Emphysematous cystitis and pyelonephritis in a nondiabetic dog and a diabetic cat.

Emphysematous cystitis (EC) and emphysematous pyelonephritis (EPN) are the result of infection of the urinary bladder and kidneys by gas-producing microorganisms. Those infections are most often reported in diabetic patients and rarely occur concurrently. This article describes two cases of concurrent EC and EPN, one in a nondiabetic dog and the other in a diabetic cat. The use of diagnostic imaging is necessary in the diagnosis of emphysematous infections. Both radiography and ultrasonography were used in the diagnosis of EC and EPN in the patients described in this report.

Liver failure in a dog following suspected ingestion of blue-green algae (Microcystis spp.): a case report and review of the toxin.

A 2.5 yr old spayed female Weimaraner presented after ingestion of blue-green algae (Microcystis spp.). One day prior to presentation, the patient was swimming at a local lake known to be contaminated with high levels of blue-green algae that was responsible for deaths of several other dogs the same summer. The patient presented 24 hr after exposure with vomiting, inappetence, weakness, and lethargy. Blood work at the time of admission was consistent with acute hepatic failure, characteristic findings of intoxication by Microcystis spp. Diagnosis was suspected by analyzing a water sample from the location where the patient was swimming. Supportive care including fluids, fresh frozen plasma, whole blood, vitamin K, B complex vitamins, S-adenosyl methionine, and Silybum marianum were started. The patient was discharged on supportive medications, and follow-up blood work showed continued improvement. Ingestion is typically fatal for most patients. This is the first canine to be reported in the literature to survive treatment after known exposure.

Endoscopic-guided sclerotherapy for renal-sparing treatment of idiopathic renal hematuria in dogs: 6 cases (2010-2012).

OBJECTIVE: To describe the use of sclerotherapy for the renal-sparing treatment of idiopathic renal hematuria (IRH) in dogs and report clinical outcomes. DESIGN: Retrospective case series. ANIMALS: 6 dogs (8 renal pelvises) with IRH. PROCEDURES: Medical records of dogs that underwent sclerotherapy were reviewed. Each ureterovesicular junction was identified cystoscopically to determine the side of bleeding, and a retrograde ureteropyelogram was performed with endoscopic and fluoroscopic guidance. A ureteropelvic junction balloon was used for ureteral occlusion, and pelvis filling volumes were recorded. A povidone iodine mixture, followed by a sterile silver nitrate solution, was infused into the renal pelvis. A double-pigtail ureteral stent was placed after the procedure. Information on preprocedure and postprocedure biochemical changes, imaging parameters, and clinical outcomes was obtained. RESULTS: 6 dogs (5 males and 1 female) had sclerotherapy for unilateral (4) or bilateral (2) bleeding. Five were right-sided and 3 were left-sided. The median age and weight of dogs were 3 years and 42.4 kg (93.28 lb), respectively. Median procedure time was 150 minutes. One dog that did not have a ureteral stent placed following the procedure developed short-term signs of renal pain and pyelectasis. Cessation of macroscopic hematuria occurred in 4 of 6 dogs (median, 6 hours). Two additional dogs improved moderately. Median follow-up time was 8 months (range, 3.5 to 20.5 months). CONCLUSIONS AND CLINICAL RELEVANCE: Topical sclerotherapy for IRH was safe and effective. Local sclerotherapy for IRH in dogs could be considered a valuable and minimally invasive renal-sparing treatment over ureteronephrectomy.

UTIs in small animal patients: part 2: diagnosis, treatment, and complications.

There are multiple considerations when making a treatment plan for patients with urinary tract infections (UTIs). In part 2 of this review the authors discuss the clinical signs, diagnosis, treatment, and complications associated with bacterial UTIs in dogs and cats. Part 1 of this review summarized etiology and pathogenesis (see the Jan/Feb 2013 issue of the Journal of the American Animal Hospital Association).

UTIs in small animal patients: part 1: etiology and pathogenesis.

Understanding how urinary tract infections (UTIs) can occur and how to classify them can help the practitioner to make a plan for treatment. This review summarizes the etiology, pathogenesis, and host defense mechanisms associated with bacterial UTIs in dogs and cats. UTIs in Small Animal Patients: Part 2: Diagnosis, Treatment, and Complications will appear in the March/April 2013 issue of the Journal of the American Animal Hospital Association.

Pharmacokinetics of oral pimobendan in healthy cats.

