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35 result(s) for "Gommeren, Kris"
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Prevalence of Hemoplasma spp. positivity in potential feline blood donors and study of the association with selected clinical variables
Background Hemotropic mycoplasmas, hemoplasmas, are epi‐erythrocytic parasitic bacteria that can be transmitted through blood transfusion. Objectives To study the prevalence of hemoplasma infection of potential feline blood donors and investigate the association between Hemoplasma spp. quantitative polymerase chain reaction (qPCR) positivity in blood units and selected variables. Animals Seven thousand five hundred seventy‐three blood units from 4121 privately‐owned potential donor cats. Methods Retrospective observational cross‐sectional study. The Banco Sangue Animal (BSA)—Animal Blood Bank medical database was reviewed for all feline donations performed in 2022 in Portugal, Spain, and Belgium. Baseline characteristics and results of blood‐borne pathogens screening tests were extracted from the medical records. Results Two hundred twelve of 4034 Portuguese donor cats and 2 of 70 Spanish donor cats tested positive for Hemoplasma spp. qPCR in 2022 leading to an overall estimated prevalence of 5.2% (95% CI: 4.5%‐5.9%) in potential blood donors. Using multivariable generalized estimation equation models, Hemoplasma spp. qPCR was more often positive among blood units issued from male cats (OR = 1.9, 95% CI: 1.4‐2.6, P < .0001), units positive for FeLV (OR = 2.8, 95% CI: 1.4‐5.6, P = .0023), and units collected in winter months (OR = 2.5, 95% CI: 1.7‐3.6, P < .0001). Conclusions and Clinical Importance This study underscores the importance of Hemoplasma spp. and other relevant blood‐borne pathogens screening at every donation. Implementing stringent screening protocols is crucial to mitigate the risk of hemoplasma transmission via blood transfusions, thereby safeguarding the health and welfare of cats receiving transfusions.
Assessment of Volume Status and Fluid Responsiveness in Small Animals
Intravenous fluids are an essential component of shock management in human and veterinary emergency and critical care to increase cardiac output and improve tissue perfusion. Unfortunately, there are very few evidence-based guidelines to help direct fluid therapy in the clinical setting. Giving insufficient fluids and/or administering fluids too slowly to hypotensive patients with hypovolemia can contribute to continued hypoperfusion and increased morbidity and mortality. Similarly, giving excessive fluids to a volume unresponsive patient can contribute to volume overload and can equally increase morbidity and mortality. Therefore, assessing a patient's volume status and fluid responsiveness, and monitoring patient's response to fluid administration is critical in maintaining the balance between meeting a patient's fluid needs vs. contributing to complications of volume overload. This article will focus on the physiology behind fluid responsiveness and the methodologies used to estimate volume status and fluid responsiveness in the clinical setting.
Sonographic Assessment of Hyperechoic Vertical Artifact Characteristics in Lung Ultrasound Using Microconvex, Phased Array, and Linear Transducers
Hyperechoic vertical artifacts are an essential feature of lung ultrasound (LUS) arising from various pathological states. Those that meet the criteria for B-lines have the most significant diagnostic value and should be differentiated from other hyperechoic vertical artifacts of unspecified clinical importance. Although numerous studies have assessed the impacts of transducer type on the appearance of B-lines in human medicine, comparative studies in veterinary medicine are limited and conflicting. This study compares three transducer types for the assessment of hyperechoic vertical artifacts in dogs. We hypothesize that there is high-level reviewer agreement in the assessment of HVA image quality and characteristics, and that the image quality/characteristics differ between the three transducers. Dogs (n = 8) with HVAs and sonographic absence of lung consolidations, pleural effusion, and/or pneumothorax were enrolled. Twenty-four cine-loops (5 s) containing HVAs were retrospectively and independently reviewed by two reviewers, who were blinded to the case details but not transducer type. The reviewers assessed the cine-loops for the following: whether HVAs meet the B-line criteria, ease of counting HVAs, and overall image quality. Paired cine-loops from the same patient using different transducers were then presented for HVA quality comparison. Inter-rater concordance was determined using the Kappa coefficient, Kendall’s tau, and Pearson correlation coefficient, while characteristics were compared using chi-square and Kruskal–Wallis tests (level of significance, α = 0.05). The overall concordance of image quality was good (Pearson’s coefficient = 0.82). The PA transducer scored lower in image quality (p < 0.001), HVA blending (p = 0.014), graininess (p < 0.001), and clarity of edges (p < 0.001) when compared with the microconvex and linear transducers, and the identification of B-line criteria differed between transducers (p = 0.024). Furthermore, the PA scored lowest in the comparison of paired cine-loops regarding the image and HVA quality (p < 0.001). Although more HVAs failed to reach the far field with the linear transducer (10/16, 62.5%) compared with the microconvex (8/16, 50%) and PA (3/16, 18.5%) transducers, the linear transducer scored higher than the microconvex and PA transducers regarding its ability to count B-lines (p < 0.001). This study demonstrates that the type of transducer significantly impacts the characteristics of HVAs, with the PA transducer producing lower-quality images compared with the microconvex and linear transducers.
