S. P. Gregory

Developments in the understanding of the pathophysiology of urethral sphincter mechanism incompetence in the bitch

Developments in understanding the pathophysiology of urinary incontinence caused by urethral sphincter mechanism incompetence (SMI) are reviewed. SMI is a multifactorial condition; affected bitches have shorter urethras, reduced urethral tone and more caudally positioned bladder necks than continent bitches. Other factors thought to be important in the aetiology of SMI include neutering, breed, body size, docking and obesity. Most of the recent developments in the understanding of SMI have resulted from radiographic and urodynamic investigations of normal and affected bitches. The urodynamic technique of urethral pressure profilometry is discussed and its contribution as an investigative tool reviewed.

Ultrasound-guided percutaneous drainage as the primary treatment for prostatic abscesses and cysts in dogs.

Thirteen dogs with prostatic abscesses and cysts were treated using percutaneous ultrasound-guided drainage. Eight dogs were diagnosed with prostatic abscesses and five with cysts on the basis of cytopathological examination and bacterial culture of the prostatic fluid. Antibiotic therapy, based on culture and sensitivity results, was administered for a minimum of 4 weeks. Intact dogs were castrated after initial drainage. Repeat ultrasonography of the prostate was performed every 1 to 6 weeks, and any residual cavitary lesions were drained and fluid analysis repeated. The median number of drainage procedures required to completely resolve the lesions was two (range, one to four). No complications were observed after drainage, and clinical signs resolved in all dogs. None of the dogs developed clinical signs of recurrent abscesses or cysts in the follow-up period (median, 36 months; range, 10 to 50 months). Ultrasound-guided, percutaneous drainage of prostatic abscesses and cysts appears to be a useful alternative to surgical treatment in select dogs.

A retrospective study of surgically treated cases of septic peritonitis in the cat (2000–2007)

OBJECTIVES To review aetiology, clinical signs and outcome of cats surgically treated for septic peritonitis (2000-2007). METHODS A retrospective study. Inclusion criteria were the identification of intracellular bacteria and degenerate neutrophils and/or a positive culture from abdominal fluid and exploratory coeliotomy. Aetiology, clinical signs, haematological and biochemical parameters, surgical treatment and outcome were recorded and analysed. RESULTS Twenty-six cats fulfilled the inclusion criteria. Abdominal pain was reported in 10 (38 per cent) and vomiting was reported in 11 (42 per cent) of the cats. The most common aetiology was trauma (31 per cent). The principal source of contamination was the gastrointestinal tract. Hyperlactataemia, hypoproteinaemia and hyperglycaemia were reported in 9, 13 and 14 of the 26 cases, respectively. Non-survivors had significantly higher blood lactate concentrations than survivors (P=0.02). Nineteen cats were managed with primary closure, two with closed suction drains and three with open peritoneal drainage. Twelve (46 per cent) cats survived to discharge. CLINICAL SIGNIFICANCE In cats, lethargy, depression and anorexia were more common clinical signs than abdominal pain. Lactate level at the time of diagnosis may be a useful prognostic indicator in cats. The proportion of cats that survived was lower than previously reported and owners should be given a guarded prognosis.

Evaluation of the canine tympanic membrane by positive contrast ear canalography

Positive contrast ear canalography was described briefly in 1973 as a method for detecting rupture of the tympanic membrane in dogs with otitis media. The purpose of this study was to evaluate the sensitivity and usefulness of the technique. The ears of 10 normal canine cadavers and 31 dogs with clinical signs of ear disease were examined using otoscopy, radiography and contrast radiography after infusing 2 to 5 ml of positive contrast medium into the ear canals. These examinations were repeated in the cadavers after the tympanic membrane had been punctured with a Spreull needle. In the cadavers 14 of 19 (74 per cent) of the tympanic membranes were visible otoscopically; contrast medium did not enter the tympanic bulia of any of the ears before the tympanic membrane was ruptured, but was visible in the bulia in every ear after rupture. In the clinical study, 40 of 61 (66 per cent) of the tympanic membranes were visible otoscopicaily, and 12 appeared to be ruptured. Radiographic signs of otitis media (increased opacity and/or thickening of the tympanic bulla) were identified in seven ears. Canalography was positive for rupture of the tympanic membrane in 13 ears, including four in which it appeared to be intact otoscopically. In normal canine ears, canalography was a more accurate method for detecting iatrogenic tympanic membrane rupture than otoscopy. In dogs with ear disease, canalography may be more sensitive for otitis media than either otoscopy or survey radiography.

Pattern-recognition receptor mRNA expression and function in canine monocyte/macrophages and relevance to canine anal furunuclosis

Pattern-recognition receptors (PRRs) are important components of the innate immune system, enabling early detection of infection. Defective PRR function has been implicated in several infectious and immune-mediated diseases of human beings, including Crohns disease (CD). Anal furunculosis (AF) is an immune-mediated disease which primarily occurs in German shepherd dogs (GSD) and could result from a similar type of PRR dysfunction. The aim of the current study was to investigate canine PRR responses in vitro and to test the hypothesis that these were altered in AF-affected GSD. The pattern-recognition receptors TLR1, TLR2, TLR4, TLR6, TLR9, NOD1 (nucleotide-binding oligomerisation domain) and NOD2 were evaluated in the DH82 canine monocyte/macrophage cell line. These cells were found to express mRNA for all the selected PRRs with TLR2 mRNA the most and TLR5 mRNA the least abundant. A similar pattern of expression was found in canine blood-derived monocyte/macrophages. Stimulation of DH82 cells and blood-derived monocyte/macrophages using specific PRR-ligands, resulted in expression of pro-inflammatory cytokine mRNA. Quantification of TNFalpha mRNA and protein secretion from stimulated cells demonstrated variable responses with lipopolysaccharide (TLR4 ligand) and PAM(3)CSK4 (TLR1/2 ligand) proving to be the most potent and CpG DNA (TLR9 ligand) the least potent. Comparing PRR responses in blood-derived monocyte/macrophages from healthy blood-donor dogs with those from AF-affected GSD showed a deficiency in the latter in response to LD-MDP (NOD2 ligand) at the mRNA level but not at the protein level. It is possible that dysfunctional NOD2 responses by cells of the monocyte/macrophage lineage are involved in the pathogenesis of AF.

