Point of care pancreas-specific lipase testing is focus for study

Point of care pancreas-specific lipase tests are useful for rapid diagnosis of pancreatitis in dogs, but it is possible that false positives may be recorded with other conditions.

Gastrointestinal foreign body obstructions have similar clinical signs to pancreatitis, so it’s important to know whether false positive results are found with pancreas-specific lipase tests in cases of obstruction without pancreatitis.

Luce et al¹ included 50 dogs with acute abdomen syndrome in a prospective observational cohort study. Twenty-five dogs with gastrointestinal foreign bodies were compared to 25 controls without gastrointestinal foreign bodies. Dogs with evidence of pancreatitis were excluded from the study.

All dogs had SNAP canine pancreatic lipase (cPL) tests performed within 24 hours of presentation and before any surgical procedures were performed. No significant difference was observed in the number of positive cPL results between the two groups. Abnormal cPL results were more likely to be seen in older dogs.

The authors concluded that cPL results are largely accurate, but can be abnormal in a small number of dogs with gastrointestinal foreign bodies and recommend abdominal imaging in all dogs with abnormal cPL results.

COVID-19 in cats

COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is known that this virus can affect animals.

Patania et al² performed a study to assess the pathological findings in cats that had been experimentally infected with SARS-CoV-2.

Histopathological examination of the lungs up to 28 days after inoculation showed mild to moderate patchy interstitial pneumonia, bronchiolar epithelial damage and occlusive histiocytic bronchiolitis. Blood vessel endothelium also showed changes.

One cat had severe subacute lymphohistiocytic pneumonia.

Viral RNA was below the limit of detection by 10 days after inoculation.

The authors noted that cats can be useful models to study subacute pulmonary sequelae of SARS-CoV-2.

Photobiomodulation in dogs with bilateral hip arthritis

Photobiomodulation is the application of red or near-infrared light with the aim of healing tissues. It was previously known as low-level laser light therapy.

Alves et al³ performed a double-blinded, randomised controlled trial to assess the effect of photobiomodulation on dogs with bilateral hip arthritis. Twenty dogs were included in the study. Twenty joints were assigned to a control group and 20 to a treatment group.

Joint range of motion and various assessments of pain and canine OA were examined before treatment, and at various time points up to 90 days later.

Twenty-six cases had moderate OA and 14 had severe OA.

Photobiomodulation was associated with a better result at certain time points for some of the conditions, although a primary outcome and primary timepoint were not pre-specified, making it harder to interpret the value of these results.

Nevertheless, the authors concluded that Kaplan-Meier estimators showed that photobiomodulation gave periods with better results than the control.

Pharmacokinetics

Providing long-acting, effective and well-tolerated analgesia is important for the welfare of veterinary patients undergoing surgical procedures.

Bieberly et al⁴ performed a pharmacokinetic preliminary study on three dogs and a clinical trial in 42 dogs to assess the pharmacokinetics, clinical efficacy and adverse effects of methadone with the pharmacokinetic enhancer fluconazole, compared to standard injectable methadone in dogs undergoing ovariohysterectomy.

Dogs were monitored perioperatively with the Glasgow Composite Measure Pain Scale short form and sedation scales. The evaluators were blinded.

The preliminary pharmacokinetic studies suggested two doses would provide 24 hours of exposure to the drug. Control cases were given usual methadone formulation every four hours, while methadone-fluconazole injection was repeated once at six hours.

No significant differences were observed in treatment failures or pain scores between the two groups. No dogs had residual sedation 24 hours after surgery.

The authors concluded that twice-daily long-acting methadone gives effective and well-tolerated analgesia after ovariohysterectomy and may improve clinical compliance.

Chlorhexidine and povidone-iodine for skin preparation

Chlorhexidine and povidone-iodine have traditionally been used in veterinary surgery for preoperative aseptic skin preparation.

Marchionatti et al⁵ performed a systematic review to compare the efficacy of these two techniques. Studies comparing chlorhexidine and povidone-iodine published between 1990 and 2020 were identified following searches of Pubmed, Web of Science and CAB Abstracts, as well as other sources.

Efficacy of skin asepsis was assessed, with the primary outcome measure being incidence of surgical site infection and the secondary outcome measure being skin bacterial colonisation. Nine relevant studies were included for analysis.

No difference was found in the incidence of postoperative surgical site infection or skin bacterial colonisation between the two protocols. However, risk of bias was hard to assess because of incomplete information.

The authors concluded that this study shows no difference between povidone-iodine and chlorhexidine in terms of skin asepsis, but that higher quality studies are needed to confirm this.

Total hip replacements in cats

Total hip replacements (THR) in cats are less common than in dogs, and less information exists in the literature regarding these cases.

Rodiño Tilve et al⁶ performed a retrospective cohort study to report the indications, complications and long-term outcomes after THR in cats.

Forty-four cats that underwent replacements of 56 hips were included in the study. The median age was two years, with British shorthair and domestic shorthair the most common breeds. Thirty-three of the 44 cats were neutered males.

Slipped capital femoral epiphysis was the most common reason for the procedure. Eleven of the 56 replacements had complications, with 9 of them being major complications. Owner satisfaction was reported as very good in 91% of cases.

The authors concluded that THR as a treatment for feline hip disease has a very good owner satisfaction rate and acceptable complication rates.

Chemotherapy protocols in dogs

Chemotherapy as a treatment for cancer is a well-established strategy in veterinary medicine and can be highly successful in certain forms of cancer.

However, it can be associated with adverse effects, which can sometimes be severe.

Little published information exists on the overall prevalence of severe side effects in veterinary medicine. Chavalle et al⁷ performed a retrospective study to assess the frequency and risk of serious adverse effects to a variety of chemotherapy protocols in dogs. In total, 155 dogs receiving chemotherapy were included in the study.

The Veterinary Comparative Oncology Group-Common Terminology Criteria for Adverse Events grading system was used to score the adverse effects.

Adverse effects were observed at least once in 80% of dogs receiving chemotherapy and serious adverse effects were observed in 32%. Gastrointestinal adverse effects were observed in 14.8% of cases and 20% had myelotoxic adverse effects.

Twenty-four per cent of dogs had to be hospitalised because of adverse events and 8% had to have the chemotherapy paused or discontinued. Six per cent of dogs were euthanised because of adverse events.

A higher frequency of serious adverse events was observed with treatment of haemopoietic tumours.

Higher bodyweight was associated with less frequent adverse events, while multi-agent protocols were associated with a higher risk of serious adverse events.

The authors concluded that side effects are common with chemotherapy, and that clinicians should be particularly alert for adverse events in small dogs and dogs being treated with multi-agent protocols.