Clinical evaluation of hyperimmune plasma for treatment of dogs with naturally occurring parvoviral enteritis.

OBJECTIVE: To evaluate the clinical efficacy of a single infusion of hyperimmune plasma (HIP) in dogs with canine parvovirus (CPV). DESIGN: Prospective, randomized, placebo-controlled clinical trial. SETTING: University teaching hospital. ANIMALS: Client-owned dogs with naturally occurring CPV. INTERVENTIONS: Dogs presenting for CPV treatment (n = 31) underwent cardiovascular resuscitation and were randomized to receive a single dose of either HIP (10 mL/kg IV) or placebo (0.9% sodium chloride [10 mL/kg IV]) during the first 6 hours of hospitalization. All dogs were treated with a standardized treatment protocol (IV fluid therapy [120 mL/kg/d isotonic crystalloids], cefoxitin [30 mg/kg IV q 8 h], maropitant [1 mg/kg IV q 24 h], and buprenorphine [0.01-0.02 mg/kg IV q 8 h]) until hospital discharge. MEASUREMENTS AND MAIN RESULTS: Dogs treated with HIP (n = 16) demonstrated a lower shock index at 24 hours (median = 0.77, range: 0.5-1.5) than those treated with placebo (n = 15, median = 1.34, range: 0.5-1.7; P = 0.02). Plasma lactate concentration was lower at 24 hours in HIP-treated dogs (median = 1.3 mmol/L, range: 0.9-3.4 mmol/L) than in placebo-treated dogs (median = 2.1 mmol/L, range: 1.1-3.4 mmol/L; P = 0.01). There was no difference in duration of hospitalization when comparing HIP-treated dogs (median = 3.2 days, range: 0.83-10 days) to placebo-treated dogs (median = 2.83 days, range: 1-8.38 days; P = 0.35). Survival was 16 of 16 (100%) for the HIP group and 14 of 15 (93.3%) for the placebo group (P = 0.32). CONCLUSIONS: HIP at 10 mL/kg IV administered to dogs with CPV within the first 6 hours of hospitalization improves markers of shock during the initial 24 hours of hospitalization. No effects were observed on duration of hospitalization or mortality; however, this study was underpowered to evaluate these effects. HIP was well tolerated in this population of critically ill dogs.

Development of a tension pneumomediastinum during mechanical ventilation of a young Irish Wolfhound.

OBJECTIVE: To report the development of a tension pneumomediastinum during mechanical ventilation of a young Irish Wolfhound with aspiration pneumonia. CASE SUMMARY: A 9-month-old intact female Irish Wolfhound was presented for clinical signs consistent with aspiration pneumonia. Evaluation of her pedigree and clinical signs prompted suspicion of Irish Wolfhound rhinitis bronchopneumonia syndrome as a contributing factor. Despite supportive care for bronchopneumonia, progressive hypoxemia and increased work of breathing required mechanical ventilation (MV). Development of a pneumothorax 36 hours after initiation of MV necessitated bilateral thoracostomy tubes. Cardiovascular decline persisted despite resolution of the pneumothorax and 1 hour later the dog was humanely euthanized. On necropsy, severe pneumomediastinum was identified without other evidence of barotrauma. Necropsy results suggested tension pneumomediastinum as the cause of pneumothorax and cardiovascular deterioration. NEW OR UNIQUE INFORMATION PROVIDED: Pneumomediastinum has not been described in dogs receiving MV. This case highlights the importance of rapid detection of pneumomediastinum during MV, as the complication can quickly become life-threatening.

Serum D-lactate concentrations in dogs with parvoviral enteritis.

