Background: Measurement of plasma-free metanephrines is the test of choice to identify pheochromocytoma in human patients.Objectives: To establish the sensitivity and specificity of plasma-free metanephrine (fMN) and free normetanephrine (fNMN) concentrations to diagnose pheochromocytoma in dogs.Animals: Forty-five client-owned dogs (8 dogs with pheochromocytoma, 11 dogs with adrenocortical tumors, 15 dogs with nonadrenal disease, and 11 healthy dogs.)Methods: A prospective study. EDTA plasma was collected from diseased and healthy dogs and submitted for fMN and fNMN measurement by liquid chromatography-tandem mass spectrometry (LC-MS/MS).Results .01] nmol/L); P < 0.01). When used to diagnose pheochromocytoma, a fMN concentration of 4.18 nmol/L had a sensitivity of 62.5% and specificity of 97.3%, and a fNMN concentration of 5.52 nmol/L had a sensitivity of 100% and specificity of 97.6%.Conclusions and Clinical Importance: Plasma fNMN concentration has excellent sensitivity and specificity for the diagnosis of pheochromocytoma in dogs, whereas fMN concentration has moderate sensitivity and excellent specificity. Measurement of plasma-free metanephrines provides an effective, noninvasive, means of identifying dogs with pheochromocytoma.

Background: Mycobacterium avium subspecies paratuberculosis (MAP) is the cause of paratuberculosis. MAP infections have not been reliably detected in dogs, but a reemerging debate about the link between MAP and Crohn's disease has renewed interest about the occurrence of MAP in pets. Hypothesis: This study was undertaken to examine canine intestinal biopsies for the presence of MAP‐specific DNA. Animals: Forty‐two dogs with chronic vomiting, diarrhea, or both; and 14 dogs with no gastrointestinal disease. Methods: All dogs with signs of gastrointestinal disease had a standard work‐up for chronic gastrointestinal disease. Endoscopically obtained intestinal biopsies were submitted for histopathologic and molecular investigations. Biopsies were screened for MAP‐specific DNA by 3 polymerase chain reaction (PCR) methods (nested, seminested, and triplex real‐time PCR). Samples from control dogs were obtained during necropsy. Results: Histopathology of the biopsies was indicative of inflammatory bowel disease (IBD) in 17 and neoplasia in 6 dogs. Six dogs showing nonspecific changes responded to diet and were classified as having food‐responsive enteropathy. In 13 dogs a final diagnosis was not established. MAP‐specific DNA was detected and confirmed by sequencing in 8 dogs (19%). These dogs were diagnosed with food‐responsive enteropathy (n = 3), IBD (n = 2), and open diagnosis (n = 3). MAP‐specific DNA was not detected in dogs with no gastrointestinal disease. Conclusions and clinical importance: MAP‐specific DNA was detected in approximately one fifth of dogs with chronic gastrointestinal disease and might play a role as a pathogenic agent. Apart from animal welfare, the zoonotic aspect warrants further studies addressing the viability of MAP organism in canine intestinal biopsies by culture.

Background: Postprandial (PP) serum bile acid (SBA) stimulation is an important test for detecting hepatic dysfunction in dogs. However, this test is influenced by numerous variables, and a standardized approach using an injectable cholecystokinin analog (ceruletide) may be advantageous.Hypothesis: Ceruletide SBA stimulation test is more sensitive than PP SBA stimulation in dogs. Animals: Animals with portosystemic shunt (PSS) (n 5 11) and dogs with upper respiratory disease (URD) (n 5 9) were investigated. Healthy dogs (n 5 13) and dogs with other diseases (n 5 17) served as controls.Methods: All dogs underwent SBA stimulation with food and ceruletide. Stimulation blood samples were drawn at 60/120 minutes and 20/30/40 minutes, respectively. Results were compared statistically, and the sensitivity and specificity were determined with receiver-operating characteristic curves.Results: Stimulated SBA were significantly higher in both study groups than in controls. For dogs with PSS, the sensitivity and specificity (435 mmol/L) were 100% postprandially (120 minutes) and 91 and 100%, respectively, postceruletide (30 minutes). The difference between these values was not statistically significant. For dogs with URD, the sensitivity and specificity (422 mmol/L) were 44 and 88% postprandially (120 minutes) and 100 and 88% postceruletide (30 minutes).Conclusions and Clinical Importance: Ceruletide SBA stimulation circumvents exogenous and endogenous influences associated with PP SBA stimulation. The results indicate that ceruletide SBA stimulation performs as well as PP SBA stimulation in dogs with PSS and is more sensitive for the detection of hepatic dysfunction in dogs with URD.

A case of pulmonary blastomycosis in a pediatric patient diagnosed by gastric lavage is described. Use of gastric lavage averted the need for more invasive diagnostic techniques including bronchoscopy. Further study is required to define the sensitivity of gastric lavage for recovery of Blastomyces dermatitidis from pediatric patients with pulmonary blastomycosis.

AMD3100 (A), an inhibitor of SDF-1∞ binding to CXCR4, has been used alone and with G-CSF (G) to mobilize CD34+ cells from healthy volunteers and donors and from cancer patients undergoing autologous transplantation. In several studies it enhanced mobilization of poor mobilizers. Therefore, a CUP was submitted to the FDA; more than 100 patients (most commonly NHL; N=42) have been entered. Results from the first 70 patients enrolled are reported here. Three patients underwent a second mobilization with A following initial failure (2) and disease relapse (1); data on the first mobilization is in this report. Entry requirements include documented inability to mobilize 2 x 106 CD34+ cells/kg. Patients must have acceptable cardiac and pulmonary status, no active infection, and to have WBC >3.0 x 109/L, ANC > 1.5 x109/L, PLT >100,000 x 109/L, LFT within 2 x ULN, and creatinine clearance >60 ml/min. as well as other acceptable laboratory values. After signing consent and undergoing history, physical, laboratory, CXR, and ECG evaluation, patients are given G (10 mg/kg) for 4 days. At about 10 p.m. on day 4 they receive 240 mg/kg of A subcutaneously. The next a.m. they receive G and undergo apheresis. The evening A, the a.m. G, and the apheresis are repeated until enough cells are collected or until it is clear insufficient cells could be collected. There were 38 males and 32 females. Five were 18 years or younger (10, 12, 13, 16 and 18 years). The rest ranged in age from 21 to 81 years. Most common diseases were NHL (31), MM (14), AML (8), and Hodgkin’s disease (HD) (10). The 70 patients had undergone 93 possible mobilizations and 16 patients failed multiple prior regimens. Nearly all (91/93) prior mobilization regimens contained G. The most common regimens were G alone (33), cyclophosphamide plus G (17), and cyclophosphamide plus G plus other agents (30). In a subset of patients (N=27) the median time between the prior failed mobilization and the CUP mobilization was 34 days. A was generally well tolerated with AEs being similar to that previously reported. Only one SAE was felt related - patient with worsening of GI symptoms. The percent of patients collecting >2 x 106 cells/kg for the more common cancers were 58 for NHL, 64 for MM, 50 for AML, and 70 for HD. For those collecting >2 x 106 cells/kg (N=40) the median collection was 4.72 106 cells/kg in a median of 3.5 aphereses. The number of these patients transplanted was 36 of 40 with 31 successful engraftments, 3 pending, and two deaths post successful PMN, but not PLT engraftment. Of all the patients transplanted 4 additional patients have died. Durability has been good with at least 24 patients at 6 months or beyond. The success of mobilization compares very favorably with prior published data. A offers a generally safe and effective way to enhance mobilization of patients who have previously failed mobilizations.