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Se presenta una revisión de la bibliográfica y se comentan los principales aspectos epidemiológicos y clínicos de la patología preinvasora del cérvix. La historia natural de esta enfermedad revela la presencia de un fenómeno dinámico de progresión persistencia y regresión de lesiones intraepiteliales en las cuales el virus papiloma humano juega un rol preponderante. Se resalta el rol actual de la colposcopia en el manejo de una citología alterada. Se revisa los resultados del manejo colpohistológico de un frotis atípico demostrando un 9% de lesiones de alto grado para los ASCUS y de 25% para los ASC-H. Finalmente se presentan las alternativas terapéuticas y se analizan los resultados de la escisión con asa grande en pacientes portadoras de NIE III demostrando un 89% de curaciónWe present the most important aspects related to the epidemiology and natural history of cervical intraepithelial neoplasia (CIN). CIN natural history is a dynamic process characterized not only by progression but also by persistence and regression. 9% of ASCUS revealed at biopsy confirmed CIN - 2.3 and 25% of ASC-H revealed at biopsy confirmed CIN - 2,3. Treatment of women with biopsy- confirmed CIN-3 with LLETZ showed a 89% healing

Herpes gestationis es una rara enfermedad autoinmune que se presenta en mujeres embarazadas, compromete principalmente la piel y puede manifestarse como lesiones bulosas intensamente pruriginosas que, en ocasiones, son de difícil diagnóstico. Nosotros reportamos dos casos clínicos simultáneos que se presentaron en nuestro Servicio en marzo del año 2002, hecho que no deja de sorprender dado lo infrecuente y poco común de esta patología.Herpes gestationis is an uncommon autoimmune disease seen in pregnant women. The condition involves mainly the skin, and results in bulous lesions with intense pruritus, which can sometimes be very difficult to deal with. We report 2 clinical cases which presented simultaneously at our Service, a surprising fact indeed, if we take into consideration the uncommon and peculiar character of this disease.

Background: Inhaled glucocorticoids reduce airway inflammation while minimizing systemic effects in several species. Hypothesis: Inhaled fluticasone suppresses the hypothalamic–pituitary–adrenal axis (HPAA), modifies immune function, and induces clinical signs to a lesser extent than PO-administered prednisone in dogs. Animals: Seven healthy adult pet dogs. Methods: Dogs were randomized to 1 of 3 treatment groups in a crossover design: fluticasone propionate (220 μg actuation of a metered dose inhaler delivered via a spacer and mask, q12h), placebo (spacer and mask alone, q12h), or prednisone (1 mg/kg PO q24h). Each treatment was administered for 3 weeks followed by a 4-week washout. Appetite, attitude, and water consumption were recorded during the last week of each treatment period. Urine cortisol : creatinine ratios, ACTH stimulation tests, white blood cell counts, lymphocyte phenotype, and serum IgM and IgA concentrations were recorded at each baseline and after the last day of each treatment. Clinical observations were expressed descriptively. Friedman's test was applied to all data comparisons. Pairwise comparisons were made with a mixed model analysis when data were normally distributed, whereas signed rank tests were used otherwise (significance P-value <.01). Results: Appetite and water consumption increased during prednisone treatment. Peak serum cortisol concentrations post-ACTH were significantly decreased in prednisone- and fluticasone-treated dogs compared with placebo (prednisone > fluticasone). Serum IgM concentrations were significantly decreased in dogs treated with prednisone. Conclusions and Clinical Importance: As used, fluticasone suppresses the HPAA to a lesser extent than prednisone and may avert systemic signs associated with PO-administered glucocorticoids in dogs. [ABSTRACT FROM AUTHOR]

