Veterinary Clinical Digest Summary

Kaplan, JL, Visser, LC, Gunther-Harrington, CT, et al. Effect of standard-dose and high-dose pimobendan on select indices of renal and cardiac function in dogs with American College of Veterinary Internal Medicine stage B2 myxomatous mitral valve disease. J Vet Intern Med. 2022; 36( 6): 1892- 1899.

Pimobendan is commonly recommended as a treatment for heart failure and certain cases of heart disease prior to the onset of heart failure in dogs. It is possible that pimobendan also has a beneficial effect on renal function, but this has not been investigated in dogs with mitral valve disease. This study aimed to determine the effect of standard or high dose pimobendan on glomerular filtration rate (GFR) and cardiac size and function in dogs with preclinical mitral valve disease. Thirty non-azotaemic dogs with stage B2 myxomatous mitral valve disease were included in this prospective, randomised, double-blinded, placebo-controlled study. Each dog had echocardiography performed as well as pro-BNP, quality of life scores and GFR measurement by iohexol clearance, at baseline and 7 to 10 days later. No difference was found in GFR or quality of life scores between the groups. Pro-BNP and echocardiographic indices were significantly different from placebo in the high dose and standard dose groups, but not between the groups.

This study suggests that pimobendan does not affect renal function in non-azotaemic dogs with mitral valve disease, and there was no benefit to a higher dose of pimobendan.

Veterinary Clinical Digest Summary

Kurtz, M, Desquilbet, L, Maire, J, et al. Alendronate treatment in cats with persistent ionized hypercalcemia: A retrospective cohort study of 20 cases. J Vet Intern Med. 2022; 36( 6): 1921- 1930.

Persistent ionised hypercalcaemia for which no cause can be found is occasionally encountered in cats. There is little information about treatment of this condition. This retrospective study aimed to investigate the efficacy and long-term tolerance of treatment with alendronate in these cases. Twenty cats with persistent ionised hypercalcaemia of undetermined origin were included in the study. Cats were divided into two groups, one group of 11 cats that received alendronate and one group of 9 cats that did not receive alendronate. 75% of cases had azotaemia. Aldendronate was well-tolerated over a median follow up time of 9.5 months except in one case that developed severe hypophosphataemia. Alendronate treatment was significantly associated with a shorter time to reach a 15% decrease in ionised calcium concentration, but this effect disappeared after adjustment for age and initial ionised calcium levels.

The authors conclude that alendronate is well-tolerated and can be used in the treatment of persistent ionised hypercalcaemia in cats.

Veterinary Clinical Digest Summary

Schwartz, SM, Urfer, SR, White, M, et al. Lifetime prevalence of malignant and benign tumours in companion dogs: Cross-sectional analysis of Dog Aging Project baseline survey. Vet Comp Oncol. 2022; 20( 4): 797- 804.

Cancer is commonly encountered in dogs, but data on its overall frequency is sparse. The Dog Aging Project provides data on the prevalence of cancer, and this cross-sectional study used data from the Dog Aging Project baseline survey. Data from the owners of 27541 dogs were used to estimate the prevalence of benign and malignant tumours. Owners reported 817 malignant tumours, with 56% being situated in the skin or other soft tissue site. 404 benign tumours were reported, with 69% in skin or other soft tissue. The lifetime prevalence of malignant tumours was roughly double that of benign tumours (29.7/1000 v 14.7/1000). The prevalence increased with the age of the dog at the time of the survey completion. There was no obvious difference in lifetime prevalence of tumours in mixed versus purebred dogs. However, there was an increased lifetime prevalence of tumours with increasing size class – larger dogs had between 1.65 and 3.67 times the prevalence of malignant tumours compared to toy and small breed dogs. Ongoing studies should provide more data on risk factors for cancer.

This study gives estimates for lifetime prevalence of cancer in dogs, and suggests that the risk is higher in larger dogs.

Veterinary Clinical Digest Summary

Sotelo, C. K., Shropshire, S. B., Quimby, J., Simpson, S., Gustafson, D. L., & Zersen, K. M. (2022). Pharmacokinetics and anti-nausea effects of intravenous ondansetron in hospitalized dogs exhibiting clinical signs of nausea. Journal of Veterinary Pharmacology and Therapeutics, 45, 508– 515.

Nausea and vomiting in hospitalised dogs is a serious problem for clinicians, both because of poor welfare and because of their effect on food intake. Ondansetron is a powerful anti-emetic, and this study aimed to assess the pharmacokinetics of the drug when administered intravenously. 24 dogs with a variety of causes of nausea including gastroenteritis, pancreatitis, acute kidney injury and pyometra were included in the study. They were randomly assigned to receive different doses of ondansetron and blood samples were collected and nausea levels scored at various times up to 24 hours after the first dose. Ondansetron levels were measured, and the drug demonstrated linear pharmacokinetics. Serum ondansetron levels were not significantly different between dogs that did and did not require rescue therapy. Nausea scores significantly reduced regardless of dosage protocol, but some doses led to a higher rate of complete resolution of nausea.

