Comparison of auricular and rectal temperature measurement in normothermic, hypothermic, and hyperthermic dogs.

OBJECTIVE: Measurement of rectal temperature is the most common method and considered gold standard for obtaining body temperature in dogs. So far, no study has been performed comparing agreement between rectal and auricular measurements in a large case series. The purpose of the study was to assess agreement between rectal and auricular temperature measurement in normothermic, hypothermic, and hyperthermic dogs with consideration of different environmental conditions and ear conformations. MATERIALS AND METHODS: Reference values for both methods were established using 62 healthy dogs. Three hundred dogs with various diseases (220 normothermic, 32 hypothermic, 48 hyperthermic) were enrolled in this prospective study. Rectal temperature was compared to auricular temperature and differences in agreement with regard to environmental temperature, relative humidity, and different ear conformations (pendulous versus prick ears) were evaluated using Pearson's correlation coefficient and Bland-Altman analysis. RESULTS: Correlation between rec- tal and auricular temperature was significant (r: 0.892; p  <  0.01). However, Bland-Altman plots showed an inacceptable variation of values (bias: 0.300 °C; limits of agreement: -0.606 to 1.206 °C). This variation was above a maximal clinical tolerance of 0.3 °C, which was established by experts' opinion (n = 16). Relative humidity had a significant influence (p   =   0.001), whereas environmental temperature did not. CONCLUSION: Variation between the two methods of measuring body temperature was clinically unacceptable. CLINICAL RELEVANCE: Although measurement of auricular temperature is fast, simple, and well tolerated, this method provides a clinically unacceptable difference to the rectal measurement.

[Disseminated intravascular coagulopathy in a dog with Angiostrongylus vasorum infection]. / Disseminierte intravasale Koagulopathie bei einem Hund mit Angiostrongylus-vasorum-Infektion.

A 2-year-old female spayed Epagneul-Breton dog was presented with ecchymoses, but an undisturbed general condition. Clinical examination additionally revealed petechia and a haematoma. Travel history included Italy and Denmark. Laboratory abnormalities were moderate thrombocytopenia, prolonged PT, aPTT and TT, and elevated d-dimers. Initial therapy consisted of plasma transfusions, fluids, doxycycline and famotidine administration. Babesiosis, ehrlichiosis, leishmaniosis, dirofilariosis or anaplasmosis could not be confirmed. Abdominal ultrasound was unremarkable, while thoracic radiographs showed a bronchointerstitial pattern. Faecal samples collected over 3 days were positive for Angiostrongylus vasorum after examination using the Baermann lungworm test. The A. vasorum infection was successfully treated with fenbendazole, whereupon thrombocytopenia and prolonged coagulation times were resolved. In regions of low prevalence, an infection with A. vasorum should also be considered as a differential diagnosis in dogs with coagulation abnormalities. Respiratory signs can be absent with this disease. The patient may have acquired the infection abroad or in Germany.

Treatment of aseptic dogs with hemorrhagic gastroenteritis with amoxicillin/clavulanic acid: a prospective blinded study.

BACKGROUND: Antibiotics generally are recommended to treat hemorrhagic gastroenteritis (HGE). Inappropriate use of antibiotics may promote risk of antimicrobial resistance and unnecessary adverse drug reactions. The necessity of antimicrobial therapy in dogs with HGE has not been demonstrated. OBJECTIVE: The purpose of this prospective, placebo-controlled, blinded study was to evaluate whether treatment with amoxicillin/clavulanic acid improves the clinical course and outcome of HGE in dogs that show no signs of sepsis. ANIMALS: The study included 60 dogs diagnosed with HGE between 2007 and 2009 at the Clinic of Small Animal Medicine, LMU University of Munich, Germany. The inclusion criterion was the presence of acute hemorrhagic diarrhea (<3 days). Dogs pretreated with antibiotics, with signs of sepsis, or diagnosed with any disease known to cause bloody diarrhea were excluded from the study. METHODS: Patients were randomly divided into treatment (amoxicillin/clavulanic acid for 7 days) and placebo groups. To evaluate treatment efficacy, severity of clinical signs (based on a newly developed HGE index), duration of hospitalization, and mortality rate were compared between the 2 groups. RESULTS: Fifty-three of 60 dogs completed the study. No significant difference between treatment groups concerning mortality rate, dropout rate, duration of hospitalization, or severity of clinical signs, either on any individual day or over the course of disease, was observed. CONCLUSIONS AND CLINICAL IMPORTANCE: In some dogs with HGE that show no signs of sepsis, antibiotics may not change the case outcome or time to recovery.

Prognostic factors in cats with feline panleukopenia.

