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The web site itself may have changed. You can check the current page or check for previous versions at the Internet Archive. Yahoo! is not affiliated with the authors of this page or responsible for its content. VIRGINIA-MARYLAND VETERINARY NOTES Veterinary Teaching Hospital, Virginia-Maryland Regional College of Veterinary Medicine VIRGINIA-MARYLAND VETERINARY NOTES October - December, 2005 No. 116
WHATS INSIDE!
The Vomiting Cat (First Installment) ...............................................................................................................................Page 2 Fall Mushroom Toxicosis .......................................................................................................................................................Page 5 Would You Believe? .................................................................................................................................................................Page 5 Adoption vs. Euthanasia of Shelter dogs .........................................................................................................................Page 6 Memory .........................................................................................................................................................................................Page 6 Mast Cell and Eosiniphils in Feline Allergic Dermatitis ...........................................................................................Page 7
Continuing Education Opportunities ...............................................................................................................................Page 7
Thought for the Month Women are like teabags, they dont know how strong they are until they get in hot water. Eleanor Roosevelt Would You Believe? Work like you dont need the money, love like youve never been hurt, and dance like you do when nobodys watching. Anonymous Human Felicity is produced not so much by great pieces of good fortune that seldom happen, as by little advantages that occur every day. Benjamin Franklin
VIRGINIA POLYTECHNIC INSTITUTE AND STATE UNIVERSITY This newsletter is published quarterly in support of the outreach program of
the Veterinary Teaching Hospital VMRCVM, Blacksburg, VA and is
prepared for and distributed to veterinarians in the Mid Atlantic Region 2 The Vomiting Cat
The clinical importance of vomiting stems from its association with a large and varied group of diseases, and
the potentially life threatening consequences of vomiting per se, such as aspiration pneumonia, fluid and
electrolyte depletion, acid-base derangement and esophagitis. Patient management should always be aimed at
determining the medical significance of vomiting and detecting and treating the cause of vomiting. Where the
cause is undetermined it is necessary to adopt a rational approach to controlling emesis.
Causes of Vomiting
There are so many potential causes of vomiting that it is often easiest to think in broad terms initially and
consider more specific causes when vomiting is localized to one of the following groups:
Gastric: gastritis, ulceration, neoplasia, outflow obstruction, foreign bodies, motility/functional disorders
Intestinal: inflammatory bowel disease, neoplasia, foreign bodies, intussusception, functional disorders
Intra-abdominal non-GI tract:
Pancreas - pancreatitis, pancreatic neoplasia
Liver - hepatitis, cholangiohepatitis, biliary obstruction
Genitourinary - nephritis, pyelonephritis, nephrolithiasis, urinary obstruction, pyometra, peritonitis
Metabolic/Endocrine: uremia, hyperthyroidism, diabetic ketoacidosis, hepatic encephalopathy,
hypoadrenocorticism, hypercalcemia, septicemia
Drugs: xylazine, digoxin, erythromycin, chemotherapy
Toxins: strychnine, ethylene glycol, lead
Dietary: indiscretion, intolerance, allergy
Neurologic: vestibular disease, encephalitis, neoplasia, raised intra-cranial pressure
Infectious: panleukopenia, FIP, salmonella infection, helicobacter infection
Parasitic: Ollulanus, heartworm
Patient Evaluation and Diagnostic Approach
The initial plan for vomiting animals is to separate those whose problems are acute and self-limiting from those
who require more thorough investigation and treatment.
Acute Vomiting and Systemically Well: If vomiting is acute and the cat is systemically well with no historical
or physical "red flags," further diagnostic testing is usually not warranted as vomiting often resolves on its own
or after symptomatic therapy. If there is any doubt about hydration status a minimum data base consisting of a
microhematocrit and total protein can be performed to more objectively evaluate hydration status. In kittens, a
fecal examination to detect endoparasites may also be performed.
Chronic Vomiting or Systemically Unwell: If the cat is systemically unwell, has been vomiting for more than
10 days, or has hematemesis, bloody diarrhea or localizing signs such as abdominal pain or jaundice, a more
aggressive work-up is necessary. The diagnostic approach described below should enable the clinician to detect
the majority of causes of vomiting. The emphasis is on efficiently identifying conditions that require surgical
intervention (e.g., septic peritonitis) and ruling out non-gastrointestinal causes of vomiting before proceeding to
more specialized or invasive diagnostic procedures aimed at detecting primary gastric and intestinal disorders.
3
Most non-gastrointestinal causes of vomiting, and gastrointestinal causes such as focal masses or GI
perforation, are usually detected, or ruled out, by taking a detailed history, performing a thorough physical
examination, routine laboratory tests (CBC, profile, UA, fecal and T4, FeLV, FIV, pancreatic lipase/TLI,
cobalamin and folate where indicated) and abdominal radiographs. Abdominal ultrasonography is useful for
detecting pancreatic lesions, parenchymal abnormalities, GI thickening and sampling masses. If these tests are
negative or show abnormalities compatible with primary gastric or intestinal disease, further workup for
gastrointestinal disease is indicated (e.g., endoscopy, contrast radiography, exploratory laparotomy).
