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The Canadian Veterinary Journal = La... May 2024Extrahepatic biliary tract obstruction (EHBO) is uncommonly encountered in cats. Surgical treatment aims to decompress the biliary tract and insure bile duct patency. In...
Extrahepatic biliary tract obstruction (EHBO) is uncommonly encountered in cats. Surgical treatment aims to decompress the biliary tract and insure bile duct patency. In veterinary medicine, cholecystotomy is not widely used in practice. The objective was to describe the use of cholecystotomy, retrograde hydropulsion of choleliths, and choledochal stenting to remove choleliths from the extrahepatic biliary tract back in the gallbladder. Three adult domestic shorthair cats were presented with anorexia, lethargy, and vomiting. Serum biochemistry revealed hyperbilirubinemia and increased hepatic enzymes. Abdominal ultrasonography showed evidence of EHBO requiring surgical intervention. Choleliths were localized in the proximal and middle portions of the common bile duct (CBD) in the first case, in the distal portion of the CBD and within the major duodenal papilla in the second case, and in the middle and distal portions of the CBD in the third case. Cholecystotomy was followed by retrograde hydropulsion of the choleliths into the gallbladder, after which choledochal stenting was performed. Complications were defined as major when requiring additional medical or surgical treatment, or minor when not. Three major complications were reported. In 2 cases, severe anemia requiring blood transfusion occurred 24 h postoperatively; in 1 case, EHBO recurrence was encountered 41 d postoperatively. All cats were discharged within 4 d following surgery. Two cats were still alive at 12 and 14 mo after surgery, respectively. In the last case, owners refused revision surgery and the cat was euthanized. Key clinical message: Cholecystotomy combined with retrograde hydropulsion of choleliths permitted removal of choleliths and decompression of the biliary tract in 3 cats. Major complications included severe anemia and EHBO recurrence.
Topics: Animals; Cats; Cat Diseases; Stents; Male; Cholestasis, Extrahepatic; Female; Cholecystectomy; Bile Ducts, Extrahepatic
PubMed: 38694743
DOI: No ID Found -
The Canadian Veterinary Journal = La... May 2024A pregnant female domestic longhair cat ~8 mo of age was referred to the Western College of Veterinary Medicine (Saskatoon, Saskatchewan) for a diagnostic evaluation of...
Recognizing uterine torsion as a differential diagnosis in pregnant cats with severe anemia to provide appropriate and timely care in the absence of a definitive presurgical diagnosis.
A pregnant female domestic longhair cat ~8 mo of age was referred to the Western College of Veterinary Medicine (Saskatoon, Saskatchewan) for a diagnostic evaluation of severe anemia (PCV: 10.8%) after a 2-day period of lethargy. A CBC, serum biochemistry profile, FeLV/FIV testing, and abdominal radiographs were completed and did not determine a cause for the anemia. Abdominal ultrasonography identified 1 viable and 6 nonviable and fetuses, anechoic fluid in the uterus, and a mild volume of peritoneal effusion. A whole-blood transfusion and C-section with ovariohysterectomy were performed even though a definitive presurgical diagnosis for the anemia had not yet been established. Exploratory surgery revealed a left uterine horn torsion with a necrotic base, severe congestion, and 7 nonviable fetuses. Following surgery, the queen made a full clinical recovery. Key clinical message: Uterine torsion can be easily overlooked as a cause of severe anemia due to the relative infrequency of this condition in cats and the low sensitivity of ultrasonography to provide a definitive presurgical diagnosis. Client communication must emphasize the need for a prompt surgical intervention to establish the diagnosis and to save the cat, despite poor rates of neonatal survival. Once the animal is stabilized after surgery, further diagnostic tests and procedures are indicated if the cause of anemia has not yet been identified.
Topics: Animals; Female; Cats; Pregnancy; Anemia; Cat Diseases; Uterine Diseases; Torsion Abnormality; Diagnosis, Differential; Pregnancy Complications; Hysterectomy
PubMed: 38694738
DOI: No ID Found -
The Canadian Veterinary Journal = La... May 2024To evaluate the signalment and clinical, laboratory, treatment, and outcome features of dogs diagnosed with anticoagulant rodenticide (AR) intoxication in Saskatchewan.
