Friday, May 31, 2013

Escore APPLE felinos: Um sistema para estratificação de gravidade de doenças para felinos hospitalizados / The Feline Acute Patient Physiologic and Laboratory Evaluation (Feline APPLE) Score: A Severity of Illness Stratification System for Hospitalized Cats

The Feline Acute Patient Physiologic and Laboratory Evaluation (Feline APPLE) Score: A Severity of Illness Stratification System for Hospitalized Cats

  1. G. Hayes1
  2. K. Mathews1
  3. G. Doig3
  4. S. Kruth1
  5. S. Boston1
  6. S. Nykamp1
  7. Z. Poljak2
  8. C. Dewey2
Article first published online: 8 DEC 2010
DOI: 10.1111/j.1939-1676.2010.0648.x
Journal of Veterinary Internal Medicine

Journal of Veterinary Internal Medicine

Volume 25Issue 1pages 26–38January/February 2011

Keywords:

  • Cats;
  • health outcome assessment;
  • Illness severity score;
  • Intensive care unit
Background: Scores allowing objective stratification of illness severity are available for dogs and horses, but not cats. Validated illness severity scores facilitate the risk-adjusted analysis of results in clinical research, and also have applications in triage and therapeutic protocols.
Objective: To develop and validate an accurate, user-friendly score to stratify illness severity in hospitalized cats.
Animals: Six hundred cats admitted consecutively to a teaching hospital intensive care unit.
Methods: This observational cohort study enrolled all cats admitted over a 32-month period. Data on interventional, physiological, and biochemical variables were collected over 24 hours after admission. Patient mortality outcome at hospital discharge was recorded. After random division, 450 cats were used for logistic regression model construction, and data from 150 cats for validation.
Results: Patient mortality was 25.8%. Five- and 8-variable scores were developed. The 8-variable score contained mentation score, temperature, mean arterial pressure (MAP), lactate, PCV, urea, chloride, and body cavity fluid score. Area under the receiver operator characteristic curve (AUROC) on the construction cohort was 0.91 (95% CI, 0.87–0.94), and 0.88 (95% CI, 0.84–0.96) on the validation cohort. The 5-variable score contained mentation score, temperature, MAP, lactate, and PCV. AUROC on the construction cohort was 0.83 (95% CI, 0.79–0.86), and 0.76 (95% CI, 0.72–0.84) on the validation cohort.
Conclusions and Clinical Importance: Two scores are presented enabling allocation of an accurate and user-friendly illness severity measure to hospitalized cats. Scores are calculated from data obtained over the 1st 24 hours after admission, and are diagnosis-independent. The 8-variable score predicts outcome significantly better than does the 5-variable score.



Thursday, May 30, 2013

Falta de associação entre os achados ultrassonográficos e o diagnóstico histopatológico das lesões do parênquima hepático de cães / Lack of associations between ultrasonographic appearance of parenchymal lesions of the canine liver and histological diagnosis

Lack of associations between ultrasonographic appearance of parenchymal lesions of the canine liver and histological diagnosis

  1. C. M. R. Warren-Smith1
  2. S. Andrew2
  3. P. Mantis1
  4. C. R. Lamb1
Article first published online: 5 MAR 2012
DOI: 10.1111/j.1748-5827.2011.01184.x
Journal of Small Animal Practice