Clinicopathologic Testing
Clinicopathologic testing is used to detect the causes and consequences of vomiting. It is very important that
blood and urine samples submitted for clinicopathological analysis are obtained prior to treatment.
Rapid initial tests are recommended for vomiting animals that are suspected of being dehydrated. These rapid
tests are the measurement of microhematocrit (PCV), total solids (TS), blood glucose, blood urea nitrogen and a
urine specific gravity and dipstick. Plasma concentrations of sodium and potassium should also be determined
where possible. Blood and urine samples should be evaluated before treatment. These simple tests provide
valuable information that helps to determine cause (e.g., azotemia and unconcentrated urine suggests renal
disease) and guide initial management pending more definitive testing.
A complete blood count may yield abnormalities such as anemia (regenerative, non-regenerative), erythrocyte
microcytosis, macrocytosis, basophilic stippling or Heinz bodies, and leukocytosis, leukopenia, eosinophilia or
thrombocytosis that help to identify the cause of vomiting. For example, erythrocyte macrocytosis is relatively
common in FeLV-infected cats, whereas eosinophilia may indicate hypereosinophilic syndrome or eosinophilic
enteritis.
The serum biochemical profile should be evaluated for elevations in creatinine, urea, calcium, potassium,
glucose, liver enzymes, bilirubin, cholesterol, triglycerides and globulin, and decreases in sodium, calcium, urea
or albumin that are associated with nonGI causes of vomiting. Panhypoproteinemia that is not related to blood
loss suggests a protein losing enteropathy; which in cats is most often associated with severe inflammatory
bowel disease (IBD) or lymphoma. Determination of acid-base status by measurement of total CO2 or venous
blood gas analysis enables the presence of metabolic acidosis or alkalosis to be detected. This facilitates optimal
supportive care and may also help to determine the cause of vomiting. For example, metabolic alkalosis
accompanied by hypochloremia, hypokalemia and an acid urine - so called paradoxic aciduria - is highly
suggestive of gastric outflow, or upper GI, obstruction. Venous blood gases and plasma osmolality are often
determined in animals suspected of ethylene glycol ingestion, with the findings of metabolic acidosis and a high
osmolal gap (determinedby subtracting calculated from measured osmolality) supportive of ingestion. Urine
should be evaluated for specific gravity, pH, glucose, casts, crystals and bacteria. The finding of white cell casts
in the urine may be the only laboratory evidence that pyelonephritis is the cause of vomiting.
Additional clinicopathologic tests are required to detect hypoadrenocorticism (ACTH stimulation) - extremely
rare in cats - liver dysfunction (pre- and postprandial bile acids), hyperthyroidism (T4), pancreatitis (pancreas
specific lipase and trypsin-like immunoreactivity), and intestinal disease (serum cobalamin and folate). When
vomiting is accompanied by hematemesis or melena, coagulation testing is indicated. Coagulation testing is also
indicated in patients with acute abdomen (abdominal pain) to detect DIC, and in those with chronic vomiting
and diarrhea or weight loss to detect Vitamin K malabsorption. Infectious diseases associated with vomiting
and diarrhea require fecal examination (giardia, endoparasites, Salmonella, Campylobacter) and parvovirus (ELISA) or serologic testing (FeLV, FIV) for diagnosis.
Diagnostic Imaging
Diagnostic imaging provides information that complements and extends clinicopathologic testing. The primary
diagnostic imaging modalities employed to investigate vomiting are abdominal radiographs and abdominal
ultrasonography. Radiographs are the test of choice for the initial evaluation of vomiting and acute abdomen.
They provide information on gastric position and contents, size of the liver, kidneys and spleen, and may
identify foreign bodies, Gl obstruction, intussusception, peritonitis and changes suggestive of pancreatitis.
Where radiography is inconclusive, ultrasound is employed to achieve a more accurate diagnosis.
Ultrasonography is especially useful for detecting and localizing thickenings of the intestinal tract,
lymphadenopathy, abdominal masses, radiolucent foreign bodies, and changes in the size and echogenicity of
the pancreas, liver, kidneys or spleen. Ultrasonography also enables the detection of low volume abdominal
effusions and detailed investigation of the abdomen of patients with large volume effusions and "white
radiographs". Ultrasound guided aspiration is employed for sampling peritoneal fluid or parenchymal
abnormalities. Ultrasound guided needle biopsy is also useful for non-invasive sampling of abdominal organs
and parenchymal abnormalities.
Article to be continued in the next issue of Virginia-Maryland Veterinary Notes
Adapted with permission from the Proceedings of the 16 th Annual Fred Scott Feline Symposium held July 30 August 1, 2004 at Cornell Universitys College of Veterinary Medicine, as reported in Feline
Health Topics, Vol. 19, No. 3 July September 2004, Cornell Feline Health Center Cornell University,
Ithaca, NY
4 5 Fall Mushroom Toxicosis A variety of mushroom species appear in mid summer and survive into the fall. One that has been problematic for dogs in the last few years during the fall is Amanita muscaria. This species of Amanita is
unlike the more infamous Amanita spp., which initially cause GI problems and later cause fulminant hepatic and
renal necrosis. A. muscaria generates more of a CNS syndrome with some initial GI effects.
