Pyloric outflow obstruction secondary to sclerosing encapsulating peritonitis in a dog.

A 6-year-old, male neutered mixed breed dog was presented emergently with a three-week history of hyporexia, vomiting, diarrhoea and weight loss. Upon examination, the patient was dull, had generalised muscle atrophy, moderate abdominal pain and a mild amount of peritoneal effusion. A fluid-filled, distended, corrugated small bowel with marked gastroparesis and moderate peritoneal effusion was noted on abdominal ultrasonography. Endoscopy revealed hyperaemic and friable mucosa and a subjectively narrowed pylorus. Emergency exploratory celiotomy was performed due to worsening patient condition and revealed thick, diffuse, fibrous adhesions of the abdominal cavity. Based on these findings, sclerosing encapsulating peritonitis (SEP) was suspected. A large mass of omentum adjacent to the greater curvature of the stomach had caused a pyloric outflow obstruction. Adhesiolysis was attempted but was unsuccessful due to the friability of the small intestines. The dog was humanely euthanased under anaesthesia. A diagnosis of SEP was confirmed via necropsy. No underlying cause was identified. This is the first known case of a pyloric outflow obstruction secondary to SEP in a dog. Although rare, this condition should be considered as a differential for dogs with signs of a pyloric outflow obstruction with concurrent ascites and abdominal pain, hyporexia, vomiting and diarrhoea.

ACVIM Small Animal Consensus Recommendations on the Treatment and Prevention of Uroliths in Dogs and Cats.

In an age of advancing endoscopic and lithotripsy technologies, the management of urolithiasis poses a unique opportunity to advance compassionate veterinary care, not only for patients with urolithiasis but for those with other urinary diseases as well. The following are consensus-derived, research and experience-supported, patient-centered recommendations for the treatment and prevention of uroliths in dogs and cats utilizing contemporary strategies. Ultimately, we hope that these recommendations will serve as a foundation for ongoing and future clinical research and inspiration for innovative problem solving.

Relationship of adiponectin and its multimers to metabolic indices in cats during weight change.

Adiponectin is an important anti-inflammatory hormone secreted from adipose tissue. The high-molecular-weight form of adiponectin (HMW) closely correlates with insulin sensitivity in human beings. This study uses a novel method of size-exclusion gel chromatography combined with enzyme-linked immunosorbent assay to measure HMW feline adiponectin and determine its relationship to leptin, cholesterol, and insulin sensitivity as cats gain and lose weight. In addition, total adiponectin and its messenger RNA expression in subcutaneous adipose tissue were measured. No correlations were found between total serum adiponectin and subcutaneous adipose messenger RNA expression, fat mass, or measures of insulin sensitivity. This study demonstrates that cats have high percentages of HMW adiponectin. Although weak correlations between HMW adiponectin and fat mass were detected, additional cats are needed to determine if the correlations are significant.

Radiotherapy-induced myelosuppression in dogs: 103 cases (2002-2006).

Definitive radiotherapy refers to delivery of large doses, typically 48-62 Gray, of ionizing radiation over several weeks using a daily or alternate-day fractionation schedule. The impact of definitive radiotherapy alone on haematopoiesis in tumour-bearing dogs is unknown. Medical records from 103 dogs receiving definitive (60) Cobalt teletherapy for cancer over a 5-year period were reviewed for signalment, tumour type and location, total radiotherapy dose and fractionation scheme. Complete blood count data were collected before, halfway through, and at the end of radiation treatment, and analysed for changes associated with patient variables. The results demonstrate significant reductions in haematocrit, total white blood cell count, neutrophils, eosinophils, monocytes, lymphocytes and platelets occurred during definitive radiotherapy but remained within laboratory reference intervals. These data are important for anticipation of toxicity associated with combinations of radiotherapy and chemotherapy in dogs but do not support the routine monitoring of haematology parameters during definitive radiotherapy.

Size of food bowl and scoop affects amount of food owners feed their dogs.

