher scores in groups receiving prednisone at t 3 than t 1 . Nineteen of thirty-three episodes of diarrhea occurred in the prednisone with omeprazole group. Gastric mucosal lesion scores differed by treatment-by-time (F[6,60] = 2.86, P = .05), among treatment groups (F[3,60] = 4.9, P = .004), and over time (F[2,60] = 16.5, P < .001). Post hoc analysis revealed lesion scores increased over time for all groups receiving prednisone. At t 3 , scores for the prednisone (8.7 ± 4.9) and prednisone with probiotics (8.7 ± 4.9) groups differed significantly from placebo (1.8 ± 1.8; P ≤ .04), whereas scores for the prednisone with omeprazole (6.5 ± 5.5) group did not differ from placebo (P = .7). Ulcers occurred only in dogs receiving prednisone., Conclusions and Clinical Importance: Prednisone-induced gastric bleeding. Co-administration of omeprazole partially mitigated bleeding, but a similar protective benefit was not demonstrated by co-administration of the evaluated probiotic., (© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Cats and kittens in animal shelters and catteries regularly suffer from severe gastrointestinal coccidiosis, which can be fatal, and there are no drugs labeled for feline coccidiosis in the United States. Ponazuril, a triazine-class drug, is increasingly used at a dose of 50 mg/kg/d, orally, for three to five days in shelter environments for coccidiosis. A single oral dose of ponazuril paste 15% (Marquis ® ; Merial) at 50 mg/kg was administered to six healthy adult cats. Sample analysis was completed via high-performance liquid chromatography. Plasma concentrations peaked at 7.49 ± 2.06 µg/ml at 14.67 ± 7.45 hr post-administration. This study shows that ponazuril achieved a plasma concentration that inhibits growth of similar organisms after a single oral dose in cats. Further studies are necessary to optimize dosing for the treatment of clinical coccidiosis in cats., (© 2022 The Authors. Journal of Veterinary Pharmacology and Therapeutics published by John Wiley & Sons Ltd.)

Background: Antibiotic-associated gastrointestinal signs occurred in 100% of dogs administered enrofloxacin with metronidazole in a previous study, and signs partially were mitigated by synbiotics. The objective of this randomized, double-blinded, placebo-controlled trial was to compare the fecal microbiome and metabolome of dogs administered enrofloxacin and metronidazole, followed by either a placebo or a bacterial/yeast synbiotic combination. Methods: Twenty-two healthy research dogs were randomized to two treatment groups. There were three study periods: baseline, treatment, and washout. Dogs were administered enrofloxacin (10 mg/kg qd) and metronidazole (12.5 mg/kg BID), followed 1 h later by placebo or a commercially-available synbiotic combination (BID), per os for 21 days with reevaluation 56 days thereafter. Fecal samples were collected on days 5-7 (baseline), 26-28, and 82-84. The fecal microbiome was analyzed by qPCR and sequencing of 16S rRNA genes; time-of-flight mass spectrometry was used to determine metabolomic profiles. Split plot repeated measures mixed model ANOVA was used to compare results between treatment groups. P < 0.05 was considered significant, with Benjamini and Hochberg's False Discovery Rate used to adjust for multiple comparisons. Results: Alpha diversity metrics differed significantly over time in both treatment groups, with incomplete recovery by days 82-84. Beta diversity and the dysbiosis index differed significantly over time and between treatment groups, with incomplete recovery at days 82-84 for dogs in the placebo group. Significant group-by-time interactions were noted for 15 genera, including Adlercreutzia, Bifidobacterium, Slackia, Turicibacter, Clostridium (including C. hiranonis ) [ Ruminococcus ], Erysipelotrichaceae&#95;g&#95; , [ Eubacterium ], and Succinivibrionaceae&#95;g&#95; . Concurrent group and time effects were present for six genera, including Collinsella, Ruminococcaceae&#95;g &#95;, and Prevotella . Metabolite profiles differed significantly by group-by-time, group, and time for 28, 20, and 192 metabolites, respectively. These included short-chain fatty acid, bile acid, tryptophan, sphingolipid, benzoic acid, and cinnaminic acid metabolites, as well as fucose and ethanolamine. Changes in many taxa and metabolites persisted through days 82-84. Conclusion: Antibiotic administration causes sustained dysbiosis and dysmetabolism in dogs. Significant group-by-time interactions were noted for a number of taxa and metabolites, potentially contributing to decreased antibiotic-induced gastrointestinal effects in dogs administered synbiotics., Competing Interests: JW and JS have received past honoraria from Nutramax Laboratories Veterinary Sciences, Inc. for development of educational materials and public speaking. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Whittemore, Price, Moyers and Suchodolski.)

A 13-year-old castrated male Maine coon cat with a 5-year history of atypical mycobacteriosis was euthanized and submitted for necropsy. The cat had been kept in clinical remission since diagnosis using a combination of the antimycobacterial drug clofazimine and additional multimodal antimicrobial therapy. Grossly, tissues were diffusely discolored red-brown to yellow. Histologically, the myocardial interstitum was expanded by numerous, often multinucleated cells, which were distended by uniformly shaped acicular cytoplasmic spaces. These cells were immunopositive for CD18 and immunonegative for desmin, suggesting a histiocytic rather than muscular origin. Macrophages in other tissues contained similar acicular spaces. Ultrastructurally, the spaces were surrounded by 2 lipid membranes, resembling an autophagosome. Based on the clinical history and histologic, immunohistochemical, and ultrastructural data, we diagnosed clofazimine crystal storage. To our knowledge, this is the first report of clofazimine storage in a cat or within myocardial interstitial macrophages.

