Effusion is the abnormal accumulation of fluid within a body cavity that can result from a variety of disease processes. This article reviews the normal production and resorption of body cavity fluid and the pathophysiology of abnormal fluid accumulation. In addition, classification schemes, differential diagnoses, and currently available diagnostic tests for evaluation of effusions are reviewed.
The authors compared the symptomatic effectiveness of a complex homeopathic preparation Zeel (1–3 tablets orally per day depending on body weight) to carprofen (4 mg/kg body weight) in dogs (n=68) aged >1 yr diagnosed with osteoarthritis in a multicenter, prospective, observational open-label cohort study in 12 German veterinary clinics. The active treatment period was 56 days. Symptomatic effectiveness, lameness, stiffness of movements, and pain on palpation were evaluated by treating veterinarians and owners. Clinical signs of osteoarthritis improved significantly (P<0.05) at all time points (days 1, 28, and 56) with both therapies. At the end of the treatment period, effectiveness was comparable in both groups. Both treatment regimens were well tolerated with only three treatment-related adverse events, all in the carprofen group.
Desmopressin (DDAVP) is a vasopressin peptide analog with hemostatic properties that has been successfully used during surgery in patients with bleeding disorders. Recently published experimental and clinical data indicate that perioperative administration of DDAVP can minimize spread and survival of residual mammary cancer cells. The central aim of this study was to explore the effect of perioperative DDAVP and its relation to histologic grade in bitches with locally advanced mammary carcinoma. Of the 32 dogs initially recruited, 28 intact bitches with mammary carcinoma tumors stage III or IV were ultimately included. These dogs were randomized to receive DDAVP at intravenous doses of 1 μg/kg (n=18) or saline solution as placebo (n=10). En bloc mastectomy of the affected gland(s) was performed. Tumor malignancy was graded by the method of Elston and Ellis into well-differentiated (grade 1), moderately differentiated (grade 2), or poorly differentiated (grade 3). DDAVP therapy significantly prolonged the disease-free survival (P<0.001) and overall survival (P<0.01) in bitches with grade 2 or 3 carcinomas compared with bitches in the control group. No significant difference in disease-free period or overall survival was found between treatment groups in bitches with grade 1 tumors. The present data suggest that DDAVP may be an excellent candidate as a surgical adjuvant in the management of aggressive cancers in small animals. More research in this field is warranted.
A retrospective epidemiologic study evaluated 1,129 feline intestinal tumor patients via data entered into the Veterinary Medical Database (VMDB) from 1964 to 2004. Cases were analyzed by breed, age, yr of diagnosis, tumor type, and location. The VMDB incidence of all intestinal tumors reported during this 40 yr period was 0.4%, with small intestinal tumors predominating. The most common intestinal tumor was lymphoma, but the most common nonlymphoid tumor was adenocarcinoma. The Siamese breed and increasing age after 7 yr conferred an increased risk. Intact males and females appeared to have a decreased risk compared with neutered patients, but this may be explained by the age difference among these patients as older patients were more likely to be neutered. Prospective studies evaluating neuter status predilection and prognosis are warranted.
This study reports the outcomes of dogs with grade 3 mast cell tumors (MCTs). Clinical and histopathological data were available for 43 dogs. Median progression-free survival (PFS) and overall survival (OS) were 133 and 257 days, respectively. Tumor size, lymph node (LN) status, and mitotic index (MI) significantly influenced PFS in univariate analysis. Tumor size and LN status remained significant in the multivariate analysis. Lymph node status, local tumor control, LN treatment, and MI significantly influenced OS in univariate analysis but only LN status remained significant in multivariate analysis. These results confirm that locoregional control improves outcomes in patients with grade 3 MCTs.
A 2 yr old spayed female German shepherd presented with a chief complaint of acute onset paraparesis and weight loss. At presentation, the dog was pyrexic, nonambulatory, and had generalized muscle wasting. Neurolocalization was consistent with a thoracolumbar spinal cord lesion. An abdominal ultrasound was performed and revealed a focal dilation (4 cm) of the terminal aorta with evidence of blood stasis consistent with an aortic aneurysm. The dog was euthanized shortly after admission to the hospital and a post mortem examination was performed. Fungal organisms were identified in the aortic aneurysm as well as from the thoracic vertebrae, mesenteric lymph nodes, axillary lymph nodes, spleen, kidneys, liver, lungs, and heart. Although the morphology was consistent with Candida spp., immunohistochemistry and PCR could not definitively identify the causative organism. Mycotic aortic aneurysms are a rare finding in humans and have not been previously reported in the dog. To the authors’ knowledge, this is the first known report of an aortic aneurysm associated with systemic fungal infection in a dog.
