Bile peritonitis with fibrillar mucinous material in abdominal fluid has not been described previously in dogs. The material was similar to "white bile" observed in humans and experimentally in dogs as a sequela to extrahepatic biliary tract obstruction. When mucinous material is observed in abdominal fluid from dogs and the fluid bilirubin concentration is greater than twice the serum bilirubin concentration, rupture of the extrahepatic biliary tract should be suspected.
An ehrlichia was identified in the blood of a diseased llama (Lama glama). Sequencing of its 16S rRNA gene showed the ehrlichia to be closely related to members of the Ehrlichia phagocytophila genogroup. The agent was also found in a pool of ticks (Ixodes pacificus) collected at the llama site.
Background: Cytology often is used to obtain a diagnosis, such as that of malignant neoplasia. When a diagnosis is uncertain, pathologists often express probability using qualitative terms, such as “probable,” that have imprecise meanings.
Hypothesis: Terms expressing probability are interpreted variably by veterinary practitioners and affect decisions regarding treatment and euthanasia.
Animals: None.
Methods: An online survey of members of the Veterinary Information Network was conducted. Veterinarians were asked to assign percentage probabilities to 18 modifiers of a diagnosis of lymphoma. They also were asked to select their most likely clinical action based on a diagnosis of lymphoma qualified one of 4 modifiers. Results were analyzed using descriptive and nonparametric methods. Percentage probabilities were analyzed by ANOVA after variance stabilization.
Results: For 871 valid surveys, probabilities assigned to the 18 modifiers overlapped substantially, with medians (interquartile range) of 50% (50–70%) for “possible,” 66% (66–85%) for “probable,” and 70% (70–90%) for “consistent with.” More (P < .001) veterinarians (50.4%) chose to initiate treatment with a diagnosis of “consistent with lymphoma” as compared with “probable” (14.6%) or “possible” (1.6%) lymphoma. For clients considering euthanasia if the diagnosis was cancer, more (P < .001) veterinarians recommended euthanasia with a diagnosis of “consistent with lymphoma” (62.5%) as compared with “probable” (35.3%), or “possible” (2.0%) lymphoma.
Conclusions and Clinical Importance: Probability expressions are interpreted variably yet have a major impact on clinical decision‐making, including the decision to recommend euthanasia. Standardized terminology could improve decision‐making and enhance clinical outcome.
Results suggested that improving communication between veterinary practitioners and veterinary clinical pathologists could enhance the diagnostic value of cytologic examinations and improve clinical decision-making.
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