BACKGROUND: Dogs infected with canine parvovirus (CPV) have compromised intestinal epithelial barrier integrity. Production of D-lactate by enteric bacteria may directly reflect disease severity or contribute to metabolic acid-base status in these dogs. HYPOTHESIS: Serum D-lactate concentration will be increased in CPV dogs compared to healthy controls and correlate with markers of disease severity and acid-base status. ANIMALS: Dogs with CPV undergoing treatment (n = 40) and healthy control dogs (n = 9). METHODS: Prospective observational study. Dogs with CPV had a baseline and daily CBC, venous blood gas with serum electrolyte concentrations, composite clinical severity score, and serum D-lactate concentration performed. A single serum D-lactate measurement was obtained from healthy control dogs. RESULTS: The CPV dogs had a higher D-lactate concentration (mean ± SD) of 469 ± 173 µM compared to controls, 306 ± 45 µM (P < .001). There was no difference in baseline D-lactate concentrations for CPV survivors (474 ± 28 µM), versus nonsurvivors (424 ± 116 µM; P = .70). D-lactate concentration decreased over the first 4 days of treatment (-9.6 µM/d; P = .46). Dogs hospitalized for <4 days had lower baseline D-lactate concentrations compared to those hospitalized ≥4 days (400 ± 178 µM versus 520 ± 152 µM; P = .03). No sustained correlation over time between serum D-lactate concentration and clinical severity score or recorded acid-base results. CONCLUSIONS AND CLINICAL IMPORTANCE: Serum D-lactate concentrations are higher in dogs with CPV compared to healthy controls but do not appear to be clinically relevant. No relationship identified between serum D-lactate concentrations and markers of CPV disease severity, acid-base status, or outcome.

Antivenin-associated serum sickness in a dog.

OBJECTIVE: To describe a case of documented serum sickness in a dog following administration of a single dose of a novel antivenin crotalidae polyvalent. CASE SUMMARY: A 4-year-old female neutered mixed breed dog developed recurrent signs of hypersensitivity (swelling, edema, urticaria/hives, gastrointestinal signs, vasculitis) at 1 and 2 weeks following administration of a single unit of a novel antivenin crotalidae polyvalent plasma product. Both episodes were treated with antihistamines and glucocorticoids and signs improved rapidly, with a prolonged course of glucocorticoids and antihistamines administered following the second occurrence. Diagnosis of serum sickness was based on clinical appearance of delayed hypersensitivity following exposure to novel biologic product, absence of other inciting cause of hypersensitivity, complement testing, and skin biopsies confirming vasculitis. NEW OR UNIQUE INFORMATION PROVIDED: This case documents the first report of delayed hypersensitivity with a novel antivenin plasma product. This is the only case report of serum sickness to a single unit of antivenin. Additionally, the dog developed recurrence of hypersensitivity following the initial episode at 1 week; appropriate identification and prolonged treatment could have prevented recurrence and additional hospitalization. Cost and benefit analysis should be considered with antivenin administration.

Assessing the Efficacy of Maropitant Versus Ondansetron in the Treatment of Dogs with Parvoviral Enteritis.

Antiemetics are commonly prescribed during the treatment of canine parvoviral enteritis. This blinded, randomized prospective study compared the quality of clinical recovery and duration of hospitalization in canine parvoviral dogs receiving either maropitant (1 mg/kg [0.45 mg/lb] IV q 24 hr, n = 11) or ondansetron (0.5 mg/kg [0.23 mg/lb] IV q 8 hr, n = 11). All dogs were treated with IV fluids, cefoxitin, and enteral nutrition. Frequency of vomiting and pain scoring were recorded twice daily. Rescue analgesics and antiemetics were administered as dictated by specific pain and vomiting criteria. Clinical severity scoring, body weight, and caloric intake were monitored daily. When comparing dogs receiving maropitant versus ondansetron, respectively, there were no differences in duration of hospitalization (3.36 ± 0.56 versus 2.73 ± 0.38 days, P = .36), requirement of rescue antiemetic (3/11 versus 5/11 dogs, P = .66), duration of vomiting (5 versus 4 days, P = .65), or days to voluntary food intake (2 versus 1.5 days, P = 1.0). Results of this study suggest that maropitant and ondansetron are equally effective in controlling clinical signs associated with parvoviral enteritis.

Validation of a smartphone-based point-of-care hemoglobin assay for use in dogs.