Journal of Small Animal Practice

Volume 53Issue 3pages 168–173March 2012


Objective: To assess if there are any ultrasonographic features that may enable tentative diagnosis of hepatic parenchymal disease.
Methods: Records of 371 dogs that had abdominal ultrasonography and abnormal liver on biopsy or necropsy were reviewed.
Results: Histological diagnoses were hepatitis (n=77), nodular hyperplasia (n=47), vacuolar change (n=45), fibrosis (n=32), primary hepatic carcinoma (n=30), lymphoma (n=28), metastatic neoplasia (n=27), necrosis (n=21), lipidosis (n=17), haemangiosarcoma (n=13), round cell tumour (n=9), hepatocellular adenoma (n=8), degenerative change (n=6), steroid hepatopathy (n=7) and extramedullary haematopoiesis (n=4). The most prevalent ultrasonographic features were multifocal lesions (63% livers with haemangiosarcoma and 43% livers with hepatocellular carcinoma), diffuse lesions (71% livers with steroid hepatopathy, 44% livers with fibrosis and 40% livers with vacuolar hepatopathy), hyperechoic lesions (71% livers with steroid hepatopathy, 41% livers with lipidosis and 38% livers with fibrosis), heterogeneous lesions (62% livers with haemangiosarcoma), hepatomegaly (43% livers with steroid hepatopathy) and peritoneal fluid (62% livers with haemangiosarcoma). Target lesions were associated with malignancy in 67% instances. Marked variability in ultrasonographic appearance of lesions was observed for all diagnoses, and no statistically significant associations between ultrasonographic appearance and diagnosis were found.
Clinical Significance: Histological examination remains essential for diagnosis of canine hepatic disease.

Table 1.  Summary of hepatic diagnoses in 371 dogs
Histological diagnosisn (%)Sensitivity* (%)
  1. *Proportion of affected dogs in which the liver appeared abnormal ultrasonographically
Hepatitis77 (21)37/77 (48)
Nodular hyperplasia47 (13)33/47 (70)
Vacuolar hepatopathy45 (12)30/45 (67)
Fibrosis32 (9)22/32 (69)
Hepatocellular carcinoma30 (8)24/30 (80)
Lymphoma28 (8)19/28 (68)
Metastasis27 (7)15/27 (56)
Necrosis21 (6)13/21 (62)
Lipidosis17 (5)13/17 (76)
Haemangiosarcoma13 (4)11/13 (85)
Round cell neoplasia9 (2)4/9 (44)
Hepatocellular adenoma8 (2)6/8 (75)
Steroid hepatopathy7 (2)6/7 (86)
Degeneration6 (2)4/6 (67)
Extramedullary haematopoiesis4 (1)3/4 (75)

Complicações e desfechos associados ao uso da cistotomia por tubo em cães e gatos: 76 casos / Outcome of and complications associated with tube cystostomy in dogs and cats: 76 cases

 cover
Abstract
April 15, 2007, Vol. 230, No. 8, Pages 1184-1189
doi: 10.2460/javma.230.8.1184

Outcome of and complications associated with tube cystostomy in dogs and cats: 76 cases (1995–2006)

Alison L. BeckBVScJames M. GriersonBVetMedDaniel M. OgdenBVScMichael H. HamiltonBVM&SVictoria J. LipscombMA, VetMB
Department of Veterinary Clinical Sciences, Royal Veterinary College, North Mymms, Herts AL9 7TA, England. (Beck, Grierson, Ogden, Lipscomb); Queen's Veterinary School Hospital, Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, England. (Hamilton)
Objective
To determine indications for cystostomy tube use in dogs and cats, complications associated with their use, and outcome of dogs and cats in which cystostomy tubes had been inserted.

Design
Retrospective case series.

Animals
37 dogs and 39 cats.

Procedures
Information was obtained from medical records.Long-term follow-up information was obtained by use of a client questionnaire.

Results
Indications for cystostomy tube placement were bladder dysfunction, urinary tract rupture, obstructive urinary tract neoplasia, urinary diversion following urogenital surgery, obstructive urolithiasis, and feline lower urinary tract disease.Median time tubes were in place was 11 days, but duration of tube use was significantly longer for animals with blad-der dysfunction than for animals with urinary tract trauma, urinary diversion, or urinary tract obstruction.Thirty-seven (49%) animals had tube complications.Development of complica tions was not significantly associated with species, age, body weight, duration of tube use, or tube type, except that animals were significantly more likely to develop complications following long-rather than short-term use.In 42 animals, the underlying condition resolved and the tube was removed; 22 animals died or were euthanatized with the tube in place.