Ondansetron can be used intravenously in the treatment of nausea in dogs.

Veterinary Clinical Digest Summary

Pierini, A, Criscuolo, MC, Bonfanti, U, Benvenuti, E, Marchetti, V, Bottero, E. Usefulness of squash preparation cytology in the diagnosis of canine urinary bladder carcinomas. Vet Clin Pathol. 2022; 51: 498- 506.

Definitive diagnosis of cancer usually requires histopathology. Epithelial cells show varying degrees of cytological atypia in malignant and non-malignant bladder tumours but cytology may still be a useful aid. This study aimed to assess the diagnostic accuracy of squash cytology preparations in urinary bladder carcinomas. Squash preparations from dogs that had undergone transurethral cystoscopy were assessed by two blinded cytopathologists for 11 cytological features such as multinucleation, cytoplasmic vacuolation and atypical mitoses. The associations between cytological and histological findings, and the agreement between the cytologists was assessed. 44 dogs with urinary bladder carcinomas and 17 with non-malignant lesions were included in the study. The agreement between the cytologists was excellent. Factors associated with urinary bladder carcinoma were presence of multinucleated cells and nuclear moulding, and absence of neutrophilic inflammation. Using these factors gave a positive predictive value of 0.88 and negative predictive value of 0.92.

The authors conclude that squash preparation cytology could be a useful aid in the diagnosis of urinary bladder carcinoma in dogs.

Veterinary Clinical Digest Summary

Crowe, YC, Groth, AD, Billson, FM, et al. Gabapentin reduces stress and does not affect ocular parameters in clinically normal cats. Vet Ophthalmol. 2022; 25: 493- 498.

Veterinary examination is often a stressful experience for cats, which has both welfare implications and causes problems for veterinary ophthalmologists who need to carry out detailed examinations in conscious animals. Gabapentin has been recommended to reduce anxiety in cats. This masked, placebo-controlled, randomised crossover trial involved ten young, healthy cats which were scheduled to visit the vets twice, a week apart. They were randomised to receive gabapentin or placebo at their first visit and the opposite intervention at their second visit. Respiratory rate, heart rate, stress score, sedation score, compliance score and ophthalmic measurements such as pupil diameter, intraocular pressure and Schirmer tear test were assessed before and at various intervals after the intervention. The respiratory rate was found to be significantly reduced at 1.5 and 3 hours after gabapentin administration and the stress score at 1.5 hours after administration. The sedation score was increased at 1.5 and 3 hours after administration. There was no significant effect on heart rate or ophthalmic measurements.

The authors conclude that gabapentin reduces stress and increases sedation in cats with no effect on pupil diameter, intraocular pressure or Schirmer tear test.

Veterinary Clinical Digest Summary

Fontes, G, McCarthy, R, Kutzler, M, Zitek-Morrison, E. The effects of sex and neuter status on trauma survival in dogs: a Veterinary Committee on Trauma registry study. J Vet Emerg Crit Care. 2022; 32: 756– 763

Trauma cases often present as veterinary emergencies in critical condition. This prospective case series, which was retrospectively analysed, comprised a consecutive sample of 2649 dogs from the American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma patient registry. Inclusion criteria included having complete data entries, being over 7 months of age for females and 10 months for males, and having sustained moderate to severe trauma. Dogs that were dead on arrival, or euthanased for financial or unknown reasons were excluded. 56% of dogs survived to hospital discharge. Neutered females were found to have a significantly higher survival rate than intact females (58.3% compared to 51.3%), and neutered males had a significantly higher survival rate than intact males (56.6% compared to 50.7%). There was no significant difference in survival between intact females and males or between neutered females and males The trauma score was higher in intact groups and was associated with survival.

Neutering is associated with lower trauma scores and improved survival after moderate to severe trauma in dogs of both sexes.

Veterinary Clinical Digest Summary

Pfeifer, JM, Levy, NA, Carter, DL, Beal, MW. Gastric or duodenal perforation and secondary septic peritonitis following therapeutic nonsteroidal anti-inflammatory drug administration. J Vet Emerg Crit Care. 2022; 32: 764– 768

Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed chronic medications, especially given their importance in managing chronically painful conditions such as osteoarthritis. However, they are not free of adverse effects. This retrospective cohort study aimed to report the associations between NSAIDs and gastric or duodenal perforation. 30 dogs were included in the study. Four dogs were administered more than one NSAID in the seven days prior to gastric or duodenal perforation, 3 dogs received a NSAID together with a corticosteroid, and one dog received two NSAIDs and a corticosteroid. One dog received an overdose of one NSAID. However, eighteen dogs received only one NSAID, given at the recommended label dose. 44.4% of these received meloxicam, 27.8% received fibrocoxib, 16.7% received deracoxib and 2 cases received piroxicam. In the referring practices, carprofen was the most commonly prescribed NSAID at 70.6%, then meloxicam at 10.6%.