OBJECTIVE: To validate a smartphone-based spectrophotometric assay for point-of-care (POC) measurement of hemoglobin (Hgb) concentration against the standard measurement method in dogs without increases in serum lipemia, hemolysis, or bilirubin. DESIGN: Prospective observational study. SETTING: University teaching hospital. ANIMALS: One hundred thirty-nine dogs that had a CBC and corresponding biochemical profile submitted to the clinical pathology laboratory. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Blood tubes submitted for CBC were collected for hemoglobin (Hgb) measurements performed on a POC smartphone device. Each whole blood sample was run on the smartphone in duplicate using 2 strips, for a total of 4 POC Hgb readings per dog. Data collected for each dog included CBC Hgb value, 4 POC Hgb values, and select biochemistry values (bilirubin, lipemia, hemolysis, icterus). A calibration equation was estimated using a weighted linear regression: estimated CBC = (avgPOC-0.4871)/1.0015. For each dog, the percent error was computed between estimated and actual Hgb values; 95% of the percent errors ranged from -13.2% to 20.1%. The standard deviation of percent errors was 7.9% overall. When samples were further divided according to CBC Hgb concentration (low, normal or high), the standard deviation of percent error was 6.7% when Hgb<13 g/dL [130 g/L], 8.9% when Hgb 13-20 g/dL [130-200 g/L], and 6.5% when Hgb>20 g/dL [200 g/L]. The coefficient of variability among the 4 individual POC readings was 3.4%. CONCLUSIONS: A smartphone-based photometric method for measuring Hgb represents a clinically useful POC alternative to a standard laboratory Hgb measurement. There was excellent intrasample reproducibility, and the standard deviation of percent errors was relatively constant across CBC ranges. Additional sampling of patients with a greater range of diseases and biochemical abnormalities that may influence spectrophotometric assays (ie, abnormal bilirubin, icterus, lipemia, hemolysis) is warranted to extend the findings of this study.

Evaluation of an outpatient protocol in the treatment of canine parvoviral enteritis.

OBJECTIVE: To compare 2 treatment protocols (standard in-hospital versus modified outpatient) in affecting the duration of treatment or survival of dogs with parvoviral enteritis. DESIGN: Prospective, randomized study. SETTING: University teaching hospital. ANIMALS: Client-owned dogs with naturally acquired parvovirus were randomized to receive either an inpatient (n = 20) or outpatient (n = 20) treatment protocol. INTERVENTIONS: Both groups received intravenous (IV) fluid resuscitation and correction of hypoglycemia at hospital admission. Following stabilization, basic inpatient interventions included administration of IV fluids, administration of cefoxitin (22 mg/kg IV q 8 h), and maropitant (1 mg/kg IV q 24 h). Basic outpatient interventions (provided in-hospital) included administration of subcutaneous (SC) fluid (30 mL/kg q 6 h), administration of maropitant (1 mg/kg SC q 24 h) and cefovecin (8 mg/kg SC once). Using daily electrolyte and glucose evaluations, dextrose and potassium supplementation was provided intravenously (inpatients) or orally (outpatients) as indicated. Rescue criteria were used in both groups for analgesia and nausea. All dogs were syringe fed a commercial canine convalescence diet (1 mL/kg PO q 6 h) until voluntary appetite returned. MEASUREMENTS AND MAIN RESULTS: Protocol success, defined as survival to hospital discharge, was 90% (18/20) for the inpatient group compared to 80% (16/20) for the outpatient group (P = 0.66). There was no difference detected in duration of hospitalization for inpatient dogs (4.6 ± 2 days) versus outpatient dogs (3.8 ± 1.8 days, P = 0.20). Metabolic disturbances were frequent in the outpatient group, with 50% of dogs requiring dextrose supplementation and 60% of dogs requiring potassium supplementation. CONCLUSIONS: An outpatient protocol may be a reasonable alternative for dogs that cannot receive standard in-hospital treatment for parvoviral enteritis. Diligent supportive care and monitoring are still required to optimize treatment of dogs with parvoviral enteritis in an outpatient setting.

Palatability and Clinical Effects of an Oral Recuperation Fluid During the Recovery of Dogs With Suspected Parvoviral Enteritis.