The incidence of canine obesity appears to be increasing dramatically and understanding factors impacting the amount of food pet owners provide their dogs may improve weight management. Human research has shown the size of food bowls, plates and utensils can significantly impact the amount of food portioned and consumed. This effect can be attributed to both the Delboeuf optical illusion and the Ebbinghaus-Titchener size-contrast illusion. To investigate the existence of a similar effect with dog owners, 54 dogs and their owners were recruited for a four treatment randomized prospective trial. Owners scooped out a normal kibble-based meal using a small bowl and small scoop, small bowl and large scoop, large bowl and small scoop or a large bowl and large scoop. Each treatment was used once per owner over four visits. Repeated measures anova revealed the mean amount of food portioned using the small bowl and small scoop was significantly less than all other bowl and scoop combinations (150.7 g vs. 171.5 g vs. 172.7 g vs. 184.5 g, p < 0.05). The small bowl and large scoop combination did not differ from large bowl and small scoop (171.5 g vs. 172.7 g, p > 0.05). Owners were more likely to portion a larger amount of food with a large bowl and large scoop. Results are consistent with human data and emphasize the need for owners to use standard measuring cups. Results also suggest owner compliance during weight loss programs may be improved with smaller bowls and serving scoops.

Adrenal response to adrenocorticotropic hormone in dogs before and after surgical attenuation of a single congenital portosystemic shunt.

BACKGROUND: Dogs with single congenital portosystemic shunts (CPSS) often develop postoperative hypoglycemia and prolonged anesthetic recovery. These abnormalities could be attributable to inadequate adrenal response. However, adequacy of adrenal response after CPSS surgery is unexplored. HYPOTHESIS: Dogs with CPSS have inadequate postoperative adrenal response. ANIMALS: Eight nonoperated, 8 ovariohysterectomy (OHE), and 16 CPSS dogs. METHODS: Consecutive day ACTH stimulation tests were performed on nonoperated healthy dogs, healthy dogs before and after OHE, and CPSS dogs before and after surgery. Adequate response was defined as >50% or >30 ng/mL increase in cortisol after ACTH administration. Blood glucose (BG) was monitored before and after surgery. Prolonged anesthetic recovery and refractory hypoglycemia episodes were recorded. RESULTS: Results of consecutive day ACTH stimulation tests did not vary in normal dogs. Results of preoperative ACTH stimulation tests of CPSS and OHE dogs were not significantly different. Dogs with CPSS had higher postoperative baseline cortisol concentrations (median, 329 ng/mL) than OHE dogs (median, 153 ng/mL). Postoperative cortisol increase after ACTH in CPSS was < or =50% in 10/16 and < or =30 ng/mL in 6/16. After surgery, BG was < or =60 mg/dL in 7/16 CPSS dogs. Cortisol concentrations were not correlated with BG. Two CPSS dogs had refractory hypoglycemia and 4 had delayed recovery; all improved with dexamethasone administration (0.1-0.2 mg/kg/IV). CONCLUSIONS AND CLINICAL IMPORTANCE: Contrary to previous reports, baseline cortisol concentrations in CPSS and healthy dogs are similar. Many CPSS dogs have postoperative hypercortisolemia. Response to ACTH does not correlate with postoperative hypoglycemia or prolonged anesthetic recovery.

Effects of L-asparaginase on plasma amino acid profiles and tumor burden in cats with lymphoma.

BACKGROUND: L-Asparaginase (Elspar(a)), is an Escherichia coli-derived enzyme that depletes lymphoma cells of asparagine, inhibiting protein synthesis and resulting in cell death. The single agent response rate in cats with lymphoma and impact of L-asparaginase on plasma amino acid concentrations is unknown. HYPOTHESES: L-Asparaginase significantly reduces plasma asparagine concentrations and has demonstrable efficacy against untreated lymphoma in cats. ANIMALS: Thirteen cats with confirmed lymphoma (LSA) of any anatomic site were given 1 dose 400 IU/kg IM) of L-asparaginase for initial LSA treatment. METHODS: Plasma collected at 0, 2, and 7 days after L-asparaginase therapy was assayed for ammonia, asparagine, aspartic acid, glutamine, and glutamic acid concentrations. Cats were restaged 7 days later to assess tumor response. RESULTS: Eight cats had T-cell LSA, 4 cats had B-cell LSA, and 1 cat's immunophenotype was unknown. Two complete and 2 partial responses to L-asparaginase were seen. Four cats had stable disease, and 5 cats had progressive disease. Ammonia and aspartic acid concentrations were increased from baseline at 2 and 7 days posttreatment. Asparagine concentrations were decreased from baseline at 2 days but not 7 days posttreatment. Glutamic acid concentrations were increased at day 2 compared to day 7 posttreatment but not compared to baseline. Glutamine concentrations were unchanged. CONCLUSIONS AND CLINICAL IMPORTANCE: L-asparaginase significantly reduced asparagine concentrations within 2 days of treatment, but this effect was lost within 7 days. The apparent overall response rate of feline LSA to L-asparaginase in this study was 30%.