Airway hyperresponsiveness (AHR) is a key feature of asthma and can be measured using bronchoprovo-cation. Direct (methacholine, MCh) or indirect (adenosine-5-monophosphate, AMP: or mannitol) bron-choprovocants are used in human patients, the latter inducing AHR only with pre-existing airway inflammation. The present study compared the responses to direct (MCh) and indirect (mannitol, AMP) bronchoprovocation in healthy and asthmatic cats (n = 6/group). The order of bronchoprovocant was randomized using a published table of random numbers and there was a 1-month washout before cross-over to the next treatment. Pulmonary mechanics were measured in anesthetized and mechanically ventilated cats using a critical care ventilator. Saline at baseline and increasing doses of each broncho-provocant were aerosolized for 30 s, followed by 4 min of data collection between doses. The endpoint for each bronchoprovocant was reached when airway resistance exceeded 200% of baseline values (EC200Raw). There was a significant difference (P < 0.001 ) in the airway response of asthmatic vs. healthy cats over the range of MCh concentrations, despite there being no significant difference in the EC200Raw between the groups. Response to MCh was significantly greater (P < 0.05) in asthmatic than in healthy cats at MCh concentrations as low as 0.0625 mg/mL. For AMP, a small subset of asthmatics (n = 2/6) responded at low concentrations: four asthmatic cats and all healthy cats failed to respond even to the highest concentra-tions of AMP. One asthmatic cat but no healthy cats responded to mannitol. In conclusion, MCh discrim-inated asthmatic from healthy cats but neither AMP nor mannitol was an effective bronchoprovocant in this model. [ABSTRACT FROM AUTHOR]

A 10-year-old male castrated Somali cat presented with neurologic signs, severe systemic hypertension, and hypokalemia. Abdominal ultrasonography demonstrated a left adrenal mass, and the serum aldosterone concentration was increased. Computed tomography and follow-up diagnostic testing confirmed a left adrenal mass consistent with functional adenocarcinoma; additional findings included chronic airway and parenchymal disease. Transthoracic echocardiography revealed biatrial enlargement, with abdominal and pericardial effusion, consistent with right-sided congestive heart failure. The cat was treated for congestive heart failure and adrenalectomy was performed. Cardiac structure and function returned to normal within 6 months postoperatively. This report highlights a case of reversible congestive heart failure secondary to primary hyperaldosteronism., Competing Interests: Conflict of Interest Statement The authors do not have any conflicts of interest to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Aerophagia (ingestion of air), is a functional aerodigestive disorder in people. Criteria for diagnosis of aerophagia in dogs are >1/3 of bolus volume containing air or ingested air resulting in gastric distention (>1/3 of end gastric volume). Aerophagia is highlighted during eating and drinking. Videofluoroscopic swallow studies (VFSS) document aerophagia in dogs, but the incidence, clinical signs (CS), and associated disorders are unknown., Objectives: Identify the incidence of aerophagia, compare CS between dogs with and without aerophagia, and identify associated and predisposing disorders using VFSS., Animals: A total of 120 client-owned dogs., Methods: Sequential VFSS and associated medical records from dogs presenting to veterinary teaching hospitals at Auburn University and the University of Missouri were retrospectively reviewed. Statistical comparisons were made using Mann-Whitney and chi-squared tests, odds ratios (OR), and multiple logistic regression (P < .05)., Results: The incidence (95% confidence interval [CI]) of aerophagia was 40% (31.7-48.9). Dogs with mixed CS (gastrointestinal [GI] and respiratory; P < .001, 58.3%) were more likely to have aerophagia than dogs with exclusively respiratory CS (25%). Aerophagia was significantly more common in brachycephalic dogs (P = .01; 45.8% vs 13.8%), dogs with nonbrachycephalic upper airway obstruction (P < .001; 33.3% vs 4.1%), pathologic penetration and aspiration (P-A) scores (P = .04; 41.6% vs 23.6%), and gagging (P < .001; 25% vs 11.7%). Mixed CS (P = .01), brachycephaly (P < .001), and upper airway obstruction (P < .001) were independent predictors of aerophagia., Conclusions and Clinical Importance: Aerophagia was common, particularly in dogs with mixed CS. Brachycephalic dogs and dogs with upper airway obstruction are predisposed. Aspiration risk was high, emphasizing overlapping upper aerodigestive pathways., (© 2024 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Introduction: The primary objective of this study was to assess the feasibility of a 6-week internet-delivered Mantram Repetition Program (MRP) for women recently treated for breast cancer. A secondary objective explored changes in perceived stress, psycho-spiritual measures, and cytokines in the treatment group compared to a waitlist. Methods: A feasibility study (ORBIT model Phase IIa) with a randomized controlled trial pilot was conducted. Eligible women recently treated for breast cancer were randomized to the treatment group ( n = 14) or a waitlist group ( n = 12) and participated for 12 weeks. During weeks 1-6, the treatment group received the MRP intervention while the waitlisted group was inactive. During weeks 7-12, the treatment group was inactive while the waitlisted group received the MRP intervention. The primary outcomes were feasibility and acceptability of the internet-delivered MRP intervention protocol. Participants completed pre and post-intervention psycho-spiritual health assessments. A subset of participants provided serum for cytokine analyses at enrollment and week 6, coinciding with the period in which the treatment group receiving the MRP intervention. Results: Overall study attrition was 19.2%. MRP adherence for both groups was 86% at post-intervention and 90% in the treatment group at 6-week follow-up. Pre-to-post-intervention analyses pooling both groups' data demonstrated decreased perceived stress ( p = .045) and increased spiritual well-being ( p =.004). IFN-γ and IL-17A were increased in the waitlisted group and decreased in the treatment group ( p = 0.048). Conclusion: Feasibility of a 6-week, internet-delivered MRP intervention for breast cancer survivors was established. Psycho-spiritual variables and serum cytokines are suitable clinical outcome measures for future MRP studies with breast cancer survivors. Data suggest MRP may reduce perceived stress and support spiritual well-being in women with breast cancer; however, additional studies are needed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Apply the 3-site echocardiographic metrics utilized to assess pulmonary hypertension (PH) probability in dogs and humans to feline echocardiographic examinations to investigate the translatability of this scheme and subsequent enhancement of detection of PH in cats., Animals: 27 client-owned cats (euthyroid [n = 11] and hyperthyroid [16])., Methods: This was a single-center, prospective, observational case-control study. Demographic, physical examination, and echocardiographic data from hyperthyroid and euthyroid cats were compared via Fisher exact test and Kruskal-Wallis test., Results: Hyperthyroid versus euthyroid cats had significantly greater right atrial area index values and were more likely to have late-peaking main pulmonary artery pulsed-wave flow profiles. Two hyperthyroid cats had measurable tricuspid regurgitation tracings (one with a high probability of PH and another with a low probability of PH)., Clinical Relevance: Hyperthyroid cats demonstrated altered pulmonary arterial hemodynamics and lacked consistent intermediate or high probability of PH. The 3-site echocardiographic metrics scheme is applicable for the evaluation of right-sided cardiac and pulmonary arterial hemodynamics in cats. Further research is needed to determine reference ranges in larger populations of healthy cats and those with high clinical suspicion for PH.

