Congenital Portosystemic Shunts in Dogs and Cats: Treatment, Complications and Prognosis.

Congenital portosystemic shunts (CPSS) are a common vascular anomaly of the liver in dogs and cats. Clinical signs of CPSS are non-specific and may wax and wane, while laboratory findings can raise the clinical suspicion for CPSS, but they are also not specific. Definitive diagnosis will be established by evaluation of liver function tests and diagnostic imaging. The aim of this article is to review the management, both medical and surgical, complications, and prognosis of CPSS in dogs and cats. Attenuation of the CPSS is the treatment of choice and may be performed by open surgical intervention using ameroid ring constrictors, thin film banding, and partial or complete suture ligation or by percutaneous transvenous coil embolization. There is no strong evidence to recommend one surgical technique over another. Medical treatment strategies include administration of non-absorbable disaccharides (i.e., lactulose), antibiotics, and dietary changes, and are indicated for pre-surgical stabilization or when surgical intervention is not feasible. After CPSS attenuation, short- and long-term post-surgical complications may be seen, such as post-operative seizures and recurrence of clinical signs, respectively. Prognosis after surgical attenuation of CPSS is generally favorable for dogs and fair for cats.

Congenital Portosystemic Shunts in Dogs and Cats: Classification, Pathophysiology, Clinical Presentation and Diagnosis.

Congenital portosystemic shunts (CPSS) are abnormal vascular communications between the portal and the systemic circulation, bypassing the hepatic parenchyma and resulting in liver hypoplasia and hepatic insufficiency. Such connections develop in utero and persist postnatally. CPSS are among the two most common congenital vascular anomalies of the liver in small animals, along with primary hypoplasia of the portal vein without portal hypertension (PHPV without PH). CPSS can be extrahepatic (ECPSS), most commonly diagnosed in small and toy breed dogs and cats, or intrahepatic (ICPSS), most commonly seen in large breed dogs. Single ECPSS is the most common type encountered in both dogs and cats. Clinical signs of CPSS are non-specific and may wax and wane, while laboratory findings can raise clinical suspicion for CPSS, but they are also not specific. Definitive diagnosis will be established by evaluation of liver function tests, such as determination of fasting plasma ammonia (FA) levels, and pre- and postprandial serum bile acids concentrations, and diagnostic imaging. The purpose of this article is to review the definition, classification, pathogenesis, clinical presentation, and diagnosis of CPSS in dogs and cats, highlighted by the authors' clinical experience.

Bronchoscopy and Lung Fine-Needle Aspiration for Antemortem Evaluation of Pulmonary Involvement in Dogs with Naturally Occurring Canine Leishmaniosis.

Clinical manifestations from the lower respiratory tract are rare in canine leishmaniosis (CanL), making bronchoscopy and lung fine-needle aspiration (FNA) seldomly justified. The aim of this prospective study was to investigate the involvement of Leishmania infantum in the lungs of dogs with naturally occurring CanL by bronchoscopy and examination of bronchoalveolar lavage fluid (BALF), bronchial mucosa biopsies, and FNA, using immunodiagnostics. Dogs with relevant concurrent diseases and azotemia were excluded. Cough was detected in 5/31 (16.1%) dogs. Lesions (hyperemia, edema, mucosal granularity, secretions) were identified upon bronchoscopy in 19/31 (61.3%) dogs. The cytology of BALF revealed histiocytic inflammation in 14/31 (45.2%) dogs; the parasite was identified in one dog (3.2%). The immunofluorescence antibody test in BALF was positive in 15/31 (48.4%) dogs. Histopathology of bronchial mucosa and/or adjacent alveoli revealed lesions (mononuclear cell infiltration, fibrosis, edema, thickening of the inter-alveolar septa) in 24/31 (77.4%) dogs, with no Leishmania amastigotes. Positive antigen staining was observed within the cytoplasm of mononuclear cells in immunocytochemistry and immunohistochemistry. Μononuclear cells showed antigenic positivity in bronchial mucosa (27/31; 87.1%), BALF (30/31; 96.8%), and lung FNA (27/31; 87.1%). In conclusion, lungs seem to be affected from CanL more commonly than previously believed, and bronchoscopy allows obtaining valuable samples for antemortem diagnosis.