OBJECTIVE
To evaluate the signalment and clinical, laboratory, treatment, and outcome features of dogs diagnosed with anticoagulant rodenticide (AR) intoxication in Saskatchewan.
ANIMALS
We studied 349 dogs.
PROCEDURE
Medical records from the Veterinary Medical Centre (Saskatoon, Saskatchewan) between 1999 and 2022 were reviewed. Cases were included if they met at least 1 of the following criteria: owner witnessed the dog ingesting an AR; AR was seen in the vomitus when emesis was induced; the dog had clinical signs of coagulopathy, with elevation of PT ± aPTT that normalized after vitamin K1 therapy, in the presence of appropriate clinical and paraclinical data and the absence of other causes of hypocoagulable state determined by the primary clinician.
RESULTS
Fifty-three percent of cases were seen between July and October. Most dogs (61%) came from an urban setting. Ninety-two percent of dogs ingested a 2nd-generation AR and the most frequent toxin was bromadiolone. Clinical signs were reported in 30% of AR intoxications and included lethargy (86%), dyspnea (55%), and evidence of external hemorrhage (44%). The most common site of hemorrhage was the pleural space, accounting for 43% of hemorrhage sites. Consumptive thrombocytopenia was reported in 24% of dogs with evidence of AR-induced hemorrhage, with moderate (platelet count < 60 K/μL) and marked (< 30 K/μL) thrombocytopenia in 7/12 and 2/12 dogs, respectively. Blood products were administered to 84% of dogs with AR-induced hemorrhage; the most common product administered was fresh frozen plasma (56% of cases). Among dogs with AR-induced hemorrhage, those that received blood products were more likely to survive to discharge (81%) compared to those that did not (19%) ( = 0.017). Eighty-six percent of dogs with AR-induced hemorrhage survived to discharge.
CONCLUSION AND CLINICAL RELEVANCE
The pleural space was the most common site of hemorrhage. Moderate thrombocytopenia was a common finding. Eighty-six percent of dogs with AR-induced hemorrhage survived to discharge.
Topics: Animals; Dogs; Rodenticides; Retrospective Studies; Dog Diseases; Saskatchewan; Male; Female; Anticoagulants; 4-Hydroxycoumarins
PubMed: 38694735
DOI: No ID Found -
IDCases 2024This article describes a case of polymicrobial pharyngitis and sinusitis complicated by intracranial complications and reviews similar cases in the literature.
OBJECTIVE
This article describes a case of polymicrobial pharyngitis and sinusitis complicated by intracranial complications and reviews similar cases in the literature.
CASE SUMMARY
A 21-year-old immunocompetent male presented with symptoms of sore throat, rhinorrhoea, lethargy, headache, and rash. Imaging demonstrated sinusitis, pre-septal sinusitis, peritonsillar abscess formation, subdural empyema and cerebritis. He was managed with endoscopic sinus surgery, craniotomy for evacuation of subdural empyema and antibiotics. Microbiological samples demonstrated growth of , , and . He subsequently developed a cerebral abscess requiring stereotactic needle drainage. After a prolonged course of antibiotics, the patient was discharge and made a good recovery.
DISCUSSION
is an uncommon cause of non-streptococcal pharyngitis that may occur alongside other microorganisms and is rarely associated with severe intracranial complications. This organism and its antibiotic susceptibility patterns should be considered in complicated upper respiratory tract infections in immunocompetent hosts. Penicillins and macrolide antibiotics form the mainstay of therapy for .
PubMed: 38690576
DOI: 10.1016/j.idcr.2024.e01960 -
BMC Public Health Apr 2024Social restrictions associated with the COVID-19 pandemic have altered children's movement behaviours and impacted their mental health. However, the influence of social...
School-aged children's movement behaviours and subjective health complaints in Japan: a cross-sectional study during COVID-19 pandemic-related school closures and after school reopenings.
BACKGROUND
Social restrictions associated with the COVID-19 pandemic have altered children's movement behaviours and impacted their mental health. However, the influence of social restrictions on subjective health complaints remains inadequately understood. This study compared adherence to 24-hour movement behaviour guidelines and the prevalence of subjective health complaints during school closure and one year after reopening. We also examined how combinations of adherence to movement behaviour recommendations relate to subjective health complaints.
