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Title => Comparison of smartphone-based and standard base-apex electrocardiography in healthy dairy cows Abstract => Background: There is good diagnostic accuracy of smartphone-based ECG in the evaluation of heart rate (HR), heart rhythm, and ECG values for humans, horses, dogs, and cats. Objectives: Assess feasibility and reliability of a smartphone ECG device to evaluate HR expressed as beats per minute and ECG values in cows. Animals: Fifty-five healthy Holstein Friesian cows. Methods: Prospective observational study. A standard base-apex ECG was acquired for 60 seconds in each cow. A smartphone ECG tracing was recorded simultaneously using a single-lead bipolar ECG recorder. All ECGs were reviewed by 1 blinded investigator. The following ECG variables were assessed: HR, P wave duration, PR interval, QRS complex and QT interval (milliseconds), P wave, and QRS complex polarity. Agreement between standard and smartphone ECG was evaluated by Cohen's k test and the Bland-Altman test. Results: Smartphone ECG tracings were interpretable in 89% of the recordings. Minimal differences of no clinical relevance were found between standard and smartphone ECG tracings regarding HR and duration of ECG waves and interval. Good agreement found in the evaluation of QRS complex polarity (85%) but not for P wave polarity (k = 0.006). Artifacts were rare but of significantly higher frequency in smartphone ECG compared to standard ECG tracings (22% versus 0%; P = .005). Conclusions and Clinical Importance: Good quality single-lead ECG tracings can be recorded by smartphone device in healthy cows. Smartphone tracings are reliable for evaluation of HR and selective ECG variables. Smartphone ECG can represent an additional tool for ECG screening in cows. Authors => Francesca Bonelli | Tommaso Vezzosi | Mireille Meylan | Irene Nocera | Vincenzo Ferrulli | Carlotta Buralli | Valentina Meucci | Rosalba Tognetti published => First published: 27 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15396

Title => The use of diffusion tractography to characterize a corpus callosum malformation in a dog Abstract => Introduction: The pathogenesis of corpus callosum malformations (CCM) is not well defined in the dog because of inherent limitations of structural magnetic resonance imaging (MRI) to evaluate the white matter. We used the advanced neuroimaging technique of tractography to virtually dissect the white matter projections in a dog with a CCM and in a normal control dog. Methods: A 9-month-old male Coonhound that had a previous structural MRI diagnosis of CCM and a normal control dog underwent anesthesia and 3-Tesla MRI. Diffusion-tensor imaging and 3D T1-weighted and 2D T2-weighted sequences were acquired. Diffusion data were processed before tensor reconstruction and fiber tracking. Virtual dissections were performed to dissect out the major white matter projections in each dog. Results: In the dog with CCM, the corpus callosum exhibited interhemispheric crossing fibers at the level of the splenium and formed longitudinal callosal fasciculi (Probst bundles). In addition, the fornix was small and the cingula enlarged and exhibited increased dorsal connectivity relative to the normal control. Conclusions and Clinical Importance: We used tractography to describe a white matter malformation in a dog. The results suggest that, embryologically, formed axons fail to cross midline and instead create Probst bundles. Authors => Philippa J. Johnson | Erica F. Barry | Wen-Ming Luh | Emma Davies published => First published: 26 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15392

Title => Focal epilepsy with fear-related behavior as primary presentation in Boerboel dogs Abstract => Background: Focal seizures with fear as a primary ictal manifestation, their diagnostic challenges, and impact on quality of life are well described in human medicine. Reports focusing on ictal fear-like behavior in animals are scarce. Objective: To describe the clinical and histopathological characteristics of a novel focal epilepsy in Boerboel dogs. Animals: Five client-owned Boerboel littermates presented for evaluation of sudden episodes of severe fear-related behavior. Methods: Clinical examination, complete blood cell count, routine blood biochemistry, and urinalysis were performed in all dogs. Magnetic resonance imaging (MRI) scans of the brain were performed in 3 affected Boerboels. In addition, in 2 affected Boerboels, metabolic screening, cerebrospinal fluid (CSF) analysis, and necropsy were performed. Results: Onset of signs was 3 months of age in all affected Boerboels. All Boerboels howled loudly, had an extremely fearful facial expression and trembled during seizures. All affected Boerboels also had autonomic or motor signs. Results of laboratory investigations, diagnostic imaging, and metabolic screening were generally unremarkable. Histopathology showed moderate numbers of single large vacuoles in the perikaryon of neurons throughout the brain, specifically in the deeper cerebral cortical regions. Family history, pedigree analysis, and the homogenous phenotype were suggestive of autosomal recessive inheritance. Conclusions and Clinical Importance: The observed paroxysmal fear-related behavior represents a newly recognized hereditary focal epilepsy in dogs with distinctive clinical and histopathologic features. Veterinarians should be aware that sudden episodes of unusual behavior can represent focal epilepsy. Authors => Quirine E. M. Stassen | Guy C. M. Grinwis | Nieke C. van Rhijn | Martjin Beukers | Nanda M. Verhoeven-Duif | Peter A. J. Leegwater published => First published: 22 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15346

Title => Intracranial pressure monitoring in normal dogs using subdural and intraparenchymal miniature strain-gauge transducers Abstract => Background: Monitoring of intracranial pressure (ICP) is a critical component in the management of intracranial hypertension. Safety, efficacy, and optimal location of microsensor devices have not been defined in dogs. Hypothesis/Objective: Assessment of ICP using a microsensor transducer is feasible in anesthetized and conscious animals and is independent of transducer location. Intraparenchymal transducer placement is associated with more adverse effects. Animals: Seven adult, bred-for-research dogs. Methods: In a prospective investigational study, microsensor ICP transducers were inserted into subdural and intraparenchymal locations at defined rostral or caudal locations within the rostrotentorial compartment under general anesthesia. Mean arterial pressure and ICP were measured continuously during physiological maneuvers, and for 20 hours after anesthesia. Results: Baseline mean ± SD values for ICP and cerebral perfusion pressure were 7.2 ± 2.3 and 78.9 ± 7.6 mm Hg, respectively. Catheter position did not have a significant effect on ICP measurements. There was significant variation from baseline ICP accompanying physiological maneuvers (P < .001) and with normal activities, especially with changes in head position (P < .001). Pathological sequelae were more evident after intraparenchymal versus subdural placement. Conclusions and Clinical Importance: Use of a microsensor ICP transducer was technically straightforward and provided ICP measurements within previously reported reference ranges. Results support the use of an accessible dorsal location and subdural positioning. Transient fluctuations in ICP are normal events in conscious dogs and large variations associated with head position should be accounted for when evaluating animals with intracranial hypertension. Authors => Beverly K. Sturges | Peter J. Dickinson | Linda D. Tripp | Irina Udaltsova | Richard A. LeCouteur published => First published: 21 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15333

Title => Evaluation of plasma angiopoietin-2 and vascular endothelial growth factor in healthy dogs and dogs with systemic inflammatory response syndrome or sepsis Abstract => Background: Angiopoietin-2 (Ang-2) and vascular endothelial growth factor (VEGF) are regulators of endothelial permeability. Objective: Plasma concentrations of Ang-2 and VEGF are increased in dogs with systemic inflammatory response syndrome (SIRS) and sepsis and are correlated with disease severity and outcome. Animals: Healthy dogs (n = 18) and client-owned dogs with SIRS (n = 34) or sepsis (n = 25). Methods: Prospective observational study. Ang-2 and VEGF concentrations in admission plasma samples were compared between healthy dogs and dogs with SIRS or sepsis, and between survivors and non-survivors. Correlations with the acute patient physiologic and laboratory evaluation (APPLEfast) disease severity score were examined. Results: Median Ang-2 was significantly higher in dogs with SIRS (19.3; interquartile range [IQR]: 8.6-25.7 ng/mL) and sepsis (21.2; IQR: 10.3-30.1 ng/mL) compared to healthy dogs (7.6; IQR: 6.7-9.8 ng/mL). Ang-2 was significantly higher in non-survivors (24.1; IQR: 11.9-50.0 ng/mL) than survivors (10.2; IQR: 7.2-21.5 ng/mL) but did not correlate with the APPLEfast score. Admission Ang-2 predicted negative outcome in dogs with SIRS and sepsis with reasonable accuracy (area under the curve [AUC]: 0.75, confidence interval [CI]: 0.59-0.85; sensitivity: 0.5, CI: 0.29-0.71; specificity: 0.87, CI: 0.75-0.95); differentiation between sepsis and SIRS was poor (AUC: 0.58). Plasma VEGF was significantly higher in dogs with sepsis (45; IQR: 14-107.5 pg/mL) than in dogs with SIRS (3.3; IQR: 0-35.6 pg/mL) or healthy dogs (0; IQR: 0 pg/mL; P = 0.008). VEGF was significantly (P = .0004) higher in non-survivors (34.5; IQR: 0-105.7 pg/mL) than in survivors (0; IQR: 0-55.2 pg/mL). The ability of VEGF to predict a negative outcome was poor. Conclusions and Clinical Importance: Ang-2 may represent a useful additional prognostic marker in dogs with SIRS. Authors => Maya König | Alice Nentwig | Eliane Marti | Jelena Mirkovitch | Katja-Nicole Adamik | Simone Schuller published => First published: 21 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15369

Title => Clinical and histologic outcome in a dog surviving massive hepatic necrosis Abstract => Authors => Peter H. Kook | Miriam Baumstark | Maja Ruetten published => First published: 21 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15391

Title => Fungi in respiratory samples of horses with inflammatory airway disease Abstract => Background: Fungi contribute to the inflammatory response of lungs in horses with recurrent airway obstruction and in some forms of asthma in humans. The role of fungi in inflammatory airway disease (IAD) has not been assessed. Objectives: Evaluate the prevalence of fungi in the respiratory samples of horses diagnosed with IAD, describe clinical signs associated with the presence of fungi in respiratory samples, and assess the risk factors associated with IAD and with the presence of fungi in the airways. Animals: Seven-hundred thirty-one active horses referred to a specialized ambulatory practice for signs of respiratory disease or poor performance. Methods: A prospective observational study was performed, collecting clinical data, environmental conditions, and results of a tracheal wash (TW; cytology, fungal culture, and bacterial culture), and bronchoalveolar lavage (cytology). Results: A positive fungal culture was obtained in 55% (402/731) of horses. Horses with fungal elements observed on the TW cytology had 2 times greater chance of having IAD than horses without fungi (odds ratio [OR] = 2.1; 95% CI 1.08-3.33; P = .0003). Risks of being diagnosed with IAD and likelihood of fungi in TW were higher when horses were bedded on straw (OR = 2.0; 95% CI 1.2-3.2 and OR = 1.9; 95% CI 1.3-2.6, respectively) or fed dry hay (OR = 2.7; 95% CI 1.7-4.4 and OR = 2.6; 95% CI 1.6-3.4, respectively). Conclusions and Clinical Importance: Horses inhaling aerosolized fungal particles are at a significantly higher risk of developing IAD. The type of bedding and forage represent significant risk factors for IAD and fungal contamination of equine airways. Authors => Julie Dauvillier | Fe ter Woort | Emmanuelle van Erck-Westergren published => First published: 21 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15397

Title => Seizure-precipitating factors in dogs with idiopathic epilepsy Abstract => Background: Stress, sleep deprivation, and infectious diseases are important seizure-precipitating factors in human epilepsy patients. However, these factors have not been thoroughly studied in epileptic dogs. Objective: Seizure-precipitating factors are common in dogs with idiopathic epilepsy and the occurrence of these factors associate with the dogs' signalment, personality, and epilepsy-related factors. Animals: Fifty dogs with diagnosed idiopathic epilepsy from the hospital populations of University Veterinary Teaching Hospital of University of Helsinki and Referral Animal Hospital Aisti. Methods: In a retrospective cross-sectional observational study, owners were interviewed about their dogs' possible seizure-precipitating factors according to a predefined questionnaire. The dogs were identified and selected by searching the medical records of the participating animal hospitals. Results: The prevalence of seizure-precipitating factors in the study population was 74% (37/50). The most frequently reported factors included stress-related situations, sleep deprivation, weather, and hormonal factors. In dogs with focal onset seizures, the number of precipitating factors was 1.9 (95% CI 1.1-3.4) times higher compared to dogs with generalized seizures. Conclusions and Clinical Importance: Seizure-precipitating factors are common in dogs with idiopathic epilepsy, and the nature of these factors is consistent with those of human patients. Aside from antiepileptic medication, acknowledging and avoiding seizure-precipitating factors could help veterinarians achieve better treatment outcomes. Authors => Johanna A. Forsgård | Liisa Metsähonkala | Anna-Mariam Kiviranta | Sigitas Cizinauskas | Jouni J.T. Junnila | Outi Laitinen-Vapaavuori | Tarja S. Jokinen published => First published: 21 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15402

Title => RESEARCH COMMUNICATIONS OF THE 28th ECVIM-CA CONGRESS Abstract => None Abstract Authors => published => First published: 19 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15372

Title => The fecal microbiome and serum concentrations of indoxyl sulfate and p-cresol sulfate in cats with chronic kidney disease Abstract => Background: Intestinal dysbiosis has been documented in humans with chronic kidney disease (CKD) and is thought to contribute to production of the uremic toxins indoxyl sulfate (IS) and p-cresol sulfate (pCS). Characteristics of the fecal microbiome in cats with CKD and correlation to serum concentrations of uremic toxins are unknown. Objectives: To characterize the fecal microbiome and measure serum IS and pCS concentrations of cats with CKD in comparison to healthy older cats. Animals: Thirty client-owned cats with CKD (International Renal Interest Society stages 2-4) and 11 older (≥8 years) healthy control cats. Methods: Prospective, cross-sectional study. Fecal samples were analyzed by sequencing of 16S rRNA genes and Escherichia coli quantitative PCR (qPCR). Serum concentrations of IS and pCS measured using liquid chromatography tandem mass spectrometry. Results: Cats with CKD had significantly decreased fecal bacterial diversity and richness. Escherichia coli qPCR showed no significant difference in bacteria count between control and CKD cats. Cats with stage 2 (P = .01) and stages 3 and 4 (P = .0006) CKD had significantly higher serum IS concentrations compared to control cats. No significant difference found between stage 2 and stages 3 and 4 CKD. The pCS concentrations were not significantly different between CKD cats and control cats. Conclusions and Clinical Importance: Decreased fecal microbiome diversity and richness is associated with CKD in cats. Indoxyl sulfate concentration is significantly increased with CKD, and cats with stage 2 CKD may suffer from a similar uremic toxin burden as do cats with later stage disease. Authors => Stacie C. Summers | Jessica M. Quimby | Anitha Isaiah | Jan S. Suchodolski | Paul J. Lunghofer | Daniel L. Gustafson published => First published: 18 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15389

Title => Factors associated with disease progression in dogs with presumed preclinical degenerative mitral valve disease attending primary care veterinary practices in the United Kingdom Abstract => Background: Factors associated with disease progression in dogs with preclinical (stage B) degenerative mitral valve disease (DMVD) have not been evaluated previously in primary care veterinary practice. Objectives: To evaluate whether plasma cardiac biomarkers, clinical signs, and physical examination findings are associated with clinical progression (reaching the composite endpoint of initiation of treatment with a potent diuretic or cardiac death) in dogs presumed to have stage B DMVD. Animals: Six-hundred and eighty-four dogs diagnosed with DMVD recruited from 73 primary care practices in the United Kingdom. Dogs were not receiving potent diuretics at recruitment. Methods: Prospective cohort study design. Primary care veterinarians recorded the presence or absence of clinical signs and physical examination findings. Baseline plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin I were measured. Cox regression models measured associations between risk factor variables and clinical progression. Flexible parametric models generated predicted probabilities of reaching the composite endpoint for dogs with different combinations of prognostic risk factor variables. Results: Plasma NT-proBNP, heart rate, heart murmur intensity, presence of a cough, being a Cavalier King Charles Spaniel, and being prescribed pimobendan were associated with clinical progression to initiation of treatment with a potent diuretic or cardiac-related death. Conclusions and Clinical Importance: Dogs with stage B DMVD identified as having a high risk of disease progression might benefit from more frequent monitoring or further diagnostic evaluation. The prognostic factors identified could facilitate risk stratification of dogs presenting with preclinical DMVD. Authors => Madeleine J. Mattin | David C. Brodbelt | David B. Church | Adrian Boswood published => First published: 18 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15390

Title => Efficacy of long-term oral telmisartan treatment in cats with hypertension: Results of a prospective European clinical trial Abstract => Background: Efficacy of telmisartan in treating hypertension (HT) in cats has not been largely investigated. Objective: Telmisartan oral solution effectively controls systolic arterial blood pressure (SABP) in hypertensive cats. Animals: Two-hundred eighty-five client-owned cats with systemic HT. Methods: Prospective, multicenter, placebo-controlled, randomized, double-blinded study. Hypertensive cats diagnosed with SABP ≥160 mmHg and ≤200 mmHg without target-organ-damage were randomized (2 : 1 ratio) to receive 2 mg/kg telmisartan or placebo q24 PO. A 28-day efficacy phase was followed by a 120-day extended use phase. Efficacy was defined as significant difference in mean SABP reduction between telmisartan and placebo on Day 14 and group mean reduction in SABP of > 20 mmHg by telmisartan on Day 28 compared to baseline. Results: Two-hundred fifty-two cats completed the efficacy and 144 cats the extended use phases. Mean SABP reduction at Day 14 differed significantly between groups (P < .001). Telmisartan reduced baseline SABP of 179 mmHg by 19.2 (95% confidence interval [CI]: 15.92-22.52) and 24.6 (95% CI: 21.11-28.14) mmHg at Days 14 and 28. The placebo group baseline SABP of 177 mmHg was reduced by 9.0 (95% CI: 5.30-12.80) and 11.4 (95% CI: 7.94-14.95) mmHg, respectively. Of note, 52% of telmisartan-treated cats had SABP <150 mmHg at Day 28. Mean SABP reduction by telmisartan in severe (≥180 mmHg) and moderate HT (160-179 mmHg) was comparable and persistent over time. Conclusions and Clinical Importance: Telmisartan solution (PO) was effective in reducing SABP in hypertensive cats with SABP ≥160 mmHg and ≤200 mmHg. Authors => Tony M. Glaus | Jonathan Elliott | Esther Herberich | Tanja Zimmering | Balazs Albrecht published => First published: 18 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15394

