Spirocercosis is a disease occurring predominantly in Canidae, caused by the nematode Spirocerca lupi. Typical clinical signs are regurgitation, vomiting and dyspnoea. The lifecycle involves an intermediate (coprophagous beetle) and a variety of paratenic hosts. Larvae follow a specific migratory route, penetrating the gastric mucosa of the host, migrating along arteries, maturing in the thoracic aorta before eventually moving to the caudal oesophagus. Here the worm lives in nodules and passes larvated eggs which can be detected using zinc sulphate faecal flotation. Histologically, the mature oesophageal nodule is composed mostly of actively dividing fibroblasts.Spirocerca lupi-associated oesophageal sarcomas may occur and damage to the aorta results in aneurysms. A pathognomonic lesion for spirocercosis is spondylitis of the thoracic vertebrae. Primary radiological lesions include an oesophageal mass, usually in the terminal oesophagus, spondylitis, and undulation of the aortic border. Contrast radiography and computed tomography are helpful additional emerging modalities. Oesophageal endoscopy has a greater diagnostic sensitivity than radiography. Endoscopic biopsies are not sensitive for detecting neoplastic transformation. Doramectin is the current drug of choice, effectively killing adult worms and decreasing egg shedding. Early diagnosis of infection is still a challenge and to date no ideal regimen for prophylaxis has been published.
Canine babesiosis typically causes hemolytic anemia but also can result in multiple organ dysfunction. Human patients with severe disease often have persistent hyperlactatemia, and blood lactate concentration is correlated with survival rate. In dogs, blood lactate concentration has been shown to be of prognostic value in patients with gastric dilatation-volvulus and in dogs admitted to intensive care units. Serial blood lactate and glucose concentrations and hematocrit on admission were determined in 90 dogs with naturally occurring, severe or complicated canine babesiosis. Forty-five dogs (50%) had hyperlactatemia (blood lactate concentration 22.5 mg/dL) and 20 (22.2%) had hypoglycemia (blood glucose concentration 59.4 mg/dL) at presentation. Measurements significantly associated with mortality were hypoglycemia on admission, blood lactate concentration 45 mg/dL on admission, blood lactate concentration 22.5 mg/dL at 8, 16, and 24 hours after admission, and increase or 50% decrease in blood lactate concentration within 8 and 16 hours after admission. Blood lactate concentration persistently 40 mg/dL indicated a very poor prognosis. We conclude that serial blood lactate measurements are useful in predicting survival in dogs with severe and complicated canine babesiosis.
Hypoglycemia is a common complication of virulent canine babesiosis. A study was conducted to determine the prevalence of and potential risk factors for hypoglycemia in canine babesiosis from Babesia canis rossi. Plasma glucose concentration was measured at presentation in 250 dogs with babesiosis, of which 111 were admitted to hospital. The prevalence of hypoglycemia (Ͻ60 mg/ dL) was 9% (23/250). Twenty-two hypoglycemic dogs required admission, making the prevalence of hypoglycemia in admitted dogs 19.8%. Sixteen dogs had severe hypoglycemia (Ͻ40 mg/dL), of which 5 had glucose Ͻ 18 mg/dL. Hyperglycemia (Ͼ100 mg/dL) was present in 38 dogs, of which 21 were admitted. Risk factors for hypoglycemia identified by univariate analysis were collapsed state (P Ͻ .00001), severe anemia (P ϭ .0002), icterus (P ϭ .003), age Ͻ6 months (P ϭ .02), and vomiting (P ϭ .03). After logistic regression analysis, collapsed state (odds ratio [OR] ϭ 18; 95% CI, 1.9-171; P ϭ .01) and young age (OR ϭ 2.8; 95% CI, 0.8-9.7; P ϭ .1) remained significantly associated with hypoglycemia. Toy breeds and pregnant bitches were not at higher risk for hypoglycemia than other dogs. Blood glucose concentration should ideally be measured in all dogs requiring inpatient treatment for babesiosis but is mandatory in collapsed dogs; puppies; and dogs with severe anemia, vomiting, or icterus. Many dogs have probably been misdiagnosed with cerebral babesiosis in the past, and hypoglycemia should be suspected in any dog with coma or other neurological signs.
Double aortic arch denotes the persistence of both fourth aortic arches and has been reported as 'very rare' in the dog. Most reported cases have been seen in German shepherd dogs. An eight-week-old, male, 1.5-kg beagle presented with a three-week history of regurgitation and dyspnoea. A barium oesophagram showed severe oesophageal constriction cranial to the base of the heart, and a provisional diagnosis of a persistent right aortic arch was made. A left-sided fourth intercostal thoracotomy was performed. The ligamentum arteriosum was ligated and divided. The oesophagus was seen lying on the right-hand side of the aorta. Postoperatively, the puppy deteriorated and was euthanized. Postmortem revealed a double aortic arch entrapping both the oesophagus and trachea. The inexperienced surgeon could consider computed tomography or angiography to determine the exact vascular ring, and other possible concurrent vascular anomalies present, before surgery.
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