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The use of cytotoxic agents in the treatment of immune-mediated diseases of dogs and cats.

Cytotoxic drugs are often combined with glucocorticoids in the therapy of immune-mediated diseases. Cyclophosphamide, azathioprine, chlorambucil, and methotrexate are cytotoxic drugs used most commonly for the purpose of immunosuppression. Cyclophosphamide and chlorambucil are alkylating agents, which cause cross-linking of DNA resulting in altered protein production, decreased cell division, and cell death. Azathioprine and methotrexate are anti-metabolites, which cause inhibition of DNA synthesis and a cascade of other effects. These drugs, in general, are more effective if administered during the initial phases of disease when immunocompetent lymphocytes are in a phase of rapid proliferation. This is often impractical in the clinical situation and may explain therapeutic failures. This article focuses on the use of these drugs in the treatment of immune-mediated diseases in dogs and cats and covers mechanisms of action, dosages, and side effects of individual cytotoxic agents.

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Naturally occurring trypanosomiasis (Chagas' disease) in dogs.

Nine fatal cases of canine American trypanosomiasis (Chagas' disease) were encountered from November, 1972, through November, 1975. Of the 9 cases, 7 occurred in dogs from 5 central Texas counties, and all but one case was diagnosed during the months of September, October, or November. The source of infection was discovered in only one case--that being a doghouse heavily infested with Triatoma lectularius occulta. Each of 6 bugs collected had infective forms of the protozoan, Trypanosoma cruzi. Trypanosomiasis usually is not considered in the differential clinical diagnosis of cardiac dysfunction in man or other mammals in the United States. An antemortem diagnosis was made in only 1 of the 9 dogs, with diagnosis in the remaining dogs being made at necropsy. The predominant microscopic lesion in all dogs was necrotizing granulomatous myocarditis associated with the amastigotes of T cruzi.

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Western immunoblot analysis for distinguishing vaccination and infection status with Borrelia burgdorferi (Lyme disease) in dogs.

Serodiagnosis of Lyme borreliosis in dogs is complicated by the use of commercially available Lyme disease vaccines that may cross-react with certain diagnostic assays. Western immunoblotting may be used to distinguish between dogs naturally exposed and those vaccinated against Borrelia burgdorferi. Because current vaccines are not 100% efficacious and dogs may be vaccinated after natural exposure, certain dogs may show serum antibody responses against both natural and vaccine exposure (dual status). In this study, samples from 17 nonexposed, 17 B. burgdorferi-bacterin vaccinated, 13 naturally exposed, and 8 dual-status dogs were tested by western immunoblot to determine if dual-status dogs could be reliably differentiated from naturally infected or vaccinated dogs. Reaction to outer surface protein A antigen of B. burgdorferi (31 kD) was a consistent marker for vaccination, appearing in all samples from vaccinate and dual-status dogs and in no samples from single-status naturally exposed dogs. Antibodies to 4 bands, at 80, 39, 29, and 28 kD, were present in all naturally infected and dual-status dogs. No samples from vaccinated or nonexposed dogs were reactive to all 4 of these bands simultaneously. Thus, vaccine and natural exposure produce differing antibody responses, whereas dual-status dogs produced the full antibody response of both types of exposure.

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[Diagnosis of liver diseases in dogs, cats and horses].

Clinical symptoms of hepatopathies are not specific and must be verified by further investigation. Laboratory diagnosis is a very useful method to decide if liver disease is present or not. In individual cases laboratory methods can give hints as to the aetiology of the illness. If necessary, biopsy, angiography or/and cholecystography can be carried out for further clarification of the diagnosis.

Animals↗

Induction of hepatic veno-occlusive disease in dogs.

