Robert M. Hardy

Double-masked, placebo-controlled study of intravenous levetiracetam for the treatment of status epilepticus and acute repetitive seizures in dogs.

BACKGROUND Status epilepticus (SE) and acute repetitive seizures (ARS) are common canine neurologic emergencies. No evidence-based studies are available to guide treatment in veterinary patients. Parenteral levetiracetam (LEV) has many favorable properties for the emergency treatment of seizures, but its safety and efficacy in dogs for SE and ARS are unknown. HYPOTHESIS Intravenous LEV is superior to placebo in controlling seizures in dogs with SE or ARS after treatment with IV diazepam. ANIMALS Nineteen client-owned dogs admitted for SE or ARS. METHODS Randomized, placebo-controlled, double-masked study. Dogs with SE or ARS were randomized to receive IV LEV (30 or 60 mg/kg using an adaptive dose-escalation approach) or placebo, in addition to standard of care treatment. They were monitored for at least 24 hours after admission for additional seizures. RESULTS The responder rate (defined as dogs with no additional seizures after administration of the study medication) after LEV was 56% compared with 10% for placebo (P = .06). Dogs in the placebo group required significantly more boluses of diazepam compared with the LEV group (P < .03). Seizure etiologies identified were idiopathic epilepsy (n = 10), inflammatory central nervous system disease (n = 4), intracranial neoplasia (n = 2), hepatic encephalopathy (n = 1), and 2 dogs had no cause determined. No serious adverse effects were attributable to LEV administration. CONCLUSIONS AND CLINICAL IMPORTANCE LEV was safe and potentially effective for the treatment of SE and ARS in these client-owned dogs. Larger, controlled clinical trials are needed to confirm this preliminary observation.

Canine gastric neoplasia: utility of ultrasonography in diagnosis.

The utility of ultrasonography in the diagnosis of canine gastric neoplasia was evaluated prospectively in a series of six cases subsequently confirmed as having adenocarcinoma by cytological or histological examination or both. Gastric neoplasia was associated with mural thickening with loss of normal wall sonographic layers and decreased or absent local motility. Sonographic findings were consistent with tumor localization obtained by other diagnostic methods employed. Ultrasonographic-guided, percutaneous, fine-needle aspirations biopsies were successful in two of the three cases in which they were performed. Ultrasonography appears useful in the diagnostic of canine gastric neoplasia.

Acalculous cholecystitis in four canine cases: ultrasonographic findings and use of ultrasonographic-guided, percutaneous cholecystocentesis in diagnosis

Canine cholecystitis is diagnosed infrequently. Clinical signs, physical examination findings, and clinicopathological abnormalities are nonspecific. Few reports exist of associated ultrasonographic findings which also are nonspecific for the disorder. Ultrasonographic-guided, percutaneous cholecystocentesis has been suggested for diagnostic confirmation. The present report further documents ultrasonographic findings associated with canine acalculous cholecystitis and demonstrates the utility of ultrasonographic-guided, percutaneous cholecystocentesis in confirmation of the diagnosis in a prospectively acquired clinical case series.

Chronic Hepatitis: An Emerging Syndrome in Dogs

Chronic active hepatitis has been recognized in humans since the 1950s but has been recognized only recently as a disease syndrome in dogs. The author describes this diverse group of chronic inflammatory liver diseases and discusses the factors related to its etiology, pathogenesis, diagnosis, and therapy.

Evaluation of plasma islet amyloid polypeptide and serum glucose and insulin concentrations in nondiabetic cats classified by body condition score and in cats with naturally occurring diabetes mellitus

OBJECTIVE To evaluate and compare circulating concentrations of islet amyloid polypeptide (IAPP), insulin, and glucose in nondiabetic cats classified by body condition score (BCS) and in cats with naturally occurring diabetes mellitus. ANIMALS 109 (82 nondiabetic, 21 nonketoacidotic diabetic, and 6 ketoacidotic diabetic) cats. PROCEDURES Cats were examined and BCSs were assessed on a scale of 1 to 9. After food was withheld for 12 hours, blood was collected and plasma concentrations of IAPP and serum concentrations of insulin and glucose were measured. Differences in these values were evaluated among nondiabetic cats grouped according to BCS and in diabetic cats grouped as ketoacidotic or nonketoacidotic on the basis of clinicopathologic findings. Correlations were determined among variables. RESULTS In nondiabetic cats, BCS was significantly and positively correlated with circulating IAPP and insulin concentrations. Mean plasma IAPP concentrations were significantly different between cats with BCSs of 5 and 7, and mean serum insulin concentrations were significantly different between cats with BCSs of 5 and 8. Serum glucose concentrations were not significantly different among nondiabetic cats. Mean IAPP concentrations were similar between nonketoacidotic diabetic cats and nondiabetic cats with BCSs of 8 or 9. Mean IAPP concentrations were significantly reduced in ketoacidotic diabetic cats, compared with those of nondiabetic cats with BCSs of 6 through 8 and of nonketoacidotic diabetic cats. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that increased BCS (a measure of obesity) is associated with increased circulating concentrations of IAPP and insulin in nondiabetic cats.

