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Heather H Vaske, Thomas Schermerhorn, Laura Armbrust, Gregory F Grauer Department of Clinical Sciences, Kansas State University, Manhattan, KS, USA Abstract: Previous and ongoing research has provided insights to the pathophysiology and diagnosis of hyperthyroidism as well as new treatment modalities. This paper reviews the etiology, clinical presentation, and clinicopathologic changes associated with hyperthyroidism, and provides a thorough explanation of confirmatory testing and treatment options. Keywords: feline hyperthyroidism, diagnosis, management

Abstract Background Pancreatic beta cells express ATP-sensitive potassium (KATP) channels that are needed for normal insulin secretion and are targets for drugs that modulate insulin secretion. The KATP channel is composed of two subunits: a sulfonylurea receptor (SUR 1) and an inward rectifying potassium channel (Kir6.2). KATP channel activity is influenced by the metabolic state of the cell and initiates the ionic events that precede insulin exocytosis. Although drugs that target the KATP channel have the expected effects on insulin secretion in dogs, little is known about molecular aspects of this potassium channel. To learn more about canine beta cell KATP channels, we studied KATP channel expression by the normal canine pancreas and by insulin-secreting tumors of dogs. Results Pancreatic tissue from normal dogs and tumor tissue from three dogs with histologically-confirmed insulinomas was examined for expression of KATP channel subunits (SUR1 and Kir6.2) using RT-PCR. Normal canine pancreas expressed SUR1 and Kir6.2 subunits of the KATP channel. The partial nucleotide sequences for SUR1 and Kir6.2 obtained from the normal pancreas showed a high degree of homology to published sequences for other mammalian species. SUR1 and Kir6.2 expression was observed in each of the three canine insulinomas examined. Comparison of short sequences from insulinomas with those obtained from normal pancreas did not reveal any mutations in either SUR1 or Kir6.2 in any of the insulinomas. Conclusion Canine pancreatic KATP channels have the same subunit composition as those found in the endocrine pancreases of humans, rats, and mice, suggesting that the canine channel is regulated in a similar fashion as in other species. SUR1 and Kir6.2 expression was found in the three insulinomas examined indicating that unregulated insulin secretion by these tumors does not result from failure to express one or both KATP channel subunits.

A 2-year-old male intact pet Holland Lop rabbit (Oryctolagus cuniculus) was presented for routine bilateral orchiectomy at which time two distinct raised, alopecic, non-ulcerated skin masses over the right shoulder and caudal abdomen were observed on physical examination. Complete resection of both masses was attained via excisional biopsies which healed without complication. Histologically, the skin masses were identical and were composed of a mixed cellular dermal infiltrate of primarily eosinophils with macrophages, mast cells, lymphocytes, plasma cells, and heterophils. Based on these findings, a diagnosis of eosinophilic granuloma was made, indicating this rare condition should be considered in rabbits presented with similar lesions. [ABSTRACT FROM AUTHOR]

Objective: To investigate safety and effectiveness of velagliflozin oral solution as sole therapy in naïve and previously insulin-treated diabetic cats., Animals: 252 client-owned cats receiving ≥ 2 doses of velagliflozin; 214 (85%) naïve diabetics and 38 (15%) insulin-treated diabetics., Procedures: Prospective, baseline-controlled, open-label clinical field trial. Cats received velagliflozin orally, once daily. Physical examinations and blood collections were performed days 0, 3, 7, 30, 60, 120, and 180., Results: Data are median (range). Screening blood glucose (BG) was 436 mg/dL (272 to 676 mg/dL). On days 30, 60, 120, and 180, single BG after receiving velagliflozin was 153 mg/dL (62 to 480 mg/dL), 134 mg/dL (64 to 414 mg/dL), 128 mg/dL (55 to 461 mg/dL), and 125 mg/dL (77 to 384 mg/dL), respectively. Screening fructosamine was 538 µmol/L (375 to 794 µmol/L). On the same recheck days, fructosamine was 310 µmol/L (204 to 609 µmol/L), 286 µmol/L (175 to 531 µmol/L), 269 µmol/L (189 to 575 µmol/L), and 263 µmol/L (203 to 620 µmol/L). At day 180, 81% of 158 cats remaining had BG and/or fructosamine within reference ranges; 88.6% (124 of 140) and 87.7% (121 of 138) showed improvement in polyuria and polydipsia, respectively. Ketonuria developed in 35 cats (13.9%), including 18 (7.1%) that had ketoacidosis. Ketoacidosis was less common in naïve diabetic cats (11 of 214 [5.1%]) compared to insulin-treated diabetic cats (7 of 38 [18.4%]). At ketoacidosis diagnosis, 14 of 18 cats (77.8%) were euglycemic (ie, BG < 250 mg/dL). Most episodes of ketosis or ketoacidosis (30 of 35 [85.7%]) occurred within the first 14 days of treatment. Insulin-treated diabetic cats were less likely to complete the trial. No clinical hypoglycemia occurred., Clinical Relevance: Velagliflozin improved glycemic parameters and clinical signs in diabetic cats. Velagliflozin provides an alternative to insulin as a stand-alone treatment of diabetic cats.