A. muscaria comes in a number of varieties. Different varieties have various colored caps. All A. muscaria mushrooms have distinctive white warts or patches on their cap, which has a diameter of 2-6 inches.
The most distinctive variety is A. muscaria var. muscaria with its very red to scarlet colored cap. In the Eastern
U.S., we more typically find A. muscaria var. formosa with a yellow colored cap or A. muscaria var. alba with
a white to cream colored cap. All A. muscaria mushrooms and A. pantherina mushrooms contain ibotenic acid,
muscimol and an insignificant amount of muscarine. The muscarine toxin was the initial one isolated and was
the reason for naming the species. However, ibotenic acid and muscimol are responsible for the majority of the
CNS signs, since they are able to cross the blood brain barrier and muscarine cannot. Ibotenic acid is in highest
concentration in the mushroom. Muscimol is a decarboxylation product of ibotenic acid that is formed to some
degree in the mushroom, but more significantly after ingestion.
Most of the related case reports in the past have involved A. pantherina toxicosis in dogs and cats. A. muscaria cases have only been documented in dogs; but because cats are known to ingest mushrooms, A.
muscaria poisonings should also be considered possible in cats. Few toxicity trials have studied the toxicity of
either ibotenic acid or muscimol in dogs or cats. A single mushroom (A. pantherina) has been lethal for 5 wk
old Labrador puppies. Ibotenic acid is a glutamate agonist in the body. Glutamate is an excitatory
neurotransmitter in the CNS. Muscimol, on the other hand, is a GABA agonist. GABA agonists are CNS
inhibitors causing CNS depression.
Onset of clinical signs is usually within 1- 2 hr after consumption. Initial clinical signs in dogs often involve GI problems of vomiting, excess salivation and possibly diarrhea. CNS problems initially relate to CNS
excitation and include clonic-tonic convulsions, muscle fasiculations, opisthotonus and fly-biting activity. Later
in the course of the syndrome, dogs are often depressed and somnolent for 24-48 hr. Miosis and bradycardia
are also likely clinical signs. Dogs experiencing A. muscaria toxicosis have a fair-guarded prognosis with
prompt medical attention. Most have returned to normal over a period of several days with symptomatic
treatment.
An empirical diagnosis can be made in the fall by asking about potential mushroom availability and ingestion. Vomitus or feces may contain white mushrrom bits. The owner may be able to bring in a mushroom
for identification. If the mushroom is sent to a specialist for identification, it should be wrapped in paper
towels, put in a paper bag and refrigerated. Plastic bags cause accelerated autolysis of mushrooms and make
identification impossible. Few diagnostic labs offer analysis of serum or urine for ibotenic acid and muscimol.
Treatment is based on first alleviating CNS convulsions. Diazepam has been effective in most cases although multiple injections have been required. Methocarbamol may be a longer lasting alternative to
diazepam. If the suggested insert dose of methocarbamol is insufficient to control the convulsions, additional
therapy with diazepam or a short acting barbituate may be required. Some recent cases have required constant
rate infusions with phenobarbital, diazepam or propofol. Early presentations within 2-3 hours post ingestion
may benefit from emesis or gastric lavage followed by activated charcoal combined with an osmotic cathartic
such as sorbitol or sodium sulfate. Severe salivation or bradycardia can be controlled with a pre-anesthetic dose
of atropine.
Dennis Blodgett, D.V.M., Ph.D., Diplomate, A.B.V.T., Toxicology, Virginia-Maryland Regional College of Veterinary Medicine, Va. Tech, Blacksburg, VA
Would You Believe? The human brain is incapable of processing the emotions of laughter and stress simultaneously.
6
Determinants of Adoption and Euthanasia of Shelter Dogs
Pet overpopulation is a reality faced by animal shelters across the nation, and few solutions exist for effectively
decreasing the numbers of unwanted pets. An estimated six to eight million dogs and cats enter animal shelters
each year. Of this population, owners reclaim approximately 15% of pets and 25% are adopted, leaving three to
four million dogs and cats to be euthanized. In one report, 76% of dogs were adoptable at the time of entry to
the shelter in the opinion of the relinquishing owner. A cross-sectional study of cats and dogs in the United
States found that an average of only 30% of animals were sterilized; thus, a major factor in pet overpopulation
was lack of owner compliance in neutering programs. Between 10% and 25% of the pet population in the
United States is euthanized each year because of a surplus population.
At the University of California, Davis (UCD), shelter dogs are neutered by veterinary students and then returned
to the shelter for adoption. The rates of adoption and euthanasia of the dogs neutered at UCD were contrasted
with a comparison shelter group to determine the effect of pre-adoption neutering. This study contains
information on a total of 573 dogs neutered at UCD (226 from Sacramento County, 347 from Yolo County) and
1301 comparison dogs (643 from Sacramento County, 658 from Yolo County). The UCD-neutered dogs had a
lower rate of euthanasia than the comparison shelter group at the shelters investigated. At Sacramento County
Animal Care and Regulation, 73 % of the UCD group but only 36% of the comparison group were adopted. At
Yolo County Animal Services, 71 % of the UCD group and 45% of the comparison group were adopted. The
sex of an animal did not significantly affect the rate of euthanasia. Dogs that were predominantly pit bull,
rottweiler, or chow breeds had higher rates of euthanasia than other breeds, independent of neuter status. Also,
juveniles (less than one year old) had lower rates of euthanasia than adults, independent of neuter status. UCD
adult dogs had lower rates of euthanasia than comparison adults.
