Weight: 156.33 Paper Topics: steroid purpose study demonstrate efficacy of suggest regimen for oral treatment csu patients refractory high dosage antihistamines conducted retrospective chart review patients diagnosed urticaria feburary 1 2012 december 31 2014 total 98 patients csu included these 16 patients 163% antihistamineresistant prescribed 2-week course steroid thirteen patients 812% successfully controlled antihistamines stopping course second course steroid induced remission additionally patients 125% adverse events complications associated oral steroid observed study period study demonstrated excellence 2-week course oral corticosteroid antihistamine-resistant csu propose standardized corticosteroid treatment regimenthe altered distribution follicular helper cells predict pronounced clinical course primary sjogren's syndrome margit zeher division
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Pre-Coseasonal Treatment with a 5-Grass Pollen Sublingual Tablet in Adults Demonstrated a Reduction on Asthma Symptoms in Réunion IslandBashir Omarjee D'allergologie Et Exploration Du Sommeil, Reunion World Allergy Organization Journal 2016, 9(Suppl 1):A336 Background: Asthma is a heterogeneous disease, not only in its clinical expression and course but also in its response to treatment. Most patients are clinically stable with current therapies, while a substantial part of the asthma population develops exacerbation during grass pollen season. The purpose of this study is to document the impact of a grass allergy immunotherapy tablet (AIT) on the symptom severity in patients with severe allergic rhinitis (SAR) and persistent allergic asthma (PAA). Method: This study included 22 adults, aged 20-45 yrs, with PAA and SAR who met the following inclusion: ≥ two severe asthma exacerbations requiring oral corticosteroids while receiving high dose ICS (≥1600 ug BECLOMETHAZONE daily or equivalent), additional controller medications (long acting B2 agonist) during one year prior to screening. Patients were examined at baseline and received a tablet 300IR (GRAZAX® ALK or ORALAIR® Stallergènes SA) approximately 2 months before the expected start of the grass pollen season in Réunion Island and then throughout the season between November 2013/April 2014 and November 2014/April 2015. Results: AIT significantly reduced scores from baseline in ocular and nasal symptoms. Reductions were also seen in the asthmatic scores: improvement of FEV 1 (p<0.05 of predicted values) and breathlessness scores (p=0.0002). The asthma quality-of-life (AQLQ) questionnaire scores improved from baseline after AIT: p=0.003. At the final visit only 24% had daily activity impairment and 34% had some sleep impairment. Conclusion: The Pre-Coseasonal treatment with 5-grass AIT showed effective symptom control in severe persistent allergic asthma. Symptoms of comorbidities such as rhinitis and conjunctivitis were decreased. Object: To obtain the peak expiratory flow meter rate (PEFR) normal value in healthy children 5 to 14 years old from Beijing urban area and to establish the predicted equations of PEFR in children. We also compare the values of PEFR measured by the Mini Wright peak flow meter with peak expiratory flow (PEF) measured by the spirometry. Methods: F425 healthy school children (213 boys and 212 girls) aged 5 to 14 years old were chosen from kindergarten, primary and middle schools in Beijing urban area. We used peak flow meter (Mini -Wright, AFS) from PARI company of German to measure peak expiratory flow rate and recorded gender, age, height, weight and other physical parameters. Flow-volume curve was carried out using Jaeger spirometry instrument and peak expiratory flow (PEF) values were adopted. The difference peak expiratory flow values between two measures were compared using SPSS13.0 statistical software. Stepwise multiple linear regression was used to derive the regression equations. Results: The values of PEFR increased along with age among children. There were statistically significant difference between different age groups (P <0.05). The PEFR values of boys were higher than those of girls and the difference between males and females reached significant level at the age of 11, 13 and 14 (P <0.05). Either in boys or girls, PEFR significantly correlated with age, height, weight, the high degree of correlation existed with height and then age and weight. The predicted equations of PEFR reference values was established in children 5-14 years old living in Beijing urban area as follows: PEFR(L/min)=5.29×H |427.1(boys)and PEFR(L/min)=4.94×H |399.8(girls) respectively. The PEFR value measured by peak flow meter (309.1 ± 74.1 L/min) was higher than those measured by spirometry (298.9±91.3 L/min), and the difference between was statistically significant (P < 0.001). Conclusions: New reference values of the peak expiratory flow rate were determined, and the predicted equations were built for children 5 to 14 years old in Beijing urban area, and providing evidence for the clinical management of respiratory diseases. Background: Food-dependent exercise-induced anaphylaxis (FDEIA) is a disorder where exercise following allergen ingestion triggers anaphylaxis although exercise and allergen exposure are independently tolerated. There are an increasing number of reported cases of anaphylaxis due to soybean, but FDEIA due to soybean is a rare disorder. Methods: We characterized the clinical features of a 10 year old boy with a history of walnut allergy who developed FDEIA due to tofu (a soybean product). The patient developed anaphylaxis while running during his physical exercise class after eating tofu. He presented with symptoms of cough, nasal obstruction, generalized urticaria, loss of activity and cyanosis. His symptoms improved an hour after treatment with loratadine but he was not administered epinephrine. In order to detect the causative allergenic food and other cofactors that induced the symptoms of FDEIA, we performed specific IgE test, skin prick test and ISAC. Immunoblot analysis for soybeans and soybean products using the patient's serum was also performed. Provocation tests with ingestion of tofu followed by exercise is also scheduled to be done to further confirm the diagnosis. Results: Skin prick test with raw soybean product (tofu, fried tofu and soy milk) was strongly positive. The level of serum specific IgE to soybean was 11.90 UA/ml. The ISAC(Phadia, Uppsala, Sweden) results revealed Gly m 4, Gly m 5, and Gly m 6 as 3.3, 0.3, and 7.1 ISU, respectively. About a year and a half later, the specific IgE to soybean, Gly m 4, Gly m 5, Gly m 6 were 40.2, 3.61, 21.4, 51.7 UA/ml, respectively. The patient is well tolerant to soybean products in the absence of any exercise following the intake of the soybean products. Immunoblot analysis of soy powder with patient's serum showed positive band between 50 and 70 kilo daltons, indicating the presence of specific IgE against storage proteins Gly m 5 and Gly m 6. Conclusions: These results suggest the strong possibility of storage proteins such as Gly m 5 and Gly m 6 as the causative allergen of FDEIA induced by soybean (tofu). The prevalence of allergic disease has risen in the last few years in Mongolia. Artemisia species is an anemophilous genus included in the Compositae family and is widely spread the Mongolian temperate climate zone. Pollen from the various Artemisia vulgaris (mugwort) is one of the main causes of allergic rhinitis in late summer and autumn in Mongolia, where the frequency of sensitization approximately 67% of 256 adult patients with sensitized plant pollen in 2010. We aim to determine the sensitivity for pollen allergy of mugwort and lamb's quarters. Method: The Research is been done under the department of Cellular biology Biochemistry of Pharmacy -Bio Medicine School, MNUMS with the help of " Effect" Allergy -Asthma Hospital. During the study of research, one period descriptive research is done by studying the selected 191 patients who are diagnosed positive for the pollen allergens by skin pricking test and these group is chosen from the airborne allergic patients "Effect" Allergy -Asthma Hospital in 2010-2012 census. Results: We were chosen 191 subjects who are sensitized to pollen allergens. All of cases with age range between 3-74 years old and sex ratio is women and men are 42.3% and 57.7%. 169 (88,48%, 95% CI:) out of total subjects were sensitized to allergens of different plants pollen. the average diameters of wheals that had sensitized to mugwort (Artemisia vulgaris) was 9.29±5.01 mm 2 , to lamb's quarter was 4.85±2.15 mm 2 , to positive control histamine hydrochloride 0.1% was 4.89±1.33 mm 2 . Conclusion: The sensitization of levels to Mugwort increased in last few years and the wheals size is increasing year by year. Allergic rhinitis (AR) is an airway hyper-responsiveness (AHR) and mucosal inflammation disease mediated by IgE-associated processes that is characterised by sneezing, nasal congestion, and rhinorrhea. The imbalance of Th1/Th2 immune response is considered to contribute to allergic diseases, however the interval between inflammation and AHR remains unclear. Growing information illustrated that nerve growth factor (NGF), a neurotrophin, plays an important role in neuroimmune interactions by augmenting an existing Th2 immune response. Since probiotics and biocompatible water-soluble chitosan (WSC) have been demonstrated to have anti-inflammatory properties that could inhibit the development of allergic Th2 response, we aim to assess the effect of WSC and probiotic extracts on NGF in Dermatophagoides pteronyssinus (Der p)-induced AR murine model. Intranasal administration of both WSC and probiotic extracts attenuated AHR in Der p-challenged mice due to a lower respiratory resistance and improved the nasal congestion by manifestation higher respirator rate than non-treated mice. Under management of both WSC and probiotic extracts, the thickness of nasal respiratory epithelium was reduced in microscopy. Both of WSC and probiotic extracts treatment moderated allergic inflammation including a decreased level of total and Der p-specific IgE in the serum, lowered expressions of IL-4, IL-5, and IL-13 in nasal lavage fluid, as well as less eosinphil infiltration in the nasal cavity. In particular, therapeutics with both treatments reduced NGF performance in nasal lavage fluid along with its receptors, p75NTR and TrkA, in the respiratory epithelium of nasal mucosa in Der p-stimulated mice. We suggested that the reduced NGF and its receptor levels may correspond to a decrease in AHR and mucosa inflammation by both WSC and probiotic extracts treatment. Background: Mimotopes are short peptides mimicking epitopes. The potential of mimotopes as treatments for allergy diseases were investigated. Methods: Mimotopes specific to the epitopes of the major shellfish allergen tropomyosin were identified by screening the one-bead-one-compound (OBOC) peptide library. The OBOC library is a chemical synthetic library allowing high throughput screening of mimotopes with quantitative estimation on binding affinity. This method is advantageous over the conventional phage-displayed libraries by allowing the use of polyclonal antibodies or even untreated serum samples. The mimicry potential of the mimotopes was validated by both in silico and in vivo analysis. To investigate the therapeutic potential of mimotopes for allergy diseases, we used a mouse model of shrimp allergy through intragastric gavage of tropomyosin with cholera toxin as adjuvant followed by oral challenge. Splenocyte proliferation and local cytokine expression in the jejunum were analyzed to elucidate possible mechanisms of therapeutic effects of the mimotopes. Results: Twenty-five mimotopes specific to shrimp tropomyosin were identified by screening OBOC peptide library. In silico analysis revealed six clusters of mimotopes, with the mimotopes in each cluster sharing at least three or more identical amino acid residues at the same position. With the automated epitope mapping tool EpiSearch, the six clusters of mimotopes could be mapped to six epitope regions of shrimp tropomyosin, of which five were identical to the previous reported epitopes. One mimotope from each cluster were synthesized and conjugated to the carrier protein keyhole limpet hemocyanin (KLH) for in vivo analysis. BALB/c mice immunized with mimotope-KLH conjugate were found to have an elevated level of tropomyosin-specific IgG but not in mice immunized with KLH alone or an irrelevant mimotope. The therapeutic potential of these mimotopes were further investigated with the use of the BALB/c mouse model of shrimp allergy. Sensitized mice were injected with a mixture of six mimotope-KLH conjugates, one from each cluster, before receiving a subsequent oral challenge. Compared to the control mice receiving KLH alone, the mimotopes-treated mice demonstrated a suppressed splenocyte proliferation response to tropomyosin and a reduced expression of cytokines in the jejunum. Conclusion: The OBOC peptide library is a useful tool in identifying mimotopes for allergens with multiple epitopes. Mimotopes specific to the tropomyosin were identified by screening OBOC library and validated by in silico and in vivo experiments. The mimotopes could be potential therapeutic candidates for allergy diseases. Background: Therapeutic education is important for successful management of Atopic dermatitis (AD). To provide effective therapeutic education, common misunderstandings and demands about AD among patients and caregivers need to be reviewed. Methods: A questionnaire survey about the course, etiology and management of AD was conducted for patients and caregivers who visited Department of Dermatology at Seoul National University Hospital, Seoul, Korea. Results: A total of 177 subjects participated in the study. A few subjects understood natural course of AD. Only 34.5% of subjects was aware of natural course of AD that usually improves with age. Many subjects (52.6%) misunderstood relapse of AD symptoms for development of tolerance to topical steroids. 158 (89.3%) subjects believed that enhancement of patients' immune system can improve the symptoms of AD. Dietary restriction is considered as an essential management strategy (72.9%), and many of them (55.4%) agreed to postpone the beginning of weaning food in patients with AD. Food, thought to be associated with an aggravation of AD were as follows in the order of; instant food, snack, egg and wheat (38 (25.6%), 32 (21.5%), 19 (12.8%) and 18 (12.1%) of 149, respectively). Most subjects did not have accurate information about cleansing. In particular, 34.3% of subjects reported that they used only water without any cleanser, and 27.3% agreed that soap made of natural ingredients should be used to avoid harmful effects of chemical substances. Most subjects (57 of 115, 49.6%) obtained information about AD from medical doctors, and consider them as the most reliable sources (137 of 164, 83.5%). Subjects prefer printed materials (69 of 162, 42.6%) to seminars or video-clips for obtaining educational contents. Conclusion: In this study, we found that patients and caregivers have lots of misunderstandings about AD. Therapeutic education about the course, etiology and management of AD with printed materials made by physicians will be valuable for the effective management of AD. Background: It is recommended to use 200 (2 puffs) or 400 (4 puffs) ug of salbutamol in the bronchodilator response (BDR) test. We aimed to compare the difference between these two dosages with regard to the small airway dysfunction. Methods: Subjects, who had never been diagnosed as asthma, were consecutively enrolled from June 1st to November 31st, 2013. Based on the subject's past and family history, we evaluated the possibility of asthma by scoring each subject on a scale of 0 to 10 (pre asthma score). The subjects were randomly assigned the bronchodilator tests of the two dosages without physician's knowledge and performed the BDR tests using the spirometric and impulse oscillometric lung function. Asthma diagnosis (post asthma score) was later reevaluated after BDR test. Results: A total of 119 subjects participated in this study, and the mean age was 7.8 (±3.6) years. The number of participants who were assigned 2 puffs and 4 puffs were 59 and 57, respectively. The mean age of 4 puffs group was older than the 2 puffs group (p=0.012). Before the BDR test, there was no statistical difference in pre asthma score between the two groups (2 puffs = 5.46 vs. 4 puffs = 4.9) (p=0.428). After the BDR test, the post asthma scores of the two groups were 5.8 (±3.4) and 4.7 (±3.4), respectively, which also showed no statistically significant difference between the two groups (p=0.098). The pre asthma score was significantly correlated with forced expiratory volume in 1 sec/forced vital capacity (FEV1/FVC) (r=−0.212, p=0.021), forced expiratory flow at 25% to 75% (FEF25-75) of FVC (r=−0.184, p=0.046) and reactance at 5 Hz (Xrs5) (r=0.201, p=0.029) Z score. However, there was no significant difference in FEV1 and FEV1/FVC of spirometric parameters, and resistance at 5 Hz (Rrs5) and Xrs5 of impulse oscillometry system (IOS) value between the 2 puffs group and 4 puffs group. Conclusion: There was no significant relationship between the amount of bronchodilators administered and the small airway dysfunction in children. However, Xrs5 showed a significant correlation with the physician's asthma predictive score. Objective: To study the effect of natural killer-T (NKT) lymphocytes and CD4+ NKT lymphocytes levels in peripheral blood onset of children with asthma. Methods: 85 asthmatic children who were diagnosed and treated by pediatric department of Renmin Hospital Affiliated to Wuhan University from Jan. 2012 to Dec. 2014 were selected as asthmatic group. 76 healthy children were selected as control group. The peripheral blood mononuclear cells were collected by using the density gradient centrifugation method. The ratio of peripheral blood NKT cells and CD4+ NKT cells were measured by immunofluorescence and flow cytometry assays. The relationships between the NKT cells number, CD4+ NKT cells and the total IgE level were observed. The levels of IL-4,IL-13, IFN-γ in peripheral blood were detected by enzymelinked immunosorbent assay after proliferate in response to α-Galcer. Results: Compared with the control group, the ratio of NKT cells and CD4+ NKT cells in peripheral blood in asthmatic group were significantly decreased (t=3.795, P<0.05; t=4.106, P<0.05). There was no significant correlation between the NKT cells, CD4+ NKT cells and the total IgE (t=1.032, P>0.05; t=0.856, P>0.05). The levels of IL-4 and IL-13 in asthmatic group were higher than that of the control group (t=4.683, P<0.05; t=3.992, P<0.05). There was no significant difference in the level of IFN-γbetween the two groups (t=0.877, P>0.05). Conclusion: The dysfunction of NKT cells and CD4+ NKT cells and the functional change of cytokines may play an important role in the pathogenesis of asthma.
Prevalence of Food Sensitization, IgE-Mediated and Non-IgE-Mediated Food Allergy Among Pediatric Patients Diagnosed with Autism Spectrum DisordersAimee Lou Manalo Nano University of the Philippines Philippine General Hospital, Philippines World Allergy Organization Journal 2016, 9(Suppl 1):A384 A) Background: Autism spectrum disorders and food allergies are conditions with increasing prevalences. Studies have investigated the link between intake of certain food among ASD patients and onset of adverse reactions. Results of these studies are varied and conflicting. This is the first local study on the prevalence of food allergies among these patients. This study aims to determine the prevalence of food sensitization, IgE-mediated and non-IgE-mediated food allergies among pediatric ASD patients. It also aims to determine the prevalence of perceived food allergies, and its triggers and the types of reactions of perceived food allergies and on open food challenge. B) Methods: This is a cross-sectional, prospective study. Pediatric patients diagnosed with Autism Spectrum Disorders were enrolled in the study. Excluded were: children with uncontrolled asthma, with a recent anaphylactic reaction, and those on chronic high dose steroid therapy. Required sample size is 92. Complete history and PE were obtained and previous reactions to food and suspected allergens were duly noted. All patients underwent skin prick testing (SPT) to cow milk, wheat, soy and other perceived food allergens. Those with perceived food allergies underwent open food challenge to specific food allergens. Frequencies and proportions were determined to analyze the different variables. C) Results: Data were gathered from 84 patients diagnosed with ASD. 32/84 (38%) have perceived food allergies, mostly to milk (31.3%), chocolate (25%), and egg (18.8%). Most commonly perceived allergic reactions to food allergens were: hyperactivity (53.1%), loose stools (25%), pruritus (15.6%), and wheals (12.5%). A total of 17 (20.2%) patients had (+) skin prick test result, hence food sensitization, to at least 1 food allergen, mostly to soy (41.2%) and milk (35.3%). Of these patients, 8 had perceived food allergies. 6 of these patients underwent open food challenge and all of them had (-) results. D) Conclusion: Prevalences of perceived food allergies and food sensitization are higher among ASD patients in this study compared to the general population. The most common perceived food allergens are similar with that of other children. Notably, the common perceived allergic reactions to food were behavioral or gastrointestinal symptoms, which may be non-IgE mediated or not food allergies at all. Hence, ASD patients with adverse food reactions are recommended to undergo complete, systematic evaluation and possible restrictive diets should be based on welldocumented food allergies Background: Little is known about the data on component-resolved diagnosis (CRD) for allergy to Dermatophagoides pteronyssinus (Der p) in the Chinese population. We aimed to measure the prevalence of sensitization to Der p allergen components among patients in southern China. Methods: 200 Der p-positive and 20 Der p-negative subjects were tested for serum immunoglobulin E (sIgE) against Der p 1, Der p 2, and Der p 10 using ImmunoCAP 100. 75 poly-sensitized patients were further examined with ImmunoCAP Immuno Solid-Phase Allergen Chip (ISAC). Der p 10-positive subjects were tested further for sIgE to crude extracts of cockroach, moth, and shrimp. Results: 91.5% (183/200) patients were sensitized to Der p 1 and/ or Der p 2. 6% (12/200) Der p-positive patients were sensitized to Der p 10. The positive proportion and median level of sIgE against Der p 1 were higher in children than in adults. Der p 1 and Der 2 correlated with Der p in sIgE levels (r=0.862, 0.799, P<0.001). ImmunoCAP ISAC demonstrated 100% specificity and 84% sensitivity in detecting Der p 1, p 2, and p 10 compared to ImmunoCAP 100. According to ImmunoCAP ISAC, 8 of these 12 Der p 10-positive patients were triple positive and 3 patients were triple negative to Pen m 1, Bla g 7, and Ani s 3; one was solely positive to Pen m1. Sensitization to Der p 10 correlated well with sIgE to shrimp, moths, cockroaches, Pen m 1, Bla g 7, and Ani s 3. Conclusions: The detection of Der p 1 and Der p 2 well reflected atopy to Der p in a Chinese cohort. Sensitization to Der p 10 may result from cross-reactivity to seafood and cockroaches in coastal southern China. ImmunoCAP ISAC may offer a useful tool for CRD with performance comparable to ImmunoCAP 100. The type of allergic disease, the allergens producing sensitivity, the vaccine content, the adjuvant content, and the effects of treatment phase on frequency of adverse effects were investigated. Results: Out of 329 patients included, there was local reaction in 11.9%, large local reaction in 6% and systemic reaction in 4.7%; local reactions were observed in 0.38% of all injections, whereas a systemic reaction was observed in 0.1% of all injections. Local reactions were frequent at the initial phase and systemic reactions were frequent at the maintenance phase (p=0.01). Adverse reactions were more common in patients vaccinated (SCIT) with multiple allergens and house-dust-mites (p=0.002) (p=0.001). No statistically significant difference was found between the content of the adjuvant and the frequency of adverse effects (p=0.319). Conclusion: The frequency of local and wide local reactions during subcutaneous immunotherapy were lower than expected. Although systemic reactions are frequently seen, no fatal reaction was observed in the current study. Mite immunotherapy and multiple allergen use increase the risk of reaction. Background: Cyclical anaphylaxis is a rare reaction occurring in the luteal phase of menstruation. Presentation may include dyspnea, respiratory distress, cutaneous and gastrointestinal symptoms. Previous successful treatment options of this condition have been limited to medical or surgical ovulatory suppression. At present, the use of IgE-inhibition with the drug omalizumab has shown success in multiple individuals, making it the favorable treatment over oophorectomy for women looking to conceive. We report the first successful case series of four patients treated with omalizumab for cyclical anaphylaxis. Methods: A literature review was conducted of published data pertaining to cyclical anaphylaxis in the luteal phase of menstruation. This information was summarized and the four patients from our center were included in this summary. Results: Omalizumab has resulted in symptom resolution or significant reduction in symptoms in all four patients. There is no consistent literature definition of cyclical anaphylaxis and the nomenclature of similar and/or overlapping conditions makes any uniform treatment decisions challenging to make consensus recommendations for. For cyclical urticaria and anaphylaxis, omalizumab and represents a safer and preferable treatment option for this rare condition(s). Conclusion: Through evaluating data regarding the use of omalizumab it can be noted that this is the preferred treatment of cyclical anaphylaxis for women who would like to maintain the option of conception later in life. Continued research is necessary in order to fully understand the generalizability and reliability of study data to the population. We also propose a more systematic classification of this and related conditions to better direct future research. Acute lung injury (ALT), which is associated with a high mortality and morbidity in both infants and adults, is caused by severe lung inflammation resulted from a variety of local and systemic infection such as sepsis and pneumonia. According to the disease procession, there are three stages: exudate formation, proliferation, and fibrosis. Idiopathic pulmonary fibrosis (IPF) is another chronic, progressive and lethal fibrotic lung disease. The etiology of IPF is still unknown. However, both diseases have some similar hallmarks such as hypoxemia and respiratory failure. Surfactant protein D (SP-D), a C-type lectin, which is produced by alveolar type II cells, is important on respiratory innate immunity and anti-inflammation. The action of SP-D in these diseases is still unrevealed. In this study, we used bleomycin to induce the animal model of ALI and IPF. Bleomycin is a chemotherapeutic antibiotic drug clinically used in lymphoma and squamous cell carcinomas, but the following overproduction of reactive oxygen can lead to irreversible lung injury. In this animal model, we have found that 14-day-course was the group presenting the most severe resistance and the poorest elastance of lung tissue. In addition, the proinflammatory cytokines (interleukin-6, interleukin-17, tumor necrosis factor-α, interferon-γ and nitric oxide) were followed by increased expression of pro-fibrotic cytokines (transforming growth factor-β1). The histological alterations caused by bleomycin such as mural incorporation of collagen and obliteration of the alveolar space are similar to human IPF. In ex vivo study, pretreatment with recombinant human SP-D or native SP-D can significantly decrease the production of pro-inflammatory cytokines. In in vivo study, treatment with native SP-D in bleomycin-induced lung fibrosis in mice also showed significant body weight increase, recovery of lung function, decline of the production of transforming growth factor-β1 (TGF-β1) and nitric oxide. Therefore, we conclude that SP-D may have prominent anti-inflammatory and anti-fibrotic effects on ALI and IPF, and also have the potential to become a novel treatment of ALI and IPF in the near future. We have previously demonstrated that Hsp90 release by activated endothelial cells leads to conversion of prekallikrein to kallikrein if prekallikrein is bound to HK. Kallikrein formation is therefore stoichiometric and occurs in the absence of factor XII. Since kallikrein activates factor XII, we theorized that endothelial cell activation might first generate kallikrein which then recruits factor XII. We now demonstrate that estrogen, interleukin 1, and to a lesser degree TNFa can activate endothelial cells to release Hsp90. The dose range tested for each in ng/ml was 0, 0.5, 1.0, 5.0, and 10.0. A dose-response for estrogen or IL-1 was maximal at the 10 ng/ml dose while TNFa was best between 0.1 and 5 ng/ml. A time course for each up to 4 hrs incubation revealed maximal Hsp90 secretion between 30 and 60 min with a significant increase noted by 15 min for each. Our observations are particularly relevant for types I and II HAE (C1 inhibitor deficiency) where estrogen and inflammation are known triggers of angioedema events and for HAE with normal C1 inhibitor (HAE-N) where estrogen exposure is a key precipitant. For the latter, studies of endothelial cell release of urokinase and tissue plasminogen activator are in progress given recent observations regarding inhibitors of fibrinolysis. sunny days and in 56 days limits for dust and polyaromatic hydrocarbons were overthrown. In the medical professional institute Metylovice located 410 meters above sea level found in Štramberk highlands during a 4-week stay for treatment with vitamin D, we investigated the effect of climate on the parameters of bronchial asthma and changes of physical parameters by modified Cooperoe test in asthmatic children. The main goal of the study is to assess the effectiveness and benefits of the stay with described treatment.
