Three Cases of Transtracheal Catheter Oxygenation for Postoperative Dyspnoea with Pituitary-Dependent Hyperadrenocorticism in Dogs Treated by Surgery.

Transsphenoidal surgery (TSS) is a curative treatment for pituitary-dependent hyperadrenocorticism, and its use in dogs has recently increased. One of the most serious postoperative complications of TSS is dyspnoea. We report three cases where transtracheal catheter oxygen therapy prevented death from respiratory distress secondary to enlarged soft palate after TSS.

Utility of a corticotropin-releasing hormone test to differentiate pituitary-dependent hyperadrenocorticism from cortisol-producing adrenal tumors in dogs.

BACKGROUND: Hyperadrenocorticism (HAC) is a common endocrine disorder in dogs; however, there are no reports on the use of the corticotropin-releasing hormone test (CRHT) to differentiate between pituitary-dependent hyperadrenocorticism (PDH) and cortisol-producing adrenal tumors (CPATs), both causative of HAC. OBJECTIVES: To evaluate the usefulness of CRHT as a tool to differentiate between PDH and CPAT in dogs and to determine the reference intervals for CRHT in healthy, PDH, and CPAT dogs. ANIMALS: Dogs diagnosed with PDH (n = 21), CPAT (n = 6), and healthy beagle dogs (n = 33). METHODS: This prospective study included dogs with a definitive diagnosis of PDH and CPAT and healthy beagle dogs, in which CRHT was performed, were prospectively evaluated. We investigated the correlations of CRHT (endogenous adrenocorticotropic hormone [ACTH] concentration, endogenous ACTH concentration [EAC], and poststimulation ACTH concentration [PAC]) with pituitary-to-brain ratio (PBR) (in PDH) and with indices of adrenal ultrasonography (smaller and larger adrenal gland dorsoventral thickness in PDH and CPAT). RESULTS: For EAC, the area under the curve (AUC) was 0.95, with a cutoff value of 26.3 pg/mL (sensitivity: 90.62%, specificity: 87.50%). The AUC for PAC was 0.96 with a cutoff value of 54.5 pg/mL (sensitivity: 100.00%, specificity: 66.67%). The 95% reference interval for CRHT in healthy (control) dogs ranged 5.00 to 79.8 pg/mL (1.10-17.57 pmol/L) for EAC, and 1.92 to 153.42 pg/mL (0.42-33.78 pmol/L) for PAC. There was no significant correlation between PBR and CRHT, nor adrenal size and CRHT. CONCLUSIONS AND CLINICAL IMPORTANCE: CRHT appears to be a rapid and reliable test for differentiating PDH from CPAT in dogs.

Thoracic Wall Reconstruction with Dorsal Diaphragmatic Traction and Preservation of Diaphragmatic Attachments in a Dog with Resection of the 11-13th Ribs.

A 9-year-old, 4.7 kg, spayed female Chihuahua presented with a 3.5 cm soft tissue sarcoma on the dorsal right thoracic wall. The tumor was resected, including the 11−13th ribs, resulting in a caudal dorsal thoracic wall defect. The defect was reconstructed with direct traction of part of the diaphragm dorsally, preserving the diaphragmatic attachments to the body wall, and the diaphragm was sutured to the surrounding ribs and muscles. Possible respiratory complications, including paradoxical respiration and exercise intolerance, were not observed during the perioperative or postoperative observation periods. This novel procedure is expected to be an option for caudal thoracic wall reconstruction when the diaphragmatic attachments remain intact even after the resection of the last rib. In addition, this procedure can be performed in dogs weighing <5 kg, with small pleural cavities and without respiratory disorders.

Long-term administration of prednisolone: Effects on the myocardial tissue of healthy beagle dogs.

This study aimed to assess the structural and functional effects of long-term hyperglucocorticoidemia on canine myocardium and compare these parameters with histopathological changes. Twelve healthy male beagle dogs were enrolled and assigned to the high-dose prednisolone (P; n=6) and control (C; n=6) groups. The P group was treated with 2 mg/kg of prednisolone BID for 84 days. Clinical parameters were measured using echocardiography and non-invasive systolic blood pressure (SBP) measured before the initiation of synthetic corticosteroids and at 7, 28, 56, and 84 days after the start of medication. For histological evaluation, cardiovascular tissue was harvested from dogs in groups P (at the end of the medication period) and C (scheduled to be euthanized for unrelated reasons). In the P group, clinical changes including thickening of the left ventricular free wall (LVFW) and interventricular septum (IVS), decreased left ventricular (LV) diastolic function, and increased SBP were observed after the start of medication. During histological evaluation, fibrosis was observed in the LVFW and IVS in the P group. Furthermore, decreased glucocorticoid receptor (GCR) levels were observed in the LVFW, right ventricular free wall (RVFW), and IVS and increased mineralocorticoid receptor (MCR) levels were observed in the LVFW and RVFW in the P group compared with those in the C group. In conclusion, fibrosis may cause LV structural and functional abnormalities in dogs with hyperadrenocorticism. Furthermore, GCR downregulation and upregulated MCR might influence the myocardial fibrosis.

