Transoperative glycemia in pets: validating old ones, and presenting lip mucosa as new sampling site.

The aim of our study was to investigate the viability and validity of blood sampling from the upper lip mucosa in healthy dogs and cats for monitoring transoperative glycemia and compare the results with those obtained from samples taken from previously described blood sampling sites for determination of glycemia using a glucose meter. Blood glucose (BG) levels were determined in samples taken from the upper lip mucosa of 24 dogs and 31 cats undergoing neutering or spaying surgeries. These values were compared to those of samples obtained from other sites previously described for capillary blood glucose monitoring (marginal ear vein, carpal pad in dogs, metacarpal pad in cats) using a glucose meter. Additionally, BG from peripheral venous blood was determined using a glucose meter, and the gold standard enzymatic colorimetric assay. The clinical reliability of BG values taken from lip mucosa and from all the other BG values measured by the glucose meter was evaluated using the error grid analysis modified by Parkes et al (2000). The upper lip mucosa was an easily accessible site for the obtainment of appropriate blood samples, and glucose levels read in these samples correlated positively with glycemic values read in blood samples from all other sites in dogs and cats. All BG made using glucose meters taken from all sites were within the clinically acceptable range when compared with enzymatic colorimetric assay (gold standard), and were analytically accurate according to the error grid (zones A and B). All blood sampling sites described in this work can be used to assess transoperative glycemia. The upper lip mucosa is a viable blood sampling site for precise monitoring of transoperative glycemia in healthy dogs and cats and shows promise for alternative blood glucose monitoring.

Acoustic radiation force impulse (ARFI) elastography of adrenal glands in healthy adult dogs / Elastografia acoustic radiation force impulse (ARFI) das glândulas adrenais de cães adultos saudáveis

To describe the ARFI elastography in the evaluation of the adrenal glands in adult dogs, to evaluate the stiffness of adrenal parenchyma and to determine the qualitative and quantitative standards of the ARFI technique, which have not yet been described in veterinary medicine. Sixty adrenal glands from thirty healthy adult dogs were evaluated by B-mode and qualitative and quantitative ARFI elastography to assess the stiffness of healthy parenchyma and to determine the quality and quantity (shear velocity) standards of ARFI technique in body, cranial and caudal adrenal poles. Findings of ultrasonography evaluations were normal. Qualitative elastography showed that adrenal glands were not deformable and presented homogeneous middle-gray areas. The results of shear wave velocity were similar statically (P = 0.3087): 1) left adrenal - 1.42 m/s for cranial polar, 1.31 m/s for body region, and 1.71 m/s for caudal polar; 2) right adrenal - 1.42 m/s for cranial polar, 1.74 m/s for body region and 1.63 m/s for caudal pole. Quantitative and qualitative ARFI elastography of dogs' adrenal glands is feasible, well tolerated, easily implemented and may provide baseline data in the study of this structure to allow the use of ARFI.(AU)

Objetivou-se descrever a técnica de elastografia ARFI na avaliação das glândulas adrenais em cães adultos, visando avaliar a rigidez do parênquima adrenal saudável e determinar os padrões qualitativos e quantitativos (velocidade de cisalhamento) da técnica ARFI, ainda não descritos em medicina veterinária. Sessenta glândulas adrenais de 30 cães adultos saudáveis foram avaliadas pela ultrassonografia modo B e pela elastografia ARFI qualitativa e quantitativa para avaliar a rigidez do parênquima saudável e determinar a velocidade de cisalhamento e padrões qualitativos da ARFI no corpo, polos adrenais cranial e caudal. As características ultrassonográficas das glândulas foram normais. A elastografia qualitativa mostrou que glândulas adrenais não se apresentaram deformáveis e homogêneas (coloração cinza médio). Os resultados da velocidade de cisalhamento foram semelhantes (P = 0,3087): 1) adrenal esquerda ( 1,42m/s para polo cranial, 1,31m/s para corpo e 1,71m/s para polo caudal; 2) adrenal direita ( 1,42m/s para polo cranial, 1,74m/s para corpo e 1,63m/s para polo caudal. A elastografia quantitativa e qualitativa (ARFI) das glândulas adrenais de cães é uma ferramenta viável e facilmente implementada, podendo proporcionar valores padrão para o estudo dessa estrutura.(AU)

Spleen evaluation using contrast enhanced ultrasonography and Doppler in dogs with subclinical ehrlichiosis / Ultrassonografia por contraste com microbolhas e Doppler na avaliação do baço de cães com erliquiose subclínica

The aim of this study was to evaluate the splenic parenchyma of dogs with subclinical ehrlichiosis using Doppler and contrast-enhanced ultrasonography and provide reference values for this organ in affected animals. Seventeen dogs naturally infected with E. canis were selected for this study. Splenic parenchyma echotexture and echogenicity, size and borders were determined by ultrasound scan. The vascular indices of the splenic artery were determined by Doppler. SonoVue, at 0.1mL per animal, was used in microbubble contrast-enhanced ultrasonography to determine wash in, wash out and peak enhancement time in the splenic tissue. B-mode ultrasonography revealed splenomegaly with rounded borders, heterogeneous echotexture and mixed echogenicity. The vascular indices of the splenic artery were: systolic velocity of 22.59±8.07cm/s, diastolic velocity of 5.25±4.66cm/s and resistance index of 0.71±0.14; values not yet reported in Veterinary Medicine. Contrast-enhanced ultrasonography recorded wash in time of 5.31±0.7s, peak enhancement time of 18.56±2.90s and wash out time of 94.56±35.21s. The combination of conventional ultrasonography of the spleen and hemodynamic evaluation by Doppler and contrast-enhanced ultrasonography is important for the diagnosis of canine ehrlichiosis and could help monitor the clinical evolution of subclinical cases.

