Wednesday, July 31, 2013

Estudo retrospectivo da administração de estreptoquinase em 46 gatos com tromboembolismo aórtico / Retrospective study of streptokinase administrarion in 46 cats with aortic thromboembolism

Retrospective Study of Streptokinase Administration in 46 Cats with Arterial Thromboembolism

  1. Kari E. Moore DVM1
  2. Nancy Morris DVM1,
  3. Nishi Dhupa BVSc, DACVECC, DACVIM1,
  4. Robert J. Murtaugh DVM, MS, DACVECC, DACVIM2
  5. John E. Rush DVM, MS, DACVIM (Cardiology), DACVECC3,*
Article first published online: 1 JUL 2007
DOI: 10.1111/j.1476-4431.2000.tb00010.x
Journal of Veterinary Emergency and Critical Care

Journal of Veterinary Emergency and Critical Care

Volume 10Issue 4pages 245–257December 2000

Keywords:

  • arterial thromboembolism;
  • streptokinase;
  • hyperkalemia;
  • coagulopathy;
  • cardiomyopathy;
  • aortic thromboembolism

Summary

A retrospective evaluation was performed on 46 cats with arterial thromboembolism (ATE) that were treated with streptokinase (SK). Significant heart disease was diagnosed in 45/46 cats, and 21/46 cats had congestive heart failure. Variable dosing schemes of streptokinase were administered within 1–20 hours following the onset of clinical signs (median = 5.5 hours). There was no difference between survivors (S) and non-survivors (NS), based on time of administration of SK after onset of clinical signs. Twenty-five (54%) of the cats had return of pulses within 2–24 hours of treatment. Fourteen (30%) of the cats had return of motor function between 9 hours and 6 days. Fifteen of the cats (33%) were discharged from the hospital, 18 (39%) died in the hospital, and 13 (28%) cats were euthanized due to complications or poor response to treatment. Four of 5 cats (80%) with single limb dysfunction survived to hospital discharge. Life threatening hyperkalemia was diagnosed in 16 cats (35%) after SK administration. Hyperkalemia was more likely to occur with the longer duration of SK infusion. Eleven cats (24%) developed clinical signs of bleeding following SK administration and 3 of these cats required a blood transfusion. Laboratory testing documented coagulopathy following SK administration in 11 out of 17 cats tested. Hypothermia and azotemia prior to SK administration and the development of hyperkalemia were negatively associated with survival.

Tuesday, July 30, 2013

Hipercoagulabilidade em gatos com miocardiopatia / Hypercoagulability in cats with cardiomyopathy

Hypercoagulability in Cats with Cardiomyopathy

  1. T. Stokol1
  2. M. Brooks1
  3. J.E. Rush3
  4. M. Rishniw2
  5. H. Erb1
  6. E. Rozanski3
  7. M.S. Kraus2
  8. A.L. Gelzer2
Article first published online: 10 JUL 2008
DOI: 10.1111/j.1939-1676.2008.0098.x
Journal of Veterinary Internal Medicine

Journal of Veterinary Internal Medicine

Volume 22Issue 3pages 546–552May–June 2008

Keywords:

  • Aortic thromboembolism;
  • d-dimer;
  • Endothelial injury;
  • Hemostasis;
  • Spontaneous echocardiographic contrast;
  • Thrombin-antithrombin complexes
Background: Arterial thromboembolism (ATE) is a common complication of feline cardiomyopathy; however, the pathogenesis of ATE is unknown.
Hypothesis: Systemic activation of the coagulation cascade (hypercoagulability) and endothelial injury promote ATE in cardiomyopathic cats.
Animals: Healthy cats (n = 30) and 3 groups of cardiomyopathic cats: Group (1) left atrial enlargement only (LAE [n = 11]), ie, left atrial to aortic ratio >1.4; Group (2) LAE with spontaneous echocardiographic contrast, atrial thrombi or both (SEC-T [n = 16]); and Group (3) acute ATE with LAE (n = 16).
Methods: Hypercoagulability was defined by 2 or more laboratory abnormalities reflecting coagulation factor excess (high fibrinogen concentration or Factor VIII coagulant activity), inhibitor deficiency (low antithrombin activity), or thrombin generation (high thrombin-antithrombin complex [TAT] and d-dimer concentrations). High von Willebrand factor antigen concentration (vWF : Ag) was considered a marker of endothelial injury. Data were analyzed using nonparametric statistics.
Results: The 3 groups of cats with cardiac disease had higher median fibrinogen concentrations than did the healthy cats. Criteria of hypercoagulability were found exclusively in cats with SEC-T (50%) and ATE (56%). Hypercoagulability was not associated with left atrial size or congestive heart failure (CHF). ATE cats had significantly higher median vWF : Ag concentration than did the other groups.
Conclusinos and Clinical Importance: Systemic hypercoagulability is evident in many cardiomyopathic cats, often without concurrent CHF or overt ATE. Hypercoagulabilty may represent a risk factor for ATE. High vWF : Ag in ATE cats was attributed to downstream endothelial injury from the occlusive thrombus.