Weight: 153.07 Paper Topics: sicure nel promuovere gestire cambiamenti necessari coniugare pratiche ed efficaci l'efficienza l'equita la sostenibilita dei servizi sanitari essenziale la conoscenza la diffusione l'adesione alle raccomandazioni la pratica professionale derivanti da linee guida lg italia la legge 24/2017 "disposizioni materia di sicurezza delle cure della persona assistita nonche materia di responsabilita professionale degli esercenti le professioni sanitarie" stabilendo che "gli esercenti le professioni sanitarie nell'esecuzione delle prestazioni sanitarie finalita preventive diagnostiche terapeutiche palliative riabilitative di medicina legale si attengono salve le specificita del caso concreto alle raccomandazioni previste dalle linee guida pubblicate ed elaborate
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AbstractCome è noto, l'implementazione degli interventi orientati a tutelare la salute pubblica, spesso, comporta costi elevati e solo attraverso un percorso di valutazione è possibile garantire che le risorse vengano impiegate in modo appropriato ed efficiente, evitando di finanziare interventi inefficaci o, addirittura, dannosi. Tuttavia, è estremamente complesso sottoporre le politiche sanitarie a processi valutativi evidence-based. Poco o nulla si conosce sull'impatto degli interventi di Sanità Pubblica in termini di miglioramento della salute e del benessere delle comunità e, come richiamato in precedenza, l'impatto di un intervento nel "contesto reale" può essere diverso rispetto a quanto atteso sulla base dei risultati di studi scientifici. In Italia, la crisi di sostenibilità del Servizio Sanitario Nazionale ha acceso il dibattito sull'importanza del value, riconoscendo in esso il driver della sanità. Michael Porter definisce il value come il ritorno in termini di salute delle risorse investite in Sanità, calcolato rapportando gli outcome di salute, intesi come esiti favorevoli ed effetti avversi, e i costi sostenuti dal sistema. Sir Muir Gray ha attribuito al concetto di value un significato più articolato, facendo riferimento a tre dimensioni (allocativa, tecnica e personale) la cui valutazione è ineludibile per la sostenibilità dei servizi sanitari. La dimensione (efficienza) tecnica può essere incrementata disinvestendo da servizi e prestazioni sanitarie che consumano risorse senza migliorare gli outcome e riallocando le risorse in quelli ad elevato value. Nel nostro Paese esistono numerosi ostacoli all'implementazione di questa dimensione, primo tra tutti la non adeguatezza dei sistemi informativi per una rilevazione sistematica degli outcome, in particolare quelli a medio e lungo termine. Risulta evidente che l'individuazione degli strumenti metodologici e applicativi per la valutazione delle politiche sanitarie rappresenta ancora una straordinaria sfida per la ricerca in Sanità Pubblica. A parere di chi scrive, è una opportunità da non perdere l'attuazione di una strategia nazionale di evidencebased patient information. Le decisioni in sanità non solo devono essere basate sulle migliori evidenze disponibili, ma anche condivise e personalizzate tenendo conto delle condizioni sociali, delle preferenze e aspettative degli individui. Nel documento Crossing the Quality Chasm: A New Health System for the 21st Century, l'Institute of Medicine individua l'assistenza centrata sul paziente come uno dei fattori chiave per migliorare i moderni sistemi sanitari. Creare nel cittadino una cultura della salute appare ancor più importante per le pratiche di Sanità Pubblica. Mentre ogni singolo malato sa esattamente quello che vuole, una diagnosi e una terapia efficace, la maggior parte degli individui sani non sa, al contrario, come proteggere la salute. In conclusione, è possibile, pertanto, affermare che la complessità della ricerca orientata alla definizione e realizzazione delle politiche per la salute delle popolazioni può essere affrontata solo con grande umiltà e utilizzando uno degli strumenti che da sempre hanno caratterizzato la cultura dell'igienista: la capacità di "mettere insieme" ricercatori e operatori di Sanità Pubblica e di dialogare con le diverse professionalità. In tal senso, ci piace ricordare Ammerman et al., quando affermano che "… per affrontare le grandi sfide della Sanità Pubblica i ricercatori devono far uso di evidenze, strumenti e strategie basati sulla pratica e generare approcci per implementare le evidenze basate sulla pratica… se vogliamo più pratica basata sull'evidenza, abbiamo bisogno di più evidenza basata sulla pratica".
Weight: 148.64 Paper Topics: presented cats follow cobalamin concentrations previously investigated cats little information available concerning hypocobalaminemic cats aimed assess frequency hypocobalaminemia large cohort gastrointestinal signs epidemiological clinical biological follow-up characteristics hypocobalaminemic cats1495 cats gastrointestinal signs cobalamin assay simultrac-snb radioassay kit vitaminb12 mpbiomedical performed 2007 2014 ldhvet laboratory retrospectively included study259 173% cats gastrointestinal signs hypocobalaminemia: majority domestic short hair 47% males 84% castrated 53% females 94% castrated aged months 18 years main clinical signs included chronic diarrhea 93% weight loss 71% polyuropolydypsia 48% vomiting 43% polyphagia 38% fatigability 36% dysorexia 19% median duration months diagnosis cobalamin values ranged 44
Weight: 146.92 Paper Topics: down-regulated gene expression encoding sarcoplasmic reticulum sr ca -atpase regulatory proteins sr ca -atpase isoform 2a serca2a phospholamban pln plays crucial role myocardial decompensation impairment intracellular ca 2+ cycling reported serca2a pln expressed peripheral blood mononuclear cells pbmc translatable myocardial setting significantly decrease dogs degenerative mitral valve disease aim study clarify effectively target genes reflect hemodynamic overload primary determinant myocardial distresshealthy laboratory beagles n 24 young dogs patent ductus arteriosus pda 8 pulmonic stenosis ps 5 enrolled study patients treated previously cardiovascular medication pda patients subclinical stage ps patients severe stenosis
Weight: 138.93 Paper Topics: myxomatous right ventricular rv dysfunction strongly independently predicts outcomes people mitral valve disease mmvd purpose prospective pilot study assess rv systolic function rvsf dogs different stages mmvd hypothesized rvsf differ stages disease decrease decompensated mmvdclient-owned dogs mmvd previously receiving cardiovascular medications moderate-or-severe pulmonary hypertension eligible enrollment dogs presenting acute congestive heart failure received single dose furosemide prior echocardiography validated indices rvsf measured: tricuspid annular plane systolic excursion tapse fractional area change lateral tricuspid annular longitudinal peak systolic velocity s' longitudinal global strain strain strain rate rv free wall groups compared using one-way anova sidak's test frequencies cases cardiac remodeling
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EN03 PERFORMANCE EVALUATION OFSerum SDMA concentrations did not distinguish hyperthyroid cats with and without azotemic CKD. The influence of hyperthyroidism on serum SDMA concentrations warrants further investigation. Obesity is a frequent nutritional disorder in dogs and it is associated with several metabolic alterations and represents a risk factor for several systemic comorbidities. However, there is controversy about which of the adipose tissues contributes more to these complications in the canine species. The present study aimed to evaluate the subcutaneous and visceral adipose tissue of ten obese female dogs and ten female dogs with eutrophic body condition, regarding adipocyte size and presence of leukocyte infiltration. The study was conducted with routine animals from the Veterinary Hospital, and all of the animals were submitted to a complete clinical examination, classification based on the body condition score and blood exams to exclude concomitant diseases. Fragments of subcutaneous and visceral adipose tissue were obtained during electives ovariosalpingohisterectomy procedures, the samples were stained with Hematoxylin-Eosin and analyzed with Zeiss Microscope software. It was observed that obese dogs presented remarkably larger adipocyte size when compared to animals with ideal body condition, in a significance level of 5% through Student's T-test. Likewise, it was noted the presence of significantly higher leukocyte infiltrate in obese animals, in a significance level of 5% in the Kruskal-Wallis test, compared to animals with normal body condition that did not have leukocyte infiltration detected. However, the size of adipocytes and leukocyte infiltrate in obese animals did not differ significantly between the visceral and subcutaneous adipose tissue samples. It was concluded, therefore, that obesity in dogs is related with the increase of adipocytes and with presence of leukocyte infiltration, but it was not possible to state in this study that different fat deposits have differentiated metabolic and endocrine levels, which could interfere in a specific way in the inherent processes in obese and diabetic patients. Obesity is a frequent nutritional disorder in dogs and cats and it results in oxidative stress. The evaluation of oxidative stress can be performed through the process of lipid peroxidation, and malonate is one of the most abundant aldehydes. The evaluation method is called "test for substances that react with thiobarbituric acid" (TBARS). Objective of the present study is to evaluate oxidative stress by measuring the TBARS present in samples of obese dogs before and after the weight loss program. The work was carried out with routine animals of the Veterinary Hospital of the Pontifical Catholic University of Parana (located in Parana, Brazil). The animals were submitted to a complete clinical examination, blood count, biochemistry, urinalysis and systolic blood pressure measurement. Subsequently, they were classified as obese on the body scale; body mass index and percentage of body fat. The animals were divided into group 1 (pre-diet) and group 2 (post-diet). Ten obese animals were selected and submitted to a hypocaloric diet loss program. TBARS was performed using the Elisa technique. All animals in groups 1 and 2 presented TBARS values above the reference value, and there was a statistically significant reduction of the values from group 1 to group 2 (P = 0.034). Based on the results, it was concluded that obese dogs present higher production of lipid peroxidation than animals with ideal body scale, leading to the development of oxidative stress and elevation of TBARS concentrations. One of the most important endocrine tests for diagnosis and control of hyperadrenocorticism (HAC) in dogs is the ACTH stimulation. The objective of this study was to evaluate the efficacy of corticotropin inducing cortisol production in dogs. This possibility can be used as an alternative to tetracosactrin (Synacthen) which is, currently, the most used drug in this adrenal challenge test, mainly in Latin America.
With flow cytometry, LTLC induced activation of B cells and T and monocytes, as reflected by upregulated expression of MHCII expression on B cells and monocytes and upregulated expression of OX40 on T cells and B cells. In addition, LTLC induced T cell proliferation.Administration of MucosImmune lessened some clinical signs of FHV-1 in both experiments in this model and decreased FHV-1 shedding when administered 24 hours prior to inoculation with FHV-1. Sporotrichosis is the most frequent subcutaneous mycosis detected in urban areas, it is caused by zoonotic pathogenic species of Sporothrix schenckii complex that affects especially cats. In Brazil, due to a large outbreak of sporotrichosis in the city of Guarulhos (State of São Paulo), the disease has become notifiable. Clinically the disease is characterized as a subcutaneous mycosis, with papular lesions with nodular feature or ulcero-gummy. The definitive diagnosis is obtained by the isolation of the fungus in culture. However, the result can take weeks, resulting in a delay to start the appropriate treatment and disease could spread through other community members. The aim of this study was standardization of the diagnosis of feline sporotrichosis by Cell Block Cytology (CB). CB consists of immediate wet cell fixation in preservative liquid based cytology solution (Surepath, BD), and histological processing. We compared two collecting methods: fine needle aspiration (FNA) and exfoliative brushing (EB) with an endocervical brush. Ten samples of skin lesions of nine suspects cats were collected, (five samples with each method). EB allowed a cell thick sediment, and production of several histological sections, with a slide stained with periodic acid Schiff method. All samples collected by this method showed positive results for fungal structures. FNA cases revealed low cellularity and impossible histological processing. This standardization shows that CB processing is possible with EB of lesions and fixation in cytology preservative solution, allowing storage for up to a month after harvest and further testing, as immunohistochemistry. CB is an alternative for sporotrichosis diagnosis. Canine leptospirosis, a disease of worldwide distribution and significant zoonotic potential, is an acute bacterial infection of dogs caused by pathogenic spirochetes belonging to the genus Leptospira. Timely diagnosis of canine leptospirosis is important because early initiation of antibiotic therapy provides the greatest opportunity for a successful patient outcome. However, diagnosis is hindered by vague clinical signs and by diagnostic methods that can be difficult to interpret and require a lag time for results to be reported. A lateral flow test (WITNESS Ò Lepto, Zoetis) has been developed for the detection of IgM antibodies to Leptospira, offering the advantage of a result in 10 minutes at the point-ofcare without the need for specialized equipment or expertise. Our hypothesis is WITNESS Lepto can detect IgM to four significant Leptospira serovars and will yield positive results earlier or concurrent to that of the microscopic agglutination test (MAT), the serological reference method for diagnosis of leptospirosis.
Weight: 132.07 Paper Topics: tests dneasy canine leishmaniasis important infectious disease worldwide commonly used antibody falsely negative direct detection pathogen polymerase chain reaction pcr necessary however pcr performed specialized laboratories available developed countries aim study evaluate sensitivity specificity rapid in-house pcr diagnosis canine leishmania infantum infection prospectively 515 samples 251 dogs 201 edta blood samples 244 conjunctival swabs 19 lymph node aspirates 51 bone marrow aspirates analysed presence leishmania dna using pcrun biogal galed labs acs ltd kibbutz galed israel results compared real time pcr gold standard identification leishmania kinetoplast dna minicircle dna extraction conducted using blood tissue kit qiagen gmbh sensitivity specificity
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Canine leishmaniasis is an important infectious disease worldwide. Although commonly used, antibody tests are often falsely negative, and direct detection of the pathogen, such as polymerase chain reaction (PCR) is necessary. However, PCR is only performed in specialized laboratories and not available in less developed countries. The aim of this study was to evaluate sensitivity and specificity of a rapid in-house PCR for the diagnosis of canine Leishmania infantum infection. Prospectively, 515 samples of 251 dogs (201 EDTA blood samples, 244 conjunctival swabs, 19 lymph node aspirates, 51 bone marrow aspirates) were analysed for the presence of Leishmania DNA using the PCRun System (Biogal, Galed Labs. Acs Ltd., Kibbutz Galed, Israel). The results were compared to those of a real time PCR (gold standard) for the identification of Leishmania kinetoplast DNA minicircle. DNA extraction was conducted using DNeasy Blood & Tissue kit (Qiagen GmbH). Sensitivity and specificity with 95% confidence range (CI 95%) were determined.
Specificity was 100% for all samples examined. Overall sensitivity of the PCRun was 36.5% ). It was 57.1% (CI 95% 35.9-78.2) in bone marrow aspirates, 58.8% 2) in lymph node aspirates, 46.9% (CI 95% 32.9-60.9) in conjunctival swabs, and 10.0% (CI 95% 1.7-18.3) in blood. The test was easy to perform and provided unambiguous results. In conclusion, the test is recommended for use in practice, and a positive result is proving an infection. A negative result, however, does not exclude infection and therefore requires further diagnostics.
ISCAID-O-2 PREVALENCE AND RISK FACTORS FOR FELIS CATUS GAMMAHERPESVIRUS 1 INFECTION AMONG PET CATS IN THE UNITED KINGDOM.Residual DNA from whole blood submitted to the Molecular Diagnostic Unit, Langford Veterinary Services, University of Bristol, for quantitative polymerase chain reaction (qPCR) testing for haemoplasmas was available for study. DNA from 90 samples testing positive for at least one haemoplasma species and 109 haemoplasma negative samples was shipped to Australia where a qPCR targeting the glycoprotein B gene of FcaGHV1 was performed. The operator (AM) was blinded to sample data (age, sex, neuter status, breed, haemoplasma PCR result). Univariable and multivariable logistic regression analyses were conducted to investigate the association of variables with FcaGHV1 detection. A Pvalue <0.05 was considered to be significant.
ST works for the Molecular Diagnostic Unit, Langford Veterinary Services, University of Bristol, which carried out the haemoplasma PCRs described in the study.
The median time elapsed between the first recognized clinical signs attributed to A. vasorum until diagnosis was 2 weeks (range1 day to 4 months); in only 2 dogs A. vasorum was the prime suspect at presentation. Respiratory signs occurred 10 days, 2 and 3 months after first bleeding in 3, occurred concurrently with bleeding in 1 (hemoptysis) and were absent in 8 dogs. In only 3 dogs cough was present before bleeding prompted referral, for 1 and 3 months in 2 with hemoptysis and for 3 months in 1 with bleeding from the lip. Most non-coughing dogs had only mild non-specific radiographic abnormalities.
Bleeding may be the only recognized abnormality in A. vasorum infection. The cause of bleeding likely varies in individual dogs, and may be a combination of thrombocytopenia, (iatrogenic) abnormal platelet function, utilization of coagulation factors and hyperfibrinolysis. Without a high index of suspicion, the diagnosis may be delayed to the point of fatal outcome.
We prospectively assessed the occurrence, clinical and biological impact of VBPs in anemic dogs, over 1 year, in a French Veterinary Teaching Hospital. The causes of anemia were also reported. Anemic client-owned dogs were included when Hematocrit (Ht) ≤ 37% and Hemoglobin (Hb) ≤ 12 g/dL and excluded if given doxycycline or imidocarb propionate within one month before appointment. We performed PCRs (Ehrlichia canis, Anaplasma platys/phagocytophilum, Babesia/Theileria spp, Hepatozoon sp., Mycoplasma haemocanis (MH)/Candidatus M.haematoparvum, Leishmania spp) and serological tests (SNAP Ò 4Dx, SNAP Ò Leish). Signalment, history, treatments, clinical, laboratory and diagnostic-imaging findings were recorded. Three board-certified specialists determined the etiology of anemia (clinical pathologist, oncologist and internist). VBP-associated anemia (VBPAA) cases were those with positive PCR results.
ISCAIDDisclosures: Disclosures to report. Sergi Segarra is employed by Bioiberica SA, Barcelona Biochemical parameters including alanine aminotransferase (ALT) and alkaline phosphatase (AP) are often used to make a presumptive diagnosis of liver disease in the dog. Especially in idiopathic and copper-associated forms or chronic hepatitis, there is a long subclinical phase in which dogs do not show clinical signs of liver disease. However, this would be the phase in which therapeutic intervention may be most effective. In dog breeds with a hereditary predisposition for the development of hepatitis, biochemical screening of subclinical dogs may be a valuable tool to identify affected dogs in an early stage. Therefore, the aim of the study was to determine the sensitivity and specificity of ALT and AP for detecting hepatocellular injury in clinically healthy Labrador retrievers. Hereto, patient files of 198 client-owned clinically healthy Labrador retrievers were reviewed. Labradors underwent a liver biopsy for screening for copper toxicosis as part of the research program into copper associated hepatitis of the Faculty of Veterinary Medicine, Utrecht University. Age, sex, liver histopathology results, ALT and AP were recorded. To determine sensitivity and specificity in these dogs, ROC analyses were used. In total, 69 dogs did not show histological abnormalities (controls) and 129 dogs showed hepatocellular injury (including 39 cases with primary hepatitis and 90 cases with reactive hepatopathy). In all 198 dogs, median ALT was 37 U/L (range 5-733) and median AP was 26 U/L (range 8-3360). Using thresholds of 70 U/L (ALT) and 89 U/L (AP) which are upper reference values in our laboratory, the sensitivity for detecting hepatocellular injury in clinically healthy dogs was 22% for ALT and 10% for AP. Specificity was 93% and 98% for ALT and AP respectively. New thresholds for ALT and AP were determined using the point closest to the top-left part of the plot with perfect sensitivity or specificity. New thresholds were 35 U/L for ALT and 26 U/L for AP. When using these values sensitivity increased to 68% (ALT) and 59% (AP) and specificity decreased to 62% (ALT) and 60% (AP). Overall, both ALT and AP have a very low sensitivity for detection of hepatocellular injury in Labradors with subclinical liver disease. Decreasing the threshold cut-off to improve the sensitivity results in a substantial decrease in specificity. Therefore, new biomarkers are needed for early detection of subclinically affected dogs, in order to avoid the progression to late stage hepatitis and liver cirrhosis.
Disclosures: No disclosures to report. concentrations is thought to be common in dogs. Excessive hepatic Cu results in hepatocyte damage from oxidative stress, resulting in cell death and subsequent necroinflammatory changes. The accumulation of abnormal hepatic Cu and inflammatory liver disease in the dog has been linked to genetic metabolic derangements in copper metabolism, environmental factors such as excessive dietary copper intake and/or the result of cholestatic disorders. Chelation therapy and low Cu diets are often successful in management of cases having abnormal hepatic Cu. The goal of this study was to determine the incidence of abnormal hepatic Cu in liver biopsies submitted to our diagnostic laboratory and to then correlate the hepatic Cu concentrations with the histolopathological diagnosis. We hypothesize that hepatic Cu would be higher in dogs with necroinflammatory liver changes compared to those with non-inflammatory changes. A second aim was to determine if the concentration of hepatic Cu was related to the extent of hepatic inflammation.
Disclosures Hepatobiliary diseases are commonly encountered in dogs and can be divided into four main categories: parenchymal, biliary, vascular, or neoplastic disorders. In many cases clinical signs of hepatobiliary diseases are non-specific. Current biochemical indicators can establish the presence of hepatobiliary disease, but cannot specify underlying disease and a thorough and extensive diagnostic workup is needed. Recently, microRNAs (miRs) have been identified as promising new serum biomarkers for hepatobiliary disease in humans and dogs. The aim of the present study was to investigate whether serum levels of an established group of microRNAs can be used to differentiate between various hepatobiliary diseases in dogs. Real-time polymerase chain reaction was used for quantification of 6 microRNAs (miR-21, miR-122, miR-126, miR-148a, miR-200c, and miR-222) in serum of 46 dogs with an established diagnosis of hepatobiliary disease compared to 11 healthy dogs. Hepatobiliary diseases included parenchymal (acute/chronic hepatitis), biliary (mucoceles/cholangitis and extra hepatic bile duct obstruction), vascular (congenital portosystemic shunts), and neoplastic (adenomas/carcinomas/malignant lymphomas) subgroups. Linear regression was used to investigate the effect of diagnostic subgroup on the serum levels of the natural logarithm of the different microRNAs, with healthy dogs as reference category. P-values were adjusted for multiple comparisons using the Benjamin-Hochberg correction. With a microRNA panel consisting of miR-21, miR-122, miR-126, miR-200c, and miR-222 it was possible to distinguish between parenchymal, biliary, and neoplastic hepatobiliary diseases. Within these groups, a differentiation between all above mentioned subgroups could be made. No differential microRNA expression was found in the adenoma and congenital portosystemic shunt groups. All other subgroups had increased levels of one or more microRNAs. MicroRNA-122 and miR-21 were both associated with hepatobiliary disease in general, while miR-126 and miR-200c were uniquely upregulated in chronic hepatitis and hepatocellular carcinomas, respectively. This study shows that serum microRNA profiling is a promising new tool that can be valuable in diagnosing and differentiating several common hepatobiliary diseases in dogs.
