Optimising the short and long-term clinical outcomes for koalas (Phascolarctos cinereus) during treatment for chlamydial infection and disease.

Koalas (Phascolarctos cinereus) have suffered severe declines in the northern extent of their range due to a variety of threats, including habitat destruction, trauma from cars and dogs, climate change and importantly, disease. The most significant pathogen in koalas is Chlamydia pecorum, which causes inflammation and fibrosis at mucosal sites, resulting in blindness, infertility and death in severe cases. Chlamydia treatment can be problematic in koalas as the response to treatment is often poor in chronic cases and antimicrobial choice is limited. Thus, chlamydial disease is a severely threatening process for koala conservation. We investigated the short and long-term clinical outcomes for 167 koalas with Chlamydia that underwent capture, telemetric monitoring and intensive veterinary management as part of a large-scale population management program in South East Queensland. Chlamydia treatments included the standard regimen of daily subcutaneous chloramphenicol injections (60mg/kg) for 14 to 28-days, and a variety of non-standard regimens such as topical antimicrobials only (for ocular disease), surgical treatment only (for bilateral reproductive tract disease), and other antimicrobials/treatment lengths. To assess these regimens we analysed clinical records, field monitoring data and swab samples collected from the urogenital tract and ocular conjunctiva. Overall, in contrast to other studies, treatment was generally successful with 86.3% of treated koalas released back into the wild. The success of treatment rose to 94.8% however, when the standard treatment regimen was employed. Further, 100% of koalas that were also treated with surgical ovariohysterectomy (n = 12) remained healthy for a median of 466 days of post-treatment monitoring, demonstrating the benefits of surgical treatment. Previous studies reported 45-day chloramphenicol regimens, but the shorter standard regimen still achieved microbiological cure and reduces the risk of negative sequelae associated with treatment and/or captivity and treatment costs. Despite these positive clinical outcomes, alternatives to chloramphenicol are warranted due to its decreasing availability.

Interventional Radiology Management of Vascular Malformations: Portosystemic Shunts and Vascular Fistulae/Malformations.

Vascular malformations are abnormal connections between blood vessels that can have various endothelial characteristics. Although uncommon, these malformations can present challenging diagnostic and therapeutic scenarios. The use of interventional radiology techniques in the management of various vascular malformations is an attractive option because of the ability to treat these malformations at the most appropriate anatomic location and in the most effective manner. Techniques such as coil embolization of intrahepatic portosystemic shunts and liquid embolization of arteriovenous fistulae/malformations have shown tremendous potential as treatments for these challenging diseases.

Fighting surgical site infections in small animals: are we getting anywhere?

A diverse array of pathogen-related, patient-related, and caretaker-related issues influence risk and prevention of surgical site infections (SSIs). The entire surgical team involved in health care settings in which surgical procedures are performed play a pivotal role in the prevention of SSIs. In this article, current knowledge of SSI risk factors and prevention methods is reviewed. Although new avenues that can be explored in the prevention of SSIs in veterinary medicine are described, the main conclusion drawn is that the best method for prevention of SSI is to adhere to what we already know.

[Clinical use of the U-shaped external fixator with enhanced threadplate (UFEG®)]. / Klinische Anwendungen des U-förmigen Fixateur externe mit Gewindeplatte (UFEG®).

OBJECTIVE: In this retrospective case study a new reusable device for external skeletal fixation (UFEG®) that has been especially designed for use in veterinary medicine was evaluated in a case series. MATERIAL AND METHODS: In total, 20 patients from three different species (13 cats, five dogs, two rabbits) with a bodyweight between 1.8 and 33.0 kg were treated with the new device. The patients suffered from fractures, luxations and ruptures of tendons at diffe- rent localizations. All injuries were treated using the UFEG® alone or in association with an internal fixation. RESULTS: The duration of the healing process of 3-12 weeks and the success rate with respect to fracture and joint stability were comparable to other clinically used external skeletal fixation systems. In comparison to other devices weighing 14-64 g, the UFEG® has a low net weight of 18 g while still providing high rigidity. Additional advantages are the relatively low price, the easy application without the need for specific instruments and the possibility to anchor many Kirschner pins of different gauges in the bone. CONCLUSION AND CLINICAL RELEVANCE: The results support the clinical usefulness of the UFEG® device. It is highly suitable for treating different limb injuries.

Reptile diagnostic endoscopy and endosurgery.

The 2.7-mm telescope commonly used in avian practice has transitioned into an invaluable diagnostic tool for the reptile clinician. Previously plagued by vague medical histories, nonpathognomonic physical examinations, indistinct diagnostic images, and less than conclusive clinical pathology results, the reptile clinician often has had trouble making a definitive, antemortem diagnosis. A definitive diagnosis generally relies on the demonstration of a host pathologic response and the causative agent. The ability to examine internal structures and collect biopsies has enabled many postmortem diagnoses to now be appreciated in the living animal, and along with accurate diagnosis comes accurate prognosis and improved case management. The advent of 3-mm human pediatric laparoscopy equipment has fueled interest in minimally invasive endosurgery in exotic pets, including reptiles. However, the chelonian shell has also served as a catalyst to speed the development of surgical approaches to the coelom that do not involve major shell surgery. This article summarizes the most common endoscopic approaches in lizards, chelonians, and snakes for the purposes of making a diagnosis and increasingly performing endosurgery.