Ultrasonographic Assessment of Caudal Vena Cava Collapsibility Index, Caudal Vena Cava-to-Aorta, and Femoral Vein-to-Artery Ratios in Healthy Sedated Adult Horses
(1) Background: Ultrasonography of major vessels helps evaluate fluid status and responsiveness in critical human and canine patients. Aims: transrectal and inguinal ultrasonography of caudal vena cava (CVC), aorta (Ao), and femoral artery (FA) and vein (FV) in horses; calculate CVC collapsibility index (CI CVC) and vein-to-artery ratios; compare B- and M-mode; and evaluate repeatability and reproducibility. (2) Methods: B-mode and M-mode video loops were recorded twice by transrectal (Ao, CVC) and inguinal ultrasonography (FV, FA) by two operators on 17 healthy, sedated adult horses. Diameters and areas were measured. CI CVC, CVC-to-Ao ratio (CVC/Ao), FV-to-FA ratio (FV/FA), reproducibility, and repeatability were calculated. (3) Results: Vessels were successfully visualized (mean time: rectal 4 min, inguinal 3 min). CVC displayed respiratory-related dimension changes. Ratios included CI CVC (mean diameter B-mode 30 ± 13%, M-mode 33 ± 12%; area 36 ± 15%), CVC/Ao (mean diameter B-mode 0.43 ± 0.15, M-mode 0.43 ± 0.11; median area 0.56, IQR 0.53–0.64), and FV/FA (mean diameter 3.80 ± 1.02; median area 26.74, IQR 25.23–32.40). M-mode was inadequate for inguinal analysis. B-mode and M-mode measurements did not differ significantly. Repeatability and reproducibility were excellent (transrectal ratios 93.9% and 94.4%, respectively); FV/FA 96.9%. (4) Conclusions: Assessment of CI CVC, CVC/Ao, and FV/FA is feasible, highly repeatable, and reproducible.
Establishment of reference values of the caudal vena cava by fast‐ultrasonography through different views in healthy dogs
Background Clinical assessment of intravascular volume status is challenging. In humans, ultrasonographic assessment of the inferior vena cava diameter, directly or as a ratio to the aortic diameter is used to estimate intravascular volume status. Objectives To ultrasonographically obtain reference values (RV) for caudal vena cava diameter (CVCD), area (CVCa) and aortic ratios using 3 views in awake healthy dogs. Animals One hundred and twenty‐six healthy adult dogs from clients, students, faculty, or staff. Methods Prospective, multicenter, observational study. Two observer pairs evaluated CVCD by a longitudinal subxiphoid view (SV), a transverse 11th‐13th right hepatic intercostal view (HV), and a longitudinal right paralumbar view (PV). Inter‐rater agreements were estimated using concordance correlation coefficients (CCC). For body weight (BW)‐dependent variables, RVs were calculated using allometric scaling for variables with a CCC ≥ 0.7. Results The CCC was ≤0.43 for the CVC/aorta ratio at the PV and ≤0.43 in both inspiration and expiration for CVC at the SV. The RVs using allometric scaling for CVCa at the HV for inspiration, expiration, and for CVCD at the PV were 6.16 × BW0.762, 7.24 × BW0.787, 2.79 × BW0.390, respectively. Conclusions and Clinical Importance The CVCD, measured at the HV and PV in healthy awake dogs of various breeds has good inter‐rater agreement suggesting these sites are reliable in measuring CVCD. Established RVs for CVCD for these sites need further comparison to results obtained in hypovolemic and hypervolemic dogs to determine their usefulness to evaluate volume status in dogs.