BACKGROUND: Feline panleukopenia is a highly contagious and often lethal disease. OBJECTIVE: The purpose of the study was to identify prognostic factors for survival of cats with panleukopenia. ANIMALS: Between 1990 and 2007, 244 cats were diagnosed with panleukopenia in the Clinic of Small Animal Medicine, LMU University of Munich, Germany. Diagnosis was established by electron microscopy, polymerase chain reaction of feces or blood, antigen ELISA of feces, pathognomonic histopathological lesions at necropsy, or some combination of these procedures. METHODS: Medical records of each cat were evaluated retrospectively. RESULTS: Survival rate was 51.1%. No significant correlation was found between outcome and living conditions, age, vaccination status (unvaccinated versus one or more vaccines administered), or severity of clinical signs. However, of the vaccinated cats, none had received a vaccine later than 12 weeks of age as a kitten. Nonsurvivors had significantly lower leukocyte and thrombocyte counts at presentation compared with survivors. The relative risk of death for patients with <1,000/µL leukocytes was 1.77 times as high as in patients with a leukocyte count of 1,000-2,500/µL (P=.038), and 1.85 times as high as in patients with >2,500/µL leukocytes (P=.001). The likelihood of a fatal outcome was higher when serum albumin concentration was <30 g/L or serum potassium concentration <4 mmol/L. CONCLUSIONS AND CLINICAL IMPORTANCE: Vaccination strategies that do not include vaccination of kittens beyond 12 weeks of age may not be adequate to prevent panleukopenia. Leukopenia, thrombocytopenia, hypoalbuminemia, and hypokalemia are negative prognostic factors in cats with panleukopenia.

Optimization of radiation dose and image quality in mammography: a clinical evaluation of rhodium versus molybdenum.

Mammography was done with a conventional molybdenum anode/filter combination and either a molybdenum/rhodium (Mo/Rh) or rhodium/rhodium (Rh/Rh) combination to compare the contrast characteristics and penetrating ability of the different techniques. Each pair was rated as being equal, one slightly better than the other, or one much better than the other. The "preferred" image was also selected. The entrance surface exposure and the mean glandular dose were determined for each exposure. Mo/Mo was compared with Mo/Rh in 26 patients and to Rh/Rh in 23. Mo/Mo was judged to produce better or equal contrast and penetration in all cases except one using the Mo/Rh combination. Mo/Rh was the preferred image only once and Rh/Rh not at all. In comparison to the conventional Mo/Mo technique, the average dose was reduced by approximately 25% with Mo/Rh and by 50% with Rh/Rh.

MR imaging of silicone gel-filled breast implants in vivo with a method that visualizes silicone selectively.

The lack of an adequately sensitive method for detecting silicone leakage and reported serious complications due to silicone leakage were cited as justification by the U.S. Food and Drug Administration for imposing the current restrictions on silicone gel-filled breast prostheses. The authors report a new magnetic resonance imaging method for visualizing silicone leakage: the silicone-only sequence (SOS). The method uses the conventional STIR (short-inversion-time inversion-recovery) technique combined with a 1331 radio-frequency pulse train widely used for water suppression in spectroscopy. With the SOS, silicone can be imaged while signals from fat and water are suppressed. The authors used the SOS to image phantoms and normal and ruptured silicone gel-filled breast prostheses.

Imaging of breast cancer after augmentation mammoplasty.

Experience with mammography in patients with augmentation mammoplasty has been limited by the younger age of the patients and the bias of the physicians that mammography may be ineffective in imaging the breast with a prosthesis. With recent advances in imaging of the augmented breast and the increase in popularity of augmentation mammoplasty, more of these patients are undergoing mammography. We reviewed the mammograms and clinical history of 25 women with breast implants and breast cancer. Seven (28%) of the 25 women were asymptomatic and referred for screening mammography. Mammography or sonography was positive in 22 (88%) of the 25 women. There was no nodal involvement in 11 of 18 patients with infiltrating duct carcinoma, 5 women with intraductal carcinoma, and 2 women with lobular carcinoma in situ. In this study, women with implants who developed breast cancer presented with nodal metastases in only 28% of cases. Modified position views should be performed in all patients, and sonography may be helpful in evaluating palpable masses even when mammography is normal. Breast cancer can be detected in the augmented breast by mammography even if clinically occult.

Intraductal extension of silicone from a ruptured breast implant.

Silicone rupture is a known complication of closed capsulotomy. Imaging of silicone within breast tissue after rupture of an implant is not uncommon. Intraductal extension of silicone on mammography is a very rare finding. This case report described the imaging features of silicone within the breast tissue and ducts that necessitated subcutaneous mastectomy for definitive treatment.

Breast imaging and the augmented breast.

Women with augmented breast implants are presenting for mammograms in greater numbers over the past year due to recent publicity regarding the safety of silicone gel-filled implants. New issues are being raised in light of this recent increase, making it essential for patients and health care providers to understand the limitations of mammography and how to best minimize problems.