Salbutamol is a bronchodilatator commonly used for the treatment of feline inflammatory lower airway disease, including asthma or acute bronchospasm. As in humans, a pressurized metered dose inhaler (pMDI) is used in conjunction with a spacer and a spherical mask to facilitate salbutamol administration. However, efficacy of inhalation therapy is influenced by different factors including the non-cooperative character of cats. In this study, the goal was to use computational fluid dynamics (CFD) to analyze the impact of breathing patterns and salbutamol particle size on overall drug transport and deposition using a specific spherical mask and spacer designed for cats. A model incorporating three-dimensional cat airway geometry, a commercially available spherical mask, and a 10 cm spacer, was used for CFD analysis. Two peak inspiratory flows were tested: 30 mL/s and 126 mL/s. Simulations were performed with 30s breathing different inspiratory and expiratory times, respiratory frequencies and peaks. Droplet spray transport and deposition were simulated with different particle sizes typical of the drug delivery therapies (1, 5, 10, and 15 μm). The percentage of particle deposition into the device and upper airways decreased with increasing particle diameter during both flows imposed in this cat model. During increased mean ventilatory rate (MVR) conditions, most of the salbutamol was lost in the upper airways. And during decreased MVR conditions, most of the particles remained in suspension (still in hold-up) between the mask and the carina, indicating the need for more than 30 s to be transported. In both flows the percentage of particles traveling to the lung was low at 1.5%-2.3%. In conclusion, in contrast to what has been described in the human literature, the results from this feline model suggest that the percentage of particles deposited on the upper airway decreases with increasing particle diameter., Competing Interests: The 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 © 2023 Fernández-Parra, Pey, Reinero and Malvè.)