Dogs infected with canine parvovirus (CPV) can develop severe enteritis that requires supportive care until voluntary food and water consumption return. An oral recuperation fluid (ORF) may assist in the overall recovery from CPV. The hypotheses of the study were that dogs with naturally infected CPV would prefer the ORF to water and that dogs consuming the ORF would have a more rapid return to voluntary appetite and improved caloric intake during the initial recovery period compared with dogs consuming water. A total of 28 dogs with CPV were enrolled. Dogs were excluded if voluntary food or water intake was present at the time of study enrollment. Dogs were randomized to either an ORF or water group. The designated fluid was offered twice daily, followed by offering the opposite fluid 1 hour later if the designated fluid was refused. Dogs also received a standardized supportive treatment protocol. Beginning on day 2, all dogs were offered a gastrointestinal diet q8h, staggered with the fluid intake trials. A total of 40% (6/15) of dogs with CPV consumed the ORF as their designated fluid, and 31% (4/13) of dogs with CPV consumed water as their designated fluid (P = .71). For those dogs who refused their designated fluid, 56% (5/9) of the dogs consuming ORF ultimately consumed water, and 22% (2/9) of the dogs consuming water also consumed the ORF (P = .33). Dogs who consumed the ORF demonstrated a more rapid return to voluntary appetite (median = 1.5 days [range: 1-3]) compared with those that consumed water (median = 4.25 days [range: 1.5-5.5], P = .01) or neither fluid (median = 2 days [range: 1.5-5.5], P = .03). Additionally, those dogs consuming the ORF demonstrated greater caloric intake [median = 100% resting energy requirement (RER), range: 61%-100%] compared with those that consumed water (median = 19% RER; range: 9%-100%; P = .004) or neither fluid (median = 37% RER; range: 3-100; P = .05). This study suggests that some dogs with CPV voluntarily consume an ORF during the recovery phase of their illness and that consumption of the ORF may foster a more rapid return of voluntary appetite as well as improved caloric intake. Additional studies are warranted to further assess additional effects of this ORF during recovery from CPV.

Dislodgement of a right atrial thrombus and subsequent pulmonary thromboembolism following tracheal stent deployment in a dog.

OBJECTIVE: To report the management of a dog that required 2 treatments with mechanical ventilation; firstly for severe tracheal collapse and secondly following deployment of a nitinol tracheal stent that immediately preceded a nonoxygen responsive pulmonary thromboembolism (PTE), suspected to have originated from the right atrium. CASE SUMMARY: A 9-year-old female spayed Shetland Sheepdog was presented for management of a gallbladder mucocoele. Pertinent history included iatrogenic hyperadrenocorticism and tracheal collapse. The dog became clinical for tracheal collapse following laparoscopic cholecystectomy. Thoracic radiographs revealed moderate to severe tracheal collapse at the level of the thoracic inlet. Arterial blood gas was consistent with hypoventilation and mechanical ventilation was instituted. Given the severity of tracheal collapse, self-expanding nitinol tracheal stent placement was elected. Immediately following tracheal stent placement, the dog developed nonoxygen responsive hypoxemia requiring mechanical ventilation. Additional diagnostic tests revealed changes consistent with a PTE and a large thrombus in the right atrium. The dog was humanely euthanized. NEW OR UNIQUE INFORMATION PROVIDED: Dislodgement of a preexisting atrial thrombus has not been described as a complication following tracheal stent deployment. Additionally, although PTE is frequently considered to be oxygen responsive, it may not be if the embolism is severe enough.

Retrospective evaluation of fluid overload and relationship to outcome in critically ill dogs.

OBJECTIVE: To determine if critically ill dogs have an increased risk of fluid overload (FO) during hospitalization compared to less ill dogs, and to determine if FO is associated with increased mortality during hospitalization. DESIGN: Observational, case-control study. SETTING: University teaching hospital. ANIMALS: Thirty-four critically ill dogs and 15 comparatively healthy stable postoperative dogs with neuro-orthopedic disease. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data recorded included underlying disease, body weight, and APPLEfast score at admission, single-day and composite APPLEfull scores during hospitalization, total fluid volume administered (L), total fluid volume output (L), and outcome. Percent FO (%FO) was calculated using the equation 100 × ([fluid volume administered - fluid volume lost]/1000 mL/L) - (% dehydration at admission), with fluid volume expressed as mL/kg of baseline body weight. Critically ill dogs developed greater %FO during hospitalization compared to stable postoperative dogs (12.1 ± 11.7% vs 0.5 ± 5.2%, P = 0.001), and half (8 out of 16) of the dogs with %FO ≥ 12% died. Composite APPLEfull scores were weakly positively correlated with %FO, whereas APPLEfast and single-day APPLEfull scores recorded at admission were not. The odds ratio for death was 1.08 for every percent increase in FO during hospitalization (95% confidence limits 1.012-1.59, P = 0.02). CONCLUSIONS: Critically ill dogs are at increased risk for FO during hospitalization, and a weak but significant association exists between %FO, illness severity, and mortality. Prospective studies are warranted to confirm the findings of this retrospective study.

