Background The pathogenic role of mycoplasmas in the lower respiratory tract (LRT) of dogs is debated, because mycoplasmas can be isolated from both healthy and sick dogs. Objectives To critically assess available data from controlled observational studies on the role of 4 mycoplasma species in LRT disease of dogs. Design Systematic review and meta‐analyses. Methods Seven electronic databases were searched for relevant publications. Risk of bias was assessed by the Newcastle‐Ottawa Scale. Meta‐analyses, stratified by mycoplasmal species, were performed using a random effects Bayesian model with noninformative priors to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs) for the association between Mycoplasma cynos, Mycoplasma canis, Mycoplasma spumans, and Mycoplasma edwardii and LRT disease in dogs. Results Five studies were included from 1201 references identified. All studies dealt with M. cynos, whereas 3 dealt with the other mycoplasma species. A significant association was found between M. cynos and LRT disease (Bayesian OR, 3.60; CI, 1.31‐10.29). Conversely, M. canis, M. spumans, and M. edwardii were not significantly associated with LRT signs (Bayesian OR, 1.06; CI, 0.10‐14.63; Bayesian OR, 3.40; CI, 0.16‐54.27; and Bayesian OR, 1.04; CI, 0.05‐23.54, respectively). Conclusions and Clinical Importance Results support a pathogenic role of M. cynos and a commensal role of M. canis and M. edwardii in LRT in dogs. Although the association was not significant based on the CI, the point estimate of the Bayesian OR was relatively high for M. spumans, making its role less clear. Mycoplasma cynos‐specific polymerase chain reaction should be considered on samples from dogs with LRT.
Background Predicted ionized calcium (piCa) can be calculated from routine biochemistry variables using a recently developed predictive model in dogs. However, it has not been evaluated with variables measured from multiple laboratories. Objectives We aimed to (a) externally validate piCa in dogs where biochemistry results were obtained from different analyzers, and (b) compare the diagnostic performances of piCa and total calcium (tCa). Methods A cross‐sectional multicentric study on 138 dogs from three different hospitals was performed. The sensitivity (Sen), specificity (Spe), positive (PPV) and negative predictive values (NPV), and diagnostic discordance of piCa and tCa were calculated using logistic regression for ionized hypercalcemia and hypocalcemia. Diagnostic performance fluctuations across hospitals were also assessed. Results For ionized hypercalcemia, the Sen (81.8%), Spe (96.1%), PPV (69.2%), NPV (97.7%), and diagnostic discordance (5.1%) of piCa were not significantly different among hospitals or from those of tCa. For ionized hypocalcemia, the Sen (range: 9.7%‐53.8%) and Spe (range: 95.6%‐99.6%) of piCa and tCa (Sen range: 16.2%‐87.8%; Spe range: 58.3%‐98.1%) varied across hospitals, although to a lesser extent for piCa. The diagnostic discordances of piCa (20.3%) and tCa (25.4%) were close. The prediction interval (PI) of piCa demonstrated high Sen to screen for ionized hypercalcemia (100%) and hypocalcemia (range: 75%‐93.3%), and high Spe to diagnose ionized hypercalcemia and hypocalcemia (100% for both). Conclusions These results support the external validation of piCa in dogs. Its PI represents a notable advantage over tCa to help clinicians explore calcium‐related disorders when ionized calcium cannot be readily measured.
CASE DESCRIPTION A 10-year-old spayed female Rottweiler was referred for evaluation because of a 2-month history of regurgitation and weight loss, despite no apparent change in appetite. The dog had received antiemetic and antacid treatment, without improvement. CLINICAL FINDINGS Physical examination revealed a low body condition score (2/5), but other findings were unremarkable. Diffuse, global esophageal dilatation was noted on plain thoracic radiographs, and normal motility was confirmed through videofluoroscopic evaluation of swallowing. Transhepatic ultrasonographic and CT examination revealed a circumferential, intraparietal lesion in the distal portion of the esophagus causing distal esophageal or cardial subobstruction and no metastases. Incisional biopsy of the lesion was performed, and findings of histologic examination supported a diagnosis of esophageal leiomyoma. TREATMENT AND OUTCOME In view of numerous possible complications associated with esophageal surgery, the decision was made to palliatively treat the dog by transcardial placement of a self-expanding, covered, nitinol esophageal stent under endoscopic guidance. Two weeks after stent placement, radiography revealed complete migration of the stent into the gastric lumen. Gastrotomy was performed, and the stent was replaced and fixed in place. Twenty-four months after initial stent placement, the dog had a healthy body condition and remained free of previous clinical signs. CLINICAL RELEVANCE Diffuse benign muscular neoplasia should be considered as a differential diagnosis for acquired esophageal dilatation in adult and elderly dogs. In the dog of this report, transcardial stent placement resulted in resolution of the clinical signs, with no apparent adverse effect on digestive function. The described procedure could be beneficial for nonsurgical treatment of benign esophageal tumors in dogs.
Endotracheal intubation is a common procedure, rarely associated with life‐threatening complications (e.g., tracheal rupture, necrosis, foreign body). A 1.5‐year‐old English Bulldog was presented for respiratory distress, with increased respiratory efforts and stridor, 2 days after endotracheal intubation. Cervical and thoracic radiographs disclosed a severe narrowing of the tracheal lumen associated with an intraluminal soft‐tissue structure at the thoracic inlet. Tracheoscopy confirmed the presence of an obstructive fibrinous tracheal pseudomembrane (OFTP) creating a 1‐way valve obstruction. Removal of the OFTP dramatically improved the dog's respiratory function, but the lesion reformed twice despite corticosteroid and antibiotic therapy PO, warranting repeated endoscopic removal of the OFTP. No additional recurrences were observed after treatment with inhaled heparin and N‐acetylcysteine q4h. No respiratory signs were reported 9 months after discharge. Postintubation OFTP has been reported rarely in humans and never described in dogs. Unexplained signs of upper airway obstruction shortly after endotracheal intubation should prompt consideration of OFTP in dogs, even if intubation was uneventful. Unlike its counterpart in humans, OFTP in dogs can reoccur after endoscopic removal, warranting repeated endoscopic extraction. A combination of corticosteroid therapy PO and heparin and N‐acetylcysteine inhalation q4h may be attempted if recurrence is observed.
An 8 yr old spayed female domestic shorthair and an 8 yr old neutered male Polish Lowland sheepdog were evaluated for a 3 wk history of sneezing and a 5 day history of left epistaxis, respectively. In both cases, computed tomography revealed a voluminous nasal mass, which was later histologically identified as carcinoma, without cribriform plate involvement. Nasal hydropulsion was performed in both animals in sternal recumbency under general anesthesia. A Poole suction tip was inserted into the orad esophageal opening and adequacy of the endotracheal tube cuff inflation was checked. Sterile saline was forcefully infused into the obstructed nasal cavity to dislodge the tumor. Both patients had temporary resolution of clinical signs. Nasal hydropulsion was repeated as a palliative last-resort treatment at each clinical relapse (four times in both animals over ≥1 yr), allowing long-term survival. Minor complications included a self-limiting retrobulbar and oropharyngeal swelling in the cat and self-limiting epistaxis in both animals. Although this technique is not intended to represent an equivalent alternative to radiation or surgical therapies, nasal hydropulsion may represent an appropriate palliative, last-resort treatment in case of obstructive nasal tumors in dogs and cats, when radiation therapy or surgery is not affordable, available, or desired.
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