Background: Glucocorticoids cause hypercoagulability, but it is unknown if they counteract clopidogrel's antiplatelet effects., Hypothesis/objectives: Determine the effects of clopidogrel and prednisone on platelet function., Animals: Twenty-four healthy dogs., Methods: Double-blinded, placebo-controlled randomized trial. Platelet function was evaluated using a platelet function analyzer and impedance aggregometry (days 0, 14, and 28) for dogs treated with placebo, clopidogrel (2-3 mg/kg/d), prednisone (2 mg/kg/d), or prednisone with clopidogrel PO for 28 days. Results were categorized as nonresponder versus responder (platelet function analyzer), and inadequate, ideal, or excessive response (aggregometry). Results were compared using mixed model, split-plot repeated measures analysis of variance and generalized estimating equation proportional odds models. P < .05 was considered significant., Results: Closure times differed by treatment (F [3, 20] = 10.5; P < .001), time (F [2, 40] = 14.3; P < .001), and treatment-by-time (F [6, 40] = 3.4; P = .01). Area under the curve (AUC) differed by treatment (F [3, 20] = 19.6; P < .001), time (F [2, 40] = 35.4; P < .001), and treatment-by-time (F [6, 40] = 13.5; P < .001). Based on closure times, 5/6 dogs each in the clopidogrel and prednisone/clopidogrel groups were responders. All dogs in the prednisone/clopidogrel group were overcontrolled based on AUC (days 14 and 28), whereas 5/6 (day 14) and 2/6 (day 28) dogs treated with clopidogrel were overcontrolled. Compared to clopidogrel, dogs receiving prednisone/clopidogrel were 11 times (P = .03) more likely to have an excessive response., Conclusions and Clinical Importance: Administration of clopidogrel/prednisone increases platelet dysfunction in healthy dogs., (© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Background: Ileoscopy is increasingly performed in dogs and cats with gastrointestinal signs, but iatrogenic ileocecocolic (ICC) perforations have not been described., Hypothesis/objectives: To characterize endoscopic ICC perforations in dogs and cats., Animals: Thirteen dogs and 2 cats., Methods: This is a retrospective case series. Signalment, presentation, endoscopic equipment, colonic preparation, endoscopist's experience level, ileal intubation technique, method of diagnosis, perforation location, histopathology, management, and outcome data were collected and reviewed., Results: Six ileal, 5 cecal, and 4 colonic perforations were identified between 2012 and 2019. Dogs weighed 2.4-26 kg (median, 10.3 kg) and cats 4.6-5.1 kg (median, 4.9 kg). Endoscopy was performed in dogs presented for vomiting (n = 4), as well as large (n = 5), mixed (n = 4), and small (n = 1) bowel diarrhea. Cats had large bowel diarrhea. Endoscopists included 1 supervised intern, 9 supervised internal medicine residents (2 first year, 6 second year, 1 third year), and 5 internal medicine diplomates. Diagnosis was delayed in 5 dogs, occurring 1-5 days after endoscopy (median, 3 days); dogs were presented again with inappetence (n = 4), lethargy (n = 4), abdominal pain (n = 3), retching (n = 2), and syncope (n = 1). All animals underwent surgical correction. Histopathology did not identify lesions at the perforation site in any animal. Two dogs required a second surgery; 1 died 12 hours after surgery. Survival to discharge was 93%, with 78% surviving ≥8 months., Conclusions and Clinical Importance: Iatrogenic endoscopic ICC perforation is not indicative of underlying disease and is associated with a good prognosis. Delayed diagnosis can occur. Therefore, perforation should be considered in the differential diagnosis for animals with clinical deterioration after endoscopy., (© 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Glucocorticoid administration is a risk factor for thromboembolism in hypercoagulable dogs, and it is unknown if aspirin counteracts glucocorticoid-induced hypercoagulability. The objective was to determine the effects of sustained aspirin and prednisone administration on platelet function and thromboxane synthesis. Our hypothesis was that aspirin would consistently inhibit platelet function and thromboxane synthesis when administered with or without prednisone. In 24 healthy dogs, platelet aggregometry and urine 11-dehydro-thromboxane-B 2 (11-dTXB 2 )-to-creatinine ratios were measured on days 0, 14, and 28. Dogs were administered placebos, aspirin (2 mg/kg/d), prednisone (2 mg/kg/d), or prednisone/aspirin combination therapy PO for 28 days in a randomized double-blinded study. Aspirin response was based on a >25% reduction in platelet aggregation compared to pre-treatment values. Results were compared using mixed model, split-plot repeated measures ANOVAs. P < 0.05 was considered significant. AUC differed significantly by time [ F (2,40) = 10.2, P < 0.001] but not treatment or treatment-by-time. On day 14, 2 dogs were aspirin responders (aspirin, 1; placebo, 1). On day 28, 3 dogs were aspirin responders (aspirin, 2; prednisone/aspirin, 1). Urine 11-dTXB 2 -to-creatinine ratios differed significantly by group [ F (3,20) = 3.9, P = 0.024] and time [ F (2,40) = 8.7, P < 0.001), but not treatment-by-time. Post-hoc analysis revealed significant differences between aspirin and placebo groups ( P =0.008), aspirin and prednisone/aspirin groups ( P = 0.030), and placebo and prednisone groups ( P = 0.030). In healthy dogs, sustained aspirin, prednisone, and combination therapy do not inhibit platelet aggregation, and when used as individual therapies, aspirin and prednisone decreased thromboxane synthesis. Additional studies using varied platelet function methodologies in hypercoagulable dogs are necessary., (Copyright © 2019 Thomason, Mooney, Price and Whittemore.)