Post-surgical UCD dogs spent a longer average time in the shelter before adoption (15 days at Sacramento; 16
days at Yolo) than the comparison dogs (11 and 12 days, respectively). UCD dogs also spent a longer average
time in the shelter before euthanasia (18 and 25 days, respectively) than the comparison dogs ( 13 days at both
shelters). Lower probabilities of euthanasia for behavioral or medical reasons were found for UCD dogs than
for the comparison dogs. The probability of euthanasia for reasons of space limitations increased with time in
shelter for both groups. In this study, pre-adoption neutering increased adoptions without increasing the
probability of medical or behavior euthanasia.
Surgery prior to adoption is in the best survival interest of the individual animal, as well as alleviating further
overpopulation. Teaming veterinary education with shelter neutering programs can provide students with
practical surgical knowledge in addition to an understanding of overpopulation and shelter management issues.
Taken from: Clevenger, J. and P. H. Kass J Vet Med Educ 30:372-378, 2003, as reported in VetMed,
Volume 10, Issue 3, May 2004, Iowa State University, Ames, IA
Memory Frequent short-term memory lapses (senior moments) are known as mild cognitive impairments (MCI). While
not serious, 15 per cent of those with MCI go on to develop Alzheimers Disease every year. About 60 biotech
and pharmaceutical companies are working on the development of memory pills, and several are in human
trials and could be on the market within a few years.
India has the lowest incidence of Alzheimers in the world. Could curry be an answer?
Studies indicate that the hippocampus is where impressions and occurrences turn into memories. Through a
complex process involving neurotransmitters and synapses, neurons in the brain band together to retain data as
memory. As we age, this intricate process occurs more and more slowly. 7
Mast Cells and Eosinophils in Feline Allergic Dermatitis: A Qualitative and Quantitative Analysis
Mast cells (MCs) and eosinophils are prominent in the perivascular infiltrate of cats with allergic dermatitis. In
the skin of allergic cats MCs were mainly observed diffusely in the superficial dermis, while eosinophils were
found mainly in the deep dermis in a perivascular pattern. MC counts were significantly higher in cats with
allergic dermatitis (P<0.05) than in healthy control cats, but the number varied widely. Moreover, the numbers
of eosinophils in the skin of allergic and control cats differed significantly (P<O.OS), none being found in the
latter. There was no significant correlation between numbers of mast cells and eosinophils in the same biopsy
sample. In the allergic cats, a significantly lower number of MCs was detected by staining for tryptase than by
staining for chymase or by Astra blue staining. Additionally, the chymase: tryptase ratio in healthy cats was
reversed in cats with allergic dermatitis. These changes were observed in lesional and nonlesional skin of cats
with allergic dermatitis. The findings indicate a generalized effect on MCs in allergic dermatitis. In addition,
eosinophils are an important indicator of allergic dermatitis.
J. P. Koeman, Dept of Pathology, Faculty of Veterinary Medicine, T. Thepen, Dept of Dermatology/
Allergology, Faculty of Medicine. and T. Willemse and P. J. Roosje, Dept of Clinical Sciences of
Companion Animals All are from Utrecht University, The Netherlands
Journal of Comparative Pathology Volume 131, Issue 1, July 2004, Pages 61-69
As reported in Veterinary News, July 2004, Penn State University, University Park, PA
Continuing Education Opportunities Date Topic Location Contact Hours October 14 & 15, 2005 Introductory Echocardiography Blacksburg 10 October 21-23, 2005 Advanced Echocardiography Blacksburg 21 October 27 & 28, 2005 Applied Ultrasonography Blacksburg 10 November 12, 2005 Urinalysis & Hematology Blacksburg 6 November 18 & 19, 2005 Diagnostic Ultrasonography Blacksburg 10 2006 March 10 & 11, 2006 Introductory Echocardiography Blacksburg 10 March 24 & 25, 2006 Thoracic Radiology Blacksburg 10 March 31 & April 1,
2006 Applied Ultrasonography Blacksburg 10 April 21 23, 2006 Advanced Echocardiography Blacksburg 21 May 6, 2006 Radiography for Technicians Blacksburg 6
Please note:
The courses listed above are limited enrollment and feature a hands-on laboratory experience under the
guidance of clinical faculty members. Program brochures provide course details. For more information, please
contact Anne Cinsavich, aclapsad@vt.edu (540) 231-5261; or to register for a program, please contact Conference Registration, Continuing Education Center, (540) 231-5182. 8
Virginia-Maryland Regional College of Veterinary Medicine Extension Staff:
Dr. W. Dee Whittier Extension Specialist Beef Cattle Dr. Scott Pleasant Extension Specialist Equine Dr. John Currin Extension specialist Dairy Cattle Anne Cinsavich Continuing Education/Extension
K.C. Roberts, Editor
Anne Cinsavich, Production Manager of VIRGINIA MARYLAND VETERINARY NOTES
VIRGINIA-MARYLAND REGIONAL Non-Profit Org. COLLEGE OF VETERINARY MEDICINE BULK MAILING VIRGINIA TECH U.S. Postage PAID BLACKSBURG, VIRGINIA 24061 Blacksburg, VA 24060 Permit No. 28
The web site itself may have changed. You can check the current page or check for previous versions at the Internet Archive. Yahoo! is not affiliated with the authors of this page or responsible for its content. VIRGINIA-MARYLAND VETERINARY NOTES Veterinary Teaching Hospital, Virginia-Maryland Regional College of Veterinary Medicine VIRGINIA-MARYLAND VETERINARY NOTES October - December, 2005 No. 116
WHATS INSIDE!