Comparison of lung ultrasound, chest radiographs, C‐reactive protein, and clinical findings in dogs treated for aspiration pneumonia
Background Comparison of clinical findings, chest radiographs (CXR), lung ultrasound (LUS) findings, and C‐reactive protein (CRP) concentrations at admission and serial follow‐up in dogs with aspiration pneumonia (AP) is lacking. Hypothesis Lung ultrasound lesions in dogs with AP are similar to those described in humans with community‐acquired pneumonia (comAP); the severity of CXR and LUS lesions are similar; normalization of CRP concentration precedes resolution of imaging abnormalities and more closely reflects the clinical improvement of dogs. Animals Seventeen dogs with AP. Methods Prospective observational study. Clinical examination, CXR, LUS, and CRP measurements performed at admission (n = 17), 2 weeks (n = 13), and 1 month after diagnosis (n = 6). All dogs received antimicrobial therapy. Lung ultrasound and CXR canine aspiration scoring systems used to compare abnormalities. Results B‐lines and shred signs with or without bronchograms were identified on LUS in 14 of 17 and 16 of 17, at admission. Chest radiographs and LUS scores differed significantly using both canine AP scoring systems at each time point (18 regions per dog, P < .001). Clinical and CRP normalization occurred in all dogs during follow up. Shred signs disappeared on LUS in all but 1 of 6 dogs at 1 month follow‐up, while B‐lines and CXR abnormalities persisted in 4 of 6 and all dogs, respectively. Conclusion and Clinical Importance Lung ultrasound findings resemble those of humans with comAP and differ from CXR findings. Shred signs and high CRP concentrations better reflect clinical findings during serial evaluation of dogs.
Prognostic Value of Body Weight-Independent Tricuspid Annular Plane Systolic Excursion to Systolic Pulmonary Arterial Pressure Ratio in Canine Precapillary Pulmonary Hypertension: A Retrospective Study
Background: The prognostic use of both the echocardiographic parameters tricuspid annular plane systolic excursion (TAPSE) and systolic pulmonary artery pressure (sPAP) in dogs with pulmonary hypertension (PH) has shown conflicting results. The ratio of TAPSE/sPAP, not yet described in dogs, is used for the evaluation and risk assessment in people with PH and is a validated surrogate for right ventricular to pulmonary artery coupling with lower values being associated with poor outcome. This study aimed to describe TAPSE/sPAP in dogs with precapillary PH (PCPH) due to various diseases. It demonstrates the correlation of this ratio with echocardiographic indices, its association with heart failure (HF) and its prognostic value. Methods: Medical records and echocardiographic data from 95 client-owned dogs with estimated mild (n = 10), moderate (n = 31) or severe (n = 54) PCPH were retrospectively reviewed. Body weight-independent TAPSE/sPAP ratios were obtained, and short-term and overall survival until death from all causes or cardio-pulmonary death (CPD) were assessed. Results: TAPSE/sPAP was lower in dogs with HF and correlated with other echocardiographic variables commonly altered in dogs with PCPH. Different TAPSE/sPAP ratios, such as nTAPSE/(sPAP(m/s)), were independent predictors of short-term CPD, as was having pulmonary thromboembolism. For overall survival only HF was a risk factor of CPD. The cut-off value of <1.05 for nTAPSE/(sPAP(m/s)) was associated with shorter survival for dogs dying from CPD. Conclusions: The TAPSE/sPAP ratio is a non-invasive echocardiographic parameter that provides prognostic information, especially in short-term survival, in dogs with PCPH and may aid in risk stratification.