Background: Dogs with immune-mediated disease often receive glucocorticoids with clopidogrel, but ulcerogenic effects of current protocols are unknown., Hypothesis/objectives: To compare gastrointestinal endoscopic findings among dogs administered clopidogrel, prednisone, and combination treatment., Animals: Twenty-four healthy research dogs., Methods: Double-blinded, placebo-controlled randomized trial. Dogs received placebo, clopidogrel (2-3 mg/kg q24h), prednisone (2 mg/kg q24h), or prednisone with clopidogrel PO for 28 days. Attitude, food intake, vomiting, and fecal score were determined daily. Clinicopathologic testing was performed at baseline and on day 28. Gastrointestinal hemorrhages, erosions, and ulcers were numerated by 2 blinded investigators for endoscopies performed on days 0, 14, and 28, and endoscopic mucosal lesion scores were calculated. Results were compared using mixed model, split-plot repeated measures ANOVAs and generalized estimating equation proportional odds models as appropriate. P < .05 was considered significant., Results: Clinical signs of gastrointestinal bleeding were not noted. Endoscopic mucosal lesion scores differed significantly by group (F[3, 20] = 12.8, P < .001) and time (F[2, 40] = 8.3, P < .001). Posthoc analysis revealed higher lesion scores in the prednisone-receiving groups (P ≤ .006 for each) and on day 14 (P ≤ .007 for each). Ulcers were identified in 4 dogs administered prednisone and 3 dogs administered prednisone/clopidogrel. Odds of having endoscopic mucosal lesion scores ≥4 were 7-times higher for dogs in prednisone (95%CI 1.1, 43.0; P = .037) and prednisone-clopidogrel (95%CI 1.1, 43.4; P = .037) groups than those in the placebo group., Conclusions and Clinical Importance: Gastrointestinal bleeding and ulceration occur commonly in healthy dogs administered prednisone or prednisone/clopidogrel treatment, but not clopidogrel monotherapy. Though lesions are severe in many cases, they are not accompanied by clinical signs., (© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Background: Dogs with immune-mediated disease are often coadministered glucocorticoids and aspirin, but ulcerogenic effects of current protocols are unknown., Objectives: To compare gastrointestinal changes among dogs administered aspirin, prednisone, and combination treatment., Animals: Twenty-four healthy research dogs., Methods: Double-blinded, placebo-controlled randomized trial of dogs administered placebo, aspirin (2 mg/kg q24h), prednisone (2 mg/kg q24h), or combination treatment PO for 28 days. Clinical signs were recorded daily, with laboratory work performed at baseline and day 28. Gastrointestinal mucosal hemorrhages, erosions, and ulcers were numerated for endoscopic studies performed on days 0, 14, and 28; endoscopic mucosal lesion scores were calculated. Results were compared using mixed model repeated-measures analyses of variance and generalized estimating equation proportional odds models. P < .05 was considered significant., Results: Gastric mucosal lesion scores differed by treatment-by-time (F[6, 40] = 4.4, P = .002), treatment (F[3, 20] = 7.1, P = .002), and time (F[2, 40] = 18.9, P < .001). Post hoc analysis revealed increased scores in the aspirin (day 14 only), prednisone, and prednisone/aspirin groups during treatment. Ulcers were identified on 14 studies, representing 10 dogs. Dogs receiving prednisone and prednisone/aspirin had 11.1 times (95% CI, 1.7-73.6) and 31.5 times (95% CI, 3.5-288.0) higher odds, respectively, of having endoscopic mucosal lesion scores ≥4 than dogs receiving placebo (P ≤ .01)., Conclusions and Clinical Importance: Gastrointestinal bleeding occurs commonly in dogs administered aspirin, prednisone, or prednisone/aspirin treatment, with higher lesion scores for dogs receiving combination treatment. Even severe lesions are not accompanied by clinical signs., (© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Objective: The purpose of this study was to assess the effect of headphone use and covariates on indirect radial Doppler flow systolic arterial blood pressure (BP) measurements in dogs., Methods: Between May and August 2018, 100 privately-owned dogs were enrolled. Blood pressure was measured in lateral recumbency, with and without headphones, using a randomized crossover design. The initial BP, mean of BP 2-6, weight, BCS, MCS, anxiety score, and heart rate were recorded. Mixed effects crossover analyses and Spearman rank correlation coefficients were determined., Results: Eighty-four dogs completed the study. Eleven dogs were removed due to excessive anxiety, 10 of which were in the non-headphone first group. The number of dogs diagnosed as hypertensive did not differ between measurement types (19 vs. 18), with seven dogs categorized as hypertensive during both periods. Significant differences in BP were identified ( F [1, 80] = 4.3, P  = 0.04) due to higher results for measurements taken without headphones for BP 1, but not BP 2-6. Systolic BP was positively correlated with anxiety score, age, and weight., Conclusions and Clinical Relevance: Though BP 1 was significantly higher when taken without headphones, this pattern did not persist for BP 2-6. Lack of association between BP 2-6 results and measurement type could reflect exclusion of dogs most sensitive to white coat hypertension, acclimation to technique, or improved sound quality of headphones. Given significantly higher BP 1 results and disproportionate exclusion of dogs due to anxiety when measurements first were taken without headphones, use of headphones is recommended to improve accuracy of results., Competing Interests: The authors declare there are no competing interests.

Background: Synbiotics decrease antibiotic-associated gastrointestinal signs (AAGS) in cats, but data supporting synbiotic use to ameliorate AAGS in dogs are lacking., Objectives: To determine if administration of synbiotics mitigates AAGS in dogs., Animals: Twenty-two healthy research dogs., Methods: Randomized, double-blinded, placebo-controlled, 2-way, 2-period, crossover study with an 8-week washout period. Each period included a 1-week baseline and 3-week treatment phase. Dogs received enrofloxacin (10 mg/kg PO q24h) and metronidazole (12.5 mg/kg PO q12h), followed 1 hour later by a bacterial/yeast synbiotic combination or placebo. Food intake, vomiting, and fecal score were compared using repeated-measures crossover analyses, with P < .05 considered significant., Results: Hyporexia, vomiting, and diarrhea occurred in 41% (95% confidence interval [CI], 21-64), 77% (95% CI, 55-92), and 100% (95% CI, 85-100) of dogs, respectively, during the first treatment period. Derangements in food intake were smaller in both periods for dogs receiving synbiotics (F-value, 5.1; P = .04) with treatment-by-period interactions (F-value, 6.0; P = .02). Days of vomiting differed over time (F-value, 4.7; P = .006). Fecal scores increased over time (F-value, 33.5; P < .001), were lower during period 2 (F-value, 14.5; P = .001), and had treatment-by-period effects (F-value, 4.8; P = .04)., Conclusions and Clinical Importance: Enrofloxacin/metronidazole administration is associated with a high frequency of AAGS. Synbiotic administration decreases food intake derangements. The presence of milder AAGS in period 2 suggests that clinical effects of synbiotics persist >9 weeks after discontinuation, mitigating AAGS in dogs being treated with antibiotics followed by placebo., (© 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.)