Background: Serum fructosamine is a routine test used for clinical monitoring of diabetes mellitus (DM) but the usefulness of HbA1c for this purpose has not been extensively studied., Hypothesis: The study aimed to compare the ability of blood HbA1c and serum fructosamine tests to correctly classify DM control determined using a clinically-based assessment., Animals: 28 client-owned dogs with naturally-occurring diabetes mellitus., Methods: Cross-sectional observational study. Ability of fructosamine and HbA1c tests to classify diabetes control in dogs was determined., Results: Clinical assessment classified 50% of dogs as having good diabetic control and 82% as having acceptable diabetic control. Analysis using Cohen's kappa test showed that agreements between fructosamine and HbA1c results and the clinical assessment ranged from poor to fair. Fructosamine and HbA1c results from each dog showed a moderate correlation. Overall, the HbA1c test showed the best agreement with the clinical assessment when diabetes control was considered either acceptable or unacceptable, although the strength of agreement was considered fair (kappa = 0.27)., Conclusions and Clinical Importance: The HbA1c concentration was found to be more consistent with clinical evaluation of diabetes control than was the serum fructosamine concentration. The HbA1c level is a useful tool for assessment of glycemic status in diabetic dogs but should be used alongside other tests for outpatient monitoring of clinically stable diabetic dogs., Competing Interests: TS received financial and material support from Baycom Diagnostics (https://baycomdiagnostics.com), which developed, markets, and performs the commercial HbA1c assay studied as part of this project. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Objective: To develop a technique for isolation and culture of canine insulinoma cells and assess expression of cellular hexokinases (glucokinase and hexokinase I) and expression and secretion of insulin from these cells in vitro., Sample: Pancreatic insulinomas and normal pancreatic tissue from 4 and 3 dogs, respectively., Procedures: Tissues were collected by surgical excision or at necropsy. Insulinoma cells from 2 dogs were cultured for up to 10 weeks with standard techniques; insulin synthesis in vitro was confirmed by immunohistochemical analysis of freshly prepared slides of cultured cells, and insulin secretion was assessed by measurement of insulin concentrations in culture medium with an ultrasensitive mouse insulin ELISA. Expression of cellular hexokinases in insulinomas and adjacent normal (nontumor) pancreatic tissue from the same dog (n = 3) was examined by quantitative reverse transcriptase PCR assay., Results: Insulinoma cells survived for up to 10 weeks but did not proliferate in culture. Insulin was detected in isolated cells and secreted into culture medium for up to 10 weeks. Both cellular hexokinases were expressed; glucokinase appeared to be overexpressed in insulinomas, compared with normal pancreatic tissue from the same dogs., Conclusions and Clinical Relevance: Canine insulinomas expressed hexokinases responsible for glucose responsiveness. Insulinoma cells were successfully maintained in short-term culture; cultured cells remained functional for 10 weeks as evidenced by cellular insulin content and had detectable secretion of insulin into the culture medium for ≥ 5 weeks. Apparent glucokinase overexpression by insulinomas suggested a possible mechanism underlying excessive insulin release by these tumors.

