JAAHA 57.3 Abstracts

Abstracts from issue 57.3 of JAAHA, Journal of the American Animal Hospital Association.

57.3 MAY/JUN 2021

Editor in Chief

Alan H. Rebar, DVM, PhD, DACVP, Purdue University, West Lafayette, Indiana

Associate Editor

Linda Ross, DVM, MS, DACVIM (SAIM), Tufts University, North Grafton, Massachusetts

Managing Editor

Karie Simpson

JAAHA, Journal of the American Animal Hospital Association, is published as an official scientific and educational publication of the American Animal Hospital Association. The purpose of the journal is to publish accurate, timely scientific and technical information pertaining to the practice of small animal medicine and surgery. JAAHA is available in print and online. Log onto jaaha.org for more information. If you are interested in becoming a reviewer for JAAHA, please contact [email protected].

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Risk Factors for the Acquisition of a blaNDM-5 Carbapenem-Resistant Escherichia coli in a Veterinary Hospital

Sondra H. Lavigne, Stephen D. Cole, Carolann Daidone, Shelley C. Rankin

Carbapenem-resistant Enterobacteriaceae (CRE) are an urgent antibiotic-resistant threat. Only sporadic reports of CRE in companion animals have been described. Our objective was to identify risk factors associated with the acquisition of a blaNDM-5 CR-Escherichia coli strain as part of an outbreak investigation at a tertiary veterinary hospital in the United States. A matched case–control study was conducted among companion animals admitted during July 1, 2018, through June 30, 2019. The 15 identified blaNDM-5 CR-E coli cases were matched 1:2 with controls (culture negative for blaNDM-5 CR-E coli) based on species and number of days of hospitalization before bacterial culture sample collection. The association between exposure to various procedures and hospital services and the acquisition of blaNDM-5 CR-E. coli was assessed through conditional logistic regression. Case patients had significantly higher odds of exposure to the anesthesia service (odds ratio [OR] = 12.8, P = .017), the surgical service (OR = 4.0, P = .046), and to endotracheal intubation (OR = 10.0, P = .03). Veterinary hospitals should be aware of the potential for transmission of CRE via anesthetic and surgical procedures, especially those that require the placement of endotracheal tubes.  Read the full article



Long-Term Treatment Results for Ovarian Tumors with Malignant Effusion in Seven Dogs

Teruo Itoh, Atsuko Kojimoto, Kazuyuki Uchida, James Chambers, Hiroki Shii

Surgery and platinum-based chemotherapy are highly efficacious for treating advanced ovarian cancers in humans, but their efficacy is less known in dogs. We evaluated the long-term treatment outcomes of seven dogs with malignant ovarian tumors with malignant abdominal effusion. Ovariohysterectomies (OVHs) were performed on all dogs; four had ovarian adenocarcinoma (AC) with gross dissemination in the peritoneum (two with pleural effusion), and three had a granulosa cell tumor (GCT) with no gross dissemination in the peritoneal cavity, although one showed pleural effusion. Effusion resolved after the OVH in all dogs. Six dogs (three ACs, three GCTs) received postoperative IV carboplatin therapy. Two dogs with GCT had no postoperative recurrence or metastasis, and one dog with GCT had recurrence 1811 days postoperatively. All dogs with AC developed recurrent effusion 171–584 days postoperatively, which resolved after intracavitary administration of cisplatin or carboplatin, with a subsequent disease-free interval of 155–368 days. Overall survival was longer for dogs with GCTs (822–1840 days) than for those with ACs (617–841 days). These results suggest that dogs with ovarian tumors with malignant effusion can survive relatively long after platinum-based chemotherapy in addition to OVH, with a more favorable prognosis for GCT than AC. Read the full article


Nasal Rhinosporidiosis: Clinical Presentation, Clinical Findings, and Outcome in Dogs