Reduction in antibiotic-associated gastrointestinal signs (AAGS) in people co-administered probiotics is believed to result from shifts in the microbiome and metabolome. Amelioration of AAGS in cats secondary to synbiotic administration has recently been demonstrated. Thus, the aim of this randomized, double-blinded, placebo-controlled trial was to characterize associated changes in the fecal microbiome and metabolome. Sixteen healthy research cats received clindamycin with food, followed 1 h later by either a placebo or synbiotic, daily for 21 days. Fecal samples were collected during baseline, antibiotic administration, and 6 weeks after antibiotic discontinuation. Sequencing of 16S rRNA genes was performed, and mass spectrometry was used to determine fecal metabolomic profiles. Results were compared using mixed-model analyses, with P < 0.05 considered significant. Alpha and beta diversity were altered significantly during treatment, with persistent changes in the Shannon and dysbiosis indices. The relative abundance of Actinobacteria ( Adlercreutzia, Bifidobacterium, Collinsella, Slackia ), Bacteroidia ( Bacteroides, Prevotella ), Ruminococcaceae ( Faecalibacterium, Ruminococcus ), Veillonellaceae ( Megamonas, Megasphaera, Phascolarctobacterium ) and Erysipelotrichaceae ([ Eubacterium ]) decreased and relative abundance of Clostridiaceae ( Clostridium ) and Proteobacteria ( Enterobacteriaceae ) increased during treatment, followed by variable return to baseline relative abundances. Derangements in short-chain fatty acid (SCFA), bile acid, tryptophan, sphingolipid, polyamine, benzoic acid, and cinnaminic acid pathways occurred with significant group by time, group, and time interactions for 10, 5, and 106 metabolites, respectively. Of particular note were changes related to polyamine synthesis. Further investigation is warranted to elucidate the role of these alterations in prevention of AAGS in cats, people, and other animals treated with synbiotics.

Background: Antibiotic-associated gastrointestinal signs (AAGS) occur commonly in cats. Co-administration of synbiotics is associated with decreased AAGS in people, potentially due to stabilization of the fecal microbiome and metabolome. The purpose of this double-blinded randomized-controlled trial was to compare AAGS and the fecal microbiome and metabolome between healthy cats that received clindamycin with a placebo or synbiotic., Methods: 16 healthy domestic shorthair cats from a research colony were randomized to receive 150 mg clindamycin with either a placebo (eight cats) or commercially-available synbiotic (eight cats) once daily for 21 days with reevaluation 603 days thereafter. All cats ate the same diet. Food consumption, vomiting, and fecal score were recorded. Fecal samples were collected daily on the last three days of baseline (days 5-7), treatment (26-28), and recovery (631-633). Sequencing of 16S rRNA genes and gas chromatography time-of-flight mass spectrometry was performed. Clinical signs, alpha and beta diversity metrics, dysbiosis indices, proportions of bacteria groups, and metabolite profiles were compared between treatment groups using repeated measures ANOVAs. Fecal metabolite pathway analysis was performed. P  < 0.05 was considered significant. The Benjamini & Hochberg's False Discovery Rate was used to adjust for multiple comparisons., Results: Median age was six and five years, respectively, for cats in the placebo and synbiotic groups. Hyporexia, vomiting, diarrhea, or some combination therein were induced in all cats. Though vomiting was less in cats receiving a synbiotic, the difference was not statistically significant. Bacterial diversity decreased significantly on days 26-28 in both treatment groups. Decreases in Actinobacteria ( Bifidobacterium , Collinsella, Slackia ), Bacteriodetes ( Bacteroides ), Lachnospiraceae ( Blautia , Coprococcus , Roseburia ), Ruminococcaceae ( Faecilobacterium , Ruminococcus ), and Erysipelotrichaceae ( Bulleidia , [ Eubacterium ]) and increases in Clostridiaceae ( Clostridium ) and Proteobacteria ( Aeromonadales , Enterobacteriaceae ) occurred in both treatment groups, with incomplete normalization by days 631-633. Derangements in short-chain fatty acid, bile acid, indole, sphingolipid, benzoic acid, cinnaminic acid, and polyamine profiles also occurred, some of which persisted through the terminal sampling timepoint and differed between treatment groups., Discussion: Cats administered clindamycin commonly develop AAGS, as well as short- and long-term dysbiosis and alterations in fecal metabolites. Despite a lack of differences in clinical signs between treatment groups, significant differences in their fecal metabolomic profiles were identified. Further investigation is warranted to determine whether antibiotic-induced dysbiosis is associated with an increased risk of future AAGS or metabolic diseases in cats and whether synbiotic administration ameliorates this risk., Competing Interests: Two of the investigators (JCW, JSS) declare past receipt of honorariums from Nutramax Laboratories for public speaking and educational materials.

