The objectives of this study were (1) to measure normal thickness values of the muscularis, submucosal, mucosal and serosal layers in each gastrointestinal (GI) segment (gastric fundus, body and pyloric antrum; duodenum; jejunum; ileum; colon), and (2) to calculate a ratio of muscularis and mucosal layer thickness to aortic diameter measured at the level of the celiac artery (Musc:Ao and Muc:Ao) in each GI segment in a sample of healthy cats. Ultrasonographic examination of the GI tract was performed, and measurements of the individual layers in each GI segment were obtained in 38 healthy cats without clinical evidence of disease. The muscularis layer was significantly thickest in the ileum, compared with other segments, and it was thicker than the submucosa in all segments except the colon. The mucosa was the thickest layer in all segments, and was thickest in the duodenum and ileum. Measurements of the submucosal and serosal layers were not significantly different between all segments. Musc:Ao and Muc:Ao in each segment were 0.12 and 0.25 (gastric fundus), 0.12 and 0.18 (gastric body), 0.11 and 0.16 (pyloric antrum), 0.08 and 0.27 (duodenum), 0.08 and 0.22 (jejunum), 0.14 and 0.25 (ileum), and 0.05 and 0.08 (colon), respectively. Musc:Ao and Muc:Ao are clinically relevant values that can be used to objectively identify thickening of the muscularis and mucosal layers in response to GI diseases.
Objective: To evaluate the use of the caudal vena cava collapsibility index (CVCCI) as a predictor of fluid responsiveness in hospitalized, critically ill dogs with hemodynamic or tissue perfusion abnormalities.
Objective
To describe the use of therapeutic membrane‐based plasma exchange (TPE) for treatment of clinical signs associated with suspected acquired myasthenia gravis (MG) in 3 dogs.
Case series summary
Three dogs presented with clinical signs consistent with acquired MG. All 3 dogs were medically managed prior to being treated with TPE. Two of the 3 dogs had increased acetylcholine receptor antibody titers that decreased after TPE. One dog diagnosed with primary MG became clinically normal after 2 sessions of TPE and continued to do well with medical management several months later. The second dog was diagnosed with a suspect thymoma, and TPE was performed as a bridge to surgery, with marked improvement of clinical signs after TPE. The dog was ultimately diagnosed with a thymic carcinoma. The third dog had a positive acetylcholine antibody titer and was ultimately diagnosed with hemangiosarcoma (spleen and liver) and invasive mediastinal thymoma. This dog developed severe pneumonia, was ventilator dependent, and died of multiple organ dysfunction. No immediate complications were observed secondary to TPE. All 3 dogs were concurrently treated with either immunosuppressive agents, anticholinesterase drugs, or both.
New or unique information provided
The use of TPE in dogs with MG appears to be well tolerated and safe. It may be a reasonable adjunct therapy to acetylcholinesterase drugs in cases that are not responding to medical management alone. Therapeutic plasma exchange might also be considered preoperatively to prevent postoperative complications in dogs with severe MG, although further studies should be performed.
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