OBJECTIVE: To describe the pharmacokinetics of oral pimobendan in healthy cats. ANIMALS: 18 purpose-bred cats. METHODS: In 10 cats, blood samples were collected before, and at multiple time points after, a single oral dose of pimobendan (0.28 ± 0.04 mg/kg). In 8 cats, blood samples were collected at 3 various time points on the first and third days of twice daily oral dosing of pimobendan for a total of 7 doses (0.31 ± 0.04 mg/kg). Plasma concentrations of pimobendan were quantified by high pressure liquid chromatography coupled to tandem mass spectrometry. RESULTS: A 1-compartment open model with first order absorption in and elimination from the central compartment with a lag time best describes the disposition of pimobendan. Two cats were removed from final pharmacokinetic descriptive analysis due to delayed minimal absorption from gastrointestinal adverse effects. After a lag time (0.3 ± 0.06 h), pimobendan was rapidly absorbed (absorption half-life = 0.2 ± 0.08 h) and eliminated (elimination half-life = 1.3 ± 0.2 h). Maximum plasma concentrations (34.50 ± 6.59 ng/mL) were high and were predicted 0.9 h after drug administration. Apparent volume of distribution at steady state (per bioavailability) was large (8.2 ± 2.5 L/kg). The multi-dose study showed the pharmacokinetic model to be robust. CONCLUSION: When administered a similar dose on a per weight basis, pimobendan has a substantially longer elimination half-life and maximal drug plasma concentration in cats as compared to those previously reported in dogs.

Severe anemia caused by babesiosis in a maned wolf (Chrysocyon brachyurus).

An 8-yr-old, captive, spayed, female maned wolf (Chrysocyon brachyurus) developed progressive lethargy and weakness over a 24-hr period. Clinical signs included vomiting, recumbency, horizontal nystagmus, possible blindness, pale icteric mucus membranes, and port-wine colored urine. A complete blood cell count revealed severe anemia (packed cell volume [PCV], 6%) and intraerythrocytic piroplasms consistent with a Babesia species. Polymerase chain reaction testing later confirmed babesiosis. The wolf was treated with imidocarb dipropionate, antibiotics, and fluid therapy. A whole-blood transfusion from a sibling maned wolf also was performed. Despite aggressive treatment, the wolf failed to improve and was euthanized. To the authors' knowledge, this is the first documented case of babesiosis in a captive maned wolf in North America. Surveillance of infectious diseases in captive and wild maned wolf populations should be expanded to include screening for Babesia species. Tick control also should be implemented to prevent and decrease transmission of the disease to this endangered species.

Refeeding syndrome in a cat with hepatic lipidosis.

Refeeding syndrome is characterized by severe hypophosphatemia occurring in patients given enteral or parenteral nutrition after severe weight loss. There are few veterinary reports that describe this syndrome but it is well documented in human medicine. This report describes a case of a domestic shorthair cat diagnosed with hepatic lipidosis following a 4-week history of decreased appetite and weight loss and in whom refeeding syndrome was documented after initiation of enteral nutrition. Clinical findings, blood work abnormalities and disease progression in this patient are described from the time of diagnosis through to recovery. A review of the current literature pertinent to this clinical syndrome is included.

Measurement of serum antinuclear antibody titer in dogs with and without systemic lupus erythematosus: 120 cases (1997-2005).

OBJECTIVE: To determine serum antinuclear antibody (ANA) titers in dogs with systemic lupus erythematosus (SLE) and in dogs with related clinical and clinicopathologic findings. DESIGN: Retrospective case series. ANIMALS: 120 dogs. PROCEDURES: Information that was evaluated included signalment, clinical signs, results of routine laboratory testing, ANA titer, and diagnosis. RESULTS: The most common clinical signs were arthralgia, myalgia, and stiffness (n = 41 [34.2%]); the most common clinicopathologic abnormality was thrombocytopenia (30 [25%]). Serum ANA titer was < 160 (seronegative) in 89 dogs (74.2%), 160 in 14 dogs (11.7%), 320 in 5 dogs (4.2%), and > or = 640 in 12 dogs (10%). Immune-mediated disease was confirmed in 40 dogs, 18 of which fulfilled the criteria for a definitive or probable diagnosis of SLE. Only 1 of 47 dogs with no major signs compatible with SLE had immune-mediated disease, compared with 26 of 57 dogs with 1 major sign and 13 of 16 dogs with > or = 2 major signs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that measurement of ANA titer was not a useful diagnostic test in dogs without any major clinical or clinicopathologic abnormalities suggestive of SLE. In contrast, there was a good chance that results of the ANA assay would be positive and that the dog would be found to have immune-mediated disease if at least 2 major signs were evident. Findings suggest that it would be reasonable to limit the use of the ANA assay to those dogs that have at least 1 major sign compatible with a diagnosis of SLE.