OBJECTIVE To compare absorption characteristics of orally administered compounded itraconazole capsules and suspension with those of reference (brand-name) formulations in healthy cats. DESIGN Randomized crossover study. ANIMALS 8 healthy adult cats. PROCEDURES After 12 hours of food withholding, cats received 50 mg of itraconazole (reference capsule, reference solution, compounded capsule, and compounded suspension) in a randomized crossover design, with a 21-day washout period. Capsules were administered with a small meal. Blood samples were collected at predetermined intervals for high-pressure liquid chromatography analysis of plasma itraconazole concentrations. Area under the concentration-time curve, maximum concentration, and terminal half-life of itraconazole were determined and compared among formulations. RESULTS 7 cats completed the study. Mean half-life of itraconazole in reference formulations was 18 to 26 hours. Absorption of the reference solution was 3 times that of the reference capsule. Compounded formulations were absorbed poorly and inconsistently. Complete pharmacokinetic results for the compounded capsule were obtained for only 3 of 6 cats and for the compounded suspension for only 1 of 5 cats, precluding bioequivalence analysis. Relative absorption of compounded formulations was only 2% to 8% of reference formulation values. CONCLUSIONS AND CLINICAL RELEVANCE Compounded oral formulations of itraconazole should not be used for cats because of poor absorption. The differences in absorption between the 2 reference formulations suggested that doses required to meet human target serum concentrations in cats are markedly different (capsules, 12.5 mg/kg [5.7 mg/lb], q 24 h, with food; solution, 4 mg/kg [1.8 mg/lb], q 24 h, without food).

OBJECTIVE To assess the effects of age, body condition score (BCS), and muscle condition score (MCS) on radial and coccygeal systolic arterial blood pressure (SAP) in cats. DESIGN Prospective randomized trial. ANIMALS 66 privately owned cats enrolled between May and December 2010. PROCEDURES BCS and MCS of cats were assessed by 2 investigators; SAP was measured via Doppler ultrasonic flow detector, with cats positioned in right lateral or sternal recumbency for measurements at the radial or coccygeal artery, respectively, with order of site randomized. Associations among variables were assessed through correlation coefficients, partial correlation coefficients, and ANCOVA. RESULTS Interrater reliability for BCS and MCS assessment was high (correlation coefficients, 0.95 and 0.83, respectively). No significant effect was identified for order of SAP measurement sites. Coccygeal and radial SAP were positively correlated (ρ = 0.45). The median difference in coccygeal versus radial SAP was 19 mm Hg, but differences were not consistently positive or negative. Radial SAP was positively correlated with age (ρ = 0.48) and negatively correlated with MCS (ρ = -0.30). On the basis of the correlation analysis, the association between radial SAP and MCS reflected the confounding influence of age. Coccygeal SAP was not significantly correlated with age, BCS, or MCS. CONCLUSIONS AND CLINICAL RELEVANCE Use of the coccygeal artery is recommended to reduce the confounding effects of age and sarcopenia on Doppler ultrasonographic SAP measurements in cats. Additionally, monitoring for changes in MCS is recommended for cats undergoing serial SAP measurement.

Objective: The purpose of this study was to assess the effects of age, body condition score (BCS) and muscle condition score (MCS) on indirect radial and coccygeal Doppler systolic arterial blood pressure (SAP) measurements in dogs., Methods: Sixty-two privately-owned dogs were enrolled between June and July 2016. The BCS and MCS were determined by two investigators. Blood pressure was measured per published guidelines and using headphones, and the order of measurement site was randomized. Dogs were positioned in right lateral recumbency for radial measurements and sternal recumbency or standing for coccygeal measurements. Associations between SAP and other variables were assessed by correlation coefficients and analysis of covariance., Results: Radial and coccygeal SAP measurements were moderately correlated ( r  = 0.45, P  < 0.01). Radial SAP measurements were higher than coccygeal SAP measurements (mean difference 9 mmHg, P  < 0.01), but discordance occurred in both directions. No difference was observed between the first measurement taken, the average of measurements 2-6, or the average of all 6 measurements for either the radial (128, 129, and 129 mmHg; P  = 0.36) or coccygeal (121, 122, and 122 mmHg; P  = 0.82) site. Associations were not found between SAP measurements for either site and age, weight, BCS, MCS, anxiety score, or cuff size. Heart rate decreased significantly from the start of acclimation to the end of the first data collection series regardless of site ( P  < 0.01)., Conclusions and Clinical Relevance: Initial measurement site can be based on patient and operator preference given lack of associations with patient variables, but the same site should be used for serial SAP measurements given discordant results between sites., Competing Interests: The authors have declare there are no competing interests.

CASE DESCRIPTION A 6-year-old spayed female Great Pyrenees (dog 1) and a 2-year-old spayed female German Shepherd Dog (dog 2) were evaluated because of gross hematuria of 5 and 2 months' duration, respectively. CLINICAL FINDINGS In both dogs, coagulation times were within reference limits, results of aerobic bacterial culture of urine samples were negative, echogenic debris could be seen within the urinary bladder ultrasonographically, and hematuric urine could be seen exiting the right ureterovesicular junction, with grossly normal urine exiting the left ureterovesicular junction, during cystoscopy. A diagnosis of idiopathic renal hematuria was made in both dogs. TREATMENT AND OUTCOME Both dogs underwent retrograde ureteropyelography, unilateral povidone iodine sclerotherapy, and ureteral stent placement. The right ureter was occluded with a ureteropelvic junction balloon catheter, and a 5% povidone iodine solution was infused into the renal pelvis 3 times. A double-pigtail ureteral stent was then placed. Both dogs recovered without complications, with cessation of gross hematuria within 12 hours. Cystoscopic removal of the ureteral stent was performed in dog 1 after 4 months; at that time, the urine sediment contained 5 to 10 RBCs/hpf. In dog 2, urine sediment contained 50 to 75 RBCs/hpf 2 weeks after sclerotherapy, with continued resolution of gross hematuria 8 weeks after sclerotherapy. The owners declined removal of the stent in dog 2. CLINICAL RELEVANCE Findings suggested that povidone iodine sclerotherapy may be an effective renal-sparing treatment for idiopathic renal hematuria in dogs. Further evaluation with longer follow-up times is warranted.

A 9-year-old, spayed female toy poodle dog developed refractory anorexia after pancreatitis. Abdominal imaging showed a cystic structure compressing the stomach. Appetite improved after percutaneous drainage of the structure, but the structure refilled within 48 h. Percutaneous ethanol ablation of the structure was attempted. Afterwards, the patient developed fatal hypotensive shock.