Conclusions and Clinical Relevance
Results suggested that cystostomy tubes may be used for animals with various conditions related to problems with urine outflow.Nearly half the animals in the study developed complications related to the cystostomy tube, suggesting that potential complications should be discussed with owners prior to tube placement. However, most complications were easily resolved.

Monday, May 27, 2013

Taquiarritmias ventriculares em 106 gatos: Doenças associadas a anormalidades estruturais. / Ventricular Tachyarrhythmias in 106 Cats: Associated Structural Cardiac Disorders

Ventricular Tachyarrhythmias in 106 Cats: Associated Structural Cardiac Disorders

  1. E. Côté1,2
  2. R. Jaeger1,3
Article first published online: 8 OCT 2008
DOI: 10.1111/j.1939-1676.2008.0207.x
Journal of Veterinary Internal Medicine

Journal of Veterinary Internal Medicine

Volume 22Issue 6pages 1444–1446November–December 2008

Keywords:

  • Arrhythmia;
  • Cardiomyopathy;
  • Cardiovascular;
  • Feline;
  • Premature
Background: Ventricular tachyarrhythmias occur in association with cardiac and extracardiac disorders in many species of animals, but information identifying concurrent disorders in cats with such arrhythmias is scarce.
Methods: We investigated coexisting diseases by retrospectively evaluating medical records of cats with ventricular tachyarrhythmias seen during a 51-month period at 1 institution. For comparative purposes, we evaluated records of dogs with similar arrhythmias during the same time period. All cats and dogs had premature ventricular complexes, accelerated idioventricular rhythm, ventricular tachycardia, or some combination of these arrhythmias, and all had undergone echocardiography during the same visit that led to the diagnosis of ventricular tachyarrhythmia.
Results and Conclusions: Most (102/106; 96%) cats had at least 1 echocardiographically apparent abnormality concurrent with ventricular tachyarrhythmias. Ventricular tachyarrhythmias in cats were most commonly associated with myocardial disease (eg, left ventricular concentric hypertrophy [n = 66], restrictive or unclassified cardiomyopathy [n = 17], and dilated cardiomyopathy [n = 6]). When comparing dogs and cats that had ventricular tachyarrhythmias and were diagnosed on the same clinical service of the same institution, an echocardiographically apparent cardiac lesion was seen more often in cats (102/106, 96%) than in dogs (95/138, 69%) (P < .001).








Tuesday, May 21, 2013

Epidemiologia da meningoencefalite necrotizante em pugs / Epidemiology of necrotizing meningoencephalitis in pug dogs


Epidemiology of Necrotizing Meningoencephalitis in Pug Dogs

  1. J.M. Levine1
  2. G.T. Fosgate2
  3. B. Porter3,
  4. S.J. Schatzberg4
  5. K. Greer3
Article first published online: 4 JUL 2008
DOI: 10.1111/j.1939-1676.2008.0137.x
Journal of Veterinary Internal Medicine

Journal of Veterinary Internal Medicine

Volume 22Issue 4pages 961–968July–August 2008

Keywords:

  • Central nervous system;
  • Encephalitis;
  • Inflammation
Background: Although the histopathologic features of necrotizing meningoencephalitis (NME) have been described previously, little information is available concerning the signalment, geographic distribution, seasonal onset, treatment, and survival of affected dogs.
Animals: Sixty Pugs with NME and 14 contemporaneous control Pugs with other intracranial diseases (non-NME group).
Methods: Pugs that were euthanized or died because of intracranial disease were prospectively obtained. All dogs had necropsy, histopathology, and testing for various infectious diseases and were subsequently divided into NME and non-NME groups. Signalment, geographic distribution, seasonal onset, treatment, and survival were compared between groups.
Results: In Pugs with NME, median age at onset of clinical signs was 18 months (range, 4–113 months). A greater proportion of female dogs were present in the NME group (40/60) compared with the control group (6/14). Pugs with NME had a significantly lower mean weight (7.81 kg) than control Pugs (9.79 kg) (P= .012). Mean survival in Pugs with NME was 93 days (range, 1–680 days), with dogs receiving any form of treatment living significantly longer than those that were not treated (P= .003). Anticonvulsive drugs were the only treatment significantly associated with longer survival (P= .003).
Conclusions and Clinical Importance: NME appears to be a common cause of intracranial signs in Pugs, based on the high proportion of NME dogs reported in this population. Pugs with NME are most commonly young adult female dogs. Although further investigation is needed to determine the optimal treatment of NME, anticonvulsive drugs appear to beneficially affect duration of survival.