Background: Quantifying hepatic gene expression is important for many pharmacogenetic studies. However, this usually requires biopsy (BX), which is invasive., Objectives: The objectives of this study were to determine the feasibility of using minimally invasive fine needle aspirate (FNA) to quantify hepatic gene expression and to assess expression variability between different sampling sites., Methods: Biopsy and FNA samples were acquired from central and peripheral locations of the right and left lateral liver lobes of a dog. Relative expression of ABCB1, GSTT1 and CYP3A12 were measured via reverse transcriptase, quantitative PCR. The effect of sampling method, lobe and location within the lobe on gene expression was assessed using a three-way ANOVA., Results: Relative expression of ABCB1 and GSTT1 were not statistically different between sampling methods but CYP3A12 expression was higher in samples collected by BX (p = .013). Lobe sampled affected ABCB1 expression (p = .001) and site within lobe affected ABCB1 (p = .018) and GSTT1 (p = .025) expression., Conclusions: FNA appears to be a feasible technique for minimally invasive evaluation of hepatic gene expression but results should not be directly compared to biopsy samples. Sampling location impacts expression of some targets; combination of FNAs from multiple sites may reduce variation., (© 2020 The Authors Veterinary Medicine and Science Published by John Wiley & Sons Ltd.)

Objective: To evaluate and compare regulation of diabetes mellitus (DM) in dogs with cataracts and well-controlled DM that received an ophthalmic preparation of prednisolone acetate versus diclofenac sodium., Animals: 22 client-owned dogs with cataracts and well-controlled DM., Procedures: A prospective, randomized, double-masked, experimental study was conducted. On days 0 and 32, serum fructosamine concentrations (SFCs), clinical scores, and body weights were determined. Dogs were assigned to receive a topically administered ophthalmic preparation of either prednisolone acetate 1% or diclofenac sodium 0.1% in each eye 4 times daily for 28 days. Data analysis was conducted with generalized linear mixed models., Results: Findings indicated no meaningful differences in SFCs, clinical scores, or body weights between the treatment groups on days 0 or 32. Clinical score on day 0 was positively associated with SFC, as indicated by the corresponding rate of change such that each 1 -unit increase in clinical score was associated with an approximately 45.6 ± 9.4 μmol/L increase in SFC. In addition, the least squares mean ± SEM SFC was higher in spayed females (539.20 ± 19.23 μmol/L; n = 12) than in castrated males (458.83 ± 23.70 μmol/L; 8) but did not substantially differ between sexually intact males (446.27 ± 49.72 μmol/L; 2) and spayed females or castrated males regardless of the treatment group assigned., Conclusions and Clinical Relevance: Findings indicated no evidence for any differential effect on DM regulation (assessed on the basis of SFCs, clinical scores, and body weights) in dogs treated topically with an ophthalmic preparation of prednisolone versus an ophthalmic preparation of diclofenac. Additional research investigating plasma concentrations of topically applied ophthalmic glucocorticoid medications is warranted. (Am J Vet Res 2019;80:1129-1135).

Serum hypertonicity may develop during diabetes mellitus due to hyperglycemia and other biochemical changes. Hypertonicity may produce detrimental cellular and systemic effects and has been identified as a serum marker for some clinical disorders. In non-diabetic dogs, the mean cell volume difference, a novel erythrocyte measure, is increased by serum hypertonicity. However, it is not known whether hyperglycemic hypertonicity produces a similar change. The hypothesis that the mean cell volume difference could detect serum hypertonicity in diabetes was investigated in a group of thirty-two dogs with naturally-occurring diabetes mellitus that were prospectively recruited over a 1-year period from the outpatient population of a veterinary teaching hospital. The effect of hyperglycemia on the mean cell volume difference and the ability of the mean cell volume difference to predict serum hypertonicity were examined. Serum hyperosmolality and hypertonicity due to hyperglycemia was present in 91% and 94% of dogs, respectively. Hyperglycemia was the principal cause identified for serum hypertonicity and hyperosmolality. Using a cut-off value of ≥ 3 μm3 for the mean cell volume difference, serum hypertonicity ≥ 320 mmol/kg was identified with 79% sensitivity and 61% specificity. The dMCV correlated with changes in serum glucose, tonicity, and measured osmolality. Dogs with a mean cell volume difference ≥ 3 μm3 were at risk for serum tonicity ≥ 320 mmol/kg (risk ratio = 2.2) and serum glucose ≥ 13.9 mmol/L (risk ratio = 2.3). In conclusion, the mean cell volume difference is a useful surrogate marker for detecting serum hypertonicity in diabetic dogs and elevated mean cell volume difference is associated with increased risks for clinically relevant serum hypertonicity and hyperglycemia., Competing Interests: The authors have declared that no competing interests exist.

