The accuracy of monthly weight assessments in nursing homes: implications for the identification of weight loss.

BACKGROUND: The prevalence of weight loss is a quality indicator for nursing homes (NH), and monthly weight assessments are conducted by NH staff to determine weight loss. METHODS: A longitudinal study was conducted with 90 long-stay residents in four NHs for 12 study months. Monthly weight values documented in the medical record by NH staff were compared to independent weight values collected by research staff using a standardized protocol. Weight loss was defined according to the Minimum Data Set (MDS) criterion: >or= 5% in 30 days or >or= 10% in 180 days. RESULTS: The total frequency of weight loss episodes per person was comparable between NH and research staff weight assessments across the 12 study months. However, monthly weight values recorded by NH staff were consistently higher than values recorded by research staff, which resulted in a higher prevalence of weight loss and earlier identification of weight loss according to research staff weight values using a standardized weighing protocol. CONCLUSIONS: A standardized weighing protocol improved the detection of weight loss among NH residents and should allow for earlier nutrition intervention.

Immunoglobulin A and immunoglobulin G biclonal gammopathy in a dog with multiple myeloma.

A nine-year-old golden retriever was referred for evaluation of chronic anorexia, vomiting, and diarrhea. Low body weight, mucous membrane pallor, and palpably enlarged liver and spleen were detected by physical examination. Anemia, hyperglobulinemia, and concurrent trichuriasis and coccidiosis were identified upon initial diagnostic evaluation. Punctate vertebral lysis was apparent radiographically. Atypical plasma cell proliferation was found in the bone marrow, liver, and spleen. An immunoglobulin A and immunoglobulin G biclonal gammopathy was demonstrated by serum protein electrophoresis and immunoelectrophoresis. The dog was diagnosed with multiple myeloma and euthanized per owner request. Multiple myeloma should be considered in the differential diagnosis for biclonal gammopathy in the dog.

Use of fenbendazole for treatment of Crenosoma vulpis infection in a dog.

An 8-month-old Labrador Retriever was examined because of a 1-month history of productive coughing unresponsive to ampicillin treatment. Larvae of Crenosoma vulpis were found in fecal samples examined by zinc sulfate centrifugation and Baermann technique. Physical examination abnormalities or larvae in fecal samples were not detected 6 weeks after treatment with prednisone (1 mg/kg, PO, q 24 h, for 7 days, then 0.5 mg/kg, PO, q 48 h, for 8 days) and fenbendazole granules (50 mg/kg, PO, q 24 h, for 3 days). This report suggests that fenbendazole may be effective for treating Crenosoma vulpis infection in dogs.

Heterogeneity of hypertrophy in feline hypertrophic heart disease.

Eighty-six cats with non-dilated left ventricular myocardial hypertrophy were studied retrospectively. Cats were categorized by two-dimensional echocardiography as having symmetric ventricular hypertrophy (Type I), asymmetric with predominant septal thickening hypertrophy (Type II), and asymmetric hypertrophy with predominant free-wall thickening (Type III). The distribution of hypertrophy was judged subjectively and objectively. Subjective and objective results were similar (P = 0.03) although overlap existed between groups. Morphologic patterns (Types I, II, and III) were compared with breed, age, sex, heart rate, percent fractional shortening, left atrial size, serum creatinine concentration, and the presence (yes/no) of pleural effusion, pulmonary edema, pericardial effusion, heart murmur, dyspnea, thromboembolism, hyperthyroidism, and being alive at the time of study. Interventricular septal thickness, left ventricular free wall thickness, percent fractional shortening, and left atrial size additionally were compared to 3-month survival. Cats with Type III hypertrophy were more likely to experience thromboembolism than cats with Type II hypertrophy (P = 0.05) and cats with Type I hypertrophy were more likely to have heart murmurs than cats with Type III (P = 0.02). No other significant associations were found in comparison to pattern of hypertrophy. Both left atrial size and percent fractional shortening significantly correlated with 3-month survival (P < 0.001 for each). The degree of interventricular septal wall thickness was associated with 3-month survival (P = 0.02) when known hyperthyroid cats were excluded from the study group, while left ventricular free wall thickness consistently was not associated with survival.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholecalciferol rodenticide intoxication in a cat.

A 4-month-old 2.5-kg sexually intact female domestic shorthair cat was referred to the teaching hospital because of suspected cholecalciferol intoxication after ingestion of a cholecalciferol-containing rodenticide. At referral, the cat was hypercalcemic, hyperkalemic, and acidotic. Despite management of hypercalcemia and preservation of renal function with physiologic saline solution, furosemide, dopamine, and calcitonin, the cat died, apparently as a result of extensive pulmonary mineralization.