METHODS
A repeated cross-sectional survey was conducted at two points. The first survey in May 2020 included 1535 (766 boys and 769 girls) participants during school closures, while the second survey from May to July 2021 involved 1125 (583 boys and 542 girls) participants one year after school reopening. The questionnaire covered socio-demographics, physical activity, screen time, sleep, and subjective health complaints. Differences between periods were analysed using chi-square tests. Logistic regression models assessed the association between adherence to guidelines and subjective health complaints.
RESULTS
During school closure, children were more likely to meet 'only sleep' recommendations and have irritability and lethargy symptoms. Irrespective of sex, those adhering to two or all three recommendations (excluding physical activity and screen time) had a lower risk of symptoms related to physical and mental pain, fatigue, irritability, and lethargy as compared to those who met none of the recommendations.
CONCLUSIONS
Children should meet at least one physical activity or screen time recommendation in addition to sleep recommendations for subjective health. Strategies considering the priority of each movement behaviour are crucial, even during abnormal situations, such as pandemic-related social restrictions. This study offers insightful findings concerning children's mental health issues during unprecedented and massive disasters or crises.
Topics: Humans; COVID-19; Cross-Sectional Studies; Male; Female; Japan; Child; Schools; Exercise; Screen Time; Pandemics; Sleep; Adolescent; Surveys and Questionnaires; Child Behavior; Diagnostic Self Evaluation
PubMed: 38689272
DOI: 10.1186/s12889-024-18712-6 -
BMJ Case Reports Apr 2024Catheter-related bloodstream infection (CRBSI) is one of the common healthcare-acquired infections imposing a high burden of morbidity and mortality on the patients....
Catheter-related bloodstream infection (CRBSI) is one of the common healthcare-acquired infections imposing a high burden of morbidity and mortality on the patients. Non-tuberculous mycobacterium is a rare aetiology for CRBSI and poses challenges in laboratory diagnosis and clinical management. This is a case of a woman in her early 60s with underlying end-stage renal failure, diabetes mellitus and hypertension presented with a 2-week history of high-grade fever postregular haemodialysis, vomiting, lethargy and altered mental status.Blood cultures from a permanent catheter and peripheral taken concurrently yielded , identified by matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry, which established the diagnosis of CRBSI atypically presented with concurrent acute intracranial bleeding and cerebrovascular infarction at initial presentation. She was started on a combination of oral azithromycin, oral amikacin and intravenous imipenem, and the permanent catheter was removed. Despite the treatments instituted, she developed septicaemia, acute myocardial infarction and macrophage activation-like syndrome, causing the patient's death.
Topics: Humans; Female; Catheter-Related Infections; Mycobacterium Infections, Nontuberculous; Middle Aged; Anti-Bacterial Agents; Fatal Outcome; Bacteremia; Renal Dialysis; Kidney Failure, Chronic; Amikacin
PubMed: 38688568
DOI: 10.1136/bcr-2024-259761 -
Journal of the American Veterinary... Apr 2024To report a ventral diaphragmatic advancement technique to repair a large congenital peritoneopericardial diaphragmatic hernia in a dog.
OBJECTIVE
To report a ventral diaphragmatic advancement technique to repair a large congenital peritoneopericardial diaphragmatic hernia in a dog.
ANIMAL
A 5-month-old 15-kg entire male Labrador Retriever.
CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES
The dog presented with a history of diarrhea for a week and acute-onset lethargy and vomiting for 3 days. Clinical examination revealed borborygmi on auscultation of the chest, and subsequent imaging showed a congenital peritoneopericardial diaphragmatic hernia.
TREATMENT AND OUTCOME
The ventro-central diaphragmatic defect was repaired with a pericardial flap, which subsequently failed 7 months later. The revision surgery was performed with a novel surgical technique. The defect was closed by means of incising the ventral attachments of the diaphragm either side of the defect and sliding it medially to allow a tension-free closure. The ventral aspect of the incised diaphragm was reattached with circumcostal sutures and the central defect closed. The dog recovered rapidly and without complication. An excellent outcome was reported after surgery.
CLINICAL RELEVANCE
This novel technique was a simple method to repair a peritoneopericardial diaphragmatic hernia and had good clinical results in this case.