Preliminary studies have supported use of toceranib phosphate (Palladia®) in treatment of canine nasal carcinomas, though the mechanisms of its activity are unknown. This study evaluated sixteen canine nasal carcinoma and five normal nasal epithelium samples for expression and phosphorylation of known targets of toceranib [vascular endothelial growth factor receptor-2 (VEGR2), platelet derived growth factor alpha (PDGFR-α), platelet derived growth factor receptor beta (PDGFR-β), and stem cell factor receptor (c-KIT)] and epidermal growth factor receptor 1 (EGFR1) using immunohistochemistry, RT-PCR and a receptor tyrosine kinase (RTK) phosphorylation panel. Protein for VEGFR2 was expressed in all carcinomas, PDGFR-α was noted in 15/16, whereas PDGFR-β was detected in 3/16 samples, but showed significant stromal staining. Protein expression for c-KIT was present in 4/16 and EGFR1 was noted in 14/16 samples. Normal tissue showed variable protein expression of the RTKs. Messenger RNA for VEGFR2, PDGFR-β, and c-KIT were noted in all samples. Messenger RNA for PDGFR-α and EGFR1 were detected in 15/16 samples. All normal nasal tissue detected messenger RNA. Phosphorylation of VEGFR2, PDGFR-α, PDGFR-β and c-KIT was not observed in any carcinoma or normal nasal sample, but phosphorylation of EGFR1 was noted in 10/16 carcinoma and 3/5 normal samples. The absence of phosphorylated RTK targets of toceranib suggests any clinical effect of toceranib occurs through inhibition of alternative unidentified RTK pathways in canine nasal carcinomas. The observed protein and message expression and phosphorylation of EGFR1 in the nasal carcinoma samples merits further inquiry into EGFR1 as a therapeutic target for this cancer., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: The measurement of osmolality is of interest in several clinical conditions and has been investigated in multiple veterinary studies. However, the stability of osmolality over time in frozen canine serum and urine has not been established., Objectives: The purpose of this study was to determine the stability of osmolality in canine serum and urine stored frozen at -20°C and -80°C up to 90 days, and to assess the effect of storage temperature on osmolality measurement., Methods: Serum and urine samples collected from 5 healthy Greyhound dogs were aliquoted and stored at -20°C and -80°C until measurement. Osmolality, assessed by freezing-point depression, was measured at 0, 7, 14, 30, and 90 days of storage., Results: For both serum and urine, osmolality at day 7 was not statistically different from day 0, but osmolality at days 14, 30, and 90 was significantly lower than at day 0. There was no significant effect of storage temperature on serum osmolality. However, the osmolality of urine samples stored at -20°C was slightly, but significantly lower than the osmolality of those stored at -80°C., Conclusions: Osmolality measurement in the serum and urine of healthy dogs appears to be stable for at least 7 days in frozen samples. The small changes observed after day 7 are unlikely to be relevant for individual patients, but could have implications in research study protocols., (© 2016 American Society for Veterinary Clinical Pathology.)

Chronic kidney disease and hyperthyroidism are two commonly diagnosed conditions in the geriatric feline population, and are often seen concurrently. Management of both diseases is recommended; however, the physiologic implications of both diseases must be understood to ensure the most favorable outcome for each patient. This report reviews the complex interplay between hyperthyroidism and kidney function, as well as the effects of hyperthyroid therapy on kidney function., (© ISFM and AAFP 2015.)