Bilateral Renal Large B Cell Lymphoma in a Dog: A Case Report and Review of the Literature.

Canine lymphoma is a commonly reported neoplasia and, in most dogs, arises from lymph nodes before spreading to other organs. Renal lymphoma rarely occurs, and kidneys usually are a secondary site of origin. Primary renal lymphoma is infrequently described in the veterinary literature. In this study, we present a rare case of primary renal lymphoma in a dog and a review of similar cases. A 3-year-old male dog was admitted due to anorexia, weakness and vomiting. Clinical examination revealed bilaterally enlarged kidneys. Imaging demonstrated the presence of multiple renal masses. Cytology of abdominal fluid and kidneys led to the diagnosis of large cell lymphoma. Histopathology and immunohistochemistry on tissue samples taken from the kidneys confirmed the cytological diagnosis of lymphoma and categorized it as primary bilateral renal large B-cell lymphoma (LBCL).

Colonic mucosal and cytobrush sample cytokine mRNA expression in canine inflammatory bowel disease and their correlation with disease activity, endoscopic and histopathologic score.

Canine inflammatory bowel disease (IBD) is a group of chronic gastrointestinal disorders, the pathogenesis of which remains elusive, but it possibly involves the interaction of the intestinal immune system with luminal microbiota and food-derived antigens. Mucosal cytokines profiles in canine IBD have been investigated mainly in small intestinal disease, while data on cytokine profiles in large intestinal IBD are limited. The objective of this study was to measure colonic mucosal and cytobrush sample messenger (m)RNA expression of interleukin (IL)-1ß, IL-2, IL-12p40, IL-23p19, tumor necrosis factor-alpha (TNF-α) and chemokine C-C motif ligand (CCL28) in dogs with IBD and healthy controls using quantitative real-time polymerase chain reaction (PCR), and assess their correlation with clinical disease activity, endoscopic and histopathologic score. Dogs with IBD had a significantly increased mRNA expression of IL-1ß, IL-23p19 and CCL28 in the colonic mucosa, compared to healthy controls. None of the selected cytokines had significantly different mRNA expression in the colonic cytobrush samples between the two groups or between the colonic mucosa and cytobrush samples of dogs with IBD. Finally, there was a statistically significant correlation of clinical disease activity with endoscopic activity score and fibrosis and atrophy of the colonic mucosa in dogs with large intestinal IBD. IL-1ß, IL-23p19 and CCL28 could play a role in the pathogenesis of canine large intestinal IBD. Colonic cytokine expression does not correlate with clinical disease activity and/or endoscopic score. However, clinical signs reflect the severity of endoscopic lesions.

Colonic mucosal and serum expression of microRNAs in canine large intestinal inflammatory bowel disease.

BACKGROUND: Canine inflammatory bowel disease (IBD) is a group of chronic gastrointestinal (GI) disorders of still largely unknown etiology. Canine IBD diagnosis is time-consuming and costly as other diseases with similar signs should be initially excluded. In human IBD microRNA (miR) expression changes have been reported in GI mucosa and blood. Thus, there is a possibility that miRs may provide insight into disease pathogenesis, diagnosis and even treatment of canine IBD. The aim of this study was to determine the colonic mucosal and serum relative expression of a miRs panel in dogs with large intestinal IBD and healthy control dogs. RESULTS: Compared to healthy control dogs, dogs with large intestinal IBD showed significantly increased relative expression of miR-16, miR-21, miR-122 and miR-147 in the colonic mucosa and serum, while the relative expression of miR-185, miR-192 and miR-223 was significantly decreased. Relative expression of miR-146a was significantly increased only in the serum of dogs with large intestinal IBD. Furthermore, serum miR-192 and miR-223 relative expression correlated to disease activity and endoscopic score, respectively. CONCLUSION: Our data suggest the existence of dysregulated miRs expression patterns in canine IBD and support the potential future use of serum miRs as useful noninvasive biomarkers.