Efficacy and toxicity of BOPP and LOPP chemotherapy for the treatment of relapsed canine lymphoma.

Mechlorethamine (Mustargen), Oncovin) (vincristine), procarbazine and prednisone (MOPP) chemotherapy is useful for relapsed canine lymphoma. This study evaluates the efficacy of MOPP after substitution of CCNU (lomustine, LOPP protocol) or BCNU (carmustine, BOPP protocol) for mechlorethamine in 60 dogs with relapsed lymphoma. Seven of 14 (50%) dogs treated with BOPP responded, for a median of 129.5 days for complete responders (range 9-354 days) and a median of 140 days for partial responders (range 4-276 days). Twenty-three of 44 (52%) dogs treated with LOPP responded for a median of 112 days for complete responders (range 48-250 days) and a median of 84.5 days for partial responders (range 69-290 days). Two dogs receiving a combination of LOPP and BOPP partially responded for 28 and 163 days, respectively. With BOPP chemotherapy, nine dogs (20.5%) and seven dogs (50%) had one or more episodes of Grade II or higher neutropenia and thrombocytopenia, respectively. Seven dogs (50%) had one or more episodes of Grade II or higher gastrointestinal toxicity. While receiving LOPP chemotherapy, 28 dogs (63.6%) and 17 dogs (38.6%) had one or more episodes of Grade II or higher neutropenia and thrombocytopenia, respectively. Seventeen dogs (38.6%) had one or more episodes of Grade II or higher gastrointestinal toxicity. Overall, there were 17 non-fatal treatment-related episodes of sepsis requiring hospitalization. Eight dogs (13%) died or were euthanized because of treatment-related sepsis and/or chemotherapy-related complications. Severe haematologic toxicity, coupled with the improved response duration observed in dogs receiving reduced doses during B/L-OPP rescue, underscores the need for protocol optimization.

Evaluation of urinary carnitine and taurine excretion in 5 cystinuric dogs with carnitine and taurine deficiency.

Five client owned dogs with cystinuria were diagnosed with carnitine and taurine deficiency while participating in a clinical trial that used dietary management of their urolithiasis. Stored 24-hour urine samples collected from the cystinuric dogs before enrollment in the clinical diet trial were quantitatively evaluated for carnitine and taurine. These results were compared to those obtained from 18 healthy Beagles. Both groups of dogs were fed the same maintenance diet for a minimum of 2 weeks before 24-hour urine collection. The protocol used for 24-hour urine collections was the same for cystinuric dogs and healthy Beagles except that cystinuric dogs were catheterized at baseline, 8 hours, 12 hours, and at the end of the collection, whereas Beagles were catheterized at baseline, 8 hours, and at the end of the collection. Three of 5 dogs with cystinuria had increased renal excretion of carnitine. None of the cystinuric dogs had increased renal excretion of taurine, but cystinuric dogs excreted significantly less (P < .05) taurine in their urine than the healthy Beagles. Carnitinuria has not been recognized previously in either humans or dogs with cystinuria, and it may be 1 risk factor for developing carnitine deficiency. Cystinuric dogs in this study were not taurinuric; however, cystine is a precursor amino acid for taurine synthesis. Therefore, cystinuria may be 1 risk factor for developing taurine deficiency in dogs. We suggest that dogs with cystinuria be monitored for carnitine and taurine deficiency or supplemented with carnitine and taurine.

Influence of diet on urinary pH, urine and serum biochemical variables, and blood-ionized calcium concentrations in healthy dogs.