Surgical treatment of rostrotentorial meningioma complicated by foraminal herniation in the cat.

OBJECTIVES: This study was performed to evaluate retrospectively the clinical signs, complications and postoperative outcomes of feline intracranial meningioma (IM) with concurrent cingulate, transtentorial and foramen magnum herniations. METHODS: The medical records and MRI scans of cats with IM and cerebral herniation were reviewed. Cases involving concurrent cingulate, transtentorial and foramen magnum herniations were included. Owners were contacted to obtain long-term follow-up information. RESULTS: Seven cats (four castrated males and three spayed females) met the inclusion criteria. Median age was 13.0 years (range 9.9-16.1 years) and median duration of clinical signs was 35 days (range 21-163 days). The clinical signs of cats with cerebral herniation included visual impairment (n = 5 [71.4%]), ataxia (n = 4 [57.1%]), impaired consciousness (n = 2 [28.6%]), head pressing (n = 2 [28.6%]), paresis (n = 1 [14.3%]), torticollis (n = 1 [14.3%]) and personality changes (n = 1 [14.3%]). Median tumour volume, cranial cavity volume and tumour volume:intracranial volume ratio before surgery were 3.37 cm3 (range 3.23-11.5 cm3), 32.6 cm3 (range 29.8-78.3 cm3) and 10.4% (range 5.3-35.3%), respectively. Median overall tumour excision rate was 90.6%. Preoperative intracranial pressure (ICP) ranged from 15 to 32 mmHg (median 29 mmHg). In all cases, the ICP dropped to 0 mmHg immediately after tumour removal. No adjuvant therapy was required after surgery. The median survival period was 612 days (range 55-1453 days). CONCLUSIONS AND RELEVANCE: The results of this study indicate that surgical treatment of rostrotentorial IM is effective and allows prolonged survival, even in cats with concurrent cingulate, transtentorial and foramen magnum herniations.

Epidemiological and morphological characteristics of incomplete ossification of the dorsal neural arch of the atlas in dogs with atlantoaxial instability.

OBJECTIVE To retrospectively evaluate the epidemiological and morphological features and outcome of surgical treatment of incomplete ossification of the dorsal neural arch of the atlas (IODA) in dogs with atlantoaxial instability (AAI). ANIMALS 106 AAI-affected dogs that underwent ventral fixation of the atlantoaxial joint. PROCEDURES Medical records and CT images for each dog were reviewed. Dogs were allocated to 1 of 2 groups on the basis of the presence or absence of IODA or of dens abnormalities (DAs) in CT images. RESULTS Of the 106 dogs with AAI, 75 had and 31 did not have IODA; 70 had and 36 did not have DAs. Incomplete ossification was present in the cranialmost, central, or caudalmost portion of the dorsal neural arch of the atlas in 59, 39, and 28 dogs, respectively; 2 or 3 portions were affected in 29 and 11 dogs, respectively. The mean CT value (in Hounsfield units) for the midline of the dorsal neural arch of the atlas in dogs with IODA was significantly lower than that for the same site in the dogs without IODA. The mean age at surgery for dogs with central IODA was significantly higher than that of the non-IODA group. The severity of spinal cord injury before or after atlantoaxial ventral fixation did not differ between the IODA and non-IODA groups. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that concomitant DAs or IODA is common in dogs with AAI. In dogs with incomplete ossification in the central part of the dorsal neural arch of the atlas, surgical treatment of AAI generally occurs at a middle to advanced age.

Protein expression of somatostatin receptor 2, somatostatin receptor 5 and dopamine D2 receptor in normal pituitary gland and ACTH-secreting pituitary adenoma in dogs.