Objective: To evaluate mean corpuscular volume difference (dMCV) as a marker for hypertonicity induced by water deprivation in dogs., Animals: 5 healthy Greyhounds maintained in a research colony., Procedures: Water was withheld for 24 hours. Blood and urine samples were collected before (time 0) and every 6 hours during water deprivation. Serum and urine osmolality were measured on the basis of freezing point depression, and dMCV was calculated from routine hematologic variables., Results: Serum and urine osmolality significantly increased and body weight decreased over time in healthy Greyhounds during water deprivation, although most dogs developed only a slight increase in serum osmolality. The dMCV also increased over time, but the value at 24 hours did not differ significantly from the value at time 0. However, a significant correlation was found between serum osmolality and dMCV. A dMCV ≥ 5 fL yielded 100% specificity for predicting hypertonicity when hypertonicity was defined as serum osmolality ≥ 310 mOsM., Conclusions and Clinical Relevance: dMCV may be a useful marker for detection of mild hypertonicity in dogs and may have clinical and research applications for use in screening canine populations for hypertonicity.

Objective: To determine the tonicity effects of β-hydroxybutyrate, acetoacetate, and lactate in canine RBCs., Sample: RBCs from approximately 40 dogs., Procedures: 2 in vitro methods were used to conduct 4 experiments. The modified osmotic fragility assay was used to measure the ability of ketoacid salts added to serial sucrose dilutions to protect RBCs from osmotic hemolysis. In a second assay, a handheld cell counting device was used to measure changes in RBC diameter to assess the tonicity effect of solutions of ketoacid and lactate salts., Results: For the modified osmotic fragility assay, all ketoacid salts had an osmoprotective effect, but the effect was determined to be completely attributable to the tonicity effect of added cations (sodium and lithium) and not the ketoacid moieties. However, both the sodium and lithium lactate salts provided osmoprotection attributable to both the cation and lactate anion. For the second assay, RBC diameter was significantly increased with the addition of urea (an ineffective osmole) but did not change with the addition of glucose (an effective osmole), which established the behaviors of ineffective and effective osmoles in this assay. The RBC diameter was significantly increased over that of control samples by the addition of sodium β-hydroxybutyrate, lithium acetoacetate, and lithium lactate but was decreased by the addition of sodium lactate., Conclusions and Clinical Relevance: For both assays, β-hydroxybutyrate and acetoacetate acted as ineffective osmoles, whereas lactate acted as an effective osmole in 3 of 4 experiments.

Background: Glucokinase (GK) is a metabolic enzyme encoded by the GCK gene and expressed in glucose-sensitive tissues, principally pancreatic islets cell and hepatocytes. The GK protein acts in pancreatic islets as a "glucose sensor" that couples fluctuations in the blood glucose concentration to changes in cellular function and insulin secretion. GCK and GK have proposed importance in the development and progression of diabetes mellitus and are potential therapeutic targets for diabetes treatment. The study was undertaken to determine the nucleotide sequence of feline pancreatic GK cDNA, predict the amino acid sequence and structure of the feline GK protein, and perform comparative bioinformatic analysis of feline cDNA and protein. Routine PCR techniques were used with cDNA from feline pancreas. Clones were assembled to obtain the full length cDNA. Protein prediction and modeling were performed using bioinformatic tools., Results: Full-length feline pancreatic GK cDNA contains a 1398 nucleotide coding sequence with high identity to other pancreatic GK cDNAs. The deduced 465 amino acid feline protein has 15 amino acid substitutions not found in other mammalian GK proteins but maintains high structural homology with human GK. Feline pancreatic GK is highly conserved at nucleotide and protein levels. Residues crucial for substrate binding and catalysis are completely conserved in the feline protein., Conclusion: Molecular analysis predicts that feline pancreatic GK functions similarly to other mammalian GK proteins.