This review article seeks to define and describe aerodigestive disease in dogs, and review current and emerging methods of diagnostic evaluation. Aspiration of gastric contents into the respiratory tract is associated with the development and progression of numerous respiratory diseases in humans. In veterinary medicine the term "aspiration" is considered synonymous with "aspiration pneumonia" which, while frequently encountered, does not accurately reflect the breadth of aspiration associated respiratory syndromes (AARS). In the clinical veterinary literature, the effect of alimentary dysfunction on respiratory disease and vice versa (aerodigestive disease) is rarely investigated despite evidence in the human literature, animal models, and some studies and case reports linking alimentary and respiratory disease in small animals. Current methods of investigating aerodigestive diseases in veterinary patients are limited by inadeqate  sensitivity or specificity, potential for bias, cost, and availability. This necessitates investigations into advanced diagnostics to identify potentially underrecognized animals with AARS. Additionally, similarities in anatomy, physiology, and several disorders between dogs and humans, make experimental and naturally occurring canine models of AARS integral to translational research. Thus, evaluating dogs with aerodigestive disease might represent an area of substantial clinical relevance in human as well as veterinary medicine., (© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC. on behalf of the American College of Veterinary Internal Medicine.)

Objectives: Hyperthyroidism is a common endocrinopathy affecting middle-aged to elderly cats, with multisystemic repercussions. Hyperthyroid humans show decreased lung compliance and increased cardiac output with subsequent left heart failure leading to pulmonary capillary congestion. Prognosis worsens with the development of increased pulmonary vascular pressures (ie, pulmonary hypertension [PH]) in hyperthyroid humans. The effect of excess thyroid hormone concentration on pulmonary arterial hemodynamics is unknown in cats. Assessing pulmonary vascular pressures in veterinary medicine relies heavily on echocardiographic measurements performed at the level of the heart and pulmonary trunk. This study investigated right-sided cardiac and pulmonary arterial hemodynamics in hyperthyroid cats using echocardiography., Methods: Echocardiographic examinations of hyperthyroid cats identified through a bi-institutional database search were reviewed for the determination of systolic pulmonary arterial pressure (PAP) and 20 other metrics. Values were compared with those of a healthy cat group using non-parametric statistical analyses., Results: Systolic PAP could not be determined in 23/26 hyperthyroid and 13/14 healthy cats owing to unmeasurable tricuspid regurgitation flow velocity. Hyperthyroid cats were roughly twice as old ( P <0.001) and had 2-4-fold higher respiratory rates ( P <0.001) than healthy cats. Hyperthyroid cats showed an increase in acceleration time-to-ejection time ratio of pulmonary flow (1.4-fold, P  = 0.001), pulmonary artery velocity time integral (1.2-1.6-fold, P  = 0.001), maximal pulmonary velocity (1.3-1.7-fold, P  = 0.002), stroke volume (1.5-fold, P  = 0.001) and cardiac output (1.6-fold, P <0.001) vs healthy cats. None of the other echocardiographic metrics reached statistical significance., Conclusions and Relevance: Systolic PAP estimation proved unsuitable as a sole measurement for the assessment of PH in hyperthyroid cats owing to the frequent inability to interrogate tricuspid regurgitant flow velocity. Hyperthyroid cats have altered echocardiographic measures of pulmonary hemodynamics dissimilar to those reported in hyperthyroid humans. Differential effects of thyrotoxic cardiomyopathy on ventricular systolic function may underlie species differences.