Title => Evaluation of hepatic tumor portal perfusion using mesenteric angiography: A pilot study in 5 dogs Abstract => Background: Mesenteric angiography is a sensitive method for visualizing portal perfusion in the dog. Objectives: To evaluate hepatic portal perfusion in dogs with incompletely resectable hepatic tumors using mesenteric angiography. Animals: Five client-owned dogs with incompletely resectable hepatic tumors evaluated with mesenteric angiography. Methods: Retrospective case series. Electronic medical records at the Animal Medical Center were analyzed to identify dogs that underwent mesenteric portography to determine blood flow to nonresectable hepatic tumors and subsequently determine ideal routes for transarterial embolization, vascular stent placement, or both. The images obtained from mesenteric angiography were analyzed and compared to those obtained from computed tomography angiography. Results: Portography was accomplished using direct mesenteric venography in 3 dogs with hepatocellular carcinoma (HCC), cranial mesenteric arteriography in 1 dog with hepatic adenoma or well-differentiated HCC, and via splenic arteriovenous fistula in 1 dog with diffuse hepatic hemangiosarcoma metastases. Mean pixel densities in areas of hepatic tumor growth identified statistically significant decreases in portal blood flow (P = .02) compared to normal hepatic parenchyma. Conclusions and Clinical Importance: Initial findings indicate that the blood supply to large and metastatic hepatic tumors in dogs may correlate with that in humans, such that the majority of the tumor blood supply arises from the hepatic artery and not the portal vein. Differences in blood supply between normal hepatic parenchyma and hepatic tumors might be exploited by developing selective tumor therapies such as arterial embolization or chemoembolization that largely spare normal liver tissue. Further investigation is warranted. Authors => Kelsey Goode | Chick Weisse | Allyson Berent | Ken Lamb published => First published: 18 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15395

Title => Myoclonus and hypercalcemia in a dog with poorly differentiated lymphoproliferative neoplasia Abstract => Authors => Cassia H. Z. Hare | Joy Archer | Emilie Cloup | Marie-Aude Genain | Katherine Hughes | Katie E. McCallum | Lisa Alves published => First published: 18 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15398

Title => Hepatic copper accumulation in a young cat with familial variations in the ATP7B gene Abstract => Authors => Hajime Asada | Mari Kojima | Takuro Nagahara | Yuko Goto-Koshino | James K. Chambers | Taisuke Nakagawa | Nozomu Yokoyama | Kazuyuki Uchida | Hajime Tsujimoto | Koichi Ohno published => First published: 18 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15399

Title => Comparison of 2 differently sized endoscopic biopsy forceps in the evaluation of intestinal disease in cats Abstract => Background: In clinical practice, histopathological diagnosis of chronic intestinal disease is challenging because of difficulty in obtaining adequate duodenal samples. At present, no studies have investigated the influence of biopsy forceps size on sample quality in cats. Objectives: Duodenal biopsy using larger biopsy forceps (2.4 mm) will provide higher quality samples. Animals: Fifty client-owned cats underwent endoscopy of the upper gastrointestinal tract for evaluation of chronic gastrointestinal signs, with inflammatory bowel disease (IBD) or intestinal lymphoma as differential diagnoses. Methods: For each cat, duodenal biopsy specimens were obtained using both small (1.8 mm) and large (2.4 mm) forceps and evaluated for adequacy, orientation, the presence of artifacts, villi morphology, the presence of inflammation, and neoplastic infiltration. Results: The percentage of adequate and evaluable biopsy specimens obtained using the larger forceps was significantly higher than that collected using the smaller forceps. Agreement between the forceps was variable for histological features and substantial in the case of lymphoma. However, in case of disagreement, the proper diagnosis usually was achieved only with the larger biopsy forceps. Conclusions and Clinical Importance: Use of a larger biopsy forceps allows collection of a higher percentage of adequate and evaluable biopsy specimens compared to the commonly used smaller forceps and indirectly decreases the percentage of artifacts and increases the percentage of samples with evaluable villi. The use of a larger forceps could be helpful to obtain high-quality samples and improve diagnostic accuracy. Authors => Enrico Bottero | Emanuele Mussi | Camillo Pieramati | Davide De Lorenzi | Serenella Silvestri | Elvio Lepri published => First published: 17 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15356

Title => Clinical findings and outcome of dogs with unilateral masticatory muscle atrophy Abstract => Background: Little is known about the spectrum of underlying disorders in dogs with unilateral masticatory muscle (MM) atrophy. Objectives: To evaluate the clinical presentation, magnetic resonance imaging (MRI) findings, and outcome of dogs with unilateral MM atrophy. Animals: Sixty-three client-owned dogs. Methods: The medical database was retrospectively reviewed for dogs that underwent MRI for evaluation of unilateral MM atrophy. Imaging studies were reviewed and follow-up information was obtained from telephone interviews. Results: Presumptive trigeminal nerve sheath tumor (pTNST) was diagnosed in 30 dogs (47.6%); survival time varied from 1 day to 21 months (median, 5 months). Other extra-axial mass lesions were observed in 13 dogs (20.6%); survival time varied from 6 days to 25 months (median, 2.5 months). In 18 dogs (28.6%), no abnormalities were observed on MRI; neurological signs only progressed in 1 dog. Diagnosis had a significant influence on the type of neurological abnormalities, with additional neurological deficits observed in most dogs with pTNST and in all dogs with other extra-axial mass lesions. Diagnosis had a significant effect on euthanasia at the time of diagnosis and likelihood of neurological deterioration. Dogs with mass lesions were more likely to be euthanized or experience neurological deterioration, whereas these outcomes occurred less often in dogs in which no causative lesion could be identified. Conclusions and Clinical Importance: Trigeminal nerve sheath tumors should not be considered the only cause of unilateral MM atrophy. Our results illustrate the importance of performing a neurological examination and MRI when evaluating dogs with unilateral MM atrophy. Authors => Emily Jayne Milodowski | Pablo Amengual-Batle | Elsa Beltran | Rodrigo Gutierrez-Quintana | Steven De Decker published => First published: 17 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15373

Title => A monoclonal antibody-based urine Histoplasma antigen enzyme immunoassay (IMMY®) for the diagnosis of histoplasmosis in cats Abstract => Background: An in-house Histoplasma urine antigen test for cats might be desirable in certain situations. Objective: To validate and compare the diagnostic performance of a monoclonal antibody-based IMMY urine Histoplasma antigen enzyme immunoassay (IMMY EIA) to the commercially available urine Histoplasma antigen enzyme immunoassay (MiraVista Diagnostics, MV EIA). Animals: One hundred ninety-three urine samples from 105 client-owned and purpose-bred research cats. Methods: Cats were classified as Histoplasma positive or negative based on diagnostic investigation. The IMMY EIA and MV EIA were performed on all urine samples. Correlation and agreement between the assays were determined. Diagnostic performance was determined and compared between assays. Results: The IMMY EIA, with a 0.25 ng/mL diagnostic cutoff, provided a diagnostic sensitivity (DSe), diagnostic specificity (DSp), and diagnostic accuracy (DAc) of 89% (95% confidence interval [CI]; 73%-97%), 80% (67%-89%), and 83% (74%-90%), respectively. The IMMY EIA, with a 1.1 ng/mL diagnostic cutoff, provided a DSe, DSp, and DAc of 77% (95% CI 60%-90%), 97% (88%-100%), and 89% (81%-95%), respectively. The MV EIA provided a DSe, DSp, and DAc of 94% (95% CI 81%-99%), 97% (89%-100%), and 96% (90%-99%), respectively. Moderate overall agreement was found between MV EIA and IMMY EIA using the 0.25 ng/mL cut-off (к = 0.44; 95% CI 0.31-0.57) and the 1.1 ng/mL cut-off (к = 0.43, 95% CI, 0.31-0.56). Conclusions and Clinical Importance: The IMMY EIA might be useful as a diagnostic test for histoplasmosis in cats. Further modifications of the IMMY EIA are required to achieve the diagnostic performance of the MV EIA. Authors => Lana Rothenburg | Andrew S. Hanzlicek | Mark E. Payton published => First published: 17 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15379

Title => Detection of naturally occurring alloantibody by an in-clinic antiglobulin-enhanced and standard crossmatch gel column test in non-transfused domestic shorthair cats Abstract => Background: Blood typing for the A and B antigens is essential and crossmatching testing is generally recommended before transfusing blood to cats. Objective: To evaluate 2 crossmatch (XM) tests. Animals: Forty-nine healthy domestic shorthair cats that had not received a blood transfusion. Methods: Prospective study. Blood samples were typed for AB using immunochromatographic and flow cytometric techniques. A gel column (GC) and a feline antiglobulin-enhanced gel column (AGC) XM tests were used for crossmatching. Results: The population included 34 type A, 13 B, and 2 AB cats, with concordant results (r = 1, P < .005) by flow cytometry and immunochromatographic strip kit. The plasma from type A cats had either no or weak anti-B alloantibodies. The plasma of 12 of 13 type B cats contained strong anti-A alloantibodies. For crossmatching, plasma to RBC pairings were prepared using the GC (n = 446) and AGC (n = 630) tests. Both methods showed compatibilities in 329 and incompatibilities in 102 pairings including all A-B mismatches. Additionally 15 pairings showed agglutination by the AGC but not GC method. Fourteen incompatibilities outside the expected A-B mismatches were only revealed by AGC. Conclusions and Clinical Importance: AB typing using immunochromatographic strip is as accurate as laboratory flow cytometry. The 2 XM methods had good agreement with additional incompatibilities being recognized by the AGC XM beyond A-B incompatibilities. In clinic, feline AB typing and sensitive XM test kits are available and recommended before each transfusion, although the clinical implications of incompatible XM test results and clinical benefits of such crossmatching have not been documented. Authors => Isabelle Goy-Thollot | Alexandra Nectoux | Maryline Guidetti | Benjamin Chaprier | Sarah Bourgeois | Catherine Boisvineau | Anthony Barthélemy | Céline Pouzot-Nevoret | Urs Giger published => First published: 17 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15381

Title => Effects of the potassium-sparing diuretic amiloride on chemotherapy response in canine osteosarcoma cells Abstract => Background: Osteosarcoma (OSA) is a common bone tumor of mesenchymal origin in dogs. Chemotherapy delays metastasis, yet most dogs die of this disease within 1 year of diagnosis. The high metabolic demand of cancer cells promotes proton pump upregulation, leading to acidification of the tumor microenvironment and chemoresistance. The potassium-sparing diuretic amiloride is among a class of proton pump inhibitors prescribed for refractory heart failure treatment in dogs. Objective: We hypothesized that amiloride treatment improves chemotherapy response by reducing acidification in canine OSA cells. Our objective was to assess the in vitro effects of amiloride on cell viability, apoptosis, and metabolism. Methods: In vitro study. Assessments of cell viability and apoptosis were performed after single agent or combination treatment, along with calculations of pharmacological synergism using the combination index. Protein signaling during apoptosis was evaluated by Western blotting. Metabolic profiling was performed using a Seahorse bioanalyzer. Results: Amiloride strongly synergized with doxorubicin in combination treatment and exhibited additive or antagonistic effects with carboplatin in canine OSA cells. Combination treatment with doxorubicin significantly upregulated p53-mitochondrial signaling to activate apoptosis and downregulate Akt phosphorylation. Amiloride-treated cells further exhibited metabolic switching with reductions in glycolytic capacity and maximal respiration. Conclusion and Clinical Importance: Amiloride synergized with doxorubicin to potentiate apoptosis in canine OSA cells. These results justify further investigation into repurposing of amiloride as an oncology drug for the treatment of OSA in dogs. Authors => Andrew C. Poon | Jordon M. Inkol | Anita K. Luu | Anthony J. Mutsaers published => First published: 17 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15382

Title => Anatomy, baseline characteristics, and procedural outcome of patent ductus arteriosus in German Shepherd dogs Abstract => Background: German Shepherd dogs (GSD) are predisposed to developing patent ductus arteriosus (PDA) and are reportedly prone to type III (tubular) PDA anatomy. Dogs with type III anatomy are not considered favorable candidates for device-based intervention. Objective: To describe the PDA anatomy, baseline characteristics, and procedural outcome of GSD with PDA. Animals: Twenty-eight client-owned GSD. Methods: Retrospective review of medical records of 28 GSD diagnosed with PDA that underwent surgical ligation or transcatheter device closure between 2007 and 2017. Results: German Shepherd dogs with PDA often presented with clinical signs (50%), concurrent congenital heart disease (35.7%), and arrhythmias (29%). Dogs were typically mature at presentation (median age, 12.1 months) and evenly distributed by sex (57% female). The PDA anatomy was classified in 24 of 28 GSD, with type II anatomy being most common (21/24). Three dogs had unusual anatomy (type IV in 1, type V in 2). Median minimal ductal diameter (MDD) in this population was larger than previously reported in a mixed population and ranged between 4.4 and 4.9 mm depending upon imaging modality. Successful closure was achieved using an Amplatz canine duct occluder (ACDO) in 22 dogs or by surgical ligation in 6 dogs. No cases of type III anatomy were confirmed. Conclusions and Clinical Importance: The majority of GSD in this population had type II PDA anatomy that was amenable to ACDO deployment. Predisposition for large MDD and occasional, unusual PDA anatomy suggests that transesophageal echocardiography may be beneficial for optimal procedural planning in this breed. Authors => Sonya Wesselowski | Ashley B. Saunders | Sonya G. Gordon published => First published: 17 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15401

Title => Daily oral cyanocobalamin supplementation in Beagles with hereditary cobalamin malabsorption (Imerslund-Gräsbeck syndrome) maintains normal clinical and cellular cobalamin status Abstract => Background: Efficacy of PO cobalamin (Cbl) supplementation in dogs with hereditary Cbl malabsorption (Imerslund-Gräsbeck syndrome, IGS) is unknown. Objectives: To evaluate PO Cbl supplementation in Beagles with IGS previously treated parenterally. We hypothesized that 1 mg cyano-Cbl daily PO would maintain clinical and metabolic remission. Animals: Three client-owned Beagles with IGS and 48 healthy control dogs. Methods: Prospective study. Daily PO cyanocobalamin (cyano-Cbl; 1 mg) supplementation was monitored for 13 (2 dogs) and 8 months (1 dog). Health status was assessed by owner observations. Methylmalonic acid (MMA)-to-creatinine concentrations were measured using an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-TMS) method on urine samples collected monthly. Concurrent measurements of serum MMA concentration (n = 7; UPLC-TMS) were available for 1 dog. Results: All dogs remained in excellent health during PO supplementation. Urine MMA remained consistently low in 2 dogs (median, 2.5 mmol/mol creatinine; range, 1.2-9; healthy dogs [n = 30], median, 2.9 mmol/mol creatinine; range, 1.3-76.5). Urine MMA ranged from 38.9-84.9 mmol/mol creatinine during the first 6 months in 1 dog already known to excrete comparable amounts when supplemented parenterally. Brief antibiotic treatment for an unrelated condition after 6 months resulted in low urine MMA (median, 2.8 mmol/mol creatinine; range, 1.9-4.8) for the next 7 months. All concurrent serum MMA concentrations (median, 651 nmol/L; range, 399-919) before and after month 6 were within the established reference interval (393-1476 nmol/L; n = 48). Conclusions and Clinical Importance: One milligram of cyano-Cbl daily PO appears efficacious for maintaining normal clinical status and normal cellular markers of Cbl metabolism in Beagles with IGS. Authors => Peter H. Kook | Martin Hersberger published => First published: 15 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15380

Title => Pharmacokinetics and pharmacodynamics of intravenous esomeprazole at 2 different dosages in dogs Abstract => Background: Although the demand for esomeprazole is increasing in veterinary medicine, the pharmacokinetics (PK) and pharmacodynamics of esomeprazole have been described in only a few studies. Objective: To determine the PK of 0.5 and 1 mg/kg esomeprazole administered IV q12h and to investigate its effects on intragastric pH in healthy dogs. Animals: Six adult Beagles. Methods: Open-label, randomized, and crossover design. The dogs received 0.5 or 1 mg/kg esomeprazole IV q12h for 48 hours. Plasma concentrations of esomeprazole were measured by high-performance liquid chromatography-tandem mass spectrometry. Intragastric pH was determined using the Bravo pH monitoring system and recorded as mean percentage time (MPT) for which pH was ≥3 and ≥4 for 24 hours in each group. Results: The peak plasma concentration and area under the curve from the time of dosing to the last measurable concentration in the 1 mg/kg group were higher than those in the 0.5 mg/kg group. However, when the dosage normalized, intergroup differences were not significant. The MPTs for which intragastric pH was ≥3 and ≥4 for 48 hours were 88% ± 7% and 81% ± 9% for the 0.5 mg/kg group and 90% ± 9% and 85% ± 11% for the 1 mg/kg group, respectively, with no significant intergroup differences. Conclusions and Clinical Importance: The pharmacokinetic parameters and acid suppressant effect for 0.5 and 1 mg/kg esomeprazole were not significantly different. Furthermore, the efficacy of esomeprazole 0.5 mg/kg IV q12h was sufficient to increase intragastric pH in Beagles. Authors => Do-Hyun Seo | Jong-Bok Lee | Ji-Hye Hwang | Jong-Woo Jeong | Gun-Ho Song | Tae-Sung Koo | Kyoung-Won Seo published => First published: 13 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15383

Title => Atypical actinobacillosis affecting hind limbs and lungs in a single beef cattle herd Abstract => Authors => Anne Relun | Nora Cesbron | Patrick Bourdeau | Laëtitia Dorso | Thomas Brement | Sébastien Assié | Henrik Christensen | Raphaël Guatteo published => First published: 12 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15387

Title => Computed tomographic angiography and ultrasonography in the diagnosis and evaluation of acute pancreatitis in dogs Abstract => Background: Acute pancreatitis in dogs is an under-diagnosed disease. Current diagnostic methods are insufficient at identifying sequelae and lack prognostic capability. Computed tomographic angiography (CTA) is accurate for diagnosis and prognostication of pancreatitis in humans. Objectives: In comparison to ultrasound (US), CTA will (1) better diagnose more severe pancreatitis and sequelae and (2) provide assessment of patient outcome by identification of pancreatic contrast enhancement patterns. Animals: Twenty-six client-owned dogs suspected to have acute pancreatitis. Methods: US and CTA examinations performed at time of admission were compared to determine the detection of pancreatic changes and sequelae. CTA findings also were compared to outcome indicators for prognosis of dogs with acute pancreatitis. Specific canine pancreatic lipase (cPL) samples were obtained and compared with CTA findings. Results: Ten of 26 dogs had heterogeneous contrast enhancement of the pancreas. Compared to US, CTA better identified portal vein thrombosis (P = .003). Patients with heterogeneous contrast enhancement had longer hospitalization (P = .01), including hospital stays for >5 days (P = .02), had more relapses, and were more likely to have portal vein thrombosis (P = .002). Patients with heterogeneous contrast enhancement had increased spec cPL (P = .006). Conclusions and Clinical Importance: In comparison to US, CTA better identified dogs with more severe acute pancreatitis and those with portal vein thrombosis, factors that may predict longer hospitalization and increased risk of relapse. The presence of heterogeneous contrast enhancement and portal vein thrombosis may change therapy for patients with acute pancreatitis. Authors => John M. French | David C. Twedt | Sangeeta Rao | Angela J. Marolf published => First published: 11 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15364