Urolithiasis is a common cause of lower urinary tract disease in dogs. Diet influences urine composition, and dietary change is often incorporated into medical management of uroliths. The purpose of this study was to determine the influence of four diets on urine pH in healthy dogs. Sixteen adult dogs of various breeds, ages, and weights were fed four diets in Latin Square design: a diet formulated for adult dogs at maintenance (Diet A; ProPlan Canine Chicken and Rice Adult [dry], Ralston Purina Co, St. Louis, MO); a diet formulated to aid in management of fiber-responsive diseases (Diet B; CNM Canine DCO [dry], Ralston Purina Co, St. Louis, MO); a diet formulated to aid in management of chronic renal failure (Diet C; CNM Canine NF [dry], Ralston Purina Co, St. Louis, MO); and a diet designed to aid in prevention of struvite urolithiasis (Diet D; Prescription Diet Canine c/d [dry], Hill's Pet Nutrition Inc, Topeka, KS). Diets were fed for 21 days. On day 21, blood and urine samples were collected before feeding one-half of daily caloric requirements, and urine was collected 4 and 8 hours later. A biochemical analysis and ionized-calcium test were conducted on blood samples, and a complete urinalysis and urine pH determined by a pH-electrode were conducted on urine samples. Thirteen dogs completed the study. Serum phosphorous concentrations were significantly lower and urine pH was significantly higher when dogs consumed Diet C when compared with the other three diets. A postprandial effect on urine pH was not demonstrated when dogs consumed any diet. Other urinalysis parameters were not different between dogs or diets. Diet does influence urine pH in healthy dogs; however, healthy dogs produced urine with an acidic pH except while consuming a diet specifically formulated to produce alkaluria. Furthermore, crystalluria was commonly found in these healthy dogs regardless of the diet.

Hypercalcemia and calcium oxalate urolithiasis in cats: a report of five cases.

Five cats that presented for signs of lower urinary tract disease (i.e., pollakiuria and hematuria) secondary to a calcium oxalate urolithiasis are presented. On evaluation, all five cats had elevations of both serum ionized as well as total serum calcium. The hypercalcemia resolved after discontinuation of urinary acidifying therapy or a dietary change, or both.

Methods for evaluating treatment of uroliths.

Formation of uroliths is not a disease but rather a complication of several disorders. Some disorders can be identified and corrected (e.g., infection-induced struvite urolith formation), and some can be identified but not corrected (e.g., hyperuricosuria occurring in Dalmatians that form ammonium urate uroliths), although for others, the underlying etiopathogenesis is not known (e.g., calcium oxalate urolith formation in Miniature Schnauzers). A common denominator of these disorders is that from time to time, they can create oversaturation of urine with one or more crystal precursors, resulting in formation of crystals. To develop rational and effective approaches to treatment, abnormalities that promote urolith formation must be identified with the goal of eliminating or modifying them. It is therefore important to understand several basic concepts associated with urolithiasis.

Medical dissolution and prevention of canine struvite urolithiasis. Twenty years of experience.

Two types of canine struvite uroliths have been recognized: infection-induced struvite is the most common type; sterile struvite is uncommonly recognized. Infection-induced struvite is most commonly associated with urease-producing staphylococcal UTI. For dogs that qualify, medical dissolution is an effective method of treatment. Medical dissolution protocols encompass: (1) eradication or control of UTI; (2) use of calculolytic diets; and (3) administration of urease inhibitors to patients with persistent UTI caused by urease-producing microbes.

Canine urate urolithiasis. Etiopathogenesis, diagnosis, and management.

Etiopathologic factors predisposing to urate lithogenesis in Dalmatian and non-Dalmatian dogs represent diverse pathologic and/or physiologic processes involving purine nucleotide and ammonia synthesis, biodegradation, and excretion. Predisposing factors for urate urolith formation include hyperuricemia, hyperammonemia, hyperuricosuria, hyperammonuria, aciduria, and genetic predisposition. Medical therapy of dogs forming urate uroliths should be directed at modifying these predisposing factors through dietary modification, administration of allopurinol, and/or surgical correction of portovascular anomalies if present. The precise mechanisms resulting in urate urolith formation in dogs have not been determined.

Canine cystine urolithiasis. Cause, detection, treatment, and prevention.

Cystine uroliths are a sequela to cystinuria, an inherited renal tubular defect in reabsorption of cystine and some other amino acids. At the Minnesota Urolith Center, 67 breeds of dogs were identified, including English Bulldogs, Dachshunds, Mastiffs, and Newfoundlands. In some dogs, the severity of cystinuria may decline with advancing age. Current recommendations for dissolution of cystine uroliths include various combinations of diet modification, diuresis administration of 2-MPG, and alkalinization of urine.