Prevalence of increased canine pancreas-specific lipase concentrations in young dogs with parvovirus enteritis.

BACKGROUND: Pancreatic abnormalities during canine parvovirus (CPV) enteritis have not been studied prospectively. OBJECTIVES: The objective of this study was to evaluate the diagnostic significance of canine serum pancreas-specific lipase (Spec cPL) concentration in dogs with CPV enteritis for the presence of acute pancreatitis (AP). Puppies with naturally occurring CPV enteritis were recruited and prospectively allocated into 2 groups according to normal or increased serum Spec cPL concentration. Clinical signs, laboratory findings, and pancreas-associated variables were compared between groups, and the impact of possible AP on disease course, duration of hospitalization, and outcome was assessed. RESULTS: Serum Spec cPL concentration in 35 puppies was above the upper limit of the RI in 17/35 (48.6%) dogs (Group A) and within the RI in 18 dogs (Group B). An increased serum lipase activity was present in 29/35 (82.9%) dogs, and Group A dogs had a higher serum lipase activity than Group B (P = .006). Serum Spec cPL in Group A dogs was positively correlated with serum lipase activity at the day of presentation (r = .667; P = .003) and day of discharge (r = .628; P = .007). No statistically significant difference was found between groups (P = .233) for the presence of systemic inflammatory response syndrome (SIRS) (6/17 or 35.3% dogs Group A, and 8/18 or 44.4% dogs Group B), the disease course, duration of hospitalization, or outcome between groups. CONCLUSIONS: Increased serum Spec cPL is relatively common in dogs with CPV enteritis. However, such increases do not seem to correlate with the outcome of disease.

Upper Airway Injury in Dogs Secondary to Trauma: 10 Dogs (2000-2011).

Ten dogs that presented with trauma-induced upper airway rupture or stenosis were reviewed. Tracheal rupture was seen in seven dogs, tracheal stenosis in one dog, and laryngeal rupture in two dogs. Clinical abnormalities included respiratory distress in five dogs, subcutaneous emphysema in eight, air leakage through the cervical wound in seven, stridor in three dogs, pneumomediastinum in four and pneumothorax in one dog. Reconstruction with simple interrupted sutures was performed in four dogs, tracheal resection and end-to-end anastomosis in five dogs, and one dog was euthanized intraoperatively. Complications were seen in three dogs including aspiration pneumonia in one and vocalization alterations in two dogs.

Canine bronchomalacia: a clinicopathological study of 18 cases diagnosed by endoscopy.

Canine bronchomalacia (BM) is characterized by weakness leading to collapse of the bronchial wall. A prospective study of 18 affected dogs (age range: 1-15 years) was undertaken to characterize the clinicopathological and histological features of BM. Poodles and Yorkshire terriers were commonly affected. Half of the dogs were overweight or obese. The clinical presentation was a mild, wheezing, chronic cough and pulmonary crackles were heard in 28% of the dogs. Compatible radiographic changes were present in 61% of the dogs. Using bronchoscopy, both lungs were affected in half of the animals, whereas in the others the disease appeared to affect predominantly the left lung. Analysis of bronchoalveolar lavage fluid and biopsies of bronchial mucosa revealed pure or mixed neutrophilic inflammation. Underlying infectious bronchitis was considered possible in 56% of the dogs. It was concluded that canine BM may present as an isolated clinical entity associated with infection and/or inflammation.

Aspergillus fumigatus Bronchopneumonia in a Hellenic Shepherd Dog.

A 3 yr old intact female Hellenic shepherd dog was referred due to depression, partial anorexia, fever, and a mild productive cough of 2 mo duration. Thoracic radiographs showed increased opacity of all of the left lung lobes. Upon bronchoscopy, a sanguineous, purulent discharge was detected in the tracheal lumen with hyperplastic tissue narrowing the left main stem bronchus. Cultures were positive for bacteria (Bacillus spp. and Clostridium spp.) but negative for fungi. Due to the severity of the lesions, a complete left lung pneumonectomy was performed. Histopathological examination of the excised lung tissues revealed a severe granulomatous bronchopneumonia with numerous alveolar macrophages laden with structures stained positively by periodic acid-Schiff and Grocott stain that had morphology consistent with fungi. PCR and sequencing of internal transcribed spacer regions 1 and 2 from genetic material extracted from paraffin-embedded pulmonary tissue confirmed the presence of Aspergillus fumigatus. Itraconazole was administrated for 5.5 mo and the dog was clinically normal 26 mo after surgery.