Spurious increase in erythrocyte mean corpuscular volume (MCV) on automated cell analyzers is a well-characterized lab error in hypertonic patients. A difference between automated and manual MCV (dMCV) greater than 2 fl has been shown to predict hypertonicity in humans. The purpose of this study was to investigate dMCV as a marker for serum hypertonicity in dogs and to examine the relationship between dMCV and three methods of estimating serum tonicity: measured (OsMM), calculated (OsMC), and calculated effective (OsMCE) osmolalities. OsMC, OsMCE, and dMCV were calculated from routine blood values and OsMM was directly measured in 121 dogs. The dMCV of hypertonic dogs was significantly larger than that of normotonic dogs for all three osmolality methods. dMCV predicted hypertonicity as estimated by OsMM better than it predicted hypertonicity as estimated by OsMC and OsMCE. A cutoff of 2.96 fl yielded the best sensitivity (76%) and specificity (71%) for hypertonicity estimated by OsMM., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Carnivores, such as the dolphin and the domestic cat, have numerous adaptations that befit consumption of diets with high protein and fat content, with little carbohydrate content. Consequently, nutrient metabolism in carnivorous species differs substantially from that of non-carnivores. Important metabolic pathways known to differ between carnivores and non-carnivores are implicated in the development of diabetes and insulin resistance in non-carnivores: (1) the hepatic glucokinase (GCK) pathway is absent in healthy carnivores yet GCK deficiency may result in diabetes in rodents and humans, (2) healthy dolphins and cats are prone to periods of fasting hyperglycemia and exhibit insulin resistance, both of which are risk factors for diabetes in non-carnivores. Similarly, carnivores develop naturally occurring diseases such as hemochromatosis, fatty liver, obesity, and diabetes that have strong parallels with the same disorders in humans. Understanding how evolution, environment, diet, and domestication may play a role with nutrient metabolism in the dolphin and cat may also be relevant to human diabetes.

Extramedullary hematopoiesis (EMH) is the process by which normal blood cells are produced outside the bone marrow. In humans, EMH effusions are rare and are characterized by the presence of megakaryocytes, immature erythrocytes, immature leukocytes, or combinations of those cells. To the authors' knowledge, this is the first report to describe a case of peritoneal EMH effusion in a dog. A 5 yr old castrated male shorthaired dachshund presented with a 2 day history of pigmenturia and inappetence. A complete blood count revealed regenerative anemia with marked agglutination, spherocytosis, and an acute inflammatory leukogram characterized by a neutrophilia, regenerative left shift, and monocytosis. Ultrasound-guided aspiration of peritoneal effusion yielded a sample of high nucleated cellularity predominantly composed of mature and immature neutrophils and erythroid precursor cells. The patient was diagnosed with primary immune-mediated hemolytic anemia with concurrent EMH peritoneal effusion. The following case description and discussion explore the clinical findings associated with the unusual effusion and outline the possible pathogenesis by which the EMH effusion may have arisen in the dog.

A 5.5-y-old spayed female ferret (Mustela putorius furo) with a history of adrenal disease, respiratory disease, and chronic obesity was evaluated for progressive lethargy and ataxia, diminished appetite, and possible polyuria and polydipsia. Physical examination revealed obesity, lethargy, tachypnea, dyspnea, a pendulous abdomen, significant weakness and ataxia of the hindlimbs, prolonged skin tenting, and mild tail-tip alopecia. Clinicopathologic analysis revealed severe hyperglycemia, azotemia, an increased anion gap, glucosuria, ketonuria, proteinuria, and hematuria. Abdominal ultrasonography showed hyperechoic hepatomegaly, bilateral adrenomegaly, splenic nodules, mild peritoneal effusion, and thickened and mildly hypoechoic limbs of the pancreas with surrounding hyperechoic mesentery. Fine-needle aspirates of the liver were highly suggestive of hepatic lipidosis. In light of a diagnosis of concurrent diabetic ketoacidosis and pancreatitis, the ferret was treated with fluid therapy, regular and long-acting insulin administration, and pain medication. However, electrolyte derangements, metabolic acidosis, dyspnea, and the clinical appearance of the ferret progressively worsened despite treatment, and euthanasia was elected. Necropsy revealed severe hepatic lipidosis, severe suppurative pancreatitis and vacuolar degeneration of pancreatic islet cells, a pancreatic β islet cell tumor, bilateral adrenal cortical adenomas, and myocardial fibrosis. To our knowledge, this case represents the first report of concurrent diabetes mellitus, pancreatitis, pancreatic β islet cell tumor (insulinoma), and adrenal disease in a domestic ferret. The simultaneous existence of 3 endocrine diseases, pancreatitis, and their associated complications is a unique and clinically challenging situation., (Copyright 2011 by the American Association for Laboratory Animal Science)