Thromboelastographic evidence of inhibition of fibrinolysis after ε-aminocaproic acid administration in a dog with suspected acute traumatic coagulopathy.

OBJECTIVE: To describe the thromboelastographic changes in fibrinolysis with ε-aminocaproic acid treatment in a dog with suspected acute traumatic coagulopathy. CASE SUMMARY: A 9-year-old female spayed Airedale Terrier was presented with multiple injuries consistent with motor vehicle trauma. After surgical repair of a diaphragmatic hernia and minor laceration of the right cranial lung lobe, the dog continued to produce copious volumes of hemorrhagic fluid from the thoracic cavity despite multiple plasma transfusions, autotransfusions, and failure to locate a definitive source of bleeding during 2 separate surgeries. ε-Aminocaproic acid treatment was initiated and was associated with rapid clinical improvement and diminished fibrinolysis based on a modified plasma-based thromboelastogram. NEW OR UNIQUE INFORMATION PROVIDED: This report describes thromboelastographic evidence of inhibition of fibrinolysis after ε-aminocaproic acid administration in a dog with suspected acute traumatic coagulopathy. Thromboelastrography may be useful in monitoring therapy with antifibrinolytic drugs.

The effects of omeprazole therapy on bacterial colonization of the pharynx in healthy dogs.

OBJECTIVE: To identify the relative abundance of commensal pharyngeal flora in healthy dogs and determine if abundance of pharyngeal flora is altered during omeprazole administration. ANIMALS: Eight adult Beagles. PROCEDURES: A total of 3 baseline pharyngeal swabs, collected 48 hours apart, were obtained from each dog. Omeprazole (1 mg/kg PO q 24 h) was administered for a total of 12 days. During omeprazole administration, pharyngeal swabs were obtained on Days 8, 10, and 12. All swabs were submitted for semiquantitative aerobic and anaerobic culture. Growth of bacterial isolates, as well as genus of isolates, was compared between the pretreatment (n = 24) and treatment (n = 24) swabs. RESULTS: A greater abundance of several bacterial species was identified during the treatment period, including coagulase-negative Staphylococcus (P < 0.01), Bacillus (P < 0.01), and Pasteurella (P = 0.05). The abundance of bacterial species in samples collected during the treatment period was unchanged for Escherichia coli (P = 0.16), Provotella (P = 0.40), hemolytic Streptococcus (P = 0.34), and nonhemolytic Streptococcus (P = 0.14). CONCLUSIONS AND CLINICAL RELEVANCE: This small study indicates that shifts in canine pharyngeal flora may occur during omeprazole therapy. Further studies are warranted to determine the clinical significance of gastric acid suppressants on pharyngeal flora in dogs.

Palatability assessment of an oral recuperation fluid in healthy dogs during the perioperative period.