Disclosures: This study was generously supported by the Winn Feline Foundation (grant number W15-037). Feline hepatic lipidosis (HL) is a common, potentially life-threatening disease, resulting from prolonged anorexia and increased catabolism. The aim of this retrospective study was to identify clinical and laboratory parameters associated with mortality. Data were collected from the medical records of cats diagnosed with HL based on liver cytology or histopathology at the Hebrew University Veterinary Teaching Hospital (years 2004 to 2015) .
Disclosures: No disclosures to report. The presence of a systolic murmur in apparently halthy cats has been previously described. The aim of this retrospectvive study was to determine whether the aorto-septal angle (AoSA), assessed by echocardiography, is correlated with the presence of a systolic murmur in cardiologically normal cats. The medical records between January 2014 and March 2016 have been reviewed. Inclusion criteria included a normal echocardiographic exam, regardless the presence of a cardiac murmur. Cats had also to be normotensive (systolic blood pressure < 160 mmHg) and euthyroid. Cats with echocardiographic evidence of dynamic right ventricular outflow obstruction were not included. Cats with normal diastolic thickness of the left ventricle but mild hypertrophy of the sub-aortic portion of the interventricular septum were also included. The AoSA was measured from the right parasternal five chambers view as previously described. For each echocardiographic parameter, the mean of three consecutive measures was used for statistics. Forty-one cats of different breed were included; 21 females and 20 males, aging 6.4 AE 5.5 (mean AE SD); 22 with a cardiac murmur, 19 without a cardiac murmur. The AoSA in cats with a cardiac murmur (131.1°AE 8.6°) was significantly narrower (P = 0.048) than AoSA in cats without a cardiac murmur (136.3°AE 7.2°). The presence of septal hypertrophy was not associated with the presence of a systolic murmur (P = 0.41). Cats with septal hypertrophy were older (P = 0.0037), however there was not correlation between AoSA and age (P > 0.05). In conclusion, a narrow AoSA is associated with the presence of a systolic murmur in cats and might be considered as potential cause of ejection murmur in apparently healthy cats. A longitudinal study is needed to assess if a narrow AoSA might play a role in the remodeling of the interventricular septum at the level of the left outflow tract. Disclosures: No disclosures to report. A high degree of accuracy is required when using echocardiography to diagnose hypertrophic cardiomyopathy (HCM) in cats, as variation in measurements of 0.5 mm may affect classification of individuals as 'normal' or 'abnormal'. This study in adult cats analysed inter-observer variability between two echocardiographers with specialist veterinary cardiology training. Twenty-four female European shorthair cats, colony-housed compliant with EU regulations, were examined at 12, 18 and 24 months of age by observer 1 (Obs-1). Cardiac ultrasound images (2D) were taken in conscious cats to measure: aortic diameter (Ao), left atrial diameter (LA), diastolic interventricular septum (IVSd), diastolic interventricular septum outflow (IVSd-LVOT), diastolic and systolic left ventricular internal dimension (LVIDd/s), diastolic left ventricular free wall (LVPWd) and left ventricular free wall outflow (LVPWd-LVOT). Cardiac ultrasound measurements were repeated by observer 2 (Obs-2) on stored images. Measurements were analysed for effect of age, observer (mean value for the 3 time points) and age-observer interaction. Additionally, based on IVSd and LVPW thickness, cats were categorized as 'normal' (≤ 6 mm or ≤ 5 mm in cats <6 kg BW) or 'abnormal ' (Gundler et al. 2008) . Linear mixed models (generalised when appropriate) were performed using SAS v9.3. Cat was defined as a random term. Normality of residual distribution of each model involving a quantitative output was checked. Level of significance was 5%. Post-hoc analyses were adjusted for a-risk inflation.
ESVC -European Society of Veterinary CardiologyThe CT thoracic studies of 878 dogs carried out between 2011 to 2014 at Langford Veterinary Services (University of Bristol) were reviewed. Poor quality CTs or those of young dogs with clinical evidence of congenital cardiac disease or regurgitation were excluded. A total of 802 studies met the inclusion criteria. A panel of three boarded cardiologists and one boarded diagnostic imager reviewed the abnormalities.
Disclosures: No disclosures to report. Dyspnea caused by primary respiratory disease or congestive heart failure is a common emergency in dogs. Early, accurate diagnosis is essential for optimal therapy. However, physical examination (PE) alone may be insufficient to differentiate causes of dyspnea and patient instability frequently necessitates delay of radiography and echocardiography. In human patients, emergency clinicianperformed focused cardiac ultrasound (FCU) helps differentiate causes of dyspnea quickly and safely. We hypothesized that FCU performed by emergency and critical care (ECC) clinicians would improve diagnostic accuracy in dyspneic dogs compared to medical history and PE alone. ECC faculty and residents underwent a 3-hour structured FCU training program. Goals included recognizing basic cardiac structure and function and quantitatively measuring left atrial and aortic root diameter (LA/Ao) from right parasternal views. Dogs presenting with dyspnea to the University of Pennsylvania Veterinary Hospital were prospectively recruited. Exclusion criteria included intravenous fluid therapy within 72 hours of presentation, known trauma, and severe systemic disease precluding participation. Medical history, PE, and FCU were obtained at presentation. The ECC clinician, blinded to any radiographic or echocardiographic data, recorded a diagnosis of respiratory (R) or cardiac (C) before and after FCU. Thoracic radiography was performed within 3 hours and echocardiography was performed by a cardiologist or cardiology resident within 24 hours.
ECC clinician diagnostic accuracy was calculated against a gold-standard diagnosis (agreement of a board-certified cardiologist and criticalist with access to all diagnostic test results). Comparisons between groups were made using Mann-Whitney tests. Agreement between LA/Ao on FCU and echocardiography was investigated using univariate linear regression. Significance was set at P < 0.05.
Thirty-eight dogs were recruited. In 3 dogs, gold-standard diagnosis could not be determined. The remaining 35 dogs were used for analysis: 13 in group R, 22 in group C. LA/Ao on echocardiography (P < 0.0001) and FCU (P = 0.0004), and vertebral heart size (P < 0.0001) were significantly higher in group C vs. group R. LA/Ao on FCU and echocardiography were significantly associated (B = 0.75, P = 0.0002, R 2 =0.354). Prior to FCU, 27/35 dogs (77.1%, 95% CI: 60%, 90%) were correctly diagnosed by the ECC clinician. Two cardiac and 6 respiratory cases were misassigned. Following FCU examination, 30/35 dogs (85.7%, 95% CI:70%, 95%) were correctly diagnosed. One cardiac and 4 respiratory cases were mis-assigned. No dogs with a correct diagnosis were reassigned incorrectly following FCU.
In conclusion, performance of FCU by ECC clinicians following training improved diagnostic accuracy compared with medical history and PE alone in dyspneic dogs.
Disclosures: No disclosures to report. In humans, early identification of the same disease is possible through the detection or repolarisation abnormalities on precordial chest leads: particularly T-wave inversion and possibly J-point abnormalities. We hypothesized that these same ECG abnormalities would be able to identify ARVC in a population of Boxer dogs. 12-lead ECGs were prospectively recorded from adult Boxer dogs presenting to the Cardiology services of five veterinary referral centres and one general practice in the UK. Dogs with aortic stenosis were excluded. ARVC (n = 21) was diagnosed based upon the presence of >50 VPCs/24 h on Holter. Control dogs (n = 34) had no evidence of ventricular arrhythmia, no significant heart murmur, and no clinical signs or history of cardiovascular disease. T waves were classified as positive or negative in each pre-cordial chest lead (V1-V6), and J waves were recorded as present or absent, with identification of J-point slurring or notching as described for humans. There was no significant difference in age, weight or sex between groups. J-point abnormalities were identified in up to 48% of dogs (greatest in lead V4, but variable between different precordial leads). There was no significant difference in the frequency with which J-point abnormalities were identified in dogs with ARVC vs. controls (P > 0.272). The frequency of T-wave inversion varied according to chest lead: in lead V1 it was rare (ARVC 0%, controls 3%) but in lead V6 it was common (ARVC 81%, controls 68%). ARVC dogs had a significantly greater prevalence of Twave inversion in lead V4 (29%, vs. controls 6%, P = 0.046) and lead V5 (52%, vs. controls 15%, P = 0.005).
First-opinion clinicians investigated each case; supervising clinicians (DD, CL, JH) reviewed the final diagnosis and categorised cases as cardiac, respiratory, neoplastic, traumatic or miscellaneous, based upon objective and accepted clinical, radiographic, echocardiographic or post-mortem criteria. Records lacking critical data were excluded. Relationships between historical/clinical variables and dyspnoea aetiology were examined. Receiver operating characteristic (ROC) and standard diagnostic test performance analyses were used to find optimal cut-offs for select historical/ clinical variables that could differentiate cardiac and non-cardiac dyspnoea.
A total of 102 cats were enrolled and a definitive diagnosis was reached in 87 cases. Fifty-eight were cardiac (66.7%); 13 respiratory (14.9%); 10 neoplasia (11.5%) and 6 traumatic (6.9%). Fifteen (25.9%) of cats with cardiac dyspnoea had a recent history of cough. Fifteen cats had heart murmurs, 13 of these were in the cardiac group and two had neoplasia. Thirteen cats had gallop sounds and all were in the cardiac group. Eleven had arrhythmias; 10 were cardiac and one traumatic.
Our findings provide first-opinion clinicians with simple means of stratifying dyspnoeic feline patients. Dyspnoeic cats with hypothermia, tachycardia, gallop sounds or profound tachypnea are likely to have CHF underlying their dyspnea. Additional diagnostics are required for cats without these findings to help differentiate aetiologies. Cats with a history of coughing cannot be automatically assumed to be "non-cardiac".
Disclosures: Disclosures to report. One author's salary is paid by VIN. All authors have recieved speaker honoraria from pharmaceutical companies for delivering lectures to general practitioners. None of these were related to this research. No direct or indirect financial support was provided for this research. Feline cardiomyopathies are currently classified according to the human system, despite poor characterization of feline phenotypes (including the effect of age), difficulties ascribing a category in many cats, unknown etiology in most cases, and a lack of diagnostic consensus.
Hearts from cats submitted for necropsy from March 2013 to December 2015 were examined prospectively by a single, trained observer using a standardized set of criteria for macroscopic and microscopic evaluation and assigned a diagnosis based on conventional classification. Cluster analysis was performed using a twostep cluster method.
Dogs with PS and SAS that have "soft"(grade II) murmurs have mild disease. Dogs with palpable murmurs mostly have severe disease, but require additional diagnostics. Therefore, a simple 3-level scale of "soft", "not soft", and "palpable"suffices for physical evaluation of dogs with PS and SAS as no additional information is obtained from more complex classification.
Ninety-six privately owned dogs of 33 breeds diagnosed with MMVD were examined using 2D and RT3D echocardiography. According to the ACVIM classification, 22 dogs were classified with congestive heart failure (CHF) (2 in class C1 and 20 in class C2) and 74 dogs without CHF (64 dogs in class B1 and 10 dogs in class B2). Age ranged from 4 to 14 years (median 10 years), and body weight ranged from 2 to 37 kg (median 9 kg). Fifty-eight (60%) males and 38 (40%) females were included, and heart rate ranged from 80 to 222 beats/min (median 135 b/min).
Disclosures: No disclosures to report. No disclosures regarding this study. The pulmonary vein-to-pulmonary artery ratio (PV/PA) has been shown to be decreased in West Highland white terriers affected with pulmonary fibrosis in comparison with age-and breedmatched controls, suggesting its potential use in the non-invasive diagnosis of pulmonary hypertension (PH). The aim of the present work was to determine the value of PV/PA for the prediction of tricuspid regurgitation pressure gradient (TRPG) compared with other echocardiographic indices in dogs with pre-capillary PH of different origins. Echocardiographic images obtained from dogs with a tricuspid regurgitant jet were retrospectively reviewed. PV/ PA, acceleration time to ejection time ratio of the pulmonary flow (AT:ET), main pulmonary artery to aorta ratio (MPA/Ao) and right pulmonary artery distensibility index (RPADi) were evaluated. Dogs were grouped into control (Group1, n = 19, TRPG<30 mmHg), and mildly (Group2, n = 10, TRPG 30-50 mmHg), moderately (Group3, n = 4, TRPG 50-75 mmHg), and severely (Group4, n = 11, TRPG>75 mmHg) affected with PH. Ten dogs were clinically heathy, and the remaining 34 dogs were suffering from angiostrongylosis (n = 13), brachycephalic syndrome (n = 6), bronchomalacia (n = 6), heart-worm disease (n = 2), chronic pulmonary thromboembolism (n = 2), PH of unknown origin (n = 2), eosinophilic bronnchopneumopathy (n = 1), pulmonary fibrosis (n = 1), and diffuse pulmonary carcinoma ( Results of the Spearman correlation analyses revealed the strongest correlation for PV/PA_2D (r = -0.767, P < 0.0001) to TRPG followed by PV/PA_MM (r = -0.766, P < 0.0001), MPA/Ao (r = 0.720, P < 0.0001), RPADi (r = -0.567, P = 0.001) and AT:ET (r = -0.537, P = 0.003). PV/PA_2D possessed the most accurate cut-off (0.776, AUC 0.974, Se 100%, Sp 88%) to predict a TRPG ≥ 50 mmHg followed by PV/PA_MM (0.756, AUC 0.963, Se 100%, Sp 88%), RPADi (24%, AUC 0.953, Se 91%, Sp 91%), AT:ET (0.390, AUC 0.902, Se 85%, Sp 86%), and MPA/Ao (0.926, AUC 0.865, Se 69%, Sp 92%). In conclusion, PV/PA measured in 2D or MM is an accurate predictor of TRPG and may be particularly useful if TR is absent or difficult to measure in dogs affected with pre-capillary PH.
ESVCDisclosures: No disclosures to report. Eighteen of these dogs were diagnosed with DCM: 3 pre-clinical and 15 clinical DCM. Seven were females and 11 were males. Their age at the time of initial admission was 7.2 years (range 1.5-11) and their weight was 15.1 kg (9.5-20.8). Heparinised plasma Taurine levels were measured in 16/18 dogs and were low in 13/16 (mean 16.07 lmol/L, range 1-39; normal reference 50-180). When low, taurine supplementation was started, in addition to conventional cardiac medications. Of these 18 dogs, 3 were lost to followup. Of the 15 remaining dogs, 7 were still alive at the time of this study and 8 were dead. Of the 3 dogs with preclinical DCM, one was still alive, the other two were dead but remained preclinical at the time of death. The mean survival time (MST) for the overall populations of dogs with clinical DCM was 1237.5 days (95% CI 510.8-1694.2). The MST for the subgroup of ECS with low taurine levels started on taurine supplementation was 1644.9 days (740.4-2549.4) while the MST for the three dogs with normal taurine levels was 381.7 days (3.8-759.5) (P = 0.010). Like American Cocker Spaniels, also ECS diagnosed with DCM phenotype are commonly affected by taurine deficiency. Considering their MST, the prognosis for ECS with DCM may be better than other breeds affected by DCM. In addition, the MST of taurine deficiency ECS may be better than ECS with normal taurine levels. Larger samples and prospective studies are needed.
Disclosures: No disclosures to report. There is an established link between autonomic nervous system (ANS) dysfunction and human cardiovascular disease. Altered heart rate variability (HRV) is associated with human disease severity and outcome, however canine HRV studies have largely failed to show a similar relationship. Electronic measurement of cardiac vagal tone (cardiac index of parasympathetic activity, CIPA) has prognostic value in dogs, however measurement is impractical in a clinical setting. Deceleration capacity (DC), a a novel measure of vagal tone, quantifies deceleration-related heart rate modulation from 24-hour ECG recordings and is a powerful predictor of human cardiac mortality. The prognostic value of DC measurement in canine heart disease is unknown. We sought to assess DC in a population of normal Doberman pinschers and those affected with dilated cardiomyopathy (DCM). Clinical records and Holter data were collected retrospectively from 64 client-owned Doberman pinschers, comprising 20 healthy animals (NORMAL), 30 with preclinical DCM (DCM) and 14 with DCM and congestive heart failure (DCM-CHF). Accepted echocardiographic measurement criteria were used for the diagnosis of DCM. The NORMAL group were healthy dogs presented for DCM screening. The DCM group included dogs identified previously for a large, multicentre, prospective clinical trial (PRO-TECT trial) as well as clinical cases presented for screening, with the same inclusion criteria. Quantitative Holter analysis was performed and data exported for measurement of DC.
Arrhythmia-induced cardiomyopathy (AICM) is defined as systolic and/or diastolic ventricular dysfunction resulting from a prolonged elevated heart rhythm, which is reversible upon control of the heart rate. Familiar dilated cardiomyopathy (DCM) is a primary cardiac disease with genetic predisposition causing mainly left ventricular systolic failure. To the best to the authors knowledge there are no data regarding echocardiographic difference between these two disorders in the dog. The aim of this study was, therefore, to retrospectively evaluate echocardiographic parameters in dogs with AICM secondary to sustained accessory pathways-mediated tachycardia (APMT) and in dogs with familiar DCM. According to the breed and the presence of APMT two groups of dogs were made, and for each group reported monodimensional and B-dimensional echocardiographic measurements indexed to body surface area were taken by one author (MP). Group A included 21 dogs of different breeds with a mean age (AE SD) of 2.8 AE 2.1 years, a mean body weight of 28.0 AE 6.7 kg, and M:F 2.5:1 with AICM induced by APMT diagnosed with endocardial mapping prior to the ablation of the accessory pathway, group B, 12 Doberman Pinschers with mean age of 7.3 AE 2.3 years, a mean body weight of 34.8 AE 7.0 kg, a M:F 1.4:1 with familiar DCM. In group A echocardiographic parameters obtained during sinus rhythm and during APMT were compared to assess the effects of acute changes in heart rate. Echocardiographic measurements obtained in both groups during sinus rhythm were then compared to determine possible screening factors to differentiate these two entities. Normal distribution of values was assessed by the Shapiro-Wilk W-test. Normally distributed data were tested using Student's t-test and non-normally distributed data using Wilcoxon's sum rank test. In group A, shortening fraction (FS) and 2-D ejection fraction (EF) were significantly higher during sinus rhythm than during tachycardia (P respectively 0.001 and 0.004). Shortening fraction and 2D EF were significantly higher in group A than in group B (P respectively 0.002 and 0.007) while end-diastolic volume index, end-systolic volume index and E-point-septal separation were significantly lower than in group B (P respectively 0.03, 0.001, 0.01). The echocardiographic difference between AICM dogs and DCM dogs found may reflect different pathophysiologic mechanisms or different rate of evolution of these myocardial diseases. Further studies are needed to determine cut-off values allowing the differentiation between AICM and familiar DCM.
Disclosures: No disclosures to report. Chronic kidney disease (CKD) is commonly diagnosed in cats in the UK. Previous studies have estimated a prevalence of 1.7-3.6% in the cat population in the UK. Little is known about how CKD is diagnosed and treated in the primary-care setting in the UK. The aims of the present study were to estimate the prevalence and incidence of CKD in the UK and to describe diagnostic procedures and treatments employed.
ESVNU -European Society of Veterinary Nephrology and UrologyCats that presented to 90 veterinary clinics between January 2012 and December 2013 were included in the study. Using the VetCompass database, potential cases were identified by searching the electronic patient record for key terms associated with CKD diagnosis. A random sample of 20% of the potential cases were reviewed in detail to identify cats diagnosed with CKD. Data were extracted from the database for demographics, diagnosis, treatment and comorbidities. Prevalence and incidence were estimated adjusting for the sampling approach.
Of 104977 cats presented, 6691 potential cases were identified. From the potential cases reviewed in detail, 345 new and 199 preexisting cases were confirmed. Estimated prevalence was 2.6% (95% CI 2.4-2.8%) and estimated incidence of new cases was 1.6% (95% CI 1.5-1.8%) over the study period. Median age at diagnosis was 15 years(IQR 12.5-16.9 yr). Most cats (61.1%) were presented because of owner reported clinical signs. The majority of cats (51%) had 2 or more signs at diagnosis with weight loss (44.1%) and polydipsia (32.5%) most commonly reported. Combined biochemistry and urinalysis was the most common method of diagnosis (61.9%). One fifth (20.9%) of cats had a UPC performed. Just under one third (30.4%) of vets recorded IRIS staging with just over half (50.2%) of the staged cats having IRIS CKD stage 2 at diagnosis. One third (33.6%) of cats had at least one blood pressure measurement, with 47.4% of these cats being diagnosed with hypertension. A commercial 'renal diet' (65.8%) and Benazepril (32.8%) were the most common treatments prescribed.
One in 40 cats presenting to primary-care practices in the UK were diagnosed with CKD. UPC and blood pressure are performed in a minority of cats, despite the recognised importance of proteinuria and hypertension influencing prognosis and treatment of cats diagnosed with CKD. Improved knowledge of how veterinarians are diagnosing CKD in primary-care practice will allow targeted continuing education of practitioners. This study also highlights the need for better owner education regarding CKD.
Disclosures: No disclosures to report. calcification. This retrospective observational cohort study examined the association between plasma FGF-23 concentration and hypertension in cats with CKD. Clinicopathologic information from cats at diagnosis of azotaemic CKD was sourced from the records of two first opinion practices. Clinical data are presented as median [25 th , 75 th percentile]. Comparisons were made between hypertensive (HT) and normotensive (NT) cats at diagnosis of CKD using independent samples t-tests or Mann-Whitney U tests. Cats treated with medications known to influence systolic blood pressure (SBP) were excluded. The normotensive group was subsequently used to identify predictors of incident hypertension using Cox regression analysis (hazard ratio (HR) and 95% confidence intervals (CI) reported). Cats with follow-up of <90 days after diagnosis of CKD, or that developed hypertension within that period were excluded from this analysis. SBP and packed cell volume (PCV), were considered as continuous variables, whilst FGF-23 (terciles) and body weight (median) were entered as categorical variables.
Disclosures: No disclosures to report. Urinary tract infection (UTI) is a common cause of antibiotic prescription in dogs. Clinical signs are unspecific for infection, and appropriate diagnostic work-up is a prerequisite for a correct diagnosis.
The aim of the study was to assess the impact of diagnostic work-up on decision to treat (DTT) with antibiotics in dogs with suspected UTI in small animal practice.
The study was designed as a prospective cohort study of small animal practices in Denmark. Dogs with clinical signs of UTI were enrolled and the diagnostic work-up, the diagnosis and prescribed treatment were registered. A urine sample was submitted to a reference laboratory for gold standard bacterial culture (BC). Antibiotic prescription was only considered correct DTT in case of significant bacteriuria on reference BC.
Fifty-six clinics enrolled 154 dogs. Diagnostic pathways were A) Dipstick+Microscopy+BC (n = 66); B) Dipstick+BC (n = 13); C) Dipstick+Microscopy (n = 62) and D) Dipstick (n = 13). Overall, 88% were diagnosed with UTI by the veterinarian, though only 48% had significant bacteriuria on reference BC. Correct DTT was made in 56% in total with over-prescription in 41% and under-prescription in 3% of the dogs. Diagnostic pathways led to correct DTT in 65%(A), 31%(B), 55%(C) and 46%(D) of cases. Pathways with and without BC led to a correct DTT in 59% and 53%, respectively. No significant difference in correct DTT could be found between the diagnostic pathways.
