ABSTRACT
BACKGROUND: Cytology often is used to obtain a diagnosis, such as that of malignant neoplasia. When a diagnosis is uncertain, pathologists often express probability using qualitative terms, such as "probable," that have imprecise meanings. HYPOTHESIS: Terms expressing probability are interpreted variably by veterinary practitioners and affect decisions regarding treatment and euthanasia. ANIMALS: None. METHODS: An online survey of members of the Veterinary Information Network was conducted. Veterinarians were asked to assign percentage probabilities to 18 modifiers of a diagnosis of lymphoma. They also were asked to select their most likely clinical action based on a diagnosis of lymphoma qualified one of 4 modifiers. Results were analyzed using descriptive and nonparametric methods. Percentage probabilities were analyzed by ANOVA after variance stabilization. RESULTS: For 871 valid surveys, probabilities assigned to the 18 modifiers overlapped substantially, with medians (interquartile range) of 50% (50-70%) for "possible," 66% (66-85%) for "probable," and 70% (70-90%) for "consistent with." More (P < .001) veterinarians (50.4%) chose to initiate treatment with a diagnosis of "consistent with lymphoma" as compared with "probable" (14.6%) or "possible" (1.6%) lymphoma. For clients considering euthanasia if the diagnosis was cancer, more (P < .001) veterinarians recommended euthanasia with a diagnosis of "consistent with lymphoma" (62.5%) as compared with "probable" (35.3%), or "possible" (2.0%) lymphoma. CONCLUSIONS AND CLINICAL IMPORTANCE: Probability expressions are interpreted variably yet have a major impact on clinical decision-making, including the decision to recommend euthanasia. Standardized terminology could improve decision-making and enhance clinical outcome.
Subject(s)
Cytological Techniques/veterinary , Decision Making , Pathology, Clinical/standards , Pathology, Veterinary/standards , Data Collection , Humans , Terminology as TopicABSTRACT
An ehrlichia was identified in the blood of a diseased llama (lama glama). Sequencing of its 16S rRNA gene showed the ehrlichia to be closely related to members of the Ehrlichia phagocytophila genogroup. The agent was also found in a pool of ticks (Ixodes pacificus) collected at the llama site.
Subject(s)
Camelids, New World/microbiology , Ehrlichia/isolation & purification , Ehrlichiosis/veterinary , Ixodes/microbiology , Animals , Ehrlichia/genetics , Ehrlichiosis/microbiology , Male , Molecular Sequence Data , RNA, Bacterial/analysis , RNA, Ribosomal, 16S/geneticsABSTRACT
Nonspherocytic hemolytic anemia, characterized by marked reticulocytosis, hepatosplenomegaly, hemosiderosis of reticuloendothelial organs and bone marrow myelofibrosis, and osteosclerosis, was diagnosed in 5 related Poodles. The unremitting anemia was clinically evident by 1 year of age, and was fatal as early as 3 years of age. Despite intense diagnostic endeavors including RBC fragility studies, RBC enzyme assays, and hemoglobin electrophoresis, the cause of this nonspherocytic hemolytic anemia remains to be determined.