Three cats were evaluated at a veterinary teaching hospital for congestive heart failure (CHF) secondary to hyperviscosity syndrome from plasma cell neoplasia. All cats had severe hyperproteinemia due to hyperglobulinemia. Multiple myeloma or plasma cell neoplasia was diagnosed based on cytopathology and post mortem examination. The cats presented with signs of CHF including acute collapse, tachypnea, increased respiratory effort, and pulmonary crackles. All cats had heart murmurs and echocardiographic signs consistent with hypertrophic cardiomyopathy. An enlarged left atrium was found in all cats and two of three cats also had spontaneous echocardiographic contrast. Plasmapheresis (centrifugal plasma exchange) was performed on all three cats by the removal of whole blood and the infusion of a balanced electrolyte solution while the whole blood was centrifuged and separated. The RBCs were then washed before being readministered to the patient. Plasmapheresis alleviated the clinical signs of CHF (tachypnea) in all three cats. Plasmapheresis should be considered in cases of CHF secondary to hyperviscosity syndrome to rapidly alleviate clinical signs associated with heart failure while diagnosis of the underlying cause is made and appropriate therapy implemented.
A 1 yr old male castrated Yorkshire terrier was referred after ingesting magnets. Dehydration, fever, tachycardia, and abdominal pain were noted on physical examination. Abdominal radiographs revealed two radiopaque foreign objects in close proximity to each other with decreased abdominal detail. Surgical exploration identified magnets adhered together in the omentum with perforations present in the transverse colon and stomach. The perforations were closed and a Jackson-Pratt continuous suction drain was placed. Septic peritonitis secondary to intestinal perforation from magnet ingestion was successfully treated with a combination of surgery and a closed suction drain.
A dog presenting for chronic purulent nasal discharge was diagnosed with an Eucoleus boehmi infection based upon rhinoscopic appearance of the nasal worms in situ, identification of the adult parasites in rhinoscopic nasal biopsies, and ova in the feces. The dog was successfully treated with a 2 wk course of fenbendazole and measures preventing reinfection through coprophagia. Patients with chronic nasal discharge should have a fecal examination performed to rule out infection with E. boehmi.
A 9 mo old male mixed-breed dog was presented with a history of chronic vomiting and fever after undergoing a cholecystectomy for the management of traumatic cystic duct rupture associated with biliary effusion 10 days before referral. A 6 cm × 6 cm intrahepatic bile collection, a biloma, was diagnosed on abdominal ultrasound and fine-needle aspiration. The biloma was treated with percutaneous catheter drainage under ultrasonographic guidance. Two years after aspiration, the dog continued to do well.
Canine leishmaniasis during pregnancy is rarely reported, even in countries where the infection in dogs is endemic. The authors report a case of a 4 yr old bitch with leishmaniasis treated with meglumine antimoniate during pregnancy. The pregnancy and delivery were normal and the bitch presented improvement of the infection during treatment. Three puppies died within 2 days of birth and tested negative via real-time PCR for L. infantum. The two surviving puppies were followed clinically, serologically, and by real-time PCR until 1 yr of age with no evidence of congenital leishmaniasis. L. infantum DNA was detected with real-time PCR analysis of uterine tissue from the bitch at the time of ovariohysterectomy. PCR analysis was performed after an ovariohysterectomy of the bitch that was performed two months after parturition. Meglumine antimoniate use in the pregnant bitch may have prevented vertical transmission of leishmaniasis.
A 5 yr old female intact English setter with a 17 day history of a penetrating oropharyngeal wound was referred for cervical swelling and pain. Physical examination revealed swelling at the left lateral aspect of the cranial cervical region. Pain was elicited upon flexion, extension, and leftward movement of the neck. Neurologic deficits were not identified. Cervical ultrasonography showed a 0.4 cm × 2.3 cm linear, hyperechoic structure in the soft tissues ventrolateral to the first (C1) and second (C2) cervical vertebrae. MRI demonstrated a linear structure 2 cm in length adjacent to the cranial aspect of C2. The foreign material was isointense to hyperintense on precontrast T1-weighted images, isointense on postcontrast T1-weighted images, and hypointense on T2-weighted images relative to adjacent muscle. Abnormalities within the spinal canal were not identified. Upon surgical exploration, a reed foreign body was identified deep to the serratus ventralis muscle. The patient was normal on follow-up evaluations 4 wk postsurgically.
This report describes a 4 mo old intact male Akita that presented for evaluation of a life-long history of facial swelling and failure to thrive. Physical examination revealed an enlarged cranium with prominent bony swellings on the maxillary bone, excessive laxity and crepitus involving multiple joints, and proprioceptive deficits. Radiographs demonstrated multiple osseous abnormalities including endosteal thickening of the femurs and ilium. Necropsy revealed gross compression of the cerebellum and brainstem. Physical exam findings, radiographic abnormalities, and histopathology of multiple boney lesions were all consistent with craniomandibular osteopathy. In this unique case of craniomandibular osteopathy, the dog was affected with severe bony proliferations leading to generalized hyperostotic lesions and brainstem compression resulting in neurologic deficits.