The results reveal a high proportion of antibiotic over-prescription in dogs with suspected UTI, regardless of the diagnostic pathways pursued.
Disclosures: Disclosures to report. The study was supported by the UC-CARE research centre (www.uc-care.ku.dk), 'Vetfond' and 'Fondet for sygdomsbekaempelse hos vore familiedyr'. The aim of the study was to investigate the impact of diagnostic work-up on appropriate choice of treatment (COT) and assess whether bacterial culture (BC) improved COT for canine UTI in small animal (SA) practice.
The study was designed as a prospective cohort study of small animal (SA) practices in Denmark. Dogs with clinical signs of UTI were enrolled. The diagnostic work-up, the diagnosis and prescribed treatment were registered, and a urine sample was submitted to a reference laboratory for gold standard BC. Appropriate COT was defined as prescribing antibiotics with in-vitro susceptibility in combination with choosing first-line agents over secondline agents.
Fifty-six clinics enrolled 154 dogs. Based on reference BC, 74 dogs had UTI and appropriate COT was instituted in 38% of these cases. Inappropriate second-line agents were prescribed in 54%, and first-line agents with in-vitro resistance were prescribed in 8%. Diagnostic work-up included BC in 50% of cases. Appropriate COT was instituted in 38% of cases regardless if BC where included in the diagnostic work-up or not. No significant difference could be demonstrated between the groups.
Disclosures: Disclosures to report. The study was supported by the UC-CARE research centre (www.uc-care.ku.dk), 'Vetfond' and 'Fondet for sygdomsbekaempelse hos vore familiedyr'. Measurement of urinary alkaline phosphatase (uALP) and urinary c-glutamyl transpeptidase (uGGT) activities is readily available and inexpensive. Most studies of uGGT and uALP are limited to small number of dogs with AKI of a single etiology or to experimentally-induced AKI. We aimed to investigate their clinical utility for diagnosing naturally occurring AKI in a large, heterogeneous group of dogs. The study included client-owned dogs with AKI (34 dogs), chronic kidney disease (CKD, 13), urinary tract infection (UTI, 15) and healthy controls (51). uALP and uGGT activities were normalized to urinary creatinine concentration (uALP/uCrea and uGGT/uCrea, respectively). uALP/ uCrea and uGGT/uCrea significantly correlated (r = 0.67, P < 0.001). Both differed significantly (P < 0.001) among study groups, and between the AKI group and either the UTI or CKD groups (P < 0.05), but not the control group. Areas under the receiver operator characteristics curves for uALP/uCrea and uGGT/uCrea as predictors of AKI were 0.68 and 0.61, respectively. Optimal cut-off points for uALP/uCrea and uGGT/uCrea showed poor sensitivity/specificity (58%/70% and 58%/68%, respectively). Higher cut-off points with 90% specificity were associated with decreased sensitivity (38%, 41%, respectively).In conclusion, uGGT/uCrea and uALP/uCrea demonstrated poor discriminatory power for diagnosing AKI in dogs, contrary to previous reports of naturally-occurring and experimentally-induced AKI, and therefore cannot be recommended as screening tests for AKI. uALP/uCrea is a superior marker of AKI to uGGT/uCrea. Since both measures are readily available and inexpensive, they may serve as ancillary biomarkers for early detection of AKI, if appropriate cut-off points, with high specificities, are used.
ESVNU-O-8 THE DIAGNOSTIC UTILITY OF URINARY ALKALINE PHOSPHATASE AND c-GLUTAMYLDisclosures: No disclosures to report. In cats, ureterolithiasis is an emergent medical condition and could predispose to upper urinary tract infection. Although culture of urine sampled directly from the renal pelvis is the gold standard to confirm pyelonephritis, culture of urine obtained by cystocentesis is most commonly performed. But in case of ureteral obstruction culture of urine collected by cystocentesis could be negative because of interruption of urine flow in the affected ureter. The objectives of this study were to determine the incidence of pyelonephritis in feline ureteral obstruction, to investigate if clinical signs and laboratory findings could help diagnose pyelonephritis and to compare results of urine culture obtained by pyelocentesis and cystocentesis in the same individuals. Cats in which pyelocentesis was performed during surgical management of ureteral obstruction were retrospectively included. Pyelonephritis was diagnosed if a positive urine culture was obtained in the sample collected by pyelocentesis. Signalment, clinicopathologic data and abdominal ultrasonography findings were compared between cats with pyelonephritis (group P+) and cats with negative urine culture obtained by pyelocentesis (group P-). Forty-five cats were included. Culture of urine collected by pyelocentesis was positive in 8 of 45 (18%) cats. The isolates were E. coli (n = 3), Raoultella Terrigina (n = 3), Enterobacter cloacae (n = 1) and Enterococcus faecalis (n = 1). The cats in the P+ group were significantly older than in the P-group. The average monocyte count was significantly higher in the P+ group. No significant differences were observed concerning clinical data, other laboratory findings or results of abdominal ultrasonography between the two groups. Three of 8 cats of the P+ group and 9 of 37 cats of the P-group had received antibiotic therapy prior to the urine culture. In thirty-three cats (7 from P+ group, 26 from P-group) urinary culture was also performed in samples collected by cystocentesis. In 4 of 7 (57%) cases from the P+ group, the urine obtained by cystocentesis was sterile and in 3 of 7 (43%) cases culture results were similar between the samples collected by pyelocentesis and cystocentesis. Two of 26 (8%) cats from the P-group had a positive urine culture obtained by cystocentesis. In this study, the incidence of pyelonephritis in cats with ureteral obstruction was 18%. Feline ureterolithiasis is one of the most common causes of acute azotaemia in cats. The placement of ureteral stents or Subcutaneous Ureteral Bypass (SUB) devices has been recently developed in order to overcome the limitations of traditional medical and surgical therapies. The objective of this study was to compare clinical outcome and complication rates of cats with ureteral calculi managed with ureteral stents or SUBs.
A retrospective comparative study was performed. Medical records of cats diagnosed with feline ureteral obstruction undergoing placement of stents or SUB devices between 2011 and 2015 were reviewed. Information about signalement, clinical signs, biochemical data, surgical procedure, length of hospitalization, complications and a minimal 6-month follow-up was obtained.
A total of 50 cats diagnosed with ureterolithiasis were enrolled. A stent was placed in twenty-seven cats (stent group) and 23 cats received a SUB device (SUB group). Regarding pre-operative azotemia, no difference was observed between groups. There was no significant difference on perioperative mortality rate between groups (18% for ureteral stent versus 13% for SUB, P = 0.71). A significant decrease of serum creatinine and urea concentrations was observed in both groups in the first 48 h after surgical intervention (P < 0.0001).
ESVE -European Society of Veterinary EndocrinologyDisclosures: Yes disclosures to report. Claudia Reusch is consultant for Boehringer Ingelheim, and has been a consultant for Novartis Animal Health in the past. She has received financial support for her endocrine research from various companies such as Nestle Purina, Hills, Provet, Antlia SA, Glycemicon and from the clinical studies fund of the ECVIM-CA and from the Society of Comparative Endocrinology. Treatment of canine diabetes mellitus (DM) always requires exogenous insulin therapy. Two types of commonly used insulin are lente insulin and Neutral Protamin Hegerdon (NPH) insulin. The aim of this prospective, randomized clinical trial was to compare the effects of lente and NPH insulin in dogs with DM. Clientowned dogs with newly diagnosed DM were enrolled. Dogs with relevant concurrent diseases and with prior administration of diabetogenic drugs were excluded. Dogs were randomized into two groups such as lente insulin (Caninsulin Ò ) and NPH insulin (Humulin I Ò ). In each group dogs were treated with insulin SC, BID and fed BID with the same commercial diet low in simple carbohydrates and high in fiber. Follow-up evaluations were done at 1, 2, 4, 6, 8, 12 weeks. At each re-evaluation a physical exam, blood glucose curve (BGC) and serum fructosamine concentrations were performed. The glycemic control was classified as good on the basis of absence of PU/PD, body weight stability, normal attitude/activity and >50% of the values in the BGC within 90 and 270 mg/dL. Eight dogs were treated with lente and 12 with NPH insulin. At the time of diagnosis (T0) both groups were homogenous considering age, body weight, gender, serum glucose concentrations and serum fructosamine concentrations. At the last re-evaluation (T12) mean(AESD) glucose concentrations of BGCs and median(range) serum fructosamine concentrations evaluated in the lente group were 279 mg/dL (AE53), 474 lg/dL (336-749) and in the NPH group were 219 mg/dL (AE114), 419 lg/dL (292-597), respectively; such differences were not significant between groups. Median(range) lente insulin dose per injection at T0 [0.35 U/kg (0.3-0.6)] was significantly lower (P = 0.007) compared with T12 (0.6 U/kg;0.4-0.9); median dose of NPH was not significantly different between T0 (0.3 U/kg; 0.1-0.4) and T12 (0.5 U/kg;0.2-0.7). Median fructosamine concentrations at T12 were significantly lower (P = 0.01) compared to T0 in the NPH group but not in the lente group (P = 0.4). At T12 good glycemic control was found in 25% (2/8) and in 75% (9/12) of dogs treated with lente and NPH insulin, respectively; however the difference was not significant (P = 0.06). Hypoglycemic events (nadir <90 mg/dL) were identified in 4 patients (4% of the BGCs in the lente group and 7% in the NPH group) and such difference was not significant. According to our preliminary results the use of both insulin preparates is effective in the treatment of dogs with DM, however the success rate with NPH insulin seems to be greater than that with lente insulin.
Medical records of cats confirmed to have thyroid cysts by technetium scan, ultrasound, or necropsy from 2005-2016 were reviewed. Signalment, clinical features, imaging procedures, diagnostic tests, treatment protocols, and outcomes were recorded.
Thirty-seven cats were identified; 35/37 cats were hyperthyroid. Median time from initial diagnosis of hyperthyroidism to cyst diagnosis was 18 (1-96) months. Clinical signs included palpable neck mass (24/37), weight loss (14/37), dysphagia (7/37), poor appetite (5/37), and dyspnea (4/37). Median aspirated cyst fluid volume in 19/37 cats was 23 (1-300) mL. Advanced imaging in 36/ 37 cats and necropsy in 1 cat confirmed small (<2 cm 3 ), mediumlarge (2-8 cm 3 ), and huge (>8 cm 3 ) thyroid cysts in 9/37 (24%), 7/ 37 (19%), and 21/37 (57%) cats, respectively. Cats with huge thyroid cysts were more likely to display dysphagia or dyspnea.
Disclosures: No disclosures to report. Newly diagnosed hyperthyroid cats from two London-based first opinion practices were recruited into the study. iCa (measured by iSTAT) and plasma calcitonin concentrations (measured by previously validated immunoradiometric assay) were measured at the time of diagnosis and at the time of establishment of euthyroidism. The limit of blank (LOB) of the assay was 1.2 pg/mL. The Mann-Whitney U test was used to compare plasma calcitonin concentrations between hypocalcaemic (iCa <1.18 mmol/L) and normocalcaemic hyperthyroid cats, and the Wilcoxon signed rank test was used to evaluate the change in plasma calcitonin concentrations following treatment. Spearman's rank correlation was used to evaluate the correlation between baseline plasma calcitonin concentrations and iCa and plasma total thyroxine concentration (TT4). Statistical significance was defined as P < 0.05.
This study, approved by the Ethics Committee of Animal Experimentation of the University Complutense Madrid, included 12 dogs diagnosed with HAC. Dogs were of different breeds, 7 females and 5 males, with an age ranged from 8 to 12 years (mean AE SD 10.38 AE 1.39 years). Under stereotaxic conditions and anesthetized, animals were studied in a high magnetic field (3T) MRI, and underwent to radiosurgery at the Ruber International Hospital (Madrid). Dogs were followed-up after radiosurgery and clinical, laboratorial and control of HAC was evaluated in every visit. Time and cause of death were registered.
Results of MRI showed the presence of pituitary microadenoma in 7 dogs and masses greater than 10 mm (diagnosed as macroadenomas) in 5 animals. Treatment (mean AE SD) doses administered was 30.0 AE 3.2 Gy; with a range of 25.0 to 35.0 Gy. Good control of HAC was achieved in dogs with microadenoma between 3 to 6 months after treatment without trilostane (n = 6). In dogs with macroadenoma, a reduction in neurological signs was observed within the first week after treatment, but trilostane was required to control HAC, with lower dosages than before radiosurgery.
Short time and midterm secondary effects were not observed. One dog developed hypothyroidism 2 years after radiotherapy. One dog diagnosed with macroadenoma died due to diencephalic radionecrosis at 348 days. A tumor recurrence was observed at 515 days (n = 1).
Mean survival time in dogs diagnosed with microadenoma was 1123 AE 873.14 days, with a range of 40 to 2798 days. Mean survival time in dogs diagnosed with macroadenoma was 375 AE 232.14 days, (ranging from 181 to 751 days). Survival times in dogs with microadenomas are longer than the observed in other studies in dogs with HAC using mitotane (mean 985 AE 57 days) or trilostane (mean 1051 AE 78 days). In dogs with macroadenoma, survival times are similar to reported with fractionated radiotherapy.
Cases (n = 107) were retrospectively grouped based on pre-study treatment history: cases treated long-term with fludrocortisone (≥ 30 days): (LT; n = 12); cases treated short-term with fludrocortisone (≤ 7 days) (ST; n = 19); newly diagnosed cases never treated with fludrocortisone (NF; n = 76). Dogs were administered Zycortal at an initial dose of 2.2 mg/kg subcutaneously, with subsequent doses administered approximately every 30 days for up to 5 months. Treatment success on Days 90 and 180 occurred when the veterinarian assessed the case as improved, or unchanged (if not new cases of PH) compared to baseline (veterinarian-assessed improvement), and Na + and K + concentrations or the Na + /K + ratio were within the reference range. Dogs were concurrently treated with prednisolone or prednisone.
Zycortal was equally effective in managing clinical signs and electrolyte concentrations in newly diagnosed cases of PH compared to cases previously treated with fludrocortisone, showing beneficial effects on electrolyte normalisation. Dogs previously receiving fludrocortisone were successfully transitioned to Zycortal.
ESCG -European Society of Comparative GastroenterologyOnly diet D2 is a suitable diet to diagnose gastrointestinal bleeding in cats with chronic kidney disease. To reliably detect minimal amounts of blood, the Haemoccult Sensa Ò should be used.
Disclosures: No disclosures to report. . FRD shares many similarities to Coeliac Disease (CD) in humans, such as complete response to strict elimination diet, and typical histological findings such as shortening of the small intestinal villi. Autoantibodies used to test for CD in humans include anti-reticulin, anti-endomysium (anti-EMA) and anti-de-amidated gliadin peptide antibodies. The aim of this study was to test the hypothesis that anti-reticulin, anti-EMA and de-amidated gliadin antibodies can be useful for the diagnosis of FRD in dogs. We hypothesized that anti-EMA antibodies would be detected more frequently in dogs with FRD compared to healthy dogs and dogs with SRD. Antibodies were detected using a human indirect immunofluorescence assay that was adapted for use in canine patients. Tissues on the BIOCHIP TM (Euroimmun Ltd, GE) for this assay included primate intestine, primate oesophagus, primate liver and GAF-3X (synthetic de-amidated gliadin antigen). Use of these BIOCHIPs TM yields a characteristic fluorescence pattern if samples are considered to be positive. Serum was evaluated from 20 healthy control dogs, 17 dogs with FRD, and 28 dogs with SRD. All dogs underwent rigorous diagnostic investigations including clinical staging using the severity scoring (CCECAI), comprehensive laboratory evaluation, ultrasonographic examination of the abdomen and endoscopy with intestinal biopsies. Healthy control dogs and SRD dogs tested negative for any autoantibodies. All dogs with FRD tested negative for antibodies directed against endomysium and de-amidated gliadin peptides, however, five out of 17 dogs with FRD tested positive for anti-reticulin antibodies. There was a significant association between the presence of food-responsive disease and a positive immunofluorescence response for anti-reticulin antibodies when compared to the healthy control (P = 0.014) and SRD groups (P = 0.009). Although the immunofluorescence pattern visualized was not typical for anti-reticulin patterns usually seen with CD, this finding may indicate the presence of autoantibodies against EMA in dogs with FRD and may warrant further study in larger cohorts.
Cats diagnosed with IBD (n = 14) and AL (n = 16) between 2007 and 2013 were included. The feline chronic enteropathy activity index (FCEAI) was calculated for all cases. Control group was composed by 3 healthy indoor female cats and 5 sick cats died or euthanized (non-gastrointestinal illness). Diagnosis and classification of IBD and AL was established according to WSAVA gastrointestinal standardization group template and the National Cancer Institute formulation, respectively. Furthermore, a modified WSAVA template (villous stunting, epithelial injury, crypt distension and lacteal dilation) was applied for low grade AL (LGAL, n = 12) evaluation.
Disclosures: No disclosures to report. Acute pancreatitis (AP) is the most common disease of the exocrine pancreas in dogs. In AP, inflammatory cytokines are released into circulation leading to potentially severe systemic complications and significant morbidity and mortality. The goal of this study was to investigate risk factors associated with short-term mortality in dogs diagnosed with AP.
Medical records of all dogs evaluated between 2008 and 2015 were reviewed and dogs diagnosed with AP were included. Diagnosis of AP was based on the association of at least two clinical signs consistent with AP (vomiting, abdominal pain, anorexia, lethargy, diarrhoea) present for less than 7 days and serum cPL concentration > 400 lg/L or at least two clinical signs consistent with AP present for less than 7 days, serum cPL concentration between 200 and 400 lg/L and ultrasonographic findings consistent with AP (thickened hypoechoic pancreas with blurred margins and surrounded by hyperechoic adipose tissue).
Clinical signs at admission, laboratory data, serum cPL concentration and date of death within 30 days from diagnosis were recorded. Survival analysis using the Cox proportional hazards model was performed to investigate variables associated with short-term (30 days) mortality. Dogs still alive 30 days after diagnosis were censored.
One hundred and thirty-eight dogs were included. Forty-six dogs (33%) died within 30 days of diagnosis. Multivariate analysis identified that presence of IRIS grade 4 or 5 (versus 1, 2, or 3) of acute kidney injury (adjusted hazard ratio [aHR], 8.6; 95% confidence interval [CI], 1.0-71.2; P = 0.05), serum bilirubin concentration ≥ 18.7 mg/L (aHR, 6.5; 95%CI, 1.3-32; P = 0.02], hypercreatininemia (aHR, 3.4; 95%CI, 1.7-6.8; P < 0.01), hypocalcaemia (aHR, 2.9; 95%CI, 1.5-5.9; P < 0.01), metabolic acidosis (aHR, 2.4; 95%CI, 1.2-5.1; P = 0.02) and serum cPL concentration ≥ 1000 lg/L (aHR, 1.8; 95%CI, 1.0-3.3; P = 0.04) were significantly associated with short-term mortality.
This study suggests that presence of serum bilirubin concentration ≥ 18.7 mg/L, hypercreatininemia, hypocalcaemia, metabolic acidosis, and IRIS grade 4 and 5 of acute kidney injury increase short-term mortality in dogs diagnosed with AP. The results of this study add relevant information to the current literature, allowing clinicians to recognize severe cases. Development of acute kidney injury in cases of AP needs to be further investigated.
Disclosures: Disclosures to report. The residency program of Dr V. Fabres is partly financed by Royal Canin. Unrelated to the subject matter of the abstract. To the authors' knowledge, the diameter value of the pylorus sphincter in cats has never been established. As pyloric stenosis is poorly documented in cats, the diagnosis is currently based on clinical signs of pyloric outflow obstruction and abnormal pyloric conformation detected by ultrasonography. The aims of this study were to describe an endoscopic technique allowing the assessment of the pyloric diameter and to report this measure in 20 healthy cats.
This study is, to the authors' knowledge, the first one to describe a method assessing the pyloric diameter in cats. This endoscopic technique was safe and of short duration. In this study, based on 20 healthy cats, the mean diameter of the pylorus was estimated at 9.35 mm. Determination of a reference interval is now warranted in order to help in the diagnosis of pyloric stenosis in cats.
Disclosures: No disclosures to report. Canine chronic enteropathy (CCE) summarizes disease entities characterized by persistent gastrointestinal symptoms and inflammatory infiltrates. Lymphoplasmacellular enteritis (LPE) is the most common form. Based on the response to treatment, food responsive diarrhoea (FRD), inflammatory bowel disease (IBD, steroid-responsive diarrhea) and protein loosing enteropathy (PLE) are differentiated. Differentiation between LPE and intestinal lymphoma is a diagnostic challenge as histopathology might fail to yield unequivocal results. Inflammatory lymphocytic infiltrates, polyclonal in their origin, often cannot be reliably differentiated from clonally proliferating lymphomas by histopathology alone. Clonality testing for detection of antigen receptor gene rearrangement by polymerase chain reaction might offer a useful solution for this dilemma.
The canine IBD activity index (CIBDAI) was used and endoscopic duodenal and colonic biopsies were evaluated by histopathology and clonality testing. Based on clinical data and response to therapy CCE dogs were allocated to 3 groups: FRD (N = 13), IBD (N = 9), IBD with secondary PLE (N = 9). One dog in the FRD group was also diagnosed with histiocytic ulcerative colitis (HUC).
In conclusion, clonality testing might be useful as a complementary tool to investigate the nature of a lymphocytic intestinal infiltrate. Results of clonality must be interpreted in context with clinical signs, other diagnostic findings, and response to therapy. More data -that is long term follow up -is needed to decide, if this new tool might help to detect early lymphoma in patients with CCE.
Disclosures: No disclosures to report. Acquired pyloric stenosis (APS) is poorly reported in cats and is a diagnostic challenge. This is partly because the dimensions of the healthy feline pylorus have not been defined. However, since the pylorus is usually passable with an 8.8 mm diameter endoscope, inability to intubate the pylorus despite several attempts could be a useful diagnostic indicator of pyloric stenosis (PS). The aim of this retrospective study was to compare the clinical characteristics of 34 cats with possible APS (based on the presence of gastrointestinal signs and an inability to pass an endoscope; group A), with a control group of cats with gastrointestinal signs but where the pylorus was passable (group B).
This study was conducted in two referral centres (2006) (2007) (2008) (2009) (2010) (2011) (2012) (2013) (2014) . All cats had signs of gastrointestinal disease and underwent an upper gastro-intestinal endoscopy as part of their diagnostic investigations, all of which were performed by the same clinician (VF). Group A comprised 34 adult cats with a presumptive diagnosis of APS and Group B included 37 cats. Signalment and all clinical parameters were statistically compared between groups (Chi squared test, Fisher's exact test, Student's t-test).
There were significantly more Siamese and Siamese-related cats in group A (7/34) than in group B (1/37 P = 0.045). However, neither age nor weight were significantly different between the groups. Chronic vomiting was the main presenting complaint ( Defining the presence, distribution, and severity of GI disease in endoscopic biopsy specimens from dogs with inflammatory bowel disease (IBD) is difficult. Prior studies have failed to detect a convincing association between mucosal histopathology and clinical signs, or response to therapy and outcome in dogs with IBD. For this reason, a standardized grading scheme for the interpretation of GI histopathologic findings was introduced (WSAVA grading scheme). However, no larger scale studies so far have evaluated whether clinical scoring systems linearly correlate with the WSAVA histopathological grading scheme. Such information would be useful for the clinician as WSAVA grading could be used to monitor treatment response and may give prognostic information. The aim of this study was to evaluate whether dogs that were diagnosed with IBD and had clinical scoring performed using the Canine Chronic Enteropathy Clinical Activity Index (CCE-CAI) and histopathology scoring using the WSAVA scoring scheme are linearly correlated to one another. Electronic data of WSAVA graded endoscopically retrieved biopsy scores assigned by a veterinary pathologist at one single centre were collected. A maximum of five sites were evaluated per animal: stomach; pylorus (n = 87) and fundus (n = 46), duodenum (n = 96), ileum (n = 37) and colon (n = 61). One hundred and two dogs diagnosed with IBD were included in this study. WSAVA scores were compared to the CCECAI scores assigned to the animals at the time of diagnosis. Linear correlation was assessed using Spearman Rank's test. Linear correlation of scores was very weak, with r 2 ranging from 0.009 to 0.249 (gastric fundus; r 2 = 0.05, gastric pylorus; r 2 = 0.028, duodenum; r 2 = 0.249, ileum; r 2 = 0.009 and colon; r 2 = 0.095).