The authors attempted to induce hepatic veno-occlusive disease (VOD) in 64 dogs. Preparative treatments included combinations of total-body irradiation (TBI) or localized hepatic irradiation (LI) or both and chemotherapy consisting of dimethylbusulfan (DMB), L-phenylalanine mustard (L-PAM), methotrexate, or monocrotaline. VOD occurred infrequently in those dogs given 9.2 Gy TBI and DMB (1/10), TBI and/or LI (9.2-27 Gy) with L-PAM (2/36) or high dose methotrexate and LI (0/2). Specifically, VOD occurred in the dogs with a shorter interval between TBI and DMB or in the dog that received the glutathione reductase inhibitor, buthionine sulfoximide (BSO) before L-PAM. In contrast, among 17 dogs given monocrotaline, 8 developed VOD, particularly when used with L-PAM +/- irradiation (7/13). The major cause of death, early gastrointestinal toxicity, was further augmented by higher doses of irradiation, by shortening the interval between LI and L-PAM administration to less than 4 weeks, and administering BSO or monocrotaline before L-PAM. Gastrointestinal toxicity was lessened by giving low dose cyclophosphamide given before L-PAM. VOD can be produced in dogs especially with monocrotaline or BSO given before and L-PAM +/- irradiation. However, gastrointestinal toxicity renders the study of VOD beyond the acute phase difficult. Nevertheless, this approach appears useful for the study of VOD in other animals and for developing agents aimed at preventing VOD.

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[Radiologic diagnosis of internal diseases in dogs (2)].

Many veterinarians use radiography mainly as a diagnostic aid in surgical cases. However, internal diseases are at least as important an indication for radiography. For the optimal evaluation of internal radiographs the veterinarian should have a very good knowledge about the normal structures as well as the abnormal patterns which may be seen in diseases. Some important points for the evaluation of thoracic radiographs of the dog are given in this study.

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The low seroprevalence of tick-transmitted agents of disease in dogs from southern Ontario and Quebec.

Infectious diseases caused by pathogens transmitted by ticks and other insect vectors are an important cause of morbidity and mortality in both dogs and humans throughout North America. The purpose of this study was to determine the seroprevalence of selected vector-transmitted pathogens in southern Ontario and Quebec. Samples submitted to the Vector Borne Disease Diagnostic Laboratory (VBDDL) at the North Carolina State University College of Veterinary Medicine were evaluated for antibodies to Ehrlichia canis, Anaplasma phagocytophilum, Babesia canis, Bartonella henselae, Borrelia burgdorferi, Bartonella vinsonii subspecies berkhoffii, and Rickettsia rickettsii. Information regarding breed and the city or province from which the sample originated was recorded; however, travel history was unknown for the majority of dogs. Overall seroprevalence to these tick-borne pathogens in southern Ontario and Quebec is low compared with most regions of the United States, suggesting that veterinarians in this region of Canada should pursue diagnostic evidence of infection in dogs with a travel history or prior residence in areas endemic for exposure to tick-borne infections.

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Lack of supportive susceptibility data for use of ampicillin together with trimethoprim-sulfonamide as broad-spectrum antimicrobial treatment of bacterial disease in dogs.

The combination of ampicillin together with trimethoprim-sulfonamide is sometimes used as a broad-spectrum antimicrobial regimen for treatment of dogs with bacterial infections of unknown etiopathogenesis. To determine whether this combination is indeed broad spectrum, we analyzed susceptibility data derived from commonly encountered bacterial agents in dogs. A total of 381 isolates from 344 cases was studied. Overall, 80 (20.9%) of the 381 isolates were resistant to ampicillin and to trimethoprim-sulfonamide; 159 (41.7%) were resistant to ampicillin, but susceptible to trimethoprim-sulfonamide; 131 (34.4%) were susceptible to both ampicillin and trimethoprim-sulfonamide; and 11 (2.9%) were susceptible to ampicillin, but resistant to trimethoprim-sulfonamide. Of isolates susceptible to ampicillin and/or trimethoprim-sulfonamide, 290 (96.3%) were susceptible to trimethoprim-sulfonamide (ampicillin increased the coverage by 3.7%). On the other hand, 142 (47.2%) were susceptible to ampicillin. In addition, with respect to agents most commonly encountered (members of the family Enterobacteriaceae and members of the genus Staphylococcus), combining ampicillin with trimethoprim-sulfonamide increased coverage by 2.2% over use of trimethoprim-sulfonamide alone. We contend, therefore, that use of ampicillin together with trimethoprim-sulfonamide does not result in an acceptable broad-spectrum antimicrobial regimen for treatment of bacterial disease in dogs.

Ampicillin↗

Hemorrhagic disease in dogs infected with an unclassified intraendothelial piroplasm in southern Brazil.