Case Description: An 8-year-old spayed female Yorkshire Terrier and 5-year-old castrated male West Highland White Terrier were evaluated because of cyclophosphamide intoxication subsequent to pharmacy error. Both dogs received cumulative doses of approximately 1,080 mg of cyclophosphamide/m(2) after cyclophosphamide was erroneously dispensed instead of cyclosporine by different pharmacies., Clinical Findings: Both dogs became lethargic, and 1 dog also had anorexia, vomiting, and diarrhea within 2 days after initiation of cyclophosphamide administration. The other dog developed anorexia on the seventh day after initiation of cyclophosphamide administration. The dogs were evaluated by their primary-care veterinarians 9 and 11 days after administration of the first dose of cyclophosphamide, and both had severe leukopenia and thrombocytopenia., Treatment and Outcome: One dog was treated on an outpatient basis with broad-spectrum antimicrobials, granulocyte colony-stimulating factor, and an appetite stimulant. The other dog was more severely affected and was hospitalized for 7 days, during which it was treated with broad-spectrum antimicrobials, gastroprotectants, granulocyte colony-stimulating factor, and cryopreserved platelet and packed RBC transfusions. Both dogs fully recovered after treatment., Clinical Relevance: This was the first report of survival for dogs with inadvertent prolonged cyclophosphamide intoxication subsequent to pharmacy error. Although the 2 dogs had similar clinical signs and clinicopathologic findings, the severity of disease and treatment required differed for each dog. Dogs can recover from prolonged cyclophosphamide intoxication provided appropriate supportive care is administered.

A prospective study to assess changes in selected plasma biochemistry and electrolyte values, plasma insulin and aldosterone concentrations, and electrocardiography (ECG) was performed on eight female captive tigers (Panthera tigris) and three lions (Panthera leo) undergoing general anesthesia for elective laparoscopic ovariectomy. Each animal was sedated with medetomidine (18-25 microg/kg) and midazolam (0.06-0.1 mg/kg) intramuscularly, and anesthesia was induced with ketamine (1.9-3.5 mg/kg) intramuscularly and maintained with isoflurane. Venous blood samples were collected and analyzed for plasma biochemistry parameters and insulin and aldosterone concentrations. An ECG was recorded at the time of each blood sample collection. Mean plasma potassium, glucose, phosphorus, and aldosterone concentrations increased during anesthesia (P < or = 0.05). One tiger developed hyperkalemia (6.5 mmol/L) 2.5 hr after anesthetic induction. Plasma insulin concentrations were initially below the low end of the domestic cat reference interval (72-583 pmol/L), but mean insulin concentration increased (P < or = 0.05) over time compared with the baseline values. Three tigers and two lions had ECG changes that were representative of myocardial hypoxemia. Based on these results, continuous monitoring of clinical and biochemical alterations during general anesthesia in large nondomestic felids is warranted, and consideration should be given to reversal of medetomidine in these animals should significant changes in electrolytes or ECG occur.

An 8-year-old, brachycephalic, mixed breed cat underwent full mouth tooth extractions for the treatment of tooth root abscessation. Subsequently, the cat developed anterior uveitis refractory to topical therapy that eventually necessitated enucleation. Actinomyces species were isolated from both the tooth root abscesses and the anterior chamber after enucleation. Histopathology of the enucleated eye revealed panophthalmitis with abundant intralesional bacteria morphologically consistent with Actinomyces. Between the time of tooth root extraction and enucleation (20 weeks), the cat was diagnosed with hyperthyroidism and treated with oral steroids for inflammatory bowel syndrome. We believe this report represents a rare case of endogenous endophthalmitis secondary to dental disease, possibly precipitated by concurrent immunosuppression., (© 2013 American College of Veterinary Ophthalmologists.)

Objective: To determine the diagnostic accuracy of tissue impedance measurement interpretation (TIMI) for determining correct versus incorrect Veress needle placement in feline cadavers., Study Design: Prospective, randomized, blinded trial., Study Population: Cat cadavers (n = 24)., Methods: Two laparoscopists (1 experienced, 1 novice), blinded to TIMI, placed reusable Veress needles in study subjects in a randomized order. A third individual interpreted impedance measurements as consistent with correct versus incorrect placement. Veress needle tip locations were marked by injecting contrasting colors of India ink. Tissue dissection was performed to localize ink. Sensitivity, specificity, accuracy, precision, and kappa statistics for TIMI for placements by the experienced and novice laparoscopist were determined. P < .05 was considered significant., Results: TIMI identified 36/38 correct and 2/10 incorrect placements. TIMI identified 2/2 bowel perforations but was unable to identify 8 inappropriate placements in the retroperitoneal fat pad. Impedance measurement interpretation had 94.7% sensitivity, 20% specificity, 79.2% accuracy, and 81% precision overall. Agreement between TIMI and Veress needle location was absent (kappa = -0.15, P = .01) for placements by the experienced laparoscopist and substantial (kappa = 0.78, P < .01) for the novice laparoscopist., Conclusions: Failure of TIMI to identify placement in the retroperitoneal fat pad resulted in poor accuracy. Small cat size limited the number of appropriate placement sites, perhaps resulting in excessively dorsal placements. Use of TIMI may increase detection of clinically significant inappropriate Veress needle placements, like bowel perforations, and decrease installment phase complications. Further evaluation of Veress needle placement with and without TIMI is warranted., (© Copyright 2013 by The American College of Veterinary Surgeons.)