The aim of the present study was to prospectively investigate the presence of virulence genes associated with diarheagenic E.coli in the intestinal mucosa of dogs with LP-IBD. Twelve GSDs and twenty non-GSDs evaluated between March and October 2013 at the Royal Veterinary College (London, UK) were included in the study. The diagnosis of LP-IBD was based on clinical signs, intestinal histopathology, and exclusion of other known causes of gastro-intestinal signs. E. coli was cultured from endoscopically collected mucosal biopsy material on Sheep Blood agar and MacConkey. Colonies showing characteristics consistent with E. coli were identified using API20E (bioM erieux). DNA was extracted from the strains using the MagNA Pure 96 Ò System (Roche), followed by loop-mediated isothermal PCR amplification (LAMP) to detect the presence of shigatoxin (stx1 und stx2), heatstable enterotoxin (sta), and attaching and effacing (intimin) gene (eae). A total number of 47 mucosa-associated E.coli strains were isolated from 26/32 dogs. There was a higher frequency of E.coli strains being isolated in GSDs (12/12, with 1-6 positive cultures per dog) vs. dogs of other breeds (14/20, with 0-2 positive cultures per dog)( P = 0.035). None of the E.coli strains were positive for stx1, stx2 or sta. The eae gene was found in 4 strains and eae-positive E. coli were more frequently isolated from GSD (4/12; 33%) than other breeds with LP-IBD (0/20; 0%) (P = 0.006). These results suggest that E.coli carrying the eae gene and possibly other, yet to be investigated virulence factors could be involved in the pathogenesis of LP-IBD in GSDs.
ESVIM -European Society of VeterinaryThe electronic records of a tertiary referral institution were searched to identify dogs that were anaemic (with packed cell volume less than 35%) and had at least one of the following features: spontaneous agglutination of red blood cells after dilution in saline, spherocytosis without other evidence of shear damage on evaluation of a fresh blood smear, titre of at least 1:16 in direct antiglobulin test, or detection of erythrophagocytosis by myeloid cells in the bone marrow. Dogs were considered to have nrIMHA if the absolute reticulocyte concentration (ARC) did not increase above 60x10 9 /l within five days of presentation. Underlying causes of immune-mediated disease were excluded by diagnostic imaging, serum biochemistry, testing for vector-borne diseases, and urinalysis. The CHAOS score was calculated for each dog: this score incorporates age, rectal temperature, serum albumin and total bilirubin concentrations and the platelet concentration. Associations between clinicopathological variables and survival were evaluated by Cox proportional hazards analysis, with initial univariable analysis followed by construction of a multivariable model. A separate analysis was conducted with CHAOS as the sole explanatory variable.
Disclosures: No disclosures to report. Platelet count can increase within 1-3.5 days in dogs with IMT treated with prednisolone and hIVIG, but treatment failure and death may still occur. Aims of this study were to investigate shortterm response to hIVIG in the management of IMT. Twenty-seven dogs with IMT/Evans-Syndrome (ES) that received hIVIG were included. Dogs with concurrent diseases or receiving medication/vaccination within 30 days of IMT/ES diagnosis were classified with secondary IMT (sIMT), the remaining with primary IMT (pIMT). Based on platelet count at 60 AE 12 hr (T 60 ) post-hIVIG infusion dogs were divided in responders (n = 19) or non-responders (n = 8). A positive response was defined as an increase in platelet count≥40,000/lL compared to the value before hIVIG infusion (T 0 ).
Disclosures: No disclosures to report. From 10/2014 until 12/2015 7 dogs with refractory or recurring ITP were treated with romiplostim. Inclusion criteria were a diagnosis of primary or secondary ITP based on complete medical records, platelet counts < 150,000/ll and a positive platelet-bound antibody test. Primary ITP was only diagnosed, if there was no evidence of any cause, which might have triggered platelets' destruction. Discrimination of primary and secondary forms of ITP was based on a complete diagnostic work-up (complete blood count, blood smear evaluation, testing for erythrocyte agglutination, clinical chemistry, coagulation panel, diagnostic imaging, tests for infectious diseases, and immunological testing).
Primary and secondary ITP was diagnosed in 5 (2 of them Evans' syndrome) and 2 dogs (with Ehrlicha canis infection), respectively. All dogs were pretreated with prednisolone, mycophenolate mofetil, cyclosporine, and dexamethasone alone or in combination. Due to inadequate response or relapses, romiplostim was administered in addition (3-5 lg/kg, median (m) 4.7 lg/kg) subcutaneously. In 5 of 7 dogs, an increase in platelet counts was noted 3-6 days after the first romiplostim injection. One dog with primary ITP had an increase after 10 days and the second administration (10 lg/kg). Another dog with secondary ITP did not respond to 5 but to 13 lg/kg. This dog was lost to follow-up. One dog with a platelet count in the reference range was euthanized due to immune-mediated hemolytic anemia after 2.5 months. During the observation period (3-53 weeks, median 10.7) in 6 of 7 dogs the initially given dose could be reduced. None of the treated dogs developed any side effects. Concomitant therapy with other drugs was gradually reduced and halted in 4 of the dogs when the platelet count was stable. Interestingly, none of the 6 dogs relapsed during the observation period.
Disclosures: No disclosures to report. Acute phase proteins (APPs) are sensitive markers of inflammation and serum C-reactive protein (CRP) has been shown to be a useful diagnostic biomarker in dogs with bacterial pneumonia (BP). In humans with pneumonia APPs have also great utility as follow-up biomarkers. In order to investigate the applicability of APPs as biomarkers of treatment response in dogs with BP, serum C-reactive protein (CRP), serum amyloid A (SAA) and haptoglobin (Hp) were followed simultaneously along with hematology, serum biochemistry, arterial blood gas analysis and thoracic radiographs during a natural course of BP (n = 19). 64 healthy dogs were included as controls. All measured APPs were initially significantly elevated in dogs with BP compared to healthy controls, but the magnitude of elevation was not connected to disease severity. CRP and SAA reflected well the recovery process and declined rapidly after initiation of therapy. Normalization of serum CRP was applied to guide the length of antibiotic therapy (therapy was stopped 5-7 days after CRP normalization) in 9/17 dogs surviving to discharge (median treatment length 21 days, IQR 19-29 days), whereas 8/17 dogs were treated according to conventional recommendations (median 35, IQR 29-48 respectively). When CRP was applied to guide antibiotic therapy, treatment length was significantly (P = 0.015) reduced without increasing the number of relapses. According to this study serum CRP and SAA may be used as biomarkers of treatment response and the normalization of serum CRP may be applied to guide the length of antibiotic therapy in dogs with BP.
Twenty-six dogs presented with BS were included. At diagnosis, respiratory clinical signs were assessed as well as the degree of laryngeal collapse before and after Dxp injection (1.1 mg/kg intravenously). One month after corrective surgery of the BS, respiratory clinical signs, and the degree of laryngeal collapse were reevaluated. Respiratory clinical signs were scored (0 to 4) based on the frequency of snoring, inspiratory effort, exercise intolerance and syncope. Degree of laryngeal collapse (from 0 to 3) was assessed according to the classification described by Leonard (1960) .
Disclosures: No disclosures to report. There are no published studies identifying the causes of pyrexia in cats. The primary aim of this study was to describe the features and diagnoses of a population of cats referred with pyrexia. A secondary objective was to describe, and evaluate the utility of, diagnostic investigations performed. Finally, treatments before referral and their possible effect on reaching a diagnosis were assessed.
ESVIM-O-Clinical records of cats with pyrexia (>39.2°C) documented at least twice (at the referring and/or referral practices) were retrospectively reviewed. Cases were assigned into the following disease categories based on diagnosis: infectious, inflammatory, immunemediated, neoplastic, miscellaneous and no diagnosis (pyrexia of unknown origin, PUO). When more than one diagnosis was made in a case, the diagnosis deemed most likely to be the cause of the pyrexia was used for categorisation, or if unclear was attributed to 'miscellaneous'. Differences in signalment, peak temperature before referral, temperature at presentation, presence/severity of common haematological and serum biochemical abnormalities, and outcome were all evaluated between disease categories. Diagnostic investigations were classified as 'enabling', 'assisting' or 'not helpful' in achieving a diagnosis. Effect of treatment before referral was assessed for any association with temperature at presentation and ability to reach a diagnosis. Chi-squared tests were used for categorical data and Kruskall-Wallis testing for continuous data.
Infectious disease was most common category (41/106, 38.7%), with 22 cats having feline infectious peritonitis. Inflammatory conditions were found in 19/106 (17.9%), neoplasia in 13/106 (12.3%; including 6 cats with lymphoma), miscellaneous causes in 11/106 (10.4%) and immune-mediated disease in 6/106 cats (5.7%). Despite often extensive diagnostic investigations, 16/106 (15.0%) had PUO. Pedigree versus non-pedigree status (P = 0.019) and age (P = 0.003) differed significantly between disease categories, as did outcome (P = 0.019), but PUO was not associated with a worse outcome than other categories (P = 0.46). Cytology (including fluid analysis) and histopathology most often 'enabled' or 'assisted' in reaching a diagnosis. Most cats (91/106, 85.8%) received treatment before referral; antimicrobials were administered in 82.1% of cases. Non-steroidal anti-inflammatory administration was significantly associated with a lower temperature at presentation (P = 0.010). Ability to reach a diagnosis was not associated with treatment before referral (P = 0.99). This is the first study of the causes of pyrexia in cats and shows that, in contrast to dogs, infectious diseases are most common and immune-mediated disease is comparatively rare. PUO was not associated with a worse outcome, in agreement with human reports.
ESVONC-O-2 IMPACT OF PRE-CHEMOTHERAPY NEUTROPHIL COUNT ON CHEMOTHERAPY ADMINISTRATION AND TOXICITY.Q. Fournier, J. Lawrence, I. Handel, J.C. Serra. University of Edinburgh, Roslin, UK Complete blood counts (CBCs) are routinely assessed prior to administration of chemotherapy in dogs in an effort to minimize clinical illness. Neutrophil criteria ("cutoffs") that suggest it is safe to administer chemotherapy are arbitrary and vary across clinicians. Chemotherapy dose intensity is theoretically important for maximal tumour response, suggesting determination of an optimal neutrophil "cutoff"is also important. Similarly, arbitrary guidelines are utilized for the administration of prophylactic antibiotics for neutropenic dogs. The primary objective of this study was to evaluate the impact of various pre-treatment absolute neutrophil count (ANC) "cutoffs"on chemotherapy administration and to determine if there was an association between pre-treatment ANC and incidence and severity of toxicity. The secondary objective was to evaluate a currently utilized neutrophil criteria algorithm used to guide the prescription of prophylactic antibiotics in afebrile, clinically well, neutropenic dogs. Six hundred-fifteen CBCs from 64 dogs that presented for standardized multidrug chemotherapy following a diagnosis of highgrade lymphoma were evaluated and stratified according to their ANC. ANC classes included <1.5 x 10 9 /L, 1.5-2.0 x 10 9 /L, 2.0-2.5 x 10 9 /L, and 2.5-3.0 x 10 9 /L. The number of events in which chemotherapy would not have been administered due to an ANC value below each "cutoff"was determined. Chemotherapy-related toxicities were graded per standardized criteria and Mann-Whitney tests were performed to determine the presence of an association between pre-treatment ANC class and toxicity. To address the secondary objective, afebrile, clinically well, neutropenic dogs with ANC <1.5 x 10 9 /L but above the clinic's criteria for prophylactic antibiotics were evaluated.
ESVONC-O-3 ALTERNATIVE LENGTHENING OF TELOMERES IS USEDDisclosures: This study was conducted by Oncovet Clinical Research (OCR) as part of a collaborative research project between OCR and Pierre Fabre Medicament. Mesotheliomas are rare tumors in dogs known to induce effusions in coelomic cavities. Neoplastic tissue biopsy is often difficult to obtain and, even if cytological diagnosis can be straightforward in some cases, it can be challenging in others. Therefore, diagnosis of mesothelioma is complicated. Only a few cases are described in the literature and no study assesses in a case-control manner the efficiency of surgery, radiation therapy or chemotherapy.
ESVONC-O-5 CASE-CONTROL STUDY OF CHEMOTHERAPY FOR THEDogs with a cytological and/or histological diagnosis of mesothelioma were collected in the medical database. Dogs that were treated with intravenous (IV) and/or intracavitary (IC) chemotherapy were included in Group 1 and dogs that did not received cytotoxic treatment in Group 2. Signalment, type and duration of clinical signs, anatomic location of the mesothelioma, results of staging procedures, cytological and/or histological examinations and type of treatment (surgery, chemotherapy) were collected for all dogs. Follow-up data were obtained from the medical records or from telephone interview of the owners or referring veterinarians. Progression-free survival (PFS) defined as time between diagnosis and evidence of disease progression or death was calculated for all dogs. PFS functions were estimated using the Kaplan Meier method and were compared between groups using the log rank test.
ESVCN-O-5 EFFECTIVENESS OF A NEW DIETETIC FOOD TO ACHIEVE WEIGHT LOSS AND TO IMPROVE MOBILITYOne-hundred-thirty-seven dogs were included, fourteen (10%) were mildly anorexic, 34 (25%) moderately anorexic and 89 (65%) severely anorexic. Fifty-six dogs (41%) were diagnosed with acute gastroenteritis, 11 (8%), with septic peritonitis, 10 (7%) with pyometra, and 7 (5%) with acute pancreatitis. Forty-six dogs (34%) started eating voluntarily within 72 hours from admission, 30 dogs (40%) 72 hours after admission, and 61 dogs (44%) never ate food voluntarily. Fifty-nine dogs (43%) died: 57 dogs (42%) never resumed eating, and two dogs (1%) started eating after 72 hours from admission. Significant difference in mortality rate was found between severe anorexic group and moderate anorexic group (P = 0.0095). No significant differences were found in mortality rate and in length of hospitalization among different disease processes. Statistically significant difference was observed in length of hospitalization between dogs that gained voluntary eating within 72 hours (5 AE 2 days) and after 72 hours (8 AE 3 days) after admission (P = 0.001).
ISCAID -International Society for Companion Animal Infectious DiseasesTwenty-one dogs with a mean age of 45.5 months (2-156 months) were included; thirteen dogs were intact male. Three dogs were mixed-breed dog the others belonged to different breeds. Only 6 dogs had a history of risk exposure. Main duration of clinical signs was 10.6 days (1-30 days) with coughing (12 dogs) and dyspnea (7) the main symptoms. Three dogs had only neurological signs. Eight dogs had a mean hematocrit of 22.6% (15.3-30.1%) and concurrent disseminated intravascular coagulation. All dogs but one had thoracic radiographs characterized by a diffuse moderate (2) or severe (18) mixed alveolar-bronchialinterstitial pattern. Thirteen dogs had positive Baermann result, two of them tested positive for Angiostrongylus vasorum (IDEXX Angio-detect-test) and one negative; overall, nine dogs were tested for Angiostrongylus v. and eight tested positive; two dogs with negative fecal result were diagnosed post mortem with lung mixed infection and disseminated Aelurostrongylus a. infection respectively. One dog was diagnosed on BAL and one on lung cytology. Five dogs died; the others recovered. Therapy, other than fenbendazole 50 mg/kg for 3 weeks, depended on the clinical status.
Lungworm infection might be an underestimated disease in urban and suburban areas and should be considered in the differential diagnosis of dogs and cats presenting with respiratory disease. Limitation of this study was is retrospective view and that not all dogs with positive Baermann had lungworm infection typing; the small number of dogs tested for Angiostrongylus v. was due to the late introduction of the in-clinic test. Cats of uncertain provenance should be routinely screened.
Disclosures: No disclosures to report. Age ranged from one to 9 years with a median of 3.5 years. The majority of dogs (n = 13, 81%) were pure bred with 85% (n = 11) belonging to large breeds such as the Boxer or Labrador and only 15% (n = 2) to small breeds (Yorkshire Terrier and French Bull dog). Three large mixed-breed dogs (19%) were also diagnosed. Interestingly, males (n = 11, 69%) were more frequently diagnosed than females (n = 5, 31%). The most common clinicopathological findings were ulcerative or nodular cutaneous lesions, lymphadenomegaly, lameness, mild to moderate non-regenerative anemia, hypergammaglobulinemia, proteinuria and renal azotemia. Serology based on immunofluorescence or quantitative ELISA at the time of diagnosis was positive in all dogs with the exception of one dog, which was negative. Most dogs received a full vaccination protocol, although in some cases, vaccine was not administered in the same veterinary center where clinical leishmaniosis was diagnosed. Dogs were apparently healthy at the time of vaccination and most of them were considered seronegative based on a rapid serological test. Interestingly, the majority of dogs were diagnosed with clinical leishmaniosis prior to the first annual revaccination. The mean AE standard deviation of time between vaccination and appearance of clinical illness was 7 AE 3 months with a range of 2 and 12 months. In conclusion, this study describes, for the first time, clinicopathological data in dogs with leishmaniosis after vaccination. Moreover, the majority of dogs were diagnosed few months after vaccination highlighting the importance of the use of accurate screening diagnostic tests prior to vaccination in dogs living in endemic areas.
ISCAID-P-6 TYPING OF FELINE CORONAVIRUS BIOTYPES IN CATSDisclosures: Disclosures to report: The authors are employees of IDEXX Laboratories. Tick-borne encephalitis is a zoonotic disease transmitted by ticks. The causative agent is tick-borne encephalitis virus (TBEV), a member of the genus Flavivirus. Since no anti-TBEV canine vaccine is available, seropositivity of dogs indicates natural exposures to Flavivirus. Dogs have served as sentinels in identifying the risk areas for humans of the natural Flavivirus foci and the seroprevalences in healthy dogs were shown to fluctuate from 0-30% depending on areas. Dogs may be resistant to developing clinical signs but clinical cases are often fatal. Our study had two aims: (i) assess the TBEV-seroprevalence in dogs showing neurological signs and its relationship with regard to gender, age and breed, (ii) evaluate the possible concordance of TBEV-seroprevalence and the specific areas suspected of Flavivirus foci in accordance with the RKI (Robert-Koch Institute, Berlin, Germany) classification of 'risk counties'. Between 2013 and 2015, we analysed 433 blood samples obtained from dogs with various unspecified neurological signs suspected of TBEV-infection. The majority of the samples came from Germany (299), Austria (54), Czech Republic (33), Sweden (15), Switzerland (12), and Norway (10). IgG-antibodies to TBEV were assayed using a commercially available ELISA. Based on the Antibody-titre results, dogs could be classified as follows: Ab-positive (>126 U/ml): 48/433 (11.1%), 'borderline range' (≥63 ≤ 126 U/ml): 20/433 (4.6%), and Ab-negative (<63 U/ml): 365/433 (84.3%). By breed with ≥10 dogs, Ab-positive dogs were in the following decreasing order: Golden Retrievers, Labrador Retrievers, Yorkshire Terriers, Mongrels, and Bernese Mountain Dogs. No gender-dependency could be detected. The median age of the Ab-positive dogs was 6.5 (1-13) years. 28/299 (9.4%) dogs from Germany were Ab-positive and 27/28 (96.4%) came from risk areas (Bavaria, Baden-Wuerttemberg, Hesse, Thuringia, and Saarland). Dogs from other countries presented the following Abpositivity; Austria: 14/54 (26%), Czech Republic: 4/33 (12.1%), Norway: 1/10 (10%) and Switzerland: 0/12 (0%). Our present study showed that (i) Retrievers were the predominant breeds with respect to TBEV-seropositivity and (ii) a high concordance was confirmed between seropositive dogs with neurological signs and the TBEV-risk areas in Germany as defined by the classification of the RKI. Our data also suggested that, although seroprevalence could be low, TBE should be considered a potentially useful differential diagnosis in dogs with neurological signs when the dog has a history of travelling or living in risk areas and, in that case, the serological diagnosis should be confirmed by a paired sample, taken two weeks apart.
ISCAID-P-8 PREVALENCE AND PHYLOGENETIC ANALYSIS OFMedical records of dogs diagnosed with A. vasorum were evaluated retrospectively. The inclusion criterion was a diagnosis of A. vasorum infection based on detection of larvae in fecal samples (8), in tracheal wash fluid (6) and/or via antigen testing (IDEXX, Angio DetectTM) in serum (15).
In 23 dogs consisting of 19 different breeds and 3 crossbreed dogs angiostrongylosis was diagnosed. The median age was 4 years (range 0.5 to 11), 15 dogs were male and 8 female. Twenty of 23 dogs came from Berlin. Eight of 14 dogs with a known travel history had never left Germany. The most common signs on admission were cough (48%), tachypnea/dyspnea (30%), vomitus (17%) and neurological signs (17%). Hematological changes included leukocytosis (70%), eosinophilia (78%), neutrophilia (65%), monocytosis (65%), thrombocytopenia (30%) and anemia (26%). Biochemistry abnormalities were hyperproteinemia (50%), hypoalbuminemia (57%), azotemia (20%), and hypercalcemia (14%). Four of 8 dogs had a prolonged activated partial thromboplastin time. Thoracic radiographic abnormalities were detected in 15 dogs (65%).
A. vasorum infection is an emerging disease and should be considered as important differential diagnosis for various clinical signs in the Berlin/Brandenburg area.
Disclosures: The study was partially sponsored by IDEXX Laboraties Ludwigsburg. IDEXX Laboratories is the Producer of Angio Detect TM. The co-author E. Huisinga is employee of IDEXX Laboratories. The aim of study was to describe retrospectively clinical, radiographic and therapeutic features in cats from Italy diagnosed with lungworm infections.
In 2013-2015, twenty-six cats infected by lungworms at the Veterinary Teaching Hospital of the University of Teramo underwent to physical examination, laboratory analysis, thoracic radiography and fecal examination. Parasites elements were identified by floatation and Baermann-Wetzel methods and all results were confirmed by PCR. All animals were treated with different anthelmintics and followed-up every 2 weeks until recovery. All cats (13 males, 13 females), with median age of 24.9 months (2-132), lived or were allowed to roam outdoor. Infections by Aelurostrongylus abstrusus (n = 15), Troglostrongylus brevior (n = 3) and Capillaria aerophila (n = 1) and co-infections by T. brevior/A. abstrusus (n = 6) and T. brevior/C. aerophila (n = 1) were diagnosed. All cats harboring T. brevior (n = 10) had less than four months. Respiratory signs recorded were coughing (n = 12), increased vesicular sounds (n = 10), dyspnoea (n = 9), tachypnoea (n = 6), abdominal breathing (n = 5), oculo-nasal discharge (n = 5), sneezing (n = 4), wheezing (n = 2) and crackles (n = 1). One cat was asymptomatic. Haematobiochemical abnormalities were anemia (n = 7), neutrophilia (n = 7), eosinopenia (n = 2), eosinophilia (n = 1) and monocytosis (n = 1). Radiographic features were interstitial (n = 24), bronchial (n = 21), alveolar (n = 10) and vascular (n = 2) patterns. Twenty-five cats showed a complete recovery within 2-6 weeks, while one kitten died few days after the diagnosis. Cats infected by A. abstrusus, after a 3-day course of oral fenbendazole (n = 3) or one (n = 4), two (n = 7) or three (n = 1) topical moxidectin two weeks apart, recovered within 14-42 days. Animals with troglostrongylosis recovered in 14-42 days after a single administration of moxidectin (n = 2) or emodepside (n = 1). Cats with co-infection by T. brevior/A. abstrusus received single topical emodepside (n = 1), single oral milbemycin oxime (n = 2), or two (n = 2), three (n = 1) administrations of moxidectin. Five cats were healthy in 14-42 days, while one, treated with milbemycin oxime, died after an acute onset of dyspnoea. Two cats infected by C. aerophila and T.brevior/C. aerophila received a single administration of eprinomectin and emodepside, respectively, and they were healthy after two weeks.
Lungworms should always be included in the differential diagnoses in cats living in endemic areas and presenting respiratory and radiographic signs and copromicroscopic examinations should be considered as first step. As radiographic changes may be evident before the onset of clinical signs, radiographic examinations are mandatory if lungworms are suspected. In fact, in most cases, a timely therapy guarantees the recovery, being various compounds effective against felid lungworms.