Airway collapse (AC) in dogs includes a tracheal collapse, mainstem and lobar bronchial collapse, and bronchomalacia (i.e., segmental/subsegmental bronchial collapse). The clinical presentation of AC may overlap with non-collapsible airway disease (NCAD) or another non-lower airway respiratory disease (NLARD). This study determined whether paired inspiratory (I)/expiratory (E)-breath-hold computed tomography (I/E-BH CT) can detect a static and dynamic AC in dogs with spontaneous respiratory disease and it compared the CT-derived metrics of the AC to the tracheobronchoscopy metrics. The CT-acquired I and E diameter and cross-sectional area (CSA) for the trachea, mainstem and lobar bronchi in dogs with an AC ( n = 16), NCAD (16), and NLARD (19) served for a dynamic percent of the airway narrowing (%AN) calculation. A scoring system assessed the bronchomalacia. The circularity was calculated for each airway. The results were compared to the tracheobronchoscopy collapse grading. In the dogs with an AC, the %AN was larger for the trachea, right mainstem bronchus and right middle lobar bronchus when they were compared to the dogs with NCAD and NLARD. Flattening was only identified for the trachea of the AC dogs. The agreement between the CT and tracheobronchoscopy scores was 20% from trachea to the lobar bronchi and 47% for the segmental/subsegmental bronchi. Paired I/E-BH CT can detect static and dynamic AC with limited agreement with the tracheobronchoscopy metrics. Independent scoring systems that are tailored to the clinical manifestations of functional impairments are needed.

Objective: To describe the current standard of care among specialists for the routine diagnostic evaluation and medical management of stable tracheal collapse in dogs, identifying gaps between practice and scientific evidence to facilitate the development of future prospective studies. A secondary objective was to describe the perceived incidence of selected comorbid disorders in dogs with tracheal collapse and the diagnostic tests performed to evaluate for those disorders., Sample: 180 veterinary specialists in 22 countries., Procedures: An electronic survey was sent to 4 specialty listservs to target diplomates. Respondents completed multiple-choice and free-response questions related to the diagnostic evaluation and treatment of a theoretical stable dog with suspected tracheal collapse., Results: Most respondents routinely utilized radiography, tracheobronchoscopy, and fluoroscopy to diagnose tracheal collapse and performed airway sampling, sedated airway examination, and echocardiograms to rule out comorbidities. The most frequently perceived comorbid disorders included chronic bronchitis, bronchomalacia, and myxomatous mitral valve disease. Respondents most often prescribed opioid antitussives, glucocorticoids, anxiolytics, and antibiotics as treatments. Less frequently, they utilized bronchodilators and nonopioid medications for cough., Clinical Relevance: Despite a lack of published guidelines, specialists have similar approaches in their diagnostic and therapeutic approach to a stable dog with suspected tracheal collapse and believe evaluating for comorbid disorders is important. A description of a typical diagnostic approach and knowledge of realistic treatment goals will assist the general practitioner managing dogs with stable tracheal collapse. Additionally, gaps between current practices established via this survey and data supporting those practices exist, specifically concerning the use of antibiotics and nonopioid medications for cough, representing areas for further study.

Background: Aerodigestive diseases (AeroD), hybrid disorders between the respiratory and gastrointestinal (GI) tracts, may present without GI signs. Sliding hiatal hernia (sHH) is an important AeroD in brachycephalic dogs linked to respiratory pathology. The spectrum of other AeroD and respiratory clinical signs (CS) in brachycephalic and nonbrachycephalic dogs with sHH is unknown., Objectives: Characterize CS of AeroD in dogs with sHH, compare CS between brachycephalic and nonbrachycephalic dogs, and compare thoracic radiographs and videofluoroscopic swallow study (VFSS) for diagnosing sHH., Animals: Sixty-seven client-owned dogs with sHH., Methods: Medical records of dogs with sHH presented to the veterinary teaching hospitals at Auburn University and the University of Missouri between 1 January 2009 and 31 December 2020 were retrospectively reviewed. Between group, comparisons were made using Mann-Whitney test, Chi-square analysis, and Spearman correlation (P < .05)., Results: Dogs with sHH presented with exclusively GI signs (28/67), mixed respiratory and GI signs (22/67), or with exclusively respiratory signs (17/67). Wheras brachycephalic dogs were not significantly more likely to present with respiratory CS (P = .145), they were younger (P < .001), and more likely to present in respiratory distress (P = .02), and with radiographic evidence of aspiration pneumonia (P < .001) compared to nonbrachycephalic dogs. Six of 12 dogs with normal thoracic radiographs having sHH presented with respiratory CS. For detection of sHH, VFSS was superior to radiographs (P < .001)., Conclusions and Clinical Importance: Dogs with sHH may present with exclusively respiratory signs. Respiratory signs may be more severe in brachycephalic compared to nonbrachycephalic dogs. Videofluoroscopic swallow study was superior to thoracic radiographs for detection of sHH in dogs., (© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC. on behalf of the American College of Veterinary Internal Medicine.)