O objetivo deste estudo foi avaliar o parênquima esplênico de cães com erliquiose na fase subclínica, por meio do Doppler e da ultrassonografia por contraste com microbolhas. Dezessete cães naturalmente infectados por E. canis na fase subclínica foram selecionados para este estudo. Por meio da ultrassonografia, avaliou-se a ecotextura, a ecogenicidade, o tamanho e os bordos do baço e, pelo Doppler, foram determinados os índices vasculares da artéria esplênica dos cães. Para a avaliação por contraste com microbolhas, foi utilizado SonoVue, na dosagem de 0,1mL por animal, e determinou-se o tempo de entrada e saída, bem como o pico de realce no tecido esplênico. Ao exame modo-B, foram observadas esplenomegalia com presença de bordas arredondadas, ecotextura heterogênea e ecogenicidade mista do baço. Ao Doppler, foram encontrados valores para os índices vasculares da artéria esplênica: velocidade sistólica: 22,59±8,07cm/s; velocidade diastólica: 5,25±4,66cm/s; e índice de resistência: 0,71±0,14, valores ainda não descritos em veterinária. Pela ultrassonografia com contraste, observaram-se valores para wash-in de 5,31±0.7s, pico de realce de 18,56±2.90s e wash-out de 94,56±35.21s. A ultrassonografia convencional do baço de cães com erliquiose, associada com a utilização do método Doppler e a ultrassonografia contrastada, é uma importante ferramenta na triagem diagnóstica e pode auxiliar a monitoração e a evolução de animais na fase subclínica.

Pharmacokinetics and pharmacodynamics of the glucagon-like peptide-1 analog liraglutide in healthy cats.

Glucagon-like peptide-1 (GLP-1) is an intestinal hormone that induces glucose-dependent stimulation of insulin secretion while suppressing glucagon secretion. Glucagon-like peptide-1 also increases beta cell mass and satiation while decelerating gastric emptying. Liraglutide is a fatty-acid derivative of GLP-1 with a protracted pharmacokinetic profile that is used in people for treatment of type II diabetes mellitus and obesity. The aim of this study was to determine the pharmacokinetics and pharmacodynamics of liraglutide in healthy cats. Hyperglycemic clamps were performed on days 0 (HGC) and 14 (LgHGC) in 7 healthy cats. Liraglutide was administered subcutaneously (0.6 mg/cat) once daily on days 8 through 14. Compared with the HGC (mean ± standard deviation; 455.5 ± 115.8 ng/L), insulin concentrations during LgHGC were increased (760.8 ± 350.7 ng/L; P = 0.0022), glucagon concentrations decreased (0.66 ± 0.4 pmol/L during HGC vs 0.5 ± 0.4 pmol/L during LgHGC; P = 0.0089), and there was a trend toward an increased total glucose infused (median [range] = 1.61 (1.11-2.54) g/kg and 2.25 (1.64-3.10) g/kg, respectively; P = 0.087). Appetite reduction and decreased body weight (9% ± 3%; P = 0.006) were observed in all cats. Liraglutide has similar effects and pharmacokinetics profile in cats to those reported in people. With a half-life of approximately 12 h, once daily dosing might be feasible; however, significant effects on appetite and weight loss may necessitate dosage or dosing frequency reductions. Further investigation of liraglutide in diabetic cats and overweight cats is warranted.

Pharmacology of the glucagon-like peptide-1 analog exenatide extended-release in healthy cats.

Exenatide extended-release (ER) is a microencapsulated formulation of the glucagon-like peptide 1-receptor agonist exenatide. It has a protracted pharmacokinetic profile that allows a once-weekly injection with comparable efficacy to insulin with an improved safety profile in type II diabetic people. Here, we studied the pharmacology of exenatide ER in 6 healthy cats. A single subcutaneous injection of exenatide ER (0.13 mg/kg) was administered on day 0. Exenatide concentrations were measured for 12 wk. A hyperglycemic clamp (target = 225 mg/dL) was performed on days -7 (clamp I) and 21 (clamp II) with measurements of insulin and glucagon concentrations. Glucose tolerance was defined as the amount of glucose required to maintain hyperglycemia during the clamp. Continuous glucose monitoring was performed on weeks 0, 2, and 6 after injection. Plasma concentrations of exenatide peaked at 1 h and 4 wk after injection. Comparing clamp I with clamp II, fasting blood glucose decreased (mean ± standard deviation = -11 ± 8 mg/dL, P = 0.02), glucose tolerance improved (median [range] +33% [4%-138%], P = 0.04), insulin concentrations increased (+36.5% [-9.9% to 274.1%], P = 0.02), and glucagon concentrations decreased (-4.7% [0%-12.1%], P = 0.005). Compared with preinjection values on continuous glucose monitoring, glucose concentrations decreased and the frequency of readings <50 mg/dL increased at 2 and 6 wk after injection of exenatide ER. This did not correspond to clinical hypoglycemia. No other side effects were observed throughout the study. Exenatide ER was safe and effective in improving glucose tolerance 3 wk after a single injection. Further evaluation is needed to determine its safety, efficacy, and duration of action in diabetic cats.