An in vitro model of early islet amyloid polypeptide (IAPP) fibrillogenesis using human IAPP-transgenic mouse islets

The mechanisms underlying insufficient insulin secretion and loss of β-cell mass in feline and human type 2 diabetes mellitus are incompletely understood. However, islet amyloid polypeptide (IAPP)-derived islet amyloidosis (IA) has been linked to increased rates of β-cell apoptosis and, therefore, our goal was to develop an in vitro model of IAPP fibrillogenesis using isolated pancreatic islets from mice transgenic for human IAPP (hIAPP Tg mice). Islets from hIAPP Tg mice, from mice transgenic for non-amyloidogenic murine IAPP (mIAPP Tg mice), and from the FVB background strain were exposed to normal (5.5 mM) or high (28 mM) glucose conditions in cell culture for 8 days. On days 0 and 8, islets were collected for electron microscopy (EM). EM showed no abnormalities in the mIAPP Tg or FVB islets at either time point. On day 8, hIAPP Tg islets cultured at high glucose concentration formed extracellular IAPP-derived flocculent deposits. No significant differences in rates of apoptosis were found between groups. Our findings, therefore, show that in vitro culture of hIAPP Tg mouse islets under high glucose conditions produces a readily available and rapidly inducible model of IAPP-derived fibrillogenesis and enables the study of early phases of the molecular pathogenesis of IA.

Retroperitoneoscopy in dogs

Retroperitoneoscopy, an endoscopic procedure which permits visualization of the retroperiloneal contents, was performed on 13 adult dogs. The procedure combines the techniques of retroperitoneal pneumography and peritoneoscopy. The kidneys, ureters, adrenals, vena cava, and aorta were examined. Renal biopsies were obtained under direct vision through the endoscope. Retroperitoneoscopy may have clinical application to the diagnosis and staging of retroperitoneal disease in human patients.

Clinical Resolution of Nasal Aspergillosis Following Therapy with a Homeopathic Remedy in a Dog

A 6 yr old, male, neutered Weimaraner was treated homeopathically for nasal aspergillosis after failing to respond to two treatments of topical (intranasal) clotrimazole and oral amoxicillin trihydrate/clavulanate potassium. Computed tomography, rhinoscopy, fungal culture, and cytology previously confirmed the diagnosis. At presentation for homeopathic treatment, the dog had aggressive left-sided sinusitis and rhinitis with destruction of nasal turbinates and severe bouts of epistaxis. Erosion and depigmentation of the nasal planum were evident. After two treatments with homeopathic aurum metallicum, resolution of clinical signs occurred and clearance of the aspergillosis organisms was documented by computed tomographic scan, rhinoscopy, and histopathology. Homeopathic aurum metallicum may be beneficial in treating cases of canine nasal aspergillosis.

General Physical Examination of the Canine Patient

It should be obvious from the above discussion that the physical examination of animals is not a simple task. The details that must be performed are numerous. Even more numerous are the abnormalities that can be discovered by the careful observer. My attempt was not to list all the abnormalities that can be detected during a physical exam, but rather to develop an organized approach to looking at your patients so that the most may be gained from the effort expended. If you know normal anatomy and physiology and study healthy animals thoroughly, significant abnormalities will become obvious. Your physical examination skills will continue to grow with each patient examined. Your data base of disease findings will be constantly expanding, and your diagnostic accuracy will improve every year of your practice life.

Nasal Rhinosporidiosis in Two Dogs Native to the Upper Mississippi River Valley Region

Two dogs, 4 and 7 years of age, were presented for evaluation and treatment of excessive sneezing. Physical examinations in both cases were within acceptable limits except for the presence of a single mass in the left nasal passage in the first case and left-sided nasal discharge in the second case. Rhinoscopy was used to visualize the nasal masses, and in both cases a single mass was surgically removed. Impression smears and histopathology submitted from each mass revealed lymphoplasmacytic and neutrophilic inflammation with spores typical of Rhinosporidium seeberi. These are the first reported cases of nasal rhinosporidiosis in two dogs native to the Upper Mississippi River Valley area with no travel history outside the region.