Disclosures: No disclosures to report. The purpose of this investigation was to evaluate the diagnostic sensitivity and specificity of a point of care lateral flow test (WIT-NESSÒ Lepto, Zoetis) that detects IgM to Leptospira, using wellcharacterized canine sera archived at the Freie Universit€ at Berlin. The test requires 5 μL of serum, plasma, or whole blood, and a result is obtained in 10 minutes. A total of 187 samples collected from 122 dogs in four different groups were tested: (i) 37 dogs with acute clinical leptospirosis confirmed by one or more of the following: acute MAT serology (titer of ≥1:800 for non-vaccine serovars), convalescent MAT serology, blood PCR, urine PCR. Convalescent sera from nine of these dogs, collected approximately two weeks after the acute sample, were also tested; (ii) 15 dogs with clinical signs compatible with leptospirosis but a different final diagnosis; (iii) 45 healthy dogs, and (iv) 25 recently vaccinated dogs sampled 0, 4, and 12 weeks post-vaccination (wpv), with six animals also tested at 26 wpv.
ISCAID-P-13 EVALUATION OFThe WITNESS test detected 28 of 37 infected animals (Group 1; 75.7%) while only 9/37 (24.3%) had high diagnostic titers on acute MAT. Of the 9 false negative samples on the WITNESS test, only 1 had a high diagnostic acute MAT titer. Seroconversion in the Group 1 convalescent samples was evident as all nine were WIT-NESS-positive, compared 5 of the 9 that were WITNESS-positive with the acute sample. All Group 2 and 44/45 (97.8%) Group 3 dogs were negative on WITNESS. In this population of dogs, the WITNESS diagnostic sensitivity and specificity were therefore 75.7% (95% CI 60.3-87.2%) and 98.3% (92.5-99.8%), respectively. The WITNESS test did also detect vaccine-generated IgM for up to 12 wpv. After an initial rapid increase in positive tests À16/25 (64%) by 4 wpv-only 6/25 (24%) remained positive 12 wpv and these dogs returned to negative WITNESS status by 26 wpv.
In conclusion, WITNESSÒ Lepto is a reliable test for the diagnosis of acute leptospirosis and is capable of detecting IgM ealier than MAT. A negative result should be interpreted as leptospirosis-negative, however if suspicion remains, confirmatory testing is necessary. A positive test is indicative of leptospirosis but must be considered within the context of clinical presentation and the timing of the most recent Leptospira vaccination.
ISCAIDDisclosures [AH] . Diagnoses and accurate SV anatomy were obtained from perioperative CT and intraoperative portography images associate with hyperammonemia. Left-sided IHPSS were visualized in four animals. Two cats presented seizure episodes previous to the surgery. Two dogs and a cat had previously undergone partial shunt ligation with posterior recurrent hyperammonemia. Mean age at the time of diagnosis was nine months (range five to twelve months). French multipurpose catheters (3-5Fr) were inserted in the mesenteric vein or PV and advanced to the shunt site through a guidewire after transperitoneal approaches. Coil anchors were inserted in the SV of a dog [AK] and a cat [RB] previous to coil embolization procedure. PSS attenuation required deployment of additional coils due to persistent shunting flow in the dogs. The pushable coils were used to occlude PSS in the dogs because of low probability of coil migration, and the detachable microcoils were used to occlude the PSS in the cats due to the adaptability to irregular SVs and possibility of retrieve the device in case of instable coil deployment. PV pressures were measured to determine pre-and post-occlusion plausible changes. Preoperative serum ammonia ranged from 95 to 254 lmol/L and from 15 to 130 lmol/L in postoperative period. Serum liver enzymes remained elevated in the follow-up period in all patients. However, neurological and gastrointestinal abnormalities gradually improved in the short-term post-operative period. The residual PSS flow is expected to gradually cease due to blood clotting around the coils. Nevertheless, a long-term follow-up is recommended after PSS attenuation because of the risks involving coil dislocation and shunt recanalization. Follow-up signs of liver dysfunction were managed using low protein diet and hepatoprotectives drugs.
ESVC-P-4 TAPSE-TO-AORTIC RATIO PROVIDESDisclosures: No disclosures to report. Heart rate variability (HRV) is a known risk factor for mortality in healthy and dogs with heart failure. In healthy human reference of normal values for short-term measures of HRV (ST-HRV) were published as an appendix to the paper "Heart rate variability: Standards of measurement, physiological interpretation and clinical use' (Circulation, 1996; 93, 1043 -1065 . In healthy dogs reference values of ST-HRV were publish (Pol J Vet Sci. 2015, 18, 307-312) . The aim of the study was to compare normal value of short-term HRV in healthy dogs (H) (n = 50) and dogs with sick sinus syndrome (SSS) (n = 10). The ECG was recorded continuously for at least 180 min in dark and clam room. All QRS complexes from ECG were first edited automatically and then manually by careful inspection of the RR intervals. The data had no atrial or ventricular premature complexes. Signals were transformed into a spectrum by Fast Fourier Transformation. Heart rate variability parameters were measured at fixed time at the number of sample 60 min. Separate frequency (Hz) components of the HRV were obtained including very low frequency (VLF), low frequency (LF), high frequency (HF), total power (TP) and LF/ HF ratio. Research of new biomarkers to detect myocardial injury is crucial in medicine. Although whole blood and serum choline are suggested as emerging biomarkers in patients with myocardial ischemia, there is no available data on its usefulness for predicting cardiac events in dogs and cats. Thus, this study was aimed to evaluate the use of serum choline concentration as a potential biomarker for myocardial ischemia, and determine whether there was a correlation between cardiac troponin (cTnI) and serum choline in dogs and cats with heart diseases. Dogs with congestive heart failure (n = 10) and cats with either hypertrophic cardiomyopathy (n = 9) or dilated cardiomyopathy (n = 5) were used as cardiac group. Heart disease was diagnosed based on the clinical, radiologic, electrocardiographic (ECG) and echocardiographic findings. Myocardial injury was determined by elevation of serum cTnI level; dogs >0.07 ng/mL and cats >0.16 ng/mL. Healthy age-and breed-matched dogs (n = 10) and cats (n = 10) were used as controls. All dogs and cats selected for this study were sero-negative for common vector-borne pathogens and feline infectious diseases, respectively. Serum free-choline concentration of each sample was analyzed by high performance liquid chromatography in triplicate and results were expressed as micromolar (lM).
These data suggest that serum choline concentration might be used as a biomarker for the diagnosis of myocardial ischemia in dogs and cats with various heart diseases, and thereby may contribute to differentiate between ischemic and non-ischemic etiologies of cTnI elevations.
The clinical archives of the Clinica Veterinaria Gran Sasso (Italy) and of the cardiology unit of DIMEVET (University of Milan, Italy) from 1997 to 2015 were reviewed for all cats diagnosed with RCM based on an echocardiographic exam. The diagnosis was based on distinctive echocardiographic phenotype of left atrial/biatrial enlargement, normal left ventricular (LV) wall thickness, and restrictive LV filling pattern with pulsed Doppler echocardiography. Inclusion criteria were any patient with a complete case record and an echocardiographic diagnosis of RCM. Cats diagnosed with another form of cardiomyopathies CMs, with congenital heart disease, with hypertension or hyperthyroidism or those with incomplete case records were excluded. Follow-up status and cause of death were determined by reviewing the medical records or by phone interviews with the owners.
Between 5/1990-3/2016 IW (n = 1588; 732 m; 856 f) were examined by physical examination, echocardiography and electrocardiography (AV). Dogs were longitudinally followed, and owners instructed to report date and circumstances of death. DCM was diagnosed in 411 dogs (248 m, 163 f), of these associated with sinus rhythm in 29 m and 39 f, and with AF in 219 m and 124 f. AF was the only abnormality of 19 m and 24 f, and additionally was diagnosed in 4 dogs with valvular disease.
RBBB was diagnosed in 3 IW with and 10 without DCM, while 3 IW with and one without DCM had LBBB. LAFB were more common in IW without DCM (10 versus 1 with DCM). Other abnormalities of QRS complexes like notched and splintered forms were common in both groups (8.5% of dogs with DCM and 9.5% of normal IW).
Disclosures: No disclosures to report. Pulmonary-vein-to-pulmonary-artery ratio (PV:PA) has been proposed as a method of identifying various stages of cardiovascular disease, including congestive heart failure (CHF) and pulmonary hypertension (PH). However, few studies exist that have examined the diagnostic utility of PV:PA, or other PV or PA measurements in the diagnosis of CHF or PH. M-mode echocardiographic evaluations were performed on 93 dogs with mitral valve disease (MMVD) +/-PH (tricuspid regurgitant velocity <3 m/s). The right ostium of the PV and PA were measured at the maximal and minimal diameters (mechanically timed), and at the peak of the QRS and end of the T-waves (ECG timed). Left atrium and aorta were measured at the onset of diastole. Dogs were classified as being subclinical (B1, B2) or having CHF (C). Various indices of PV and PA were calculated. These indices were examined in a subset of dogs with similar LA:Ao but different clinical classifications (B2[n = 24] versus C [n = 12]) to determine the clinical utility of PV:PA in identifying CHF. PV and PA indices were also examined in dogs with (n = 35) and without (n = 26) PH to determine the clinical utility of identifying PH.
ESVC-P-19 USE OF TORASEMIDE IN CATS FOR CONGESTIVE HEART FAILURE. R. Mcdonald. University of Glasgow, Glasgow, UKCollected data included signalment, presenting signs, diagnosis, concurrent medications, maximum dose of furosemide before transition to torasemide, starting torasemide dose, maximum torasemide dose reached during CHF therapy, survival time after commencing torasemide and comparison of renal parameters and electrolytes prior-to and after commencing torasemide. Adverse reactions were recorded. A board-certified cardiologist retrospectively reviewed the cases. All owners signed consent forms to permit the use of off-licensed drugs.
ESVC-P-20 IRON STATUS IN DOGS WITH MITRAL VALVE DISEASE.Disclosures: No disclosures to report. Post-capillary pulmonary hypertension is common in dogs with degenerative mitral valve disease (DMVD). Its prevalence increases with severity of DMVD and its presence is a predictor of worse outcome. Left atrial (LA) function and size are prognostic indicators in DMVD. In dogs, LA contractile function has been shown to decrease with severity of DMVD. In human with chronic mitral regurgitation, LA function is an important correlate of right ventricular systolic pressure. The aim of this study was to assess if LA dysfunction was associated with PH in dogs with DMVD. Dogs with DMVD and a measurable tricuspid regurgitation (TR) were retrospectively recruited. Maximal LA diameter, LA diameter at the onset of the P wave and minimal LA diameter were measured on anatomic M-mode from 2D cineloops on aortic short axis view. Left atrial reservoir (LA expansion index; Total LA shortening fraction), conduit (Passive LA shortening fraction) and contractile function (Active LA shortening fraction) indices were derived from above measures. Ninety three dogs including ACVIM stage B1 (22), B2 (28), C (39) and D (4), were included. Dogs were assigned to pulmonary hypertensive group (PH) (TR pressure gradient >40 mmHg) (n = 29, median: 51 mmHg; range: 40-114) or pulmonary normotensive group (PN) (n = 64, 29 mmHg; 5-40). LA reservoir and contractile function indices were reduced in ACVIM stage C and D compared to asymptomatic stages (P < 0.001) and TR pressure gradient was higher in symptomatic dogs (P < 0.05) compared to asymptomatic dogs. TR gradient was positively correlated with LA size measured at different time intervals (P < 0.001) and negatively correlated with LA reservoir (P = 0.02) and contractile (P = 0.009) variables LA reservoir variables (P = 0.008), and active LA shortening fraction (P = 0.006) were lower in PH group compared to PN ANCOVA was used to test the categorical effect of ACVIM stages along with the effects of LA function indices on TR pressure gradient. ACVIM stage had a strong effect on TR gradient (P < 0.001) but LA function parameters did not persist after correction for ACVIM stages. This study confirmed that, in dogs with DMVD, PH is strongly associated with the stage of heart failure but failed to show an independent relationship between LA dysfunction and development of PH. The reason may be a lack of accuracy of one dimensional variables to assess LA phasic function or the absence of causal link between LA dysfunction and development of pulmonary hypertension in DMVD dogs. Disclosures: No disclosures to report. Mineralisation of the heart and great vessels has been reported as an incidental radiographic finding in dogs. The prevalence has been reported at 0.61% on thoracic radiography. Thoracic computed tomography (CT) imaging is being used more frequently in dogs in recent years, but the CT prevalence of mineralisation is unreported. It may be higher because of the increased sensitivity of CT compared with radiography. The aim of the study was therefore to describe the prevalence and location of cardiac and great vessel mineralisation in dogs and to evaluate its association with age, sex and concurrent disease. Thoracic CT studies of 878 dogs carried out between 2011-2014 at a veterinary teaching hospital were reviewed. Poor quality CTs were excluded, resulting in 802 dogs available for inclusion. A single, trained operator systematically reviewed all CT studies and a panel of three Board-certified Cardiologists and one Board-certified Diagnostic Imager reviewed all abnormalities. The cases were grouped by: sex (male/female); age (1-5 years, ≥5 to 10 years, and >10 years), and concurrent disease process: neoplasia, cardiorespiratory, neurological, internal medicine, surgical (soft tissue and orthopaedics), and miscellaneous.
ESVCThe purpose of our study was to asses the sympathetic activity in dogs with chronic kidney disease, using the heart rate variability analysis (HRV) on short time ECG monitoring (5 minutes). We included 10 dogs (various age and breeds) with chronic kidney disease (CKD group), diagnosed according to IRIS classifications. We evaluate time domain and frequency domain parameters to estimate overall HRV (SDNN), vagal tone activity (pNN50 and HF) and sympathetic tone (LF and LF/HF), using Kubios HRV software. To compare the results we included HRV data from 10 healthy dogs (no heart or kidney disease present) with matched age, weight and gender.
ESVNUDisclosures: No disclosures to report. The risk of functional impairment of the kidney, CKD and AKI, is a common problem in cancer due to infiltration or nephrotoxic chemotherapeutics. While about 40% of human lymphoma patients are known to have compromised kidney function, only 20% of the affected patients are diagnosed by creatinine while the remaining 80% require biopsies for diagnostic accuracy. A study of 5000 human patients with a variety of solid tumors demonstrated that the prevalence of reduced GFR was about 52% and 12% had advanced CKD (stages 3-5). Given the increased incidence of cancer; new therapies are being developed at a frenetic pace leading to an increased need to identify kidney disease early and highlighting the demand for more effective and sensitive biomarkers. At this time such detailed information is nonexistent for veterinary patients, however there is no reason to think that it is any different. Methylation of arginine is a signaling process with asymmetric methylation activating transcription and expression while symmetric methylation is a repressive signal. It's important to understand if increased protein turnover in malignancies will lead to increased production of dimethylarginines. In a human study that included different types of cancer, ADMA but not SDMA, was shown to have significantly increased in the cancer cohort compared to controls. The observed increase in SDMA is likely due to impaired kidneys and not cancer related increased production of SDMA; while the increase in ADMA is likely due to increased protein turnover as a result of transcriptional activation.
Disclosures: Disclosures to report: Murthy Yerramilli, Mahalakshmi Yerramilli, Giosi Farace, Jane Robertson and Roberta Relford are all employees of IDEXX Laboratories Inc. Dennis Jewell is an employee of Hill's Pet Nutrition Inc. Despite progress in early diagnosis and recognition, acute renal failure attributable to leptospirosis remain a challenging condition. Intensive care and costly procedures, including renal replacement therapy are frequently recquirred.
A retrospective study focusing on dogs presenting for intermittent haemodialysis treatment, in which a diagnosis of acute renal failure secondary to confirmed leptospirosis was conducted.
Epidemiological, clinical and paraclinical datas a diagnosis were recorded. Survival at discharge and long term outcome was recorded.
Dyspnoea was present at diagnosis in 28% of cases, whereas 2 dogs presented with neurological signs (seizure and coma). Mean s erum urea and creatinine value were markedly elevalted at diagnosis (4.8 g/L and 102 mg/L respectively), 25% of dogs were initially oliguric to anuric.
Diagnosis of leptospirosis rely on MAT for 23/29 dogs and identify a pr edominant reaction to the Australis serogroup in 16/ 23 dogs. In 6 dogs diagnosis of leptosirosis infection rely on PCR examination of blood and urine.
Polypnea at diagnosis, anuria and neurologic signs had a negative impact on survival, whereas urea and creatinine value did not.
The IDEXX SDMATM Test shows superior accuracy and precision over the human SDMA-ELISA. The positive bias and poor precision of the SDMA-ELISA test severely limits its clinical utility for diagnosing and staging of CKD in dogs and cats.
Disclosures: Disclosures to report: There is a potential indirect disclosure to report. The authors all work for IDEXX, which runs a laboratory service that performs an assay that is discussed in the abstract. Upper and lower urinary tract disorders of small animals are commonly seen in our country. When 2/3 of the kidneys become dysfunctional, clinical signs are apparently present in the patient. In this study, enzymuria and microalbuminuria were evaluated in eighty dogs with the lower urinary tract symptoms (pollakiuria, dysuria-stranguria, hematuria, urinary incontinence, polyuria, polydipsia, excessive licking of the urogenital area) that were referred to Istanbul University, Veterinary Teaching and Research Hospital, Internal Medicine Clinics. Blood and urine samples were collected aseptically from each dog. The specific parameters that were detected in the study were; urine microalbumin concentration (Heska Ò E.R.D.-HealthScreen Canine Urine Test), urine protein creatinine ratio (UPC), urine culture and enzymes (urine N-acetylbeta-D-glucosaminidase (NAG), Alkaline phosphatese (ALP), Gamma Glutamyl Transferase (GGT), Lactate Dehydrogenase (LDH), Alanin Aminopeptidase (AAP) ). The blood pressure was measured with high definition oscillometric device (Memodiagnostic Ò ). Statistical analysis "General Linear Model"was based on gender, age, nutrition, microalbuminuria and urinary tract disorders of the dogs. With the comparison of urine dipstick, urine protein-creatinine ratio and microalbuminuria test results, it was agreed that microalbuminuria test was the most trustable and the practical method in small animal practice. It was also determined that microalbuminuria levels could be affected from the many factors like age and nutrition. Except microalbuminuria, the enzymes especially NAG and AAP were markedly elevated in dogs with lower urinary tract disorders. Thus, it was approved that parameters that were controlled in this study, can be easily used in SDMA is a biomarker for AKI in human medicine. The aim of this study was to investigate SDMA in dogs with AKI and to assess if SDMA discriminates AKI from CKD. Blood samples stored for a previous study to investigate renal biomarkers in dogs with AKI or CKD were analyzed for SDMA. Over a period of 1 year SDMA was measured in all dogs with renal azotemia (48 AKI, 29 CKD) and 18 healthy control dogs and SDMA/creatinine ratio was calculated.
Disclosures: No disclosures to report. Urinary lesions of the urinary bladder are represented by tumours, polyps, eosinophilic cystitis and chronic urinary bladder inflammation which can resemble urinary bladder growth. For definite diagnosis cytological and histopathological examination is required. Fine needle aspiration has been associated with metastatic tract along the needle path; brushing and traumatic catheterism have been used with variable results.
The aim of this work is to evaluate the effectiveness of transurethral ultrasound guided biopsy of urinary bladder lesions in male dogs. The authors hypothesized that the passage of an atraumatic flexible endoscopic biopsy forceps (1.6 mm diameter) through the urethra in male dogs would allow to collect suitable sized samples for cytological and histopathological diagnosis.
Six male dogs of different size diagnosed with a urinary bladder lesion were enrolled in the study.
In five dogs there was full agreement between cytology and histopathology evaluation and diagnosis was transitional cell carcinoma (TCC); in one dog the procedure was repeated because of discordance between cytological and histopathological diagnosis on first sampling, being cytology consistent with a TCC and histopathology with an eosinophilic cystitis. On second sampling, histopathology was consistent with TCC. Two dogs were followed for a 6 months period and extension of the TCC along the urethra was not detected on subsequent controls.
Transurethral ultrasound guided biopsy of urinary bladder lesions in male dogs can represent an effective, minimal invasive and non-expensive procedure for the diagnosis of urinary bladder lesions in male dogs and allows to avoid the size limit. Further evaluation of a larger number of cases is recommended.
Disclosures: No disclosures to report. Proteinuria in cats has been associated with the diagnosis, prognosis and monitoring of several conditions, including chronic kidney disease. The urine dipstick test (UDT) is the most common method used to assess proteinuria in practice, and the urine protein-to-creatinine ratio (UPCR) helps to confirm and quantify it. The purpose of this study was to assess a UDT together with the urine specific gravity (USG) as a possible predictor of the UPCR in cats. In the authors' knowledge this has been previously described for dogs, but it has not been studied in cats.
This study showed a poor correlation between the two assessed diagnostic methods. The results matched with the previously described high sensitivity and poor specificity for the diagnosis of proteinuria with UDT in cats. The higher sensitivity (91.4%) was achieved when considering only 0 + as a dipstick-negative result in samples with USG > 1.012, although a greater population would be needed to perform a more representative assessment.
Disclosures: No disclosures to report. In veterinary practice, in-clinic measurement of total thyroxine (TT 4 ) is commonly done for both diagnosis and monitoring, although the accuracy of some analyzers for TT 4 quantification has been questioned. Recently, IDEXX Laboratories introduced a novel immunoassay method to measure TT 4 on the Catalyst One Chemistry Analyzer (C1), a point-of-care instrument previously validated for chemistry testing.
ESVE -European Society of Veterinary EndocrinologyDisclosures: Disclosures to report: The primary and second author have nothing to disclose. No form of direct financial support was given to the first author or his clinic for the work done on this research study. The only support for this study was that the reagents for the in-clinic TT4 test were supplied at no charge by Idexx laboratories, the manufacture of the testing kit. The third author is an employee of Idexx Laboratories, Inc, the company that makes the in-clinic test TT4 test evaluated in this study. None of the data analysis were performed by this individual, however, and the results were not modified in any way for the company's benefit (this arrangement was made prior to initiation of the study). The ACTH stimulation test (ACTHST) is commonly used to screen dogs for spontaneous hyperadrenocorticism (HAC). This study aimed to evaluate the contribution of baseline cortisol in the interpretation of ACTHST. The study included samples from 73 dogs, submitted to a referral laboratory for evaluation of HAC by ACTHST, and completed questionnaires about the referring veterinarians' (rDVMs) interpretation of the results. rDVMs reported whether the test results were considered confirmatory for HAC, how baseline and post-stimulation cortisol were interpreted, and their final decision whether the dog had HAC. Most rDVMs (77%) considered both baseline (B) and post-stimulation (P) cortisol in their interpretation, either their difference (P-B) or their ratio (P/B). Receiver operator characteristics (ROC) analyses were used to assess the predictive accuracy of baseline cortisol alone, post-stimulation cortisol alone, P-B and P/B. The areas under the ROC curve (AUC) for baseline cortisol, P/B, P-B, and post-stimulation cortisol were 0.61, 0.62, 0.84 and 0.89, respectively, when the outcome was a confirmatory result, and 0.63, 0.58, 0.77 and 0.85, respectively, when the outcome was a final diagnosis of HAC. Post-stimulation cortisol AUCs were significantly higher than all other AUCs, excluding P-B AUC, for predicting a confirmatory result of HAC. In conclusion, post-stimulation cortisol demonstrated good discriminatory ability for the interpretation of the ACTHST, and for the final diagnosis made by rDVMs. It was either superior or comparable to P-B while baseline cortisol and P/ B were ineffective. Baseline cortisol has no additive value in interpreting ACTHST results and diagnosing HAC by rDVMs.