Bone marrow cytological evaluation in dogs with chronic kidney disease / Avaliação citológica da medula óssea de cães com doença renal crônica

Since anemia is indicated as an important compromising factor for the quality of life of dogs with chronic kidney disease (CKD), bone marrow cytological analysis may provide more information on the hematological profile these dogs and, therefore, allow clinicians to not only choose the most adequate treatment but also monitor the response to therapy. The aim of this study was to investigate the feasibility with sternal bone marrow puncture in chronic kidney disease (CKD) using only local anesthesia and check if the cytological analysis is helpful to determine the hematological status. We found that erythroid hypoplasia occurred only in terminal CKD patients, and that the bone marrows of dogs with CKD stages 2 and 3 were quantitatively similar to those of elderly dogs. All dogs tolerated the bone marrow puncture using only local anesthesia with lidocaine and bone marrow cytological evaluation may be a useful tool for hematopoietic evaluation of anemic dogs with CKD...

Sendo a anemia apontada como um importante fator comprometedor da qualidade de vida dos cães portadores de doença renal crônica (DRC), a análise citológica da medula óssea poderia fornecer mais informações acerca do perfil hematológico desses animais e, portanto, possibilitar ao clínico não somente optar por um tratamento mais adequado, mas também monitorar a resposta à terapia. Diante disso, objetivou-se com este estudo avaliar a praticabilidade e a aceitação do procedimento de coleta de medula óssea do osso esterno de cães com doença renal crônica (DRC) utilizando somente anestesia local, bem como verificar se os resultados fornecidos na análise citológica fazem-se úteis à composição do quadro hematológico desses pacientes. Observou-se que a manifestação de hipoplasia da série eritroide só ocorreu nos pacientes em estádio terminal da DRC, e que as medulas ósseas dos DRC em estádio 2 e 3 assemelharam-se quantitativamente à medula de animais idosos. Os cães de todos dos grupos toleraram bem a punção do osso esterno somente com uso de lidocaína, podendo ser esta, portanto, uma ferramenta útil na complementação da abordagem hematopoiética de cães anêmicos com DRC...

Transrectal bladder prolapse secondary to pelvic fracture in two dogs.

This report describes the exteriorisation of the urinary bladder in two dogs as a result of a laceration of the rectum from a traumatic pelvic fracture. Clinical examination and contrast radiography of the bladder were used as diagnostic tools. Both patients were treated with exploratory laparotomy, where traction of the bladder was utilised to pull the bladder through the traumatic rectal laceration allowing the organ to return to its normal anatomical position. This procedure was followed by surgical reconstruction of the rectum, resulting in effective resolution of each case.

Bilateral extraluminal ectopic ureters in a Maine Coon cat / Ureter ectópico extraluminal bilateral em um felino da raça Maine Coon

Ectopic ureters are rarely observed in cats. Therefore, for a better chance of success in the corrective surgical procedure and survival of the patient, diagnosis should be confirmed early. This report illustrates the occurrence of bilateral ectopic ureters in a seven month old Maine Coon cat and describes the medical and surgical management adopted for correction of the abnormality.

A ectopia dos ureteres é raramente observada em gatos. Assim, para aumentar as chances de sucesso do procedimento cirúrgico corretivo e promover a sobrevivência, o diagnóstico deve ser firmado precocemente. O relato em tela ilustra a ocorrência de ureter ectópico bilateral em uma gata Maine Coon, de sete meses, e descrevem-se as manobras médico-cirúrgicas adotadas na correção dessa anormalidade.

The carpal pad as an alternative sampling site for blood glucose testing in dogs.

OBJECTIVE: To investigate the feasibility and validity of sampling blood from the carpal pad in hospitalised healthy and diabetic dogs. METHODS: The carpal pad was compared to the ear as a sampling site in 60 dogs (30 healthy and 30 diabetic dogs). RESULTS: Lancing the pads was very well tolerated. The average glucose concentrations in blood samples obtained from the ears and carpal pads exhibited a strong positive correlation (r = 0·938) and there were no significant differences between them (P = 0·914). In addition, 98·3% of the values obtained were clinically acceptable when assessed by the error grid analysis. CLINICAL SIGNIFICANCE: The carpal pad is a good alternative sampling site for home monitoring, especially in animals with a soft and/or light-coloured pad.