Vaginal rupture and evisceration in a dog.

A 1.5-year-old German Shepherd mixed breed dog was admitted with mild haemorrhage from the vulva and a perineal mass of 24-hour duration, which had been first observed immediately after parturition. Parturition had occurred at low ambient temperature, and only one puppy survived out of the seven oversized fetuses. The dog was in poor body condition, dehydrated, hypothermic, depressed, non-ambulatory and in a state of shock. Intestinal loops, the urinary bladder and the uterine horns and body were protruding from the vulva. A true vaginal prolapse was also observed. The abdominal viscera were flushed with warm sterile saline solution, protected and maintained wet. The laboratory findings included moderate anaemia, leukocytosis, hypoalbuminaemia, azotaemia and elevated liver enzyme activities. Stabilisation of the dog's general condition was attempted before surgery. Antimicrobial and analgesic drugs were also administered. After exploratory laparotomy the protruding organs, which were in good condition, were reduced. A recent rupture in the vaginal wall, approximately 6 cm long, was observed. Ovariohysterectomy and partial vaginectomy were performed. The preoperative course of therapy was continued, but the bitch died 12 hours later. The probable cause of vaginal rupture and evisceration in this bitch was tenesmus and/or trauma due to the oversized fetuses.

Spontaneous reduction of intestinal intussusception in five young dogs.

Five, 3- to 8-month-old dogs had clinical and ultrasonographic findings consistent with intestinal intussusception, but findings were negative on exploratory celiotomy. Ultrasonography had revealed a target-like mass (median maximal diameter 25 mm) on transverse section and multiple hyperechoic or hypoechoic parallel lines (median length 36.8 mm) on longitudinal section. Blood flow in the intussuscepted bowel was detected in most of the cases. In dogs with similar findings, the authors recommend ultrasonographic reexamination of the abdomen after general anesthesia (but before surgery) to exclude spontaneous reduction of the intussusception.

Isolated abdominal fat tissue inflammation and necrosis in a cat.

This report describes a rare clinical case of a 4.5-month-old, female domestic shorthair, cat with isolated abdominal fat tissue inflammation and necrosis, resembling human omental panniculitis. Its possible relationship with pancreatitis or bile induced chemical peritonitis is also discussed. The overall clinical course was considered benign. Initial clinical signs were vomiting and anorexia, presumably due to inflammation, followed by mass development. It was speculated that, eventually, the kitten was vomiting because of mechanical pressure from the mass, and that this pressure subsided as the kitten grew. The mass was surgically resected and no relapse was evident during the next 4 years.

Asymptomatic colitis in naturally infected dogs with Leishmania infantum: a prospective study.

A total of 31 dogs with naturally occurring and symptomatic leishmaniasis (Leishmania infantum), but without historical or clinical evidence of overt colitis, were included in this study. With owners' consent, a colonoscopy was performed in all these dogs, revealing patches of hyperemic, edematous, irregular, and mildly erosive colonic mucosa in 25.8% of the animals. Biopsies were obtained from the colonic mucosa and stained with hematoxylin-eosin (histopathology) and avidin-biotin-peroxidase technique (immunohistochemical detection of parasites). Leishmania amastigotes were detected immunohistochemically in 32.3% of the dogs. The most common inflammatory pattern in the colonic mucosa of these dogs was pyogranulomatous (90%), whereas in the dogs without Leishmania amastigotes immunohistochemically detected in the colonic mucosa (67.7%), there was no evidence of gross and microscopic lesions. Also, in 2 of the 10 dogs in which parasites were detected immunohistochemically in the colonic mucosa, no lesions could be detected on colonoscopy. There was no correlation between the dogs with or without parasites detected in the colonic mucosa regarding the sex, age, or the type of diet of these animals. However, the positive correlation (P < 0.001) found between colonic parasitism and gross lesions detected on colonoscopy would justify the inclusion of canine leishmaniasis in the list of differentials of canine chronic or recurrent colitis.