The Vomiting Cat (First Installment) ...............................................................................................................................Page 2 Fall Mushroom Toxicosis .......................................................................................................................................................Page 5 Would You Believe? .................................................................................................................................................................Page 5 Adoption vs. Euthanasia of Shelter dogs .........................................................................................................................Page 6 Memory .........................................................................................................................................................................................Page 6 Mast Cell and Eosiniphils in Feline Allergic Dermatitis ...........................................................................................Page 7
Continuing Education Opportunities ...............................................................................................................................Page 7
Thought for the Month Women are like teabags, they dont know how strong they are until they get in hot water. Eleanor Roosevelt Would You Believe? Work like you dont need the money, love like youve never been hurt, and dance like you do when nobodys watching. Anonymous Human Felicity is produced not so much by great pieces of good fortune that seldom happen, as by little advantages that occur every day. Benjamin Franklin
VIRGINIA POLYTECHNIC INSTITUTE AND STATE UNIVERSITY This newsletter is published quarterly in support of the outreach program of
the Veterinary Teaching Hospital VMRCVM, Blacksburg, VA and is
prepared for and distributed to veterinarians in the Mid Atlantic Region 2 The Vomiting Cat
The clinical importance of vomiting stems from its association with a large and varied group of diseases, and
the potentially life threatening consequences of vomiting per se, such as aspiration pneumonia, fluid and
electrolyte depletion, acid-base derangement and esophagitis. Patient management should always be aimed at
determining the medical significance of vomiting and detecting and treating the cause of vomiting. Where the
cause is undetermined it is necessary to adopt a rational approach to controlling emesis.
Causes of Vomiting
There are so many potential causes of vomiting that it is often easiest to think in broad terms initially and
consider more specific causes when vomiting is localized to one of the following groups:
Gastric: gastritis, ulceration, neoplasia, outflow obstruction, foreign bodies, motility/functional disorders
Intestinal: inflammatory bowel disease, neoplasia, foreign bodies, intussusception, functional disorders
Intra-abdominal non-GI tract:
Pancreas - pancreatitis, pancreatic neoplasia
Liver - hepatitis, cholangiohepatitis, biliary obstruction
Genitourinary - nephritis, pyelonephritis, nephrolithiasis, urinary obstruction, pyometra, peritonitis
Metabolic/Endocrine: uremia, hyperthyroidism, diabetic ketoacidosis, hepatic encephalopathy,
hypoadrenocorticism, hypercalcemia, septicemia
Drugs: xylazine, digoxin, erythromycin, chemotherapy
Toxins: strychnine, ethylene glycol, lead
Dietary: indiscretion, intolerance, allergy
Neurologic: vestibular disease, encephalitis, neoplasia, raised intra-cranial pressure
Infectious: panleukopenia, FIP, salmonella infection, helicobacter infection
Parasitic: Ollulanus, heartworm
Patient Evaluation and Diagnostic Approach
The initial plan for vomiting animals is to separate those whose problems are acute and self-limiting from those
who require more thorough investigation and treatment.
Acute Vomiting and Systemically Well: If vomiting is acute and the cat is systemically well with no historical
or physical "red flags," further diagnostic testing is usually not warranted as vomiting often resolves on its own
or after symptomatic therapy. If there is any doubt about hydration status a minimum data base consisting of a
microhematocrit and total protein can be performed to more objectively evaluate hydration status. In kittens, a
fecal examination to detect endoparasites may also be performed.
Chronic Vomiting or Systemically Unwell: If the cat is systemically unwell, has been vomiting for more than
10 days, or has hematemesis, bloody diarrhea or localizing signs such as abdominal pain or jaundice, a more
aggressive work-up is necessary. The diagnostic approach described below should enable the clinician to detect
the majority of causes of vomiting. The emphasis is on efficiently identifying conditions that require surgical
intervention (e.g., septic peritonitis) and ruling out non-gastrointestinal causes of vomiting before proceeding to
more specialized or invasive diagnostic procedures aimed at detecting primary gastric and intestinal disorders.
3
Most non-gastrointestinal causes of vomiting, and gastrointestinal causes such as focal masses or GI
perforation, are usually detected, or ruled out, by taking a detailed history, performing a thorough physical
examination, routine laboratory tests (CBC, profile, UA, fecal and T4, FeLV, FIV, pancreatic lipase/TLI,
cobalamin and folate where indicated) and abdominal radiographs. Abdominal ultrasonography is useful for
detecting pancreatic lesions, parenchymal abnormalities, GI thickening and sampling masses. If these tests are
negative or show abnormalities compatible with primary gastric or intestinal disease, further workup for
gastrointestinal disease is indicated (e.g., endoscopy, contrast radiography, exploratory laparotomy).