ESVE-P-The prevalence of hyperthyroidism (tT4 > 50 nmol/L or tT4 between 30-50 nmol/L with TSH < 0.03 ng/ml and fT4 > 50 pmol/ L) within this population was 7.0% [95% CI: 4.4, 10] with no significant difference in prevalence between healthy (5.1% [1.9, 11]) and sick (8.2% [4.6, 13] ) cats. Cats ≥ 12 years of age (OR = 4.3 [95% CI: 1.2, 15], P = 0.02) and cats with canned food in their diet (OR = 2.1 [95% CI: 0.8, 5.4], P = 0.1) were more likely to be diagnosed with hyperthyroidism. . No statistically significant relationship between vaccinations, parasite control or indoor environment and hyperthyroidism was observed. Hyperthyroid cats were more likely to present with weight loss (OR = 3.2 [95% CI: 1.2, 8.9], P = 0.01) and with a heart rate ≥ 200 bpm (OR = 5 [95% CI: 1.7, 16.1], P = 0.01) than cats without the disease.
Disclosures: No disclosures to report. Feline hyperthyroidism is currently treated with anti-thyroid drugs, surgery and/or radiotherapy. Recently, an iodine-deficient diet (Hill's Ò Prescription diet Ò y/d Ò : "y/d") emerged as an alternative treatment, but limited data are available on therapeutic effects on a large cohort. Sixty-six cats were retrospectively included, based on a diagnosis of hyperthyroidism (clinical signs and free thyroxinemia "fT4" >40 pmol/L). All received the iodine-deficient diet as a first-line treatment and as exclusive food. We aimed to assess the clinical and biological efficiencies of this diet. Forty-seven females (41 spayed) and 19 males (16 neutered), mainly Domestic Short Hair (88%) and ranged from 8 to 20 years (median 13.6 years), were retrospectively included in the study. The main clinical signs at diagnosis were weight loss (94%), polyuropolydipsia (74%), polyphagia (67%), tachycardia (56%), digestive signs (54%) and palpable thyroid nodule (31%). The main biological signs were high fT4 (median: 68 pmol/L, range [40;100]), uremia >3.6 mmol/L for 46% of the cats, creatininemia >159 lmol/L for 11% and ALT >80 U/L for 62%. 54.3% of the cats received dry y/d, 5.7% the canned form and 40.0% both. The majority of the cats (90%) accepted to eat y/d but only 1/3 accepted it spontaneously in a first place. At the first control (median time = 64 days), the clinical efficiency was considered by the practioners as satisfactory for 40% of the cats, partial for 40%, and poor for 20%. Body weight was not significantly changed after y/d (3.6 kg [1. 8-5.8] The iodine-deficient diet Hill's Ò y/d Ò was associated with a satisfactory clinical improvement in 40% of the cats and a significant decrease in fT4 two months after the beginning of the treatment. A long-term follow-up study is currently conduced to assess y/d palatability, clinical and biological changes (particularly creatininemia and ALT activity) and survival on this cohort.
ESVEMedical records of all dogs presented to the Internal Medicine Service of the Veterinary Teaching Hospital Complutense Madrid between January 2013 and December 2015 diagnosed with DM, HAC or both were reviewed. Only cases in which a urine culture was performed were included (n = 60). Dogs were classified considering the type and the control of the endocrine disease. Dogs with UTI were treated with appropriated antibiotics based on culture sensitivity. Animals were followed up and response to treatment was evaluated with urine culture.
Dogs were classified as follows, Group1: 22 dogs diagnosed with DM (37%); Group2: 27 dogs with HAC (45%) and Group3: 11 dogs with both diseases (18%). UTI was observed in 13/60 dogs (22%). In Group1, UTI was presented in 4 (18%) dogs. In Group2, 6 dogs (22%) had UTI and in Group3, 3 dogs (27%) had UTI. There was no significant relationship between UTI and control of the endocrine diseases. Escherichia coli was the most common organism isolated (6/13).
There was strong correlation between assays with a bias for both canine and feline samples. The significance of this bias is unknown in the absence of a gold standard. Systemic hypertension is common in dogs with hyperadrenocorticism (HAC), however its prevalence and factors associated have not been frequently reported. The aims of this study were to determine prevalence and severity of hypertension in dogs with HAC at the time of diagnosis and the potential relation between systolic blood pressure (SBP) and different parameters (age, sex, reproductive status, duration of clinical signs before diagnosis, body condition score, concurrent diseases, type of HAC and ACTH stimulation test results).
Forty-three dogs with newly diagnosed HAC at the Veterinary Teaching Hospital Complutense Madrid between January 2013 and December 2015 were evaluated.. Blood pressure was measured using Doppler ultrasonography. The SBP was calculated as the average of 5 consecutive readings. Hypertension was defined as a SBP >150 mm Hg and sub-classified according to the risk of target organ damage (RTOD) (ACVIM guidelines). Dogs with concurrent diseases knowing to affect SBP (chronic kidney disease IRIS 3/4, or cardiac disease stage C/D) at diagnosis were excluded. Significant values were considered for P < 0.1.
Forty dogs with HAC were included, 35 with pituitary HAC and 5 with adrenal HAC. Age ranged from 6 to 15 years, 15 dogs were intact and 25 dogs were neutered. Twenty eight dogs (70%) were hypertensive and 18/40 (45%) at severe RTOD (>180 mmHg). Higher prevalence of hypertension and higher mean values of SBP were observed in intact dogs (87%; 183.3 AE 30.2 mm Hg) than in neutered (60%; 165.3 AE 35.7 mm Hg) (P = 0.074; P = 0.078). Higher prevalence of severe RTOD was also observed in intact dogs (67% versus 32%) (P = 0.033). Positive correlation between SBP and duration of clinical signs before diagnosis was observed (P = 0.063). Dogs at severe RTOD had clinical signs for a longer period of time before diagnosis (10.5 AE 5.6 months) than animals with moderate/mild RTOD or normotensive (7.68 AE 5.6 months) (P = 0.084). No significant correlation was observed between SBP and the rest of the variables listed above.
PH was diagnosed by the presence of clinical signs consistent with PH, Na + /K + ratio ≤ 27, and basal and post ACTH-stimulation test cortisol concentrations ≤ 55.2 nmol/L. Client-owned dogs (n = 152) with PH were randomised in a 3:1 ratio, and treated at an initial dose of 2.2 mg/kg body weight with either Zycortal (subcutaneously) or Percorten-V (intramuscularly). Subsequent doses were administered approximately monthly for up to 5 months; adjustments to dose and dosage regimen were permitted.
The 74 cats (36% males, 74% females) were 13 AE 2.5 years old. TT4 concentration at the time of diagnosis varied between 57 and 193 nmol/L (140 nmol/L AE 49). At inclusion, the veterinarian survey was fulfilled for 34 (46%) cats. For 12/34 (35%), a sole therapeutic option (antithyroid drug in 94% of cases) was proposed. For 15/34 (44%) cats, two therapeutic options were proposed. In this case, antithyroid drug and an iodine-restricted diet were proposed in 100% and 87% of cases, respectively. In total, an iodinerestricted diet was proposed for 21/34 (62%) cats and finally chosen for 4 (19%) cats. Prescribing habits and medication convenience were the reasons most commonly cited. A partial or complete TT4 follow-up for one year was available for 50 (67%) cats, 42/50 receiving antithyroid drugs and 8/50 eating an iodinerestricted diet. Euthyroidism appeared more rapidly achieved (4 versus 9 weeks) but less stable in cats receiving antithyroid drugs compared to cats eating a specialized diet, even for outdoor cats. Side effects were uncommon (16% and 0% with medicinal and dietetic treatment, respectively). After one year, 37 (50%) owner surveys were available. Most owners (35/37) were satisfied or very satisfied with the treatment issue.
A letter of invitation to participate in the web survey was sent out by mail to 6822 owners to cats with a previous or ongoing insurance in Agria Animal Insurance. The study population included cats with a diagnosis of diabetes during the years 2009-2013 (n = 1369) and a control group of cats (n = 5363) without the diagnosis, matched on birth year with the diabetic cats. The web survey contained questions on e.g. the signalment of the cat, environment, activity level, access to the outdoors, feeding regime, type of diet, eating habits, body condition, health, medications, vaccination status, other animals in the household, or if other changes had occurred in the cat's life before the diagnosis of diabetes.
A total of 2171 complete replies were acquired, of which 481 from diabetic cats and 1690 control cats (answering frequency 35% and 32%, respectively). Results from a multivariable logistic regression showed significant associations between a diagnosis of diabetes and several of the responses in the questionnaire. Burmese breed, being male, being an indoor cat, having a greedy eating habit, and being overweight were all independently associated with increased odds of diabetes.
Disclosures: No disclosures to report. Hypertension is frequent in dogs with hyperadrenocorticism (HAC) even when adequate control of HAC is achieved. The aim of this study was to evaluate systolic blood pressure (SBP) before and during the first 6 months of trilostane treatment in dogs with newly diagnosed HAC and to determine whether there is association with the control of the disease. Forty-three client-owned dogs were diagnosed with HAC at the Veterinary Teaching Hospital Complutense Madrid between January 2013 and December 2015 following the ACVIM consensus guidelines. Trilostane treatment was initiated at a starting dose of 0.5-1.5 mg/kg BID. Dogs were evaluated at one (n = 26), three (n = 19) and six (n = 15) months after treatment (MAT). History, physical exam, hematology, biochemistry, ACTH stimulation and blood pressure using Doppler ultrasonography were assessed in every visit. Dogs with chronic kidney or cardiac diseases (stages C/D) or receiving antihypertensive medication at diagnosis were excluded. Hypertension was defined as a SBP ≥150 mm Hg. Following the ACVIM guidelines, hypertensive animals were sub-classified according to the risk of target organ damage (RTOD) and antihypertensive treatment (benazepril and/or amlodipine) was administered if deemed appropriate.
Twenty-six dogs were included, 15 females and 9 males. Ages ranged from 7 to 15 years. Twenty dogs (77%) were hypertensive at diagnosis and 15/26 (58%) were at severe RTOD. Prevalence of hypertension was similar throughout the study (73% 1-MAT, 84% 3-MAT, 80% 6-MAT) whilst the percentage of hypertensive animals at severe RTOD decreased (75% before treatment; 63% 1-MAT, 31% 3-MAT and 42% 6-MAT; but not significantly). Of the normotensive dogs at diagnosis, 2/5 (40%) remained normotensive 6-MAT and 3/5 (60%) became hypertensive at mild RTOD (150-159 mm Hg). Of the hypertensive dogs at diagnosis, 9/10 (90%) remained hypertensive 6-MAT being 5/10 (50%) at severe RTOD (≥180 mmHg).
Disclosures: No disclosures to report. Canine Addisonian crisis occurs due to a deficiency in cortisol, typically associated with a concurrent deficiency in aldosterone. The glucocorticoid dexamethasone is most commonly used for emergency parenteral treatment in a crisis but this drug has negligible mineralocorticoid activity. The use of hydrocortisone sodium succinate (HSS) is described in human medicine. Besides its glucocorticoid activity, it has potent mineralocorticoid activity potentially making it superior to dexamethasone for treatment of Addisonian crisis. Our aims were to describe treatment of Addisonian crisis using HSS in a cohort of dogs. Furthermore, we compared this therapy to dogs treated with dexamethasone over the same period. Records from a single referral hospital were searched between 2007 and 2015, identifying 15 dogs diagnosed with an Addisonian crisis (serum cortisol concentration <55 nmol/L after administration of tetracosactrin, requiring hospitalization for emergency stabilisation). Dogs were excluded if they had already received any glucocorticoid and/or mineralocorticoid therapy prior to admission, or had incomplete data concerning treatment, laboratory tests or outcomes. Seven dogs were treated with HSS continuous rate infusions ranging from 0.3 to 0.625 mg/kg/h (Group A). Eight dogs were treated with intravenous dexamethasone doses ranging from 0.05 to 0.3 mg/kg (group B). None of the dogs in group A required treatment with dexamethasone and none of the dogs in group B received HSS at any stage during treatment. Both HSS and dexamethasone were associated with adequate management of the acute adrenocortical insufficiency in every case with all patients surviving to discharge. No significant differences were found between the two groups regarding age, weight, gender, admission Na+ and K+ concentrations, length and median cost of hospitalisation, median time for K+ concentration to normalise, time to spontaneously eat or amount of crystalloid and colloid fluids used.
Disclosures: No disclosures to report. with the diagnosis being confirmed on laparotomy. A recent study showed that a gastric foreign body was a significant risk factor for the development of gastric dilatation and volvulus in dogs. The purpose of this study was to correlate if cats or dogs with a GI foreign body had underlying GI disease. The hypothesis was that cats or dogs with a GI foreign body have primary underlying gastro-intestinal disease resulting in pica and the subsequent ingestion of a foreign body.
The records of 28 privately owned cats or dogs that had been diagnosed with a gastro-intestinal foreign body and had histopathology done of the gastro-intestinal tract were retrospectively evaluated. Inclusion criteria were a diagnosis of a GI foreign body together with histopathology of the GI tract from biopsies taken at the time of surgical removal of the foreign body.
Of the 28 cases, there were 11 cats and 17 dogs. The mean age of the cats was 9.2 years (range 4-15) and that of the dogs 9.1 years (range 2-14). All cats were classified as DSH and the dog breeds were varied. There were 5 males and 6 females within the cat group and 8 males and 9 females within the dog group. Histopathology diagnosis in the cats was lymphoplasmacytic enteritis (4), lymphoma (5), and carcinoma (2); whereas in dogs the histopathology diagnosis was lymphoplasmacytic enteritis (7), lymphoma (3), necrotic enteritis (3), carcinoma (2), and eosinophilic enteritis (2).
Our findings reveal that E.coli associated GC can also affect cats and should be considered on the differential diagnosis of chronic hematochezia. Further studies are needed to assess molecular, genetic and immune pathways beneath intracellular invasion by E.coli in cats with GC.
Disclosures: No disclosures to report. The diagnosis of pancreatitis is based on history, physical exam, pancreas-specific lipase assay and ultrasonography. This retrospective study analyses the agreement between feline and canine pancreas-specific lipase with pancreatic ultrasonographic findings in dogs and cats with a clinical suspicion of pancreatitis. It also assesses the sensitivity (Se) and specificity (Sp) of ultrasonographic parameters useful for the diagnosis of pancreatitis. Between 2007 and 2013, 62 cats and 54 dogs with a clinical suspicion of pancreatitis and who were presented at a veterinary teaching hospital underwent a quantitative (Spec cPLÒ or Spec fPLÒ ; cutoffs: 5.4 μg/l for cat, 400 μg/l for dog) or qualitative (SNAP cPLÒ) assessment of pancreas-specific lipase combined with an abdominal ultrasonography. The Cohen's kappa was used to compare agreement between pancreatic lipase and ultrasonography. The sensitivity and specificity of ultrasonographic parameters (size, echogenicity and margins of the pancreas, peri-pancreatic fluid, increased echogenicity around pancreas) to diagnose pancreatitis were determined, using pancreas-specific lipase as the gold standard.
The 62 cats (63% males, 37% females) were 8.1 AE 4.5 years old. Among them, 19 (31%) had a pancreatic lipase suggestive of pancreatitis and 46 (74%) had an ultrasonographic diagnosis of pancreatitis. The 54 dogs (49% males, 51% females) were 8.6 AE 4.1 years old. Among them, 22 (41%) had a pancreatic lipase suggestive of pancreatitis and 31 (57%) had an ultrasonographic diagnosis of pancreatitis. Agreement between pancreatic lipase and ultrasonography was very low for cat (k = 0.11) and low for dog (k = 0.28). Increased size of the pancreas was the most sensitive parameter for detecting pancreatitis in cats and dogs (Se = 94% and 100%, respectively). Increased echogenicity around the pancreas was the most specific parameter for detecting pancreatitis in cats and dogs (Sp = 60% and 83%, respectively).
Disclosures: No disclosures to report. were defined as dogs that had responded to treatment, in which immunosuppressive drugs and antibiotic treatment was discontinued without relapses. Group 2, were defined as dogs that responded to treatment with immunosuppressive drugs but the disease relapsed after interruption of treatment. Group 3, were defined as dogs that did not respond to diet, antibiotic and immunosuppressive drugs. Kaplan-Meier survival curves were obtained for groups 1, 2 and 3; the survival curves for these groups were compared using the log-rank test. A two stage-analysis was also applied. In the first univariate stage, the variables were screened using x 2 test. In the second stage, factors that screened through P < 0.15 were evaluated using multivariate logistic regression, The odds ratio (OR) and 95% confidence intervals (95% CI) were calculated from the final model. One hundred and four dogs met the inclusion criteria. Dogs of group 1 and 2 had a median survival longer than dogs of group 3, 1250 days (range 210-4380) and 913 days (range 61-3100) versus 210 days (range 30-2005), respectively. At univariate regression analysis, a statistical difference in dogs of group 3 with respect to dogs of group 1 and 2 in following variables, were observed: previous treatment with steroids; weight loss; prevalence of small bowel diarrhoea; decreased haematocrit, serum albumin, total protein, creatinine, cholesterol; increased concentration of aspartate amino transferase (AST) and alanine aminotransferase (ALT); and received treatment with other immunosuppressive drugs than steroids at diagnosis. In multivariable model analysis previous treatment with steroids (OR = 5.47; 95%CI 1.86-16.11; P = 0.001) and decreased total proteins (OR = 12.5; 95%CI 3.62-41.75; P = 0.016) were independent variables associated with belonging to group 3.
Cats diagnosed with IBD (n = 11) and LGAL (n = 9) between 2007 and 2013 were included. The feline chronic enteropathy activity index (FCEAI) was calculated for all cases. Control group was composed by 3 healthy indoor cats and 5 sick cats died or euthanized (non-gastrointestinal illness). Diagnosis and classification of IBD and LGAL was established according to WSAVA gastrointestinal standardization group template and the National Cancer Institute formulation, respectively. Furthermore, a modified WSAVA template (villous stunting, epithelial injury, crypt distension and lacteal dilation) was applied for LGAL evaluation.
Disclosures: No disclosures to report. IBD pathogenesis remains poorly defined, although it is hypothesized to be influenced by immunological, environmental and genetic factors. In canine lymphocytic-plasmacytic colitis (cLPC) a form of IBD, mucosal cytokines seem to be involved in the disease's pathogenesis, however sufficient data are lacking. The aim of the current study was to evaluate the mRNA expression levels of proinflammatory cytokines interleukin (IL)-1beta, IL-2, IL-23, TNF-alpha and mucosa associated epithelial chemokine (CCL28) in the colonic mucosa and mucus from dogs with cLPC and their correlation with canine IBD activity index (CIBDAI) and endoscopic activity score (quantitative and qualitative) for canine IBD. Colonic mucosa and mucus from 17 dogs with cLPC (histological diagnosis) and from 4 healthy dogs were obtained by endoscopic biopsy and cytology brush, respectively. Total RNA was extracted from colonic mucosa and mucus and cDNA was synthesized. The mRNA of IL-1beta, IL-2, IL-23, TNF-alpha and CCL28 were measured using real-time quantitative reverse transcriptase polymerase chain reaction (real-time qRT-PCR). Results were normalized using GAPDH as a housekeeper gene.
Disclosures: No disclosures to report. Gastrin is a peptide hormone, produced by gastric and duodenal G cells, which stimulates gastric acid secretion and exerts trophic effects on the gastric mucosa. Hypergastrinemia is suggested to be useful for diagnosing canine gastrinomas if increases are >10 9 the upper reference limit (URL), but hypergastrinemia can also be caused by antacid therapy or lymphoplasmacytic enteritis. The effect of antacid therapy on hypergastrinemia in dogs with chronic enteropathy (CE) and the biological variation (BV) of serum gastrin concentrations are unknown. Aims of the current study were to evaluate serum gastrin concentrations in antacid-treated or antacid-na€ ıve CE dogs, test for an association between serum gastrin concentrations and microscopic findings in the stomach/duodenum, and evaluate the BV of serum gastrin concentrations in CE dogs. Serum samples were collected from 251 dogs undergoing routine diagnostic evaluation of chronic gastrointestinal signs and being diagnosed with CE. Serum gastrin concentrations were measured by a chemiluminescence (Immulite Ò 2000 Gastrin) assay, and the severity of gastric/duodenal histologic lesions was assessed. BV of serum gastrin concentrations was evaluated using serial samples from 45 CE dogs. Statistical analyses included non-parametric group comparisons, likelihood ratio and Spearman correlation tests, and a nested ANOVA.
These results suggest an additive effect of antacid (particularly PPI) treatment on the hypergastrinemia seen in CE dogs, especially dogs with more severe gastric/duodenal lesions. Also, the hypergastrinemia associated with CE and antacid therapy is unlikely to compromise a diagnosis of gastrinoma in dogs. Use of a population-based URL for serum gastrin and the currently used URL in dogs (≤27.8 ng/L) are appropriate.
Disclosures: No disclosures to report. Nova Scotia Duck Tolling Retriever (NSDTR) dogs are predisposed to immune-mediated disorders and particularly to a disorder characterized by chronic stiffness and pain from multiple joints, indicative of non-erosive polyarthritis. Dogs affected by this disorder, called immune-mediated rheumatic disease (IMRD), commonly display antinuclear antibodies (ANA) on indirect immunofluorescence (IIF). Non-erosive polyarthritis and ANA are commonly present in systemic lupus erythematosus (SLE) and in other systemic rheumatic diseases, in humans as well as in dogs. IMRD may be described as an SLE-related disease. Diagnosis and monitoring of IMRD are primarily based on clinical signs and presence of ANA, and an objective, quick and cost-effective test would be highly valuable. The acute phase protein C-reactive protein (CRP) is used for diagnosing and monitoring systemic inflammation in both humans and dogs. It is considered to be a quantitative marker of inflammation in most diseases, but in human SLE, CRP concentrations are mildly to moderately increased and not correlated to the degree of inflammation. The aim of the study was to investigate CRP concentrations in NSDTRs with IMRD. The hypothesis was that CRP concentrations would be mildly to moderately increased in IMRD compared to healthy dogs, similar to what has been reported in humans with SLE. Serum CRP concentrations were measured in 18 IMRD affected NSDTRs (9 IIF-ANA positive and 9 IIF-ANA negative) and 19 healthy control NSDTRs using two canine-specific immunoturbidimetric assays (Gentian cCRP assay and high-sensitivity CRP assay, Gentian AS, Moss, Norway). None of the dogs were treated with anti-inflammatory medication at the time of sampling. Dogs with IMRD had higher CRP concentrations compared to control dogs (Welch two sample t-test with log-transformation of data, P = 0.003) but no difference was observed between the groups of IMRD dogs with and without positive IIF-ANA, respectively (P = 0.6). The median CRP concentration was 10.3 mg/L in the IMRD dogs and 2.1 mg/L in the control dogs. The CRP concentration was low to moderately increased in a majority of IMRD dogs, as is seen in humans with SLE. The CRP concentration was lower than observed in, for example, studies of immune-mediated polyarthritis in other dog breeds but higher than in canine osteoarthritis, two disorders that can resemble IMRD. The potential clinical value of CRP in dogs with IMRD warrants further investigations. Disclosures: Disclosures to report: Anna Hillstr€ om PhD project at the Swedish University of Agricultural Sciences (SLU) was partly financed by Gentian AS, the company manufacturing the CRP assay used in this study. Actual reports of bacterial contamination of blood units has emerged as a cause of morbidity and mortality in human transfusion medicine, but they are rare in veterinary literature. An underestimation of the extent of the risk of the bacterial contamination of blood units could be expected.