Symphyseal distraction-osteotomy using a novel spacer of spirally fashioned orthopaedic wire for the management of obstipation.

Three domestic shorthair cats, one male and two females, 17.6+/-6.5 months old and 3.5+/-0.4 kg body weight, were admitted with a 6.6+/-1.1 (range 6-8) month history of recurrent bouts of obstipation. Defecatory difficulties had started within a month of conservatively managed pelvic fractures. Clinical and radiographic examination revealed severe colonic distension with faeces and a narrow pelvic canal caused by malunion of the pelvic fractures. A pelvic symphyseal distraction-osteotomy (SDO) technique was performed, using a novel metal spacer of spirally fashioned orthopaedic wire. Pelvic canal enlargement allowed the insertion of an index finger into the rectum. Following this, no further episodes of obstipation occurred during a follow-up period of 1-3 years. The SDO technique may be successful for the treatment of obstipation secondary to post-traumatic pelvic canal stenosis in the cat, if the colon motility is not already permanently affected.

Serum and liver iron concentration in dogs with experimentally induced hepatopathy.

BACKGROUND AND AIM: Iron (Fe) status is altered in human and experimental animal hepatopathies. In dogs limited data are available. The aim of this study was to investigate serum iron (SI), total iron binding capacity (TIBC), percentage transferrin saturation (SAT) and Fe status in the liver of dogs with experimentally induced hepatopathy. METHODS: Fourteen 1-year-old dogs were divided into two equal groups. In order for hepatopathy to be induced, 0.25 mL/kg body weight of carbon tetrachloride (CCl4) solution was administered once daily, orally, for a 10-week period in group B dogs, while group A dogs were used as controls. SI, TIBC and SAT values were measured 3 times before the beginning (baseline value) and 10 times at weekly intervals during the experiment. Liver samples, obtained before the administration of CCl4 and at the end of the experimental period (10 weeks), were subjected to Fe determination, as well as to histopathological and histochemical analysis. RESULTS: At the end of the experiment SI, TIBC and liver iron concentration, as well as liver total iron score were significantly increased in group B dogs. Distribution of granular hemosiderin iron in hepatocytes, Kupffer cells, and portal triads was noticed. Positive correlations were found between SI and liver Fe concentration, as well as histochemically determined Fe. Moreover, positive correlations were evident between liver fibrosis and serum, as well as liver Fe values. CONCLUSIONS: Experimentally induced chronic hepatopathy in dogs causes Fe status disturbances. Increased serum and liver iron concentration produces liver histopathological deterioration and it may be worth attention during laboratory evaluation in canine hepatopathy.

Serum vitamin A concentration in dogs with experimentally induced exocrine pancreatic insufficiency.

Serum concentration of Vitamin A was determined in dogs with experimentally induced exocrine pancreatic insufficiency following oral administration of vitamin A, or pancreatic enzyme and vitamin A. In dogs receiving vitamin A alone, serum vitamin A concentration was significantly lower than that of dogs supplemented with pancreatic enzyme and vitamin A. In dogs with exocrine pancreatic insufficiency, serum vitamin A concentration was lower than in healthy dogs. In healthy dogs, the normal range of serum vitamin A concentration is high in comparison with other species, and humans. It is concluded that in dogs with exocrine pancreatic insufficiency, additional supplementation of vitamin A may be needed.

Benign esophageal stricture in the dog and cat: a retrospective study of 20 cases.

Twenty animals with benign esophageal strictures are presented. Most of the esophageal strictures were thought to be related to gastroesophageal reflux during ovariohysterectomy and were located at the distal portion of the thoracic esophagus (caudal to the base of the heart). For the dilation procedure, the endoscope tip or a balloon catheter was used and the outcome was generally considered to be good. The endoscope tip was an adequate instrument for dilation in some cases.