NSAID administration, even at recommended doses, can be associated with gastric or duodenal perforation. However, despite carprofen being commonly prescribed in referring practices, none of the cases referred with gastric or duodenal perforation had received carprofen as a single agent.

Veterinary Clinical Digest Summary

Barton, A.K., Troppenz, A., Klaus, D., Lindenberg, I., Merle, R., & Gehlen, H. (2022) Tongue ties do not widen the upper airways in racehorses. Equine Veterinary Journal. 

Why I chose this paper: given the controversial use and inconclusive evidence for the efficacy of tongue ties, further evidence is warranted to determine the efficacy in racehorses.

There is contradictory evidence on the potential benefits of tongue ties on upper airway function and their efficacy in inhibiting intermittent dorsal displacement of the soft palate (DDSP) in racehorses. The aim of this prospective, crossover blinded clinical study was to test the hypothesis that tongue ties increase the pharyngeal diameter and decrease the occurrence of dynamic airway obstruction in racehorses.

Data from 22 Thoroughbred and 8 Standardbred racehorses examined using overground endoscopy under full-intensity exercise on training racetracks with and without fixation of the tongue by use of tongue ties were analysed. Equivalent exercise intensity was ensured by measuring heart rate (bpm), speed (GPS) and venous lactate. Pharyngeal diameter was expressed as pharyngeal:epiglottis (PE) ratios and laryngeal abduction accordingly as laryngeal:median ratios. Data were analysed using multivariable repeated-measurements ANOVA.

The PE ratio increased significantly from 1.11 ± 0.19 to 1.28 ± 0.30 in all horses between rest and full-intensity exercise (P < 0.01). This effect decreased significantly by the application of tongue ties (1.15 ± 0.27, P < 0.01). Tongue ties did not influence maximum laryngeal width (P = 0.09) and area (P = 0.2) significantly. DDSP was found in 4/30 examinations with tongue tie and in 1/30 examinations without tongue tie.

Bottom Line: There was no positive effect of tongue ties on pharyngeal or laryngeal diameters;  therefore, the results of this study do not support the use of tongue ties to enhance upper airway function.

Veterinary Clinical Digest Summary

Whisenant, K. D., Ruggles, A. J., Stefanovski, D., Woodie, J. B., Hopper, S. A., & Embertson, R. M. (2022). Prognosis for survival to discharge and racing performance in Thoroughbred foals treated for single joint septic arthritis (2009–2016). Equine Veterinary Journal.

Why I chose this study: Haematogenous septic arthritis is a major cause of morbidity and mortality in foals and whilst previous studies have found decreased survival with multiple joint involvement, there are few studies evaluating the prognosis of single joint septic arthritis. 

Haematogenous septic arthritis is a major cause of morbidity and mortality in foals. Previous research has demonstrated a variable prognosis for athletic performance in foals diagnosed with septic arthritis. Most studies have analysed a diverse group of subjects with cases having multiple joint involvement and significant comorbidities and have found decreased survival with multiple joint involvement compared to a single affected joint.

The aim of this retrospective cohort study was to determine the racing prognosis for Thoroughbred foals, 6 months of age or less with single septic joint of presumed haematogenous origin without recognised systemic sepsis or other serious comorbidity compared with a group of maternal sibling controls.

Data were collected from in-patient records from 2009 to 2016. Parameters evaluated included diagnostic tests, therapeutic regimens, final diagnosis, and outcome. Racing records were obtained from a public archive for cases and two maternal siblings. Racing performance data was collected for the number of starts, age at first race, number of wins/places/shows and total winnings per career. Univariable analyses of categorical variables were conducted.

Ninety-five cases were included in this study, of which 93% survived to discharge. The last measured synovial cell count prior to hospital discharge or euthanasia (OR 0.5, p value 0.002, 95% CI: 0.3–0.8) was an indicator of poor prognosis for survival to discharge. In cases nonresponsive to treatment, the last SNCC was measured prior to euthanasia was higher (median 86 800 cells/μL; IQR 30600–113 200 cells/μL) than the final measured SNCC in cases discharged alive from the hospital (median 7200 cells/μL; IQR 800–91 600 cells/μL). Total winnings per career were the only statistically significant racing performance variable between cases and paired controls (IRR 0.7, p value, 0.05, 95% CI: 0.5–0.99).

Bottom Line: The prognosis for survival was high (93%) and the prognosis to race was similar to healthy maternal siblings, but the total earnings were lower.