Antimicrobial discontinuation in dogs with acute aspiration pneumonia based on clinical improvement and normalization of C‐reactive protein concentration
Background Evidence regarding optimal treatment duration in dogs with aspiration pneumonia (AP) and the role of thoracic radiographs (TXR) and lung ultrasonography (LUS) in the long‐term follow‐up of affected dogs is lacking. C‐reactive protein (CRP) is a reliable acute phase protein to monitor bacterial pneumonia in dogs. Hypothesis Investigate the safety of antimicrobial discontinuation based on clinical improvement and serum CRP normalization, as well as the usefulness of TXR and LUS for follow‐up. Animals Dogs diagnosed with AP and treated with antimicrobials. Methods Prospective observational study. Antimicrobials were discontinued based on clinical improvement and serum CRP normalization after 1, 3, or 5 weeks. At each consultation, a quality‐of‐life questionnaire, physical examination, serum CRP, TXR, and LUS were assessed. Short‐ (2 weeks) and long‐term (>1 month) follow‐ups after treatment discontinuation were performed to monitor for possible relapses. Results Seventeen dogs were included. Antimicrobials were discontinued after 1 week in 12 dogs (70.6%) and 3 weeks in the remaining 5 dogs (29.4%). Short‐term relapse was not observed in any dog and long‐term relapse was diagnosed in 3 dogs. Thoracic radiographs and LUS were useful for diagnosis, but did not add additional information during follow‐up, because image normalization lagged behind clinical improvement and serum CRP normalization. Conclusion and Clinical Importance Dogs with AP can be safely and effectively treated using a short‐term antimicrobial regimen discontinued after clinical improvement and serum CRP normalization. Imaging might still be useful for complicated cases with a less favorable response to treatment.
Abnormal Curtain Signs Identified With a Novel Lung Ultrasound Protocol in Six Dogs With Pneumothorax
Pneumothorax is typically ruled out sonographically by detecting a glide sign, lung pulse, and/or B lines, and ruled in by detecting the return of a glide sign and/or presence of a lung point. This case series describes novel lung ultrasound findings (abnormal curtain signs) in dogs with naturally-occurring pneumothorax. This case series also describes a novel lung ultrasound protocol that involves evaluating the curtain sign along the entire thoracoabdominal border and evaluating the ventral pleural space with the probe parallel to the ribs. Six dogs with pneumothorax (three traumatic pneumothorax and three spontaneous pneumothorax) had lung ultrasound performed. All dogs had normal synchronous curtain signs in the caudal mid-to-ventral region of the thorax and abnormal curtain signs in the caudal mid-to-dorsal thoracic regions. Five dogs had bilateral pneumothorax; four had a lung point and absence of a glide sign bilaterally, and one had a lung point identified unilaterally (a lung point was not visible on the opposite side and the glide sign was equivocal bilaterally). One dog had a unilateral pneumothorax, in which a lung point and absence of a glide sign were identified. With the probe parallel to the ribs in the ventral thorax, a small volume pleural effusion was also identified in two dogs. All dogs had mild to moderate quantities of pleural air removed via thoracentesis or chest tubes following lung ultrasound. Two distinct types of abnormal curtain sign were observed, referred to as the asynchronous curtain sign and the double curtain sign. The authors hypothesize that these abnormal curtain signs are caused by the presence of free air within and/or cranial to the costophrenic recess. To the authors' knowledge, this is the first description of pneumothorax-induced abnormal curtain signs, and the first report of evaluating the curtain sign to diagnose pneumothorax in any species. Further research is required to determine the sensitivity and specificity of asynchronous and double curtain signs in diagnosing pneumothorax, and to investigate whether probe orientation parallel to the ribs in the ventral thorax will improve detection of pleural effusion.
A retrospective study on parapneumonic effusion in 130 dogs with a clinical diagnosis of pneumonia
To screen the occurrence of parapneumonic effusion in dogs. Medical records were searched for dogs with a presumptive diagnosis of bacterial pneumonia from 2017 to 2021 at the Liege university teaching hospital. Bacterial pneumonia was presumptively diagnosed based on compatible clinical signs and findings; thoracic radiographs compatible with bacterial bronchopneumonia; and either increased serum C-reactive protein (CRP) levels, a positive bronchoalveolar lavage culture or a positive clinical evolution in response to antibiotic therapy. Patients diagnosed with parasitic or other non-bacterial inflammatory pneumonia or with pulmonary neoplasia were excluded. Signalment, clinical findings, and outcome were recorded. One hundred and thirty dogs were included in the study, of which 44 dogs (33.8%) developed a parapneumonic effusion. Four of these dogs (4/44; 9%) had thoracocentesis performed, displaying a modified transudate (2) or septic exudate (2). Although parapneumonic effusion in dogs with a presumptive diagnosis of bacterial pneumonia appears to be rather common (33.8%), thoracocentesis or chest tube placement was rarely performed. Furthermore, the outcome of dogs with and without parapneumonic effusion appears to be similar.