PURPOSE: To evaluate the protein expression of somatostatin receptor (SSTR) 2, SSTR5 and dopamine D2 receptor (DA2R)-targets of somatostatin analogs and dopamine agonists-in normal canine pituitary and canine adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas. METHODS: Six normal canine pituitary glands and 14 canine ACTH-secreting pituitary adenoma cases were included in this study. The protein expression of SSTR2, SSTR5 and DA2R was determined by double-label immunofluorescence staining of these receptors and ACTH. RESULTS: SSTR2, SSTR5, and DA2R proteins were expressed in the anterior and intermediate lobes of normal canine pituitary glands. In the anterior pituitary lobes, the percentages of SSTR2-, SSTR5-, and DA2R-positive cells among the ACTH-positive population were 27.0 ±â€¯8.6%, 27.9 ±â€¯5.9%, and 34.0 ±â€¯9.4%, respectively. In contrast, the corresponding percentages in the intermediate pituitary lobes were 97.8 ±â€¯1.5%, 94.1 ±â€¯4.4%, and 96.1 ±â€¯6.6%, respectively. Of the 14 ACTH-secreting pituitary adenoma cases, 11, 12, and 6 cases expressed SSTR2, SSTR5, and DA2R, respectively. Additionally, four cases showed strong positive staining for both SSTR2 and SSTR5. Two of these were ACTH-secreting pituitary adenomas likely derived from the intermediate pituitary lobe, because these are α-Melanocyte-stimulation hormone (α-MSH)-positive stains. CONCLUSION: Immunohistological detection and characterization of SSTR2, SSTR5 and DA2R may provide useful additional information for determining treatment options when an ACTH-secreting pituitary adenoma cannot be completely resected, or in the case of recurrence.

Atlantooccipital overlapping and its effect on outcomes after ventral fixation in dogs with atlantoaxial instability.

We compared clinical outcomes after ventral fixation in dogs with atlantoaxial instability (AAI) on the basis of the presence or absence of atlantooccipital overlapping (AOO). Of 41 dogs diagnosed with AAI and treated ventral fixation, 12 exhibited AOO (AOO group), whereas 29 did not (non-AOO group). The AOO group had significantly higher neurological scores before (P=0.024) and 1 month after (P=0.033) surgery compared with the non-AOO group; however, no significant differences were observed between the groups 2 months after surgery. The presence of complicating AOO affected the clinical signs for dogs with AAI, but did not directly affect the outcome of surgical stabilization of AAI.

Effect of rCaIFN-γ pretreatment on propofol-isoflurane suppression of NK cytotoxic activity in the peripheral blood of dogs.

In dogs, natural killer (NK) cell cytotoxic activity, which is an index of antitumor immunity, decreases after general anesthesia. In this study, we examined whether the decrease in NK cytotoxic activity can be controlled with interferon-gamma (IFN-γ) treatment. Beagles were divided into 2 groups: a treated group (n = 6) that received recombinant canine IFN-γ (rCaIFN-γ) and an untreated control group (n = 6). Blood samples were taken before and at 24, 120, and 192 hours after anesthesia. NK cytotoxic activity toward canine thyroid cancer cells was measured in isolated lymphocytes with the Rose Bengal assay. The decrease in NK cytotoxic activity after anesthesia was significantly inhibited by administration of rCaIFN-γ before propofol-isoflurane anesthesia. Further studies are necessary to evaluate the clinical implications of rCaIFN-γ treatment in tumor recurrence and morbidity.

Conception outcomes and opinions about pregnancy for men with inflammatory bowel disease.

BACKGROUND AND AIMS: Patients with inflammatory bowel disease (IBD) who want to have children are anxious to receive medical treatment. The consensus regarding pregnancy has not been surveyed for male IBD patients. The present study was investigated opinions among male IBD patients about pregnancy, conception and neonatal outcomes for partners. METHODS: Subjects comprised 364 of 386 patients enrolled (94.3%). Subjects received a questionnaire regarding their opinions and thoughts about pregnancy. The course of partner's conceptions and presence of neonatal malformations was also surveyed. RESULTS: The rate of live births for partners of male IBD patients was 91.6% (219/239). Most patients with CD (29/33; 88%) had their children after surgery had been performed. The rate of expressing hopes to have a child tended to be higher for patients with UC (93/128; 73%) than for patients with CD (61/97; 63%; p=0.21). Furthermore, the rate of hesitation was significantly higher in CD patients (34/107; 32%) than in UC patients (38/188; 20%; p=0.03).Patients considered that safety of medication (51%) and maintenance of remission (41%) was more important than receiving no treatment for IBD (19%) when planning to conceive. Mesalamine and infliximab were more favorable at conception than sulfasalazine and immunomodulators. CONCLUSIONS: This is the first report to survey the thinking of male IBD patients regarding pregnancy. Most male IBD patients considered "maintaining remission" as important at conception. Our study provides important information for IBD patients and for the treating physician when planning to conceive.