Saturday, July 27, 2013

Avaliação da concentração do lactato plasmático e do excesso de base no momento da admissão hospitalar como preditor da necrose gástrica e desfecho em cães com dilatação volvulo gatrica / Evaluation of plasma lactate concentration and base excess at the time of hospital admission as predictors of gastric necrosis and outcome and correlation between those variables in dogs with gastric dilatation-volvulus: 78 cases (2004–2009)

 cover
Abstract
January 1, 2013, Vol. 242, No. 1, Pages 54-58
doi: 10.2460/javma.242.1.54

Evaluation of plasma lactate concentration and base excess at the time of hospital admission as predictors of gastric necrosis and outcome and correlation between those variables in dogs with gastric dilatation-volvulus: 78 cases (2004–2009)

Kari A. Santoro BeerDVMRebecca S. SyringDVM, DACVECCKenneth J. DrobatzDVM, MSCE, DACVECC, DACVIM

Objective—To determine the correlation between plasma lactate concentration and base excess at the time of hospital admission and evaluate each variable as a predictor of gastric necrosis or outcome in dogs with gastric dilatation-volvulus (GDV).
Design—Retrospective case series.
Animals—78 dogs.
Procedures—For each dog, various data, including plasma lactate concentration and base excess at the time of hospital admission, surgical or necropsy findings, and outcome, were collected from medical records.
Results—Gastric necrosis was identified in 12 dogs at the time of surgery and in 4 dogs at necropsy. Sixty-five (83%) dogs survived to hospital discharge, whereas 13 (17%) dogs died or were euthanized. Of the 65 survivors and 8 nonsurvivors that underwent surgery, gastric necrosis was detected in 8 and 4 dogs, respectively. Via receiver operating characteristic curve analysis, an initial plasma lactate concentration cutoff of 7.4 mmol/L was 82% accurate for predicting gastric necrosis (sensitivity, 50%; specificity, 88%) and 88% accurate for predicting outcome (sensitivity, 75%; specificity, 89%). Among all dogs, the correlation between initial plasma lactate concentration and base excess was significant, although base excess was a poor discriminator for predicting gastric necrosis or outcome (area under the receiver operating characteristic curve, 0.571 and 0.565, respectively).
Conclusions and Clinical Relevance—In dogs with GDV, plasma lactate concentration at the time of hospital admission was a good predictor of gastric necrosis and outcome. However, despite the correlation between initial base excess and plasma lactate concentration, base excess should not be used for prediction of gastric necrosis or outcome in those patients.




Friday, July 26, 2013

Prognóstico para cães com hemoperitoneo agudo não traumático; Análise retrospectiva dem 60 casos / Prognosis for Acute Nontraumatic Hemoperitoneum in the Dog: A Retrospective Analysis of 60 Cases

Current Issue

  1. Journal of the American Animal Hospital Associationvol. 45no. 2 72-77

 Prognosis for Acute Nontraumatic Hemoperitoneum in the Dog: A Retrospective Analysis of 60 Cases (2003–2006)


  1. Barbara E. Powers, DVM, PhD, Diplomate ACVP
+Author Affiliations
  1. From the Department of Surgery (Aronsohn, Dubiel) and Animal Emergency and Critical Care Services (Roberts), Veterinary Specialists of South Florida, 9410 Stirling Road, Cooper City, Florida 33024 and Veterinary Diagnostic Laboratory (Powers), College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523.