Disclosures: No disclosures to report. Cats in severe respiratory distress may be too unstable to receive many clinical manipulations. The aims of this study were to noninvasively quantify tidal breathing status in cats present with respiratory distress, and to compare the difference in ventilatory function between cats with respiratory distress and healthy cats. We hypothesized that ventilatory parameters such as respiratory rate and volumes will be elevated in cats experiencing significant labored breathing because of respiratory diseases and increase in ventilatory demand. Twelve cats present in NTUVH with persistently increased respiratory effort due to various etiologies (lung parenchymal disease, pleural space disease, upper airway obstruction, or lower airway disease) were enrolled in the study, and the informed consents were obtained from the owners. The cat was placed in a transparent Plexiglas chamber of the barometric whole body plethysmography (BWBP) system without restraint for recording tidal breathing signals, and the breathing status of the cat could be observed easily by the clinicians at the same time without causing disturbance or stress to the cat. Compared with 14 cats without respiratory signs or historic respiratory diseases, cats in respiratory distress had significantly higher minute volume/ body weight (MV/BW) (531.6 versus 234.5 mL/kg; P < 0.001), tidal volume/BW (TV/BW) (7.55 versus 5.46 mL/kg; P = 0.026), peak inspiratory flow/BW (PIF/BW) (29.2 versus 13.8 mL/s/kg; P < 0.001), peak expiratory flow/BW (PEF/BW) (35.2 versus 12.9 mL/s/kg; P < 0.001), enhanced pause (1.60 versus 1.00; P = 0.003), and significantly lower relaxation time (0.17 versus 0.36 s; P = 0.010). Among cats with respiratory distress, 5 cats that eventually died with respiratory failure had statistically higher MV/BW than 5 cats that survived and became stable over at least 3 months (639.0 versus 390.1; mL/kg) (P = 0.028). Interestingly, respiratory rate was neither significantly different between cats in respiratory distress and control cats, nor between cats that died and cats that survived. In conclusion, ventilatory function could be non-invasively and non-harmfully assessed in cats with respiratory distress by BWBP method. Elevation of MV/BW under natural breathing implies the increase in ventilatory demand and might be a poor prognostic indicator or severity index in cats with labored breathing. Furthermore, respiratory rate might not be reliable for identifying increased respiratory effort or disease severity. Care should be taken when the assessment relies on respiratory rate alone. Disclosures: No disclosures to report. Many causes of pleural effusion (PE) are known in cats, but little is known about their frequency and potential indicative factors at the time of diagnosis. This study aimed to identify the aetiologies that lead to PE in cats, along with clinical signs, treatments and outcomes associated with this condition. We hypothesized that the major causes of PE in cats would be congestive heart failure (CHF) and neoplasia; and also that cats suffering from CHF would have a lower rectal temperatures (RTs) than cats with noncardiogenic PE.
The medical records of a total of 465 client-owned cats with PE were reviewed. Cases were selected based on their complete demographic data, a physical examination and the presence of PE. Several procedures were performed to investigate the underlying aetiology: infectious diseases screening, clinical pathology analysis, diagnostic imaging examinations and surgical interventions.
CHF and neoplasia were the most common causes of PE in cats (36.7% and 35.8%, respectively). Other causes included pyothorax (13.0%), idiopathic chylothorax (4.0%), trauma (3.8%), feline infectious peritonitis (2.8%) and diaphragmatic hernia (1.9%). Cats with CHF were younger (10 AE 4.7 years old) than those with neoplasia (11 AE 4.1 years old, P < 0.001). Cats with lymphoma (8.8 AE 3.8 years old) were younger than those with carcinoma (12 AE 2.3 years old, P < 0.001). Cats with CHF had significantly lower RTs at admission than those with PE due to other causes (36.9 AE 1.1°C versus 38.0 AE 1.0°C, respectively, P < 0.001). Male cats were significantly overrepresented in the CHF group (72.3%). A quarter of the global population (117/465) died or was euthanized within 3 days following the diagnosis.
The study included 52 dogs (Pisa n = 30; Koret n = 22) presented with hematocrit <30%, combined with ≥1 of the following: spherocytosis, positive osmotic fragility test, autoagglutination, positive Coombs' test or positive flow cytometry for RBC-bound IgG and/or IgM. Cases were excluded if positive to tick-borne disease or other infections, based on serology or PCR assay, or if diagnosed with systemic neoplasia. Data retrieved from medical records included the signalment, clinical and laboratory findings.
This study confirms previous findings regarding the signalment, clinical and laboratory characteristics of pIMHA in dogs. The microscopic evaluation of the blood smear is a valuable tool in the diagnosis of pIMHA. The Koret group was characterized by a more severe presentation of the disease, likely because this hospital admits more emergency primary care cases.
Routine haematology was performed using a laser based cell counter (Sysmex XT-2000iV; Sysmex). An extended panel of biochemical analytes was determined on serum using an automated spectrophotometer (Cobas Mira, Roche Diagnostics). The transference method was used to compare the results of Shetland Sheepdogs with the RI of the general canine population. If more than 25% of values were outside the claimed RI, new RI were calculated according to the ASVCP guidelines, using an Excel spreadsheet with the Reference Value Advisor (2.0) set of macroinstructions after removal of far outliers. Based on data distribution, a non-parametric method or the Robust method were used to define the RI with 90% confidence interval.
Disclosures: No disclosures to report. Bronchial vegetal foreign bodies are a common problem in dogs in Europe, especially during the summer season. Foxtails are usually inhaled/aspirated during exercise and then deepen their position into the bronchial tree. These torpedo shaped awns may become irreversibly lodged into the bronchi or even migrate through the pulmonary parenchyma to other regions (ex. paravertebral muscles, pleural space). Bronchoscopy is the gold standard technique for localization and often removal of airway foreign bodies (AFB). An early diagnosis and treatment is important to avoid respiratory and sometimes neurological complications due to foreign body migration and local infection.
ESVIM-P-11The aim of this study is to describe and evaluate the correlation between laryngeal lesions and the presence of foreign bodies inside the bronchial tree. This laryngeal findings may be helpful to facilitate an early diagnosis, since their presence could be related to that one of AFB.
Among the dogs presenting with an AFB, 83% of them were positive for the "puddle" sign. Moreover, in the BAL positive group, 80% of dogs did not present the "puddle"sign. These last results suggest that the laryngeal sign we are evaluating is specifically related to the presence of AFB and not to all kinds of bacterial lower respiratory tract infections. Grass awns carry many bacterial agents that perpetuate a continuos and highly suppurative bronchial infection. Then the strong expulsive effort of cough, tends to remove this purulent exudate that remains trapped into the ventral part of the larynx, probably due to the conformation of the canine upper respiratory tract. Therefore, the "puddle"sign could be helpful in directing an early diagnosis and treatment of AFB.
ESVONC -European Society of Veterinary OncologyKruskal-Wallis and Wilcoxon-Mann-Whitney tests were used to compare groups. Risk to death at 90 days after diagnosis within B-MM and NB-MM dogs was evaluated by Pearson's X 2 test. ROC curves were used to identify the best analyte to predict death.
Disclosures: No disclosures to report. Body condition score (BCS) is a method that is commonly used in the diagnosis of nutritional status in small animals. However, clinical veterinarians recognize that BCS assessment has an error to some extent. This is because that BCS is an assessment of the subjective method based on ocular inspection and the palpation. Therefore we built a BCS model for the BCS assessment in dogs and examined its accuracy. We reported that variability of BCS value was less when the BCS model was used in nutritional assessment of the dog . In this study, a survey was conducted to make clear usefulness of the BCS model in clinical veterinarians and dog owners. The BCS model was developed with resin molded artificial ribs. Polychloroprene sponge sheet and natural rubber sheet were laminated to fit the palpation feeling of each BCS. A survey was carried out for both clinical veterinarians (n = 23) and dog owners (n = 46). The main questions were as follows: actual use of BCS in clinic, perception of using the BCS model and application of the BCS model in the clinic for clinical veterinarians, and awareness of the BCS and BCS assessment of own dog for dog owners.
Weight: 131.08 Paper Topics: dogs idiopathic hyperlipidemia ih common condition miniature schnauzers ms 75% years old affected >45% dogs having moderate severe fasting hypertriglyceridemia htg combined hypercholesterolemia hchol severe htg poses increased risk development conditions eg pancreatitis insulin resistance recent studies humans suggest ih associated low-grade inflammation involved pathogenesis diseases associated ih risk complications decreases medical control ih given biomarkers inflammation investigated ms ih aims study evaluate serum calprotectin s100a12 concentrations i healthy ms ms ih ii ms ih response dietary intervention management ih serum samples collected 152 clinically healthy ms study questionnaire completed dog confirm health status medication history serum triglyceride
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Disclosures: No disclosures to report. Exocrine pancreatic insufficiency (EPI) in dogs is diagnosed by observing serum canine trypsin-like immunoreactivity (cTLI) to be <2.5 µg/L; affected dogs have severe fat malabsorption. Some dogs with signs of EPI have marginally subnormal serum cTLI (3-6 µg/ L) and do not respond to enzyme replacement therapy (subclinical EPI, SEPI), but given their clinical signs, abnormal serum cobalamin or folate, and absence of other detectable non-enteric disease presumably have an idiopathic chronic enteropathy (ICE). Unpublished preliminary data indicate decreased serum tocopherol concentrations in dogs with EPI that do not resolve after pancreatic enzyme supplementation. The objectives of this study were to measure serum tocopherol and retinol in dogs with EPI and those with subclinical EPI and ICE (SEPI/ICE). Inclusion criteria for the EPI group (n = 8) were clinical signs of EPI and serum cTLI concentrations <2.5 µg/L. Dogs in the SEPI/ICE group (n = 9) had clinical signs of ICE and serum cTLI concentrations in the 3.0-6.0 µg/L range. Diets of dogs in both groups were supplemented with oral pancreatic enzyme extract. Control samples were collected from 10 healthy dogs before and after 10 days of pancreatic enzyme supplementation. All samples were surplus from another study approved by our institutional ethics committee, and stored at À80°C prior to assay of tocopherol and retinol by high-performance liquid chromatography.
Disclosures: No disclosures to report. Clostridium difficile (CD) is a common cause of hospital-acquired diarrhea in humans and has been associated with diarrhea in dogs. Salmonellosis is a major zoonotic disease but the transmission pathway is unclear. It is thus important to evaluate the risk factors that increase the likelihood of infection. Canine parvovirus (CPV) is a prevalent and fatal cause of canine enteritis often exacerbated by concurrent infection with other enteropathogens. Persistent isolation of Salmonella spp. during hospital environmental surveys of the isolation ward prompted further investigation. This study was designed to determine the comparative prevalence of CD and Salmonella spp. in dogs with CPV and healthy dogs. The study was approved by the ethics committee of the University of Pretoria and conducted from October 2015 to March 2017. Fresh fecal samples were collected from dogs aged 6 weeks to 9 months diagnosed and admitted with CPV infection, and healthy dogs presented for vaccination or routine hospital procedures. CPV shedding was confirmed using negative staining electron microscopy. CD was detected via commercial fecal antigen enzyme immunoassay for glutamate dehydrogenase (GDH), TcdA and TcdB. In addition, feces was submitted for the isolation, antimicrobial susceptibility and serotyping of Salmonella spp.
Thirty five dogs diagnosed with a chronic enteropathy were prospectively enrolled and biopsies taken at endoscopy from the duodenum were evaluated for VDR expression with both immunohistochemistry and quantitative polymerase chain reaction (qPCR). Twenty three control dogs were also prospectively enrolled without clinical signs of gastrointestinal disease.
Serum samples were collected from 21 dogs diagnosed with active LP IBD. All dogs had undergone upper and/or lower GI endoscopy according to clinical signs, were diagnosed histopathologically according to the guidelines of the WSAVA International Gastrointestinal Standardization Group (Washabau et al. 2010) and by clinical exclusion diagnosis. In addition, serum samples were available from 14 clinically healthy control dogs for comparison. Total RNA from serum was isolated using Trizol, and reverse transcribed into cDNA. The expression of serum miRs genes was measured using real-time quantitative reverse transcriptase polymerase chain reaction (real-time qRT-PCR). Clinical disease activity was recorded for all dogs using the Canine Chronic Enteropathy Clinical Activity Index (CCECAI; Allenspach et al. 2008) . Endoscopies were performed and graded according to the canine IBD endoscopic index (Slovak et al. 2014) .
This study shows that some circulating miRs are differentially expressed in the serum of dogs with LP IBD versus healthy dogs. Further studies are needed to evaluate the usefulness of these markers in the diagnosis and treatment of canine IBD.
Disclosures: No disclosures to report. mucosal E. coli harboring ExPEC virulence genes may drive inflammation in the small intestine of dogs with lymphoplasmacytic IBD and contribute to a more severe clinical presentation. A comprehensive investigation of virulence genes in E.coli strains from dogs diagnosed with IBD was performed using a 17panel multiplex PCR, targeting for 8 genes typical for human IBD-associated adherent and invasive E. coli [Group 1 genes: eaeH, irp2, fimH, ratA, fepC, usp, colV, dsbA] and 9 genes more typically associated with ExPEC [Group 2 genes: cvaC, ompTp, hlyF, etaB, iss, aerJ, ereA, papC] (Johnson, TJ, JMicrobiol 2008) . A cohort of 12 German Shepherd Dogs (GSDs) and 20 non-GSDs diagnosed with lympho-plasmacytic IBD on the basis of clinical signs, intestinal histopathology, and exclusion of other known causes of chronic gastro-intestinal signs was enrolled. E. coli was cultured from endoscopically collected biopsies using MacConkey and Sheep Blood agar, and identified using API20E (BioM erieux). Statistical analysis was performed using univariate linear mixed effect models and Fisher's exact tests for continuous and categorical variables, respectively. The following dependent variables were considered: (i) clinical activity of disease (CCECAI; Allenspach K 2007), (ii) histological severity score (WSAVA index; Day M 2008)), (iii) use of immunosuppressive agents, and (iv) euthanasia due to intractable IBD or survival within 1 year after diagnosis. Results revealed that none of the tested virulence factors were significantly associated with the CCECAI index. However, one virulence factor from group 1 [colV:colicin V, antimicrobial peptide; P = 0.03) had a significant effect on the WSAVA index. Two of the virulence genes typically associated with ExPEC (Group 2: ompTP: inactivates antimicrobials, and cvaC: secreted toxin resulting in cytolysis) were significantly associated with euthanasia due to intractable IBD (ompTP: OR: 19, cvaC: OR: 30, P = 0.05), as well as an increased likelihood of having been treated with immunosuppressives (P = 0.03). These data are reminiscent of reports on human ulcerative colitis cases harboring mucosal E. coli with multiple ExPEC virulence factors that were associated with clinical severity. Similarly, our data indicate that specific microbial factors may be important determinants and predictors of disease progression and survival in a sub-group of dogs with IBD.
In conclusion, several ECSs and dogs of other breeds fulfilled the histological criteria for diagnosis of IgG4-RD, supporting the existence of a multi-organ immune-mediated disease in ECS and some other dogs. Strict inclusion criteria for controls with multiorgan inflammatory disease likely selected for dogs of other breeds with IgG4-RD. Anal sacculitis showed histological changes suggesting an immune-mediated etiology. Future studies will focus on the immunology and treatment of the disease.
Disclosures: Disclosures to report. This study was financially supported by the Kennel Club Chari- Diagnosis of canine inflammatory bowel disease (IBD) requires confirmation of histopathologic inflammation in intestinal biopsies. Different studies have found it difficult to correlate histopathologic findings with clinical disease severity due to a lack of consistency between pathologists when describing histopathologic changes and the questionable quality of specimens submitted for diagnostic evaluation. The WSAVA* GI standardization grading scheme (Day, 2008) was an attempt to rectify some of these problems but even it is associated with poor agreement among pathologists. The aim of the present study was to utilize a new grading scheme for improved consistency of evaluation of GI histopathologic findings and to correlate these features to clinical disease activity in dogs with IBD.
Disclosures: No disclosures to report. The aim of this study was to evaluate the application, tolerability and outcome of continuous positive airway pressure (CPAP) compared to another non-invasive oxygen therapy (flow-by), in dogs diagnosed with cardiogenic pulmonary edema secondary to severe mitral valve disease (MVD).
Records of dogs diagnosed with cardiogenic pulmonary edema based on clinical findings, thoracic radiographs and echocardiography were retrospectively evaluated. Newly diagnosed dogs with MVD and dogs already in treatment for MVD were included in the study.
Disclosures: No disclosures to report. Clinicians in first-opinion practice commonly diagnose congestive heart failure (CHF) in small breed dogs with myxomatous mitral valve disease (MMVD) that do not have CHF. To improve the accuracy of CHF diagnosis, we developed an initial algorithm based on historical, physical and radiographic findings that might help a clinician in first opinion practice to more accurately diagnose CHF in these dogs. We then sought to refine and validate the algorithm by determining which of these historical, physical and radiographic findings help discriminate dogs with MMVD into CHF and "not CHF" groups. We collected the following historical and physical examination information on 52 small-breed dogs presenting for evaluation of a cough, murmur, or suspicion of CHF to the referral clinician: presence or absence of coughing, duration of coughing, recent worsening of cough, presence of loud crackles, murmur intensity, presence of sinus arrhythmia, heart rate, in-clinic respiratory rate, presence or absence of dyspnea, sleeping respiratory rate, response to a diuretic trial (if considered necessary by the referral clinician) and radiographic evaluation of left atrial size. Additionally, all dogs underwent echocardiographic evaluation. The diagnosis of "CHF" or "not CHF" was made by each investigator on their own cases, using all required diagnostic tests and treatment, and not validated by other investigators.
Historical and physical variables that excluded a diagnosis of CHF included presence of a sinus arrhythmia (never identified in CHF dogs), a murmur that was "less than loud", a heart rate <120 bpm, an in-clinic RR <35 breaths/min, less-than-moderate left atrial enlargement on radiographs. A positive diuretic trial which alleviated dyspnea confirmed a diagnosis of CHF. 20/21 coughing dogs with CHF showed a recently worsening cough.
Based on these findings, we refined our algorithm so that detection of either a sinus arrhythmia, a soft murmur, a sinus rate <100 bpm, or an in-clinic RR < 30 breaths/min excludes a diagnosis of CHF. Presence of a cough or crackles does not help, but a recently worsening cough warrants increases the suspicion of CHF. In cases where CHF is suspected, a resolution of dyspnea with appropriate diuresis strongly supports the diagnosis of CHF. How well the refined algorithm performs with first opinion clinicians remains to be determined.
Six dogs weighing 19.2 kg (7.2-33.9), were included. Diagnosis included pulmonary hypertension (n = 3), congenital heart disease (n = 2) and pericardial effusion (n = 1). 6/6 and 5/6 dogs had SV-CVCMax and SV-CVCMin above RI, respectively. All dogs had CI (19% (7-24)) within RI. HV-CVCMax and HV-CVCMin were above RI in 5/6 and 4/6 dogs, respectively. 2/6 HV-CVCMax/Ao and HV-CVCMin/Ao ratios were above RI. The PV-CVC/Ao ratio was 1.28 (1.13-1.47) , and above RI in 4 dogs. The PV-CVC diameter, using allometric scaling, was above RI in one dog.
the disease in several Labradors including a family with three consecutive generations. The aim of our study was to describe the inheritance pattern and to identify potentially causative gene mutations in our population. Study population consisted of 12 Labradors. Eight dog was diagnosed with different severity of the disease, one was a 13 years old healthy littermate in an affected family, three dogs (>10 years old) from different breed lines served as controls. Clinical diagnosis was made by electrocardiography and echocardiography. Inheritance pattern was studied by pedigree analysis. Genomic DNA was isolated from EDTA-anticoagulated blood samples using a commercial kit. Whole exome sequencing (WES) of healthy and diseased littermates was used to identify candidate mutations (Illumina HiSeq2500 next generation sequencing system, Agilent Sure Select Canine All Exon 54 Mb librarykit, 50x-coverage, CanFam3.1 annotation). Selection of target mutations in genes related to calcium transport was based on clinical experience with calcium channel blocker diltiazem, that could effectively control the disease. Sanger-sequencing was used to validate WES results in the study population and in controls (ABI3500 capillary-sequencing system, BigDye3.1 chemistry). The disease was present in all generations (affecting both genders) of the affected Labrador family, although the symptoms varied among the individuals. Sudden death at young age occurred in the offsprings of parents that were both clinically affected. Development of congestive heart failure between 5 and 8 years of age due to tachycardiomyopathy was another observed phenotype, while there were also some clinically asymptomatic dogs with or without the arrhythmia. In early stages of ARVC, diagnosis is difficult due to the absence of echocardiographic changes and day-to-day arrhythmia variability. A definitive diagnosis requires histopathologic identification of transmural fibrofatty replacement of the right ventricle. Reduction of immunofluorescent signal for the desmosomal protein plakoglobin has been reported in ARVC-affected humans and boxers. Reduction in plakoglobin signal within endomyocardial biopsy samples (EMBs) may help diagnose ARVC.
EMBs were obtained with owner consent from 48 dogs: 42 with advanced cardiac disease and six asymptomatic boxers (>5 years) with mild to moderate ventricular arrhythmia (VA) burden. Investigators were blinded to breed and clinical signs of the dogs. ARVC was diagnosed from EMBs by histopathology (MT) in 5 dogs. Of these, 3 had clinical signs consistent with ARVC (2 boxers, 1 English bulldog). Two were asymptomatic boxers with a moderate VA burden. Confocal microscopy was performed (EMO) to detect immunoreactive signal for plakoglobin in EMBs. Samples were prepared with antibodies recognizing cadherin (intercalated disc marker) and plakoglobin.
Forty-two samples were positive for cadherin signal and 6 were non-diagnostic. Plakoglobin signal was reduced in 4 samples: 2 boxers and 1 English bulldog with clinical signs and histopathologic diagnoses of ARVC. The fourth sample was from a mongrel diagnosed with myocarditis. Plakoglobin signal was present in all 6 asymptomatic boxers, including those with a histopathologic diagnosis of ARVC.
Disclosures: No disclosures to report. is a new echocardiographic technique that allows an objective and quantitative evaluation of global and regional myocardial function through the analysis of the motion of speckles that are created by the interaction of ultrasonic beams and the myocardium during the 2-dimensional examination. We tested the hypothesis that 2D-STE may detect left ventricular systolic dysfunction, not diagnosed by conventional echocardiography, in dogs with SIRS. Seventeen dogs with evidence of SIRS and 17 healthy dogs as a control group were included in this prospective study. All the procedures were performed for diagnostic purpose; the control group was composed of healthy dogs undergoing surgical castration or ovariohysterectomy. We excluded from the study breeds predisposed to dilated cardiomyopathy, pregnant females, dogs treated with opioids, sedatives or anesthetic drugs during the 12 h before echocardiography. We also excluded dogs with previous diagnosis of, or echocardiographic evidence of congenital or acquired cardiac disease and dogs with an arrhythmia. At the time of Hospital admission each dog was submitted to standard 2D, M-mode, Doppler and 2D-STE with simultaneous ECG and blood pressure measurement. Furthermore, blood samples were obtained for CBC, biochemical profile and the measurements of cTnI and CRP serum levels. The results showed that the standard echocardiographic indices of systolic function such as EF, FS were not significantly different between the two groups. On the contrary, the Left Ventricular Global Longitudinal Peak Strain of endomyocardial layer and the STE-derived Ejection Fraction (STE-EF) were significantly lower in the SIRS group than in the control group. We did not find significant correlation between CRP serum levels and 2D-STE variables and between cTnI and STE variables. Furthermore we did not find a significant difference in cTnI serum levels between the two groups. Our study demonstrated that 2D-STE was more sensitive than standard echocardiography in detecting early or mild to moderate myocardial dysfunction, not detected by conventional echocardiography, in a population of dogs with SIRS. Disclosures: No disclosures to report. Chronic valvular heart disease is common in the Cavalier King Charles spaniel (CKCS). However, genetic factors contributing to development or progression of the disease are unknown. Although classically considered a non-inflammatory disease, upregulated expression of genes involved in inflammation and immune function has been identified in affected valvular tissue. Therefore, genetic determinants of the immune response could influence disease progression in individual dogs. The aims of this study were to document major histocompatibility haplotype (MHC) dog leukocyte antigen (DLA) class II haplotypes in the CKCS, and to examine potential associations between individual haplotypes and progression of disease.
Heart disease was detected in 51 cats (prevalence 0.4% total population). Diagnoses included obstructive (n = 19) and nonobstructive (n = 6) mitral valve dysplasia, ventricular septal defect (n = 15), tricuspid valve dysplasia (n = 7), pulmonic stenosis (n = 1), double chamber right ventricle (n = 1), subvalvular aortic stenosis (n = 1), and hypertrophic cardiomyopathy (n = 1). The murmur was non-pathological in 170 cats (of which 3 cats had dynamic right ventricular outflow tract obstruction).
In conclusion, in this study the prevalence of heart murmurs and heart disease were 1.7% and 0.4%, respectively, with mitral valve dysplasia and ventricular septal defects most commonly diagnosed. Murmur grading was helpful in differentiating non-pathological from pathological heart murmurs.