Title => Correlation of plasma coagulation tests and fibrinogenClauss with rotational thromboelastometry parameters and prediction of bleeding in dogs Abstract => Background: Correlation of plasma fibrinogen concentration (fibrinogenClauss) with rotational thromboelastometry (ROTEM) parameters has not been investigated in dogs. Objectives: To determine the correlation between plasma coagulation tests and fibrinogenClauss with ROTEM parameters and to evaluate their ability to predict bleeding in dogs. Animals: Ninety-seven dogs with concurrent determination of fibrinogenClauss and fibrin polymerization test (FIBTEM) analysis. Methods: Signalment, pretreatment, clinical signs of bleeding, fibrinogenClauss, plasma coagulation test results, hematocrit, platelet count, FIBTEM, extrinsic (EXTEM) and intrinsic (INTEM) activated ROTEM assays were retrieved retrospectively. Correlations between fibrinogenClauss and FIBTEM maximum clot firmness (MCFFIBTEM) and between prothrombin time (PT) or activated partial thromboplastin time (aPTT) and ROTEM parameters were determined. Dogs were further assigned to groups with or without clinical signs of bleeding. The prognostic significance of significantly different parameters to predict bleeding was evaluated. Results: FibrinogenClauss showed strong correlation with MCFFIBTEM (r = 0.860, n = 97, P < .001). PT showed strong correlation with EXTEM clotting time (CTEXTEM) (r = 0.839, n = 53, P < .001), and aPTT was strongly correlated with INTEM CT (CTINTEM) (r = 0.664, n = 31, P < .001). Platelet count, PT/aPTT, EXTEM clot formation time (CFTEXTEM), MCFEXTEM, EXTEM maximum clot elasticity (MCEEXTEM), and CTINTEM were significantly different between groups. A CTINTEM >149 seconds was 100% sensitive to detect bleeding. Conclusions and Clinical Importance: The MCFFIBTEM can be used to evaluate the effect of fibrinogen on hemostasis as an alternative to determination of fibrinogenClauss. In addition, CTEXTEM and CTINTEM are strongly correlated with PT and aPTT, respectively. Authors => Nathalie M. Enk | Annette P. N. Kutter | Claudia Kuemmerle-Fraune | Nadja E. Sigrist published => First published: 11 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15365

Title => Association of circulating microRNA-122 and microRNA-29a with stage of fibrosis and progression of chronic hepatitis in Labrador Retrievers Abstract => Background: Chronic hepatitis (CH) in dogs is common and has the tendency to progress to liver cirrhosis (LC). Circulating microRNAs might have the potential as markers for disease progression. Objectives: To investigate whether concentration of specific microRNAs in serum correlate with the stage and grade of CH in Labrador Retrievers. Animals: Twenty-two Labrador Retrievers with histological CH (n = 8), LC (n = 7), and normal liver (NL, n = 7). Methods: In this retrospective study, serum concentrations of miR-122, miR-29a, miR-133a, miR-181b, and miR-17-5p were measured by quantitative real-time PCR and evaluated using univariate linear regression in dogs. A multivariate model was fit including the grade of hepatitis and the stage of fibrosis. Results: Of the 5 microRNAs, only circulating miR-122 and miR-29a were significantly associated with the grade of hepatitis and the stage of fibrosis. A positive correlation was identified between the grade of hepatitis with miR-122 (rs = 0.79, P < .001) and miR-29a (rs = 0.78, P < .001). Both miR-122 (rs = 0.81, P < .001) and miR-29a (rs = 0.67, P < .001) showed a significant positive correlation with the stage of fibrosis. MiR-122 concentrations were significantly higher in the CH (P < .01) and LC groups (P < .001) compared to the NL group. MiR-29a concentrations were significantly higher in the CH (P < .001) and LC (P < .001) groups compared to the NL group. Conclusions and Clinical Importance: Circulating miR-122 and miR-29a concentrations might be useful for monitoring the response to treatment and progression of canine CH. Authors => Manabu Sakai | Bart Spee | Guy C. M. Grinwis | Louis C. Penning | Monique E. van Wolferen | Luc J. W. van der Laan | Hille Fieten published => First published: 11 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15366

Title => Association between life span and body condition in neutered client-owned dogs Abstract => Background: There is an association between overweight status and life span in kenneled dogs, but a similar association has not been reported for pet dogs. Objectives: To examine the effects of being overweight in middle age on the life span of neutered client-owned dogs. Animals: Fifty-thousand seven-hundred eighty seven middle-aged neutered client-owned dogs attending a network of approximately 900 veterinary hospitals across North America. Methods: Retrospective case-control study. For each of 12 breeds, groups of dogs aged between 6.5 and 8.5 years were identified as being in “overweight” or “normal” body condition. Within each breed and sex, differences in life span between dogs in normal body condition and overweight body condition in the 2 groups were then analyzed by Cox proportional hazards models. Results: For all breeds, instantaneous risk of death for dogs in overweight body condition was greater than those in normal body condition throughout the age range studied, with hazard ratios ranging from 1.35 (99.79% confidence interval [CI] 1.05-1.73) for German Shepherd dog to 2.86 (99.79% CI 2.14-3.83) for Yorkshire Terrier. In all breeds, median life span was shorter in overweight compared with normal weight dogs, with the difference being greatest in Yorkshire Terriers (overweight: 13.7 years, 99.79% CI 13.3-14.2; normal: 16.2 years, 99.79% CI 15.7-16.5) and least in German Shepherd dogs (overweight: 12.1 years, 99.79% CI 11.8-12.4; normal: 12.5 years, 99.79% CI 12.2-12.9). Conclusions and Clinical Importance: Veterinary professionals should consider promoting healthy body condition for dogs, particularly from midlife onward. Authors => Carina Salt | Penelope J. Morris | Derek Wilson | Elizabeth M. Lund | Alexander J. German published => First published: 11 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15367

Title => Influence of canine donor plasma hemostatic protein concentration on quality of cryoprecipitate Abstract => Background: Cryoprecipitate (CRYO) is a plasma component containing high concentrations of factor VIII (FVIII), von Willebrand factor (VWF), and fibrinogen. Because Greyhounds are reported to have lower plasma VWF and fibrinogen concentrations, their plasma may not yield high potency CRYO. Objectives: To determine if plasma hemostatic protein concentration is a good predictor of CRYO potency and if a difference exists in quality of CRYO prepared from Greyhounds versus non-Greyhounds. Animals: Twenty Greyhounds and 20 non-Greyhounds. Methods: A 450 mL unit of blood was collected from each donor, centrifuged to prepare fresh frozen plasma (FFP), and processed to CRYO. Aliquots of FFP and CRYO were analyzed for FVIII, VWF, and fibrinogen content and factor recovery. Results: A positive correlation was found among donor plasma FVIII, VWF and fibrinogen concentration, and CRYO factor content (P < .001). Mean recovery was highest for VWF (67%), followed by fibrinogen (47%), and FVIII (37%). No breed difference was found in mean CRYO FVIII content, but CRYO VWF and fibrinogen were lower in Greyhounds (P = .004 and P < .001, respectively). No difference was found between Greyhounds and non-Greyhounds for the number of CRYO units meeting human blood banking standards. Conclusions and Clinical Importance: Factor concentration in FFP is associated with CRYO potency, suggesting that prescreening of blood donors may enhance CRYO quality. Despite lower VWF and fibrinogen content, CRYO prepared from Greyhounds is acceptable based on blood banking standards for humans, indicating that Greyhound FFP does not need to be excluded from CRYO production. Authors => Macy Drinkhouse | Marjory B. Brooks | Darko Stefanovski | Kimberly Marryott | Mary Beth Callan published => First published: 11 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15376

Title => Concurrent pituitary and adrenocortical lesions on computed tomography imaging in dogs with spontaneous hypercortisolism Abstract => Background: Spontaneous hypercortisolism or Cushing's syndrome in dogs is either pituitary or adrenal dependent, but concurrent pituitary and adrenal hypercortisolism also has been reported. Objective: To determine how often concurrent pituitary and adrenal lesions are present in dogs with spontaneous hypercortisolism. Animals: Two hundred one client-owned dogs with spontaneous hypercortisolism. Methods: Retrospective study. Pre- and post-contrast computed tomography (CT) scans of the pituitary and adrenal glands were performed in dogs with confirmed hypercortisolism. Results: In dogs with dexamethasone-suppressible hypercortisolism (122/201), 78 dogs (64%) had an enlarged pituitary gland (median pituitary height/brain area [P/B], 0.43 × 10−2 mm−1; range, 0.32-1.21 × 10−2 mm−1). Two of these 78 dogs had concurrent adrenal lesions. In the remaining dogs (44/122; 36%), the pituitary gland was not enlarged. In the dexamethasone-resistant group (79/201), the pituitary gland was enlarged in 47 dogs (59%; median P/B, 0.57 × 10−2; range, 0.32-1.50 × 10−2 mm−1). Eight of these 47 dogs (17%) had concurrent adrenal lesions. In the remaining 32 dexamethasone-resistant dogs (41%), the pituitary gland was not enlarged. Among them, 27 dogs had adrenal lesions and suppressed ACTH concentrations consistent with adrenal-dependent hypercortisolism and 5 dogs were diagnosed with pituitary-dependent hypercortisolism. Conclusions and Clinical Importance: Concurrent pituitary and adrenal lesions were present in 5% of all dogs with hypercortisolism and in 10% of the dexamethasone-resistant dogs. Diagnostic imaging of both pituitary and adrenal glands should be included in the diagnostic evaluation of every dog with spontaneous hypercortisolism to obtain information needed for estimation of prognosis and choosing the optimal treatment. Authors => Kirsten L. van Bokhorst | Hans S. Kooistra | Susanne A.E.B. Boroffka | Sara Galac published => First published: 11 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15378

Title => Evaluation of a high-sensitivity cardiac troponin I assay compared to a first-generation cardiac troponin I assay in Doberman Pinschers with and without dilated cardiomyopathy Abstract => Background: Echocardiography and 24-hour ECG are the gold standard tests to diagnose dilated cardiomyopathy (DCM) in Doberman Pinschers (DP), but myocardial damage might be detected earlier using a high-sensitivity cardiac troponin I (hs-cTnI) assay. Objective: To evaluate and compare an hs-cTnI assay (Advia Centaur TnI-Ultra assay) with a conventional cTnI assay in DP with different stages of DCM and in healthy DP. Animals: Three hundred forty-five examinations from 162 DP with and 179 DP without DCM. Methods: Prospective longitudinal study. Dogs were allocated into 6 groups based on echocardiographic and 24-hour ECG criteria: (1) healthy group (179 dogs), (2) last-normal group (29 dogs), which included dogs that were considered to be healthy at the time of their examination but were assigned to the last-normal group retrospectively when DCM was diagnosed at their next examination within 1.5 years, (3) only arrhythmias (45 dogs, 119 examinations), (4) only echocardiographic changes (24 dogs, 61 examinations), (5) echocardiographic changes with ventricular premature complexes (41 dogs, 100 examinations), and (6) decompensated (23 dogs, 36 examinations). Hs-cTnI and conventional cTnI concentration measurements were performed and compared. Results: A cutoff value of hs-cTnI concentration >0.113 ng/mL had a sensitivity of 81.2% and a specificity of 73.2% to identify the presence of DCM. The conventional cTnI assay showed a similar test performance, but the hs-cTnI assay identified more dogs (21/29 dogs, 72%) in the last-normal group compared to the conventional cTnI test (18/29 dogs, 62%). Conclusions and Clinical Importance: The hs-cTnI is an additional test with good potential to identify early DCM. Authors => Lena Klüser | Elizabeth T. Maier | Gerhard Wess published => First published: 11 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15384

Title => The effect of inhaled heliox on peak flow rates in normal and brachycephalic dogs Abstract => Background: Heliox, a mixture of helium and oxygen, alleviates airway obstruction in people and improves air flow, and its use has been proposed in dogs. Brachycephalic dogs have naturally occurring airway obstruction where heliox might be a useful therapeutic option. Objective: The purposes of this study were to (1) determine the impact of breathing heliox on peak inspiratory and expiratory flows (PIF/PEF) in healthy dogs and (2) determine if brachycephalic dogs and mesocephalic dogs have similar responses to inhaled heliox. Animals: Eleven healthy dogs: 5 mesocephalic and 6 brachycephalic dogs. Methods: A prospective study. Tidal breathing flow-volume loops were recorded when dogs were breathing room air (nitrogen-oxygen) and heliox. Peak inspiratory and expiratory flow rates were recorded and the subjective shape of loops assessed. Peak inspiratory and expiratory flows pre- and post-heliox were compared using a Mann-Whitney Rank sum test with a P-value of <.05 considered significant. Results: In inhaled heliox, PIF and PEF were evaluated by tidal breathing flow-volume loops. In mesocephalic dogs, PIF increased from a median of 820 mL/s (range, 494-1010 mL/s) to 1386 mL/s; P = .02; and for PEF from 688 mL/s to 1793 mL/s (P = .04), whereas in brachycephalic dogs, the median PIF increased from 282 mL/s to 694 mL/s; P = .01 and the median PEF increased from 212 mL/s to 517 mL/sec; P = .03. Brachycephalic dogs showed normalization of loop shapes. Conclusions and clinical importance: Heliox improves flow rate and appears to improve flow patterns in brachycephalic dogs. Authors => Kathryn Benavides | Elizabeth Rozanski | John D. Anastasio | Daniela Bedenice published => First published: 11 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15385

Title => Narrative review of therapies for chronic enteropathies in dogs and cats Abstract => Background: The optimal medical treatment for chronic enteropathy (CE) in dogs and cats is controversial. Sequential treatment using diet, antimicrobials, and immunosuppressive drugs is the most common strategy used by clinicians. Objectives: To review the evidence for the effectiveness of dietary, drug, and alternative health interventions for inducing clinical remission in dogs and cats with CE. Animals: Retrospective study of dogs and cats with a diagnosis of chronic enteropathy. Methods: MEDLINE and Centre for Agriculture and Bioscience International (CABI) databases (1950 to March 2017) were searched for randomized controlled trials (RCTs), observational studies, and case series. The primary outcome was induction of clinical remission. All studies were evaluated using the quality of evidence grading guidelines (I-IV), which assign a score defining the strength and quality of the evidence. Results: Twenty-two studies (11 RCTs in dogs and 2 in cats and 9 cohort studies or case series) met the inclusion criteria for inducing remission of gastrointestinal (GI) signs. Of the 13 RCTs achieving grade I scores, 10 studies (totaling 218 dogs and 65 cats) compared single treatment: diet (n = 3), immunosuppressives (n = 3), antimicrobials (n = 2), anti-inflammatory drugs (n = 1), and probiotics (n = 1). Three case series (grade III) reported clinical remission using an elimination diet fed to 55 cats and use of enrofloxacin to induce remission in dogs with granulomatous colitis (2 studies totaling 16 dogs). Conclusions and Clinical Importance: The current evidence for treatment of CE is much greater in dogs than in cats. There is sufficient strong evidence to recommend the use of therapeutic GI diets, glucocorticoids, enrofloxacin, or some combination of these in dogs with CE. Therapeutic GI diets and glucocorticoids are most useful in cats with CE. Authors => Kelly Makielski | Jonah Cullen | Annette O'Connor | Albert E. Jergens published => First published: 06 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15345

Title => Allergen-specific immunoglobulin E in sera of horses affected with insect bite hypersensitivity, severe equine asthma or both conditions Abstract => Background: Genetic, epidemiologic, and clinical evidence suggests that, in horses, there are manifestations of hypersensitivity that can occur together. Objectives: To investigate whether concurrent insect bite hypersensitivity (IBH) and severe equine asthma (EA) is associated with higher allergen-specific and total serum immunoglobulin E (IgE) concentrations than only EA or IBH. Animals: Healthy control horses (C, n = 40), horses with IBH (IBH, n = 24), severe EA (EA, n = 18), and both conditions (IBH/EA, n = 23) were included. Methods: In our retrospective comparative study, sera from horses with signs of severe EA, IBH, and control animals were used. IgE specific for 15 recombinant (r) allergens as well as total serum IgE concentrations were measured by enzyme-linked immunosorbent assay. Results: Group IBH (median sum r-Culicoides IgE: optical density at 405 nm [OD405] = 3.54 [0.48-15.07]) and group IBH/EA (OD405 = 4.55 [0.46-17.15]) had significantly (P < .001) higher IgE against Culicoides r-allergens than groups C (OD405 = 0.44 [0.21-2.05]) and EA (OD405 = 0.6 [0.2-2.9]). There were no significant (P > .05) differences between group IBH and group IBH/EA. No significant differences among the groups were found for the other r-allergens or total serum IgE concentration. Compared to controls, horses with severe IBH had significantly increased IgE concentration to 5 Culicoides r-allergens (P < .05), whereas horses with moderate IBH had significantly increased IgE concentration to only 3 Culicoides r-allergens (P < .05). Conclusions and Clinical Importance: Susceptibility of IBH-affected horses to develop EA is likely not associated with IgE-mediated immune reactions but with other immunopathological mechanisms. Authors => Maëva Verdon | Simone Lanz | Claudio Rhyner | Vinzenz Gerber | Eliane Marti published => First published: 06 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15355

Title => Viral testing of 10 cases of Theiler's disease and 37 in-contact horses in the absence of equine biologic product administration: A prospective study (2014-2018) Abstract => Background: A novel equine parvovirus (EqPV-H) was recently discovered in the equine liver with Theiler's disease. Objectives: To determine the prevalence of EqPV-H infection in naturally occurring Theiler's disease cases and in-contact horses in the absence of historical equine biologic product administration. Animals: Ten cases of Theiler's disease from 6 separate properties were included in the study, based on the criteria of acute onset of clinical signs of liver failure with laboratory or histopathologic findings characteristic of Theiler's disease and no history of receiving an equine biologic product within the preceding 4 months. In addition, 37 in-contact horses from 4 of the 6 properties were screened for EqPV-H infection and hepatitis. Methods: In prospective case series, cases were diagnosed with Theiler's disease by the attending veterinarian and were tested for EqPV-H by PCR of liver or serum. In-contact horses were assessed via serum chemistry and PCR at the attending veterinarian's discretion. Hepatitis was defined as serum gamma-glutamyltransferase activity above reference interval. The association of EqPV-H with hepatitis was determined by Fisher's exact test. Results: Nine of 10 (90%) Theiler's disease cases and 54% of tested in-contact horses were EqPV-H positive. Hepatitis was significantly associated with EqPV-H infection (P = .036). Conclusions and Clinical Importance: Although further study is required to identify EqPV-H as the causative agent of Theiler's disease, EqPV-H appears strongly associated with cases of fatal Theiler's disease and subclinical hepatitis in horses in contact with those cases. The prevalence of EqPV-H infection on affected properties can be high. Authors => Joy E. Tomlinson | Bud C. Tennant | Alyssa Struzyna | Dawn Mrad | Nimet Browne | Dorothy Whelchel | Philip J. Johnson | Camilla Jamieson | Christiane V. Löhr | Robert Bildfell | Erica C. McKenzie | Melissa Laverack | Randall W. Renshaw | Edward Dubovi | Amit Kapoor | Richard S. Meirs | Rodney Belgrave | Julie Engiles | Gerlinde R. Van de Walle | Thomas J. Divers published => First published: 06 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15362