Harry Cridge, Nataly Mamaliger, Brittany Baughman, Andrew J. Mackin

The purpose of this study was to describe the clinical presentation, imaging findings, and outcome in 10 dogs diagnosed with Rhinosporidium seeberi infections. Histopathology and cytology records were searched at a veterinary teaching hospital and a veterinary diagnostic laboratory to identify dogs with rhinosporidiosis. Medical records were reviewed for clinical, imaging, endoscopic, and surgical findings. Outcome was determined via evaluation of records and, where possible, telephone conversation with the primary care veterinarian and/or owner. Young to middle-aged large-breed dogs with an approximately equal sex distribution were represented. Unilateral signs predominated. Diagnosis was confirmed by histopathology in 9 cases, and cytology was diagnostic in only 1 of 3 cases. Histopathology was superior to cytology. Masses were soft tissue and contrast enhancing with no evidence of bony lysis on computed tomography (2 dogs). Direct or rhinoscopic (2 dogs) visualization revealed white to yellow pinpoint foci. Surgical resection (4 dogs) can result in long-term disease-free periods (up to 2659 days), although repeat surgery can be required. Dapsone was well tolerated in 1 dog, and relapse was not noted despite incomplete surgical resection (follow-up 749 days). Visualization of pale foci on a rostral intranasal mass in an endemic region should prompt consideration of rhinosporidiosis. Read the full article


Gorilla Glue Ingestion in Dogs: 22 Cases (2005–2019)

Sarah Friday, Christina Murphy, Daniel Lopez, Philipp Mayhew, David Holt

Gorilla Glue contains methylene diphenyl diisocyanate that expands significantly and hardens once exposed to moisture. Case reports of methylene diphenyl diisocyanate glue ingestion in dogs document gastrointestinal foreign body formation and mechanical obstruction. Medical record queries from four veterinary hospitals identified 22 dogs with Gorilla Glue ingestion. Records were evaluated retrospectively to characterize clinical presentation, diagnostic findings, treatment, and patient outcome. Vomiting was the most common clinical sign (n = 11), with a median time from ingestion to presentation of 42 hr. Abnormal abdominal palpation (e.g., pain) was the most reported examination finding (n = 13). Radiographs were performed in 18/22 dogs, with Gorilla Glue expansion described as granular or mottled soft tissue with gas in the stomach. In 73% (11/15) of dogs requiring surgery, history, clinical findings, and survey abdominal radiographs sufficed to proceed with celiotomy. Surgical removal of the Gorilla Glue foreign body was performed via gastrotomy (n = 14) or gastrotomy and duodenotomy (n = 1). Endoscopic removal was performed in one dog. One dog with suspected mechanical obstruction was euthanized owing to financial constraints. Remaining cases were managed conservatively (n = 5). Short-term prognosis following appropriate fluid therapy and surgical or endoscopic removal was very good. Read the full article


Skull Base Primary Extracranial Meningioma with Hyperostosis in a Small Mixed-Breed Dog

Joshua Samuel Montel, Arathi Vinayak, Jin Heo, E. J. Ehrhart

A 7 yr old female spayed Chihuahua-terrier mix was presented for a progressive dry, hacking cough over 9 mo, with dyspnea aggravated by eating and drinking. Computed tomography of the skull revealed a large mineral attenuating mass associated with the left skull base, without intracranial involvement. A modified ventral paramedian hypophysectomy approach along the medial aspect of the left ramus was used to approach the base of the skull. Ninety percent of the mass was debulked via high-speed pneumatic burr. Histopathology was consistent with hyperostosis originating from a primary extracranial meningioma (ECM), with the tissue staining positive for vimentin and negative for cytokeratin. The patient was symptom free for 9 mo before clinical signs returned because of tumor recurrence and was euthanized 11 mo postoperation because of diminished quality of life. ECM is uncommonly reported in the dog, and to the authors’ knowledge has not previously been reported with hyperostosis or located along the skull base at the level of the tympanic bulla. Additionally, although hyperostosis predominantly occurs as diffuse bone thickening adjacent to a meningioma, proliferative focal hyperostosis is uncommon. Given the findings in this patient, ECM should be considered as a differential diagnosis for osseous skull base masses. Read the full article


Asymptomatic Enteric Duplication Cyst in a Geriatric Cat: Case Report and Review of the Literature