Clinicopathologic Testing
Clinicopathologic testing is used to detect the causes and consequences of vomiting. It is very important that
blood and urine samples submitted for clinicopathological analysis are obtained prior to treatment.
Rapid initial tests are recommended for vomiting animals that are suspected of being dehydrated. These rapid
tests are the measurement of microhematocrit (PCV), total solids (TS), blood glucose, blood urea nitrogen and a
urine specific gravity and dipstick. Plasma concentrations of sodium and potassium should also be determined
where possible. Blood and urine samples should be evaluated before treatment. These simple tests provide
valuable information that helps to determine cause (e.g., azotemia and unconcentrated urine suggests renal
disease) and guide initial management pending more definitive testing.
A complete blood count may yield abnormalities such as anemia (regenerative, non-regenerative), erythrocyte
microcytosis, macrocytosis, basophilic stippling or Heinz bodies, and leukocytosis, leukopenia, eosinophilia or
thrombocytosis that help to identify the cause of vomiting. For example, erythrocyte macrocytosis is relatively
common in FeLV-infected cats, whereas eosinophilia may indicate hypereosinophilic syndrome or eosinophilic
enteritis.
The serum biochemical profile should be evaluated for elevations in creatinine, urea, calcium, potassium,
glucose, liver enzymes, bilirubin, cholesterol, triglycerides and globulin, and decreases in sodium, calcium, urea
or albumin that are associated with nonGI causes of vomiting. Panhypoproteinemia that is not related to blood
loss suggests a protein losing enteropathy; which in cats is most often associated with severe inflammatory
bowel disease (IBD) or lymphoma. Determination of acid-base status by measurement of total CO2 or venous
blood gas analysis enables the presence of metabolic acidosis or alkalosis to be detected. This facilitates optimal
supportive care and may also help to determine the cause of vomiting. For example, metabolic alkalosis
accompanied by hypochloremia, hypokalemia and an acid urine - so called paradoxic aciduria - is highly
suggestive of gastric outflow, or upper GI, obstruction. Venous blood gases and plasma osmolality are often
determined in animals suspected of ethylene glycol ingestion, with the findings of metabolic acidosis and a high
osmolal gap (determinedby subtracting calculated from measured osmolality) supportive of ingestion. Urine
should be evaluated for specific gravity, pH, glucose, casts, crystals and bacteria. The finding of white cell casts
in the urine may be the only laboratory evidence that pyelonephritis is the cause of vomiting.
Additional clinicopathologic tests are required to detect hypoadrenocorticism (ACTH stimulation) - extremely
rare in cats - liver dysfunction (pre- and postprandial bile acids), hyperthyroidism (T4), pancreatitis (pancreas
specific lipase and trypsin-like immunoreactivity), and intestinal disease (serum cobalamin and folate). When
vomiting is accompanied by hematemesis or melena, coagulation testing is indicated. Coagulation testing is also
indicated in patients with acute abdomen (abdominal pain) to detect DIC, and in those with chronic vomiting
and diarrhea or weight loss to detect Vitamin K malabsorption. Infectious diseases associated with vomiting
and diarrhea require fecal examination (giardia, endoparasites, Salmonella, Campylobacter) and parvovirus (ELISA) or serologic testing (FeLV, FIV) for diagnosis.
Diagnostic Imaging
Diagnostic imaging provides information that complements and extends clinicopathologic testing. The primary
diagnostic imaging modalities employed to investigate vomiting are abdominal radiographs and abdominal
ultrasonography. Radiographs are the test of choice for the initial evaluation of vomiting and acute abdomen.
They provide information on gastric position and contents, size of the liver, kidneys and spleen, and may
identify foreign bodies, Gl obstruction, intussusception, peritonitis and changes suggestive of pancreatitis.
Where radiography is inconclusive, ultrasound is employed to achieve a more accurate diagnosis.
Ultrasonography is especially useful for detecting and localizing thickenings of the intestinal tract,
lymphadenopathy, abdominal masses, radiolucent foreign bodies, and changes in the size and echogenicity of
the pancreas, liver, kidneys or spleen. Ultrasonography also enables the detection of low volume abdominal
effusions and detailed investigation of the abdomen of patients with large volume effusions and "white
radiographs". Ultrasound guided aspiration is employed for sampling peritoneal fluid or parenchymal
abnormalities. Ultrasound guided needle biopsy is also useful for non-invasive sampling of abdominal organs
and parenchymal abnormalities.
Article to be continued in the next issue of Virginia-Maryland Veterinary Notes
Adapted with permission from the Proceedings of the 16 th Annual Fred Scott Feline Symposium held July 30 August 1, 2004 at Cornell Universitys College of Veterinary Medicine, as reported in Feline
Health Topics, Vol. 19, No. 3 July September 2004, Cornell Feline Health Center Cornell University,
Ithaca, NY
4 5 Fall Mushroom Toxicosis A variety of mushroom species appear in mid summer and survive into the fall. One that has been problematic for dogs in the last few years during the fall is Amanita muscaria. This species of Amanita is
unlike the more infamous Amanita spp., which initially cause GI problems and later cause fulminant hepatic and
renal necrosis. A. muscaria generates more of a CNS syndrome with some initial GI effects.
