Larry T. Glickman

Time Trends and Risk Factors for Diabetes Mellitus in Dogs: Analysis of Veterinary Medical Data Base Records (1970–1999)

The objectives of the study were to identify recent trends in the prevalence of diabetes mellitus (DM) in dogs and to identify host risk factors. Veterinary Medical Data Base (VMDB) electronic records of 6860 dogs with a diagnosis of DM (VMDB code 870178500) between 1970 and 1999 were evaluated to determine time trends. Records of 6707 dogs with DM and 6707 frequency matched dogs with any diagnosis other than DM from the same teaching hospitals in the same year, selected as controls, were evaluated for risk factor analysis. The prevalence of DM in dogs presented to veterinary teaching hospitals increased from 19 cases per 10,000 admissions per year in 1970 to 64 cases per 10,000 in 1999, while the case-fatality rate decreased from 37% to 5%. The hospital prevalence of DM was consistently greater over time in older compared with younger dogs with the highest prevalence occurring in dogs 10-15 years of age. Dogs weighing <22.7 kg had a significantly (P<0.001) greater risk of DM compared with heavier dogs. Female dogs had an increased risk of DM compared with males (P<0.001).

A Comparison of GlideScope Video Laryngoscopy Versus Direct Laryngoscopy Intubation in the Emergency Department

OBJECTIVES The first-attempt success rate of intubation was compared using GlideScope video laryngoscopy and direct laryngoscopy in an emergency department (ED). METHODS A prospective observational study was conducted of adult patients undergoing intubation in the ED of a Level 1 trauma center with an emergency medicine residency program. Patients were consecutively enrolled between August 2006 and February 2008. Data collected included indication for intubation, patient characteristics, device used, initial oxygen saturation, and resident postgraduate year. The primary outcome measure was success with first attempt. Secondary outcome measures included time to successful intubation, intubation failure, and lowest oxygen saturation levels. An attempt was defined as the introduction of the laryngoscope into the mouth. Failure was defined as an esophageal intubation, changing to a different device or physician, or inability to place the endotracheal tube after three attempts. RESULTS A total of 280 patients were enrolled, of whom video laryngoscopy was used for the initial intubation attempt in 63 (22%) and direct laryngoscopy was used in 217 (78%). Reasons for intubation included altered mental status (64%), respiratory distress (47%), facial trauma (9%), and immobilization for imaging (9%). Overall, 233 (83%) intubations were successful on the first attempt, 26 (9%) failures occurred, and one patient received a cricothyrotomy. The first-attempt success rate was 51 of 63 (81%, 95% confidence interval [CI] = 70% to 89%) for video laryngoscopy versus 182 of 217 (84%, 95% CI = 79% to 88%) for direct laryngoscopy (p = 0.59). Median time to successful intubation was 42 seconds (range, 13 to 350 seconds) for video laryngoscopy versus 30 seconds (range, 11 to 600 seconds) for direct laryngoscopy (p < 0.01). CONCLUSIONS Rates of successful intubation on first attempt were not significantly different between video and direct laryngoscopy. However, intubation using video laryngoscopy required significantly more time to complete.

Time trends and risk factors for diabetes mellitus in cats presented to veterinary teaching hospitals

Veterinary Medical Data Base records of cats with diabetes mellitus (DM) from 1970 through 1999 were reviewed to identify trends in hospital prevalence of DM and potential host risk factors. Hospital prevalence increased from eight cases per 10,000 in 1970 to 124 per 10,000 in 1999 (P < 0.001). Case fatality percent at first visit decreased from 40% to 10% (P < 0.001). Hospital prevalence increased in all age groups (P < 0.002). There was no apparent seasonal pattern in hospital prevalence. Significant risk factors included male gender, increasing age for both genders (P < 0.001), increasing weight for males (P < 0.001), and mixed vs pure breed for females (P = 0.006).

A prospective study of survival and recurrence following the acute gastric dilatation-volvulus syndrome in 136 dogs.

Dogs (n = 136) with gastric dilatation-volvulus (GDV) syndrome were followed over time to measure recurrence and mortality rates and to identify prognostic factors. Thirty-three (24.3%) died or were euthanized during the first seven days. Of 85 cases that were followed for up to three years, nine (10.6%) cases each had a recurrence of GDV and seven (8.2%) cases died or were euthanized. The median survival times for cases that had gastropexies and those that did not were 547 and 188 days, respectively. Depressed or comatose cases on admission were three and 36 times, respectively, more likely to die than alert cases, while cases with gastric necrosis were 11 times more likely to die.