Monday, May 20, 2013

Cloro: um guia rápido / Chloride: a quick reference



    Volume 38, Issue 3, May 2008, Pages 459–465
    Advances in Fluid, Electrolyte, and Acid-Base Disorders

    Chloride: A Quick Reference

    • a Departamento de Medicina Veterinária, Universidade Federal do Paraná, Avenida dos Funcionários, 1540, 80.035, Curitiba, Paraná, Brazil
    • b Department of Medical Sciences, University of Wisconsin—Madison, 2015 Linden Drive, Madison, WI 53706, USA


    Full-size image (38 K)Full-size image (50 K)

    Wednesday, May 15, 2013

    Efeito dos opióides e anestésicos sobre a temperatura corporal em gatos / Effects of opioids and anesthetic drugs on body temperature in cats



    Effects of opioids and anesthetic drugs on body temperature in cats

    1. Lysa P Posner1
    2. Alana A Pavuk1
    3. Jennifer L Rokshar1
    4. Jennifer E Carter1
    5. Jay F Levine2
    Article first published online: 11 DEC 2009
    DOI: 10.1111/j.1467-2995.2009.00508.x
    Veterinary Anaesthesia and Analgesia

    Veterinary Anaesthesia and Analgesia

    Volume 37Issue 1pages 35–43January 2010

    Abstract

    Objective  To determine which class of opioid alone or in conjunction with other anesthetic drugs causes post-anesthetic hyperthermia in cats.
    Study design  Prospective, randomized, crossover study.
    Animals  Eight adult, healthy, cats (four spayed females and four castrated males weighing 3.8 ± 0.6 kg).
    Methods  Each cat was instrumented with a wireless thermistor in the abdominal cavity. Temperature in all phases was recorded every 5 minutes for 5 hours. Population body temperature (PBT) was recorded for ∼8 days. Baseline body temperature is the final 24 hours of the PBT. All injectable drugs were given intramuscularly. The cats were administered drugs in four phases: 1) hydromorphone (H) 0.05, 0.1, or 0.2 mg kg−1; 2) morphine (M) (0.5 mg kg−1), buprenorphine (BUP) (0.02 mg kg−1), or butorphanol (BUT) (0.2 mg kg−1); 3) ketamine (K) (5 mg kg−1) or ketamine (5 mg kg−1) plus hydromorphone (0.1 mg kg−1) (KH); 4) isoflurane in oxygen for 1 hour. Fifteen minutes prior to inhalant anesthetic, cats received either no premed (I), hydromorphone (0.1 mg kg−1) (IH), or hydromorphone (0.1 mg kg−1) plus ketamine (5 mg kg−1) (IHK).
    Results  Mean PBT for all unmedicated cats was 38.9 ± 0.6 °C (102.0 ± 1 °F). The temperature of cats administered all doses of hydromorphone increased from baseline (p < 0.03) All four opioids (H, M, BUP and BUT) studied increased body temperature compared with baseline (p < 0.005). A significant difference was observed between baseline temperature values and those in treatment KH (p < 0.03). Following recovery from anesthesia, temperature in treatments IH and IHK was different from baseline (p < 0.002).
    Conclusions and clinical relevance  All of the opioids tested, alone or in combination with ketamine or isoflurane, caused an increase in body temperature. The increase seen was mild to moderate (<40.1 °C (104.2 °F) and self limiting.