The objective of this study was to determine whether healthy dogs undergoing elective surgery will accept and prefer an oral recuperation fluid (ORF) to water during the perioperative time period and if the consumption of an ORF would lead to increased caloric intake during the final preoperative and first postoperative periods. This prospective, observational study was performed in the setting of a University Veterinary Teaching Hospital. A total of 67 healthy dogs were presented for routine ovariectomy (n = 30) or castration (n = 37). Before surgical intervention, dogs were offered an ORF to assess their voluntary acceptance of the fluid. After 2 hours, the ORF was offered alongside water to assess fluid preference. Routine castration or ovariectomy was then performed. During the immediate postoperative period, dogs were reassessed as to their acceptance and preference of the ORF. A high percentage of dogs accepted the ORF in both the preoperative (55/67, 82%) and postoperative (42/67, 63%) periods (P < .01 and P = .04, respectively). Of dogs that demonstrated a preference between the ORF and water, 87% (95% CI: 77%-93%) chose the ORF preoperatively, whereas 98% (95% CI: 87%-99.5%) chose the ORF postoperatively (P < .01 and P < .01, respectively). Dogs that consumed the ORF in each measurement period ingested a higher amount of food (measured as percentage of kilocalories offered) when compared with those that did not consume the ORF (preoperatively 83% vs. 49%, P < .01; postoperatively 51% vs. 27%, P = .01). A commercially manufactured veterinary ORF was found to be palatable, as determined by acceptance and preference testing, in healthy dogs during the preoperative and postoperative phases of routine sterilization. Further studies in dogs undergoing more intensive surgical procedures or recovering from nonsurgical illness or both are warranted.

Diagnosis of secondary dysmyelopoiesis via costochondral rib aspirate in a dog.

OBJECTIVE: To describe a novel bone marrow sampling technique utilized in a dog diagnosed with secondary dysmyelopoiesis. CASE SUMMARY: A 1.5-year-old female spayed Lhasa Apso was treated for generalized seizures, aspiration pneumonia, and severe sepsis. Pertinent history included administration of phenobarbital (2.1 mg/kg PO q 12 h) for the 6 months prior to presentation for suspected idiopathic epilepsy. Initial leukopenia and thrombocytopenia was attributed to underlying sepsis and disseminated intravascular coagulation. Progressive decline in all cell lines (ie, leukopenia, thrombocytopenia, and anemia), along with history of phenobarbital administration, suggested myelodysplastic disease. Bone marrow cytology via serial costochondral rib aspirates confirmed secondary dysmyelopoiesis. Phenobarbital therapy was abruptly discontinued and replaced with alternative anticonvulsant therapy. Complete resolution of the observed leukopenia, thrombocytopenia, and anemia were observed 2 weeks after discontinuation of phenobarbital. NEW OR UNIQUE INFORMATION PROVIDED: Costochondral rib aspirate appears to be a simple, viable method for bone marrow evaluation in dogs. Dysmyelopoiesis is a rare adverse effect of phenobarbital administration that can possess fatal consequences if not quickly recognized. Prompt diagnosis and discontinuation of the inciting drug is imperative to successful case management. Prognosis for return of bone marrow function appears good following drug discontinuation.

Evaluation of ultrasound-guided vascular access in dogs.

OBJECTIVE: To describe the technique and determine the feasibility, success rate, perceived difficulty, and time to vascular access using ultrasound guidance for jugular vein catheterization in a cardiac arrest dog model. DESIGN: Prospective descriptive study. SETTING: University teaching hospital. ANIMALS: Nine Walker hounds. MEASUREMENTS AND MAIN RESULTS: A total of 27 jugular catheterizations were performed postcardiac arrest using ultrasound guidance. Catheterizations were recorded based on the order in which they were performed and presence/absence of a hematoma around the vein. Time (minutes) until successful vascular access and perceived difficulty in achieving vascular access (scale of 1 = easy to 10 = difficult) were recorded for each catheterization. Mean time to vascular access was 1.9 minutes (95% confidence interval, 1.1-3.4 min) for catheterizations without hematoma, versus 4.3 minutes (1.8-10.1 min) for catheterizations with hematoma (P = 0.1). Median perceived difficulty was 2 of 10 (range 1-7) for catheterizations without hematoma, versus 2 of 10 (range 1-8) for catheterizations with hematoma (P = 0.3). A learning curve was evaluated by comparing mean time to vascular access and perceived difficulty in initial versus subsequent catheterizations. Mean time to vascular access was 2.5 minutes (1.0-6.4 min) in the initial 13 catheterizations versus 3.3 minutes (1.5-7.5 min) in the subsequent 14 catheterizations (P = 0.6). Median perceived difficulty in the first 13 catheterizations (3, range 1-8) was significantly greater (P = 0.049) than median perceived difficulty in the subsequent 14 catheterizations (2, range 1-6). CONCLUSIONS: Ultrasound-guided jugular catheterization is associated with a learning curve but is successful in obtaining rapid vascular access in dogs. Further prospective studies are warranted to confirm the utility of this technique in a clinical setting.