Pathologic Features of Naturally Occurring Juvenile Polyarteritis in Beagle Dogs

Eighteen young Beagle dogs (eight males and 10 females), ages 6-40 months, with canine juvenile polyarteritis syndrome (CJPS), a naturally occurring vasculitis and perivasculitis of unknown etiology, were necropsied, and their tissues were examined by histopathologic and histochemical methods. The condition is characterized by recurring episodes of an acute onset of fever (>40 C) and neck pain that persist for 3-7 days. The major histopathologic alterations were a systemic vasculitis and perivasculitis. During the febrile, painful period of CJPS, the vascular lesions ranged from a histiocytic-lymphocytic periarterial infiltration to transmural arterial inflammation with concomitant fibrinoid necrosis and vascular thrombosis. Massive periarterial accumulations of inflammatory cells were common and often extended into adjacent tissues. The small- to medium- sized muscular arteries of the heart, cranial mediastinum, and cervical spinal meninges were consistently involved. Vasculitis occasionally occurred in other organ systems. The vascular lesions in dogs examined during clinically normal periods consisted of intimai and medial fibrosis, ruptured elastic laminae, and mild perivasculitis; these lesions were probably related to previous episodes of vasculitis. Eight dogs that had experienced repeated acute episodes also developed splenic, hepatic, and renal amyloidosis. The clinical signs, laboratory abnormalities, and the vascular lesions suggest that the condition may be immune-system mediated. CJPS may serve as a naturally occurring animal model of human immune-system-mediated vasculitides such as polyarteritis nodosa, infantile polyarteritis, and Kawasaki disease.

Influence of thoracic conformation and genetics on the risk of gastric dilatation-volvulus in Irish setters

Body measurements, history of gastric dilatation-volvulus (GDV), and other data were obtained for 155 Irish setters at the 1994 National Specialty Show. The dogs ranged in age from 6.5 months to 12.4 years (mean+/-standard deviation [SD], 3.6+/-2.6 years); 11 (7%) of the dogs had histories of GDV. Gastric dilatation-volvulus risk increased 33% for each year of age (p of 0.01). Dogs with the deepest thorax relative to width (ratio range, 1.61 to 1.85) had a significantly greater GDV risk than those with the shallowest thorax (ratio range, 1.20 to 1.50); the odds ratio was 8.45; the 95% confidence limits were 1.44 to 49.57; and the p value equaled 0.02. Having a relative (particularly a parent) with GDV also increased GDV risk. Five-generation pedigrees yielded a significantly higher mean coefficient of relationship for the 11 dogs with GDV than for the 11 dogs without GDV.

Prevalence of intestinal nematode parasitism among pet dogs in the United States (2003-2006).

OBJECTIVE To estimate prevalence of intestinal nematode parasitism among pet dogs in the United States and characterize risk factors for infection. DESIGN Retrospective period prevalence survey. ANIMALS 1,213,061 dogs examined at 547 private veterinary hospitals in 44 states from January 1, 2003, through December 31, 2006. PROCEDURES Data were obtained from electronic medical records of all dogs that had at least 1 fecal flotation test. Risk factors for intestinal nematode parasitism were identified by means of multivariable logistic regression analysis. RESULTS 2,785,248 fecal flotation tests were performed during the study period. When results for only the first test in each dog were considered, prevalences of Toxocara, Ancylostoma, and Trichuris parasitism were 5.04%, 4.50%, and 0.81%, respectively. Dogs < 0.5 years old had higher odds of Toxocara and Ancylostoma parasitism, compared with dogs > 5.0 years old; sexually intact male and female dogs had higher odds of parasitism, compared with spayed female dogs; toy dogs had lower odds of parasitism, compared with dogs in other breed groups; and dogs living in the mountain region had lower odds of parasitism, compared with dogs living in other regions. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that age, body weight, sex, breed, and geographic region were risk factors for intestinal nematode parasitism among pet dogs in the United States.

Feline Hyperthyroidism: Potential Relationship with Iodine Supplement Requirements of Commercial Cat Foods

Article rationale Since the late 1970s, there has been a significant increase in the prevalence of feline hyperthyroidism (FH). It is now recognized worldwide as the most common endocrinopathy of older cats, resembling toxic nodular goiter of older humans in iodine-deficient areas. The purpose of this article is to identify the potential for iodine concentrations in the diet to contribute to the etiology of FH. Historical context Iodine concentrations of commercial cat foods vary widely. A review of historical iodine recommendations revealed that the units of iodine supplementation changed in the 1970s. Given this change, foods minimally supplemented since the late 1970s would have been iodine deficient for most cats. Practical relevance Iodine supplementation of commercial cat foods should be evaluated in the light of the iodine recommendations revised in 2006. Foods may remain deficient in iodine if supplemented at the minimum recommended concentration, possibly contributing to the development of FH.

Canine distemper infection in pet dogs: II. A case-control study of risk factors during a suspected outbreak in Indiana

The epidemiologic features of an outbreak of canine distemper during 1992 and 1993 in pet dogs in Indiana are described. Risk factors for disease were characterized using hospital records of private veterinary practitioners. The risk of disease for purebred dogs was 85% lower than the risk of disease for mixed-breed dogs. Lack of vaccination was associated with a 350-fold increase in the risk of canine distemper, and 93.8% of all cases could be attributed to the lack of vaccination. For many of the owners, the cost of medical treatment exceeded the cost of a vaccination program.

Predisposition to gastric dilatation-volvulus in relation to genetics of thoracic conformation in Irish setters

Thoracic depth/width ratios (TDWRs) were calculated from measurements of the parents (i.e., common dam and two sires) and puppies in two litters of Irish setters. The TDWRs of the parents, distribution of TDWRs in the litters, and comparisons with earlier population studies suggest that an incompletely dominant major gene and a background of minor genes and environmental factors are responsible for the TDWR. A history of gastric dilatation-volvulus (GDV) (i.e., bloat) was correlated with high TDWRs in this family as it was for Irish setters and certain other breeds studied earlier. It may be possible to reduce the incidence of GDV by selective breeding of dogs with lower TDWRs.