Title => Strangles, convalescent Streptococcus equi subspecies equi M antibody titers, and presence of complications Abstract => Background: Streptococcus equi subspecies equi infection elicits M protein antibody titers in equids. Interpretation of titers is not generally accepted. Hypothesis: The magnitude of S. equi M protein (SeM) antibody titer after infection (titer ≥1:12 800) will be useful to monitor for the presence of complications or the risk of development of complications. Animals: Forty-eight horses on 1 farm involved in strangles outbreak. Methods: Clinical and observational study. S. equi M protein antibody titers were measured on all horses 8 weeks after infection and select horses 12 and 28 weeks after infection. Horses were categorized: no disease, uncomplicated case, persistent guttural pouch (GP) infection, or complicated cases (metastatic abscesses, purpura hemorrhagica, secondary infections, and dysphagia). Category was compared to titer. Results: Twenty-eight of 48 (58%) developed clinical signs of S. equi infection. Of those, 11 (39%) had uncomplicated strangles, 9 (21%) had persistent GP infection, 5 (18%) were complicated cases, and 3 (11%) had both persistent GP infection and complications. Thirty-three percent of horses (16 of 48) had SeM antibody titers ≥1:12 800 eight weeks after infection. Of horses with titers ≥1:12 800, 6 of 16 had evidence of complications. Of complicated cases, 6 of 8 had titers ≥1:12 800. In this outbreak, the sensitivity (75%; 95% CI [confidence interval] 45-105) for a SeM antibody titer ≥1:12 800 detecting complications was higher than the specificity (43%; 95% CI 23-64). Conclusions and Clinical Importance: This outbreak demonstrates that SeM antibody titers can be increased after infection (≥1:12 800) in the absence of complications of strangles. Authors => Katherine M. Delph | Laurie A. Beard | Amanda C. Trimble | Maureen E. Sutter | John F. Timoney | Jennifer K. Morrow published => First published: 06 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15388

Title => Clinical, histopathologic, cystoscopic, and fluorescence in situ hybridization analysis of proliferative urethritis in 22 dogs Abstract => Background: Proliferative urethritis (PU) is a lower urinary tract disease of dogs characterized by frond-like lesions in the urethra. The etiology of PU is unknown, although an association with bacterial cystitis is reported. Objectives: Deep-seated bacterial cystitis is associated with PU, particularly in dogs with neutrophilic or granulomatous inflammation. Animals: Twenty-two client-owned dogs with PU and 5 control dogs euthanized for non-urinary disease. Methods: In retrospective analysis, medical records of dogs with PU from 1986 to 2016 were reviewed. Signalment, clinical signs, cystoscopic findings, antimicrobial use, and results of urine, bladder, or urethral tissue cultures, if available, were recorded. Histopathology was reviewed and classified as lymphocytic-plasmacytic (LP), neutrophilic, LP-neutrophilic (LPN), granulomatous, or pleocellular. Eubacterial fluorescence in situ hybridization (FISH) was performed on 18 tissue samples (13 cases, 5 controls), with subsequent evaluation of bacterial species. Results: Of the 22 dogs, 9 had LP urethritis, 6 had LPN, 4 had pleocellular, and 3 had neutrophilic urethritis. Of note, 7 of 13 PU samples were FISH+ for adherent or invasive bacteria; 1 of 5 controls were FISH+ for adherent bacteria. Five dogs had negative urine and tissue cultures when FISH was positive. There was no association detected between the type of urethral inflammation and the results of urine and tissue culture or FISH. Conclusions and Clinical Importance: The type of inflammation varied widely in these 22 PU cases. Deep-seated bacterial urethritis could be contributing to the inflammatory process in some dogs, regardless of the inflammation type. Urine and tissue cultures likely underestimate bacterial colonization of the urethra in dogs. Authors => Moria A. Borys | Sean E. Hulsebosch | F. Charles Mohr | Katherine D. Watson | Jane E. Sykes | Kenneth W. Simpson | Jodi L. Westropp published => First published: 05 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15349

Title => The use of heart rate variability analysis to detect arrhythmias in horses undergoing a standard treadmill exercise test Abstract => Background: Little is known about normal heart rate variability (HRV) in horses during exercise. It can be difficult to separate premature beats from normal beat-to-beat variation at higher heart rates. Objectives: The aim was to quantify HRV in healthy horses during a high-speed treadmill-standardized exercise test (HSET) and to compare with the HRV in horses observed to have arrhythmias during exercise. Animals: Thirteen healthy horses (Group H), 30 horses with arrhythmias (Group A), and 11 horses with poor performance but no observed arrhythmias (Group O). Methods: Prospective, observational study. All horses performed a HSET with simultaneous electrocardiograph (ECG) recorded. The ECGs were corrected for artifacts, and arrhythmias noted. Percent instantaneous beat-to-beat cycle length variation (% R-R variation) was calculated, and HRV analyses were performed on trot, canter, and recovery segments. Results: Group H showed between −4.4 and +3.8% R-R variation during trot and between −6.1 and +5.4% R-R variation during the canter phase of the HSET. Group A had significantly larger maximum and 1st percentile R-R shortening and lengthening compared with Group H and Group O during the recovery phase where most arrhythmias were observed. During recovery, a cutoff of 6% maximum % R-R shortening predicted the presence of arrhythmia with 88% sensitivity and 97% specificity and likelihood ratio of 26. Conclusions and Clinical Importance: Healthy horses have little instantaneous R-R variation during exercise. If a cardiac cycle shortens more than 6% from the previous cycle during the recovery phase, this R-R interval is likely to represent an arrhythmic event. Authors => Ladina Frick | Colin C. Schwarzwald | Katharyn J. Mitchell published => First published: 05 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15358

Title => Viral testing of 18 consecutive cases of equine serum hepatitis: A prospective study (2014-2018) Abstract => Background: Three flaviviruses (equine pegivirus [EPgV]; Theiler's disease–associated virus [TDAV]; non-primate hepacivirus [NPHV]) and equine parvovirus (EqPV-H) are present in equine blood products; the TDAV, NPHV, and EqPV-H have been suggested as potential causes of serum hepatitis. Objective: To determine the prevalence of these viruses in horses with equine serum hepatitis. Animals: Eighteen horses diagnosed with serum hepatitis, enrolled from US referral hospitals. Methods: In the prospective case study, liver, serum, or both samples were tested for EPgV, TDAV, NPHV, and EqPV-H by PCR. Results: Both liver tissue and serum were tested for 6 cases, serum only for 8 cases, and liver only for 4 cases. Twelve horses received tetanus antitoxin (TAT) 4-12.7 weeks (median = 8 weeks), 3 horses received commercial equine plasma 6-8.6 weeks, and 3 horses received allogenic stem cells 6.4-7.6 weeks before the onset of hepatic failure. All samples were TDAV negative. Two of 14 serum samples were NPHV-positive. Six of 14 serum samples were EPgV-positive. All liver samples were NPHV-negative and EPgV-negative. EqPV-H was detected in the serum (N = 8), liver (N = 4), or both samples (N = 6) of all 18 cases. The TAT of the same lot number was available for virologic testing in 10 of 12 TAT-associated cases, and all 10 samples were EqPV-H positive. Conclusions and Clinical Importance: We demonstrated EqPV-H in 18 consecutive cases of serum hepatitis. EPgV, TDAV, and NPHV were not consistently present. This information should encourage blood product manufacturers to test for EqPV-H and eliminate EqPV-H–infected horses from their donor herds. Authors => Joy E. Tomlinson | Amit Kapoor | Arvind Kumar | Bud C. Tennant | Melissa A. Laverack | Laurie Beard | Katie Delph | Elizabeth Davis | Harold Schott II | Kara Lascola | Todd C. Holbrook | Philip Johnson | Sandra D. Taylor | Erica McKenzie | Jessica Carter-Arnold | Emilie Setlakwe | Lisa Fultz | Jeff Brakenhoff | Rebecca Ruby | Sheetal Trivedi | Gerlinde R. Van de Walle | Randall W. Renshaw | Edward J. Dubovi | Thomas J. Divers published => First published: 05 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15368

Title => Influence of dietary restriction and low-intensity exercise on weight loss and insulin sensitivity in obese equids Abstract => Background: The importance of including exercise with dietary modification for the management of obese equids is not clearly understood. Objectives: To evaluate the effect of a practical low-intensity exercise regimen, in addition to dietary restriction, on indices of insulin sensitivity (SI) and plasma adipokine concentrations in obese equids. Animals: Twenty-four obese (body condition score [BCS] ≥ 7/9) horses and ponies. Methods: Over a 12-week period, animals received either dietary restriction only (DIET) or dietary restriction plus low-intensity exercise (DIET+EX). All animals were provided with a restricted ration of grass hay at 1.25% body weight (BW) on a dry matter basis, providing 82.5% estimated digestible energy requirements. The DIET+EX group undertook low-intensity exercise 5 days per week on an automated horse walker. Before and after weight loss, total body fat mass (TBFM) was determined, indices of SI were calculated using minimal model analysis of a frequently sampled IV glucose tolerance test, and adipokines plus inflammatory biomarkers were measured using validated assays. Results: Decreases in BCS, BW, and TBFM were similar between groups (all P > .05). After weight loss, animals in both groups had decreased basal insulin and leptin concentrations, and increased adiponectin concentrations (all P < .001). Furthermore, animals in the DIET+EX group had significantly improved SI and decreased serum amyloid A concentrations relative to animals in the DIET group (both P = .01). Conclusions and Clinical Importance: Regular low-intensity exercise provided additional health benefits compared with dietary restriction alone in this population of obese equids. Authors => Nicholas J. Bamford | Samantha J. Potter | Courtnay L. Baskerville | Patricia A. Harris | Simon R. Bailey published => First published: 05 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15374

Title => Comparison of the performance of the IDEXX SediVue Dx® with manual microscopy for the detection of cells and 2 crystal types in canine and feline urine Abstract => Background: Microscopic evaluation of urine is inconsistently performed in veterinary clinics. The IDEXX SediVue Dx® Urine Sediment Analyzer (SediVue) recently was introduced for automated analysis of canine and feline urine and may facilitate performance of urinalyses in practice. Objective: Compare the performance of the SediVue with manual microscopy for detecting clinically relevant numbers of cells and 2 crystal types. Samples: Five-hundred thirty urine samples (82% canine, 18% feline). Methods: For SediVue analysis (software versions [SW] 1.0.0.0 and 1.0.1.3), uncentrifuged urine was pipetted into a cartridge. Images were captured and processed using a convolutional neural network algorithm. For manual microscopy, urine was centrifuged to obtain sediment. To determine sensitivity and specificity of the SediVue compared with manual microscopy, thresholds were set at ≥5/high power field (hpf) for red blood cells (RBC) and white blood cells (WBC) and ≥1/hpf for squamous epithelial cells (sqEPI), non-squamous epithelial cells (nsEPI), struvite crystals (STR), and calcium oxalate dihydrate crystals (CaOx Di). Results: The sensitivity of the SediVue (SW1.0.1.3) was 85%-90% for the detection of RBC, WBC, and STR; 75% for CaOx Di; 71% for nsEPI; and 33% for sqEPI. Specificity was 99% for sqEPI and CaOx Di; 87%-90% for RBC, WBC, and nsEPI; and 84% for STR. Compared to SW1.0.0.0, SW1.0.1.3 had increased sensitivity but decreased specificity. Performance was similar for canine versus feline and fresh versus stored urine samples. Conclusions and Clinical Importance: The SediVue exhibits good agreement with manual microscopy for the detection of most formed elements evaluated, but improvement is needed for epithelial cells. Authors => Annalisa M. Hernandez | Graham E. A. Bilbrough | Dennis B. DeNicola | Celine Myrick | Suzanne Edwards | Jeremy M. Hammond | Alex N. Myers | Johanna C. Heseltine | Karen Russell | Marco Giraldi | Mary B. Nabity published => First published: 03 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15341

Title => Risk factors for positive urine cultures in cats with subcutaneous ureteral bypass and ureteral stents (2010-2016) Abstract => Background: Ureteral stent and subcutaneous ureteral bypass (SUB) placement are commonly used for managing ureteral obstructions. Urinary tract infection (UTI) is a recognized complication. Objectives: To determine postoperative incidence of positive urine cultures in cats undergoing ureteral stent and SUB placement and to identify risk factors associated with positive urine cultures. Design: Retrospective study. Animals: Forty-three cats that underwent 48 surgical events. Procedures: Medical records were reviewed. Cats were included if urine cultures were performed before and after surgery. Variables were compared to identify risk factors. Results: Urine cultures were positive postoperatively pre-discharge in 5/20 (25%) cats. Median duration of follow-up post-discharge was 209 days (range, 11-2184 days), with a total of 143 urine cultures performed in cats post-discharge. Of these, 16 (11%) were positive in 12/48 (25%) cats. Nine different bacteria were identified; Enterococcus spp. (n = 8) predominated as monomicrobic or mixed infections. In 14/16 instances of positive urine cultures, affected cats had lower urinary tract signs, signs of pyelonephritis or both. Cats that received antibiotics postoperatively were significantly less likely to have a positive urine culture compared to those that did not (odds ratio, 0.2, 95% confidence interval, 0.05, 0.8, P = 0.02). Chronic kidney disease, renal implant type and postoperative urinary catheterization were not associated with positive urine cultures. Conclusions and Clinical Relevance: Postoperatively, occurrence of positive urine cultures was similar to previous reports. Subclinical bacteriuria was less common than UTI. Postoperative urinary catheterization has been speculated to increase risk of bacteriuria, but this was not the case in this cohort. Authors => Lucy Kopecny | Carrie A. Palm | Kenneth J. Drobatz | Ingrid M. Balsa | William T. N. Culp published => First published: 03 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15343

Title => Efficacy of Borrelia burgdorferi vaccine in dogs in North America: A systematic review and meta-analysis Abstract => Background: Lyme borreliosis, a tick-borne disease, is endemic to some parts of North America and is an emerging disease in other parts of the world. Vaccination is an increasingly common, although controversial, method used in the prevention of Lyme disease in dogs; the reported efficacies of Borrelia burgdorferi vaccines in dogs are highly variable, ranging from 50% to 100%. Objectives: To determine the efficacy of vaccines for prevention of Lyme disease in dogs in North America. Methods: Experimental and observational study designs were eligible for inclusion. The outcome of interest was the reduction of incidence of clinical illness after exposure to B. burgdorferi. Electronic databases searched were MEDLINE, Web of Science, and Centre for Agricultural Biosciences Abstracts. Clinical signs were extracted as dichotomous outcomes: lameness, anorexia, pyrexia, depression, and lymphadenopathy. Study quality was assessed using tools from the Cochrane collaboration. Results: In total, 3 observational studies and 13 challenge trials were included. None of the challenge trials assessed lymphadenopathy, but for each of the remaining 4 clinical signs, a meta-analysis was performed. Compared to unvaccinated dogs, vaccinated dogs had a reduced odds of developing lameness, depression, pyrexia, and anorexia (odds ratio: 0.15-0.23). Conclusions and Clinical Importance: Based on the quantitative synthesis of results from challenge studies, vaccinated dogs are less likely to develop clinical signs after exposure to B. burgdorferi compared to unvaccinated dogs. These results should be interpreted with caution, however, as several shortcomings related to quality and study design were identified. Future studies should focus on larger sample sizes in field conditions. Authors => Nadine A. Vogt | Jan M. Sargeant | Melissa C. MacKinnon | Ali M. Versluis published => First published: 03 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15344

Title => A pilot study investigating circulating trimethylamine N-oxide and its precursors in dogs with degenerative mitral valve disease with or without congestive heart failure Abstract => Background: Pathophysiologic mechanisms for the development and progression of degenerative mitral valve disease (DMVD) remain elusive. Increased concentrations of circulating trimethylamine N-oxide (TMAO) and its precursors choline and l-carnitine are associated with the presence and severity of heart disease in people. Objectives: To determine if differences exist in plasma concentrations of TMAO, choline, or l-carnitine among dogs with DMVD and congestive heart failure (CHF), dogs with asymptomatic DMVD, and healthy control dogs. Animals: Thirty client-owned dogs: 10 dogs with CHF secondary to DMVD, 10 dogs with asymptomatic DMVD, and 10 healthy control dogs. Methods: A pilot cross-sectional study in which echocardiography was performed and fasting plasma concentrations of TMAO, choline, and l-carnitine (total and fractions) were measured. Results: TMAO (P = .03), total l-carnitine (P = .03), carnitine esters (P = .05), and carnitine esters to free carnitine ratio (E/F ratio; P = .05) were significantly higher in dogs with CHF compared to those with asymptomatic DMVD. TMAO (P = .02), choline (P = .01), total l-carnitine (P = .01), carnitine esters (P = .02), free carnitine (P = .02), and E/F ratio (P = .009) were significantly higher in dogs with CHF compared to healthy controls. Conclusions and Clinical Importance: Dogs with CHF secondary to DMVD had higher concentrations of TMAO compared to both asymptomatic DMVD dogs and healthy controls. Larger prospective studies are warranted to determine if TMAO plays a role in the development or progression of DMVD or CHF. Authors => Emily T. Karlin | John E. Rush | Lisa M. Freeman published => First published: 03 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15347

Title => Neuromyotonia in a horse Abstract => Authors => Luiza Stachewski Zakia | Mariana Isa Pocci Palumbo | Raffaella Bertoni Cavalcanti Teixeira | Luiz Antônio Lima Resende | Mauro Pereira Soares | José Paes de Oliveira-Filho | Rogério Martins Amorim | Alexandre Secorun Borges published => First published: 03 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15353

Title => Insulin and incretin responses to grazing in insulin-dysregulated and healthy ponies Abstract => Background: Supraphysiological insulin and incretin responses to a cereal-based diet have been described in horses and ponies with insulin dysregulation (ID). However, the hormonal responses to grazing have not yet been described. Objectives: To determine if there is a difference in the insulin and incretin responses to grazing pasture between insulin-dysregulated and healthy ponies. Animals: A cohort of 16 ponies comprising 5 with normal insulin regulation (NIR), 6 with moderate ID (MID), and 5 with severe ID (SID). Methods: In this case-control study, an oral glucose test (OGT) was used to determine the insulin responsiveness of each pony to PO carbohydrate before grazing pasture (4 hours) for 3 consecutive days. Serial blood samples collected during grazing were analyzed for glucose, insulin, glucose-dependent insulinotropic peptide (GIP) and active glucagon-like peptide-1 (aGLP-1), and compared among pony groups and day of pasture access. Results: The area under the insulin curve when grazing increased with ID severity (P < .03). The median (range) maximal insulin concentration was greater in the MID (72.5 [129] μIU/mL) and SID (255 [338.5] μIU/mL) groups, compared to the NIR (11.7 [24.9] μIU/mL) group (P < .03) and occurred within 2-4 hours of grazing. Postprandial OGT insulin concentration was positively correlated with 2 hours post-grazing insulin across all 3 grazing days (P ≤ .03). The aGLP-1 and GIP concentrations increased in response to grazing but did not differ among groups. Conclusions and Clinical Importance: Grazing pasture provoked an increased insulin and incretin response in insulin-dysregulated ponies within 4 hours of grazing. The pasture and OGT insulin concentrations were correlated. Authors => Danielle M. Fitzgerald | Donald M. Walsh | Martin N. Sillence | Christopher C. Pollitt | Melody A. de Laat published => First published: 02 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15363