PubMed: 38688312
DOI: 10.2460/javma.24.02.0098 -
Journal of Avian Medicine and Surgery Apr 2024Diabetes mellitus (DM) is an uncommon, poorly documented metabolic disorder of birds. Extrapolating knowledge from DM in mammals is challenging because of marked... (Review)
Review
Diabetes mellitus (DM) is an uncommon, poorly documented metabolic disorder of birds. Extrapolating knowledge from DM in mammals is challenging because of marked differences in avian physiology and metabolism. A literature review from December 1991 to January 2022 identified 14 publications covering 16 diabetic birds, 63% (10/16) of which belonged to the order Psittaciformes with as the predominant genus. No sex predilection was noted, but males generally presented at a younger age. Commonly reported clinical signs included polyuria 94% (15/16), polydipsia 88% (14/16), weight loss 75% (12/16), lethargy 63% (10/16), and polyphagia 38% (6/16). Diagnosis of DM was based on the presence of clinical signs and persistent hyperglycemia 100% (16/16), often with glucosuria 93% (13/14), response to insulin therapy 80% (8/10), and pancreatic pathology 90% (9/10). Specific treatment for DM was initiated in 14 patients, but blood glucose regulation for 6 months or longer was only achieved in 6 birds. Five of the regulated birds were managed with injectable long-acting insulin and 1 with oral glipizide combined with dietary modifications. However, glipizide yielded poor results in other cases, likely attributable to a lack of functional beta cells. Three diabetic birds progressed to remission. Treatment proved unsuccessful for 7 patients with a mean survival time of 36 days from diagnosis. One patient was lost to follow-up, and 2 were euthanized immediately following diagnosis. Histological examination of the pancreas frequently (90%, 9/10) revealed abnormalities including atrophy, fibrosis, and vacuolization of the endocrine islets with or without lymphoplasmacytic pancreatitis. Comorbidities, including hemosiderosis and infection, were common. This review suggests that birds diagnosed with DM are primarily affected by a type I diabetes as observed in dogs and humans. In contrast to mammalian species, avian DM is often associated with underlying disease and a complete clinical workup is essential to diagnose and address secondary disease conditions prior to initiating long-term insulin therapy.
Topics: Animals; Bird Diseases; Birds; Diabetes Mellitus
PubMed: 38686885
DOI: 10.1029/AVIANMS-D-22-00057 -
BJPsych Open Apr 2024Catatonia is a neuropsychiatric disorder characterised by psychomotor changes that can affect individuals across the lifespan. Although features of catatonia have been...
BACKGROUND
Catatonia is a neuropsychiatric disorder characterised by psychomotor changes that can affect individuals across the lifespan. Although features of catatonia have been described in adults, the most common clinical symptoms among paediatric patients with catatonia are not well characterised.
AIMS
The goal of this study was to characterise the symptoms of catatonia demonstrated by paediatric patients, and to explore demographic and diagnostic factors associated with greater catatonia severity.
METHOD
We conducted a multicentre retrospective cohort study, from 1 January 2018 to 6 January 2023, of patients aged 18 and younger with a clinical diagnosis of catatonia and symptom assessment using the Bush Francis Catatonia Rating Scale (BFCRS).
RESULTS
A total of 143 patients met inclusion criteria. The median age was 15 (interquartile range: 13-16) years and 66 (46.2%) patients were female. Neurodevelopmental disabilities were present in 55 (38.5%) patients. Patients demonstrated a mean of 6.0 ± 2.1 signs of catatonia on the Bush Francis Catatonia Screening Item, with a mean BFCRS score of 15.0 ± 5.9. Among the 23 items of the BFCRS, six were present in >50% of patients (staring, mutism, immobility/stupor, withdrawal, posturing/catalepsy, rigidity), and four were present in <20% of cases (waxy flexibility, mitgehen, gegenhalten, grasp reflex). In an adjusted model, patients with neurodevelopmental disorders demonstrated greater BFCRS severity than those with other diagnoses.
CONCLUSIONS
Catatonia was diagnosed in a range of mental health conditions. Further research is needed to define optimal diagnostic criteria for catatonia in paediatric patients, and clarify the clinical course of the disorder.
PubMed: 38686558
DOI: 10.1192/bjo.2024.61