William Bertram Phipps, Andrew Frederick Rich, Matteo Rossanese

An 11 yr old female neutered domestic shorthair presented for an 8 mo history of an asymptomatic abdominal mass. Computed tomography described an irregular, cystic structure closely associated with the duodenum, and focal ultrasonography confirmed the mass shared outer layers with the intestinal wall. Coeliotomy revealed the mass was originating from, and firmly adhered to, the antimesenteric border of the duodenum but was not communicating with the intestinal lumen. En bloc mass resection with omentalization was performed without small intestinal resection. Histopathology confirmed an enteric duplication cyst. The cat made a full recovery and remained asymptomatic postoperatively with no evidence of recurrence. A review of the literature confirms the duodenum to be the most common location of enteric duplication cysts in felines and that subtotal excision is curative in most cases. This differential should be considered in cases of cystic gastrointestinal structures in juvenile and adult felines, with or without associated clinical signs. In cases of luminal involvement or malignant transformation, intestinal resection and anastomosis is more appropriate. This report describes the presentation, investigations, and treatment of an asymptomatic duodenal duplication cyst in an adult feline and summarizes and compares current knowledge of the condition between veterinary and human literature. Read the full article


Successful Management of Urinary Bladder Clot with Intravesical Tissue Plasminogen Activator Infusion in a Cat

Chiahsin Sandy Young, Molly Racette, Jeffrey M. Todd

A 5 yr old male neutered domestic shorthair with intermittent signs of urinary tract obstruction was suspected of having a blood clot in the urinary bladder secondary to trauma. The cat was hospitalized and received standard supportive therapy for urinary tract obstruction with urinary catheterization, with the addition of intravesical saline flushes in an attempt to promote bladder clot lysis. The cat was subsequently discharged after voluntary urination was observed. The cat was re-presented 28 hr after discharge because of clinical signs consistent with urinary tract obstruction. The cat was hospitalized and intravesical tissue plasminogen activator (tPA) infusions (0.5 mg of tPA in 10 mL of saline with 2 hr dwell time q 8 hr) were administered to break down the bladder clot (2.78 × 4.46 cm). Thirty-two hours after starting tPA, the clot was no longer visible on ultrasound. The cat was discharged with no recurrent symptoms in the subsequent 11 mo. This is the first report of tPA being used for dissolution of bladder clot in a cat. There were no observed complications, suggesting that intravesical instillation of tPA may be a safe and efficacious therapy in cats, similar to the previously reported successes in dogs and humans. Read the full article


Emphysematous Cystitis and Pneumoperitoneum in a Dog with Escherichia coli Urinary Tract Infection and Hyperadrenocorticism

Samantha K. Day, Erin T. Mooney

A 9 yr old male neutered Staffordshire bull terrier with a history of poorly controlled hyperadrenocorticism, urinary tract infections, and emphysematous cystitis (EC) was presented to a veterinary referral teaching hospital for vomiting. Abdominal radiographs revealed EC and a pneumoperitoneum. The urinary bladder was found to be intact based on ultrasound and a pre- and postiohexol contrast computed tomography study with retrograde contrast cystogram. Urine culture confirmed the presence of a recurrent Escherichia coli urinary tract infection. The patient was managed medically, primarily as an outpatient, and had complete resolution of all problems. This case represents an extremely rare form of EC with pneumoperitoneum, without evidence of concurrent urinary bladder rupture. Only six similar cases have been reported in humans, with no previous cases reported in veterinary medicine. This case demonstrated that surgery is not necessarily indicated in all cases of pneumoperitoneum. The patient remained alive at 2 mo follow-up, with no evidence of recurrence of EC. Read the full article


Multimodal Imaging Characteristics of a Migrating Oropharyngeal-Spinal Foreign Body in a Cat

Jeffrey Laifer, Eli B. Cohen, Robert Rushing, Andrew Hopkins, John Meeks

A 2.5 yr old female spayed domestic shorthair presented for acute tetraparesis, dull mentation, and fever. MRI and computed tomography identified a thin linear foreign body extending from the caudal nasopharynx through the atlanto-occipital joint and cervicomedullary junction. Signal changes within the musculature were consistent with myositis, edema, and abscessation. Inflammation and edema surrounded the foreign body, and a dorsal cervical myelopathy extended caudally to the level of C6. Computed tomography attenuation values of the foreign body were most consistent with plant material. Euthanasia was performed; postmortem dissection of the soft palate confirmed a plant stem with abscess. Read the full article



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