Title => Variability of symmetric dimethylarginine in apparently healthy dogs Abstract => None Abstract Authors => Randolph M. Baral | Kathleen P. Freeman published => First published: 02 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15371

Title => Differences in miRNA differential expression in whole blood between horses with sarcoid regression and progression Abstract => Background: Currently no methods are available to predict the clinical outcome of individual horses with equine sarcoid (ES) disease. Objective: To investigate if whole blood microRNA (miRNA) profiles can predict the long-term development of ES tumors. Animals: Five horses with regression and 5 with progression of ES lesions monitored over 5-7 years and 5 control horses free of ES for at least 5 years. Methods: For this cohort study, RNA extracted from whole blood samples from the regression, progression, and control groups was used for high throughput sequencing. Known and novel miRNAs were identified using miRDeep2 and differential expression analysis was carried out by the DESeq2 algorithm. Target gene and pathway prediction as well as enrichment and network analyses were conducted using TarBase, mirPath, and metaCore from GeneGo. Results: Fourteen miRNAs were differentially expressed between regression and progression groups after accounting for the control condition: 4 miRNAs (28.6%) were upregulated and 10 miRNAs (71.4%) were downregulated with >2-fold change. Seven of the 10 downregulated miRNAs are encoded in an miRNA cluster on equine chromosome 24, homologous to the well-known 14q32 cluster in humans. Their target genes show enrichment for pathways involved in viral carcinogenesis. Conclusions and Clinical Importance: Whole blood miRNA expression profiles are associated with long-term ES growth in horses and warrant further validation as prognostic biomarkers in a larger study cohort. Deregulation of miRNAs on equine chromosome 24 might represent a trigger for ES development. Authors => Lucia Unger | Vidhya Jagannathan | Alicja Pacholewska | Tosso Leeb | Vinzenz Gerber published => First published: 02 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15375

Title => Relationships among urinary protein-to-creatinine ratio, urine specific gravity, and bacteriuria in canine urine samples Abstract => Background: Proteinuria is a marker of chronic kidney disease in dogs and a risk factor for increased morbidity and death. Predictive models using the results of readily available screening tests could foster early recognition. Objective: To determine whether urine specific gravity (USG) and semiquantitative category of dipstick protein can be used to predict urinary protein-to-creatinine ratio (UP : C) and to examine the effect of urine culture results on UP : C in dogs. Animals: Three hundred ninety-four dogs (482 visits) presented to a university Community Practice Clinic or Veterinary Teaching Hospital between January 2011 and November 2015. Methods: Retrospective study. Medical records were searched to identify dogs for which urinalysis, UP : C measurement, and urine culture testing were performed during a single hospital visit. Urine specific gravity, UP : C, dipstick protein concentration, and findings of urine sediment analysis and urine culture were recorded. Regression or Spearman correlation analysis was used to test for relationships between UP : C and USG within dipstick categories and between UP : C and bacterial colony-forming units per milliliter, respectively. Cohen's kappa test was used to evaluate agreement between urine culture and UP : C testing. Results: There were significant (P < .05) weak negative correlations (R2 range, 0.14-0.37) between UP : C and USG for all nonnegative urine protein dipstick categories. The presence of a positive urine culture did not agree with the presence of abnormal UP : C (κ = −0.06). Conclusions and Clinical Importance: Within dipstick protein categories, UP : C cannot be accurately predicted from USG. Repeating UP : C measurement after resolution of urinary tract infection is advisable. Authors => Alison G. Meindl | Bianca N. Lourenço | Amanda E. Coleman | Kate E. Creevy published => First published: 02 December 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15377

Title => Behavior in dogs with spontaneous hypothyroidism during treatment with levothyroxine Abstract => Background: Thyroid hormone supplementation anecdotally has been described as a valid treatment option for dogs with aggression-related problems. However, prospective, controlled, and blinded trials evaluating behavior and neurohormonal status in hypothyroid dogs during treatment with levothyroxine are lacking. Objective: Levothyroxine supplementation will have a significant influence on the behavior and neurohormonal status of dogs with spontaneous hypothyroidism. Animals: Twenty client-owned dogs diagnosed with spontaneous hypothyroidism. Methods: This prospective study was to evaluate the behavior of dogs, which was screened at initial presentation, and after 6 weeks, and 6 months of treatment with levothyroxine (starting dosage 10 μg/kg PO q12h) using the standardized Canine Behavioral Assessment and Research Questionnaire (C-BARQ). At each time period, circulating serotonin and prolactin (PRL) concentrations were evaluated using a commercially validated ELISA kit and heterologous radioimmunoassay, respectively. Results: After 6 weeks of thyroid hormone supplementation, C-BARQ scores demonstrated a significant increase in activity of hypothyroid dogs (P < .01). No significant change in any of the behavioral signs was observed after 6 months of treatment. No significant difference in circulating concentrations of serotonin (P > .99 and P = .46) and PRL (P = .99 and P = .37) were noted between the 6-week and 6-month periods compared with baseline. Conclusions and Clinical Importance: The results of this study indicate increased activity of hypothyroid dogs after 6 weeks of thyroid hormone supplementation. None of the hypothyroid dogs in this cohort showed a significant change in any of the evaluated behavioral signs and neurohormonal status after 6 months of thyroid hormone supplementation. Authors => Alenka Hrovat | Tiny De Keuster | Hans S. Kooistra | Luc Duchateau | Mark A. Oyama | Kathelijne Peremans | Sylvie Daminet published => First published: 30 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15342

Title => Parenterally administered vancomycin in 29 dogs and 7 cats (2003-2017) Abstract => Background: Vancomycin is commonly used to treat resistant bacterial infections in people. Reported adverse effects of vancomycin in people include acute kidney injury (AKI), neutropenia, and systemic allergic reaction. Given the increased incidence of vancomycin-resistant bacterial infections in people, support is growing for restriction of vancomycin. Objectives: To evaluate the use of intravenous (IV) vancomycin in a university teaching hospital and to describe potential adverse effects. Animals: Twenty-nine dogs and 7 cats. Methods: Medical records of dogs and cats treated with IV vancomycin at the Foster Hospital for Small Animals between January 2003 and October 2017 were reviewed. Information recorded included signalment, infection source, vancomycin dosing, potential adverse effects, and outcome. Results: Vancomycin was used to treat infections from a range of sources with a variety of dosing intervals. The most common bacterial isolates susceptible to vancomycin included Enterococcus sp. (11/36, 30.6%), methicillin-resistant Staphylococcus aureus (8/36, 22.2%), and methicillin-resistant Staphylococcus pseudintermedius (2/36, 5.6%). AKI occurred in 6 of 36 patients (16.7%) during vancomycin treatment but could not definitively be attributed to vancomycin treatment in any patients because of illness severity, additional nephrotoxic treatments, or both. Neutropenia or allergic reaction was not documented in any animal. In 2 of 36 patients (5.6%), susceptibility data documented an infection that was only susceptible to vancomycin. Most patients survived to discharge (25/36, 69.4%). Conclusions and Clinical Importance: Adverse effects attributable to vancomycin were infrequent in dogs and cats. In most cases, there were potential alternative effective antimicrobials or lack of susceptibility data to support vancomycin treatment. Authors => Ian M. DeStefano | Annie S. Wayne | Elizabeth A. Rozanski | Jonathan M. Babyak published => First published: 30 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15357

Title => Outcome and complications in goats treated by perineal urethrostomy for obstructive urolithiasis: 25 cases (2010-2017) Abstract => Background: Obstructive urolithiasis commonly affects male goats. Perineal urethrostomy (PU) can be a permanent treatment option but is generally considered undesirable because of the risk of stricture of the urethral stoma. Limited information exists regarding long-term outcome and complications in goats undergoing PU for treatment of obstructive urolithiasis. Objectives: To determine short-term and long-term outcome and complications in goats undergoing PU for treatment of obstructive urolithiasis. Animals: Twenty-five client-owned goats. Methods: Multi-institutional retrospective case series. Results: Of the 25 goats, 13 (52%) were alive at the time of follow-up. Mean time from surgery to follow-up was 34 months (range, 4-65). Nine goats (36%) died between discharge and follow-up with a mean survival time of 46 days (range, 5-120). Cause of death in 7 of 9 (78%) goats was related to urolithiasis. Goats treated by use of a modified proximal perineal urethrostomy (MPPU) were significantly more likely to survive at least 150 days postoperatively (P < .01). The most common postoperative complications were hemorrhage (10/25 [40%]) and surgical site infection (3/25 [12%]). Hemorrhage was significantly associated with MPPU (P < .0001). Stricture of the surgical stoma occurred in 7 of 22 (32%) discharged goats. Mean time to stricture was 65 days (range, 10-240). Conclusions and Clinical Importance: Perineal urethrostomy can provide effective long-term resolution of obstructive urolithiasis in goats. Re-obstruction or stricture seems most likely within the 1st 2 months after surgery. MPPU may provide better long-term results but should be approached cautiously because it can be associated with life-threatening hemorrhage. Authors => Rachel E. Oman | Emily J. Reppert | Robert N. Streeter | Meredyth Jones published => First published: 30 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15360

Title => Prevalence of Clostridium perfringens netE and netF toxin genes in the feces of dogs with acute hemorrhagic diarrhea syndrome Abstract => Background: Recently, novel pore-forming toxin genes designated netE and netF were identified in a Clostridium perfringens type A strain isolated from a dog with acute hemorrhagic diarrhea. Objectives: Pore-forming toxins could play an important role in the disease pattern of acute hemorrhagic diarrhea syndrome (AHDS) in dogs. Thus, we aimed to determine the prevalence of C. perfringens genes encoding for netE and netF in the feces of dogs with AHDS and to evaluate any association between selected clinical variables and the presence of these toxin genes. Animals: In total, 174 dogs were included in the study. Methods: Fecal samples of all dogs were tested by real-time polymerase chain reaction for netE and netF genes. Time to recovery, hospitalization time, and selected laboratory variables were compared between dogs with AHDS that were positive or negative for the toxin genes. Results: A significant difference was found among the 3 groups in the prevalence of the pore-forming toxin genes netE and netF: dogs with AHDS: 26 of 54 (48.1%); dogs with canine parvovirus (CPV) infection: 0 of 54 (0%); and healthy dogs: 8 of 66 (12.1%; P < .001). In dogs with AHDS, no significant difference was detected in any variables evaluated between netE-positive and netF-positive and netE-negative and netF-negative dogs. Conclusions and Clinical Importance: The prevalence of C. perfringens encoding for netE and netF is significantly higher in dogs with AHDS compared to control dogs. Further studies are warranted to evaluate whether these toxins are an inciting cause for AHDS in dogs. Authors => Natalie Sindern | Jan S. Suchodolski | Christian M. Leutenegger | Iman Mehdizadeh Gohari | John F. Prescott | Anna-Lena Proksch | Ralf S. Mueller | Kathrin Busch | Stefan Unterer published => First published: 30 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15361

Title => Response to letter to editor regarding Variability of symmetric dimethylarginine in apparently healthy dogs Abstract => None Abstract Authors => Matthew A. Kopke | Richard K. Burchell | Craig G. Ruaux | Stacey E. Burton | Nicolas Lopez-Villalobos | Arnon Gal published => First published: 30 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15370

Title => Layer-specific myocardial function in asymptomatic cats with obstructive hypertrophic cardiomyopathy assessed using 2-dimensional speckle-tracking echocardiography Abstract => Background: Hypertrophic cardiomyopathy (HCM), a primary disorder of the myocardium, is the most common cardiac disease in cats. However, determination of layer-specific myocardial function with 2D speckle-tracking echocardiography in cats with asymptomatic HCM has not yet been reported. Objectives: To quantitatively measure layer-specific myocardial function of asymptomatic cats with HCM. Animals: Ten client-owned, asymptomatic cats with obstructive HCM and 13 healthy cats. Methods: A retrospective, case-control study. Cats underwent assessment of layer-specific myocardial function (whole, endocardial, and epicardial) in the longitudinal and circumferential directions by using 2D speckle-tracking echocardiography. Results: Longitudinal strains were significantly lower in cats with HCM than controls in the whole (−15.5% vs −19.1%), endocardial (−18.3% vs −21.8%), and epicardial (−13.1% vs −16.8%) layers. Circumferential strains in whole and epicardial layers also were significantly lower in cats with HCM as compared with controls (−15.0% vs −20.2% and − 4.4% vs −9.4%, respectively). However, no significant difference was found between cats with HCM and controls in the global circumferential strain in the endocardial layer (−31.2% vs −34.2%). The circumferential endocardial-to-epicardial strain ratio was significantly higher in cats with HCM than in controls (6.1 vs 3.5). Conclusions and Clinical Importance: Layer-specific myocardial function assessed by 2D speckle-tracking echocardiography differed in asymptomatic cats with obstructive HCM compared to controls despite their apparently normal systolic function, as determined by conventional echocardiography. The maintained endocardial circumferential strain and higher circumferential endocardial-to-epicardial strain ratio may reflect compensation for occult systolic dysfunction in cats with obstructive HCM. Authors => Ryohei Suzuki | Yohei Mochizuki | Hiroki Yoshimatsu | Ayaka Niina | Takahiro Teshima | Hirotaka Matsumoto | Hidekazu Koyama published => First published: 29 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15339

Title => Hepatic leptospiral infections in dogs without obvious renal involvement Abstract => Background: Reports of chronic hepatitis in dogs caused by Leptospira spp. are confined to small case series. Fluorescence in situ hybridization (FISH) allows the identification of spirochetes in liver samples. Consequently, this technique may help elucidate the role of Leptospira spp. in cases of chronic hepatitis. Objectives: To describe cases of hepatic leptospirosis in dogs diagnosed by FISH and subsequent polymerase chain reaction (PCR) speciation, with the absence of clinically relevant renal involvement. Animals: Ten client-owned dogs. Methods: Retrospective case series from the University of Cambridge presented between 2013 and 2016 or cases consulted by telephone advice during this time period. Cases were selected based on histopathologically confirmed granulomatous hepatitis and leptospiral organisms identified by FISH and PCR speciation (Leptospira interrogans/kirschneri). Results: All cases had increased liver enzyme activities, and FISH in combination with PCR speciation-confirmed infection with L. interrogans/kirschneri. Four dogs underwent repeat liver biopsy, FISH and PCR speciation 4-15 months after initial presentation and doxycycline treatment with 1 dog undergoing repeat sampling at necropsy. Three dogs that underwent repeat biopsy remained positive for L. interrogans/kirschneri infection. Six dogs were alive at the time of manuscript preparation and 4 dogs were euthanized as a result of progressive liver disease. Conclusions and Clinical Importance: The presence of hepatic leptospiral organisms may be associated with chronic granulomatous hepatitis without clinical evidence of renal involvement. Further studies are necessary to elucidate the etiological role of these organisms in the disease. Authors => Katie E. McCallum | Fernando Constantino-Casas | John M. Cullen | James H. Warland | Harry Swales | Niamh Linghley | Andre J. Kortum | Alex J. Sterritt | Tristan Cogan | Penny J. Watson published => First published: 29 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15340

Title => Relationship between cobalamin and folate deficiencies and anemia in dogs Abstract => Background: Megaloblastic, nonregenerative anemia is a well-known consequence of cobalamin or folate deficiencies in humans but is not recognized in hypocobalaminemic or hypofolatemic dogs. Establishment of relationships between hypocobalaminemia or hypofolatemia and hematologic disease would encourage vitamin B testing, and potentially supplementation, in anemic dogs. Objectives: To determine the prevalence of anemia in hypocobalaminemic or hypofolatemic dogs and to report the prevalence of hypocobalaminemia and hypofolatemia and nonregenerative anemia, macrocytosis, and anisocytosis in anemic dogs. Animals: One hundred and fourteen client-owned dogs with known serum cobalamin and folate concentrations and CBCs and 42 client-owned anemic dogs. Methods: Retrospective comparison of anemia prevalence in hypocobalaminemic or hypofolatemic and normocobalaminemic or normofolatemic dogs was performed. Prospective measurement of erythrocyte variables and cobalamin and folate concentrations in anemic dogs was carried out; relationships among hypocobalaminemia and regenerative status, mean corpuscular volume, and red cell distribution width were evaluated. Results: Significant differences in prevalence of anemia between hypocobalaminemic (36%) and normocobalaminemic dogs (26%; P = .23) or between hypofolatemic (31%) and normofolatemic dogs (30%; P = .99) were not detected. Between hypocobalaminemic and normocobalaminemic dogs, no significant differences in prevalence of nonregenerative anemia (69% vs 63%; P = .65), macrocytosis (17% vs 0%; P = .53), or anisocytosis (28% vs 0%; P = .14) were detected. Anemic dogs had high prevalence of vitamin B deficiencies (nonregenerative: 64% hypocobalaminemic, 18% hypofolatemic; regenerative: 57% hypocobalaminemic, 21% hypofolatemic). Conclusions and Clinical Importance: The association between cobalamin and folate deficiencies and macrocytic, nonregenerative anemia established in humans is not routinely present in dogs. Authors => Emma Stanley | Elizabeth Appleman | Ariel Schlag | Andrea Siegel published => First published: 29 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15348

Title => Management factors and clinical implications of glandular and squamous gastric disease in horses Abstract => Background: To date, risk factors for equine glandular gastric disease (EGGD) have not been described in Thoroughbred racehorses. Objectives: To determine management factors associated with EGGD, identify clinical signs in affected horses, and compare these to equine squamous gastric disease (ESGD). Animals: The study was carried out on 109 Thoroughbred racehorses from 8 training yards (3 in the United Kingdom and 5 in Australia). Methods: Gastroscopic examination alongside a questionnaire regarding management, feeding, exercise, and health. Results: Management factors and clinical signs were different for EGGD versus ESGD. Exercising ≥5 days per week was associated with a 10.4 times (95% CI [confidence interval]: 1.34-26.9) increased risk of EGGD. Horses racing below expectation were 3.7 times (95% CI: 1.1-16.7) more likely to have EGGD. Trainer was also identified as a risk factor for EGGD. Time in work ≤6 weeks was associated with a decreased risk of ESGD (odds ratio [OR] 0.3; 95% CI: 0.1-0.99). Horses aggressive to humans were less likely to have ESGD (OR 0.12; 95% CI: 0.03-0.54). Horses with stereotypies were more likely to have ESGD (OR 5.0; 95% CI: 1.6-15.9). Conclusions and Clinical Importance: The findings of our study further support the notion that EGGD should be considered as a distinct disease entity to ESGD. Exercising ≤4 days per week could reduce the risk of EGGD. Horses with EGGD are more likely to perform below expectation and, as such, EGGD might be performance limiting in some affected individuals. Stress minimization could reduce the risk of EGGD. Authors => Benjamin W. Sykes | Mark Bowen | Jocelyn L. Habershon-Butcher | Martin Green | Gayle D. Hallowell published => First published: 29 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15350