Drug-induced urolithiasis.

Diagnostic and therapeutic drugs may enhance urolithiasis in one or a combination of ways, including: (1) alteration of urine pH in such fashion as to create an environment that increases the solubility of some lithogenic substances, (2) alteration of glomerular filtration rate, tubular reabsorption, and tubular secretion of drugs of endogenous substances so as to enhance promoters or impair inhibitors of urolithiasis, and (3) precipitation (e.g., drugs or their metabolites) to form a portion or all of a urolith.

Interventional nutrition for renal disease.

Interventional nutrition plays a central role in the management of renal diseases in veterinary medicine. Most of the clinically observable abnormalities produced by the disruption of renal function are influenced by dietary intake of calories, phosphorus, sodium, potassium, protein, or acid load. Further, the kidney is susceptible to self-perpetuating injury, an inherent property of this organ, and the extent of this injury can be modified by adjustments in dietary intake of phosphorus and polyunsaturated fatty acids. The response of each animal with renal insufficiency to the disease and to nutritional intervention varies dramatically, and individualized therapy is required; the only constant nutritional characteristic of renal insufficiency is inappetance and loss of body weight. Successful interventional nutrition must take all of these principles into account.

In vitro evaluation of contrast medium concentration and depth effects on the radiographic appearance of specific canine urolith mineral types.

Nine pure mineral types of canine uroliths (bladder or urethral origin only) identified in a chronologic sample from the Minnesota Urolith Center were compared to sequential dilutions of iodinated radiographic contrast medium in vitro. The uroliths studied were those composed of 100% magnesium ammonium phosphate, calcium oxalate monohydrate, calcium oxalate dihydrate, calcium phosphate appatite, calcium hydrogen phosphate dihydrate (brushite), ammonium acid urate, sodium acid urate, cystine, and silica. The radiopacity of the uroliths was classified as radiolucent, isopaque, or radiopaque, as compared to the radiopacity of the contrast medium solutions in which they were placed, using 2.0 mm and 5.0 mm depths in petri dishes radiographed using a table-top technique. A statistically significant relationship was found between the effective atomic number of the uroliths and the effective atomic number of the contrast medium solutions to which they were compared for the endpoints of isopacity, first lucency (in increasing iodine concentration sequence), and optimal visualization of internal architecture. In general, uroliths isopaque or radiolucent in contrast medium solutions weaker than 23.5 mgI2/ml are most likely ammonium acid urate or sodium acid urate. Uroliths isopaque or radiolucent in contrast medium solutions between 23.5 mgI2/ml and 44.4 mgI2/ml are probably magnesium ammonium phosphate, cystine, or silica. Uroliths that remained radiopaque in solutions stronger than 44.4 mgI2/ml, and particularly those radiopaque in contrast medium solutions stronger than 80 mgI2/ml, almost always contained calcium. This relative opacity assessment is proposed for use in double contrast cystography as an aid in differentiating urolith mineral types clinically to facilitate appropriate use of medical protocols to dissolve uroliths or to prevent their growth or recurrence.

Complications with non-endoscopic percutaneous gastrostomy in 31 cats and 10 dogs: a retrospective study.

Percutaneous gastrostomy tubes were placed non-endoscopically in 31 cats and 10 dogs using either a rigid insertion tube (n = 13) or an Eld gastrostomy tube applicator (n = 28). Tubes were placed successfully in 38 of the 41 animals and the consequent feeding was of therapeutic benefit to 31 of the animals. Six of 41 died or were euthanased for reasons unrelated to gastrostomy. In four cases (10 per cent), gastrostomy failed with respect to correct tube placement or tube feeding. Overall complications occurred in 18 of 41 animals. Severe procedural complications occurred in two cats; a cardiorespiratory arrest during pharyngeal manipulation and erroneous tube placement through the distal oesophagus. Moderate late complications included peristomal food leakage (n = 2), peristomal abscess (n = 2) and pyloric outflow obstruction by a migrated tube (n = 1). Complications associated with the feeding procedure, nausea and vomiting (n = 3), led to aspiration pneumonia in one case.