Abstract

The complete medical records of 60 dogs with hemoabdomen were reviewed. All dogs underwent exploratory laparotomy and had a diagnosis established by a veterinary pathologist. Final diagnoses were hemangiosarcoma in 38 (63.3%) dogs, splenic hematoma in 16 (26.6%) dogs, splenic torsion in three (5%) dogs, hepatocellular carcinoma in two (3.3%) dogs, and carcinomatosis in one (1.6%) dog. Twenty-four (63.1%) dogs with hemangiosarcoma, 14 (87.5%) dogs with splenic hematoma, three (100%) dogs with splenic torsion, and two (100%) dogs with hepatocellular carcinoma were discharged from the hospital. Dogs with hemangiosarcoma were given a poor prognosis, while dogs with splenic hematoma, splenic torsion, and hepatocellular carcinoma were given a fair to good prognosis.

Tuesday, July 23, 2013

Resposta sistêmica a infusão de baixa dose de endotoxina em gatos / Sytemic response to low-dose endotoxin infusion in cats

Research paper

Systemic response to low-dose endotoxin infusion in cats 

  • a Department of Veterinary Medicine and Surgery, University of Missouri, College of Veterinary Medicine, 900 E. Campus Drive, Columbia, MO 65211, United States
  • b Department of Pathobiology and Diagnostic Investigation, G380 Veterinary Medical Center, Michigan State University, East Lansing, MI 48824, United States
  • Abstract

    Sepsis is a common problem in feline patients and is associated with substantial morbidity and mortality. There has been little research investigating the physiologic response to bacterial infection in cats, in part because appropriate models have not been developed. The objective of this study was to characterize the response to low-dose LPS infusion in conscious, healthy cats. Measures of systemic inflammation, hemodynamic stability, coagulation, metabolic function, and organ damage were compared between placebo and low-dose LPS infusion (2 mcg/kg/h × 4 h, IV) in cats, with each cat serving as its own control. Markers of systemic inflammation including temperature, plasma TNF activity, IL-6, CXCL-8 and IL-10 concentrations were significantly increased and white blood cell counts were significantly decreased after LPS infusion. A biphasic hypotensive response was observed after initiation of LPS infusion without concurrent tachycardia. Additionally, LPS administration significantly increased blood glucose, lactate and creatinine concentrations. Patchy alveolar congestion, multifocal acute alveolar epithelial necrosis, and mild pulmonary edema were noted in the lungs along with acute centrilobular hepatocellular necrosis, and mild lymphocyte apoptosis in the spleen and/or intestinal Peyer's patches. No biologically significant alterations in coagulation parameters developed after LPS infusion. Low-dose LPS infusion in cats induced systemic inflammation, hemodynamic derangement, metabolic alterations and mild organ damage. Low-dose endotoxin infusion is a viable pre-clinical model to study naturally developing sepsis in cats.

    Keywords

    • Animal model
    • Cytokine
    • Hypotension
    • Inflammation
    • Sepsis


Monday, July 22, 2013

Alterações da concentração sérica de eletrólitos em cães com hipoadrenocorticismo / Abnormalities of serum electrolyte concentrations in dogs with hypoadrenocorticism

Abnormalities of Serum Electrolyte Concentrations in Dogs with Hypoadrenocorticism

  1. Jennifer A. Adler, 
  2. Kenneth J. Drobatz,
  3. Rebecka S. Hess*
Article first published online: 28 JUN 2008
DOI: 10.1111/j.1939-1676.2007.tb01933.x
Journal of Veterinary Internal Medicine

Journal of Veterinary Internal Medicine

Volume 21Issue 6pages 1168–1173November 2007

Keywords:

  • Ahdidosis;
  • Addison's disease;
  • Glucocorticoid;
  • Mineralocorticoid;
  • Na:K ratio
Background: The sensitivity and specificity of the sodium to potassium ratio (Na:K ratio) as a cutoff for recommendation of an adrenocorticotropic hormone (ACTH) stimulation test in dogs suspected of having hypoadrenocorticism (HA) is unknown. Additionally, abnormalities in plasma ionized calcium (iCa2+) and ionized magnesium (iMg2+) concentrations and venous pH of dogs with HA are incompletely documented.
Objectives: To define the sensitivity and specificity of the Na:K ratio as a diagnostic aid for HA in dogs and to examine for associations between venous pH and the Na:K ratio, iCa2+ concentration, or iMg2+ concentration in dogs with HA.
Animals: Seventy-six dogs with HA and 200 dogs randomly selected from the general hospital population.
Methods: Retrospective study. Dogs were included in the study if results of an ACTH stimulation test confirmed a diagnosis of HA, the dog had a serum sodium concentration below the reference range or a serum potassium concentration above the reference range, and the dog was treated with mineralocorticoids. Receiver operating curve analysis was used to determine optimal cutoffs of sensitivity and specificity for the Na:K ratio in diagnosing HA.
Results: Use of Na:K ratios of 27 or 28 classified 95% of dogs correctly as diseased or not diseased. The sensitivity of a Na:K ratio of 28 was 93% (CI, 85–98%) and that of 27 was 89% (CI, 80–95%). The specificity of a Na:K ratio of 28 was 96% (CI, 92 98%) and that of 27 was 97% (CI, 93–99%). The sensitivity and specificity of a Na:K ratio of 24 were 79% (95% CI, 67–86%) and 100% (98% CI, 97%–100%), respectively.
Conclusions and Clinical Importance: Na:K ratios of 27 or 28 identify the highest percentage of dogs with suspected mineralocorticoid and glucocorticoid deficiency correctly. In dogs with a Na:K ratio of 24 or less, the likelihood of confirming a diagnosis of HA with an ACTH stimulation test is high.

Concentração sérica de insulina em cães apresentando hipoadrenocorticismo / Insulin concentration in dogs with hypoadrenocorticism


Insulin concentrations in dogs with hypoadrenocorticism

  • a Royal (Dick) School of Veterinary Studies, The Roslin Institute, Division of Clinical Sciences, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, UK
  • b Division of Small Animal Clinical Sciences, School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, 464 Bearsden Road, Glasgow G61 1QH, UK
  • c Cambridge Specialist Laboratory Services Ltd., P.O. Box 967, Stapleford, Cambridge CB2 5XY, UK

    Abstract

    Hypoglycaemia is frequently identified in canine cases of hypoadrenocorticism. Potassium and glucose cellular uptake are intimately linked by insulin. We hypothesized that in canine hypoadrenocorticism, hyperkalaemia would stimulate insulin release as a protective mechanism, translocating potassium from the extracellular compartment to the intracellular compartment and also lower glucose concentrations. Serum insulin concentrations were measured in 11 consecutive cases of canine hypoadrenocorticism which were hyperkalaemic and 33 dogs with non-adrenal illness. There was no significant difference between insulin concentrations in the two populations, and no correlation between insulin and potassium concentration in the hypoadrenal group. Thus, no support for the hypothesis was found, although multiple other factors such as pH and osmolality may be obscuring an effect.

    Keywords

    • Canine
    • Insulin
    • Potassium
    • Hyperkalaemia
    • Hypoadrenocorticism
  • Signalment
    Glucose/mmol/L
    Potassium/mmol/L
    Insulin/μIU/mL (ref. range 4.4-17.6)
    English springer spaniel, 5years 5month, IM[low *]
    3.8
    6.3a
    3.8b
    Labrador 5years 3month, NF[low *]
    5.4
    6.8a
    2.6b
    Labradoodle 1years 1month IM[low *]
    4.0
    7.7a
    7.1
    Collie-cross, 1years 8month, NF[dagger]
    4.8
    6.85a
    33a
    St. Bernard, 1years 9month, IM[low *]
    5.1a
    6.4a
    8.5
    Chihuahua, 7years 2month, NF[low *]
    4.9
    8.8a
    <2.0b
    Standard poodle, 2years, IF[dagger]
    7.4a
    6.24a
    2.9b
    Cocker spaniel, 7years, NF[dagger]
    4.67
    10a
    27a
    German short-haired pointer, 6years, NM[dagger]
    2.9b
    8a
    <2.0b
    Border collie, 6years, NM[low *]
    4.7
    7.8a
    8.6
    English springer spaniel, 2years 6month, IF[low *]
    4.9
    6.9a
    3.5b
    (b) Below reference range.