Objectives: To (1) determine a reference interval for cardiac troponin I (cTnI) using a point-of-care device in normal dogs and compare the results with those published by the manufacturer and (2) determine if cTnI differs among dogs with cardiogenic and noncardiogenic respiratory distress., Design: Prospective observational study., Setting: Emergency and referral veterinary hospital., Animals: Twenty-six clinically normal dogs and 67 dogs in respiratory distress., Interventions: All dogs underwent whole blood sampling for cTnI concentrations., Measurements and Results: Normal dogs had a median cTnI concentration of 0.03 ng/mL (range 0-0.11 ng/mL). Thirty-six dogs were diagnosed with noncardiogenic respiratory distress with a median cTnI concentration of 0.14 ng/mL (range 0.01-4.31 ng/mL). Thirty-one dogs were diagnosed with cardiogenic respiratory distress with a median cTnI concentration of 1.74 ng/mL (range 0.05-17.1 ng/mL). A significant difference between cTnI concentrations in normal dogs and dogs with noncardiogenic respiratory distress was not detected. Significant differences in cTnI concentrations were found between normals versus cardiogenic and cardiogenic versus noncardiogenic respiratory distress groups. Significant differences in cTnI concentrations were identified in > 10 when compared with the < 5 and the 5-10 years of age groups. Receiver operating curve analysis identified cTnI concentrations > 1.5 ng/mL as the optimal "cut-off point" having a sensitivity of 78% and specificity of 51.5%. The area under the receiver operating curve was 0.72. Overall test accuracy was 65%., Conclusions: cTnI concentrations were significantly increased in dogs with cardiogenic respiratory distress versus dogs with noncardiogenic respiratory distress and normal dogs. A significant difference between normal dogs and dogs with noncardiogenic causes of respiratory distress was detected. Although highly sensitive when cTnI concentrations exceed 1.5 ng/mL, the test has low specificity. Assessment of cTnI by the methodology used cannot be recommended as the sole diagnostic modality for evaluating the cause of respiratory distress in dogs., (© Veterinary Emergency and Critical Care Society 2011.)

The purpose of this study was to evaluate the ability of specific types of multiple-choice questions delivered using an Audience Response System (ARS) to maintain student attention in a professional educational setting. Veterinary students (N=324) enrolled in the first three years of the professional curriculum were presented with four different ARS question types (knowledge base, discussion, polling, and psychological investment) and no ARS questions (control) during five lectures presented by 10 instructors in 10 core courses. Toward the end of the lecture, students were polled to determine the relative effectiveness of specific question types. Student participation was high (76.1%+/-2.0), and most students indicated that the system enhanced the lecture (64.4%). Knowledge base and discussion questions resulted in the highest student-reported attention to lecture content. Questions polling students about their experiences resulted in attention rates similar to those without use of ARS technology. Psychological investment questions, based on upcoming lecture content, detracted from student attention. Faculty preparation time for three ARS questions was shorter for knowledge base questions (22.3 min) compared with discussion and psychological investment questions (38.6 min and 34.7 min, respectively). Polling questions required less time to prepare (22.2 min) than discussion questions but were not different from other types. Faculty stated that the investment in preparation time was justified on the basis of the impact on classroom atmosphere. These findings indicate that audience response systems enhance attention and interest during lectures when used to pose questions that require application of an existing knowledge base and allow for peer interaction.