Background: Reports of clinicopathologic features of bronchomalacia (BM) differ because of inconsistent definitions and frequent prevalence of comorbid cardiopulmonary disease. Pulmonary hypertension (PH) secondary to BM is poorly described., Objectives: Dogs with BM will be older but of any somatotype, and increased expiratory effort, ≥1 comorbid disease, and PH will be more common than in dogs without BM., Animals: Client-owned dogs (n = 210) evaluated for respiratory signs., Methods: Medical records of dogs with paired inspiratory: expiratory-breath-hold computed tomography, tracheobronchoscopy, or both between January 2016 and December 2019 were retrospectively reviewed. Comparisons between dogs with and without BM using Mann-Whitney rank sum or χ 2 tests (P < .05 significant were made). Because of high numbers of variables, criteria with high prevalence (>25%) were identified (n = 10) for univariate analysis (P < .005 significant). Significant variables were submitted for multivariate analysis., Results: Bronchomalacia was identified in 41% of dogs of all sizes/somatotypes; 38% were >10 kg. All dogs with BM had ≥1 comorbid cardiopulmonary disorder. Dogs with BM were significantly older (P < .001), smaller (P < .001), and were more likely diagnosed with tracheal or mainstem bronchial collapse (P < .001) or bronchiectasis (P < .001). Multivariate analysis confirmed associations with age, tracheal or mainstem bronchial collapse, and bronchiectasis. In dogs with BM, PH was more prevalent., Conclusions and Clinical Importance: Although significantly more common in older, smaller dogs, BM occurs in dogs of all sizes and in all instances with comorbidities. Echocardiography should be considered in dogs with BM to identify PH., (© 2022 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

