Objective To evaluate association between ultrasonographic urine echogenicity and sediment examination in dogs and cats. Materials and Methods Dogs and cats undergoing ultrasound‐guided cystocentesis at a multidisciplinary referral hospital. Ultrasonographic images were stored and reviewed by a single, blinded, board‐certified radiologist. Urine appearance was described as “echoic” or “anechoic”. Urine sediment was examined for bacteriuria, pyuria, haematuria, crystalluria and urine‐specific gravity and then classified as “active” or “inactive.” Results Of the 194 cases included in this study, urine was echoic in 52 and anechoic in 142. Sediment was active in 52 and inactive in 142 samples. Sensitivity and specificity of echoic urine for active sediment were 40% (95% CI: 27 to 55%) and 78% (95% CI: 70 to 85%), respectively. Positive predictive value and negative predictive value of echoic urine for active sediment were 40% (CI 30 to 52%) and 78% (CI 74 to 82%), respectively. If urine‐specific gravity was <1.015 urine was always described ultrasonographically as anechoic. Clinical Significance Association between sediment analysis and ultrasonographic appearance of urine is poor. Echoic urine had low positive predictive value for active sediment in this study, suggesting that echoic urine alone should not prompt urinary investigations in the absence of other clinical suspicion. Despite a negative predictive value of 78%, urinalysis is still indicated for anechoic urine, especially if urine specific gravity is low.
ObjectiveThe aim of this feasibility study is to evaluate the use of tranexamic acid and its safe use alongside standard therapy in dogs with primary immune thrombocytopenia (ITP).DesignThis is a cohort feasibility study involving 10 dogs diagnosed with primary ITP that received standard therapy for ITP including corticosteroids, a single dose of vincristine, and omeprazole. Dogs were randomly divided into either the control group (n = 6) or the group receiving tranexamic acid (TXA group, n = 4).Key findingsThe mean time from the start of treatment until remission was 5 days in the TXA group and 6 days in the control group (P = 0.69). Two dogs, one in each group, did not achieve remission. Clinical bleeding scores were not significantly different between both groups (p = 0.43), and the median blood volume administered was 37.5 ml/kg for the TXA group and 9.72 ml/kg for the control group (p = 0.084). Three out of the four dogs receiving TXA of 20 mg/kg IV started vomiting within 15 min of administration and were given a reduced dose of 15 or 10 mg/kg IV.ConclusionTranexamic acid did not confer a clinical benefit in this small cohort study and was associated with a high incidence of vomiting. This study provides useful information for the design of future trials in dogs with ITP receiving tranexamic acid including outcome measures and safety.
A two-year-old entire female miniature dachshund was referred with a 10-day-history of polyuria, polydipsia, vomiting and inappetence and she was diagnosed with a left gastro-azygos portosystemic shunt. The dog underwent surgical attenuation of the shunt with a 5 mm ameroid ring constrictor and recovered uneventfully from the procedure. Two days after surgery, the dog developed acute abdominal pain. Abdominal ultrasonography revealed free peritoneal effusion and analysis of the fluid was consistent with biliary effusion. Diagnosis of biliary peritonitis was therefore made. On exploratory coeliotomy an evident leak of bile from the extrahepatic biliary tree was not detected. However, the gall bladder appeared macroscopically abnormal and a cholecystectomy was performed. Histopathological examination revealed gall bladder infarction characterised by intravascular fibrin thrombi and transmural coagulative necrosis. There was no overt inflammation and the bile was aseptic. The dog recovered uneventfully and was discharged from the hospital 10 days after surgery.
A 2‐year‐6‐month‐old, primiparous, female, entire Maltese terrier presented 4 weeks after whelping with an acute history of lethargy and vulval haemorrhage. It was found to be anaemic and severely thrombocytopenic, which raised the concern about thrombocytopenia being the primary cause of the profuse haemorrhage. The dog received a packed red blood cell transfusion that resulted in the improvement of the anaemia. The platelet count normalised without a specific intervention. Abdominal ultrasound revealed changes consistent with subinvolution of placental sites. An ovariohysterectomy was performed and the dog recovered uneventfully. This case has shown unusually severe thrombocytopenia secondary to haemorrhage, which should be considered a differential diagnosis for severe thrombocytopenia in dogs.
Objective To determine the usefulness of bacteriology swabs as a storage method of canine urine samples and the effect on quantitative bacterial culture. Materials and Methods Two hundred fourteen canine urine samples were collected by cystocentesis. The reference aliquot was placed in a sterile tube and processed for quantitative bacterial culture within 6 hours. A bacteriology swab was then immersed in the urine for 5 seconds and returned to the charcoal Amies media container. The urine samples in the sterile tube and bacteriology swab were stored at room temperature for 48 hours and processed for quantitative bacterial culture. Results Thirty‐seven of the samples were positive on reference culture with a total of 42 bacterial isolates. Samples stored in sterile tube and bacteriology swab had identical sensitivity and specificity for detection of bacteriuria (94.7% and 100%, respectively) with very good agreement (κ = 0.92; 95% CI 0.81 to 1.00). Agreement between the bacterial species of the reference sample and the bacteriology swab was higher (κ = 0.85; 95% CI 0.71 to 0.99) than compared to the sterile tube (κ = 0.78; 95% CI 0.62 to 0.94), but the overlapping confidence intervals mean improved agreement cannot be inferred. Clinical Significance Bacteriology swabs stored in Amies charcoal transport media should be considered an alternative method to preserve canine urine sample when immediate processing for quantitative bacterial culture is not possible. The sensitivity of culturing plain urine, stored for 48 hours in a sterile tube, for detection of bacteriuria, was higher than previously reported.
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