Title => Clinical features of canine pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis Abstract => Background: Histologic features of pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangiomatosis (PCH) have been described in dogs but without a thorough clinical description. Objectives: To report the clinical features, diagnostics, treatment, and outcome of dogs with histologic evidence of PVOD and PCH. Animals: Fifteen pet dogs meeting histopathologic criteria of PVOD (occlusive remodeling of small-sized to medium-sized pulmonary veins) or PCH (alveolar capillary proliferation and congestion), or both. Methods: Medical records of dogs with PVOD and PCH identified based on histopathologic features between 2003 and 2017 were retrospectively reviewed. Results: Fifteen dogs met inclusion criteria of a histologic diagnosis of PVOD or PCH or both. Dogs were older (median 11 years) with no apparent breed or sex predisposition. Dogs presented with acute clinical signs (median 3 days), usually respiratory distress. Thoracic radiography (available in 10 dogs) revealed right cardiomegaly and patchy or diffuse interstitial to alveolar patterns, with 9 dogs having a normal left cardiac silhouette. In 5 dogs tested, pulmonary arterial hypertension (PAH) was documented. In all 3 dogs, thoracic computed tomography scans showed pulmonary arterial enlargement and perivascular diffuse nodular ground-glass opacities. Ten of 15 dogs died within 1 day; median survival was 3 days. Conclusions and Clinical Importance: In dogs with PAH, the inability to document left-sided congestive heart failure and failure to identify another cause of signs of respiratory disease should increase suspicion for PVOD and PCH. With increased awareness of PVOD and PCH by clinicians and pathologists, dogs with compatible clinicopathologic features should be evaluated for these pulmonary vascular disorders. Authors => Carol R. Reinero | L. Ari Jutkowitz | Nathan Nelson | Isabelle Masseau | Samuel Jennings | Kurt Williams published => First published: 29 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15351

Title => Repeated cross-sectional study of Trypanosoma cruzi in shelter dogs in Texas, in the context of Dirofilaria immitis and tick-borne pathogen prevalence Abstract => Background: Vector-borne diseases have an adverse impact on health of dogs, and infected dogs can be sentinels for human infection. Infection with Trypanosoma cruzi, an agent of Chagas disease, causes fatal heart disease in dogs across the southern United States but has been neglected from wide-scale prevalence studies. Objectives: To determine the prevalence of exposure to T. cruzi, Ehrlichia spp., Anaplasma spp., Borrelia burgdorferi, and infection with Dirofilaria immitis among dogs in shelters across Texas and to identify risk factors for T. cruzi seropositivity. Animals: Six hundred and eight dogs. Methods: This repeated cross-sectional study was performed by collecting blood from ~30 dogs during each of the 3 visits to 7 shelters. We tested serum for antibodies to T. cruzi using 2 tests in series and for antibodies to Ehrlichia spp., Anaplasma spp., and B. burgdorferi and D. immitis antigen using the IDEXX SNAP 4DX Plus point-of-care test. DNA was extracted from blood clots and tested for T. cruzi DNA and strain type via quantitative polymerase chain reactions (qPCR). We used logistic regression to assess risk factors. Results: One hundred ten (18.1%) of 608 dogs were seropositive for T. cruzi. Prevalence of exposure to the other vector-borne agents was: Ehrlichia spp. 3.6%; Anaplasma spp. 6.9%; B. burgdorferi 0.2%; and D. immitis infection 16.0%. Six of 559 (1.1%) dogs were qPCR-positive for T. cruzi. Conclusions and Clinical Importance: T. cruzi seroprevalence was comparable to D. immitis prevalence and higher than seroprevalence of the tick-borne pathogens. T. cruzi is an underrecognized health threat to dogs across Texas and possibly other southern states where triatomine vectors are endemic. Authors => Carolyn L. Hodo | Jessica Y. Rodriguez | Rachel Curtis-Robles | Italo B. Zecca | Karen F. Snowden | Kevin J. Cummings | Sarah A. Hamer published => First published: 29 November 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15352

Title => Testing for Bartonella ssp. DNA in cerebrospinal fluid of dogs with inflammatory central nervous system disease Abstract => Background: Neurobartonellosis occurs in people. The role these organisms might play in inflammatory brain disease of dogs is unclear. Hypothesis/Objectives: That Bartonella spp. DNA would be amplified more commonly from the CSF of dogs with inflammatory disease compared to those with noninflammatory disease. To report the prevalence of Bartonella spp. in dogs with and without inflammatory CNS disease with a commercially available PCR assay. Animals: Cerebrospinal fluid (CSF) samples from 172 dogs from either Washington State University or Colorado State University. Methods: Retrospective study. A search was performed of all medical records from dogs with CSF samples submitted to CSU's Center for Companion Animal Studies or Veterinary Diagnostic Laboratory from CSU or WSU for Toxoplasma or Neospora PCR assay. Increased CSF nucleated cell counts and an adequate volume of CSF must have been present to evaluate Bartonella spp. by PCR assay. Results: Inflammatory CNS disease was confirmed in 65 dogs, none of which were positive for Bartonella spp. DNA. Of the other 107 dogs, one was positive for B. henselae DNA. The CSF from this dog contained red blood cells. Conclusions and Clinical Importance: Failure to amplify Bartonella spp. DNA from the CSF of the dogs with inflammatory disease suggests the organism was not involved in the etiology of the disease, the organism was in the CNS tissues but not in the CSF, or the organism was present but in quantities undetectable by this PCR assay. The combination of PCR and culture is the most sensitive way to detect Bartonella spp. and the use of that technique should be considered in future studies. Authors => Lisa R. Bartner | Stephanie McGrath | Adam Drury | Annie V. Chen | Arianne Morris | Melissa Brewer | Meri Hall | Michael R. Lappin published => First published: 31 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15288

Title => ACVIM consensus statement: Support for rational administration of gastrointestinal protectants to dogs and cats Abstract => None Abstract Authors => Stanley L. Marks | Peter H. Kook | Mark G. Papich | M. K. Tolbert | Michael D. Willard published => First published: 31 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15337

Title => Development of an estimated glomerular filtration rate formula in cats Abstract => Background: Estimated glomerular filtration rate (eGFR) formulas are routinely used in human patients to provide a more accurate evaluation of GFR compared to serum creatinine concentration alone. Similar formulas do not exist for cats. Objectives: To validate a prediction formula for eGFR in cats based on adjusting serum creatinine concentration. Animals: Client-owned cats with various levels of renal function. Methods: The study was cross-sectional. Glomerular filtration rate was determined by iohexol clearance. Variables including signalment, biochemical markers, and noninvasive measurements considered to represent surrogate markers of muscle mass were evaluated with the reciprocal of serum creatinine concentration in a multivariable regression model. The derived eGFR formula was subsequently tested in another group of cats and agreement with GFR assessed. Results: The formula was developed in 55 cats. Only a single morphometric measurement (pelvic circumference) along with the reciprocal of serum creatinine concentration (creatinine−1) independently predicted GFR in the final multivariate model. The derived eGFR formula was 0.408 + (243.11 × creatinine−1 [μmol/L]) - (0.014 × pelvic circumference [cm]). When the formula was tested in another 25 cats it was not found to offer any advantage over creatinine−1 alone in its relationship with GFR (eGFR, R2 = 0.44, P < .001 vs reciprocal of creatinine, R2 = 0.45, P < .001). Furthermore, agreement between eGFR and GFR was poor. Conclusions and Clinical Importance: An eGFR formula for cats that adjusted serum creatinine concentration for a marker of muscle mass was developed. The formula did not provide a reliable estimate of GFR, and therefore, its routine use cannot be recommended. Authors => Natalie C. Finch | Harriet M. Syme | Jonathan Elliott published => First published: 30 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15325

Title => 2018 ACVIM Forum Research Abstract Program Abstract => None Abstract Authors => published => First published: 25 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15319

Title => Effects of 6% tetrastarch or lactated Ringer's solution on blood coagulation in hemorrhaged dogs Abstract => Background: Tetrastarch solution (TS) can impair coagulation but the clinical relevance of this impairment is unclear in veterinary medicine. Objective: Compare the effects of volume replacement (VR) with lactated Ringer's solution (LRS) or 6% TS on coagulation in hemorrhaged dogs. Animals: Six healthy English Pointer dogs (19.7-35.3 kg). Methods: Prospective crossover study. Dogs were anesthetized without hemorrhage and VR (control). Two weeks later, dogs were hemorrhaged under anesthesia on 2 occasions (8-week washout intervals) and randomly received VR with LRS or TS at 3:1 or 1:1 of shed blood, respectively, aiming to decrease the hematocrit to 33%. Rotational thromboelastometry and other coagulation variables were determined before 0.5, 2, and 4 hours after VR during anesthesia and 24 hours after VR (conscious dogs). Results: Buccal mucosal bleeding time did not differ between treatments after VR. Activated partial thromboplastin time increased from controls 4 hours after TS (P = 0.045). Clot formation time (CFT) and alfa-angle increased from controls from 0.5 to 4 hours after LRS (CFT, P ≤ 0.0001-0.02; alpha angle, P = 0.0001-0.02) and from 0.5 to 2 hours after TS (CFT, P = 0.0002-0.01; alpha angle, P = 0.0005-0.02). The maximum clot firmness decreased from controls from 0.5 to 4 hours after LRS (P ≤ 0.0001-0.01) and TS (P ≤ 0.0001-0.04). Conclusions and Clinical Relevance: Tetrastarch does not impair primary hemostasis and induces transient dilutional coagulopathy that is similar to LRS because, when compared to a 3 times higher volume of LRS in hemorrhaged dogs, it does not cause greater interference on the viscoelastic properties of the coagulum. Authors => Miriely S. Diniz | Francisco J. Teixeira-Neto | Daniele S. Gonçalves | Nathalia Celeita-Rodríguez | Carolina H. Girotto | Mariana W. Fonseca | Regina K. Takahira published => First published: 25 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15327

Title => Prognostic factors in dogs with presumed degenerative mitral valve disease attending primary-care veterinary practices in the United Kingdom Abstract => Background: Prognostic risk factors were identified for dogs with degenerative mitral valve disease (DMVD) monitored by veterinary cardiologists. The value of these measurements has not been determined in the wider primary care setting. Objectives: To evaluate whether plasma cardiac biomarkers and data obtained from routine history-taking and physical examination are predictive of survival in dogs with DMVD attending primary care practice. Animals: Eight-hundred and ninety-three dogs with a presumptive diagnosis of DMVD recruited from 79 primary care veterinary practices in the United Kingdom. Methods: Prospective cohort study. Primary care veterinary practitioners recorded clinical data. Plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) were measured at presentation. Cox regression models evaluated associations between risk factor variables and hazard of death (all-cause mortality and cardiac-related death). Flexible parametric models generated predicted survival probabilities for dogs with different combinations of prognostic risk factor variable values. Results: Dogs with higher NT-proBNP and cTnI concentrations, higher heart rates, older dogs, females, and those reported to be exercise intolerant, dyspneic, and diagnosed with selected comorbidities had an increased hazard of death due to any cause. Dogs with higher concentrations of plasma biomarkers, higher heart rates, and heart murmur intensities, those with exercise intolerance and those receiving potent diuretics had a higher hazard of cardiac-related death. Conclusions and Clinical Importance: Cardiac biomarkers and key clinical findings identified in this study can help primary care veterinary practitioners identify dogs with DMVD that are at highest risk of death. Authors => M. J. Mattin | A. Boswood | D. B. Church | D. C. Brodbelt published => First published: 24 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15251

Title => Investigation of an experimental infection model of equine coronavirus in adult horses Abstract => Background: Equine coronavirus (ECoV) is a recently reported enteric disease of adult horses. Natural infection by ECoV has been reported in adult horses worldwide, whereas experimental infection has only been reported in juvenile horses. An experimental infection model is needed to study the clinical presentation, laboratory abnormalities, and pathophysiological changes associated with ECoV. Objectives: To investigate the clinical, hematologic, molecular, and serological features of adult horses experimentally infected with ECoV. Animals: Eight adult horses. Methods: Four horses were intragastrically infected with fecal material containing 109 genome equivalents of ECoV. Four additional horses were exposed daily to the feces from the experimentally-infected horses. Monitoring included physical examinations, as well as daily nasal swab, whole blood, and fecal collection for molecular detection of ECoV. Blood was collected every other day for hematologic analysis and weekly for serologic analysis. Results: All 8 horses shed ECoV in feces. Six of the 8 horses (75%) exhibited mild, clinical disease with soft, formed manure; 1 horse exhibited transient pyrexia. All horses maintained total white cell counts within normal limits, but 3 horses developed transient lymphopenia. No statistically significant differences (P = .20) were observed in quantity of fecal shedding of ECoV between the 2 groups. Conclusions and Clinical Importance: Experimental infection of adult horses with ECoV was associated with mild and self-limiting clinical signs, transient lymphopenia, and fecal shedding of ECoV, which mimics natural infection. No differences between experimentally-infected horses and horses exposed to ECoV-containing feces were identified. Results of our study support a fecal-oral route of transmission. Authors => Emily Schaefer | Corey Harms | Molly Viner | Samantha Barnum | Nicola Pusterla published => First published: 24 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15318

Title => Plasma cytokeratin-18 concentrations as noninvasive biomarker of early gastrointestinal toxicosis in dogs receiving toceranib Abstract => Background: No biomarkers for the early detection of gastrointestinal (GI) toxicosis secondary to antineoplastic treatment are recognized in veterinary medicine. Toceranib causes GI toxicosis in dogs. Hypothesis/Objective: To assess if changes in plasma cytokeratin 18 (CK18) concentration, measured in dogs being treated with toceranib phosphate, can predict the onset of GI toxicosis. We hypothesize that an increase in CK18 concentrations will be detected before the development of GI toxicosis in dogs treated with toceranib phosphate. Animals: Twenty healthy client-owned dogs and 25 client-owned dogs with surgically excised mast cell tumor (MCT). Methods: Prospective cohort study. Dogs were treated with toceranib (2.75 mg/kg PO q48h). Plasma was collected weekly for 4 weeks. Plasma CK18 concentration was measured on days 0, 7, 14, 21, and 28. vascular endothelial growth factor was measured on days 0 and 28. Results: Mean plasma CK18 concentration on day 0 in dogs with MCT was not significantly different than healthy controls (313.5 ± 592.8 pg/mL, 119.7 ± 76.9 pg/mL, mean ± SD P = 0.27). Mean plasma CK18 concentration decreased by 98.69 pg/mL from day 0 to day 28 (P < 0.001). Plasma CK18 concentration was not a significant predictor of the development of signs of GI toxicosis. Conclusions and Clinical Importance: Plasma CK18 concentration was not a clinically useful biomarker for the early detection of GI toxicosis secondary to toceranib administration in dogs with MCTs. Authors => Rachel L. Kovac | Gregory Ballash | Joelle Fenger | Cheryl London | Emma Warry published => First published: 24 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15326

Title => ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats Abstract => Authors => Mark J. Acierno | Scott Brown | Amanda E. Coleman | Rosanne E. Jepson | Mark Papich | Rebecca L. Stepien | Harriet M. Syme published => First published: 24 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15331

Title => Effect of an extruded animal protein-free diet on fecal microbiota of dogs with food-responsive enteropathy Abstract => Background: Dietary interventions are thought to modify gut microbial communities in healthy individuals. In dogs with chronic enteropathies, resolution of dysbiosis, along with remission of clinical signs, is expected with treatment. Hypothesis/Objective: To evaluate changes in the fecal microbiota in dogs with food-responsive chronic enteropathy (FRE) and in healthy control (HC) dogs before and after an elimination dietary trial with an animal protein-free diet (APFD). Animals: Dogs with FRE (n = 10) and HC (n = 14). Methods: Dogs were fed the APFD for 60 days. Fecal microbiota was analyzed by Illumina 16S rRNA sequencing and quantitative polymerase chain reaction (PCR). Results: A significantly lower bacterial alpha-diversity was observed in dogs with FRE compared with HC dogs at baseline, and compared with FRE dogs after the trial. Distinct microbial communities were observed in dogs with FRE at baseline compared with HC dogs at baseline and compared with dogs with FRE after the trial. Microbial communities still were different in FRE dogs after the trial compared with HC dogs at baseline. In HC dogs, the fecal microbiota did not show a significant modification after administration of the APFD. Conclusion and Clinical Importance: Our results suggest that, in FRE dogs, treatment with the APFD led to a partial recovery of the fecal microbiota by significantly increasing microbiota richness, which was significantly closer to a healthy microbiota after the treatment. In contrast, no changes were detected in the fecal microbiota of HC dogs fed the same APFD. Authors => Francesca Bresciani | Yasushi Minamoto | Jan S. Suchodolski | Giorgia Galiazzo | Carla G. Vecchiato | Carlo Pinna | Giacomo Biagi | Marco Pietra published => First published: 23 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15227

Title => The interpretive contribution of the baseline serum cortisol concentration of the ACTH stimulation test in the diagnosis of pituitary dependent hyperadrenocorticism in dogs Abstract => Background: Current recommendation for performing the ACTH stimulation test (ACTHST) for diagnosis of hyperadrenocorticism (HAC) advocates the collection of baseline serum cortisol concentration (BC), but no references for interpretation of its results exist. Objective: Evaluate the contribution of BC of the ACTHST to the diagnosis of HAC. Animals: Fifty-four dogs were evaluated for suspected HAC at a referral hospital. Methods: Records of dogs that had been evaluated by ACTHST for suspected HAC were reviewed. Receiver operator characteristics (ROC) analyses were used to assess the performance of BC, post-stimulation serum cortisol concentrations (PC), post-to-baseline cortisol concentration difference (DeltaC) and quotient (RatioC) for the diagnosis of HAC by comparing the area under the ROC curve (AUC) of PC to each of the other tests. Results: The AUC of PC (95% confidence interval [CI]: 0.92; 95% CI, 0.81-0.98) was significantly higher than AUCs of BC (0.70; 95% CI, 0.56-0.82; P = .01) and RatioC (0.55; 95% CI, 0.41-0.69; P < .001), and was not significantly different from AUC of DeltaC (0.86; 95% CI, 0.74-0.94; P = .09). An optimal cutoff value of 683 nmol/L (24.8 μg/dL) for PC yielded a sensitivity of 86% and a specificity of 94%, respectively, and a cutoff value of 718 nmol/L (26.0 μg/dL) yielded a specificity of 100% with of 81% sensitivity for the diagnosis of pituitary-dependent HAC. Conclusion and Clinical Importance: The PC had good discriminatory ability for the diagnosis of HAC. It was comparable to DeltaC, whereas BC and RatioC were ineffective. Current recommendations to collect samples for BC appear redundant. Authors => Ran Nivy | Kent R. Refsal | Ella Ariel | Sharon Kuzi | Einat Yas-Natan | Michal Mazaki-Tovi published => First published: 18 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15330