Objective: To establish the diagnostic accuracy of tissue impedance measurement interpretation (TIMI) for determining correct versus incorrect Veress needle placement., Study Design: Prospective, randomized, blinded trial., Study Population: Canine cadavers (n = 20)., Methods: Two laparoscopists (1 experienced, 1 novice), blinded to tissue impedance measurement results, placed reusable Veress needles in canine cadavers in a randomized order. A 3rd individual interpreted impedance measurements as consistent with correct or incorrect Veress needle placement. Veress needle tip locations were marked by injecting contrasting colors of India ink. Tissue dissection was performed to localize ink. Sensitivity, specificity, accuracy, precision, and kappa statistics for TIMI for placements by the experienced and novice laparoscopist were determined. P < .05 was considered significant., Results: TIMI identified 29/33 correct and 7/7 incorrect placements, respectively. Impedance measurement interpretation had 87.9% sensitivity, 100% specificity, 90% accuracy, and 100% precision overall. Agreement between TIMI and Veress needle location was moderate (kappa 0.50, P = .01) for placements by the experienced laparoscopist and very high (kappa 0.88, P < .01) for the novice laparoscopist., Conclusions: Diagnostic accuracy of TIMI for Veress needle placement was higher than has been reported for other tests, and TIMI had a shallow learning curve. TIMI successfully detected all incorrect Veress needle placements. Further prospective evaluation of Veress needle placement with and without TIMI is warranted to determine if its use increases operator detection of inappropriate Veress needle placements or decreases installment phase complication rates., (© Copyright 2013 by The American College of Veterinary Surgeons.)

In contrast to dogs, the role of copper and iron accumulation in feline hepatic disease remains poorly characterized. Therefore, the objective of the current study was to compare the amount and distribution of copper and iron accumulation for different disease processes in feline liver biopsies. Liver biopsies (from 104 privately owned cats) were categorized by primary histopathologic lesion. Copper (by rubeanic acid) and iron (by Prussian blue) accumulation were graded by amounts (0-3) and location (centrilobular, midzonal, periportal, random). The Kruskal-Wallis test and Pearson chi-square test were used to assess differences in metal grade and location, respectively, between diagnostic categories. Histologic diagnoses were normal (n = 12), congenital (n = 6), neoplastic (n = 16), infectious and/or inflammatory (n = 39), and other (n = 31). Hepatocellular iron staining was negative in 18 samples; remaining samples had grade 1 (n = 38), 2 (n = 40), and 3 (n = 8) accumulation. Ninety-two samples were negative for copper; remaining samples had grade 1 (n = 5), 2 (n = 6), and 3 (n = 1) accumulation. No significant differences were found in the amount of iron or copper accumulation between the different diagnostic categories. Diagnostic category and the location of copper or iron accumulation were not associated. Hepatic iron accumulation was common and not associated with histologic diagnosis. Hepatocellular copper accumulation was more common in cats than previously reported, had a similar pattern of distribution to fibrotic changes, and was not present in histologically normal liver biopsies.

Objective: To compare results of biochemical analyses performed on plasma samples obtained from healthy dogs and cats by use of standard and microsample blood collection tubes., Design: Evaluation study., Animals: 29 healthy client-owned animals (14 dogs and 15 cats)., Procedures: A blood sample (3 mL) was collected from each animal; 2.5 mL was transferred into a vacuum tube that contained lithium heparin, and 0.5 mL was transferred into a microsample tube that contained lithium heparin. Variables evaluated were albumin, bicarbonate, BUN, calcium, chloride, cholesterol, creatinine, glucose, phosphorus, potassium, sodium, total bilirubin, and total protein concentrations and alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, and creatine kinase activities. Results for the 2 types of tubes in each species were compared by use of Pearson correlation coefficients, Passing-Bablok regression analysis, and Bland-Altman analysis., Results: Data were normally distributed, except for creatine kinase activity of cats. The Pearson correlation coefficient was minimal for total bilirubin concentration in cats and moderate, high, or very high for all other variables. Constant bias for cholesterol and glucose concentration in dogs was identified during Bland-Altman analysis, although the mean difference between types of blood collection tubes was small. No constant or proportional bias for any other variable was revealed by regression analysis or Bland-Altman analysis., Conclusions and Clinical Relevance: Samples obtained from healthy dogs and cats by use of microsample blood collection tubes that contained lithium heparin provided clinically equivalent biochemical results, compared with results for samples obtained by use of standard blood collection tubes, and minimized the total sample volume collected for diagnostic testing.

Objective: To compare results of a CBC performed on blood samples obtained from healthy dogs and cats by use of standard and microsample collection tubes., Design: Evaluation study., Animals: 29 healthy client-owned animals (14 dogs and 15 cats)., Procedures: A blood sample (3 mL) was collected from each animal; 2.5 mL was transferred into a vacuum tube that contained sodium EDTA, and 0.5 mL was transferred into a microsample tube that contained sodium EDTA. Variables evaluated were total numbers of RBCs and WBCs, hemoglobin concentration, Hct, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration (MCHC), mean platelet volume, and plasma total protein concentration as well as neutrophil, lymphocyte, monocyte, eosinophil, basophil, and platelet counts. Results for the 2 types of tube in each species were compared by use of Pearson correlation coefficients, Passing-Bablok regression analysis, and Bland-Altman analysis., Results: The Pearson correlation coefficient was low for basophil count in cats and moderate, high, or very high for all other variables. Constant and proportional biases were identified for MCHC in dogs by use of Passing-Bablok regression analysis, although the mean difference between types of blood collection tubes was small. No evidence of constant or proportional bias for any other variable was revealed by regression analysis or Bland-Altman analysis., Conclusions and Clinical Relevance: Samples obtained from healthy dogs and cats by use of microsample blood collection tubes provided clinically equivalent CBC results, compared with results for samples obtained by use of standard blood collection tubes, and minimized the total sample volume collected for diagnostic testing.

