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Summary. A 9-year-old 35.6 kg (90 lb) female neutered German Shepherd dog was admitted due to progression of tetraparesis. The dog presented pyrexia, mild leukocytosis, and nonambulatory tetraparesis with decreased general proprioception and withdrawal in all the limbs, with the front limbs more severely affected. Magnetic resonance imaging revealed T2-weighted image (WI) hyperintense, contrast-enhancing lesion at the level of the C6-C8 spinal nerves, and epidural fat, suspected to be an infiltrative neoplasm. Medical treatments during hospitalization included glucocorticoids, antibiotics, and supportive care. Euthanasia was elected 4 days later due to financial constraints, despite clinical improvement. Postmortem findings revealed septic emboli (SE) in the epidural fat exiting the canal and following the tract of the spinal nerve roots and nerves. Staphylococcus pseudintermedius was identified as the causative agent. Although the incidence of SE without severe systemic disease is considered low in dogs, it should be considered in the differential diagnosis of focal intraspinal disease.

An increasing number of women who have coronary artery disease have undergone heart surgery and are living alone. This qualitative descriptive study identified four primary themes that constituted essential structures of the post-recovery experience for 12 older women living alone after coronary artery bypass surgery. Themes included (1) survival relief, experienced as awe and gratitude; (2) going on, described as an obligation; (3) living within a contracted world, structured by a sense of vulnerability; and (4) regained independence, characterized by affirmation of self-worth and personal freedom. Post-recovery meant restoring the identity the women had known before surgery together with actualizing the value of self-reliance.

The extensive antihyperlipidemic effects of niacin are well known. Cardiac doses of niacin are effective in lowering low density lipoprotein, triglyceride, and lipoprotein(a) levels and in elevating high density lipoprotein levels. Adverse reactions to niacin range from annoying cutaneous flushing to hepatic toxicity. A new extended‐release form of niacin (Niaspan®) has been found to have relatively mild hepatic effects. Nighttime dosing of Niaspan® appears to attenuate cutaneous flushing. Regardless of the form of drug prescribed, patients advised to use niacin should be carefully screened and monitored. Adverse effects of niacin are emphasized because of their particular importance in the provision of primary care. The dosing schedules for both plain niacin and extended‐release niacin are discussed.