Title => Investigation of a novel variable dosing protocol for radioiodine treatment of feline hyperthyroidism Abstract => Background: Radioiodine is the treatment of choice for hyperthyroidism in cats. The ideal method of dose determination of radioiodine remains controversial. Objective: To compare a method of radioiodine dose determination that utilized thyroid scintigraphy with a standard fixed dose for treatment of hyperthyroidism. Animals: Fifty-seven and 23 client-owned hyperthyroid cats in the variable and fixed dose groups, respectively. Methods: Cats with a percent dose uptake using 99mTc-pertechnetate uptake on thyroid scintigraphy <5%, 5%-10%, and >10% were to receive 3, 3.5, or 4.5 millicuries (mCi) of radioiodine, respectively, administered SC. Radioiodine dose was adjusted according to thyroid gland size as determined by the thyroid:salivary size ratio and categorized as <5:1, 5-10:1, and >10:1. If the thyroid size fell into a higher dosing category than the percent dose uptake, the dose was increased accordingly. Cats in the fixed dose group received 4.5 mCi. Six months after treatment, cats were determined to be euthyroid, hypothyroid, or hyperthyroid based on serum thyroxine and thyroid stimulating hormone concentrations. Results: No difference in outcome was found between the variable and fixed dose treatment groups. Euthyroidism, hypothyroidism, and persistent hyperthyroidism developed in 61, 30, and 9% of cats in the fixed dose group compared to 58, 26, and 16%, respectively, in the variable dose group. Conclusions: A variable dosing method of radioiodine based on percent dose uptake primarily and thyroid gland size secondarily did not improve outcome compared to a standard fixed dose method. Authors => Wendy A. Morré | David L. Panciera | Gregory B. Daniel | William E. Monroe | Stephen Werre published => First published: 17 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15296

Title => International collaborative study to assess cardiovascular risk and evaluate long-term health in cats with preclinical hypertrophic cardiomyopathy and apparently healthy cats: The REVEAL Study Abstract => None Abstract Authors => published => First published: 16 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15285

Title => Minimally invasive treatment of sino-nasal aspergillosis in dogs Abstract => Authors => Clara Ballber | Tracy L. Hill | Nick X. Bommer published => First published: 16 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15311

Title => Factors associated with survival in dogs with chronic kidney disease Abstract => Authors => Adam J. Rudinsky | Laura M. Harjes | Julie Byron | Dennis J. Chew | Ramiro E. Toribio | Catherine Langston | Valerie J. Parker published => First published: 16 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15322

Title => Comparison of electroencephalographic findings with hippocampal magnetic resonance imaging volumetry in dogs with idiopathic epilepsy Abstract => Authors => Adriana Czerwik | Marta Płonek | Przemyslaw Podgórski | Marcin Wrzosek published => First published: 16 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15323

Title => Letter to editor from Dr. Foster regarding Investigation of the role of Campylobacter infection in suspected acute polyradiculoneuritis (APN) in dogs Abstract => None Abstract Authors => Sue Foster BVSc, MVetClinStud, FANZCVS published => First published: 16 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15329

Title => Ethical conflict and moral distress in veterinary practice: A survey of North American veterinarians Abstract => Background: Concerns about ethical conflicts, moral distress, and burnout in veterinary practice are steadily increasing. Root causes of these problems have not been rigorously identified. Little research has been done to evaluate the existence of moral distress in North American veterinarians or to explore its impact on career sustainability and poor well-being. Hypothesis/Objectives: Ethical conflict and resultant moral distress are common occurrences in contemporary veterinary practice and negatively impact daily practice life, but may not be identified or labeled by veterinarians as such. Animals: No animals were used in this study. Methods: Mixed methods sequential explanatory design; confidential and anonymous on-line sampling of 889 veterinarians in North America. Results: A majority of respondents reported feeling conflict over what care is appropriate to provide. Over 70% of respondents felt that the obstacles they faced that prevented them from providing appropriate care caused them or their staff moderate to severe distress. Seventy-nine percent of participants report being asked to provide care that they consider futile. More than 70% of participants reported no training in conflict resolution or self-care. Conclusions and Clinical Importance: Veterinarians report widespread ethical conflict and moral distress across many practice types and demographics. Most veterinarians have little to no training on how to decrease the impact of these problems. Ethical conflict and resulting moral distress may be an important source of stress and poor well-being that is not widely recognized or well defined. Well-researched and effective tools used to decrease moral distress in human healthcare could be adapted to ameliorate this problem. Authors => Lisa Moses | Monica J. Malowney | Jon Wesley Boyd published => First published: 15 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15315

Title => Radioactive iodine uptake in hyperthyroid cats after administration of recombinant human thyroid stimulating hormone Abstract => Background: Radioactive iodine therapy is considered the treatment of choice for hyperthyroidism in cats, but the availability of this modality is limited by costs and hospitalization requirements. Administration of recombinant human thyroid stimulating hormone (rh-TSH) to humans with thyroid neoplasia or nodular goiter can increase thyroidal iodine uptake, thereby allowing the use of lower radioactive iodine doses for treatment. Veterinary studies of this subject are limited, and results are conflicting. Objective: To investigate the effects of rh-TSH administration on thyroidal iodine uptake in hyperthyroid cats. Animals: Ten client-owned hyperthyroid cats. Methods: In this prospective clinical study, cats were administered saline (placebo), 50 μg rh-TSH (low-dose), and 100 μg rh-TSH (high-dose) in randomized crossover design with treatments separated by 7-10 days. After each treatment, thyroid scintigraphy was performed by administering 300 μCi 123I and assessing radionuclide uptake 8 and 24 hours later. Serum thyroid hormone concentrations were measured at each visit. Results: Thyroidal percent iodine uptakes (mean ± SD at 8 and 24 hours) in cats treated with placebo (25.2 ± 13.4%, 30.0 ± 12.8%), low-dose (24.1 ± 12.5%, 29.4 ± 13.7%), and high-dose rh-TSH (24.2 ± 16.3%, 30.8 ± 15.3%) were not different (P = .76). Independent of rh-TSH administration, percent iodine uptakes were positively correlated with serum thyroid hormone concentrations. Conclusions and Clinical Importance: One-time administration of rh-TSH, even at high doses, would not be expected to lower radioactive iodine doses needed for treatment of hyperthyroidism in cats. Investigations of alternate strategies to increase thyroidal uptake of radioactive iodine are warranted. Authors => Amy E. Oberstadt | Nathan C. Nelson | Andrew K. Claude | Kent R. Refsal | J. Catharine Scott-Moncrieff | Brian K. Petroff | Daniel K. Langlois published => First published: 13 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15295

Title => Survival after diagnosis of hypertension in cats attending primary care practice in the United Kingdom Abstract => Background: Hypertension is common in older cats. There is limited evidence for predictors of survival after diagnosis. Hypothesis/Objectives: Investigate blood pressure assessment (BPA) and hypertension diagnosis in cats attending UK primary care practices (PCPs) and factors that influence survival. Animals: Cats (347 889) attending 244 UK PCPs enrolled in the VetCompass program between January 1, 2012, and December 31, 2013. Cats identified as hypertensive (282) were included in descriptive and survival analyses. Methods: All electronic patient records (EPRs) were searched to identify cats that potentially had received BPA. EPRs were read in detail to identify those that had BPA. The proportion that received BPA was evaluated using a stratified analysis and the incidence of hypertension estimated. A retrospective cohort study was used to investigate survival after diagnosis (Cox proportional hazard model). Results: Estimated incidence risk was 19.5% (95% confidence interval [CI], 17.5-21.6) from the estimated 1.34% (1.30%-1.38%) of cats that received BPA. Few cats had BPA more than once after diagnosis (median, 1; interquartile range [IQR], 0-3), with only 9.9% of diagnosed hypertensive cats having urine protein:creatinine ratio determined. Cats diagnosed as a result of monitoring of pre-existing disease had improved survival (hazard ratio [HR], 0.58; 95% CI, 0.37-0.89; P = .01) compared to cats diagnosed after clinical signs were recognized. Cats that had an amlodipine dose change had improved survival (HR, 0.56; 95% CI, 0.36-0.87; P = .01) compared to those with no dose change. Conclusions and clinical importance: These data suggest improved blood pressure monitoring in clinical practice may decrease the morbidity associated with hypertension. Authors => Megan Conroy | Yu-Mei Chang | Dave Brodbelt | Jonathan Elliott published => First published: 13 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15307

Title => Juvenile-onset polyneuropathy in American Staffordshire Terriers Abstract => Background: The only hereditary neurologic disorder described so far in American Staffordshire Terriers is adult-onset cerebellar degeneration secondary to ceroid lipofuscinosis. We have seen several dogs with a newly recognized neurological disease characterized by locomotor weakness with or without respiratory signs and juvenile onset consistent with degenerative polyneuropathy of genetic origin. Objectives: To characterize a novel polyneuropathy in juvenile American Staffordshire Terriers. Animals: Fourteen American Staffordshire Terriers presented with clinical signs consistent with juvenile-onset polyneuropathy at 5 veterinary hospitals between May 2005 and July 2017. Methods: Case series. Dogs were included retrospectively after a diagnosis of degenerative polyneuropathy had been confirmed by nerve biopsy. Clinical, pathological, electrophysiological, histological data, and outcome were reviewed and a pedigree analysis performed. Results: All dogs displayed clinical signs of neuromuscular disease with generalized motor and sensory involvement, associated with focal signs of laryngeal paralysis (10/14 dogs) and megaesophagus (1/14 dogs). Histopathological findings were consistent with degenerative polyneuropathy. Follow-up was available for 11 dogs, and 3 dogs were euthanized shortly after diagnosis. In these 11 dogs, the disease was slowly progressive and the animals maintained good quality of life with ability to walk. Pedigree analysis was mostly consistent with an autosomal recessive mode of inheritance. Conclusions and Clinical Importance: Juvenile polyneuropathy, associated with laryngeal paralysis, is a newly described entity in American Staffordshire Terriers, and results from degenerative neuropathy. When surgery for laryngeal paralysis is performed, lifespan may be similar to that of normal dogs even though affected dogs have locomotor disturbance. Authors => Hélène Vandenberghe | Catherine Escriou | Marco Rosati | Laura Porcarelli | Alfredo Recio Caride | Sonia Añor | Gualtiero Gandini | Daniele Corlazzoli | Jean-Laurent Thibaud | Kaspar Matiasek | Stéphane Blot published => First published: 13 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15316

Title => A retrospective study of 157 hospitalized cats with pancreatitis in a tertiary care center: Clinical, imaging and laboratory findings, potential prognostic markers and outcome Abstract => Background: Pancreatitis in cats (FP) has been increasingly diagnosed in recent years, but clinical studies of large numbers of affected cats are scarce. Objectives: To describe a large cohort of cats with FP requiring hospitalization. Animals: One hundred and fifty-seven client-owned cats. Methods: Retrospective study, including cats diagnosed with pancreatitis based on sonographic evidence, positive SNAP feline pancreatic lipase immunoreactivity test results, increased 1,2-o-dilauryl-rac-glycerol-glutaric Acid-(6′-methylresorufin ester)-lipase activity, histopathology, or some combination of these. Results: One-hundred and twenty-two cats (77.7%) survived to discharge. Conclusions and Clinical Importance: Previously unreported, clinically relevant, potential prognostic factors, including hypoglycemia, azotemia, parenteral nutrition, and withholding antibacterial treatment were identified in this exploratory study. These preliminary results should be examined further in confirmatory studies. Authors => Ran Nivy | Alina Kaplanov | Sharon Kuzi | Michal Mazaki-Tovi | Einat Yas | Gilad Segev | Jennifer Ben-Oz | Eran Lavy | Itamar Aroch published => First published: 13 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15317

Title => Response from Dr. Martinez-Anton, et al. to Dr. Foster letter to editor regarding Investigation of the role of Campylobacter infection in suspected acute polyradiculoneuritis (APN) in dogs Abstract => None Abstract Authors => Lorena Martinez-Anton DVM | Marc S. Marenda PhD | Simon M. Firestone BVSc, BSc, PGDipEpi, MAppEPI, PhD | Rhys N. Bushell BSc | Georgina Child BVSc, DA, CVIM (Neurology) | Alexander I. Hamilton DVM, ACVS, DECVN | Sam N. Long BVSc, PhD, DECVN | Matthias A. R. le Chevoir DMV, DECVN published => First published: 13 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15328

Title => Association between clinically probable REM sleep behavior disorder and tetanus in dogs Abstract => Background: Abnormal sleep behavior has been reported in 5 dogs during recovery from tetanus. Hypothesis: REM sleep behavior disorder (RBD) is a more common consequence of tetanus than previously reported in veterinary literature and easily confused for epileptic seizures. Animals: Sixty-one client-owned dogs diagnosed with tetanus at 2 UK referral centers. Methods: A retrospective review of medical records was combined with a questionnaire sent to owners of surviving dogs, to identify cases that developed clinically probable RBD and determine its clinical progression and effect on quality of life of affected dogs and their owners. Descriptive statistical evaluation was performed. Results: Eleven dogs (18%) died or were euthanized before discharge. At least 46% surviving dogs developed abnormal “dream enactment” clinically consistent with RBD. Twitching, running, and vocalization were new sleep behaviors in 53, 80, and 60% of affected dogs. Clinically probable RBD was described as violent or “nightmare”-like in 36% affected dogs, and like an epileptic seizure in 40% affected dogs. When trialed, antiepileptic medications were ineffective. Onset occurred before discharge in 25% cases. For dogs that developed clinically probable RBD postdischarge, onset occurred within 2 weeks of discharge in 77% dogs. Clinically probable RBD did not worsen in severity or frequency in any dog, and spontaneously resolved within 6 months in 43% cases. Conclusions and Clinical Importance: Clinically probable RBD is a common sequel to canine tetanus with many clinical similarities to epileptic seizure activity. Owners should be made aware of its potential development and care taken to avoid misdiagnosis with epileptic seizure activity. Authors => Anita Shea | Alex Hatch | Luisa De Risio | Elsa Beltran published => First published: 12 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15320

Title => Reflux aspiration in lungs of dogs with respiratory disease and in healthy West Highland White Terriers Abstract => Background: Gastroesophageal reflux and microaspiration (MA) of gastric juice are associated with various human respiratory diseases but not in dogs. Objective: To detect the presence of bile acids in bronchoalveolar lavage fluid (BALF) of dogs with various respiratory diseases. Animals: Twenty-seven West Highland White Terriers (WHWTs) with canine idiopathic pulmonary fibrosis (CIPF), 11 dogs with bacterial pneumonia (BP), 13 with chronic bronchitis (CB), 9 with eosinophilic bronchopneumopathy (EBP), 19 with laryngeal dysfunction (LD), 8 Irish Wolfhounds (IWHs) with previous BPs, 13 healthy WHWTs, all privately owned dogs, and 6 healthy research colony Beagles Methods: Prospective cross-sectional observational study with convenience sampling of dogs. Bile acids were measured by mass spectrometry in BALF samples. Total bile acid (TBA) concentration was calculated as a sum of 17 different bile acids. Results: Concentrations of TBA were above the limit of quantification in 78% of CIPF, 45% of BP, 62% of CB, 44% of EBP, 68% of LD, and 13% of IWH dogs. In healthy dogs, bile acids were detected less commonly in Beagles (0/6) than in healthy WHWTs (10/13). Concentrations of TBA were significantly higher in CIPF (median 0.013 μM, range not quantifiable [n.q.]-0.14 μM, P < .001), healthy WHWTs (0.0052 μM, n.q.-1.2 μM, P = .003), LD (0.010 μM, n.q.-2.3 μM, P = .015), and CB (0.0078 μM, n.q.-0.073 μM, P = .018) groups compared to Beagles (0 μM, n.q.). Conclusion and Clinical Importance: These results suggest that MA occurs in various respiratory diseases of dogs and also in healthy WHWTs. Authors => O. L. Merita Määttä | Henna P. Laurila | Saila Holopainen | Liisa Lilja-Maula | Marika Melamies | Sanna J. Viitanen | L. R. Johnson | Ninna Koho | Mikko Neuvonen | Mikko Niemi | Minna M. Rajamäki published => First published: 12 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15321

Title => Comparison of intestinal expression of the apical sodium-dependent bile acid transporter between dogs with and without chronic inflammatory enteropathy Abstract => Background: Intestinal absorption of bile acids is mediated by the apical sodium-dependent bile acid transporter (ASBT). Fecal bile acid dysmetabolism has been reported in dogs with chronic inflammatory enteropathy (CIE). Objective: Characterization of ASBT distribution along the intestinal tract of control dogs and comparison to dogs with CIE. Animals: Twenty-four dogs with CIE and 11 control dogs. Methods: The ASBT mRNA and protein expression were assessed using RNA in situ hybridization and immunohistochemistry, respectively. The concentrations of fecal bile acids were measured by gas chromatography-mass spectrometry. The fecal microbiota dysbiosis index was assessed with a quantitative polymerase chain reaction panel. Results: In control dogs, ASBT mRNA expression was observed in enterocytes in all analyzed intestinal segments, with highest expression in the ileum. The ASBT protein expression was restricted to enterocytes in the ileum, cecum, and colon. Dogs with CIE had significantly decreased expression of ASBT protein in the ileum (P = .001), which was negatively correlated with histopathological score (ρ = −0.40; Pcorr = .049). Additionally, dogs with CIE had a significantly increased percentage of primary bile acids in feces compared to controls (P = .04). The fecal dysbiosis index was significantly higher in dogs with CIE than in control dogs (P = .01). Conclusions and Clinical Importance: These findings indicate that ileal protein expression of ASBT is downregulated in dogs with CIE. This change may be linked to the inflammatory process, intestinal dysbiosis, and fecal bile acid dysmetabolism observed in these patients. Authors => Paula R. Giaretta | Raquel R. Rech | Blake C. Guard | Amanda B. Blake | Anna K. Blick | Jörg M. Steiner | Jonathan A. Lidbury | Audrey K. Cook | Mohsen Hanifeh | Thomas Spillmann | Susanne Kilpinen | Pernilla Syrjä | Jan S. Suchodolski published => First published: 12 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15332