Case Description: A 16-week-old female Boxer that had been treated for 5 weeks with trimethoprim-sulfamethoxazole and chloramphenicol because of aspiration pneumonia was evaluated for bilaterally symmetric masses in the subcutaneous tissues of the ventral neck, in the region of the larynx., Clinical Findings: Fine-needle aspirates were obtained from the neck masses; cytologic examination revealed well-differentiated thyroid epithelial tissue. A blood sample was collected for serum biochemical and thyroid function analyses. Mild hyperphosphatemia, severe hypercholesterolemia, mild hyperkalemia, and a mild increase in creatine kinase activity were identified. Serum concentration of total thyroxine was less than the lower reference limit, and that of thyroid-stimulating hormone was greater than the upper reference limit. Findings were consistent with a diagnosis of clinical hypothyroidism in a skeletally immature dog., Treatment and Outcome: Treatment with trimethoprim-sulfamethoxazole was discontinued. The dog was reevaluated 3 weeks later, at which time the neck masses were markedly decreased in size. Serum concentrations of cholesterol and potassium were lower; serum concentrations of total thyroxine and thyroid-stimulating hormone were near or within respective reference ranges. Age-appropriate increases in serum phosphorus concentration and serum alkaline phosphatase activity were also detected., Clinical Relevance: To the authors' knowledge, this is the first report of antimicrobial-induced goiter in a dog. Cytologic examination of fine-needle aspirates and interpretation of data from serum biochemical and thyroid function analyses were needed to obtain a definitive diagnosis. Practitioners should include goiter among the differential diagnoses for ventral neck swellings in young dogs receiving potentiated sulfonamide antimicrobials.

Objective: To determine the diagnostic usefulness of semiquantitative and quantitative microalbuminuria assays and urine albumin-to-creatinine (UAC) ratio for detecting disease in cats., Design: Prospective study., Animals: 441 cats evaluated at a veterinary teaching hospital., Procedures: Urine samples from cats for which a complete medical record was available were included. Urine dipstick results, urine protein-to-creatinine ratios (cutoffs, 0.1 and 0.4), semiquantitative and quantitative microalbuminuria assay results (cutoff, 1 mg/dL), and UAC ratio values (cutoffs, 100 and 200 mg/g) were determined. Clinical diagnoses determined within 3 months of enrollment were recorded. Sensitivity and specificity were determined with disease status used as the standard. The influences of clinical diagnosis, sex, age, serum urea nitrogen and creatinine concentrations, blood pressure, bacterial urine culture results, rectal temperature, pyuria, hematuria, and bacteriuria were evaluated by means of logistic regression., Results: Of 441 cats that were eligible for inclusion, 40 were healthy and 401 had > or = 1 disease. Results of logistic regression indicated that significant associations existed for age, presence of disease, presence of urinary tract disease, azotemia, hematuria, and pyuria and results of 1 or both of the microalbuminuria assays., Conclusions and Clinical Relevance: Microalbuminuria was associated with underlying disease. Sensitivity and specificity of the microalbuminuria assays for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase identification of occult disease. A prospective study evaluating the predictive values of screening tests with and without microalbuminuria determination is needed to validate this recommendation.

Sporotrichosis is an uncommon mycosis of dogs caused by Sporothrix schenckii. This report details the diagnosis and treatment of intranasal sporotrichosis in a dog presented for a loss of smell, sneezing, and nasal congestion. Following 6 months of itraconazole treatment, a computed tomography scan showed a complete resolution of previously identified abnormalities.

Objective: To evaluate semiquantitative and quantitative assays for microalbuminuria and determination of the urine albumin-creatinine (UAC) ratio in detection of systemic disease in dogs without overt proteinuria., Design: Prospective study., Animals: 408 dogs., Procedures: Urine samples that had been obtained from dogs for which a complete medical record was available and in which results of a dipstick test for urine protein were negative were evaluated. Urine protein-creatinine ratios (cutoff values, 0.5 and 0.1), semiquantitative and quantitative microalbuminuria values (cutoff value, 1 mg/dL), and UAC ratios (cutoff values, 100 and 200 mg/g) were determined. Clinical diagnoses rendered within 3 months of enrollment in the study were recorded. Sensitivity and specificity were determined with disease status serving as the standard. Associations with clinical diagnosis, sex, age, BUN and serum creatinine concentrations, blood pressure, results of bacterial culture of urine, temperature, pyuria, hematuria, and bacteriuria were evaluated by use of logistic regression analysis., Results: 48 dogs were healthy, and 360 had at least 1 disease. Significant associations were detected between age, presence of disease, presence of neoplastic disease, BUN and serum creatinine concentrations, and hematuria and results of 1 or both of the microalbuminuria assays., Conclusions and Clinical Relevance: Microalbuminuria was associated with underlying disease. The sensitivity and specificity of the semiquantitative microalbuminuria test for detection of systemic disease were superior to those of other tests. Microalbuminuria testing in conjunction with other screening procedures may increase diagnosis of subclinical disease, but a prospective study in which the predictive values of screening tests are evaluated, with and without microalbuminuria determination, is needed.

An 11-year-old, male castrated, Labrador Retriever was evaluated for the presence of rapidly growing concurrent leg and intraocular masses. Metastasis was noted in the chest at time of initial presentation. Indium-111 labeled vitamin B12 imaging was performed, and there was significant uptake by both primary tumors and the lung metastases. Enucleation and amputation were performed for palliative relief. The leg mass was a grade 2 soft tissue sarcoma and the ocular mass a ciliary adenoma. The dog remained symptom-free for approximately 10 weeks before developing signs of respiratory distress. He was euthanized 12 weeks after initial presentation, and there was diffuse infiltration of the lungs with metastatic sarcoma. Indium-111 labeled vitamin B12 imaging identified a ciliary adenoma in this case and may provide a useful differentiation technique for evaluation of intraocular and retrobulbar masses if it can be demonstrated that there is differential uptake between inflammatory or infectious conditions and neoplasia.

A 6-week-old male kitten was evaluated because of stranguria and possible urethral blockage; a urinary catheter placed during general anesthesia penetrated the urethral and colonic walls and entered the colon. Treatment was conservative, with fluids administered i.v., administration of piperacillin, and supportive care. The kitten never became febrile or clinically ill and continued to thrive. There was no development of clinical signs consistent with stricture, diverticulum, or fistula formation. Complications from urethral perforation include infection and urethral stricture. Reconstructive surgery is considered the treatment of choice for traumatic urethral-colonic perforation. However, surgery may not be feasible or may be cost-prohibitive in certain situations. In such instances, medical management may provide a reasonable alternative to euthanasia.