Expression of cytokine mRNA in canine anal furunculosis lesions

The pattern of expression of cytokine MRNA in the lesions of anal furunculosis was evaluated in tissue biopsies from 15 dogs, and compared with the pattern in control skin samples from 24 dogs, by reversetranscriptase PCR using canine cytokine-specific primers and a semi-quantitative multiplex PCR assay. Interleukin-2 (IL-2) was detected in 1 1 of the 15 affected dogs but in only one of the controls, and interferon-γ was detected in 14 of the affected dogs but none of the controls. In contrast, IL-4 was detected only in one of the affected dogs. Increased expression of MRNA for IL-1β, IL-6, tumour necrosis factor α, IL-, IL-10o and transforming growth factor β, was detected in the biopsies from the lesions of anal furunculosis relative to the control tissues (P<0.05).

Association between hepatic histopathologic lesions and clinical findings in dogs undergoing surgical attenuation of a congenital portosystemic shunt: 38 cases (2000–2004)

OBJECTIVE To review hepatic histopathologic lesions in dogs undergoing surgical attenuation of a congenital portosystemic shunt (CPSS) in relation to clinical findings and tolerance of complete surgical attenuation. DESIGN Retrospective case series. ANIMALS 38 dogs that underwent surgical attenuation of a CPSS. PROCEDURES Hepatic histologic examination findings and medical records of dogs undergoing surgical attenuation of a single CPSS between August 2000 and July 2004 were reviewed. Liver biopsy specimens were obtained from 38 dogs during surgery prior to complete (n = 16) or partial (22) attenuation of a CPSS and from 13 of the same dogs a median of 3 months following surgical attenuation. RESULTS Portal tracts were inadequate for interpretation in 2 liver biopsy specimens. Liver biopsy specimens obtained prior to surgical attenuation of a CPSS had a lack of identifiable portal veins (13/36 dogs), hepatic arteriolar proliferation (25/36), ductular reaction (5/36), steatosis (16/38), and iron accumulation (32/38). Lack of identifiable portal veins on histologic examination was associated with increased hepatic arteriolar proliferation, decreased tolerance to complete surgical CPSS attenuation, and decreased opacification of intrahepatic portal vessels on portovenography. Ductular reaction was always associated with failure to tolerate complete surgical attenuation of a CPSS. Surgical CPSS attenuation resulted in significant clinical, serum biochemical, and portovenographic changes indicative of improved liver function, but only subtle changes in hepatic histologic examination findings. CONCLUSIONS AND CLINICAL RELEVANCE Dogs without identifiable intrahepatic portal veins that had a ductular reaction on hepatic histologic examination were less likely to tolerate complete attenuation of a CPSS.

Spontaneous gastroduodenal perforations in dogs - a retrospective study of 15 cases

The clinical findings and outcomes following surgical management of spontaneous gastroduodenal perforations in 15 dogs were reviewed in a retrospective study to identify related risk factors. Clinical and clinicopathological findings were diverse. Use of multiple diagnostic procedures yielded a strong index of suspicion for gastrointestinal perforation. There was a trend towards improved survival for animals with perforation of the gastric fundus/body compared to pyloric or duodenal perforation, although the difference was not statistically significant. Five dogs were euthanased at surgery; two dogs died within two days after surgery. Seven of the eight surviving dogs had a favourable long-term outcome. Previous administration of NSAIDs was the only identified predisposing factor in ten of 10 of the dogs.

How good is your hand hygiene

BEYOND surgical scrubbing, hand hygiene has traditionally received only cursory attention in undergraduate veterinary teaching and veterinary nursing education, and experience suggests that it is an often neglected priority in day-to-day veterinary practice. This article highlights the importance of good hand hygiene in the veterinary environment and discusses why, how and when it should be practised. Strategies to help improve compliance among staff are also discussed.

Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery

Objective To determine the prevalence, outcome and risk factors for postoperative pyothorax in dogs undergoing thoracic surgery. Methods Case records were reviewed retrospectively to identify dogs with post thoracic surgery pyothorax, defined as septic neutrophilic inflammation within the pleural space based on cytology and/or a positive bacterial culture of pleural fluid. Those identified were reviewed for potential risk factors for postoperative pyothorax based on biological plausibility and previously published data. These potential risk factors were explored by multivariable logistic regression. Results Of 232 dogs undergoing thoracic surgery, 15 (6·5%) dogs developed pyothorax. Bacteria cultured included methicillin-resistant Staphylococcus aureus and multi-resistant Escherichia coli. Of these dogs, six died, four were euthanased and five were treated successfully. A diagnosis of idiopathic chylothorax [Odds Ratio (OR)=12·5, 95% Confidence Interval (CI)=2·7-58·5, P=0·001], preoperative intrathoracic biopsy (OR=14·3, 95% CI=1·7-118·7, P=0·014) and preoperative thoracocentesis (OR=11·2, 95% CI=1·6-78·2, P=0·015) were identified as independent risk factors for development of postoperative pyothorax. Clinical Significance Idiopathic chylothorax, intrathoracic biopsy and prior thoracocentesis are independent risk factors for postoperative pyothorax, which was associated with a 67% mortality rate.