A. muscaria comes in a number of varieties. Different varieties have various colored caps. All A. muscaria mushrooms have distinctive white warts or patches on their cap, which has a diameter of 2-6 inches.
The most distinctive variety is A. muscaria var. muscaria with its very red to scarlet colored cap. In the Eastern
U.S., we more typically find A. muscaria var. formosa with a yellow colored cap or A. muscaria var. alba with
a white to cream colored cap. All A. muscaria mushrooms and A. pantherina mushrooms contain ibotenic acid,
muscimol and an insignificant amount of muscarine. The muscarine toxin was the initial one isolated and was
the reason for naming the species. However, ibotenic acid and muscimol are responsible for the majority of the
CNS signs, since they are able to cross the blood brain barrier and muscarine cannot. Ibotenic acid is in highest
concentration in the mushroom. Muscimol is a decarboxylation product of ibotenic acid that is formed to some
degree in the mushroom, but more significantly after ingestion.
Most of the related case reports in the past have involved A. pantherina toxicosis in dogs and cats. A. muscaria cases have only been documented in dogs; but because cats are known to ingest mushrooms, A.
muscaria poisonings should also be considered possible in cats. Few toxicity trials have studied the toxicity of
either ibotenic acid or muscimol in dogs or cats. A single mushroom (A. pantherina) has been lethal for 5 wk
old Labrador puppies. Ibotenic acid is a glutamate agonist in the body. Glutamate is an excitatory
neurotransmitter in the CNS. Muscimol, on the other hand, is a GABA agonist. GABA agonists are CNS
inhibitors causing CNS depression.
Onset of clinical signs is usually within 1- 2 hr after consumption. Initial clinical signs in dogs often involve GI problems of vomiting, excess salivation and possibly diarrhea. CNS problems initially relate to CNS
excitation and include clonic-tonic convulsions, muscle fasiculations, opisthotonus and fly-biting activity. Later
in the course of the syndrome, dogs are often depressed and somnolent for 24-48 hr. Miosis and bradycardia
are also likely clinical signs. Dogs experiencing A. muscaria toxicosis have a fair-guarded prognosis with
prompt medical attention. Most have returned to normal over a period of several days with symptomatic
treatment.
An empirical diagnosis can be made in the fall by asking about potential mushroom availability and ingestion. Vomitus or feces may contain white mushrrom bits. The owner may be able to bring in a mushroom
for identification. If the mushroom is sent to a specialist for identification, it should be wrapped in paper
towels, put in a paper bag and refrigerated. Plastic bags cause accelerated autolysis of mushrooms and make
identification impossible. Few diagnostic labs offer analysis of serum or urine for ibotenic acid and muscimol.
Treatment is based on first alleviating CNS convulsions. Diazepam has been effective in most cases although multiple injections have been required. Methocarbamol may be a longer lasting alternative to
diazepam. If the suggested insert dose of methocarbamol is insufficient to control the convulsions, additional
therapy with diazepam or a short acting barbituate may be required. Some recent cases have required constant
rate infusions with phenobarbital, diazepam or propofol. Early presentations within 2-3 hours post ingestion
may benefit from emesis or gastric lavage followed by activated charcoal combined with an osmotic cathartic
such as sorbitol or sodium sulfate. Severe salivation or bradycardia can be controlled with a pre-anesthetic dose
of atropine.
Dennis Blodgett, D.V.M., Ph.D., Diplomate, A.B.V.T., Toxicology, Virginia-Maryland Regional College of Veterinary Medicine, Va. Tech, Blacksburg, VA
Would You Believe? The human brain is incapable of processing the emotions of laughter and stress simultaneously.
6
Determinants of Adoption and Euthanasia of Shelter Dogs
Pet overpopulation is a reality faced by animal shelters across the nation, and few solutions exist for effectively
decreasing the numbers of unwanted pets. An estimated six to eight million dogs and cats enter animal shelters
each year. Of this population, owners reclaim approximately 15% of pets and 25% are adopted, leaving three to
four million dogs and cats to be euthanized. In one report, 76% of dogs were adoptable at the time of entry to
the shelter in the opinion of the relinquishing owner. A cross-sectional study of cats and dogs in the United
States found that an average of only 30% of animals were sterilized; thus, a major factor in pet overpopulation
was lack of owner compliance in neutering programs. Between 10% and 25% of the pet population in the
United States is euthanized each year because of a surplus population.
At the University of California, Davis (UCD), shelter dogs are neutered by veterinary students and then returned
to the shelter for adoption. The rates of adoption and euthanasia of the dogs neutered at UCD were contrasted
with a comparison shelter group to determine the effect of pre-adoption neutering. This study contains
information on a total of 573 dogs neutered at UCD (226 from Sacramento County, 347 from Yolo County) and
1301 comparison dogs (643 from Sacramento County, 658 from Yolo County). The UCD-neutered dogs had a
lower rate of euthanasia than the comparison shelter group at the shelters investigated. At Sacramento County
Animal Care and Regulation, 73 % of the UCD group but only 36% of the comparison group were adopted. At
Yolo County Animal Services, 71 % of the UCD group and 45% of the comparison group were adopted. The
sex of an animal did not significantly affect the rate of euthanasia. Dogs that were predominantly pit bull,
rottweiler, or chow breeds had higher rates of euthanasia than other breeds, independent of neuter status. Also,
juveniles (less than one year old) had lower rates of euthanasia than adults, independent of neuter status. UCD
adult dogs had lower rates of euthanasia than comparison adults.