Objective: To evaluate the accuracy of a real-time, continuous glucose monitoring system (CGMS) in healthy dogs undergoing anesthesia for elective ovariohysterectomy or orchiectomy., Animals: 10 healthy dogs undergoing routine elective surgery., Procedures: A CGMS was placed and used to obtain calculated glucose measurements before, during, and after anesthesia in each dog. Periodically, CGMS measurements were compared with concurrent measurements of glucose concentration in peripheral venous blood obtained with a portable chemistry analyzer (PCA)., Results: CGMS-calculated glucose measurements were significantly different from PCA blood glucose measurements during most of the anesthetic period. The CGMS values differed from PCA values by > 20% in 54 of 126 (42.9%) paired measurements obtained during the anesthetic period. Hypoglycemia was evident in CGMS measurements 25 of 126 (19.8%) times during anesthesia. By comparison, only 1 incident of hypoglycemia was detected with the PCA during the same period., Conclusions and Clinical Relevance: Use of the CGMS for routine monitoring of interstitial glucose concentration as an indicator of blood glucose concentration during anesthesia cannot be recommended. Additional investigation is necessary to elucidate the cause of discrepancy between CGMS results and PCA data during anesthesia.

Ketohexokinase (KHK) metabolizes dietary fructose and is an important regulator of hepatic glucose metabolism. The veterinary literature contains conflicting data regarding the role of KHK in feline fructose metabolism. The study objectives were to determine tissue expression of KHK mRNA and protein in cats, with special emphasis on hepatic expression. KHK mRNA and protein expression were determined using routine RT-PCR and immunoblot techniques. KHK mRNA was detected in feline liver, pancreas, spleen and striated muscle but not in lung. The partial sequence of feline KHK mRNA obtained was highly similar to known KHK mRNA sequences. Immunoblot studies confirmed KHK protein expression in the feline liver. The tissue distribution of KHK mRNA in cats is similar to KHK expression in other species. KHK mRNA and protein expression in feline liver is consistent with previous reports of hepatic fructokinase activity in this species.

Objective: To describe the patient population, disease severity, and outcome in dogs with immune-mediated hemolytic anemia (IMHA) that underwent splenectomy. To compare presurgical and postsurgical data., Design: Retrospective case series., Setting: Emergency clinic/referral hospital., Animals: Ten dogs diagnosed with IMHA., Interventions: Splenectomy in addition to standard medical management for IMHA., Measurements: Medical records of 10 dogs with IMHA, in which a splenectomy was performed were reviewed. The population was analyzed with regards to physical and clinicopathologic data, severity, treatment, and outcome. Outcome was defined as survival at 30 days, percentage of dogs on medications at 30 days, and number of relapses documented by 30 days. The presurgical and postsurgical PCV and transfusion requirements were documented and compared for each dog., Results: Nine of 10 dogs survived to 30 days. Four of the 9 that survived were not on any immunosuppressive medications. There were no relapses during the 30 days. The 3-day postsplenectomy PCVs were significantly higher than presplenectomy. The number of transfusions administered postsplenectomy was significantly less than those administered presplenectomy., Conclusion: The use of splenectomy may be associated with an improved outcome in dogs with IMHA.

Objective: To develop a method for in vitro culture of canine valvular interstitial cells (VICs)., Animals, Materials and Methods: Canine VICs were isolated from the distal third of the anterior mitral valve leaflet using an explant technique and maintained in cell culture. Molecular phenotyping of the cultured cells was performed using reverse transcription polymerase chain reaction and immunocytochemistry., Results: Cells resembling fibroblasts migrated from canine mitral valve explants and were maintained in culture for up to eight passages. Establishment of the valve explant required collagen but once established, subsequent passages grew on non-coated plastic plates. At confluence the cultured cells exhibited the characteristic whorled pattern of fibroblasts in culture. The isolated valve cells expressed vimentin but not platelet endothelial cell adhesion molecule or von Willebrand's factor, consistent with the molecular phenotype of VICs., Conclusions: VICs can be readily isolated from canine mitral valve leaflets and successfully maintained in culture using standard culture techniques. The described techniques permit the study of bioactive VICs in a controlled environment and may be a useful in vitro model for investigation of cellular and molecular alterations associated with canine chronic degenerative valve disease.