A hemorrhagic disease affecting dogs in Brazil, referred to popularly as "nambiuvú" (bloody ears) and believed to be transmitted by ticks, has been observed in animals infected with an organism described originally in 1910 as a piroplasm, and known locally as Rangelia vitalii. In this series of 10 cases, the disease was characterized by anaemia, jaundice, fever, spleno- and lymphadenomegaly, hemorrhage in the gastrointestinal tract, and persistent bleeding from the nose, oral cavity and tips, margins and outer surface of the pinnae. The ixodid ticks Rhipicephalus sanguineus and Amblyomma aureolatum infested affected dogs from suburban and rural areas, respectively. Laboratory findings included regenerative anaemia, spherocytosis, icteric plasma and bilirubinuria. Those intracellular organisms were found in bone marrow smears but not in blood smears. Microscopically, zoites were seen within the cytoplasm of blood capillary endothelial cells. Parasitized and non-parasitized endothelial cells were positive immunohistochemically for von Willebrand factor (vWF). Langhans-type multinucleate giant cells were observed in the lymph nodes and choroid plexus. There was prominent erythrophagocytosis by macrophages in the lymph node sinuses and infiltration of the medullary cords by numerous plasma cells. Ultrastructurally, this organism had an apical complex that included a polar ring and rhoptries but no conoid. This parasite was contained within a parasitophorous vacuole that had a trilaminar membrane with villar protrusions and was situated in the cytoplasm of capillary endothelial cells. This organism tested positive by immunohistochemistry for Babesia microti. This pathogen was also positive by in situ hybridization for B. microti. Tentative clinical diagnosis in these cases was based on the history, clinical picture, haemogram and favorable response to therapy, and confirmed through microscopic examination of smears from the bone marrow or histological sections of multiple tissues, especially lymph nodes where zoites were most frequently found. The disease was reproduced by intravenous inoculation of blood from a naturally infected dog into an experimental dog. The authors demonstrate in this study that this organism is a protozoa of the phylum Apicomplexa, order Piroplasmorida. This piroplasm seems to be different from Babesia since it has an intraendothelial stage. Molecular phylogenetic analysis is necessary to better characterize this parasite and clarify its taxonomic status.

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Hyphema associated with retinal disease in dogs: 17 cases (1986-1991).

We evaluated the medical records of 17 dogs with hyphema of presumed retinal origin to evaluate the clinical, laboratory, ultrasonographic, and histologic features as well as known complications. The mean age of the dogs was 11.5 years. Routine hematologic and biochemical evaluation failed to identify an underlying cause in any dog. Retinal detachments, however, were identified in 10 of 13 dogs evaluated by ultrasonography and 5 of 6 globes evaluated histologically. In 1 dog, hyphema was associated with retinal vascular disease, presumed to be caused by hypertension. The prognosis for vision in geriatric dogs with hyphema, secondary to retinal disease, was found to be grave, as 10 dogs developed secondary glaucoma. The outcome for all dogs was loss of vision.

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Use of breed-specific ranges for the vertebral heart scale as an aid to the radiographic diagnosis of cardiac disease in dogs.

The vertebral heart scale was measured on right lateral recumbent thoracic radiographs of 320 dogs of six popular breeds, including for each breed at least 20 dogs with no clinical signs of cardiovascular or respiratory disease and at least 19 dogs with cardiac or respiratory disease. There were significant differences between the mean values of the scale for the different breeds; the normal boxer dogs had a significantly higher mean value than the normal dogs of all the other breeds, and the labrador retrievers had a significantly higher mean value than all the other breeds except the boxer and the cavalier King Charles spaniel. For all the breeds except the boxer, there was a trend for dogs with cardiac disease (but not respiratory disease) to have higher mean values on the scale than normal dogs of the same breed; however, at the optimal value of the scale for distinguishing between dogs of each breed with and without cardiac disease, the sensitivity and specificity were relatively low, in the range 58 to 83 per cent. The scale was most accurate for the diagnosis of cardiac disease in the Yorkshire terrier and the cavalier King Charles spaniel, breeds affected by predominantly dilative forms of cardiac disease. In contrast, it was very inaccurate in the boxer, a breed that has a higher incidence of cardiac diseases associated with concentric hypertrophy.

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