Exotic mammal diagnostic endoscopy and endosurgery.

Despite the extensive use of endoscopy in avian and domestic animal practice, inclusion of exotic mammals (rabbits, rodents, ferrets, and so forth) in the endoscopist's case load is a much more recent phenomenon. Initially used as a means for the detailed evaluation of the oral cavity, rigid endoscopy has also become invaluable for the evaluation of the nasal cavity, urogenital tract, and increasingly for laparoscopic procedures. This article summarizes the most common procedures used by the author for first opinion and referral cases, and introduces some of the recent developments that are expected to become the standard of care in exotic animal practice in the future.

Basic science and clinical application of stem cells in veterinary medicine.

Stem cells play an important role in veterinary medicine in different ways. Currently several stem cell therapies for animal patients are being developed and some, like the treatment of equine tendinopathies with mesenchymal stem cells (MSCs), have already successfully entered the market. Moreover, animal models are widely used to study the properties and potential of stem cells for possible future applications in human medicine. Therefore, in the young and emerging field of stem cell research, human and veterinary medicine are intrinsically tied to one another. Many of the pioneering innovations in the field of stem cell research are achieved by cooperating teams of human and veterinary medical scientists.Embryonic stem (ES) cell research, for instance, is mainly performed in animals. Key feature of ES cells is their potential to contribute to any tissue type of the body (Reed and Johnson, J Cell Physiol 215:329-336, 2008). ES cells are capable of self-renewal and thus have the inherent potential for exceptionally prolonged culture (up to 1-2 years). So far, ES cells have been recovered and maintained from non-human primate, mouse (Fortier, Vet Surg 34:415-423, 2005) and horse blastocysts (Guest and Allen, Stem Cells Dev 16:789-796, 2007). In addition, bovine ES cells have been grown in primary culture and there are several reports of ES cells derived from mink, rat, rabbit, chicken and pigs (Fortier, Vet Surg 34:415-423, 2005). However, clinical applications of ES cells are not possible yet, due to their in vivo teratogenic degeneration. The potential to form a teratoma consisting of tissues from all three germ lines even serves as a definitive in vivo test for ES cells.Stem cells obtained from any postnatal organism are defined as adult stem cells. Adult haematopoietic and MSCs, which can easily be recovered from extra embryonic or adult tissues, possess a more limited plasticity than their embryonic counterparts (Reed and Johnson, J Cell Physiol 215:329-336, 2008). It is believed that these stem cells serve as cell source to maintain tissue and organ mass during normal cell turnover in adult individuals. Therefore, the focus of attention in veterinary science is currently drawn to adult stem cells and their potential in regenerative medicine. Also experience gained from the treatment of animal patients provides valuable information for human medicine and serves as precursor to future stem cell use in human medicine.Compared to human medicine, haematopoietic stem cells only play a minor role in veterinary medicine because medical conditions requiring myeloablative chemotherapy followed by haematopoietic stem cell induced recovery of the immune system are relatively rare and usually not being treated for monetary as well as animal welfare reasons.In contrast, regenerative medicine utilising MSCs for the treatment of acute injuries as well as chronic disorders is gradually turning into clinical routine. Therefore, MSCs from either extra embryonic or adult tissues are in the focus of attention in veterinary medicine and research. Hence the purpose of this chapter is to offer an overview on basic science and clinical application of MSCs in veterinary medicine.

Update on veterinary cataract surgery.

PURPOSE OF REVIEW: The purpose of this review is not to specifically discuss the techniques of veterinary cataract surgery, but rather to emphasize some of the differences between the veterinary and human cataract patients, procedures and outcomes. RECENT FINDINGS: In general, veterinary cataract surgery has more similarities than differences when compared to its human counterpart. This is especially true when comparing pediatric cataract patients. Veterinary cataract surgery has changed dramatically in recent years with regards to surgical technique, ocular pharmacology, viscoelastic devices, phacoemulsification, and the most recent advancement, intraocular lens implantation for dogs, cats, and horses. SUMMARY: It is hoped that the exchange of information between the human and veterinary specialties can be of benefit to both groups as we all work to improve outcomes and resolve complications.

Application of osteochondral autografts and allografts in the treatment of articular cartilage lesions in animals.

The paper describes current views on the use of osteochondral autografts and allografts in the treatment of articular cartilage lesions in animals. It presents surgical techniques of grafting and the biological features of osteochondral auto- and allografts, and their effect on the recipient's cartilage.

Hiatal hernia and diaphragmatic eventration in a leopard (Panthera pardus).

A 1-yr-old male leopard (Panthera pardus) presented for intermittent anorexia, emaciation, and generalized muscle wasting. Plain radiographs, ultrasonography, and esophageal endoscopy led to a diagnosis of diaphragmatic eventration with probable concurrent hiatal hernia. An exploratory laparotomy confirmed both diagnoses, and surgical repair and stabilization were performed. After surgery, the leopard was maintained on small liquid meals for 4 days, with a gradual return to normal diet over 2 wk. By 4 wk after surgery, the leopard was eating well and gaining weight, and it showed no recurrence of clinical signs for 2 yr subsequently, becoming mildly obese.