Brevundimonas vesicularis isolation from a Labrador Retriever with Bacteremia, Endocarditis, Spinal Epidural Empyema, and Polyarthritis.

A 7 yr old spayed female Labrador retriever was evaluated for progressive nonambulatory tetraparesis, obtundation, joint pain, and pyrexia. The dog was diagnosed with spinal epidural empyema, bacteremia, endocarditis, and polyarthritis based on magnetic resonance imaging, echocardiography, joint fluid analysis, and blood culture. Blood culture isolated a rare and atypical pathogen, Brevundimonas vesicularis in conjunction with Escherchia coli. The patient was treated with a 10 mo antibiotic course, and clinical signs quickly resolved. This is the first report of B vesicularis in association with bacteremia, endocarditis, spinal empyema, and polyarthritis in a dog.

Approaches to Canine Heartworm Disease Treatment Among Alumni of a Single College of Veterinary Medicine.

This descriptive study was designed to ascertain the current heartworm treatment strategies employed by veterinary graduates of a single college of veterinary medicine, to assess the frequency with which each of these treatment strategies is prescribed, and to report the motivation behind the use of these treatment strategies. A survey containing a combination of multiple-choice and open-ended questions was distributed via e-mail with an online link during 2013 to graduates of the University of Georgia College of Veterinary Medicine. Demographic data and opinions regarding treatment for cases of canine heartworm disease (HWD) were obtained, and motivation for recommending different treatment strategies was assessed. Nearly all 170 respondents (99%) indicated that they recommend melarsomine dihydrochloride for first-line treatment of canine HWD. Exercise restriction (80%) and monthly heartworm preventive (75%) were components of the treatment approach to HWD with no clinical signs. The majority of respondents (74%) indicated that when first-line treatment recommendations were declined, they endorsed long-term administration of ivermectin (i.e., "slow-kill" method) despite current American Heartworm Society guidelines that recommend against the use of long-term macrocyclic lactone administration for the monotherapy treatment of canine HWD. Respondents also indicated that owners' financial concerns frequently result in modification of HWD treatment. Routine inclusion of exercise restriction is commonly, but not universally, utilized and may represent an opportunity for improvement in the management of this disease. In addition, when first-line recommendations for heartworm disease treatment are declined, a two-dose melarsomine protocol instead of the slow-kill method should be considered.

Pharmacokinetic and pharmacodynamic evaluation of oral rivaroxaban in healthy adult cats.

OBJECTIVES: To determine the pharmacodynamics and pharmacokinetics of rivaroxaban (RVX), in healthy cats and to evaluate the clinicopathologic effects of various plasma RVX concentrations within target therapeutic ranges established for people. DESIGN: Prospective randomized cross-over study performed between July 2013 and November 2014. SETTING: Veterinary university teaching hospital. ANIMALS: Six healthy adult domestic shorthair cats (3 males, 3 females). INTERVENTIONS: Cats were treated with oral RVX at single, fixed doses (1.25, 2.5, 5 mg PO), q 12 h for 3 days (1.25 mg); q 24 h for 7 days (2.5 mg); and q 24 h for 28 days (1.25 mg). Blood samples were collected for complete blood count, blood chemistry, and RVX anticoagulant activity based on prolongation of dilute prothrombin time, activated partial thromboplastin time (aPTT), activated Factor X (FXa) inhibition (anti-Xa activity [aXa]) and high-pressure liquid chromatography tandem mass spectrometry determination of drug concentration. MEASUREMENTS AND MAIN RESULTS: Treated cats had no signs of hemorrhage or clinicopathologic off-target adverse effects. There were dose-dependent prolongations of coagulation times and increase in aXa, with peak effect at 3 hours postadministration. There was a direct correlation between plasma RVX concentration and dilute prothrombin time and aXa. Coagulation parameters returned to baseline by 24 hours after the last dose. CONCLUSIONS: Oral RVX was well tolerated by healthy cats with predictable pharmacokinetics and anticoagulant effects. Clinical studies of RVX are warranted in cats with heart disease.

Evaluation of a point-of-care coagulation analyzer (Abaxis VSPro) for identification of coagulopathies in dogs.

OBJECTIVE: To evaluate the ability of the Abaxis VSPro, a point-of-care analyzer that measures prothrombin time (PT) and activated partial thromboplastin time (aPTT), to identify dogs with coagulopathies caused by administration of anticoagulants. SETTING: Veterinary teaching hospital. ANIMALS: Six healthy adult dogs that are part of a preexisting research colony. One dog was not included in the warfarin portion of the study. MEASUREMENTS AND MAIN RESULTS: Unfractionated heparin (UFH, 50 U/kg i.v. once then 300 U/kg s.q. q 8 h) was administered to prolong aPTT. Citrated whole blood was used for PT and aPTT analyses with the VSPro and were run in duplicate. The VSPro results were compared to PT and aPTT measured in plasma with a standard benchtop coagulometer (AMAX Destiny). A washout period of at least 24 hours followed. Once dogs had normal PT and aPTT values, warfarin was administered (0.25-0.30 mg/kg p.o.) once then (0.15 mg/kg p.o.) as needed up to every 12 hours to prolong PT values. Seventy separate samples were evaluated for PT and 73 samples for aPTT. Pearson correlation coefficients (PCC) for replicate VSPro measures of PT and aPTT were 0.941 and 0.891, respectively (P < 0.001). The PCC between VSPro and AMAX was 0.578 for PT and of 0.865 for PTT (P < 0.001). Receiver operating characteristic (ROC) analysis indicated a maximum sensitivity and specificity for diagnosis of coagulopathy (by AMAX) at VSPro PT value of 21.6 seconds (sensitivity 72%, specificity 86%) and a maximum sensitivity and specificity at VSPro aPTT of 105.3 seconds (sensitivity 93%, specificity 89%). The positive predictive value for PT and aPTT were 84% and 89%, respectively. CONCLUSIONS: The Abaxis VSPro showed acceptable correlation with clinical laboratory tests, and is a useful POC device for identification of animals with abnormalities in PT or aPTT.

Infectious endocarditis and chylothorax in a cat.

A 6 yr old domestic longhair cat was evaluated for progressive weight loss, weakness, and dyspnea. Results of a physical examination and electrocardiogram were suggestive of cardiac disease. Thoracic radiographs revealed pleural effusion, which thoracocentesis revealed was consistent with chyle. An echocardiogram was performed, and aortic valve endocarditis with secondary aortic insufficiency was presumptively diagnosed. The cat was treated with broad-spectrum oral antibiotics and palliative cardiac medications. Two days after discharge, the cat's dyspnea returned, and it died suddenly. Histopathology and culture confirmed Pseudomonas bacterial endocarditis of the aortic valve. Bacterial endocarditis in the cat has rarely been reported in the literature. This case described heart failure and chylothorax resulting from bacterial endocarditis.