Post-surgical UCD dogs spent a longer average time in the shelter before adoption (15 days at Sacramento; 16
days at Yolo) than the comparison dogs (11 and 12 days, respectively). UCD dogs also spent a longer average
time in the shelter before euthanasia (18 and 25 days, respectively) than the comparison dogs ( 13 days at both
shelters). Lower probabilities of euthanasia for behavioral or medical reasons were found for UCD dogs than
for the comparison dogs. The probability of euthanasia for reasons of space limitations increased with time in
shelter for both groups. In this study, pre-adoption neutering increased adoptions without increasing the
probability of medical or behavior euthanasia.
Surgery prior to adoption is in the best survival interest of the individual animal, as well as alleviating further
overpopulation. Teaming veterinary education with shelter neutering programs can provide students with
practical surgical knowledge in addition to an understanding of overpopulation and shelter management issues.
Taken from: Clevenger, J. and P. H. Kass J Vet Med Educ 30:372-378, 2003, as reported in VetMed,
Volume 10, Issue 3, May 2004, Iowa State University, Ames, IA
Memory Frequent short-term memory lapses (senior moments) are known as mild cognitive impairments (MCI). While
not serious, 15 per cent of those with MCI go on to develop Alzheimers Disease every year. About 60 biotech
and pharmaceutical companies are working on the development of memory pills, and several are in human
trials and could be on the market within a few years.
India has the lowest incidence of Alzheimers in the world. Could curry be an answer?
Studies indicate that the hippocampus is where impressions and occurrences turn into memories. Through a
complex process involving neurotransmitters and synapses, neurons in the brain band together to retain data as
memory. As we age, this intricate process occurs more and more slowly. 7
Mast Cells and Eosinophils in Feline Allergic Dermatitis: A Qualitative and Quantitative Analysis
Mast cells (MCs) and eosinophils are prominent in the perivascular infiltrate of cats with allergic dermatitis. In
the skin of allergic cats MCs were mainly observed diffusely in the superficial dermis, while eosinophils were
found mainly in the deep dermis in a perivascular pattern. MC counts were significantly higher in cats with
allergic dermatitis (P<0.05) than in healthy control cats, but the number varied widely. Moreover, the numbers
of eosinophils in the skin of allergic and control cats differed significantly (P<O.OS), none being found in the
latter. There was no significant correlation between numbers of mast cells and eosinophils in the same biopsy
sample. In the allergic cats, a significantly lower number of MCs was detected by staining for tryptase than by
staining for chymase or by Astra blue staining. Additionally, the chymase: tryptase ratio in healthy cats was
reversed in cats with allergic dermatitis. These changes were observed in lesional and nonlesional skin of cats
with allergic dermatitis. The findings indicate a generalized effect on MCs in allergic dermatitis. In addition,
eosinophils are an important indicator of allergic dermatitis.
J. P. Koeman, Dept of Pathology, Faculty of Veterinary Medicine, T. Thepen, Dept of Dermatology/
Allergology, Faculty of Medicine. and T. Willemse and P. J. Roosje, Dept of Clinical Sciences of
Companion Animals All are from Utrecht University, The Netherlands
Journal of Comparative Pathology Volume 131, Issue 1, July 2004, Pages 61-69
As reported in Veterinary News, July 2004, Penn State University, University Park, PA
Continuing Education Opportunities Date Topic Location Contact Hours October 14 & 15, 2005 Introductory Echocardiography Blacksburg 10 October 21-23, 2005 Advanced Echocardiography Blacksburg 21 October 27 & 28, 2005 Applied Ultrasonography Blacksburg 10 November 12, 2005 Urinalysis & Hematology Blacksburg 6 November 18 & 19, 2005 Diagnostic Ultrasonography Blacksburg 10 2006 March 10 & 11, 2006 Introductory Echocardiography Blacksburg 10 March 24 & 25, 2006 Thoracic Radiology Blacksburg 10 March 31 & April 1,
2006 Applied Ultrasonography Blacksburg 10 April 21 23, 2006 Advanced Echocardiography Blacksburg 21 May 6, 2006 Radiography for Technicians Blacksburg 6
Please note:
The courses listed above are limited enrollment and feature a hands-on laboratory experience under the
guidance of clinical faculty members. Program brochures provide course details. For more information, please
contact Anne Cinsavich, aclapsad@vt.edu (540) 231-5261; or to register for a program, please contact Conference Registration, Continuing Education Center, (540) 231-5182. 8
Virginia-Maryland Regional College of Veterinary Medicine Extension Staff:
Dr. W. Dee Whittier Extension Specialist Beef Cattle Dr. Scott Pleasant Extension Specialist Equine Dr. John Currin Extension specialist Dairy Cattle Anne Cinsavich Continuing Education/Extension
K.C. Roberts, Editor
Anne Cinsavich, Production Manager of VIRGINIA MARYLAND VETERINARY NOTES
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