Title => Babesia conradae infection in coyote hunting dogs infected with multiple blood-borne pathogens Abstract => Background: Babesia conradae is an intraerythrocytic piroplasm infecting dogs in the southern United States. Ticks have been suspected, but unproven, as vectors. We identified B. conradae and other blood-borne pathogens in 2 kennels of sighthounds with a history of coyote fighting. Objectives: To examine clinicopathologic abnormalities associated with B. conradae infection, risk factors for infection, and the prevalence of coinfections with other blood-borne pathogens. Animals: Fifty-five Greyhounds and Greyhound mixes Methods: Blood samples were collected from each dog for CBC, serum biochemistry panel, conventional and real-time PCR assays (Babesia spp., hemoplasmas, Ehrlichia canis, Bartonella spp., Anaplasma spp., and Rickettsia spp.), vector-borne pathogen ELISA, and immunofluorescent serology and culture for Bartonella spp and Francisella tularensis sero-agglutination test. Associations between B. conradae infection and coyote fighting, age and laboratory abnormalities were investigated. Results: Twenty-nine dogs were PCR-positive for B. conradae. Of these, 16 were PCR-positive for other vector-borne organisms including Mycoplasma haemocanis, “Candidatus Mycoplasma haematoparvum,” E. canis, and a Hepatozoon felis-like organism. Twelve of the 20 dogs tested for seroreactivity to Bartonella spp. antigens were positive, but none were seropositive for tularemia. Infection with B. conradae was associated with a history of aggressive interactions with coyotes; lower hematocrit, leukocyte count, MCHC, platelet count and serum albumin concentration; and higher MCV, MPV, and serum globulin concentration. Conclusions and Clinical Importance: Babesia conradae infection should be considered in dogs with anemia, leukopenia, thrombocytopenia, hypoalbuminemia and hyperglobulinemia. As with B. gibsoni, aggressive interactions with other canids may play a role in B. conradae transmission. Authors => Jonathan D. Dear | Sean D. Owens | LeAnn L. Lindsay | Alex W. Biondo | Bruno B. Chomel | Mary Marcondes | Jane E. Sykes published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15233

Title => In vivo and in vitro assessment of mirtazapine pharmacokinetics in cats with liver disease Abstract => Background: Liver disease (LD) prolongs mirtazapine half-life in humans, but it is unknown if this occurs in cats with LD and healthy cats. Hypothesis/Objectives: To determine pharmacokinetics of administered orally mirtazapine in vivo and in vitro (liver microsomes) in cats with LD and healthy cats. Animals: Eleven LD and 11 age-matched control cats. Methods: Case-control study. Serum was obtained 1 and 4 hours (22 cats) and 24 hours (14 cats) after oral administration of 1.88 mg mirtazapine. Mirtazapine concentrations were measured by liquid chromatography with tandem mass spectrometry. Drug exposure and half-life were predicted using limited sampling modeling and estimated using noncompartmental methods. in vitro mirtazapine pharmacokinetics were assessed using liver microsomes from 3 LD cats and 4 cats without LD. Results: There was a significant difference in time to maximum serum concentration between LD cats and control cats (median [range]: 4 [1-4] hours versus 1 [1-4] hours; P = .03). The calculated half-life of LD cats was significantly prolonged compared to controls (median [range]: 13.8 [7.9-61.4] hours versus 7.4 [6.7-9.1] hours; P < .002). Mirtazapine half-life was correlated with ALT (P = .002; r = .76), ALP (P < .0001; r = .89), and total bilirubin (P = .0008; r = .81). The rate of loss of mirtazapine was significantly different between microsomes of LD cats (–0.0022 min−1, CI: −0.0050 to 0.00054 min−1) and cats without LD (0.01849 min−1, CI: −0.025 to −0.012 min−1; P = .002). Conclusions and Clinical Importance: Cats with LD might require less frequent administration of mirtazapine than normal cats. Authors => Rikki L. Fitzpatrick | Jessica M. Quimby | Kellyi K. Benson | Dominique Ramirez | Liberty G. Sieberg | Luke A. Wittenburg | Daniel L. Gustafson published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15237

Title => Investigation of sensory thresholds in Cavalier King Charles Spaniels with and without Chiari-like malformations and syringomyelia Abstract => Background: Cavalier King Charles Spaniels (CKCS) suffer pain associated with Chiari-like malformation and syringomyelia (CMSM). People suffer from a similar condition and describe numerous sensory abnormalities. Sensory changes have not been quantified in affected CKCS. Objectives: To use quantitative sensory testing (QST) to quantify thermal and mechanical thresholds in CKCS and to compare QST in dogs with and without syringomyelia (SM). Animals: Forty-four CKCS. Methods: Prospective study. Dogs underwent neurological examinations and craniocervical magnetic resonance imaging (MRI). Thermal testing was performed over the humerus and thorax (n = 32); mechanical testing was performed on the paw and neck (n = 44). Latencies, thresholds, and response rates were compared with presence and severity of SM on MRI, presence of pain reported by the owner and pain identified on examination. Results: Thirty dogs had SM, 30 were painful on examination, 29 were owner-reported symptomatic. Thermal and mechanical variables were not significantly different based on presence or severity of SM. Dogs with pain on examination had decreased mechanical thresholds on the paw (0.38 kg, SD = 0.18) and neck (2.05 kg, SD = 0.74) compared to thresholds of dogs without pain on examination on the paw (0.60 kg, SD = 0.30) and neck (2.72 kg, SD = 0.57; P = .021). Conclusions and Clinical Importance: Mechanical and thermal sensitivity does not appear to be related to the presence of SM, but mechanical sensitivity appears to be related to the presence of pain and clinical signs. Mechanical testing may be useful for assessing sensory abnormalities during clinical trials. Authors => Courtney R. Sparks | Angela Gorney | Kim Williams | Emily H. Griffith | Sofia Cerda-Gonzalez | B. Duncan X. Lascelles | Natasha J. Olby published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15297

Title => Babesia gibsoni cytochrome b mutations in canine blood samples submitted to a US veterinary diagnostic laboratory Abstract => Authors => Adam J. Birkenheuer | Henry S. Marr | James M. Wilson | Edward B. Breitschwerdt | Barbara A. Qurollo published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15300

Title => Evaluation of cell culture-grown Bartonella antigens in immunofluorescent antibody assays for the serological diagnosis of bartonellosis in dogs Abstract => Background: Because of poor sensitivity and questionable specificity of immunofluorescent antibody assays (IFAs), serological diagnosis of Bartonella species infections in dogs remains challenging. Despite limitations, IFA testing is the historical “gold standard” for Bartonella serodiagnosis in animals and humans. Because most diagnostic laboratories test against only 1 or 2 Bartonella spp., testing against a broader panel of Bartonella antigens may enhance diagnostic sensitivity and specificity. Objective: To evaluate the sensitivity and specificity of Bartonella IFA using 8 cell culture-grown Bartonella spp. isolates. Animals: Archived serum samples from 34 Bartonella spp. naturally exposed, polymerase chain reaction (PCR)-positive dogs and from 26 PCR-negative and IFA-negative dogs. Methods: Bartonella IFA sensitivity and specificity were assessed using cell culture-grown whole cell antigens derived from 3 Bartonella henselae (Bh) strains (Bh Houston 1, Bh San Antonio Type 2, Bh California 1), 3 Bartonella vinsonii subsp. berkhoffii genotypes (Bvb I, II, and III), Bartonella koehlerae (Bk), and Bartonella quintana (Bq). Results: Only 62% of 34 Bartonella spp. PCR-positive dogs were seroreactive to any of the 8 Bartonella IFA antigens, indicating low IFA sensitivity. PCR-positive dogs were most often IFA seroreactive to Bq (n = 15), to Bvb II (n = 13), or to both (n = 9) antigens. Of the 26 previously IFA-negative/PCR-negative dogs, 4 (15%) were seroreactive using the expanded antigen panel. Conclusion and Clinical Importance: Despite IFA testing of dogs against 8 different Bartonella isolates, IFA sensitivity remained poor, and specificity was only 85%. Development of a reliable serological assay is needed to facilitate the diagnosis of Bartonella infection in dogs. Authors => Pradeep Neupane | Barbara C. Hegarty | Henry S. Marr | Ricardo G. Maggi | Adam J. Birkenheuer | Edward B. Breitschwerdt published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15301

Title => Demographic risk factors for lymphoma in Australian dogs: 6201 cases Abstract => Background: Lymphoma is common in the dog. Studies of population risk factors primarily have been derived from referral institution or insurance data. Objective: To identify and quantify the host risk factors for lymphoma in a broad population of Australian dogs. Animals: Data on 6201 client owned dogs were retrieved from a commercial veterinary laboratory, a general practice group and 2 referral hospitals. Methods: Data collected included breed, sex, and neuter status. A reference population of 640 105 dogs was generated from the referral hospitals and from council registration data. The risk of lymphoma by sex and neuter status was calculated as odds ratios (OR). Results: The study identified 30 breeds at increased risk of lymphoma, 15 that have not been reported previously, and 26 breeds at decreased risk, 18 that have not been reported previously. Males were over represented compared to females with an OR of 1.1 (95% CI, 1.1–1.2; P < .001). Neutered animals were at higher risk compared to intact animals with an OR of 3.2 (95% CI, 2.9–3.5) which was found in both males (OR, 2.8; 95% CI; 2.5–3.2) and females (OR, 4.4; 95% CI, 3.5–5.1). Conclusions and Clinical Importance: Breed, sex, and neuter status alter the risk of lymphoma in dogs. These 3 factors must be considered when evaluating lymphoma risk as potential markers of underlying differences in disease etiology. Comparison of breeds at increased and decreased risk could be advantageous when evaluating specific etiological factors. Authors => Peter F. Bennett | Rosanne Taylor | Peter Williamson published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15306

Title => Two mixed breed dogs with sensory neuropathy are homozygous for an inversion disrupting FAM134B previously identified in Border Collies Abstract => Authors => Pablo Amengual-Batle | Clare Rusbridge | Roberto José-López | Lorenzo Golini | G. Diane Shelton | Cathryn S. Mellersh | Rodrigo Gutierrez-Quintana published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15312

Title => The pharmacokinetics of gabapentin in cats Abstract => Background: Gabapentin is the most commonly prescribed medication for the treatment of chronic musculoskeletal pain in cats. Despite this common and chronic usage, clinically relevant pharmacokinetic data is lacking. Objectives: To evaluate the pharmacokinetics of clinically relevant dosing regimens of gabapentin in cats. Animals: Eight research-purpose mixed-breed cats. Methods: Cats were enrolled in a serial order, non-randomized pharmacokinetic study. Gabapentin was administered as an IV bolus (5 mg/kg), orally (10 mg/kg) as a single dose or twice daily for 2 weeks, or as a transdermal gel (10 mg/kg) in serial order. Serial blood samples were collected up to 48 hours. Plasma concentrations were determined using Ultra Performance Liquid Chromatography-Mass Spectrometry. Compartmental analysis was used to generate gabapentin time-concentration models. Results: After IV administration CL (median (range)) and terminal half-life were 160.67 mL/kg*hr (119.63-199.11) and 3.78 hours (3.12-4.47), respectively. The oral terminal half-life was 3.63 hours (2.96-4.77), and 3.72 hours (3.12-4.51) for single and repeated dosing. TMAX and CMAX, as predicted by the model were 1.05 hours (0.74-2.11), and 12.42 μg/mL (8.31-18.35) after single oral dosing, and 0.77 hours (0.58-1.64), and 14.78 μg/mL (9.70-18.41) after repeated oral dosing. Bioavailability after a single oral dose was 94.77% (82.46-122.83). Importance: Repeated oral dosing of gabapentin did not alter the drug's pharmacokinetics, making dose adjustments unnecessary with long-term treatment. As prepared, the transdermal route is an inappropriate choice for drug administration. These relevant data are important for future studies evaluating potential efficacy of the medication for treating chronic pain states in cats. Authors => Derek Adrian | Mark G. Papich | Ronald Baynes | Emma Stafford | B. Duncan X. Lascelles published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15313

Title => 2018 ACVIM Forum Research Report Program Abstract => None Abstract Authors => published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15314

Title => Comparative evaluation of a novel, moderately hypofractionated radiation protocol in 56 dogs with symptomatic intracranial neoplasia Abstract => Authors => Philip Schwarz | Valeria Meier | Alena Soukup | Randi Drees | Jürgen Besserer | Katrin Beckmann | Malgorzata Roos | Carla Rohrer Bley published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15324

Title => Prevalence of naturally occurring non-AB blood type incompatibilities in cats and influence of crossmatch on transfusion outcomes Abstract => Background: Recognition of the feline red blood cell (RBC) antigen Mik and the presence of naturally occurring anti-Mik antibodies resulting in acute hemolytic transfusion reactions prompted the recommendation to perform a crossmatch before a cat's first RBC transfusion, but this guideline has not yet become a standard practice. Objective: To determine the prevalence of naturally occurring non-AB alloantibodies detectable by tube crossmatch, and to compare transfusion outcomes in cats with and without a crossmatch performed. Animals: Three hundred cats that received an RBC transfusion, with or without a major crossmatch performed. Methods: Retrospective study. Results: Major crossmatch incompatibilities were documented in 23 of 154 transfusion-naive cats (14.9%) and in 15 of 55 previously transfused cats (27%; P = 0.042). Type-specific packed RBCs (pRBCs) were administered to 167 and 82 cats with and without a crossmatch, respectively. Median volume of pRBCs administered during the first transfusion was 5.3 mL/kg (range, 2.4-18 mL/kg). Median change in PCV scaled to dose of pRBCs was +0.8%/mL/kg; administration of crossmatch-compatible pRBCs was not associated with a greater increase in PCV. Febrile transfusion reactions occurred more often in cats that received non-crossmatched (10.1%) compared to crossmatched (2.5%) pRBCs (P = 0.022). Seventy-six percent of cats that received pRBC transfusions survived to hospital discharge. A crossmatch was not associated with improved survival to discharge or at 30 or 60 days posttransfusion. Conclusions and Clinical Importance: The prevalence of naturally occurring non-AB incompatibilities is sufficiently high to justify the recommendation to perform a crossmatch before all (including the first) RBC transfusions in cats. Authors => Megan E. McClosky | Dorothy Cimino Brown | Nicole M. Weinstein | Nicole Chappini | Michael T. Taney | Kimberly Marryott | Mary Beth Callan published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15334

Title => Retrospective evaluation of toceranib phosphate (Palladia®) use in the treatment of gastrointestinal stromal tumors of dogs Abstract => Background: Gastrointestinal stromal tumors (GISTs) are uncommon intestinal neoplasms in the dog. Literature regarding adjunctive therapy for GISTs in dogs is sparse. High-risk GISTs in humans respond to tyrosine kinase inhibition in the adjuvant setting. Objectives: To review cases of toceranib phosphate use in dogs with GISTs and provide initial assessment of possible biological activity. A secondary aim was to evaluate patient and tumor characteristics for possible prognostic value. Animals: Twenty-seven dogs with confirmed GISTs based on histopathology and immunohistochemistry treated with toceranib. Methods: Retrospective study in which cases of toceranib use in dogs with GIST were solicited using the American College of Veterinary Internal Medicine Oncology and Small Animal Internal Medicine listservs. Results: Five of 7 dogs with gross disease experienced clinical benefit (71%; 3 complete responses, 1 partial response, 1 stable disease). These included 2 dogs with durable responses after toceranib discontinuation. Median progression-free interval (PFI) in dogs with gross disease was 110 weeks (range, 36-155 weeks). Median PFI in dogs with microscopic disease was 67 weeks (range, 9-257 weeks). Metastasis at diagnosis (P = 0.04) and high mitotic index (P < 0.001) were associated with shorter PFI in toceranib-treated dogs. Conclusions and Clinical Importance: Biological activity of toceranib is evident in dogs with gross disease. Metastasis of GIST at diagnosis, as well as high tumor mitotic index, was associated with shorter PFI in toceranib-treated dogs. Larger studies are needed to define postsurgical risk and refine the use of toceranib in dogs with gross and microscopic GIST. Authors => Erika P. Berger | Chad M. Johannes | Albert E. Jergens | Karin Allenspach | Barbara E. Powers | Yingzhou Du | Jonathan P. Mochel | Leslie E. Fox | Margaret L. Musser published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15335

Title => Variables of initial examination and clinical management associated with survival in small ruminants with obstructive urolithiasis Abstract => Background: Obstructive urolithiasis is a common disease associated with a guarded prognosis in small ruminants. Hypothesis/Objective: The results of physical examination, laboratory analyses, and clinical management of male small ruminants presented to 2 referral clinics were investigated to identify variables significantly associated with disease outcome, so as to provide better recommendations to animal owners regarding the management of these patients. Animals: Two-hundred ten small ruminants (130 sheep and 80 goats) with confirmed diagnosis of obstructive urolithiasis. Methods: Clinical findings (including diagnostic imaging) and laboratory results of the 210 animals were reviewed, and relevant information regarding clinical and laboratory variables recorded upon admission and clinical management was retrieved. The association of the different variables with nonsurvival was investigated by univariable and multivariable logistic regression models. Results: Only 39% of all patients considered for treatment and 52% of those undergoing tube cystostomy survived to be released from the clinic. Nonsurvival was strongly associated with a very poor clinical condition upon presentation, obesity, castration, and evidence of uroperitoneum. Among blood variables, abnormal PCV, severely increased serum creatinine concentrations, and increased activity of the creatine kinase were associated with increased risk of nonsurvival. Presence of signs of colic or macroscopic appearance of urine was not significantly associated with outcome. Conclusions and Clinical Importance: The prognosis of obstructive urolithiasis was guarded with survival rates of 39% (overall) to 52% (after tube cystostomy). Intact young males with normal body condition presented early in the course of disease had the best chances of survival. Authors => Anna-Katharina Riedi | Christina Nathues | Gabriela Knubben-Schweizer | Karl Nuss | Mireille Meylan published => First published: 11 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15336

Title => Spontaneous primary hypothyroidism in 7 adult cats Abstract => Background: Naturally occurring hypothyroidism in adult cats is rare, with only 4 cases reported. Objectives: To describe the historical, clinical, laboratory, and scintigraphic features of adult cats with spontaneous hypothyroidism. Animals: Seven adult cats referred for suspected hypothyroidism. Methods: Prospective case series. We collected data on cats’ signalment, clinical signs, results of physical examination, routine laboratory and thyroid hormone testing, and thyroid imaging (thyroid scintigraphy or ultrasound). We subsequently treated cats with levothyroxine and evaluated their response to treatment. Results: Cats ranged from 3.5 to 11 years, with no apparent breed predilection; 6/7 cats were male. Only 2/7 cats were initially tested because of signs of hypothyroidism (hair-coat changes, lethargy, obesity); others were tested for routine thyroid monitoring or palpable thyroid nodules. Four were azotemic (serum creatinine, 2.2-3.4 mg/dL). Six of the cats had low serum thyroxine (T4) and free T4 (fT4) concentrations, whereas all 7 cats had high thyroid-stimulating hormone (TSH) concentrations. In 6/7 cats, thyroid scintigraphy revealed bilateral goiter with intense radionuclide uptake; imaging showed no visible thyroid tissue in the other. After levothyroxine treatment, serum concentrations of T4 and fT4 increased and TSH fell; high serum creatinine normalized in azotemic cats; and repeat imaging showed reduction in goiter size. Conclusions and Clinical Importance: Primary hypothyroidism develops in adult cats, with a higher prevalence than previously thought. Most cats appear to develop a goitrous form of hypothyroidism associated with thyroid hyperplasia, whereas thyroid atrophy appears to be less common. With levothyroxine replacement, clinical and laboratory abnormalities improve or resolve. Authors => Mark E. Peterson | Marcia A. Carothers | David A. Gamble | Mark Rishniw published => First published: 07 October 2018 URL => https://onlinelibrary.wiley.com//doi/10.1111/jvim.15239