In humans, classification of abnormal breathing patterns (ABP) and recognition of ancillary respiratory signs are difficult, as reflected by poor-to-moderate interclinician agreement. The aims of this study were to assess interclinician agreement for respiratory sign recognition in dogs and cats and evaluate the influence of clinical experience on agreement. Dogs and cats with ABP were recruited from three hospitals. Included animals were evaluated by three clinicians at each hospital before therapeutic intervention. Consensual definitions for each respiratory clinical sign were provided to all clinicians. Interclinician agreement was measured via Fleiss' kappa and intraclass correlation coefficient statistics. Influence of clinical experience on interobserver agreement was studied via mixed-effects logistic regression. One-hundred and fifteen dogs and 49 cats with ABP were recruited. Out of 12 clinical signs evaluated, only stertor (kappa, 0.80), stridor (kappa, 0.64), attenuation of heart/lung sounds (kappa, 0.60), and goose honking (kappa, 0.84) in dogs, and stertor (kappa, 0.65) and open-mouth breathing (kappa, 0.75) in cats, were considered sufficiently reliable among clinicians. Agreement on respiratory rate estimation was good in both species (intraclass correlation coefficient, 0.75). The greater the difference in clinical experience between two clinicians, the lower the odds of agreement between the two clinicians' respiratory physical examination findings. Interclinician agreement was demonstrated to be poor for recognition of most respiratory clinical signs in dogs and cats. Teaching and clinical experience acquisition should be encouraged to improve respiratory clinical sign recognition., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The diagnostic values of respiratory signs have been under-investigated in pets. The study aim was to explore commonly assumed associations between respiratory signs and disease localization in pets with abnormal breathing patterns (ABP). Dogs and cats with ABP presenting to three hospitals were included if investigations permitted disease localization. Hypothesized associations between respiratory signs and disease location were evaluated via mixed-effects logistic regression. Sensitivity, specificity, and positive diagnostic likelihood ratio were calculated. One-hundred and fifteen dogs and 49 cats with ABP were recruited. Confirmed associations included: inspiratory effort with extra-thoracic airway disease (odds ratio [OR], 9.1; 95% confidence interval [95% CI] 3.0-27.2); expiratory effort with intra-thoracic airway disease (OR, 6.5; 95% CI, 2.3-18.1); paradoxical breathing and attenuation of heart/lung sounds with pleural space disease (paradoxical breathing: OR, 4.5; 95% CI 1.7-12.1; sound attenuation: OR, 11.5; 95% CI 4.0-33.3); decreased nasal airflow and stertor with nasal/pharyngeal disease (nasal airflow: OR, 26.2; 95% CI 8.1-84.8; stertor: OR, 155.2; 95% CI 24.9-968.8); stridor with laryngeal or tracheal disease (laryngeal disease: OR, 39.9; 95% CI 7.6-209.0; tracheal disease: OR, 32.4; 95% CI 4.2-248.0); tracheal sensitivity with bronchial disease (OR, 3.8; 95% CI 1.5-9.6); crackles with pulmonary or bronchial disease (pulmonary disease: OR, 5.4; 95% CI 2.1-13.8; bronchial disease: OR, 3.9; 95% CI 1.6-9.8); and goose honking with tracheal disease (all dogs with goose honking had tracheal involvement). Select respiratory signs provide guidance to localize and prioritize causes of the underlying respiratory disease in pets, allowing targeted interventions in animals with ABP., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Thoracic radiography (TR), the most common screening test for pulmonary metastases in dogs, can fail to detect small lesions <3 mm. Lung ultrasonography (LUS) is a widely available imaging modality capable of detecting peripheral nodules but is underutilized for this purpose. Thoracic computed tomography (CT) is the criterion standard for diagnosis of lung metastases and nodular disease but is less practical for a variety of reasons. We hypothesized that LUS would be more sensitive but less specific at detecting nodules consistent with metastatic pulmonary disease in dogs compared to TR, using CT as the criterion standard. This was a masked, single-center prospective study of 62 client-owned dogs evaluated for respiratory signs or pulmonary metastatic neoplasia screening using TR, LUS and CT. Dogs were included if metastatic pulmonary disease was a differential. All imaging modalities were scored as having nodules (yes/no) and other types of pathologic lesions were recorded. Sensitivity (Se), specificity (Sp) and positive (LR+) and negative likelihood ratios (LR-) were determined for TR and LUS. For TR, Se and Sp were 64% and 73%, and LR+ and LR- were 2.37 and 0.49, respectively. For LUS, Se and Sp were 60% and 65% and LR+ and LR- were 1.71 and 0.62, respectively. The results of the study indicate that LUS had a similar Se to TR, with both modalities missing nodules when used for screening. The low Sp and LR- suggests caution should be used when assuming TR and LUS rule out the presence of nodules., (Published by Elsevier Ltd.)

Pressurized metered-dose inhalers (pMDI) with or without spacers are commonly used for the treatment of feline inflammatory airway disease. During traditional airways treatments, a substantial amount of drugs are wasted upstream of their target. To study the efficiency of commonly used devices in the transport of inhaled salbutamol, different computational models based on two healthy adult client-owned cats were developed. Computed tomographic images from one cat were used to generate a three-dimensional geometry, and two masks (spherical and conical shapes) and two spacers (10 and 20 cm) completed the models. A second cat was used to generate a second model having an endotracheal tube (ETT) with and without the same spacers. Airflow, droplet spray transport, and deposition were simulated and studied using computational fluid dynamics techniques. Four regions were evaluated: device, upper airways, primary bronchi, and downstream lower airways/parenchyma ("lung"). Regardless of the model, most salbutamol is deposited in devices and/or upper airways. In general, particles reaching the lung varied between 5.8 and 25.8%. Compared with the first model, pMDI application through the ETT with or without a spacer had significantly higher percentages of particles reaching the lung ( p = 0.006).