Comparison of routine urinalysis and urine Gram stain for detection of bacteriuria in dogs.

OBJECTIVE: To determine the utility of performing urine Gram stain for detection of bacteriuria compared to routine urine sediment examination and bacterial aerobic urine culture. DESIGN: Prospective, observational study. SETTING: University teaching hospital. ANIMALS: Urine samples acquired via cystocentesis through convenience sampling from 103 dogs presenting to a tertiary referral institution. INTERVENTIONS: All samples underwent routine urinalysis, including sediment examination, as well as urine Gram stain and quantitative bacterial aerobic urine culture. MEASUREMENTS AND MAIN RESULTS: The urine Gram stain demonstrated improved sensitivity (96% versus 76%), specificity (100% versus 77%), positive predictive value (100% versus 83%), and negative predictive value (93% versus 69%) when identifying bacteriuria, compared to routine urine sediment examination. CONCLUSIONS: The urine Gram stain is highly sensitive and specific when detecting the presence of bacteria in canine urine samples. Gram staining should be considered when bacteriuria is highly suspected and requires rapid identification while bacterial culture is pending.

Comparison of tissue oxygen saturation in ovariohysterectomized dogs recovering on room air versus nasal oxygen insufflation.

OBJECTIVE: To compare tissue oxygen saturation in ovariohysterectomized dogs recovering postoperatively on room air versus nasal oxygen insufflation. DESIGN: Prospective clinical study. SETTING: University teaching hospital. ANIMALS: Twenty dogs undergoing ovariohysterectomy. INTERVENTIONS: Dogs were randomized to breathe either room air or 100 mL/kg/min of nasal oxygen insufflation for 2 hours postoperatively. Tissue oxygen saturation (StO(2)) was evaluated at 2 mm and 20 mm lateral to the surgical incision, as well as in the inguinal region using a noninvasive tissue oximeter. MEASUREMENTS AND MAIN RESULTS: In dogs recovered on nasal oxygen insufflation (n = 10), tissue oxygen saturation was significantly higher--20 mm from the surgical site (88.44 ± 2.50%, P = 0.02) and in the inguinal region (83.56 ± 1.91%, P = 0.032)-- compared to dogs recovered on room air (n = 10, 79.11% ± 2.50 and 77.12% ± 1.91, respectively). CONCLUSIONS: In ovariohysterectomized dogs, oxygen supplementation for 2 hours postoperatively improves tissue oxygen saturation 20 mm adjacent to the linea alba and in the inguinal region. Oxygen supplementation in postoperative dogs is an inexpensive and easily applicable method to improve tissue oxygen saturation.

Evaluation of open versus closed urine collection systems and development of nosocomial bacteriuria in dogs.

OBJECTIVE: To determine whether use of a closed urine collection system would decrease the incidence of nosocomial bacteriuria in hospitalized dogs, compared with use of an open urine collection system (used, sterile IV bags). DESIGN: Randomized controlled trial. ANIMALS: 51 hospitalized dogs requiring indwelling urinary catheterization for >or= 24 hours. PROCEDURES: Dogs were randomly assigned to an open or closed urine collection system group. A standardized protocol for catheter placement and maintenance was followed for all dogs. A baseline urine sample was collected via cystocentesis for aerobic bacterial culture, with additional urine samples obtained daily from the urine collection reservoir. RESULTS: 27 dogs were assigned to the open urine collection system group, and 24 were assigned to the closed urine collection system group. The incidence of nosocomial bacteriuria in dogs with open urine collection systems (3/27 [11.1%]) was not significantly different from incidence in dogs with closed urine collection systems (2/24 [8.3%]). Median duration of catheterization was 2 days for dogs in both groups; the range was 1 to 7 days for dogs in the open group and 1 to 5 days for dogs in the closed group. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that for dogs requiring short-term indwelling urinary catheterization, the type of urine collection system (open vs closed) was not associated with likelihood of developing nosocomial bacteriuria. Use of a strict protocol for urinary catheter placement and maintenance was likely key in the low incidence of nosocomial bacteriuria in the present study.